Experiences of psychosocial and programme-related barriers to recovery in lifestyle interventions for noncommunicable diseases

Background: The majority of global deaths are due to noncommunicable diseases, largely preventable and treatable utilising behavioural interventions.Objectives: The study investigated patients’ experiences of a lifestyle intervention programme for noncommunicable diseases (NCDs), and the influence that psychosocial and programme-related barriers had on patients’ ability to improve their well-being.Methods: Fourteen patients with NCDs were interviewed before and on completion of a 12-week lifestyle intervention programme at a sports and exercise medicine clinic. Thematic analysis techniques were used to analyse interview data.Results: Patients described their experiences of NCDs diagnosis as traumatic, and their own relationship with their bodies and with the disorder(s) to be vulnerable and significantly challenging. Professional incompetence and unethical treatment were included as barriers to recovery. Barriers specifically relating to the programme included scheduling, as well as the online assessment component. Those reporting more premorbid psychosocial barriers were more likely to experience current complications, whether disease- or treatment-related, often emphasising the negative influence of programme and professional-related problems.Conclusion: Qualitative methodologies enabled the study to yield clinically relevant insights with respect to patients with NCDs. Accounting for the trauma and vulnerability experienced by this cohort may assist in the development of more patient-centred interventions and sustainable secondary prevention of NCDs.Keywords: chronic diseases of lifestyle; intervention evaluation; psychological risk factors; social support; professional conduc

Patterns of ash (Fraxinus excelsior L.) colonization in mountain grasslands: the importance of management practices

International audienceWoody colonization of grasslands is often associated with changes in abiotic or biotic conditions or a combination of both. Widely used as fodder and litter in the past traditional agro-pastoral system, ash (Fraxinus excelsior L.) has now become a colonizing species of mountain grasslands in the French Pyrenees. Its present distribution is dependent on past human activities and it is locally controlled by propagule pressure and abiotic conditions. However, even when all favourable conditions are met, all the potentially colonizable grasslands are not invaded. We hypothesize that management practices should play a crucial role in the control of ash colonization. From empirical field surveys we have compared the botanical composition of a set of grasslands (present and former) differing in management practices and level of ash colonization. We have displayed a kind of successional gradient positively linked to both ash cover and height but not to the age of trees. We have tested the relationships between ash presence in grassland and management types i.e. cutting and/or grazing, management intensity and some grassland communities' features i.e. total and local specific richness and species heterogeneity. Mixed use (cutting and grazing) is negatively linked to ash presence in grassland whereas grazing alone positively. Mixed use and high grazing intensity are directly preventing ash seedlings establishment, when low grazing intensity is allowing ash seedlings establishment indirectly through herbaceous vegetation neglected by livestock. Our results show the existence of a limit between grasslands with and without established ashes corresponding to a threshold in the intensity of use. Under this threshold, when ash is established, the colonization process seems to become irreversible. Ash possesses the ability of compensatory growth and therefore under a high grazing intensity develops a subterranean vegetative reproduction. However the question remains at which stage of seedling development and grazing intensity these strategies could occur

Drowning in data, thirsty for information and starved for understanding: A biodiversity information hub for cooperative environmental monitoring in South Africa

The world is firmly cemented in a notitian age (Latin: notitia, meaning data) – drowning in data, yet thirsty for information and the synthesis of knowledge into understanding. As concerns over biodiversity declines escalate, the volume, diversity and speed at which new environmental and ecological data are generated has increased exponentially. Data availability primes the research and discovery engine driving biodiversity conservation. South Africa (SA) is poised to become a world leader in biodiversity conservation. However, continent-wide resource limitations hamper the establishment of inclusive technologies and robust platforms and tools for biodiversity informatics. In this perspectives piece, we bring together the opinions of 37 co-authors from 20 different departments, across 10 SA universities, 7 national and provincial conservation research agencies, and various institutes and private conservation, research and management bodies, to develop a way forward for biodiversity informatics in SA. We propose the development of a SA Biodiversity Informatics Hub and describe the essential components necessary for its design, implementation and sustainability. We emphasise the importance of developing a culture of cooperation, collaboration and interoperability among custodians of biodiversity data to establish operational workflows for data synthesis. However, our biggest challenges are misgivings around data sharing and multidisciplinary collaboration

The bii4africa dataset of faunal and floral population intactness estimates across Africa’s major land uses

Sub-Saharan Africa is under-represented in global biodiversity datasets, particularly regarding the impact of land use on species’ population abundances. Drawing on recent advances in expert elicitation to ensure data consistency, 200 experts were convened using a modified-Delphi process to estimate ‘intactness scores’: the remaining proportion of an ‘intact’ reference population of a species group in a particular land use, on a scale from 0 (no remaining individuals) to 1 (same abundance as the reference) and, in rare cases, to 2 (populations that thrive in human-modified landscapes). The resulting bii4africa dataset contains intactness scores representing terrestrial vertebrates (tetrapods: ±5,400 amphibians, reptiles, birds, mammals) and vascular plants (±45,000 forbs, graminoids, trees, shrubs) in sub-Saharan Africa across the region’s major land uses (urban, cropland, rangeland, plantation, protected, etc.) and intensities (e.g., large-scale vs smallholder cropland). This dataset was co-produced as part of the Biodiversity Intactness Index for Africa Project. Additional uses include assessing ecosystem condition; rectifying geographic/ taxonomic biases in global biodiversity indicators and maps; and informing the Red List of Ecosystems

The bii4africa dataset of faunal and floral population intactness estimates across Africa’s major land uses

Sub-Saharan Africa is under-represented in global biodiversity datasets, particularly regarding the impact of land use on species’ population abundances. Drawing on recent advances in expert elicitation to ensure data consistency, 200 experts were convened using a modified-Delphi process to estimate ‘intactness scores’: the remaining proportion of an ‘intact’ reference population of a species group in a particular land use, on a scale from 0 (no remaining individuals) to 1 (same abundance as the reference) and, in rare cases, to 2 (populations that thrive in human-modified landscapes). The resulting bii4africa dataset contains intactness scores representing terrestrial vertebrates (tetrapods: ±5,400 amphibians, reptiles, birds, mammals) and vascular plants (±45,000 forbs, graminoids, trees, shrubs) in sub-Saharan Africa across the region’s major land uses (urban, cropland, rangeland, plantation, protected, etc.) and intensities (e.g., large-scale vs smallholder cropland). This dataset was co-produced as part of the Biodiversity Intactness Index for Africa Project. Additional uses include assessing ecosystem condition; rectifying geographic/taxonomic biases in global biodiversity indicators and maps; and informing the Red List of Ecosystems

Experiences of psychosocial and programme-related barriers to recovery in lifestyle interventions for noncommunicable diseases

Background: The majority of global deaths are due to noncommunicable diseases, largely preventable and treatable utilising behavioural interventions.Objectives: The study investigated patients’ experiences of a lifestyle intervention programme for noncommunicable diseases (NCDs), and the influence that psychosocial and programme-related barriers had on patients’ ability to improve their well-being.Methods: Fourteen patients with NCDs were interviewed before and on completion of a 12-week lifestyle intervention programme at a sports and exercise medicine clinic. Thematic analysis techniques were used to analyse interview data.Results: Patients described their experiences of NCDs diagnosis as traumatic, and their own relationship with their bodies and with the disorder(s) to be vulnerable and significantly challenging. Professional incompetence and unethical treatment were included as barriers to recovery. Barriers specifically relating to the programme included scheduling, as well as the online assessment component. Those reporting more premorbid psychosocial barriers were more likely to experience current complications, whether disease- or treatment-related, often emphasising the negative influence of programme and professional-related problems.Conclusion: Qualitative methodologies enabled the study to yield clinically relevant insights with respect to patients with NCDs. Accounting for the trauma and vulnerability experienced by this cohort may assist in the development of more patient-centred interventions and sustainable secondary prevention of NCDs

An indicator-based approach for cross-realm coastal biodiversity assessments

Ecosystem status assessments are generally separated into realm-specific analyses (terrestrial, freshwater, estuarine or marine), but without integrating these into a coherent assessment of coastal biodiversity across the land–sea interface. Trends in assessment indicators in coastal versus non-coastal areas have also rarely been considered. In this study we aimed to compile the first cross-realm national biodiversity assessment for the South African coast using three key indicators. The ecological condition, ecosystem threat status, and ecosystem protection level of coastal ecosystem types (n = 186) were determined and compared with those of non-coastal ecosystem types (n = 444). Nearly half (46.9%) of the South African coastal habitat has been degraded compared with 20% of non-coastal areas. Proportionately, there are three-times (60%) as many threatened coastal ecosystem types (or 55% by area) as there are threatened non-coastal ecosystem types (19%, 6% by area). Despite the impacted state of coastal biodiversity, protection levels are generally higher in the coastal zone (87% of ecosystem types have some protection) compared with non-coastal areas (75%), although fewer coastal ecosystem types have met their biodiversity targets (24%, vs 28% for non-coastal ecosystem types). These results illustrate the importance of using a cross-realm approach for status assessments, management and conservation of coastal biodiversity. The assessment methods described are flexible and widely applicable to other regions

Exercising with reserve: evidence that the central nervous system regulates prolonged exercise performance

OBJECTIVE: The purpose of this study was to measure the effects of an amphetamine (methylphenidate) on exercise performance at a fixed rating of perceived exertion of 16. METHODS: Eight elite cyclists ingested 10 mg methylphenidate in a randomised, placebo-controlled crossover trial. RESULTS: Compared with placebo, subjects receiving methylphenidate cycled for approximately 32% longer before power output fell to 70% of the starting value. At the equivalent time at which the placebo trial terminated, subjects receiving methylphenidate had significantly higher power outputs, oxygen consumptions, heart rates, ventilatory volumes and blood lactate concentrations although electromyographic activity remained unchanged. The ingestion of a centrally acting stimulant thus allowed subjects to exercise for longer at higher cardiorespiratory and metabolic stress indicating the presence of a muscular reserve in the natural state. CONCLUSIONS: This suggests that endurance performance is not only "limited" by mechanical failure of the exercising muscles ("peripheral fatigue"). Rather performance during prolonged endurance exercise under normal conditions is highly regulated by the central nervous system to ensure that whole-body homeostasis is protected and an emergency reserve is always present