Bump start needed: linking guidelines, policy and practice in promoting physical activity during and beyond pregnancy

First paragraph: There is compelling evidence that regular physical activity (PA) during pregnancy benefits both mother and baby.1 2 Notably, physical and psychological benefits are evident in the literature, such as marked reductions in the development of gestational diabetes and hypertensive disorders, alongside improvements in depressive symptoms and cardiorespiratory fitness.1 2 The evidence base has been reflected by recent policy initiatives, for example, in 2017 (relaunched in 2019), the UK‘s chief medical officers (CMOs) published PA guidelines for pregnant women, which made substantial strides in unifying and translating the evidence into recommendations.1 The CMO guidelines are aimed at supporting health professionals to provide consistent, evidence-based PA messages to women throughout pregnancy.1 Recently, the Chartered Institute for the Management of Sport and Physical Activity have updated their professional standards for working with antenatal and postnatal clients to align with these CMO guidelines.3 However, not all women have access to professionals with this level of expertise and training, potentially limiting the impact of the CMO guidelines

VPSIRR (Vulnerability - Pressure - State - Impact - Risk And Response): An Approach To Determine The Condition Of Estuaries And To Assess Where Management Responses Are

Estuaries are highly variable in terms of type and geomorphic classification. The condition of these systems is often a reflection of activities taking place in their catchments and the susceptibility of these systems to each particular pressure. Effective management intervention can be achieved when there is an understanding of the current condition of the estuary or component of the estuary and of the pressures likely to affect them. If this can be linked to the susceptibility of the estuary to the pressure (risk), the management activity can be prioritised. A framework based on the Pressure-State-Impact-Response model, but which also includes the vulnerability of the system to each of the pressures has been developed. A key feature of this framework is that the links between indicators of pressure, state and impact are clearly identified ensuring that only indicators relevant to the local situation are selected. In addition, a risk assessment process has been developed. This approach is called a VPSIRR (Vulnerability - Pressure - State - Impact - Risk - Response)approach. Application of this method increases the likelihood of being able to identify the causes of any observed changes in condition, making it easier to identify appropriate management actions. It also enables information to be provided to the community in a user-friendly manner. We have developed a user friendly computer package which enables the risk that each estuary is under from various pressures to be assessed and linked to condition. The package enables the certainty about various data used to inform the process, to be reported. Importantly, the package enables indicator information to be updated as better information becomes available. It also enables new indicator information to be incorporated into the software should better knowledge become available. This component would only be made available to software administrators. The package produces a colour coded and numeric report card comprising of 5 colours or numbers which is designed to be easily understood and interpreted by users from a variety of backgrounds. The software can be used to inform managers of where to focus management investment, but can also be used to educate people about natural resource issues and the implications of different catchment and estuary based activities. Fact sheets imbedded within the software provide details about the various indicators. These include how to collect data and where necessary, how to analyse them in order to use the software. The fact sheets also provide information on management responses to a variety of issues

Effectiveness of group body psychotherapy for negative symptoms of schizophrenia: multicentre randomised controlled trial

Background Negative symptoms of schizophrenia have a severe impact on functional outcomes and treatment options are limited. Arts therapies are currently recommended but more evidence is required. Aims To assess body psychotherapy as a treatment for negative symptoms compared with an active control (trial registration:ISRCTN84216587). Method Schizophrenia out-patients were randomised into a 20-session body psychotherapy or Pilates group. The primary outcome was negative symptoms at end of treatment. Secondary outcomes included psychopathology, functional, social and treatment satisfaction outcomes at treatment end and 6-months later. Results In total, 275 participants were randomised. The adjusted difference in negative symptoms was 0.03 (95% CI –1.11 to 1.17), indicating no benefit from body psychotherapy. Small improvements in expressive deficits and movement disorder symptoms were detected in favour of body psychotherapy. No other outcomes were significantly different. Conclusions Body psychotherapy does not have a clinically relevant beneficial effect in the treatment of patients with negative symptoms of schizophreni

Effectiveness and cost-effectiveness of body psychotherapy in the treatment of negative symptoms of schizophrenia - a multi-centre randomised controlled trial

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