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The Veteran Friendly Practice accreditation programme: a mixed-methods evaluation
Get PDFCopyright © 2022, The Authors.The Royal College of General Practitioners Veteran Friendly Practice Accreditation Programme launched in 2019, aiming to allow practices to better identify, treat and refer veterans, where appropriate, to dedicated NHS services. Evaluate the effectiveness of the accreditation programme, focusing on benefits for the veteran, the practice and the delivery of the programme itself. The study evaluated the views of Veteran Friendly Accredited GP Practices across England. Mixed-methods study collecting data via an online survey from 232 accredited Primary Healthcare (PHC) staff and 15 semi-structured interviews with PHC Veteran Leads. Interviews were analysed using modified Grounded Theory. 99% (N=228) of respondents would recommend the programme, 77% (N=124) reported improved awareness and 84% (N=193) a better understanding of veteran's needs. 72% (N=166) identified benefits for veterans who were engaging more with PHC but participants felt more time was needed, largely due to the Covid-19 pandemic, to fully assess the impact of the programme on help-seeking behaviour. Challenges included identifying veterans already registered, promoting the accreditation process and ensuring all PHC staff were kept up to date with veteran issues. The programme has increased signposting to veteran specific services and greater understanding of the NHS priority referral criteria for veterans. Recording of veteran status has improved and there was evidence of a better medical record coding system in PHC practices. These findings add to the limited empirical evidence exploring veteran engagement in PHC and demonstrate how accreditation results in better treatment and identification of veterans. [Abstract copyright: Copyright © 2022, The Authors.
A pilot study of a single intermittent arm cycling exercise programme on people affected by Facioscapulohumeral dystrophy (FSHD)
Get PDFFor patients affected by Facioscapulohumeral dystrophy (FSHD), alternate methods for increasing physical activity engagement that may benefit shoulder function and wider health are needed. Arm cycling has been proposed as a potential method for achieving this although dosage parameters and evidence is limited. The aim of this study was to conduct a pilot study evaluating the effect of a single intermittent arm cycling exercise programme on people affected by FSHD. People with confirmed genetic diagnosis of FSHD between the ages 18–60 years were recruited to attend a single session for the exercise intervention (5 exercise efforts lasting 2 minutes each with 30 seconds of rest between each effort). Prior to exercise, measures of shoulder function (Oxford shoulder score), strength and range of movement were recorded. During the exercise participants were video recorded to quantify range of movement and extract movement profile features. Participants comments were recorded and followed up four days later to check for adverse events. Fifteen participants, (6F:9M) were recruited with median (IQR) Oxford Shoulder Scores of 25 (18 to 39). All participants successfully completed the exercise intervention with only transient symptoms consistent with exercise being reported and achieving a median (IQR) rate of perceived exertion scores of 13 (12 to 13). Movement profile data was available for 12 out of 15 participants and suggests that exercise intensity did not compromise movement. An association between strength and shoulder function (R2 = 0.5147), Rate of perceived exertion (RPE) of the final effort against shoulder function and strength (R2 = 0.2344 and 0.1743 respectively) was identified. Participant comments were positive regarding the exercise intervention. Our study demonstrates that an intermittent arm cycling programme is feasible for people affected by FSHD. Further work is needed to evaluate physiological responses to exercise across variations in programme variables and equipment set up in a larger sample of people affected by FSHD.Funder: The Orthopaedic Institute Limited; Grant(s): RPG16
“It’s not just a man’s world” – Helping female sport psychologists to thrive not just survive. Lessons for supervisors, trainees, practitioners and mentors.
Get PDFThis is a pre-publication version of the following article: Lafferty, M. E., Coyle, M., Prince, H. R., & Adrienn Szabadics, A. (2022). “It’s not just a man’s world” – Helping female sport psychologists to thrive not just survive. Lessons for supervisors, trainees, practitioners and mentors. Sport & Exercise Psychology Review, 17(2).In the following article we present composite narratives of female sport and exercise psychologist’s (SEPs) reflections of working as practitioners in situations where they have faced sexism and a culture of toxic masculinity. We discuss the impact both professionally and personally of these experiences and look at what lessons can be learned from the sharing of these narratives. We conclude by offering our thoughts on how these negative shared experiences can be used in a positive way to inform culture change, educate supervisors of the challenges and be woven into supervision so female practitioners feel empowered and supported
Intellectual disability and autism in adults influence psychological treatments for mental health comorbidities
Get PDFThis author accepted manuscript is deposited under a Creative Commons Attribution Non-commercial 4.0 International (CC BY-NC) licence. This means that anyone may distribute, adapt, and build upon the work for non-commercial purposes, subject to full attribution. If you wish to use this manuscript for commercial purposes, please contact [email protected] health conditions are often underdiagnosed in adults with intellectual disability and do not always receive psychological interventions as recommended by the National Institute for Health and Care Excellent guidelines. To realise the national UK programme’s aim of stopping overuse of medications in people with intellectual disability, it is important that these individuals have access to appropriate non-pharmacological interventions. We examined the relationship between an individual’s level of intellectual disability and presence or absence of autism with access to relevant non-pharmacological interventions from specialist community intellectual disability services.
A cross-sectional study of adults accessing four specialist intellectual disability services in North West England in 2019.
There was high prevalence of mental health co-morbidity, even higher for autistic adults. However, a relatively small percentage of the study population were receiving psychological interventions. The most frequent non-pharmacological intervention was positive behaviour support plan, irrespective of comorbid mental illnesses.
Not having access to psychological interventions for the treatment of mental illness could result in poor health outcomes and increasing health inequalities. The study highlights the need for developing psychological interventions particularly for those with moderate to severe intellectual disability and for those with associated autism.
This large sample study examined the relationship between intellectual disability level and presence of autism with accessing psychological interventions
An Examination of the Social and Physiological Experience of Captive Livingstone’s Fruit Bats (Pteropus livingstonii)
Get PDFThis thesis presents a series of empirical studies designed to quantify the complex social and physiological experiences of individuals within the captive population of a critically endangered bat species, the Livingstone’s fruit bat (Pteropus livingstonii). The ultimate goal of this work was to apply leading-edge methodologies and technology to gain novel, evidence-based insights into the behaviour and welfare of this species in captivity. This work has not only informed the captive management of P. livingstonii, but has also developed techniques that can be applied to maximise the captive welfare of a range of other species.
A brief summary, explaining how each chapter is embedded within the overall thesis and summarising its major findings, precedes each chapter. Chapter One, the introductory chapter, will start by evaluating our current understanding of the natural history and behavioural ecology of P. livingstonii, with a focus on captive behaviour. The following sections of this chapter will then provide necessary background information to the methodologies applied in subsequent data chapters, including social network analysis, space use assessment, hormone analysis and radio-frequency identification technology. The introductory chapter is intended to provide the reader with sufficient scientific context to interpret the results of each data chapter.
Chapter Two outlines the implementation of social network analysis to characterise individual social experiences in the largest captive population of P. livingstonii, housed at Jersey Zoo. Variation in network complexity and significant individual variable-based assortment is identified in this chapter. Chapter Three presents principal component analysis as a novel compliment to traditional enclosure use assessment methodologies, quantifying the individual spatial preferences of P. livingstonii. This chapter also quantifies the relationship between high-value resource location within the enclosure at Jersey Zoo and population-level space use. Chapter Four outlines the validation and application of an enzyme immunoassay to non-invasively measure faecal cortisol in the P. livingstonii population. This chapter examines the relationship between cortisol titres, individual social roles and behavioural frequencies performed by individuals in the captive population. We find that males, older individuals and lactating females have higher concentrations of cortisol than non-lactating females and younger individuals and that social roles related to conspecific affiliation were linked to decreased cortisol titres. Lastly, Chapter Five demonstrates the application of unique radio-frequency identification technology to autonomously collect individual locational data. The resulting dataset was then utilised to interrogate the foraging network displayed by P. livingstonii and Pteropus rodricensis (a
cohabitating heterospecific) populations housed at Jersey Zoo, elucidating the relationship between individual bat characteristics and social foraging patterns. Finally, the discussion chapter evaluates the significance of the main findings of each chapter of this thesis, highlighting the wider applicability of results and methodologies to the assessment of captive animal welfare. This section also critically discusses recent challenges to hypothesis testing in the field of animal social network analysis, to evaluate the validity of methods utilised throughout this thesis. Finally, future research directives leading on from this work which may provide further benefit to the management of captive populations are proposed
Cycle campaigning for a just city
Get PDFCampaigning bodies and local actions and activism have significant impacts on the development of local infrastructural plans for cycling. These voices are frequently homogenized as presenting a unified voice. For strategic reasons, this may be an appropriate tactic. Yet in doing so, important dimensions of discussion can be missed, especially those that rethink the urban environment beyond the immediate focus of change. This paper examines a particular set of disputes between proponents of vehicular cycling and those concerned with a broader vision of mobility justice. Using ethnographic and autoethnographic methods, it shows how there are important issues of gender politics hidden in these discussions. A secondary concern of the study, arising from the research methodology, is to acknowledge and show the location of academic research within campaign communities. These analyses have implications for how planning and consultation processes are developed and implemented
The physiological, perceptual and neuromuscular responses of team sport athletes to a running and cycling high intensity interval training session
Get PDFThe version of record of this article, first published in [European Journal of Applied Physiology], is available online at Publisher’s website: http://dx.doi.org/10.1007/s00421-022-05053-8Purpose: The acute physiological, perceptual and neuromuscular responses to volume-matched running and cycling high intensity interval training (HIIT) were studied in team sport athletes. Methods: In a randomized cross-over design, 11 male team sport players completed 3 x 6 min (with 5 min between sets) repeated efforts of 15 s exercising at 120% speed (s"V" ̇O2max) or power (p"V" ̇O2max) at VO2max followed by 15 s passive recovery on a treadmill or cycle ergometer, respectively. Results: Absolute mean "V" ̇O2 (ES [95%CI] = 1.46 [0.47-2.34], p 90% VO2max during the HIIT was higher for running compared to cycling (ES [95%CI] = 1.21 [0.26-2.07], p = 0.015). Overall differential RPE (dRPE) (ES [95%CI] = 0.55 [-0.32-1.38], p = 0.094) and legs dRPE (ES [95%CI] = -0.65 [-1.48-0.23], p = 0.111) were similar whereas breathing dRPE (ES [95%CI] = 1.01 [0.08-1.85], p = 0.012) was higher for running. Maximal isometric knee extension force was unchanged after running (ES [95%CI] = -0.04 [-0.80-0.8], p = 0.726) compared to a moderate reduction after cycling (ES [95%CI] = -1.17 [-2.02- -0.22], p = 0.001). Conclusion: Cycling HIIT in team sport athletes is unlikely to meet the requirements for improving run-specific metabolic adaptation but might offer a greater lower limb neuromuscular load
Dietary restriction and ageing: Recent evolutionary perspectives
Get PDFDietary restriction (DR) represents one of the most robust interventions for extending lifespan. It is not known how DR increases lifespan. The prevailing evolutionary hypothesis suggests the DR response redirects metabolic resources towards somatic maintenance at the expense of investment in reproduction. Consequently, DR acts as a proximate mechanism which promotes a pro-longevity phenotype. This idea is known as resource reallocation. However, growing findings suggest this paradigm could be incomplete. It has been argued that during DR it is not always possible to identify a trade-off between reproduction and lifespan. It is also suggested the relationship between reproduction and somatic maintenance can be uncoupled by the removal or inclusion of specific nutrients. These findings have created an imperative to re-explore the nexus between DR and evolutionary theory. In this review I will address this evolutionary conundrum. My overarching objectives are fourfold: (1) to outline some of the evidence for and against resource reallocation; (2) to examine recent findings which have necessitated a theoretical re-evaluation of the link between life history theory and DR; (3) to present alternatives to the resource reallocation model; (4) to present emerging variables which potentially influence how DR effects evolutionary trade-offs
Human-controlled reproductive experience may contribute to incestuous behavior observed in reintroduced semi-feral stallions (Equus caballus)
Get PDFEquine reproductive behavior is affected by many factors, some remaining poorly understood. This study tested the hypothesis that a period of captivity during the juvenile period and human-controlled reproduction may potentially be involved in the disruption of the development of incestuous mating avoidance behavior in sanctuary-reintroduced male Konik polski horses. Between 1986 and 2000, cases of incestuous behavior in harem stallions born and reared until weaning in the sanctuary were studied. Eight males lived in the sanctuary’s feral herd for the rest of their lives (the non-captive group; nC). They gained their own harem of mares without human intervention (no human-controlled reproductive activity, nHC). Another five stallions were removed as weanlings, reared in captivity and then reintroduced as adults (captive, C). Three of these C stallions were used as in-hand breeding stallions, one as a “teaser” (human-controlled reproductive activity, HC) and one was not used for reproduction in captivity (nHC). Reproductive records for 46 mares, daughters of all 13 harem stallions, were scrutinized and cases of incestuous breeding were recorded by interrogation of foal parentage records. C stallions failed to expel more daughters than nC stallions (33% vs. 18%, P = 0.045), and mated with significantly more of them (28% vs. 11%, P = 0.025). Interestingly, HC stallions expelled fewer (60%) and successfully mated with more (33%) daughters that nHC stallions (84% expelled, P = 0.013, and 10% successful mating with daughters, P = 0.010). All HC stallions bred incestuously at least once.
We propose that human intervention during a critical period of development of social and reproductive behavior in young stallions, by enforced separation from their natal herd and in-hand breeding, may contribute to their later aberrant behavior and disruption of inbreeding avoidance mechanisms in these stallions. The previous occurrence of human-controlled breeding may be one of the factors promoting incestuous behavior of stallions in natural conditions. The uninterrupted presence of stallions in their harems and herd member recognition may also play important roles in inbreeding avoidance in horses
The Application of CBT for Adults with Learning Disabilities
No full textThe chapter provides an evidence-based overview of predominantly cognitive behavioural interventions for common mental disorders, e.g. anxiety and depression, undertaken in the field of intellectual disabilities (ID).
The evidence was generated by reviewing international publications between 1980 - 2020 which identified the use of Cognitive Behavioural Therapy (CBT), including third wave CBT therapies and also informed from our extensive clinical practice in the field of ID.
The first section provides an outline of the historical and sociological context of psychological therapies and the possible barriers to CBT in an ID population. The chapter includes a summary of how intellectual disabilities, depression and anxiety disorders are defined. It considers key issues, problems and solutions, associated with applying CBT and its associated approaches in an ID population.
Finally, two case vignettes introduce the reader to CBT techniques to illustrate ideas that will help clients using CBT to bring about a reduction in self-defeating behaviours. With the aid of a support worker and electronic sources, there is a much broader range of resources to help client and therapist journey and support the therapeutic alliance
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