Recovery and economics

Personal recovery as an approach to psychiatric rehabilitation is attracting growing attention in many health systems. It emphasises attainment of personal goals, meaning and control in life, rather than symptom alleviation. We examine what economic evidence there is in relation to a set of interventions that could be seen to be consistent with a recovery-focused approach. These include peer support, self-management, supported employment, welfare and debt advice, joint crisis plans and advance directives, supported housing, physical health promotion, personal budgets, anti-stigma campaigns and recovery colleges. For some interventions we could find no economic evidence, and for some others it was methodologically weak, but the interventions for which we could find evidence generally did not appear to increase costs, and many represented cost-effective uses of resources

Structure versus accident in the defeat of France’s mainstream Right, April–June 2017

Widely expected to recapture France’s presidency and win a parliamentary major ity in the 2017 elections, France’s mainstream Right instead suffered a crushing and divisive defeat. A major reason for this was contingent: the selection of a candidate who three months before polling day was placed under investigation for embezzling public funds. Other reasons were more structural, in particular the progressive dislocation of the bipolar multipartism which had characterised France’s party system for over four decades and the resultant strategic divisions within the Right. Although broadly chronological, this analysis of the long electoral cycle of 2016–2017 assesses the respective importance of proximate and long-term factors in the Right’s defeat

Family relationships and dementia: A synthesis of qualitative research including the person with dementia

yesFamily relationships are important for wellbeing across the life course and are known to be important for people living with dementia, bringing benefits to self-esteem and identity, as well as providing support for people living at home. Recent research has explored the impact of dementia upon relationships. Much of this research is qualitative in nature and rarely included in systematic reviews, however, it has the potential to provide significant contributions to understanding the interplay between family relationships and dementia and to inform interventions. A systematic synthesis of qualitative research concerning the impact of dementia upon family relationships was undertaken, using thematic synthesis. Eleven articles were reviewed, which address the perspectives of people living with dementia and their spouse and/or adult children. The aims of this review are to illuminate what is currently known about the reciprocal influences between family relationships and dementia from the perspectives of the family (including the person with dementia); and to consider the implications of these findings for research and practice. Four super-ordinate themes were identified: A shared history, negotiating the impact of dementia upon the relationship, openness and awareness, and shifting sands. This synthesis contributes to an emerging field but also highlights gaps in current understanding of the impact of dementia upon relationships and in providing appropriate interventions. Implications for research and practice are considered

The impact of sport participation on bone mass and geometry in adolescent males

Exercise is an effective approach for developing bone mass and adolescence is a key period to optimize bone health. However, sports specific training may have different effects on bone outcomes. This study examined the differences on bone outcomes between osteogenic (football) and non-osteogenic (swimming and cycling) sports and a control group in adolescent males. Methods: One hundred twenty one males (13.1±0.1 years) were measured: 41 swimmers, 37 footballers, 29 cyclists and 14 controls. Dual energy X-ray absorptiometry measured bone mineral density (BMD) and content (BMC) at lumbar spine, right and left hip and total body. Hip structural analysis evaluated bone geometry at the femoral neck. Quantitative ultrasound evaluated bone stiffness at both feet. Results: Footballers had significantly higher BMD at total body less head (7-9%), total hip (12-2%) and legs (7-11%) compared to all groups and significantly higher BMD at the femoral neck than controls (14%). Cyclists had higher BMD at the trochanter (10%) and BMC at the arms (10%) compared to controls. Geometrical analysis showed that footballers had significantly higher cross-sectional area (8-19%) compared to all groups, cross-sectional moment of inertia (17 %) compared to controls and section modulus compared to cyclists (11%) and controls (21%). Footballers had significantly higher bone stiffness compared to all groups (10-20%) at the dominant foot and (12-13%) at the nondominant foot compared to swimmers and controls. Conclusions: Adolescent male footballers exhibited higher bone density, geometry and stiffness compared to swimmers, cyclists and controls. Although swimmers and cyclists had higher bone outcomes compared to controls, these differences were not significant.The research leading to these results has received funding from the European Union Seventh Framework Programme ([FP7/2007-2013] under grant agreement n°. PCIG13-GA-2013-618496

The challenges, coping mechanisms, and recovery from the initial waves of the COVID-19 pandemic among academic radiographers.

This is the final version. Available from Radiography via the DOI in this record.INTRODUCTION: The COVID-19 pandemic arrived in Europe in March 2020 and created major challenges across healthcare provision and for healthcare education programmes as well as having a major impact on society. Within the profession of Radiography changes in medical imaging, radiotherapy, and teaching practices have been reported along with the negative impact on radiographers and students. The aim of this study was to investigate key challenges relating to academic practice during the COIVD-19 pandemic; how radiography academics have coped and to identify recommendations for further support required to facilitate recovery of the academic faculty as the pandemic ebbs. METHODS: A survey was circulated using SurveyMonkey™ via personal, national and international networks, including the European Federation of Radiographer Societies (EFRS), to reach as many academic radiographers as possible. Open questions relating to the challenges of providing radiography education during the COVID-19 pandemic and the and coping strategies used were included. Thematic analysis was conducted using NVivo (QSR International, MA). RESULTS: 533 academic radiographers responded to the whole survey from 43 different countries, with 340 responses relating to challenges and 327 for coping strategies. The main themes for the challenges were clinical practice, communication with colleagues, lack of face to face, managing change, students (support), and staff support. The coping strategy themes were communication with colleagues, physical exercise, self-care and wellbeing. CONCLUSION: These data demonstrate a multitude of challenges for academic radiographers and the pressure they worked under during the first year of the COVID-19 pandemic was clear. However, the majority employed healthy coping strategies to help them deal with the pressure, uncertainty and trauma of the situation. IMPLICATIONS FOR PRACTICE: COVID-19 had a significant impact on academic radiographers and while many reported good strategies for coping, the level of pressure is unsustainable. This study highlights the need to support academic radiographers to ensure a sustainable workforce

The risk of burnout in academic radiographers during the COVID-19 pandemic.

This is the final version. Available from Elsevier via the DOI in this record. INTRODUCTION: The COVID-19 pandemic created major challenges across society, healthcare provision and also for those delivering healthcare education programmes. Clinical placements were disrupted and, in many incidences cancelled. Higher education institutions were required to move completely to online delivery methods with little notice. This created significant additional workload, stress and the need to learn new skills at a time of great uncertainty. This study explored the risks of burnout in academic radiographers during the first 12 months of the pandemic. METHODS: A survey was circulated using SurveyMonkey™ via personal, national and international networks, including the European Federation of Radiographer Societies (EFRS), to reach as many academic radiographers as possible. Disengagement and exhaustion were measured using the Oldenburg burnout inventory. Descriptive statistics and a one-way ANOVA were used to analyse the quantitative data using STATA V16 (Statacorp, TA). RESULTS: 533 academic radiographers responded to the survey from 43 different countries. Mean disengagement was in the medium range and exhaustion was high for the total dataset. In a subset of countries with 10 or more responses, there was significant variation between countries, with the UK having highest mean exhaustion score and the UK, Ireland and France sharing the highest mean disengagement score. In the total dataset, 86% agreed workload had increased during the pandemic and 35% had considered leaving academia in the last year. CONCLUSION: These data demonstrate the stark reality of the impact of the COVID-19 pandemic on academic radiographers' workload, wellbeing, and intention to leave their roles. IMPLICATIONS FOR PRACTICE: COVID-19 has had a significant impact on academic radiographers and this study highlights the urgent need for remedial measures to better support academic radiographers in order to ensure a sufficient, and sustainable workforce

The Malagarasi River Does Not Form an Absolute Barrier to Chimpanzee Movement in Western Tanzania

The Malagarasi River has long been thought to be a barrier to chimpanzee movements in western Tanzania. This potential geographic boundary could affect chimpanzee ranging behavior, population connectivity and pathogen transmission, and thus has implications for conservation strategies and government policy. Indeed, based on mitochondrial DNA sequence comparisons it was recently argued that chimpanzees from communities to the north and to the south of the Malagarasi are surprisingly distantly related, suggesting that the river prevents gene flow. To investigate this, we conducted a survey along the Malagarasi River. We found a ford comprised of rocks that researchers could cross on foot. On a trail leading to this ford, we collected 13 fresh fecal samples containing chimpanzee DNA, two of which tested positive for SIVcpz. We also found chimpanzee feces within the riverbed. Taken together, this evidence suggests that the Malagarasi River is not an absolute barrier to chimpanzee movements and communities from the areas to the north and south should be considered a single population. These results have important consequences for our understanding of gene flow, disease dynamics and conservation management

Determinants of bone outcomes in adolescent athletes at baseline: the PRO-BONE study

This is the author accepted manuscript. The final version is available from the American College of Sports Medicine (ACSM) via the DOI in this record.Purpose: The determinants of areal bone mineral density (aBMD) and hip geometry 26 estimates in adolescent athletes are poorly understood. This study aimed to identify the 27 determinants of aBMD and hip geometry estimates in adolescent male athletes. Methods: 28 One hundred twenty one males (13.1±0.1 years) were measured: 41 swimmers, 37 29 footballers, 29 cyclists and 14 controls. Dual energy X-ray absorptiometry (DXA) measured 30 aBMD at lumbar spine, femoral neck (FN) and total body. Hip structural analysis evaluated 31 hip geometry estimates at the FN. Multiple linear regression examined the contribution of the 32 sports practised, stature, lean and fat mass, serum calcium and vitamin D, moderate to 33 vigorous physical activity (MVPA), vertical jump and cardiorespiratory fitness (CRF) with 34 aBMD and hip geometry estimates. Results: Region specific lean mass was the strongest 35 positive predictor of aBMD (β = 0.614 - 0.931) and football participation was the next 36 strongest predictor (β = 0.304 - 0.579). Stature (β = 0.235 - 0.380), fat mass (β = 0.189), 37 serum calcium (β = 0.103), serum vitamin D (β = 0.104 - 0.139) and vertical jump (β = 0.146 38 - 0.203) were associated with aBMD across various specific sites. All hip geometry estimates 39 were associated with lean mass (β = 0.370 - 0.568) and stature (β = 0.338 - 0.430). Football 40 participation was associated with hip cross-sectional area (β = 0.322) and MVPA (β = 0.140 - 41 0.142). CRF (β = 0.183 - 0.207) was associated with section modulus and cross-sectional 42 moment of inertia. Conclusions: Region specific lean mass is the strongest determinant of 43 aBMD and hip geometry estimates in adolescent male athletes. Football participation and 44 stature were important determinants for aBMD and hip geometry estimates while the 45 contribution of the other predictors was site specific.The research leading to these results has received funding from the European Union Seventh Framework Programme ([FP7/2007-2013] under grant agreement n°. PCIG13-GA-2013-61849