Does image congruence impact the effectiveness of a gain-framed physical activity message?

This is a pre-publication version of the following article: Neil Howlett, Joanne Gardiner & Abbie Foster, 'Does image congruence impact the effectiveness of gain-framed physical activity message? ', Health Psychology Update, Vol. 26 (1): Spring 2017. The version of record is available online at https://shop.bps.org.uk/publications/publication-by-series/health-psychology-update/health-psychology-update-vol-26-no-1-spring-2017.html. Published by the British Psychological Society.Background: Gain-framed messages can improve processing and physical activity, however inconsistency remains about the merits of using different accompanying images. This study explored whether gain-framed messages alongside positive images (congruent) were more effective than negative (incongruent) images at increasing Social Cognitive Theory (SCT) constructs and moderate-to-vigorous physical activity (MVPA). Method: Using a mixed design participants (N=110) were randomly assigned to read a gain-framed physical activity booklet containing either congruent or incongruent images. Data were collected at two time points (baseline and one week later) using online questionnaires assessing SCT constructs and interviews about MVPA over the previous seven days. Results: A time by condition interaction showed that intentions (p=.039, η2=.04) and self-efficacy (p=.005, η2=.07) increased in the congruent condition only. There was a time main effect for self-regulation (p=.001, η2=.09) and MVPA (p=.011, η2=.06), but no difference between conditions. Changes in self-regulation predicted changes in MVPA in both conditions (congruent, p=.003; incongruent, p=.030). Conclusions: Congruence between message content and images increased intentions and self-efficacy, but not MVPA. Improving self-regulation may increase physical activity levels regardless of message congruence.Peer reviewedFinal Accepted Versio

Effects of ingestion of a commercially available thermogenic dietary supplement on resting energy expenditure, mood state and cardiovascular measures

Background Increasing metabolism is a primary focus of many commercially available dietary supplements marketed to support weight management. Caffeine (e.g. anhydrous and herbal) and green tea are key ingredients in such products, augmenting resting energy expenditure (REE) and improving reported mood states (alertness, fatigue, focus, etc.). The purpose of this study was to evaluate the effects of a thermogenic dietary supplement (DBX) on REE, respiratory exchange ratio (RER), reported measures of alertness, focus, energy, concentration, fatigue, and hunger, as well as the general safety of the product based on electrocardiogram (ECG) and hemodynamic responses in habitual caffeine consumers.MethodsSix male and six female subjects (mean ± SD; 22.50 ± 3.22 years; 76.94 ± 14.78 kg; 22.7 ± 9.5% body fat), physically active (≥12 months), and moderate habitual caffeine consumers (<200 mg/day) received either two capsules of DBX containing 340 mg of total caffeine plus green tea extract, yerba mate extract, carnitine tartrate and other active ingredients or a placebo (PLC) in a double-blinded, crossover design. Heart rate (HR), blood pressure (BP), REE, RER and perceived mood states were measured at baseline and then hourly for four hours after ingesting either treatment. Results Resting energy expenditure was significantly increased at all four time points and significant increases were determined for perceived alertness (p = 0.026) and focus (p = 0.05) at hour 1 and for energy at 1 and 2 hours after treatment for the DBX group (p = 0.008 and p = 0.017, respectively). Additionally, perceived fatigue was decreased at the hour 1 assessment (p = 0.010). No significant differences were seen between DBX and placebo for hunger, anxiety, HR, BP, ECG patterns or RER. Conclusions The results of this investigation support that the proprietary blend of this thermogenic aid is capable of increasing REE for four hours post-ingestion while supporting increased focus, alertness, and energy as well as decreasing fatigue without promoting anxiety or causing significant changes in HR, BP, or ECG measurements in habitual caffeine consumers

Effects of a pre-and post-workout protein-carbohydrate supplement in trained crossfit individuals

Abstract Purpose The purpose was to assess effects of a pre- and a post-workout protein-carbohydrate supplement on CrossFit-specific performance and body composition. Methods In an open label randomized study, 13 male and 16 female trained Crossfit participants (mean ± SD; age: 31.87 ± 7.61 yrs, weight: 78.68 ± 16.45 kg, percent body fat: 21.97 ± 9.02) were assessed at 0 and 6 weeks for body composition, VO2max, Wingate peak (WPP) and mean power (WMP), in addition to sport-specific workouts (WOD1: 500 m row, 40 wall balls, 30 push-ups, 20 box jumps, 10 thrusters for time; WOD2: 15 minutes to complete an 800 m run "buy in", followed by as many rounds as possible (AMRAP) of 5 burpees, 10 Kettlebell swings, 15 air squats). The supplement (SUP) group consisted of 19 g of a pre-workout drink (extracts of pomegranate, tart cherry, green and black tea) taken 30 minutes before and a post-workout protein (females: 20 g; males: 40 g) and carbohydrate (females: 40 g; males: 80 g) supplement consumed immediately after each workout. The control (CTL) group consumed only water one hour before or after workouts. Participants completed three (minimum) varied workouts per week at a CrossFit gym as typical to habitual training throughout the six week study. Data were analyzed by repeated measures ANOVA (p <0 .05), 95% Confidence Intervals, and Magnitude Inferences. Results There were no time × group interactions for body composition, WMP, or WOD1 based on ANOVA statistics. VO2MAX, WPP, and WOD2 results revealed that the pre/post supplements were likely beneficial after 95% Confidence Intervals and Magnitude Inferences analysis. Conclusion The combination of proprietary supplements taken for 6 weeks may provide benefits during certain sport-specific performance in trained CrossFit athletes but not others

Acute effects of a commercially-available pre-workout supplement on markers of training: a double-blind study

Background: Pre-workout supplements containing numerous ingredients claim to increase performance and strength. Product-specific research is important for identifying efficacy of combined ingredients. The purpose of this study was to evaluate the effects of a proprietary pre-workout dietary supplement containing creatine monohydrate, beta-alanine, L-Tarurine, L-Leucine, and caffeine, on anaerobic power, muscular strength, body composition, and mood states. Methods: In a double-blind, randomized, matched-pair design, twenty male subjects (mean ± SD; 22.4 ± 9.5 yrs, 76.9 ± 11.2 kg, 22.7 ± 9.5% body fat), consumed either 30 g of a pre-workout supplement (SUP) or maltodextrin placebo (PLC) 30 minutes before a resistance training workout, after completing baseline testing. Body composition was determined via dual-energy x-ray absorptiometry (DEXA). Subjects completed 12 vertical jumps for height (VJ) and one repetition maximum (1RM) and repetitions to failure lifts on bench (BPM) and leg press (LPM). Finally, subjects completed a Wingate power test on a cycle ergometer [mean power (WMP) and peak power (WPP)]. After baseline testing, participants completed eight days of supplementation and four split-body resistance-training bouts. Side effect questionnaires were completed daily 30 minutes after consuming the supplement. Subjects completed post-supplement testing on Day 8. Data were analyzed utilizing a 2 × 2 repeated measures ANOVA [treatment (PLC vs SUP) × time (T1 vs T2)] and ninety-five percent confidence intervals. Results: There were no significant treatment × time interactions (p > 0.05). There were no significant changes in %body fat (%BF; Δ-0.43 ± 0.58; p = 0.920), fat mass (Δ-2.45 ± 5.72; p = 0.988), or lean body mass (LBM; 10.9 ± 12.2; p = 0.848). 95% CI demonstrated significant LBM increases for both groups. There was a main effect for time for WPP (Δ100.5 ± 42.7W; p = 0.001), BPM (Δ8.0 ± 12.9 lbs; p = 0.001), and LPM (Δ80.0 ± 28.8 lbs; p = 0.001), with no significant differences between treatments. There was no significant difference in mood states between groups or over time. Conclusion: The proprietary pre-workout blend combined with eight days of training did not significantly (ANOVA) improve body composition or performance. While not significant, greater gains in LPM were demonstrated in the SUP group for lean body mass and lower body strength. Future studies should evaluate more chronic effects of proprietary pre-workout blends on total training volume and performance outcomes

Meeting the cultural and service needs of Arabic international students by using QFD

Quality has become an important factor in global competition for many reasons. Intensive global competition and the demand for better quality by customers has led organizations to realize the benefits of providing quality products and services in order to successfully compete and survive. Higher education institutions are one example of these organisations. Higher education institutions work in an intensive competitive environment worldwide driven by increasing demands for learning by local and international students. As a result, the managers of these sectors have realized that improving the quality of services is important for achieving customer satisfaction which can help survival in an internationally competitive market. To do this, it is necessary for organizations to know their customers and identify their requirements. To this end, many higher education institutions have adopted principles of total quality management (TQM) to improve their education quality which leads to better performance through involvement of every department to achieve excellence in business. This chapter considers the importance of measuring quality in order to assist universities to proactively manage the design and improvement of the social and academic experiences of postgraduate international students, and plan management decision-making processes to deliver high-quality services in a globalized business of provision of higher education. Higher education institutions must operate effectively and efficiently and be able to deliver quality programs, by seeking to better understand the needs of their customers to be competitive in this market space

Rehabilitation versus surgical reconstruction for non-acute anterior cruciate ligament injury (ACL SNNAP): a pragmatic randomised controlled trial

BackgroundAnterior cruciate ligament (ACL) rupture is a common debilitating injury that can cause instability of the knee. We aimed to investigate the best management strategy between reconstructive surgery and non-surgical treatment for patients with a non-acute ACL injury and persistent symptoms of instability.MethodsWe did a pragmatic, multicentre, superiority, randomised controlled trial in 29 secondary care National Health Service orthopaedic units in the UK. Patients with symptomatic knee problems (instability) consistent with an ACL injury were eligible. We excluded patients with meniscal pathology with characteristics that indicate immediate surgery. Patients were randomly assigned (1:1) by computer to either surgery (reconstruction) or rehabilitation (physiotherapy but with subsequent reconstruction permitted if instability persisted after treatment), stratified by site and baseline Knee Injury and Osteoarthritis Outcome Score—4 domain version (KOOS4). This management design represented normal practice. The primary outcome was KOOS4 at 18 months after randomisation. The principal analyses were intention-to-treat based, with KOOS4 results analysed using linear regression. This trial is registered with ISRCTN, ISRCTN10110685, and ClinicalTrials.gov, NCT02980367.FindingsBetween Feb 1, 2017, and April 12, 2020, we recruited 316 patients. 156 (49%) participants were randomly assigned to the surgical reconstruction group and 160 (51%) to the rehabilitation group. Mean KOOS4 at 18 months was 73·0 (SD 18·3) in the surgical group and 64·6 (21·6) in the rehabilitation group. The adjusted mean difference was 7·9 (95% CI 2·5–13·2; p=0·0053) in favour of surgical management. 65 (41%) of 160 patients allocated to rehabilitation underwent subsequent surgery according to protocol within 18 months. 43 (28%) of 156 patients allocated to surgery did not receive their allocated treatment. We found no differences between groups in the proportion of intervention-related complications.InterpretationSurgical reconstruction as a management strategy for patients with non-acute ACL injury with persistent symptoms of instability was clinically superior and more cost-effective in comparison with rehabilitation management

Proceedings of the Thirteenth International Society of Sports Nutrition (ISSN) Conference and Expo

Meeting Abstracts: Proceedings of the Thirteenth International Society of Sports Nutrition (ISSN) Conference and Expo Clearwater Beach, FL, USA. 9-11 June 201

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Investigation of hospital discharge cases and SARS-CoV-2 introduction into Lothian care homes

Background The first epidemic wave of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in Scotland resulted in high case numbers and mortality in care homes. In Lothian, over one-third of care homes reported an outbreak, while there was limited testing of hospital patients discharged to care homes. Aim To investigate patients discharged from hospitals as a source of SARS-CoV-2 introduction into care homes during the first epidemic wave. Methods A clinical review was performed for all patients discharges from hospitals to care homes from 1st March 2020 to 31st May 2020. Episodes were ruled out based on coronavirus disease 2019 (COVID-19) test history, clinical assessment at discharge, whole-genome sequencing (WGS) data and an infectious period of 14 days. Clinical samples were processed for WGS, and consensus genomes generated were used for analysis using Cluster Investigation and Virus Epidemiological Tool software. Patient timelines were obtained using electronic hospital records. Findings In total, 787 patients discharged from hospitals to care homes were identified. Of these, 776 (99%) were ruled out for subsequent introduction of SARS-CoV-2 into care homes. However, for 10 episodes, the results were inconclusive as there was low genomic diversity in consensus genomes or no sequencing data were available. Only one discharge episode had a genomic, time and location link to positive cases during hospital admission, leading to 10 positive cases in their care home. Conclusion The majority of patients discharged from hospitals were ruled out for introduction of SARS-CoV-2 into care homes, highlighting the importance of screening all new admissions when faced with a novel emerging virus and no available vaccine

SARS-CoV-2 Omicron is an immune escape variant with an altered cell entry pathway

Vaccines based on the spike protein of SARS-CoV-2 are a cornerstone of the public health response to COVID-19. The emergence of hypermutated, increasingly transmissible variants of concern (VOCs) threaten this strategy. Omicron (B.1.1.529), the fifth VOC to be described, harbours multiple amino acid mutations in spike, half of which lie within the receptor-binding domain. Here we demonstrate substantial evasion of neutralization by Omicron BA.1 and BA.2 variants in vitro using sera from individuals vaccinated with ChAdOx1, BNT162b2 and mRNA-1273. These data were mirrored by a substantial reduction in real-world vaccine effectiveness that was partially restored by booster vaccination. The Omicron variants BA.1 and BA.2 did not induce cell syncytia in vitro and favoured a TMPRSS2-independent endosomal entry pathway, these phenotypes mapping to distinct regions of the spike protein. Impaired cell fusion was determined by the receptor-binding domain, while endosomal entry mapped to the S2 domain. Such marked changes in antigenicity and replicative biology may underlie the rapid global spread and altered pathogenicity of the Omicron variant