Exploring common stressors in physical education

Daily stressors, or hassles, refer to the everyday environmental demands that constitute a threat or challenge, or exceed an individual’s biological or psychological capacities (Cohen et al., 1995). Increasing evidence suggests that daily stressors have a significant impact on adolescents’ educational outcomes, for example, performance, wellbeing and negative attitudes toward school, however there is limited research examining the concept of common stressors in PE lessons. As early-adolescence is a developmental period associated with decreased engagement in PE, it is important to identify the environmental stressors that may be associated with increased disengagement. The study comprised 54 secondary school students and six PE teachers from five schools in the English Midlands. Semi-structured focus groups were conducted and a thematic analysis was applied to interview transcripts. Three higher order themes were identified from the data: the social environment, the physical and organisational environment, and the performance environment. Common stressors within the social environment included, interpersonal transactions between peers, differences in effort levels during PE, and working outside one’s peer group. Stressors within the physical and organisational environment consisted of, environmental situations within the changing facilities and the availability of activities. Finally, performance environment stressors included, situations involving the difficult acquisition of physical skills, and situations where physical appearance and physical competencies were exposed. The study extends previous findings by identifying potentially threatening and frustrating, environmental demands that have not been identified in the previous literature. The current study is the first to explore the typical stressors that are experienced by students in PE

The perspective of Canadian health care professionals on abortion service during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic and pandemic response created novel challenges for abortion services. Canada was uniquely positioned to transition to telemedicine because internationally common restrictions on abortion medication were removed before the pandemic. OBJECTIVE: We sought to characterize the experiences of abortion health care professionals in Canada during the COVID-19 pandemic and the impact of the pandemic response on abortion services. METHODS: We conducted a sequential mixed methods study between July 2020 and January 2021. We invited physicians, nurse practitioners and administrators to participate in a cross-sectional survey containing an open-ended question about the impact of the pandemic response on abortion care. We employed an inductive codebook thematic analysis, which informed the development of a second, primarily quantitative survey. RESULTS: Our initial survey had 307 respondents and our second had 78. Fifty-three percent were family physicians. Our first survey found respondents considered abortion access essential. We identified three key topicss: access to abortion care was often maintained despite pandemic-related challenges (e.g. difficulty obtaining tests, additional costs); change of practice to low-touch medication abortion care and provider perceptions of patient experience, including shifting demand, telemedicine acceptability and increased rural access. The second survey indicated uptake of telemedicine medication abortion among 89% of participants except in Quebec, where regulations meant procedures were nearly exclusively surgical. Restrictions did not delay care according to 76% of participants. CONCLUSIONS: Canadian health care professionals report their facilities deemed abortion an essential service. Provinces and territories, except Quebec, described a robust pandemic transition to telemedicine to ensure access to services. PODCAST: An accompanying podcast is available in the Supplementary Data, in which the authors Dr Madeleine Ennis and Kate Wahl discuss their research on how family planning care and access to abortion services have changed during the COVID-19 pandemic

Divergent controls of soil organic carbon between observations and process-based models

The storage and cycling of soil organic carbon (SOC) are governed by multiple co-varying factors, including climate, plant productivity, edaphic properties, and disturbance history. Yet, it remains unclear which of these factors are the dominant predictors of observed SOC stocks, globally and within biomes, and how the role of these predictors varies between observations and process-based models. Here we use global observations and an ensemble of soil biogeochemical models to quantify the emergent importance of key state factors – namely, mean annual temperature, net primary productivity, and soil mineralogy – in explaining biome- to global-scale variation in SOC stocks. We use a machine-learning approach to disentangle the role of covariates and elucidate individual relationships with SOC, without imposing expected relationships a priori. While we observe qualitatively similar relationships between SOC and covariates in observations and models, the magnitude and degree of non-linearity vary substantially among the models and observations. Models appear to overemphasize the importance of temperature and primary productivity (especially in forests and herbaceous biomes, respectively), while observations suggest a greater relative importance of soil minerals. This mismatch is also evident globally. However, we observe agreement between observations and model outputs in select individual biomes – namely, temperate deciduous forests and grasslands, which both show stronger relationships of SOC stocks with temperature and productivity, respectively. This approach highlights biomes with the largest uncertainty and mismatch with observations for targeted model improvements. Understanding the role of dominant SOC controls, and the discrepancies between models and observations, globally and across biomes, is essential for improving and validating process representations in soil and ecosystem models for projections under novel future conditions

The FRAXA and FRAXE allele repeat size of boys from the Avon Longitudinal Study of Parents and Children (ALSPAC)

The FRAXA and FRAXE alleles of the FMR1 and FMR2 genes located on the X chromosome contain varying numbers of trinucleotide repeats. Large numbers of repeats at FRAXA (full mutations) manifest as Fragile X syndrome, associated with mental impairment that affects males more severely. In this paper, we present the dataset of frequencies of FRAXA and FRAXE repeat size extracted from DNA samples collected from boys enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC). DNA data were extracted from samples collected in ALSPAC clinics from several types of samples: cord blood, venepuncture blood taken at 43 months, 61 months, seven years or nine years. The DNA was amplified at FRAXA and FRAXE using fluorescent PCR in the Wessex Regional Genetics Laboratory, Salisbury District Hospital. The mean repeat size for FRAXA is 28.92 (S.D. 5.44), the median 30 and the range 8 to 68. There were particularly high numbers of boys with repeat sizes of 20 (10.67%) and 23 (7.35%). The mean repeat size for FRAXE is 17.41 (S.D. 3.94), with median of 16 and range of 0 to 61. There is a relatively high degree of variation of the FRAXA repeat size particularly and we suggest the extensive data available from the ALSPAC study opens up areas of research into understanding phenotypes associated with relatively unexplored repeat sizes. This could be particularly interesting for the lower repeat sizes occurring with high frequency at FRAXA in this population. As the data can be linked to exposures and phenotypes, it will provide a resource for researchers worldwide

Supervised pulmonary hypertension exercise rehabilitation (SPHERe):Study protocol for a multi-centre randomised controlled trial

Background Supervised cardio-pulmonary rehabilitation may be safe and beneficial for people with pulmonary hypertension (PH) in groups 1 (pulmonary arterial hypertension) and 4 (chronic thromboembolic disease), particularly as a hospital in-patient. It has not been tested in the most common PH groups; 2 (left heart disease), 3 (lung disease), or 5 (other disorders). Further it has not been evaluated in the UK National Health Service (NHS) out-patient setting, or with long-term follow-up. The aim of this randomised controlled trial (RCT) is to test the clinical and cost-effectiveness of a supervised exercise rehabilitation intervention with psychosocial support compared to best practice usual care for people with PH in the community/outpatient setting. Methods This multi-centre, pragmatic, two-arm RCT with embedded process evaluation aims to recruit 352 clinically stable adults with PH (groups 1–5) and WHO functional class II-IV. Participants will be randomised to either the Supervised Pulmonary Hypertension Exercise Rehabilitation (SPHERe) intervention or control. The SPHERe intervention consists of 1) individual assessment and familiarisation sessions; 2) 8-week, twice-weekly, supervised out-patient exercise training; 3) psychosocial/motivational support and education; 4) guided home exercise plan. The control intervention consists of best practice usual care with a single one-to-one practitioner appointment, and general advice on physical activity. Outcomes will be measured at baseline, 4 months (post-intervention) and 12 months by researchers blinded to treatment allocation. The primary outcome is the incremental shuttle walk test at 4 months. Secondary outcomes include health-related quality of life (HRQoL), time to clinical worsening and health and social care use. A purposive sample of participants (n = 20 intervention and n = 20 control) and practitioners (n = 20) will be interviewed to explore experiences of the trial, outcomes and interventions. Discussion The SPHERe study is the first multi-centre clinical RCT to assess the clinical and cost effectiveness of a supervised exercise rehabilitation intervention compared to usual care, delivered in the UK NHS, for people in all PH groups. Results will inform clinicians and commissioners as to whether or not supervised exercise rehabilitation is effective and should be routinely provided for people with PH

Development of an online intervention for the Rehabilitation Exercise and psycholoGical support After covid-19 InfectioN (REGAIN) trial [version 2; peer review: 2 approved]

Background: Up to half of people hospitalised with COVID-19 report diverse and persistent symptoms affecting quality of life for months and sometimes years after discharge (long-COVID). We describe the development of an online group exercise and behavioural support intervention for people who continue to experience such physical and/or emotional health problems more than three months after hospital discharge.  Methods: Intervention development was informed by the Medical Research Council framework for complex interventions. Our multidisciplinary team of academics, clinicians, and people with long-COVID, had collective expertise in the development and testing of complex interventions. We integrated a bio-psycho-social model of care drawing on rehabilitation literature for long-term health conditions and experiences from our pre-pilot study. Multiple stakeholder meetings were held to refine the intervention which was designed to be deliverable within the UK National Health Service. We adhere to TIDieR guidance for transparent and explicit reporting of telehealth interventions.  Results: The final REGAIN online exercise and behavioural support intervention consisted of an initial 1:1 consultation with a trained practitioner, followed by eight online group exercise, and six group support, sessions delivered over eight weeks. Participants could also access an online library of on-demand exercise and support videos. Conclusions: The final REGAIN intervention, combining exercise and behavioural support, is fully manualised with clear pathways to delivery and implementation. It is currently being tested in a randomised controlled trial. The intervention, developed with extensive patient and stakeholder engagement, could be incorporated into existing NHS rehabilitation programmes, should it prove to be clinically and cost-effective for people with long-COVID. Trial registration: International Standard Randomised Controlled Trial Number (ISRCTN) 11466448: Rehabilitation exercise and psychological support after COVID-19 infection: REGAIN

Clinical effectiveness of an online supervised group physical and mental health rehabilitation programme for adults with post-covid-19 condition (REGAIN study):multicentre randomised controlled trial

OBJECTIVE: To evaluate whether a structured online supervised group physical and mental health rehabilitation programme can improve health related quality of life compared with usual care in adults with post-covid-19 condition (long covid).DESIGN: Pragmatic, multicentre, parallel group, superiority randomised controlled trial.SETTING: England and Wales, with home based interventions delivered remotely online from a single trial hub.PARTICIPANTS: 585 adults (26-86 years) discharged from NHS hospitals at least three months previously after covid-19 and with ongoing physical and/or mental health sequelae (post-covid-19 condition), randomised (1:1.03) to receive the Rehabilitation Exercise and psycholoGical support After covid-19 InfectioN (REGAIN) intervention (n=298) or usual care (n=287).INTERVENTIONS: Best practice usual care was a single online session of advice and support with a trained practitioner. The REGAIN intervention was delivered online over eight weeks and consisted of weekly home based, live, supervised, group exercise and psychological support sessions.MAIN OUTCOME MEASURES: The primary outcome was health related quality of life using the patient reported outcomes measurement information system (PROMIS) preference (PROPr) score at three months. Secondary outcomes, measured at three, six, and 12 months, included PROMIS subscores (depression, fatigue, sleep disturbance, pain interference, physical function, social roles/activities, and cognitive function), severity of post-traumatic stress disorder, general health, and adverse events.RESULTS: Between January 2021 and July 2022, 39 697 people were invited to take part in the study and 725 were contacted and eligible. 585 participants were randomised. Mean age was 56 (standard deviation (SD) 12) years, 52% were female participants, mean health related quality of life PROMIS-PROPr score was 0.20 (SD 0.17), and mean time from hospital discharge was 323 (SD 144) days. Compared with usual care, the REGAIN intervention led to improvements in health related quality of life (adjusted mean difference in PROPr score 0.03 (95% confidence interval 0.01 to 0.05), P=0.02) at three months, driven predominantly by greater improvements in the PROMIS subscores for depression (1.39 (0.06 to 2.71), P=0.04), fatigue (2.50 (1.19 to 3.81), P&lt;0.001), and pain interference (1.80 (0.50 to 3.11), P=0.01). Effects were sustained at 12 months (0.03 (0.01 to 0.06), P=0.02). Of 21 serious adverse events, only one was possibly related to the REGAIN intervention. In the intervention group, 141 (47%) participants fully adhered to the programme, 117 (39%) partially adhered, and 40 (13%) did not receive the intervention.CONCLUSIONS: In adults with post-covid-19 condition, an online, home based, supervised, group physical and mental health rehabilitation programme was clinically effective at improving health related quality of life at three and 12 months compared with usual care.TRIAL REGISTRATION: ISRCTN registry ISRCTN11466448.</p

A reactive transport model for geochemical mitigation of CO2 leaking into a confined aquifer

Long-term storage of anthropogenic CO2 in the subsurface generally assumes that caprock formations will serve as physical barriers to upward migration of CO2. However, as a precaution and to provide assurances to regulators and the public, monitoring is used detect any unexpected leakage from the storage reservoir. If a leak is found, the ability to rapidly deploy mitigation measures is needed. Here we use the TOUGHREACT code to develop a series of two-dimensional reactive transport simulations of the hydrogeochemical characteristics of a newly formed CO2 leak into an overlying aquifer. Using this model, we consider: (1) geochemical shifts in formation water indicative of a leak; (2) hydrodynamics of pumping wells in the vicinity of a leak; and (3) delivery of a sealant to a leak through an adjacent well bore.Our results demonstrate that characteristic shifts in pH and dissolved inorganic carbon can be detected in the aquifer prior to the breakthrough of supercritical CO2, and could offer a potential means of identifying small and newly formed leaks. Pumping water into the aquifer in the vicinity of the leak provides a hydrodynamic control that can temporarily mitigate the flux rate of CO2 and facilitate delivery of a sealant to the location of the caprock defect. Injection of a fluid-phase sealant through the pumping well is demonstrated by introduction of a silica-bearing alkaline flood, resulting in precipitation of amorphous silica in areas of neutral to acidic pH. Results show that a decrease in permeability of several orders of magnitude can be achieved with a high molar volume sealant, such that CO2 flux rate is decreased. However, individual simulation results are highly contingent upon both the properties of the sealant, the porosity-permeability relationship employed in the model, and the relative flux rates of CO2 and alkaline flood introduced into the aquifer. These conclusions highlight the need for both experimental data and controlled field tests to constrain modelling predictions

Measurement of the cross-section and charge asymmetry of WW bosons produced in proton-proton collisions at s=8\sqrt{s}=8 TeV with the ATLAS detector

This paper presents measurements of the $W^+ \rightarrow \mu^+\nu$ and $W^- \rightarrow \mu^-\nu$ cross-sections and the associated charge asymmetry as a function of the absolute pseudorapidity of the decay muon. The data were collected in proton--proton collisions at a centre-of-mass energy of 8 TeV with the ATLAS experiment at the LHC and correspond to a total integrated luminosity of 20.2~\mbox{fb^{-1}}. The precision of the cross-section measurements varies between 0.8% to 1.5% as a function of the pseudorapidity, excluding the 1.9% uncertainty on the integrated luminosity. The charge asymmetry is measured with an uncertainty between 0.002 and 0.003. The results are compared with predictions based on next-to-next-to-leading-order calculations with various parton distribution functions and have the sensitivity to discriminate between them.Comment: 38 pages in total, author list starting page 22, 5 figures, 4 tables, submitted to EPJC. All figures including auxiliary figures are available at https://atlas.web.cern.ch/Atlas/GROUPS/PHYSICS/PAPERS/STDM-2017-13