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Background: Pregnant women are at increased risk of complications from flu, but uptake of flu vaccination is below 75% targets. Evidence suggests that changing illness risk appraisals may increase vaccination behaviour. In 2018-2019, researchers, public health specialists, and pregnant women co-designed a short animation targeting (unhelpful) beliefs underlying pregnant women's flu risk appraisals aiming to promote vaccination uptake. Aims: This study aimed to examine effectiveness of a digital intervention (animation) in increasing flu vaccination among pregnant women through changing illness risk appraisals. Method: A prospective study design was used, involving convenience sampling of unvaccinated pregnant women recruited via a Qualtrics Online Panel. Participants received small payments via the panel for survey completion. Risk appraisals and intention to vaccinate were measured at baseline and immediately after intervention presentation (follow-up one). Six months later, a further survey (follow-up two) was administered measuring vaccination behaviour. Results: Baseline and first follow-up surveys were completed by 411 participants. Watching the animation led to increased appraisals of likelihood of getting flu while pregnant and severity of flu during pregnancy, and increased intentions to accept flu vaccination during pregnancy. Of the 67 respondents who completed follow-up survey two, 38 reported having the vaccination while pregnant. Conclusions: This study provides evidence supporting the promise of the intervention. Randomized controlled trials are required to produce definitive efficacy evidence. Should such a study prove intervention effectiveness, it could be readily embedded within existing campaigns at national and local levels by public health organizations.

The article focuses on advocating for a holistic approach to female athlete health and performance, moving beyond the narrow focus on the menstrual cycle as a key determinant. Topics include the influence of gendered sociocultural factors on performance and access to resources; the psychological challenges faced by female athletes in sports environments; and the need for interdisciplinary support systems to address these complex issues comprehensively.

Background: Obstetric anal sphincter injury is the most common cause of anal incontinence for women, which often has profound impacts on women's lives. GPs offer a first line of contact for many women, but we know that very few women experiencing anal incontinence postnatally report discussing it with their GPs. Aim: To identify key ways in which GPs can support women with anal incontinence caused by childbirth injuries. Design and setting: A qualitative study investigating women's experiences with their GP, and GPs' perspectives about providing such care. Method: This qualitative study combined two phases: first, a series of in-depth semi-structured interviews with women experiencing anal incontinence caused by childbirth injuries (n = 41); and second, focus groups with GPs (n = 13) stratified by experience. Thematic analysis was conducted and relevant themes from across the two datasets were examined. Results: Mediating factors in GP care for women with anal incontinence caused by childbirth injuries centred around three key themes: the role of the GP, access and pathways, and communication. Conclusion: The findings demonstrate multifactorial challenges in identifying the problem and supporting women experiencing anal incontinence after childbirth injury in primary care settings. Many GPs lacked confidence in their role in supporting women, and women were often reluctant to seek help. Those women who did seek help often experienced frustrations consulting with their GPs. In a context where women are often reluctant to ask for help, their concerns are not always taken seriously, and where GPs do not routinely ask about anal incontinence, potential anal incontinence after childbirth injury appears to be often missed in a primary care setting. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to explore experiences of women with anal incontinence following a childbirth injury, and to identify areas of missed opportunities within care they received. Design: This is a qualitative study involving semi-structured interviews. Setting: Participants were recruited via five hospitals in the UK, and via social media adverts and communication from charity organisations. Participants: Women who have experienced anal incontinence following a childbirth injury, either within 7 years of sustaining the injury, or if they identified new, or worsening symptoms of AI at the time of menopause. Main outcome measures: Main outcomes are experiences of women with anal incontinence following childbirth injury, and missed opportunities within the care they received. Results: The following main themes were identified: opportunities for diagnosis missed, missed opportunities for information sharing and continuity and timeliness of care. Conclusions: Anal Incontinence following a childbirth injury has a profound impact on women. Lack of information and awareness both amongst women and healthcare professionals contributes to delays in accurate diagnosis and appropriate treatment. [ABSTRACT FROM AUTHOR]

Background Little is known about private general practice appointment services offered via video. This study aimed to explore which patients are using a video pharmacy-based general practitioner (GP) appointment service, including patterns of use, reasons for using the service, and satisfaction with the service. Methods Descriptive statistics and parametric and nonparametric tests were used to conduct a retrospective cross-sectional analysis of routinely collected data on consultations, and postconsultation questionnaires. Interviews were conducted with patients and GPs. Results A total of 7,928 consultations were included in the analysis. More than half of appointments were booked for the same day, with lunchtime appointments being popular. The most common health condition was respiratory conditions, and 9% of consultations were used by patients using the service more than once. At least one prescription was issued in over half of all consultations. Overall, satisfactions of consultations were high. Conclusions The characteristics of those patients using the video consultation service match data on who uses online services in general practice. This study shows that some patients are willing to pay to use this private service because they feel it is more convenient, NHS services do not have capacity to see them at the time they need, or they do not have access to regular GP services. [ABSTRACT FROM AUTHOR]

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Voluntary and community sector organisations are increasing their role in supporting primary care services through 'social prescribing'. parkrun is a charity that delivers free, weekly 5 km events, on a Saturday morning in areas of open space across the UK and globally. In June 2018, parkrun and the Royal College of General Practitioners launched an initiative to encourage the linking of general practitioner practices and local parkrun events. This study investigates the interaction between parkrun events and practices in order to understand why and how parkrun events' promote such linkage, and their experiences of doing so. Its purpose was to provide practical recommendations for developing the parkrun practice initiative and similar collaborations between primary care and voluntary and community sector organisations. An online survey, which included both tick box questions and free text comments was sent to Event Directors for all UK parkrun events and completed by half (322/634, 50.8%). Over two‐thirds (225/322; 69.6%) of the event teams were knowingly linked with one or more general practices; and this was generally viewed as having been a positive experience and was motivated by wanting to positively impact on the health and well‐being of their community. Challenges centred on the process of initiating contact between parkrun events and practices; the lack of time among parkrun event volunteers to promote the scheme; and the difficulty of clarifying parkrun event and practice responsibilities, including who takes the lead. Practical recommendations include: ensuring clear pathways of communication between event teams and practices (e.g. via a Link Worker or designated person within the practice and/or parkrun event); minimising resource implications and ensuring mutual understanding from practices and parkrun event teams as to expected roles and involvement. Our findings, while focused on the parkrun practice initiative, are likely to have relevance to other collaborations between primary care and voluntary and community sector organisations. [ABSTRACT FROM AUTHOR]

The development of vaccines has been one of the major interventions in global health. Since they were first developed over two centuries ago, vaccines have played a prominent role in reducing morbidity and mortality from infectious diseases, including in pregnant women. The development of the coronavirus disease 2019 (COVID-19) vaccines has brought with it the possibility of reducing the high morbidity and mortality caused by this virus. This article focuses on the use of vaccines in pregnancy and discusses the benefits of maternal immunisation, recommended vaccines in pregnancy, the factors affecting uptake of vaccines, and COVID-19 vaccination in pregnancy. [ABSTRACT FROM AUTHOR]

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The anterior cruciate ligament (ACL) injury rate for girls/women has not changed in over 20 years, and they remain 3-6 times more likely to experience injury compared with boys/men. To date, ACL injury prevention and management has been approached from a sex-based biological point of view which has furthered our understanding of injury risk factors, mechanisms, and prevention and rehabilitation programmes. However, the traditional sex-based approach does not take into account the growing recognition of how sex and gender (a social construct) are 'entangled' and influence each other.Objective: This paper discusses the curious absence of gender as an influencer in the dialogue surrounding ACL injuries. We propose adding gender as a pervasive developmental environment as a new theoretical overlay to an established injury model to illustrate how gender can operate as an extrinsic determinant from the presport, training and competition environments through to ACL injury and the treatment environment.Approach: We draw on social epidemiological theories of the embodiment of gender and health to provide plausible examples of how gender may influence ACL injury, and demonstrate the opportunity for new, interdisciplinary research in the field.Conclusion: Over 20 years of research has failed to decrease the ACL injury rate disparity between girls/women and boys/men. Embedding gender in the study of ACL injury will heighten awareness of possible influences outside the traditional biological elements, challenge us to think about the inextricable 'entanglement' of sex and gender, and inform more effective approaches to ACL injury prevention and treatment. [ABSTRACT FROM AUTHOR]

Background: Missed GP appointments have considerable time and cost implications for healthcare services.Aim: This systematic review aims to explore the rate of missed primary care appointments, what the reported reasons are for appointments being missed, and which patients are more likely to miss appointments.Design and Setting: This study reports the findings of a systematic review. The included studies report the rate or reasons of missed appointments in a primary care setting.Method: Databases were searched using a pre-defined search strategy. Eligible studies were selected for inclusion based on detailed inclusion criteria through title, abstract, and full text screening. Quality was assessed on all included studies, and findings were synthesised to answer the research questions.Results: A total of 26 studies met the inclusion criteria for the review. Of these, 19 reported a rate of missed appointments. The mean rate of missed appointments was 15.2%, with a median of 12.9%. Twelve studies reported a reason that appointments were missed, with work or family/childcare commitments, forgetting the appointment, and transportation difficulties most commonly reported. In all, 20 studies reported characteristics of people likely to miss appointments. Patients who were likely to miss appointments were those from minority ethnicity, low sociodemographic status, and younger patients (<21 years).Conclusion: Findings from this review have potential implications for targeted interventions to address missed appointments in primary care. This is the first step for clinicians to be able to target interventions to reduce the rate of missed appointments. [ABSTRACT FROM AUTHOR]

Miller examines the "repositioning" of the "heterosexual plot" in Sydney Owenson's I O'Donnel i (1814) and Maria Edgeworth's I Ormond i (1817) in order to interrogate a "new and unstable" gentility and masculinity. In 1986, Jane Miller published I Women Writing about Men i , which made an initial foray into the examination of the depiction of male characters in literature from a female author's perspective. Miller argues that when a woman's story ends in marriage it cannot be the same as a man's adventure, as she positions women's ultimate narrative goal of the "marriage plot" as a counterpart to Sussman's "masculine plot".[6] In this argument, while men are afforded an ongoing story, in many Victorian texts marriage signals the "end" for women. [Extracted from the article]

Self-efficacy is an important determinant of health behaviour. Digital interventions are a potentially acceptable and cost-effective way of delivering programmes of health behaviour change at scale. Whether behaviour change interventions work to increase self-efficacy in this context is unknown. This systematic review and meta-analysis sought to identify whether automated digital interventions are associated with positive changes in self-efficacy amongst non-clinical populations for five major health behaviours, and which BCTs are associated with that change. A systematic literature search identified 20 studies (n = 5624) that assessed changes in self-efficacy and were included in a random-effects meta-analysis. Interventions targeted: healthy eating (k = 4), physical activity (k = 9), sexual behaviour (k = 3) and smoking (k = 4). No interventions targeting alcohol use were identified. Overall, interventions had a small, positive effect on self-efficacy (g ¯ = 0.190 , C I [ 0.078 ; 0.303 ]). The effect of interventions on self-efficacy did not differ as a function of health behaviour type (Q-between = 7.3704, p =.061, df = 3). Inclusion of the BCT 'information about social and environmental consequences' had a small, negative effect on self-efficacy (Δ g ¯ = − 0.297 , Q = 7.072 , p =.008). Whilst this review indicates that digital interventions can be used to change self-efficacy, which techniques work best in this context is not clear. [ABSTRACT FROM AUTHOR]

Since August 2015, a large range of sexual health and reproductive health services have been provided in more than 120 pharmacies across Birmingham (England). Our study aimed to explore how pharmacy staff and pharmacy users experience delivering or being provided with sexual health and reproductive health services. Between March and September 2019, semi-structured interviews were conducted with 15 pharmacy staff delivering sexual and reproductive health services and 15 people who had used a sexual and reproductive health service at the pharmacy. Interviews were analysed thematically. Pharmacy users found services convenient to use and were largely satisfied with pharmacy staff consultation skills. Staff were motivated to deliver the services, although some felt that they did not receive sufficient recognition for their work. Barriers to pharmacy-based sexual and reproductive health services were identified, including lack of privacy for users, lack of staff and user awareness of the services, lack of trained staff to deliver services and lack of capacity for copper coil insertions in females presenting for emergency contraception. The identification of barriers to effective service provision can be used to improve the delivery of sexual and reproductive health services in pharmacies and lead to a greater uptake. [ABSTRACT FROM AUTHOR]

Background: The parkrun practice initiative, a joint collaboration between parkrun and the Royal College of General Practitioners, was launched to encourage general practices to improve the health and wellbeing of patients and staff through participating in local 5 km parkrun events. Why and how practices engage with the initiative is unknown.Aim: To investigate engagement with and delivery of the parkrun practice initiative in general practice.Design and Setting: Mixed methods study conducted from April-July 2019 comprising an online survey of all registered parkrun practices, and interviews and a focus group with practice staff in the West Midlands.Method: The designated contacts at 780 registered parkrun practices were invited to complete an online survey. A purposive sample of parkrun practice staff and non-registered practice staff took part either in semi-structured interviews or a focus group, with transcripts analysed thematically.Results: Of the total number of parkrun practices, 306 (39.2%) completed the survey. Sixteen practice staff (from nine parkrun practices and four non-registered practices) took part in either semi-structured interviews (n = 12) or a focus group (n = 4). Key motivators for becoming a parkrun practice were: to improve patient and staff health and wellbeing, and to become more engaged with the community and enhance practice image. Practices most commonly encouraged patients, carers, and staff to take part in parkrun and displayed parkrun flyers and posters. Challenges in implementing activities included lack of time (both personal and during consultations) and getting staff involved. Where staff did engage there were positive effects on morale and participation. Non-registered practices were receptive to the initiative, but had apprehensions about the commitment involved.Conclusion: Practices were keen to improve patient and staff health. Addressing time constraints and staff support needs to be considered when implementing the initiative. [ABSTRACT FROM AUTHOR]

Training programs based on the Long-Term Athlete Development (LTAD) model ideally incorporate activities that optimise physical performance and create resilient athletes through promotion of movement competency and neuromuscular control. However, limited evidence exists regarding the relationship between movement control and physical performance. This study examined physical performance and movement control in adolescent athletes after participation in a 3-month training program and explored whether movement asymmetry predicts changes in physical performance. Twenty-five healthy athletes (16 female, 9 male; 14.6 ± 1.2 years of age) registered in a University youth athletic development program participated. Before and after the training program, athletes completed tests of physical performance [10 & 20 m sprints, countermovement jump (CMJ), Reactive Strength Index (RSI)] and movement control [Y-Balance test (YBT), Functional Movement Screen (FMS)]. Twenty metre sprint time (pre- 3.43 ± 0.20; post-test 3.39 ± 0.18 seconds, p=0.02), CMJ height (pre- 27.5 ± 4.4; post-test 29.5 ± 5.6 cm, p=0.002), and RSI (pre- 1.04 ± 0.42; post-test 1.20 ± 0.31, p=0.02) improved, but no change was observed in any of the movement control variables. Fewer FMS subtest asymmetries predicted greater improvement in jump height, however, YBT asymmetry, sex, and years to age of peak height velocity were not related to any of the significant improvements in performance. A youth training program, delivered 2-3x/week, improved sprint speed, jump height, and reactive strength, but did not affect movement control. Programs should perhaps consider inclusion of activities that target movement control more specifically. Movement control, as measured by YBT and FMS asymmetry, had limited influence on improvements in physical performance in youth athletes; the use of alternative measures in future studies may prove more successful. [ABSTRACT FROM AUTHOR]

The article examines literature about the innervation of the meniscus, the role of neural afferents and the surgical correction of meniscal lesions. Menisci are attached to the knee joint by coronary ligaments. Meniscus injuries or surgical procedures may decrease neuromuscular control and affect neural afferents. Following meniscal surgery, proprioceptive rehabilitation is imperative to restore knee function.

Background: Strong evidence supports the use of the FIFA 11+ injury risk reduction warm-up program among soccer players, but few studies have investigated its impact on physical performance and movement control in athletes younger than 12 years of age, or the athletes' opinions of participating in the program. Purpose: The primary purpose of this study was to measure the impact of the FIFA 11+ program on movement control [Landing Error Scoring System (LESS) and Y-Balance test (YBT)], agility, vertical jump (VJ) height, and trunk muscle endurance compared to a standard warm-up in pre-teen female athletes over one indoor soccer season. secondary purpose was to assess the athletes' tolerance and enjoyment of the program. Study Design: Cluster randomized controlled trial. Methods: All six teams in the U10 and U11 female divisions of a developmental-level soccer club were cluster randomized to the FIFA 11+ program intervention group or the control group. Participants in the control group continued with a coach-determined warm-up for the duration of a five-month indoor soccer season. Pre- and post-season participants underwent physical testing using the agility T-test, Belt Mat vertical jump (VJ), and static plank tests; and two measures of neuromuscular control (LESS, YBT). Following the soccer season, the athletes in the intervention group also completed a bespoke Tolerance and Enjoyment questionnaire. Results: The 11+ group (n=25) increased their mean static plank hold time by 26.1 ± 38.5 seconds compared to the control group (n=18), who only increased by 2.1 ± 37.1 seconds (p=0.047). For all athletes, there were improvements in mean LESS score (0.6 ± 1.3, p=0.003), and T-test time (0.4 ± 0.7, p=0.001); however, YBT scores worsened by approximately 2% from pre- to postseason. No differences were found for VJ. Athletes tolerated the program well, but the majority described the enjoyment of completing the program as moderately low. Conclusion: This study suggests that the 11+ program may improve some aspects of physical performance in 9-year-old female soccer players, but the low enthusiasm for the program could have longer term adherence implications. Level of Evidence: 2b [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Dental Hygiene is the property of Canadian Dental Hygienists Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Smoking in pregnancy remains a global public health issue due to foetal health risks and potential maternal complications. The aims of this systematic review and meta-analysis were to explore: (1) whether digital interventions for pregnancy smoking cessation are effective, (2) the impact of intervention platform on smoking cessation, (3) the associations between specific Behaviour Change Techniques (BCTs) delivered within interventions and smoking cessation and (4) the association between the total number of BCTs delivered and smoking cessation. Systematic searches of 9 databases resulted in the inclusion of 12 published articles (n = 2970). The primary meta-analysis produced a sample-weighted odds ratio (OR) of 1.44 (95% CI 1.04-2.00, p = .03) in favour of digital interventions compared with comparison groups. Computer-based (OR = 3.06, 95% CI 1.28-7.33) and text-message interventions (OR = 1.59, 95% CI 1.07-2.38) were the most effective digital platform. Moderator analyses revealed seven BCTs associated with smoking cessation: information about antecedents; action planning; problem solving; goal setting (behaviour); review behaviour goals; social support (unspecified); and pros and cons. A meta-regression suggested that interventions using larger numbers of BCTs produced the greatest effects. This paper highlights the potential for digital interventions to improve rates of smoking cessation in pregnancy. [ABSTRACT FROM AUTHOR]

Purpose: There is good evidence that for many behaviours, increasing risk appraisal can lead to a change in behaviour, heightened when efficacy appraisals are also increased. The present systematic review addressed whether interventions presenting a risk message increase risk appraisal and an increase in vaccination intentions and uptake.Method: A systematic search identified randomized controlled trials of interventions presenting a risk message and measuring risk appraisal and intentions and uptake post-intervention. Random-effects meta-analyses investigated the size of the effect that interventions had on vaccination risk appraisal and on vaccination behaviour or intention to vaccinate, and the size of the relationship between vaccination risk appraisal and vaccination intentions and uptake.Results: Eighteen studies were included and 16 meta-analysed. Interventions overall had small significant effects on risk appraisal (d = 0.161, p = .047) and perceptions of susceptibility (d = 0.195, p = .025), but no effect on perceptions of severity (d = -0.036, p = .828). Interventions showed no effect on intention to vaccinate (d = 0.138, p = .195) and no effect on vaccination behaviour (d = 0.043, p = .826). Interventions typically did not include many behaviour change techniques (BCTs), with the most common BCT unique to intervention conditions being 'Information about Health Consequences'. Few of the included studies attempted to, or successfully increased, efficacy appraisals.Conclusions: Overall, there is a lack of good-quality primary studies, and existing interventions are suboptimal. The inclusion of additional BCTs, including those to target efficacy appraisals, could increase intervention effectiveness. The protocol (CRD42015029365) is available from http://www.crd.york.ac.uk/PROSPERO/. Statement of contribution What is already known on this subject? Previous research indicates that an increase in risk appraisal is associated with increased uptake in health-related behaviours. Research suggests that interventions increasing risk appraisal have a greater effect on intention when elements of efficacy appraisals are simultaneously increased. What does this study add? This is the first systematic review to examine the effect of interventions on risk appraisal and vaccination uptake using only experimental studies. Limitations of the interventions themselves, and those caused by study methods and reporting, mean that the potential value of this type of review is lost. Instead, its value is in shining a light on the paucity of experimental studies in this area, and the quality of methods and reporting used. Future experimental studies should examine interventions that focus exclusively on increasing risk and efficacy appraisal compared to controls, use conditional measures of risk, and improve reporting to enable both more accurate coding of intervention content and more accurate assessments of study bias. [ABSTRACT FROM AUTHOR]

Background: Influenza (flu) is an acute viral infection of the respiratory tract, which can lead to serious complications for individuals within at-risk groups. Evidence indicates that aspects of organization and delivery within GP practices can have an influence on the rates of flu vaccination uptake. Positive deviance is a methodological approach that facilitates identification of factors associated with high performance.Objective: To use positive deviance to isolate factors associated with high performance by comparing GP practices achieving high and low flu vaccination uptake.Methods: This was a qualitative study. A total of 18 practice managers and 2 GPs from 20 GP practices participated, 10 with high and low vaccination rates, respectively. Telephone interviews were conducted, audio recorded and fully transcribed. Framework Analysis was used to analyse the data.Results: High uptake practices were more likely than low uptake practices to have a lead member of staff who demonstrated tenacity, have aspirational uptake targets, have developed and used additional prompts within their IT systems to identify eligible patients, have GPs who were opportunistically vaccinating and use phone calls as a first-line strategy to invite patients for vaccination.Conclusions: This is the first known qualitative study to identify strategies used by UK GP practices to deliver seasonal flu vaccination programmes. It is one of few studies using the robust and novel approach of positive deviance to inform health care recommendations. This approach has offered new and more nuanced insights into GP practice factors associated high flu vaccination uptake beyond those captured through large-scale survey research. [ABSTRACT FROM AUTHOR]

A literary criticism is presented that analyzes depictions of the fat male body and eating in the books "Jorrocks’s Jaunts and Jollities," "Handley Cross or Mr. Jorrocks’s Hunt," and "Hillingdon Hall" by author R. S. Surtees. Topics include the consumption of meat, the management of appetite, and the national identity of cuisine.

An introduction is presented to the issue of the journal that discusses topics such as representations of the English traveller in the novel "Bleak House" by Charles Dickens, advertisements of men's fashion, and issues of masculinity related to the disabled male body.