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Exploring the effects of being diagnosed with type 1 diabetes in adolescence
Get PDFA diagnosis of type 1 diabetes mellitus often comes as a shock and can be difficult for the patient to accept. When arriving during the already challenging adolescent period, this can be particularly difficult. This article explores the impact of a diagnosis during this time and offers suggestions to improve the care provided to this unique group of patients. It considers the complex nature of the condition and the challenges of day to day management for young people. There is limited research which solely focuses on the timing of a type 1 diabetes diagnosis; therefore, these findings add an insight into the experience for those who are diagnosed during those critical adolescent years. This will allow nurses and other healthcare professionals to consider the factors which are important in terms of improving the care of this group of patients
The effectiveness of fatigue monitoring in professional football
Get PDFPlayer monitoring is common practice in elite sporting environments for practitioners to
gain an advantageous insight into the general fatigue and recovery status of athletes and
has previously been investigated. However, the application and sensitivity of fatigue
markers for elite football players are yet to be fully established. The physical demands
of football have changed over time, with increases in both physical and technical
parameters observed in recent years (Barnes et al., 2014; Bush et al., 2015). Higher
physical demands, coupled with periods of fixture congestion require players to compete
in up to three games per-week, and has resulted in an increased need to monitor the
associated fatigue response to avoid performance decrements and the inherent risk of
injury (Nedelec et al., 2012; Zouhal et al., 2013).
Monitoring the impact of training and games on players’ physiological and physical
responses can allow practitioners to make informed decisions to ensure athletes are at
peak physical performance prior to the next fixture through training modification and/or
adjustment of individual player’s recovery strategies. These markers of fatigue should be
sensitive to both acute and chronic fluctuations in training/match load. Nevertheless,
most research in elite football has been conducted over a short period in-season with
limited observation of cumulative and chronic fatigue. Therefore, the primary aim of this
thesis was to evaluate the sensitivity of conventional measures of fatigue
(countermovement jump indices, creatine kinase concentrations and urine osmolality) on
elite senior first team football players (now referred to as elite football players). The
second aim was to assess whether these measures are sensitive to the stresses of an elite
competitive football season.
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The aim of the first study (Chapter 4) was to examine the acute changes from 90-minutes
(min) of competitive match-play in countermovement jump (CMJ), creatine kinase (CK)
and urine osmolality (Uosm) scores as part of routine testing and monitoring of elite
football players over the course of a season. The results indicated that CMJ height derived
from a ‘Just Jump System’ (Just Jump System, Perform Better Limited, Southam,
Warwickshire, UK) could detect significant impairments at 48-hours (h) post-match in
physical performance after performing 90-min of competitive match play (-3.9 %, P =
0.014, ES = 0.37). However, the question was raised whether the impairment was a
meaningful change in performance and/or of clinical significance. There were marked
increases in CK concentration, measured via capillary blood, 24-h pre to 48-h post-match
(41 %, P = 0.005, ES = -0.91), however post-match concentrations were low in
comparison to the large reference range reported in literature and would suggest minimal
muscular or fatigue related stress was present. Urine osmolality measured using a
handheld urinary refractometer (Osmocheck pocket pal OSMO, Vitech Scientific Ltd,
Japan) displayed no significant change 24-h pre to 48-h post-match reflecting that elite
football players are able to achieve rehydration by 48-h post-game, or the equipment
employed within the limitations of the research environment was not sensitive to
changes.
Chapter 5 mirrored that of Chapter 4 and used a more advanced assessment technique for
physical performance via a force platform (HUR Labs Force Platform 3.8.0.2, Kokkola,
Finland). Additional measures of physical performance (contraction time [CT], flight
time [FT], the ratio between flight time and contraction time [FT:CT], peak power [PP],
max force [MF], take-off velocity [TV], average power [AP], average force [AF]) were
taken. This was due to research suggesting that concentric focused outputs from the
‘push-off’ phase of the jump, such as CMJ height, lacks the resolution to detect neuromuscular fatigue (NF) in elite athletes. The findings from this study demonstrated
CMJ FT and AP (concentric based outputs) to be most sensitive to fatigue 48-h postmatch (-2.4 %, ES = -0.45 and -7.3 %, ES = -0.63, respectively) and moderately
associated with external load parameters completed during 90-min of competitive matchplay (r = -0.40 to -0.50). Decrements were also noted in FT:CT (-7.4 %, ES = -0.39)
reflecting changes to concentric push-off (FT) and altered movement strategy (CT), but
was not sensitive to match external load. The output measures of CMJ height and TV
also demonstrated sensitivity to detect signs of NF but CT, PP and MF did not. Creatine
kinase concentrations at 48-h post-match showed no association to match external load
but were sensitive to the overall demands of 90-min of competitive football (P = 0.001,
ES = 0.66). Similar to the findings of Chapter 4, Uosm did not reveal any significant
difference at 48-h post-match (P < 0.05). The position specific changes in these markers
were as expected, showing the positon of central midfielder to display the greatest
changes in CK and CMJ outputs likely attributable to their position covering the greatest
total distance, high intensity running distance and number of high intensity actions. The
studies comprising Chapter 4 and 5 show that CMJ testing and CK concentrations display
particular promise as acute, simple, non-invasive assessments for monitoring the
recovery-fatigue status of elite football players’ 48-h post-match.
The aim of the third study (Chapter 6) was to examine the longitudinal fluctuations in
the physiological and physical performance markers from Chapter 4 and 5 across a
competitive season. To the author’s knowledge, this was the first study to address weekly
variations in these measures over a competitive season. The results demonstrated large
increases in CK concentration but minimal fluctuation over a competitive season [62 to
159 %, P < 0.05], and indicated that CMJ MF can be increased (5.1 to 7.0 %, P < 0.05)
despite fluctuations in movement strategy focused outputs (TV, FT:CT and AP) possibly indicating low-level NF. Therefore, the results from this chapter support the idea that skilled performers’ are thought to exhibit greater movement variability to help achieve
consistent performance outcomes. Hydration status measured via Uosm demonstrated
significant increases to baseline over the season (30 to 84 %, P < 0.05), although the
findings indicated that players were able to maintain a euhydrated state that would be
unlikely to negatively affect performance output. Chapter 6 additionally provided 95 %
reference ranges and normative values for the recovery-fatigue variables in this subgroup of elite football players to aid the interpretation of clinically meaningful changes
from baseline.
The aim of the last experimental Chapter (Chapter 7) was to observe the association
between markers of training/match load and the conventional markers of recoveryfatigue over a competitive season, to determine the sensitivity of these markers to
preceding and cumulative load. The high inter-individual variability in the recoveryfatigue variables was addressed by transforming raw scores into ‘Z-scores’ for the
analysis. The results from regression analysis showed that the models used explained low
proportions of variance in the physiological and physical performance parameters used
(6 to 18 %). Creatine kinase had a weak positive association to cumulative match-time
over the season and Uosm to the time-trend variable ‘match-week’ (week number of the
season; P < 0.05). Match-week also demonstrated significant associations to increases in
CMJ AF. Further, the results displayed weak, marginally significant, associations
between CMJ CT and FT:CT to preceding match-load. All recovery-fatigue variables
used demonstrated poor sensitivity to training load outputs measured via GPS over a
season. The findings suggest that elite football players, who play regularly, demonstrate
the capability to maintain physical output and be sufficiently recover by 24-h pre-match
(for a Saturday fixture) despite a congested match schedule.
The overall findings of this thesis have shown that simple output measures from a CMJ
are able to detect impairments in physical performance and signs of NF 48-h post
competitive match-play in elite football players. Further, concentric derived output
measures from the ‘push-off’ phase previously criticised in research have displayed
sensitivity to match external load. Across a competitive season, players are able to
maintain MF and PP outputs despite signs of low-level NF via changes in ‘jump-strategy’
(e.g. TV, FT:CT and AP). Creatine kinase, although sensitive to overall match-play,
displays changes of minimal clinical significance 48-h post-match. However, CK did
demonstrate sensitivity to cumulative match-min played across the season. Therefore, if
interpreted correctly CK concentrations may provide practitioners with insights into
cumulative fatigue/muscular stress. Incorporating additional biomarkers may further
enhance detection of physiological and physical stress related changes to match and
training demands. Lastly, the monitoring of hydration status via Uosm reflects that
players are able to maintain a state of euhydration across a season but shows no
associations to preceding match or training demands, perhaps a limitation of the
equipment employed in the research environment was not sensitive to changes.
Therefore, monitoring for spikes in CK concentrations and impairments in CMJ
performance, when interpreted correctly, may provide clinically relevant insights of
individual players prior to the next training session and/or fixture, ultimately equipping
practitioners with an advantageous knowledge concerning recovery-fatigue status
Anticipatory effects on whole-body dynamic stability in side cutting
Get PDFThe purpose of this study was to identify the anticipatory effects on factors that influence the ability to generate medial ground reaction forces in changes of direction, and the implications for injury risk markers. Twenty recreational soccer players completed 12 anticipated and 12 unanticipated side cutting tasks, whilst 3D motion capture and force plate data were collected. Five distinct movement strategies were found to represent factors that influence the medial ground reaction force vector, and comparisons were made between the two conditions using multiple t-tests in SPM1D. Whole-body dynamic stability is compromised by limited anticipation time, with a greater demand on a corrective hip strategy following a narrower foot placement and reduced sagittal plane loading efficiency. This may have implications for change of direction performance and injury risk
The impact of childminder pre-registration training on the preparation of prospective childminders for registration with OFSTED
Get PDFThe role of government policy in influencing childcare provision in England has
seen prolific changes. The research in childminding practice has been seen to
develop and as such, changes in policies to support and influence the provision of
childminding as a method of childcare have been established. The introduction of
the Early Years Foundation Stage (EYFS) in 2008 (DCSF), and subsequent
changes in 2012 (DfE), 2104 (DfE) and more recently 2017 (DfE) have outlined
the requirements of training for those wishing to undertake the childminder
registration process with the Office for Standards in Education, Children's Services
and Skills (Ofsted). To establish an understanding of the training pathway that was
perceived to best prepare prospective childminders for such registration, this
thesis looked at 268 prospective childminders’ experiences of childminder pre-registration training offered by Bolton Local Authority (BLA) between 2009 and
2014. Adopting a theoretical framework of change management gave insight into
the steps taken by BLA to modify a classroom-based training pathway, to that of a
blended delivery (classroom delivery combined with e-learning) and ultimately a
move to a web-based fact sheet: that signposted prospective childminders to
independently search for information via the internet. Each amendment to the
training pathway was in support of the changes in the EYFS 2008 (DCSF), 2012
(DfE) and 2014 (DfE) requirements. A case-study methodological approach to
gathering qualitative and quantitative data, via the use of questionnaires, focus
groups and interviews explored the perceptions of three cohorts of prospective
childminders and the training they undertook to prepare them for childminder
registration. The three cohorts collectively consisted of seven different groups of
prospective childminders who undertook their pre-registration training via the training pathway relevant to the EYFS in force at the time. The revision of the
EYFS in 2017 is out of scope for the findings of this study. The findings of the
thesis derived from a case study of BLA’s responses to the changing political
environment within the early years sector. In reviewing the training available,
prospective childminders shared their opinions and experiences of the training
they received in providing them with the knowledge and understanding of the
practical aspects of becoming a childminder, ways in which to implement the EYFS
within the home environment, alongside an understanding of the requirements of
self-employment and an awareness of how to maintain a sustainable business. All
these elements contributed in preparing them for the registration process with
Ofsted. This research leads to a recognition that information, guidance and face-to-face training as a way of sharing information to prospective childminders was
perceived to be the most conducive to understanding the level of commitment and
knowledge required to undertake registration to become a childminde
James Kay of Turton Tower: Inventor and Flax Spinner (1774-1857)
No full textThis is the story of James Kay's invention of a novel wet spinning system for flax in 1825, which was taken up by Irish spinners and enabled the Irish linen Industry to become of global importance in the late19th and early 20th centuries. In England, his patent was invalidated by John Marshall of Leeds following a series of lawsuits during the 1835-41 period. In so doing, Marshall, one of the richest and most powerful "textile barons" of his time, destroyed Kay's reputation in England to the effect that his name has all but disappeared from the list of 19th century textile industrial entrepreneurs. James Kay did, however, become sufficiently wealthy from his invention to enable him to buy and refurbish Turton Tower to the state that may be seen to this day, but his industrial contribution and story has never been told. His invention, which enabled very fine linen yarns to be produced by steam driven machinery, may be compared to Samuel Crompton's more well-known and famous cotton spinning mule, which was invented over 40 years earlier in the late 1770s. Just as the mule drove the early 19th century Industrial Revolution so Kay's wet spinning invention provided the impetus for the growth of the Irish linen industry in the second half of the 19th century. His wet spinning process is still the basis of modern spinning of fine linen yarns, although this industry is now concentrated in Russia and China
The flexural strength of zirconia after immersion in acidic drink.
Get PDFAcidic beverages can produce erosion of natural dentition in humans when consumed frequently or excessively. The aim of the present study was to investigate the flexural strength of Zirconia after immersion in acidic drink. Zirlux® anterior multi (Zirlux®, Zahn Dental, Langden, Germany) Zirconia was tested. Thirty specimens of Zirconia were divided into 3 groups (n=10): specimens of group 1 were used as a control group that were immersed in ionised water for 7days, specimens of group 2 were immersed in 50 ml of Coca-Cola for 4 days, and specimens of group 3 were immersed in 50 ml of Coca-Cola for 7 days. The flexural strength was measured for each material using an Instron Universal Testing Machine. The Data was subjected to statistical analysis. After acidic drink immersion, no significant differences were reported between control group 1, group 2 and group 3. After immersion periods of 4 and 7 days, there was no statistical reduction in flexural strength value due to immersion in acidic drink
The impact of domestic violence on family and relationship
Get PDFThe aim of the dissertation is to explore intimate partner violence (IPV) on family and relationship. IPV is when a partner is being abused by another partner on a regular basis. The method this dissertation utilises is a library base study reviewing fifteen research papers. It explores the impact of IPV on mothers and children. The findings highlight four main themes, these are: behavioural and psychological impact of IPV. How IPV can influence the maternal attachment between mother and child and the fourth being about the services and interventions available to support victims. Thereafter, the dissertation has concluded that IPV can cause mother and child to develop symptoms of depression and anxiety which links to the psychological impact. In relation to behavioural impact, the findings have suggested that mothers found it hard to show affection to the child due to side effects of experiencing IPV. Also, the attachment between mother and child has been found to be influenced by IPV causing a barrier between a mother and child relationship, as she fears her partner will abuse the child. Lastly, the findings have discovered how families have a negative perception of services and intervention which results to them being reluctant to receive help
Flax/PP and Flax/PLA thermoplastic composites: Influence of fire retardants on the individual components
Get PDFThis study is based on previously reported reaction to fire properties of flax fibre-reinforced
polymeric (polypropylene, PP and polylactic acid, PLA) composites, prepared by pre-treating the
fabrics with different fire retardants (FRs) prior to composite preparation. It was observed that while
all of these treatments were very effective in flax/PLA in terms of achieving a V-0 rating in a UL-94
test, only an organophosphonate FR was capable of achieving a V-0 rating for flax/PP. However,
all fire-retardant treatments impaired the mechanical properties of the composites; the reduction was
more in flax/PLA compared to flax/PP composites. To understand these effects further, here thermal
analysis and pyrolysis combustion flow calorimetry of the composites and each component separately
treated with FRs have been conducted and the results analysed in terms of the effect on each
component so as to observe any interaction between the different components. The results indicated
that in flax/PLA composites, the water released during FR catalysed dehydration-decomposition
of flax may hydrolyse PLA, changing decomposition pathway of PLA to produce less flammable
volatile, hence resulting in reduced flammability
The sensitivity of countermovement jump, creatine kinase and urine osmolality to 90-min of competitive match-play in elite English Championship football players 48-h post-match
Get PDFPurpose: Examine changes from 90-minutes of competitive match-play in countermovement jump (CMJ), creatine kinase (CK) and urine osmolality (Uosm) in elite football players over a season and their association to match external load.
Methods: Eighteen football players participated. CMJ, CK and Uosm were collected 24-h pre-match and 48-h post-match. Match-performance data was examined using Prozone®.
Results: Post-match CK concentrations increased 49 % (ES: 0.66), while CMJ flight-time (FT), flight time: contraction time ratio (FT:CT), take-off velocity (TV) and average power (AP) decreased 2.4-7.4 % post-match (ES: 0.39-0.63). CMJ height post-match reduced 4.2 % (ES: 0.35). CMJ FT and AP showed associations with high intensity distance covered (HID), high intensity number (HIN), explosive sprints (EXS) and medium intensity accelerations (r = -0.395 to -0.496). Changes in CMJ FT also displayed associations to total sprint distance (TSD), total sprint number (TSN) and medium intensity decelerations (r = -0.395 to -0.446, P < 0.05). Increases in CMJ CT were associated with HIN (r = 0.39), and CMJ AF with HIN, EXS and medium accelations/decelerations (r = -0.397 to 0.459) completed during the match.
Conclusion: CMJ outputs from the push-off phase and countermovement phase were sensitive to change in neuromuscular fatigue. CK concentrations were sensitive to match-play demands. This helps practitioners determine player readiness and has implications for individual recovery strategies