The integration of single case designs in coaching contexts: A commentary for applied sport psychologists

From personal experiences of working with coaches toward the modification of behaviors and psychological constructs that include motivation, enjoyment, and self-confidence, this commentary highlights how the integration of single case designs can enhance the services of sport psychology practitioners. Interventions within golf, soccer, and tennis are outlined, targeting factors pertinent to the coaches, their players or team members, and the development of relationships with parents. Single case designs are posited as enabling the implementation of personal, evidence-based interventions that yield perceptible differences in cognitive, affective, and behavioral responses within athletic populations; factors that enhance and underpin the practitioner-coach relationship

Medication decision-making and adherence in lupus: patient–physician discordance and the impact of previous ‘adverse medical experiences’

OBJECTIVES: Medication adherence is critical in the successful management of lupus. There is very limited existing literature on reasons why non-adherence is not reported. This study explores the impact of current and previous medical experiences on patient satisfaction, adherence and reporting of non-adherence. METHODS: Mixed methodology involved thematic analysis of in-depth interviews (N = 23) to further explore the statistically analysed quantitative survey findings (N = 186). RESULTS: This study identified five themes: 1) physician-patient discordance and a 'hierarchy of evidence' in medication decisions, 2) the association of adherence with satisfaction with care, 3) the persisting impact of past Adverse Medical Experiences (AMEs), 4) the dynamic balance of patient-physician control, and 5) holistic care - beyond a purely medication- based focus. Improving quality of life (43% of participants) and a supportive medical relationship (24%) were the main reasons for adherence. Patient-priorities and self-reported symptoms were perceived as less important to physicians than organ-protection and blood results. Non-reporters of non-adherence, non-adherers and those with past AMEs (e.g. psychosomatic misdiagnoses) had statistically significant lower satisfaction with care. The importance of listening to patients was a key component of every theme, and associated with patient satisfaction and adherence. The mean rating for rheumatologist's listening skills was 2.88 for non-adherers compared to 3.53 for other participants (mean difference 0.65, P = 0.003). CONCLUSION: Patients would like more weight and discussion given to self-reported symptoms and quality of life in medication decisions. Greater understanding and interventions are required to alleviate the persisting impact of past AMEs on some patients' wellbeing, behaviour and current medical relationships

Examining the development environments of elite English Football Academies: the players’ perspective.

As a preliminary investigation, we examined elite youth football academy players' perceptions of the quality of their developmental environment, at a crucial stage in their progression to a professional level. With institutional ethics approval, the Talent Development Environment Questionnaire (TDEQ)[1]was used to survey 50 elite players aged 16-18 (m17.1,±s=0.6 years)recruited from the academies of Premier League and Championship clubs in England. Overall, the results suggest that elite player development environments are perceived to be of a good quality. However, while academies appeared strong in areas related to coaching, organisation, and sport-related support; they were somewhat deficient in areas related to athlete understanding, links to senior progression, and key stakeholder relationships. In addition to the importance of establishing well-integrated youth and senior teams and positive working relationships with parents; the findings underline the necessity for academies to pay close attention to the psychosocial environments they create for developing players. Theoretical considerations and applied implications for those involved in elite player development are discussed

Supporting people living with dementia and faecal incontinence.

This document is the Accepted Manuscript version of the following article: Bridget Russell, et al, 'Supporting people living with dementia and faecal incontinence', British Journal of Community Nursing, Vol. 22 (3): 110-114, March 2017, doi: http://www.magonlinelibrary.com/doi/pdf/10.12968/bjcn.2017.22.3.110. © 2017 MA Healthcare Ltd.There are approximately 17 500 care homes in the UK which are home to about 487 000 older people, the majority are women aged 80 years or older (Care Quality Commission, 2010). As many as 80% of care home residents may have dementia, though this is not always documented, (Gordon et al, 2014). In England the majority of care homes do not have on site nursing provision and rely on community nurse specialists for support when residents require nursing advice and care. The support of people living in care homes is a well-documented problem (Taunton et al, 2005; Heckenberg, 2008; Saga, 2014) and how well they are managed is often seen as a marker of the quality of care (Care Quality Commission, 2010). Faecal incontinence can be a source of distress, discomfort, lead to complications such as skin breakdown and infection and affect an individual’s sense of dignity and self-worth. It can also be a challenging aspect of care for those who work in care homes.Non peer reviewe

Reducing and managing faecal incontinence in people with advanced dementia who are resident in care homes: protocol for a realist synthesis.

INTRODUCTION: Faecal incontinence (FI) is the involuntary loss of liquid or solid stool that is a social or hygienic problem. The prevalence of FI in residents of care homes is high, but it is not an inevitable consequence of old age or dementia. There is good evidence on risk factors, but few studies provide evidence about effective interventions. There is a need to understand how, why, and in what circumstances particular programmes to reduce and manage FI are effective (or not) for people with dementia. The purpose of this review is to identify which (elements of the) interventions could potentially be effective, and examine the barriers and facilitators to the acceptability, uptake and implementation of interventions designed to address FI in people with dementia who are resident in care homes. METHODS AND ANALYSIS: A realist synthesis approach to review the evidence will be used which will include studies on continence, person-centred care, implementation research in care homes, workforce and research on care home culture. An iterative four-stage approach is planned. Phase 1: development of an initial programme theory or theories that will be 'tested' through a first scoping of the literature and consultation with five stakeholder groups (care home providers, user representatives, academics and practice educators, clinicians with a special interest in FI and continence specialists). Phase 2: a systematic search and analysis of published and unpublished evidence to test and develop the programme theories identified in phase 1. Phase 3: validation of programme theory/ies with a purposive sample of participants from phase 1. ETHICS AND DISSEMINATION: The overall protocol does not require ethical review. The University research ethics committee will review interviews conducted as part of phase 1 and 3. The final fourth phase will synthesise and develop recommendations for practice and develop testable hypotheses for further research

Management of Fecal Incontinence in Older People With Dementia Resident in Care Homes: A Realist Synthesis-The FINCH Study.

This document is the Accepted Manuscript version of the Editorial to Journal of the American Medical Directors Association, Vol. 198 (9):750-751. Under embargo. Embargo end date: 21 July 2018. The published version is available online at doi: https://doi.org/10.1016/j.jamda.2017.06.001. Crown Copyright © 2017 Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.Peer reviewe

Signatures from a merging galaxy cluster and its AGN population : LOFAR observations of Abell 1682

Reproduced with permission from Astronomy & Astrophysics. © 2019 ESOWe present LOFAR data from 110-180 MHz of the merging galaxy cluster Abell 1682, alongside archival optical, radio, and X-ray data. Our images of 6 arcsec in resolution at low frequencies reveal new structures associated with numerous radio galaxies in the cluster. At a resolution of 20 arcsec we see diffuse emission throughout the cluster over hundreds of kiloparsecs, indicating particle acceleration mechanisms are in play as a result of the cluster merger event and powerful active galactic nuclei. We show that a significant part of the cluster emission is from an old radio galaxy with very steep spectrum emission (having a spectral index of α < -2.5). Furthermore, we identify a new region of diffuse steep-spectrum emission (α < -1.1) as a candidate for a radio halo which is co-spatial with the centre of the cluster merger. We suggest its origin as a population of old and mildly relativistic electrons left over from radio galaxies throughout the cluster which have been re-accelerated to higher energies by shocks and turbulence induced by the cluster merger event. We also note the discovery of six new giant radio galaxies in the vicinity of Abell 1682.Peer reviewedFinal Accepted Versio

Telemedicine in rheumatology: A mixed methods study exploring acceptability, preferences and experiences among patients and clinicians

OBJECTIVES: The Covid-19 pandemic necessitated a rapid global transition towards telemedicine; yet much remains unknown about telemedicine's acceptability and safety in rheumatology. To help address this gap and inform practice, this study investigated rheumatology patient and clinician experiences and views of telemedicine. METHODS: Sequential mixed methodology combined analysis of surveys and in-depth interviews. Between and within-group differences in views of telemedicine were examined for patients and clinicians using t-tests. RESULTS: Surveys (Patients n = 1,340, Clinicians n = 111) and interviews (Patients n = 31, Clinicians n = 29) were completed between April 2021 and July 2021. The majority of patients were from the UK (96%) and had inflammatory arthritis (32%) or lupus (32%). Patients and clinicians rated telemedicine as worse than face-to-face consultations in almost all categories, although >60% found it more convenient. Building trusting medical relationships and assessment accuracy were great concerns (93% of clinicians and 86% of patients rated telemedicine as worse than face-to-face for assessment accuracy). Telemedicine was perceived to have increased misdiagnoses, inequalities and barriers to accessing care. Participants reported highly disparate telemedicine delivery and responsiveness from primary and secondary care. Although rheumatology clinicians highlighted the importance of a quick response to flaring patients, only 55% of patients were confident that their rheumatology department would respond within 48 hours. CONCLUSION: Findings indicate a preference for face-to-face consultations. Some negative experiences may be due to the pandemic rather than telemedicine specifically, although the risk of greater diagnostic inaccuracies using telemedicine is unlikely to be fully resolved. Training, choice, careful patient selection, and further consultation with clinicians and patients is required to increase telemedicine's acceptability and safety

Core burnout and power in Portuguese nursing staff: An explanatory model based on structural empowerment

In the nursing context, structural empowerment has proved to be an organizational tool leading to the prevention of stress and burnout. Structural empowerment is defined as the perception of the presence or absence of empowering conditions in the workplace. However, few studies have explored the particular relationships between power in organizations, structural empowerment, and burnout. The aim of this study was to examine the mediator role of structural empowerment (access to opportunities, information, support, and resources) in the relationship between formal and informal power, and core burnout among Portuguese nurses. We administered a questionnaire among a convenience sample of 304 nurses employed in public hospitals. Model fit and mediation analysis were conducted using path analysis and bootstrapping methods. Formal power, informal power, access to opportunities, and access to resources were significant and negative predictors of core burnout. Opportunities, resources, and informal power had a direct influence on core burnout. Formal power and informal power showed an indirect influence, mediated by opportunities and resources, on core burnout. These findings suggest that by providing nurses with high levels of formal and informal power, as well as access to resources and opportunities, their risk of core burnout can be lowered.info:eu-repo/semantics/publishedVersio

Epidemiology of basal and cutaneous squamous cell carcinoma in the U.K. 2013–15:a cohort study

BACKGROUND: Basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC), together known as keratinocyte cancers (KCs), are the commonest cancer in white ethnic populations. Recent improvements to registry data collection in England has allowed more accurate analysis of the epidemiology of BCC and cSCC and for the first time we are able to provide an accurate (representative) tumour burden for KC in the U.K. OBJECTIVES: To estimate the incidence of BCC and cSCC in the U.K. METHODS: A cohort of patients with KCs between 2013 and 2015 were identified using linkage to diagnostic codes derived from pathology reports collected into the national cancer registry. Data from England's cancer registry were combined with data from Scotland, Northern Ireland and Wales. European age-standardized incidence rates (EASRs) of the first BCC and cSCC per patient per annum (PPPA) were calculated. RESULTS: In the U.K, the EASR of the first BCC and cSCC PPPA in 2013-15 were 285 and 77 per 100 000 person years, respectively (211 120 KCs total in 2015). The mean annual percentage increase was 5% between 2013 and 2015 for both BCC and cSCC. By counting the first KC PPPA, we include an additional 51% KCs compared with the previous reporting technique which counts only the first BCC and cSCC in a patient's lifetime, yet it represents a probable underestimation of 5-11% of the true tumour count. CONCLUSIONS: Based on an improved methodology, a more representative incidence of KC is presented, which is essential to healthcare planning and will lead to improved understanding of the epidemiology of KC. What's already known about this topic? Keratinocyte cancers (KCs) are the most common cancers affecting white ethnic populations. The incidence of basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) is increasing worldwide including the U.K., most commonly in elderly male Caucasian patients. These cancers are traditionally substantially underreported and frequently excluded from national cancer statistics. What does this study add? Using improved data collection methods in England and validated tumour-reporting techniques, we report the most accurate BCC and cSCC incidence data for the U.K. ever published. Identifying the first BCC and cSCC per patient per annum, the incidence of BCC and cSCC in the U.K. (excluding Wales) was 285 and 77 per 100 000 person years, respectively, between 2013 and 2015, with more than 210 000 KCs in the U.K. in 2015