Are the attitudes of exercise instructors who work with older adults influenced by training and personal characteristics?

Little is known about the relationship between attitudes and characteristics of instructors and uptake and adherence of older people to exercise classes. This article explores these issues.Methods:The authors surveyed 731 UK exercise instructors with specialist older adult exercise qualifications. A questionnaire investigated instructors’ characteristics and attitudes toward older adults’ participation in exercise.Results:For mostly seated classes, EXTEND qualification (B = 0.36, p = .005) had a positive effect on instructors’ attitudes. Later Life Training qualification (B = −2.80, p = .003), clinical background (B = −3.99, p = .005), and delivering classes in National Health Services (B = −3.12, p &lt; .001), leisure centers (B = −2.75, p = .002), or nursing homes (B = −2.29, p = .005) had a negative effect on attitudes. For mostly standing classes, experience (B = 0.20, p = .003) and delivering in leisure centers (B = 0.46, p = .032) had a positive and clinical background (B = −1.78, p = .018) had a negative effect on instructors’ attitudes.Conclusions:Most instructors have positive attitudes, but training and work context can influence attitudes toward older people’s participation in exercise classes both positively and negatively.</jats:sec

Recovery approaches in mental health : A qualitative evaluation of the Whole Life Therapy programme for persons with schizophrenia

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International LicenseThe recovery approach within mental health services has in recent years been influential in promoting more active participation from service users concerning their treatment and progress, within a move towards models of interventions based on social models and ideas of service user empowerment. Although mental health recovery models are often heralded as ideological goals, comparatively little has been documented about the means of achieving these. This article sets out the nature and content of the Whole Life Programme, used within the Hertfordshire NHS Partnership Foundation Trust, and the results of qualitative research into the programme that set out to analyse the impact of its delivery from the perspectives of service users. The research examined the experiences and views of participants receiving treatment several months after the completion of the programme, and also of those who withdrew prematurely, in order to learn from these experiences, adding to our understanding of how one recovery based approach, the Whole Life Manual, can be applied in practiceNon peer reviewedFinal Published versio

CLASSIFICATION OF RISK IN PSYCHIATRY

Psychiatric risk-assessments generally quantify risk using broad, categorical, indicators (e.g., high-risk, low-risk). We examined reliability of such indicators when applied by mental-health professionals. Four versions of a questionnaire were used, each specifying a different clinical outcome along with a range of different probabilities at which that outcome might occur. Respondents classified each probability, allowing a comparison of the level of likelihood at which different professionals would apply the terms \u27high-risk\u27, \u27medium-risk\u27 and \u27low-risk\u27. We found little consistency among professionals who assessed risk for the same outcomes. Moreover, there were also large and unpredicted differences in response-profiles between the 4 clinical outcomes. These findings raise concerns about the communication value of current risk-assessment terminology

White Light Flare Continuum Observations with ULTRACAM

We present sub-second, continuous-coverage photometry of three flares on the dM3.5e star, EQ Peg A, using custom continuum filters with WHT/ULTRACAM. These data provide a new view of flare continuum emission, with each flare exhibiting a very distinct light curve morphology. The spectral shape of flare emission for the two large-amplitude flares is compared with synthetic ULTRACAM measurements taken from the spectra during the large 'megaflare' event on a similar type flare star. The white light shape during the impulsive phase of the EQ Peg flares is consistent with the range of colors derived from the megaflare continuum, which is known to contain a Hydrogen recombination component and compact, blackbody-like components. Tentative evidence in the ULTRACAM photometry is found for an anti-correlation between the emission of these components.Comment: 8 pages, 3 figures. Proceedings of the 16th Workshop on Cool Stars, Stellar Systems, and the Sun (PASP conference series, in press

Measurement of Plasmodium falciparum transmission intensity using serological cohort data from Indonesian schoolchildren.

BACKGROUND: As malaria transmission intensity approaches zero, measuring it becomes progressively more difficult and inefficient because parasite-positive individuals are hard to detect. This situation may arise shortly before achieving local elimination, or during surveillance post-elimination to prevent reintroduction. Antibody responses against the parasite last longer than the infections themselves. This "footprint" of infection may thus be used for assessing transmission intensity. A statistical approach is presented for measuring the seroconversion rate (SCR), a correlate of the force of infection, from individual-level longitudinal data on antibody titres in an area of low Plasmodium falciparum transmission. METHODS: Blood samples were collected from 160 Indonesian schoolchildren every month for six months. Titres of antibodies against AMA-1 and MSP-1(19) antigens of P. falciparum were measured using ELISA. The distribution of antibody titres among seronegative and -positive individuals, respectively, was estimated by comparing the titres from the study data (a mixture of both seropositive and -negative individuals) with titres from a (unexposed) negative control group of Indonesian individuals. Two Markov-Chain models for the transition of individuals between serological states were fitted to individual anti-PfAMA-1 or anti-PfMSP-1 titre time series using Bayesian Markov-Chain-Monte-Carlo (MCMC). This yielded estimates of SCR as well as of the duration of seropositivity. RESULTS: A posterior median SCR of 0.02 (Pf AMA-1) and 0.09 (PfMSP-1) person(-1) year(-1) was estimated, with credible intervals ranging from 1E-4 to 0.2 person(-1) year(-1). This level of transmission intensity is at the lower range of what can reliably be measured with the present study size. A Bayesian test for seroconversion of an individual between two observations is presented and used to identify the subjects who have most likely experienced an infection. Furthermore, the theoretical limits of measuring transmission intensity, and how these depend on duration and size of a study as well as on transmission intensity itself, is illustrated. CONCLUSIONS: This analysis shows that it is possible to measure SCR's from individual-level longitudinal data on antibody titres. In addition, individual seroconversion events can be identified, which can be useful in assessing interruption of transmission. Analyses of further serological datasets using the present method are required to improve and validate it. This includes measurement of the duration of antibody responses, how it depends on host age or cumulative exposure, or on the particular antigen used

Shadow Estimation Method for "The Episolar Constraint: Monocular Shape from Shadow Correspondence"

Recovering shadows is an important step for many vision algorithms. Current approaches that work with time-lapse sequences are limited to simple thresholding heuristics. We show these approaches only work with very careful tuning of parameters, and do not work well for long-term time-lapse sequences taken over the span of many months. We introduce a parameter-free expectation maximization approach which simultaneously estimates shadows, albedo, surface normals, and skylight. This approach is more accurate than previous methods, works over both very short and very long sequences, and is robust to the effects of nonlinear camera response. Finally, we demonstrate that the shadow masks derived through this algorithm substantially improve the performance of sun-based photometric stereo compared to earlier shadow mask estimation

Application of the Cubed-Sphere Grid to Tilted Black-Hole Accretion Disks

In recent work we presented the first results of global general relativistic magnetohydrodynamic (GRMHD) simulations of tilted (or misaligned) accretion disks around rotating black holes. The simulated tilted disks showed dramatic differences from comparable untilted disks, such as asymmetrical accretion onto the hole through opposing "plunging streams" and global precession of the disk powered by a torque provided by the black hole. However, those simulations used a traditional spherical-polar grid that was purposefully underresolved along the pole, which prevented us from assessing the behavior of any jets that may have been associated with the tilted disks. To address this shortcoming we have added a block-structured "cubed-sphere" grid option to the Cosmos++ GRMHD code, which will allow us to simultaneously resolve the disk and polar regions. Here we present our implementation of this grid and the results of a small suite of validation tests intended to demonstrate that the new grid performs as expected. The most important test in this work is a comparison of identical tilted disks, one evolved using our spherical-polar grid and the other with the cubed-sphere grid. We also demonstrate an interesting dependence of the early-time evolution of our disks on their orientation with respect to the grid alignment. This dependence arises from the differing treatment of current sheets within the disks, especially whether they are aligned with symmetry planes of the grid or not.Comment: 15 pages, 11 figures, submitted to Ap

Exercise instructors are not consistently implementing the strength component of the UK chief medical officers’ physical activity guidelines in their exercise prescription for older adults

Strength training recommendations have been embedded within the UK’s Chief Medical Officers’ physical activity guidelines since 2011. There is limited evidence that these recommendations are used by exercise instructors in the community to underpin strength training prescription in the older adult population. This study aimed to explore exercise instructors’ awareness and utilisation of the guidelines when prescribing strength training to older adults. Fifteen exercise instructors working with older adults in the UK participated in one online interview. A general inductive approach was conducted and thematic analysis allowed for major themes to be identified from the raw data. We found that most exercise instructors (n = 9), but not all (n = 6), were aware of the guidelines. Only one instructor (n = 1) had reportedly implemented the guidelines into their practice; other instructors reported that the guidelines were irrelevant. Instead, each of the instructors had their preferred sources of information that they relied on to underpin their exercise prescription, and each had their own interpretation of ‘evidence-based strength training.’ This individualised interpretation resulted in exceptionally varied prescription in the community and does not necessarily align with the progressive, evidence-based prescription known to build muscular strength. We suggest that (i) more detail on how to build muscular strength be embedded within the guidelines, (ii) a handbook on how to implement the guidelines be made available, (iii) theoretical and practical teaching materials and courses be updated, and/or (iv) a re-(education) of exercise instructors already in the field may be necessary to bring about a consistent, evidence-based strength prescription necessary for the best possible health and longevity outcomes for our ageing population

Breastfeeding Duration Is Associated with Regional, but Not Global, Differences in White Matter Tracts

Extended breastfeeding through infancy confers benefits on neurocognitive performance and intelligence tests, though few have examined the biological basis of these effects. To investigate correlations with breastfeeding, we examined the major white matter tracts in 4–8 year-old children using diffusion tensor imaging and volumetric measurements of the corpus callosum. We found a significant correlation between the duration of infant breastfeeding and fractional anisotropy scores in left-lateralized white matter tracts, including the left superior longitudinal fasciculus and left angular bundle, which is indicative of greater intrahemispheric connectivity. However, in contrast to expectations from earlier studies, no correlations were observed with corpus callosum size, and thus no correlations were observed when using such measures of global interhemispheric white matter connectivity development. These findings suggest a complex but significant positive association between breastfeeding duration and white matter connectivity, including in pathways known to be functionally relevant for reading and language development