The nature and prevalence of sexual exploitation in young people: Developing an explanatory model of vulnerability in a normative sample

This PhD aimed to identify the nature and extent of child sexual exploitation (CSE) in a young adult sample. It also aimed to identify some of the vulnerability and protective factors for CSE, as well as the potential long- term outcomes for victims

Pole dancing for fitness: The physiological and metabolic demand of a 60-minute class

Nicholas, JC, McDonald, KA, Peeling, P, Jackson, B, Dimmock, JA, Alderson, JA, and Donnelly, CJ. Pole dancing for fitness: The physiological and metabolic demand of a 60-minute class. J Strength Cond Res 33(10): 2704–2710, 2019—Little is understood about the acute physiological or metabolic demand of pole dancing classes. As such, the aims of this study were to quantify the demands of a standardized recreational pole dancing class, classifying outcomes according to American College of Sports Medicine (ACSM) exercise-intensity guidelines, and to explore differences in physiological and metabolic measures between skill- and routine-based class components. Fourteen advanced-level amateur female pole dancers completed three 60-minute standardized pole dancing classes. In one class, participants were fitted with a portable metabolic analysis unit. Overall, classes were performed at a mean Vo2 of 16.0 ml·kg−1·min−1, total energy cost (EC) of 281.6 kcal (4.7 kcal·min−1), metabolic equivalent (METs) of 4.6, heart rate of 131 b·min−1, rate of perceived exertion (RPE) of 6.3/10, and blood lactate of 3.1 mM. When comparing skill- and routine-based components of the class, EC per minute (4.4 vs. 5.3 kcal·min−1), peak Vo2 (21.5 vs. 29.6 ml·kg−1·min−1), METs (4.3 vs. 5.2), and RPE (7.2 vs. 8.4) were all greater in the routine-based component (p \u3c 0.01), indicating that classes with an increased focus on routine-based training, as compared to skill-based training, may benefit those seeking to exercise at a higher intensity level, resulting in greater caloric expenditure. In accordance with ASCM guidelines, an advanced-level 60-minute pole dancing class can be classified as a moderate-intensity cardiorespiratory exercise; when completed for ≥ 30 minutes, ≥ 5 days per week (total ≥ 150 minutes) satisfies the recommended level of exercise for improved health and cardiorespiratory fitness

Pole dancing for fitness: The physiological and metabolic demand of a 60-minute class

Nicholas, JC, McDonald, KA, Peeling, P, Jackson, B, Dimmock, JA, Alderson, JA, and Donnelly, CJ. Pole dancing for fitness: The physiological and metabolic demand of a 60-minute class. J Strength Cond Res 33(10): 2704–2710, 2019—Little is understood about the acute physiological or metabolic demand of pole dancing classes. As such, the aims of this study were to quantify the demands of a standardized recreational pole dancing class, classifying outcomes according to American College of Sports Medicine (ACSM) exercise-intensity guidelines, and to explore differences in physiological and metabolic measures between skill- and routine-based class components. Fourteen advanced-level amateur female pole dancers completed three 60-minute standardized pole dancing classes. In one class, participants were fitted with a portable metabolic analysis unit. Overall, classes were performed at a mean Vo2 of 16.0 ml·kg−1·min−1, total energy cost (EC) of 281.6 kcal (4.7 kcal·min−1), metabolic equivalent (METs) of 4.6, heart rate of 131 b·min−1, rate of perceived exertion (RPE) of 6.3/10, and blood lactate of 3.1 mM. When comparing skill- and routine-based components of the class, EC per minute (4.4 vs. 5.3 kcal·min−1), peak Vo2 (21.5 vs. 29.6 ml·kg−1·min−1), METs (4.3 vs. 5.2), and RPE (7.2 vs. 8.4) were all greater in the routine-based component (p \u3c 0.01), indicating that classes with an increased focus on routine-based training, as compared to skill-based training, may benefit those seeking to exercise at a higher intensity level, resulting in greater caloric expenditure. In accordance with ASCM guidelines, an advanced-level 60-minute pole dancing class can be classified as a moderate-intensity cardiorespiratory exercise; when completed for ≥ 30 minutes, ≥ 5 days per week (total ≥ 150 minutes) satisfies the recommended level of exercise for improved health and cardiorespiratory fitness

Child Sexual Exploitation, Poly-victimisation and Resilience

Purpose: This research examined the prevalence of Child Sexual Exploitation (CSE) and factors connected in a young adult population, through a series of connected studies. Each study considered exposure to poly-victimisation. The series of studies focused on a number of factors felt to impact on vulnerability and protective factors toward CSE. Specifically caregiver bonds, resilience, and attachment style, adolescent risk taking, quality of caregiver bonds, level/type of supportive relationships and positive schemas, as well as the impact of CSE disclosure and links to attachment style and maladaptive schemas. Design/methodology: These studies looked at a young adult population, mainly female. Study one (n = 263), Study two (n = 138) and study 3 (n = 211), predominantly collected via a series of online measures. Findings: Findings demonstrated that around half of children under 16 years had been approached sexually by an adult, with approximately one in four children subsequently exploited. Various results were noted, such as experiencing a primary caregiver as lacking in warmth and affection was associated with those reporting CSE, with further exposure to poly-victimisation contributing to a less functional coping style and insecure attachments. CSE was not associated with higher levels of adolescent risk-taking, poor bonds with the primary caregiver, fewer important childhood relationships and positive schemas. Originality: Findings were combined to propose the Protect Against CSE model (PA-CSE), and the application of this to intervention and future research is acknowledged

Sexual exploitation in children: Nature, prevalence and distinguishing characteristics reported in young adulthood

The aim of this study was to explore the nature and extent of sexual exploitation in a university student sample, whilst being clear that sexual exploitation is sexual abuse. Overall, 47% of participants (96 out of 204) reported having been approached by an adult in a sexual manner when they were under the age of 16. The study predicted that a number of individual characteristics would increase a young person’s vulnerability for sexual exploitation. These included low self-esteem, external locus of control, social loneliness and insecure attachment. Results indicated lower levels of self-esteem among those who had been approached sexually, although it is not clear in terms of causality. There were no differences in scores for locus of control or loneliness. Relationship anxiety was significantly linked with children having engaged in sexual behaviours with an adult. The implications of these findings are discussed in terms of emerging individual characteristics relating to a risk of sexual exploitation

Developing and evaluating communication strategies to support informed decisions and practice based on evidence (DECIDE) : protocol and preliminary results

Abstract Background Healthcare decision makers face challenges when using guidelines, including understanding the quality of the evidence or the values and preferences upon which recommendations are made, which are often not clear. Methods GRADE is a systematic approach towards assessing the quality of evidence and the strength of recommendations in healthcare. GRADE also gives advice on how to go from evidence to decisions. It has been developed to address the weaknesses of other grading systems and is now widely used internationally. The Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence (DECIDE) consortium (http://www.decide-collaboration.eu/), which includes members of the GRADE Working Group and other partners, will explore methods to ensure effective communication of evidence-based recommendations targeted at key stakeholders: healthcare professionals, policymakers, and managers, as well as patients and the general public. Surveys and interviews with guideline producers and other stakeholders will explore how presentation of the evidence could be improved to better meet their information needs. We will collect further stakeholder input from advisory groups, via consultations and user testing; this will be done across a wide range of healthcare systems in Europe, North America, and other countries. Targeted communication strategies will be developed, evaluated in randomized trials, refined, and assessed during the development of real guidelines. Discussion Results of the DECIDE project will improve the communication of evidence-based healthcare recommendations. Building on the work of the GRADE Working Group, DECIDE will develop and evaluate methods that address communication needs of guideline users. The project will produce strategies for communicating recommendations that have been rigorously evaluated in diverse settings, and it will support the transfer of research into practice in healthcare systems globally

Processing of Self versus Non-Self in Alzheimer’s Disease

Despite considerable evidence for abnormalities of self-awareness in Alzheimer’s disease (AD), the cognitive mechanisms of altered self-processing in AD have not been fully defined. Here we addressed this issue in a detailed analysis of self/non-self-processing in three patients with AD. We designed a novel neuropsychological battery comprising tests of tactile body schema coding, attribution of tactile events to self versus external agents, and memory for self- versus non-self-generated vocal information, administered in conjunction with a daily life measure of self/non-self-processing (the Interpersonal Reactivity Index). Three male AD patients (aged 54–68 years; one with a pathogenic mutation in the Presenilin 1 gene, one with a pathogenic mutation in the Amyloid Precursor Protein gene, and one with a CSF protein profile supporting underlying AD pathology) were studied in relation to a group of eight healthy older male individuals (aged 58–74 years). Compared to healthy controls, all patients had relatively intact tactile body schema processing. In contrast, all patients showed impaired memory for words previously presented using the patient’s own voice whereas memory for words presented in other voices was less consistently affected. Two patients showed increased levels of emotional contagion and reduced perspective taking on the Interpersonal Reactivity Index. Our findings suggest that AD may be associated with deficient self/non-self differentiation over time despite a relatively intact body image: this profile of altered self-processing contrasts with the deficit of tactile body schema previously described in frontotemporal dementia associated with C9orf72 mutations. We present these findings as a preliminary rationale to direct future systematic study in larger patient cohorts

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care

Metatarsophalangeal joint angle, net moment and power traces during stance phase (mean ± sd).

<p>Metatarsophalangeal joint angle, net moment and power traces during stance phase (mean ± sd).</p