THE TEAM APPROACH TO THE PSYCHOLOGICAL REHABILITATION OF INJURED ATHLETES: WHAT IS THE COACH’S ROLE ANYWAY?

Abstract The purpose of the study was to gain an understanding of the role of the coach in the recovery of injured youth athletes. Using qualitative methods, the experiences of 11 male coaches of male youth athletes (14-18 years) in competitive football, basketball, and hockey teams, in five Ontario communities were examined. Data were collected through a demographic questionnaire, interviews, and researcher field notes. Three themes emerged through analysis (communication, support and structure, and knowledge of the individual athlete) that suggested coaches contributed to both the physical and psychological recovery of their athletes, as part of a team that also included the athlete, other coaches, trainers, health practitioners and parents. Results are discussed based on these themes, study strengths and limitations, as well as future considerations

Building bridges? An evaluation of the costs and effectiveness of the separated parents information programme (PIP)

The Separated Parent Information Programme (PIP) is the first nationally available parent education programme for parents involved in litigation over contact and residence in England. The programme is a Contact Activity, introduced by the Children and Adoption Act 2006 as an additional tool for courts to facilitate contact. PIP is a four hour group programme for parents referred by the court. Both parties, i.e. the applicant and respondent, are required to attend the programme, but former couples attend separate groups. The groups are designed to include both men and women. The aim of the programme is to encourage parents to focus on children’s needs and perspectives. The programme is delivered by trained providers from mediation, counselling or contact services backgrounds

No One Left Behind: Implementing the Sustainable Development Goals in Australia

Australia was one of 193 countries that came together at the high-level United Nations (UN) Sustainable Development Summit in New York in September 2015 to commit to achieve the 2030 Agenda for Sustainable Development and its 17 Sustainable Development Goals (SDGs). The SDGs are a universal agenda, and their implementation is the shared responsibility of all countries at all stages of development, including OECD nations like Australia. Following a 2018 parliamentary inquiry into Australia’s SDG implementation, the Morrison Government and the Department of Prime Minister and Cabinet (PMAC) will require up-to-date knowledge on international best practice in governance, policy and planning for SDG implementation to inform its response to the 18 recommendations issued by the Australian Senate’s Foreign Affairs and Trade References Committee in February 2019. It is critical that the Australian government takes leadership in the implementation of the SDGs in part because of the political and constitutional peculiarities of Australia’s federal system of government. Only the Commonwealth has the capacity and authority to coordinate the various State and Territory jurisdictions and Local Government bodies. To date implementation of the SDG agenda has lacked leadership, prioritisation and coordination in Australia. Despite submitting its first Voluntary National Report under the SDGs in 2019, the Australian Government is yet to release a national SDG plan of action. The lack of planning and accountability mechanisms and lack of linked financing in the national budget are symptomatic of a deeper problem. In short an apparent lack of political will has meant that the SMART goal logic that many government agencies use for operationalising policy in an array of contexts is simply not present when it comes to the advancement of SDG implementation in Australia

Animals remember previous facial expressions that specific humans have exhibited

For humans, facial expressions are important social signals and how we perceive specific individuals may be influenced by subtle emotional cues that they have given us in past encounters. A wide range of animal species are also capable of discriminating the emotions of others through facial expressions [1–5], and it is clear that remembering emotional experiences with specific individuals could have clear benefits for social bonding and aggression avoidance when these individuals are encountered again. While there is evidence that non-human animals are capable of remembering the identity of individuals who have directly harmed them [6,7], it is not known whether animals may form lasting memories of specific individuals simply by observing subtle emotional expressions that they exhibit on their faces. Here we conducted controlled experiments in which domestic horses were presented with a photograph of an angry or happy human face and several hours later saw the person who had given the expression in a neutral state. Short-term exposure to the facial expression was enough to generate clear differences in subsequent responses to that individual (but not to a different mismatched person), consistent with the past angry expression having been perceived negatively and the happy expression positively. Both humans were blind to the photograph the horses had seen. Our results provide clear evidence that some non-human animals can effectively eavesdrop on the emotional state cues that humans reveal on a moment-to-moment basis, using their memory of these to guide future interactions with particular individuals

Investigating phagosome dynamics of microbial pathogens

Many microbial pathogens are able to evade killing by phagocytes of the innate immune system. This thesis focuses on two pathogens: the fungal pathogen $Cryptococcus$ $neoformans$ and the bacterial pathogen $Streptococcus$ $agalactiae$. $C$. $neoformans$ causes severe cryptococcal meningitis in mostly immunocompromised hosts, such as those with HIV infection. In contrast, $S$. $agalactiae$ is the leading cause of neonatal sepsis and meningitis. The interaction between macrophages and these pathogens is likely to be critical in determining dissemination and outcome of disease in both instances. A collection of $S$. $agalactiae$ clinical isolates, ranging in origin from colonisation cases to severe infection cases, were tested for their ability to persist with a macrophage cell line. Surprisingly, persistence within macrophages was a characteristic shared by all of the isolates tested. Furthermore, by investigating the $Streptococcus$-containing phagosome, it was revealed that streptococci are able to manipulate the acidification of macrophage phagosomes. Similarly, the maturation of phagosomes containing the fungal pathogen $C$. $neoformans$ was explored. Cryptococci are shown to be able to manipulate the phagosome they reside within. This is driven by modified acquisition of Rab GTPases to the phagosome, as well as altered acidification and cathepsin activity within $Cryptococcus$-containing phagosomes

Feasibility of a UK community-based, eTherapy mental health service in Greater Manchester: repeated-measures and between-groups study of ‘Living Life to the Full Interactive’, ‘Sleepio’ and ‘Breaking Free Online’ at ‘Self Help Services’

Objectives: There is increasing evidence to support the effectiveness of eTherapies for mental health, although limited data have been reported from community-based services. Therefore, this service evaluation reports on feasibility and outcomes from an eTherapy mental health service. Setting: ‘Self Help Services’, an Increasing Access to Psychological Therapies (IAPT) eTherapy service in Greater Manchester. Participants: 1068 service users referred to the service for secondary care for their mental health difficulties. Interventions: Participants were triaged into one of three eTherapy programmes: ‘Living Life to the Full Interactive’ for low mood, stress and anxiety; ‘Sleepio’ for insomnia; and ‘Breaking Free Online’ for substance misuse, depending on clinical need. Primary outcomes measures: Standardised psychometric assessments of depression, anxiety and social functioning, collected as part of the IAPT Minimum Data Set, were conducted at baseline and post-treatment. Results: Data indicated baseline differences, with the Breaking Free Online group having higher scores for depression and anxiety than the Living Life to the Full Interactive (depression CI 1.27 to 3.21, p<0.0001; anxiety CI 077 to 1.72, p<0.0001) and Sleepio (depression CI 1.19 to 4.52, p<0.0001; anxiety CI 2.16 to 5.23, p<0.0001) groups. Promising improvements in mental health scores were found within all three groups (all p<0.0001), as were significant reductions in numbers of service users reaching clinical threshold scores for mental health difficulties (p<0.0001). Number of days of engagement was not related to change from baseline for the Living Life to the Full or Sleepio programmes but was associated with degree of change for Breaking Free Online. Conclusion: Data presented provide evidence for feasibility of this eTherapy delivery model in supporting service users with a range of mental health difficulties and suggest that eTherapies may be a useful addition to treatment offering in community-based services

Modelling Emergency Medical Services

Emergency Medical Services (EMS) play a pivotal role in any healthcare organisation. Response and turnaround time targets are always of great concern for the Welsh Ambulance NHS Trust (WAST). In particular, the more rural areas in South East Wales consistently perform poorly with respect to Government set response standards, whilst delayed transfer of care to Emergency Departments (EDs) is a problem publicised extensively in recent years. Many Trusts, including WAST, are additionally moving towards clinical outcome based performance measures, allowing an alternative system-evaluation approach to the traditional response threshold led strategies, resulting in a more patient centred system. Three main investigative parts form this thesis, culminating in a suite of operational and strategic decision support tools to aid EMS managers. Firstly, four novel allocation model methods are developed to provide vehicle allocations to existing stations whilst maximising patient survival. A detailed simulation model then evaluates clinical outcomes given a survival based (compared to response target based) allocation, determining also the impact of the fleet, its location and a variety of system changes of interest to WAST (through ‘what-if?’ style experimentation) on entire system performance. Additionally, a developed travel time matrix generator tool, enabling the calculation and/or prediction of journey times between all pairs of locations from route distances is utilised within the aforementioned models. The conclusions of the experimentation and investigative processes suggest system improvements can in fact come from better allocating vehicles across the region, by reducing turnaround times at hospital facilities and, in application to South East Wales, through alternative operational policies without the need to increase resources. As an example, a comparable degree of improvement in patient survival is witnessed for a simulation scenario where the fleet capacity is increased by 10% in contrast to a scenario in which ideal turnaround times (within the target) occur

Provider and Caregiver Perspectives on the Family Guided Routines Based Approach to Interventions

1. What were the perceptions of EI providers that received their coaching endorsement, on the value of improving their competence and confidence in applying the FGRBI coaching model to improve client outcomes? 2. Among caregivers of children served in early intervention, what were their experiences with an FGRBI endorsed provider? The inherent nature of early intervention (EI) service delivery involves developing a strong collaborative dynamic with caregivers in support of the child.Our study investigated how providers and caregivers felt about the new implementation of theFGRBI model within HMJ counties. Despite low response rates, overall both providers and caregivers reported they felt the FGRBI modelincreased the collaboration process duringservice delivery. Consequently, providers and caregiversreported thattheFGRBI model added more value to sessions in contrast topreviouslyusedcoaching techniques. These perceptions demonstrate the positive impact the FGRBI model has made on increasing caregiver confidence in collaborating with providers for developing an appropriate client centered plan for their child. Providers also agreed that increased collaboration with caregivers seemed to promote greater levels of caregiver involvement during direct service delivery. Further research into the effectiveness of the FGRBI model in comparison to previous models, as well as more specific comparisons of key indicators should be conducted due the recent implementation of the FGRBI model in HMJ counties