The Effects of Eye Movement Desensitization and Reprocessing on Prospective Imagery and Anxiety in Golfers

© 2018, Copyright © Association for Applied Sport Psychology. In this study we make a novel contribution by examining the effects of an Eye Movement Desensitization and Reprocessing (EMDR) intervention on detrimental prospective imagery in 4 amateur golfers, using a single-case multiple-baseline across-participants design. Postintervention, all participants reported reduced negative imagery effects; Participants 1, 3, and 4 showed reduced cognitive anxiety, Participants 1 and 4 reduced somatic anxiety, and Participant 3 positively relabeled somatic anxiety experiences. Social validation data demonstrated EMDR to be perceived positively and effective in delivering notable changes. Consultancy experiences of using EMDR in golf are discussed, and areas for future researchers and applied practitioners are outlined

Statistical Multiplicity in Systematic Reviews of Anaesthesia Interventions: A Quantification and Comparison between Cochrane and Non-Cochrane Reviews

BACKGROUND: Systematic reviews with meta-analyses often contain many statistical tests. This multiplicity may increase the risk of type I error. Few attempts have been made to address the problem of statistical multiplicity in systematic reviews. Before the implications are properly considered, the size of the issue deserves clarification. Because of the emphasis on bias evaluation and because of the editorial processes involved, Cochrane reviews may contain more multiplicity than their non-Cochrane counterparts. This study measured the quantity of statistical multiplicity present in a population of systematic reviews and aimed to assess whether this quantity is different in Cochrane and non-Cochrane reviews. METHODS/PRINCIPAL FINDINGS: We selected all the systematic reviews published by the Cochrane Anaesthesia Review Group containing a meta-analysis and matched them with comparable non-Cochrane reviews. We counted the number of statistical tests done in each systematic review. The median number of tests overall was 10 (interquartile range (IQR) 6 to 18). The median was 12 in Cochrane and 8 in non-Cochrane reviews (difference in medians 4 (95% confidence interval (CI) 2.0-19.0). The proportion that used an assessment of risk of bias as a reason for doing extra analyses was 42% in Cochrane and 28% in non-Cochrane reviews (difference in proportions 14% (95% CI -8 to 36). The issue of multiplicity was addressed in 6% of all the reviews. CONCLUSION/SIGNIFICANCE: Statistical multiplicity in systematic reviews requires attention. We found more multiplicity in Cochrane reviews than in non-Cochrane reviews. Many of the reasons for the increase in multiplicity may well represent improved methodological approaches and greater transparency, but multiplicity may also cause an increased risk of spurious conclusions. Few systematic reviews, whether Cochrane or non-Cochrane, address the issue of multiplicity

The effects of REBT on irrational beliefs, self-determined motivation, and self-efficacy in American Football

It has been suggested in recent research that rational beliefs as conceptualized within rational-emotive behaviour therapy (REBT) can be operationalized as strategic self-talk, but this has yet to be meaningfully investigated. The current study examines the effects of five one-to-one REBT sessions with three amateur American Football athletes to foster rational self-talk. The purpose of the intervention was to reduce the irrational beliefs, but also in line with recent applied REBT research, to increase the self-determined motivation and self-efficacy of the athletes. Using an idiographic single-case, staggered multiple-baseline across participants design, visual analyses revealed meaningful increases in self-determined motivation and self-efficacy, adjunct to decreases in total irrational beliefs across all participants. Social validation data supported these outcomes. These findings add to the growing research indicating that REBT can influence motivational approaches in athletes, such as self-determined motivation and self-efficacy. Results are discussed in relation to processes underlying the mechanisms of change, while also reporting the limitations of the study. The robustness of the research design increases the extent to which target variable changes can be attributed to REBT, but critical reflections are undertaken to assess the veracity of the findings

Testing effectiveness of the revised Cape Town modified early warning and SBAR systems: a pilot pragmatic parallel group randomised controlled trial

Abstract Background Nurses’ recognition of clinical deterioration is crucial for patient survival. Evidence for the effectiveness of modified early warning scores (MEWS) is derived from large observation studies in developed countries. Methods We tested the effectiveness of the paper-based Cape Town (CT) MEWS vital signs observation chart and situation-background-assessment-recommendation (SBAR) communication guide. Outcomes were: proportion of appropriate responses to deterioration, differences in recording of clinical parameters and serious adverse events (SAEs) in intervention and control trial arms. Public teaching hospitals for adult patients in Cape Town were randomised to implementation of the CT MEWS/SBAR guide or usual care (observation chart without track-and-trigger information) for 31 days on general medical and surgical wards. Nurses in intervention wards received training, as they had no prior knowledge of early warning systems. Identification and reporting of patient deterioration in intervention and control wards were compared. In the intervention arm, 24 day-shift and 23 night-shift nurses received training. Clinical records were reviewed retrospectively at trial end. Only records of patients who had given signed consent were reviewed. Results We recruited two of six CT general hospitals. We consented 363 patients and analysed 292 (80.4%) patient records (n = 150, 51.4% intervention, n = 142, 48.6% control arm). Assistance was summoned for fewer patients with abnormal vital signs in the intervention arm (2/45, 4.4% versus (vs) 11/81, 13.6%, OR 0.29 (0.06–1.39)), particularly low systolic blood pressure. There was a significant difference in recording between trial arms for parameters listed on the MEWS chart but omitted from the standard observations chart: oxygen saturation, level of consciousness, pallor/cyanosis, pain, sweating, wound oozing, pedal pulses, glucose concentration, haemoglobin concentration, and “looks unwell”. SBAR was used twice. There was no statistically significant difference in SAEs (5/150, 3.3% vs 3/143, 2.1% P = 0.72, OR 1.61 (0.38–6.86)). Conclusions The revised CT MEWS observations chart improved recording of certain parameters, but did not improve nurses’ ability to identify early signs of clinical deterioration and to summon assistance. Recruitment of only two hospitals and exclusion of patients too ill to consent limits generalisation of results. Further work is needed on educational preparation for the CT MEWS/SBAR and its impact on nurses’ reporting behaviour. Trial registration Pan African Clinical Trials Registry, PACTR201406000838118. Registered on 2 June 2014, www.pactr.org

Pretend play and parents\u27 view of social competence: the construct validity of the Child-Initiated Pretend Play Assessment.

Background and Aims: Play is the primary means through which children develop skills and socially interact with other children. The aim of this study was to investigate the relationship between pretend play and social competence in 4&ndash;5-year-old typically developing children, thereby adding further knowledge to the construct validity of the Child-Initiated Pretend Play Assessment (ChIPPA). Procedure: The pretend play ability of 35 preschool children aged 4&ndash;5 years was assessed using the ChIPPA. Parent/guardians of the children were interviewed regarding their child\u27s social competence using the Vineland Social&ndash;Emotional Early Childhood Scales (Vineland SEEC Scales). Main Findings: No significant correlations were found between the children\u27s play scores and their Vineland SEEC Scales scores. A significant and negative relationship was found between cooperation and sharing and elaborate play scores, suggesting that children who scored poorly on the play assessment were rated as cooperative by parents. Principal Conclusions: Parent report of social competence cannot be inferred from play scores. Reasons for the negative and significant finding are put forward and clinical implications of the findings are discussed. Additional investigations are necessary to further explore the construct validity of inferring social competence using the ChIPPA. <br /

An Idiographic Single-Case Study Examining the Use of Rational Emotive Behavior Therapy (REBT) with Three Amateur Golfers to Alleviate Social Anxiety

© 2018, © 2018 Association for Applied Sport Psychology. Performance anxiety has been studied in relation to golf performance, but one phenomenon that has received scant attention is social anxiety. One potential intervention that could reduce social anxiety in golfers is rational emotive behavior therapy (REBT), a cognitive-behavioral approach for which research interest is growing. The current study used an idiographic single-case study design to assess the effects of REBT on the social anxiety of 3 male amateur golfers. REBT was employed both on and off the golf course to ensure integration of REBT into the golfers’ performance, offering a methodological advancement of past research. Data were collected prior to, during, and after the REBT intervention. Visual analysis following single-case guidelines revealed substantial reductions in irrational beliefs and social anxiety in all three golfers. Social validation data indicated the positive receipt of REBT by the golfers and supported the visual analysis findings. This current study supports the effectiveness of REBT and extends the research by applying REBT in a “real-world” performance setting, offering methodological advances and providing clear implications for future research and practice

A pilot study evaluating use of a computer-assisted neurorehabilitation platform for upper-extremity stroke assessment

<p>Abstract</p> <p>Background</p> <p>There is a need to develop cost-effective, sensitive stroke assessment instruments. One approach is examining kinematic measures derived from goal-directed tasks, which can potentially be sensitive to the subtle changes in the stroke rehabilitation process. This paper presents the findings from a pilot study that uses a computer-assisted neurorehabilitation platform, interfaced with a conventional force-reflecting joystick, to examine the assessment capability of the system by various types of goal-directed tasks.</p> <p>Methods</p> <p>Both stroke subjects with hemiparesis and able-bodied subjects used the force-reflecting joystick to complete a suite of goal-directed tasks under various task settings. Kinematic metrics, developed for specific types of goal-directed tasks, were used to assess various aspects of upper-extremity motor performance across subjects.</p> <p>Results</p> <p>A number of metrics based on kinematic performance were able to differentiate subjects with different impairment levels, with metrics associated with accuracy, steadiness and speed consistency showing the best capability. Significant differences were also shown on these metrics between various force field settings.</p> <p>Conclusion</p> <p>The results support the potential of using UniTherapy software with a conventional joystick system as an upper-extremity assessment instrument. We demonstrated the ability of using various types of goal-directed tasks to distinguish between subjects with different impairment levels. In addition, we were able to show that different force fields have a significant effect on the performance across subjects with different impairment levels in the trajectory tracking task. These results provide motivation for studies with a larger sample size that can more completely span the impairment space, and can use insights presented here to refine considerations of various task settings so as to generalize and extend our conclusions.</p

Predictors of Long-Term Care Utilization by Dutch Hospital Patients aged 65+

Background Long-term care is often associated with high health care expenditures. In the Netherlands, an ageing population will likely increase the demand for long-term care within the near future. The development of risk profiles will not only be useful for projecting future demand, but also for providing clues that may prevent or delay long-term care utilization. Here, we report our identification of predictors of long-term care utilization in a cohort of hospital patients aged 65+ following their discharge from hospital discharge and who, prior to hospital admission, were living at home. Methods The data were obtained from three national databases in the Netherlands: the national hospital discharge register, the long-term care expenses register and the population register. Multinomial logistic regression was applied to determine which variables were the best predictors of long-term care utilization. The model included demographic characteristics and several medical diagnoses. The outcome variables were discharge to home with no formal care (reference category), discharge to home with home care, admission to a nursing home and admission to a home for the elderly. Results The study cohort consisted of 262,439 hospitalized patients. A higher age, longer stay in the hospital and absence of

Change in basic motor abilities, quality of movement and everyday activities following intensive, goal-directed, activity-focused physiotherapy in a group setting for children with cerebral palsy

Background: The effects of intensive training for children with cerebral palsy (CP) remain uncertain. The aim of the study was to investigate the impact on motor function, quality of movements and everyday activities of three hours of goal-directed activity-focused physiotherapy in a group setting, five days a week for a period of three weeks. Methods: A repeated measures design was applied with three baseline and two follow up assessments; immediately and three weeks after intervention. Twenty-two children with hemiplegia (n = 7), diplegia (n = 11), quadriplegia (n = 2) and ataxia (n = 2) participated, age ranging 3-9 y. All levels of Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) were represented. Parents and professionals participated in goal setting and training. ANOVA was used to analyse change over repeated measures. Results: A main effect of time was shown in the primary outcome measure; Gross Motor Function Measure-66 (GMFM- 66), mean change being 4.5 (p < 0.01) from last baseline to last follow up assessment. An interaction between time and GMFCS-levels was found, implying that children classified to GMFCS-levels I-II improved more than children classified to levels III-V. There were no main or interaction effects of age or anti-spastic medication. Change scores in the Pediatric Evaluation of Disability Inventory (PEDI) ranged 2.0-6.7, p < 0.01 in the Self-care domain of the Functional Skills dimension, and the Self-care and Mobility domains of the Caregiver Assistance dimension. The children's individual goals were on average attained, Mean Goal Attainment Scaling (GAS) T-score being 51.3. Non-significant improved scores on the Gross Motor Performance Measure (GMPM) and the Quality of Upper Extremities Skills Test (QUEST) were demonstrated. Significant improvement in GMPM scores were found in improved items of the GMFM, not in items that maintained the same score. Conclusions: Basic motor abilities and self-care improved in young children with CP after goal-directed activityfocused physiotherapy with involvement of their local environment, and their need for caregiver assistance in self-care and mobility decreased. The individualized training within a group context during a limited period of time was feasible and well-tolerated. The coherence between acquisition of basic motor abilities and quality of movement should be further examined