Predicting race performance in triathlon: The role of perfectionism, achievement goals, and personal goal setting

The question of how perfectionism affects performance is highly debated. Because empirical studies examining perfectionism and competitive sport performance are missing, the present research investigated how perfectionism affected race performance and what role athletes’ goals played in this relationship in two prospective studies with competitive triathletes (Study 1: N = 112; Study 2: N = 321). Regression analyses showed that perfectionistic personal standards, high performance-approach goals, low performance-avoidance goals, and high personal goals predicted race performance beyond athletes’ performance level. Moreover, the contrast between performance-avoidance and performance-approach goals mediated the relationship between perfectionistic personal standards and performance, whereas personal goal setting mediated the relationship between performance-approach goals and performance. The findings indicate that perfectionistic personal standards do not undermine competitive performance, but are associated with goals that help athletes achieve their best possible performance

Evaluation of the Outpatients consultation in East Kent

CHSS undertook to support Kent and Medway Commissioning Support (KMCS: acting on behalf of East Kent Hospitals University NHS Foundation Trust and NHS Canterbury and Coastal Clinical Commissioning Group) in undertaking an independent analysis of a consultation on Outpatient services in East Kent. The aim of the consultation was to gain opinions from the public of a proposed Outpatient Clinical Strategy that intends to improve local access to, and facilities for, Outpatient services, and to offer a wider range of services on each site. CHSS advised on the survey, evaluated the consultation process, ran focus groups and carried out quantitative and qualitative analysis of the responses gathered during the consultation period (9th December 2013 to 17th March, 2014 - originally 9th March but period was extended). Ethical approval was not required for a consultation process, but ethical principles have been adhered to regarding data confidentiality and informed consent for the focus groups

Evaluation of a physical inactivity pilot delivered in primary care

September, 2016 Commissioned by Kent County Counci

Development of a reliable, valid measure to assess parents' and teachers' understanding of postural care for children EKHUT Internal Grant Reportwith physical disabilities.

Schools play an important role in facilitating the day time aspects of postural management programmes for children with physical disabilities, enabling children to participate at school and engage in functional tasks associated with school work; however, the majority of teachers and teaching assistants are inexperienced and lack confidence in how to manage the needs of children with a physical disability (Hutton & Coxon 2010). “Definition: A postural management programme is a planned approach encompassing all activities and interventions which impact on an individual's posture and function. Programmes are tailored specifically for each child and may include special seating, night-time support, standing supports, active exercise, orthotics, surgical interventions, and individual therapy sessions. Gericke (2006) A small exploratory study of the views of teachers and teaching assistants recommended that information about postural care be made widely available to parents and teachers in order to assist them in their role as care givers for children with disabilities. In response to these findings, a booklet, the “A-Z of Postural Care” was developed by a team of researchers, therapists, teachers and parents of children with a disability (Hutton et al., 2009)

Evaluation of the Primary Care Mental Health Specialist role: Final Report

This report details an evaluation to assess the impact of the new primary care mental health specialist (PCMHS) role in Kent and Medway. The evaluation was undertaken by the Centre for Health Services Studies (CHSS) at the University of Kent and was conducted June 2013 to December 2014. The evaluation was commissioned by NHS Kent and Medway and supported by Kent and Medway Commissioning Support. The evaluation encompasses six CCG areas across Kent and Medway, with 13 PCMHS employed in these areas (see Table 1-1 for breakdown). The number of posts per CCG is dependent on the amount CCGs invest (roughly equating to population size), rather than prevalence of illness. The PCMHS have been seconded from Kent and Medway NHS and Social Care Partnership Trust (KMPT) for the duration of the pilot, and are either community psychiatric nurses (CPN) or occupational therapists (OT) by profession. The majority of PCMHS are hosted by a voluntary organisation (mcch); three are hosted by GP practices and two by a community Interest Company, Invicta CIC. The main objectives of the evaluation are: 1. To assess the impact on patients by capturing their experience of the service; 2. To assess the impact by capturing experiences of those delivering the service (i.e., PCMHS); 3. To assess the impact by capturing experiences of other professions who work alongside the service (i.e., mental health professionals in secondary care, GPs); 4. To assess the economic cost of the new service via a unit cost analysis

Support needs in Carers of People with Parkinson’s from early to later stages: A qualitative study with 36 carers in 11 European countries

Background: Parkinson’s Disease (PD) is associated with considerable carer burden, but there has been little qualitative research on the support needs of carers of People with Parkinson’s (PwP). Methods: Semi-structured in-depth interviews with carers of PwP in 11 European countries. Results: Interviews with 36 carers of PwP were analysed. At the time of diagnosis, carers often felt that they had a role in helping get a diagnosis and then in dealing with the impact of the diagnosis on the family. Information on medication was seen as particularly important for carers, and many of the carers that their informational needs differed from that of the PwPs. Many of the carers also felt that they needed to be present at all appointments to request referrals or ask for medication changes. Carers of those in the later stages of the disease often reported feeling isolated and not having any time for themselves. Conclusions: The involvement of carers should be addressed more actively in the management of Parkinson’s

Heterogeneity in progression of prodromal features in Parkinson’s disease

Background: In the pre-diagnostic phase of Parkinson’s disease (PD), a range of motor and non-motor symptoms can occur. However, there is considerable variability in their onset and currently little information exists on the pattern of progression of clinical features before diagnosis. Methods: We analysed data from a survey amongst patients with PD from 11 European countries by the European Parkinson’s Disease Association. They completed questions on first occurrence of 21 pre-diagnostic features. A principal component analysis (PCA) with varimax rotation was performed to determine the co-occurrence of these features. Findings: 1,467 patients were included. Changes in movement were the most commonly reported features up to 4 years before diagnosis. However, at five or more years before diagnosis loss of sense of smell, sleep problems, fatigue and other non-motor features had been experienced most frequently. PCA of pre-diagnostic features’ duration revealed three factors with eigenvalues over Kaiser’s criterion of 1: a) a neuropsychiatric factor comprised of anxiety, depression, apathy, stress, and sleep problems; b) an axial factor defined by difficulty eating and/or swallowing problems, freezing, and falls/balance problems; and c) a motor factor with additional non-motor features. Bladder/bowel problems and tremor had low factor loadings on all components. However, in those with disease duration less than 5 years the autonomic features were associated with the axial factor and tremor loaded on both the motor and psychiatric symptom factors. Interpretation: The identified symptom complexes in the pre-diagnostic stage of PD may be reflective of a shared pattern of pathological disease progression

New Horizons in Supporting Older People’s Health and Wellbeing: Is Social Prescribing a Way Forward?

Older people’s health and care needs are changing. Increasing numbers live with the combined effects of age-related chronic illness or disability, social isolation and/or poor mental health. Social prescribing has potential to benefit older people by helping those with social, emotional or practical needs to access relevant services and resources within the local community. However, researchers have highlighted limitations with the existing evidence-base, while clinicians express concerns about the quality of onward referral services, liability and upfront investment required. The current article provides a critical review of evidence on social prescribing, drawing on the RE-AIM Framework (Glasgow et al., 1999) to identify questions that will need to be addressed in order to inform both the design and delivery of services and the evolving research agenda around social prescribing. We emphasise the need for researchers and planners to work together to develop a more robust evidence-base, advancing understanding of the impacts of social prescribing (on individuals, services and communities), factors associated with variation in outcomes and strategies needed to implement effective and sustainable programmes. We also call on policymakers to recognise the need for investment in allied initiatives to address barriers to engagement in social prescribing programmes, provide targeted support for carers and improve access to older adult mental health services. We conclude that social prescribing has potential to support older people’s health and wellbeing, but this potential will only be realised through strategic alignment of research, local level implementation and national policy and investment

The subjective experience of Parkinson's disease: a qualitative study in 60 people with mild to moderate Parkinson's in 11 European countries

Objective: To describe the experience of being diagnosed and living with mild to moderate Parkinson’s disease (PD). Method: Semi-structured in-depth interviews with people with Parkinson’s (PwP) in 11 European countries. Results: Interviews with 60 PwP (52% male) with a mean age of 63 (SD 8.1) years and a disease duration of 9.6 (SD 6.9) years were analysed. PwP often delayed help-seeking due to lack of awareness of symptoms, and there was sometimes a delay in specialist referral. The diagnosis typically came as a “shock”, making PwP unable to absorb all the information, but having a diagnosis for the symptoms was sometimes described as a “relief”. Prompt referral to a specialist, a clear and sensitively communicated diagnosis with reassurance about life expectancy, and a follow-up appointment with a PD nurse or other health care professionals a short interval after diagnosis were all positively viewed. Many reported worries and negative experiences with medications and wished for more time and information before initiating these. Reactions from family, friends, and work colleagues when communicating the diagnosis were typically positive. During ongoing care, longer appointments with specialists and provision of information from health care professionals, patient organisations, and self-help groups were considered important to many PwPs and helped them feel as if they could “take control” and manage their disease more effectively. Conclusions: Taking into account these findings has the potential to improve the experiences of PwP through improved communication, tailoring of appointments and information provision including self-help approaches. ? Introduction The impact of Parkinson’s disease (PD) on patients health-related quality of life has been studied extensively, demonstrating that all aspects of physical and emotional functioning can be affected in PD even at the earliest stages of the disease (Schrag et al., 2000). Management of PD aims at improving quality of life in people with Parkinson’s (PwP) using pharmacological, surgical and non-pharmacological strategies (Ferreira, et al. 2013). In order to improve quality of life in PwP, research has primarily focussed on quantitative assessments of motor and non-motor symptoms to optimise their medical treatment and thereby PwP’ wellbeing (Nicoletti et al., 2017). However, relatively little is known on the experience of being diagnosed with and living with PD from the point of view of PwP. This is particularly relevant when advising health care providers and clinicians on the non-medical aspects of managing PwP in current health care systems. We here report the results of a qualitative study in 60 individuals with a diagnosis of PD from 11 European countries on their experiences of being diagnosed and living with this disorder. Methods In 2014 and 2015, a qualitative research study was conducted as part of the “My PD Journey” project by the European Parkinson’s Disease Association (EPDA). Semi-structured interviews on the experiences of being diagnosed and living with PD were conducted with people with Parkinson’s (PwP) in 11 countries. Principles of Grounded Theory were used to guide the sampling, data collection, and data analysis (Glaser & Strauss, 2009)