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To explore the rigour of nurse-led quality improvement projects involving education, training or continuing professional development, and examine evaluation frameworks contained within.Healthcare organisations invest significantly in quality improvement in the pursuit of cost-effective, safe, evidence-based and person-centred care. Consequently, efforts to examine the success of investment in quality improvement activities are prominent, against a backdrop of rising healthcare expenditure, reforms, consumer expectations and feedback.A qualitative document analysis of quality improvement projects located in a local health district repository was undertaken.N = 3004 projects were screened against inclusion criteria, with n = 160 projects remaining for analysis. Projects were mapped to an adapted version of the Standards for QUality Improvement Reporting Excellence (SQUIRE), specifically the education extension (SQUIRE-EDU). Additionally, project evaluation frameworks were positioned within Kirkpatrick's four levels of training evaluation model. The SQUIRE checklist was also applied in line with EQUATOR guidelines.Of n = 60 completed projects assessed against four broad SQUIRE-EDU categories and relevant criteria, n = 36 were assessed not to have met any categories, n = 14 projects met one category, n = 8 projects met two categories, and n = 2 projects met three categories. None of the completed projects met all four SQUIRE-EDU categories. There was insufficient documentation relating to evaluation frameworks in n = 133 projects to position within Kirkpatrick's four levels of training evaluation.Scientific rigour should underpin all quality improvement efforts. We recommend that SQUIRE international consensus guidelines (full or abridged) should guide both the design and reporting of all local quality improvement efforts.To be of value to the expansion of evidence-based practice, quality improvement platforms should be designed to reflect the structural logic, rigour and reporting recommendations being advocated in consensus reporting guidelines. This may require investment in training and development programs, and identification of governance and support systems. No Patient or Public Contribution, as the study was retrospective in nature and involved a health service repository of quality improvement projects accessible to health service staff only.

Background Empirical evidence supports the use of structured goals of care conversations and documentation of life-sustaining treatment (LST) preferences in durable, accessible, and actionable orders to improve the care for people living with serious illness. As the largest integrated healthcare system in the USA, the Veterans Health Administration (VA) provides an excellent environment to test implementation strategies that promote this evidence-based practice. The Preferences Elicited and Respected for Seriously Ill Veterans through Enhanced Decision-Making (PERSIVED) program seeks to improve care outcomes for seriously ill Veterans by supporting efforts to conduct goals of care conversations, systematically document LST preferences, and ensure timely and accurate communication about preferences across VA and non-VA settings. Methods PERSIVED encompasses two separate but related implementation projects that support the same evidence-based practice. Project 1 will enroll 12 VA Home Based Primary Care (HBPC) programs and Project 2 will enroll six VA Community Nursing Home (CNH) programs. Both projects begin with a pre-implementation phase during which data from diverse stakeholders are gathered to identify barriers and facilitators to adoption of the LST evidence-based practice. This baseline assessment is used to tailor quality improvement activities using audit with feedback and implementation facilitation during the implementation phase. Site champions serve as the lynchpin between the PERSIVED project team and site personnel. PERSIVED teams support site champions through monthly coaching sessions. At the end of implementation, baseline site process maps are updated to reflect new steps and procedures to ensure timely conversations and documentation of treatment preferences. During the sustainability phase, intense engagement with champions ends, at which point champions work independently to maintain and improve processes and outcomes. Ongoing process evaluation, guided by the RE-AIM framework, is used to monitor Reach, Adoption, Implementation, and Maintenance outcomes. Effectiveness will be assessed using several endorsed clinical metrics for seriously ill populations. Discussion The PERSIVED program aims to prevent potentially burdensome LSTs by consistently eliciting and documenting values, goals, and treatment preferences of seriously ill Veterans. Working with clinical operational partners, we will apply our findings to HBPC and CNH programs throughout the national VA healthcare system during a future scale-out period.

Epidemiological studies of injury in elite and recreational golfers have lacked consistency in methods and definitions employed and this limits comparison of results across studies. In their sports-generic statement, the Consensus Group recruited by the IOC (2020) called for sport-specific consensus statements. On invitation by International Golf Federation, a group of international experts in sport and exercise medicine, golf research and sports injury/illness epidemiology was selected to prepare a golf-specific consensus statement. Methodological stages included literature review and initial drafting, online feedback from the consensus group, revision and second draft, virtual consensus meetings and completion of final version. This consensus statement provides golf-specific recommendations for data collection and research reporting including: (i) injury and illness definitions, and characteristics with golf-specific examples, (ii) definitions of golf-specific exposure measurements and recommendations for the calculation of prevalence and incidence, (iii) injury, illness and exposure report forms for medical staff and for golfers, and (iv) a baseline questionnaire. Implementation of the consensus methodology will enable comparison among golf studies and with other sports. It facilitates analysis of causative factors for injuries and illness in golf, and can also be used to evaluate the effects of prevention programmes to support the health of golfers.

Golf is a sport played around the globe, with an estimated 42.6 million people playing within the United Kingdom and United States of America alone. To date, there is limited data on the energy expenditure of golf. The present study assessed the activity energy expenditure (AEE) of 16 high-standard (handicap under 5) golfers who completed three rounds of competitive golf either carrying the golf bag (BC), using a manual push trolley (MT) or an electric trolley (ET) (Stewart Golf, Gloucester, UK). Prior to each round, participants were fitted with an Actiheart® accelerometer (Camntech, Fenstanton, UK) to estimate AEE, whilst ratings of perceived exertion (RPE) and enjoyment were collected following each round. Data were analysed using a one-way repeated measures ANOVA, with Hedges

Funder: Foundation for Liver Research, Funder: Royal Society and a CAMS-UK fellowship, The metabolic syndrome (MetS) is a cluster of cardiovascular risk factors characterised by central obesity, atherogenic dyslipidaemia, and changes in the circulating lipidome; the underlying mechanisms that lead to this lipid remodelling have only been partially elucidated. This study used an integrated "omics" approach (untargeted whole serum lipidomics, targeted proteomics, and lipoprotein lipidomics) to study lipoprotein remodelling and HDL composition in subjects with central obesity diagnosed with MetS (vs. controls). Compared with healthy subjects, MetS patients showed higher free fatty acids, diglycerides, phosphatidylcholines, and triglycerides, particularly those enriched in products of de novo lipogenesis. On the other hand, the "lysophosphatidylcholines to phosphatidylcholines" and "cholesteryl ester to free cholesterol" ratios were reduced, pointing to a lower activity of lecithin cholesterol acyltransferase (LCAT) in MetS; LCAT activity (directly measured and predicted by lipidomic ratios) was positively correlated with high-density lipoprotein cholesterol (HDL-C) and negatively correlated with body mass index (BMI) and insulin resistance. Moreover, many phosphatidylcholines and sphingomyelins were significantly lower in the HDL of MetS patients and strongly correlated with BMI and clinical metabolic parameters. These results suggest that MetS is associated with an impairment of phospholipid metabolism in HDL, partially led by LCAT, and associated with obesity and underlying insulin resistance. This study proposes a candidate strategy to use integrated "omics" approaches to gain mechanistic insights into lipoprotein remodelling, thus deepening the knowledge regarding the molecular basis of the association between MetS and atherosclerosis.

© 2019 National Strength and Conditioning Association Sampson, JA, Murray, A, Williams, S, Sullivan, A, and Fullagar, HHK. Subjective wellness, acute: chronic workloads and injury risk in college football. J Strength Cond Res 33(12): 3367-3373, 2019-Acute:chronic workload ratios (ACWRs) are associated with injury risk across team sports. In this study, one season of workload and wellness data from 42 collegiate football players were retrospectively analyzed. Daily 7:21 day exponentially weighted moving average (EWMA) ACWRs were calculated, and z-score fluctuations (“normal,” “better,” and “worse”) in sleep, soreness, energy, and overall wellness were assessed relative to the previous day ACWRs and considered as an interactive effect on the risk of noncontact injury within 0-3 days. Fifty-five noncontact injuries were observed, and injury risks were very likely higher when ACWRs were 2 SDs above (relative risk [RR]: 3.05, 90% confidence interval [CI]: 1.14-8.16) and below (RR: 2.49, 90% CI: 1.11-5.58) the mean. A high ACWR was trivially associated (p, 0.05) with “worse” wellness (r = 20.06, CI: 20.10 to 20.02), muscle soreness (r = 20.07, CI: 20.11 to 20.03), and energy (r = 20.05, CI: 20.09 to 20.01). Feelings of “better” overall wellness and muscle soreness with collectively high EWMA ACWRs displayed likely higher injury risks compared with “normal” (RR: 1.52, 90% CI: 0.91 to 2.54; RR: 1.64, 90% CI: 1.10-2.47) and likely or very likely (RR: 2.36, 90% CI: 0.83 to 674; RR: 2.78, 90% CI: 1.21-6.38) compared with “worse” wellness and soreness, respectively. High EWMA ACWRs increased injury risk and negatively impacted wellness. However, athletes reporting “better” wellness, driven by “better” muscle soreness presented with the highest injury risk when high EWMA ACWRs were observed. This suggests that practitioners are responsive to, and/or athletes are able to self-modulate workload activities.

Introduction Older adults with serious illness frequently receive post-acute rehabilitative care in nursing homes (NH) under the Part A Medicare Skilled Nursing Facility (SNF) Benefit. Treatment is commonly focused on disease-modifying therapies with minimal consideration for goals of care, symptom relief, and other elements of palliative care. Intervention The evidence-based Primary Palliative Care in Post-Acute Care (PPC-PAC) intervention for older adults is delivered by nurse practitioners (NP). PPC-PAC NPs assess and manage symptoms, conduct goals of care discussions and assist with decision making; they communicate findings with NH staff and providers. Implementation of PPC-PAC includes online and face-to-face training of NPs, ongoing facilitation, and a template embedded in the NH electronic health record to document PPC-PAC. Objectives The objectives of this pilot pragmatic clinical trial are to assess the feasibility, acceptability, and preliminary effectiveness of the PPC-PAC intervention and its implementation for 80 seriously ill older adults newly admitted to a NH for post-acute care. Methods Design is a two-arm nonequivalent group multi-site pilot pragmatic clinical trial. The unit of assignment is at the NP and unit of analysis is NH patients. Recruitment occurs at NHs in Pennsylvania, New Jersey, Delaware, and Maryland. Effectiveness (patient quality of life) data are collected at two times points—baseline and 14–21 days. Conclusion This will be the first study to evaluate the implementation of an evidence-based primary palliative care intervention specifically designed for older adults with serious illness who are receiving post-acute NH care., Highlights • ECC is used to make wall panel with large hollow ratio. • Experimental investigation and finite element analysis of wind resistance of ECC wall panel with large hollow ratio. • Influence of rib on rigidity and strength of wallboard.

This infographic outlines evidence-based recommendations on COVID-19 reverse transcriptase PCR (RT-PCR) testing in elite sport settings, aiming to protect personal and population health, and acknowledging resources and expertise that are often available in elite sport. Public health recommendations vary by country and region, and protocol decisions should be made in consultation with relevant public health authorities. An expert, multidisciplinary group with input from clinical virology, microbiology, public health, infectious diseases and sports medicine provides optimal implementation and interpretation of testing. Interventions to prevent COVID-19 transmission should be implemented consistently1 2 and should include The current gold standard of testing is RT-PCR testing.4–6 The test is highly sensitive and specific to SARS-CoV-2 viral RNA in laboratory conditions.2 Test results should be interpreted on the basis of the pretest probability, previous test …

The COVID-19 pandemic has had, and will have, profound effects on every person on earth. Measures advocated by the WHO and put in place by national governments, businesses and individuals will save millions of lives, but current movement restrictions (ie, various degrees of lockdown) cannot continue indefinitely. The activity restrictions imposed by governments are designed to reduce human-to-human transmission; they buy time and allow international collaboration between governments and internally to build and allocate the resources and systems to 1. Test: every suspected case where testing is merited and available while having effective prevention strategies in place. 2. Trace: follow up all confirmed cases of COVID-19 and contact trace every relevant contact to identify and cut off transmission. 3. Treat: manage all cases effectively, with adequate intensive care unit capacity, ventilators and staff. Rightly, professional sport has been placed on hold during the COVID-19 pandemic. The WHO (#BeActive) and many governments continue to promote certain types of moderate physical activity for the benefits it confers on the immune system and physical and mental health.1–4 Sport has health, social and economic benefits for individuals and society, and when the COVID-19 pandemic is better ‘controlled’, it may be appropriate to reintroduce community sport and professional sport. In this editorial, we opine on what needs to be in place for professional sport to recommence. The relaxation of movement/activity/business restrictions is likely to happen over a gradual period, and time frames will differ across nations and even within nations. The following is expected5

While sporting governing bodies prepare guidelines and policies to comply with social distancing requirements and governmental guidelines, and some may feel that such changes threaten the very existence of their sport, is there a hidden opportunity to be found among the noise? Elite team sports generate significant financial wealth and widespread media attention, but grass-roots participation rates in many traditional team sports have been decreasing, especially over the last 5 years.1 2 This contrasts with some data suggesting that physical activity levels actually may be increasing overall across the general population, especially among women and older people.1 This begs the question, are sports losing touch with the general population, and are people turning to non-traditional sports and individual activities for leisure-time physical activity? First of all, why might people be turning away from traditional team sports? We know that some of the most frequently cited barriers to participating in sporting activities include: not feeling fit enough to participate; lack of time; poor accessibility; cost and fear of injury.3 4 However, as opposed to consigning these important findings to the pages of medical journals, could sports embrace these barriers as challenges to enhance participation, and secure their futures? Positively, there are ‘bright-spots’ around the world, where these challenges have …

IntroductionRugby football (Union and League) provides physical activity (PA) with related physical and mental health benefits. However, as a collision sport, rugby research and media coverage predominantly focus on injuries in elite players while the overall impact on health and well-being remains unclear. This study aims to provide a greater understanding of the risks and benefits of rugby participation in a diverse sample of men and women, current and former rugby Union and League players from recreational to the elite level of play. We will explore: (1) joint-specific injuries and concussion; (2) joint pain and osteoarthritis (OA); (3) medical and mental health conditions; (4) PA and sedentary behaviour and (5) well-being (quality of life, flourishing and resilience).Methods and analysisThe Rugby Health and Well-being Study is designed in two phases: (1) a UK-wide cross-sectional survey and (2) cross-validation using health register data from Scotland. Participants will be at least 16 years old, current or former rugby players who have played rugby for at least one season. We will report standardised, level of play-, sex- and age-stratified prevalence of joint injury, concussion, medical conditions and PA. We will describe injury/concussion prevention expectations and protective equipment use. Rugby-related factors associated with injury, pain, OA, PA, health and well-being will be explored in regression models. We will compare joint pain intensity and duration, elements of pain perception and well-being between recreational and elite players and further investigate these associations in regression models while controlling for confounding variables. In the second phase, we will validate self-reported with health register data, and provide further information on healthcare use.Ethics and disseminationThe Yorkshire and the Humber—Leeds East Research Ethics Committee (REC reference: 19/HY/0377) has approved this study (IRAS project ID 269424). The results will be disseminated through scientific publications, conferences and social media.

ObjectiveTo scope the relationships between rugby union, and health and well-being.DesignScoping review.Data sourcesPublished and unpublished reports of any age, identified by searching electronic databases, platforms and reference lists.MethodsA three-step search strategy identified relevant published primary, secondary studies and grey literature, which were screened usinga prioriinclusion criteria. Data were extracted using a standardised tool, to form (1) a numerical analysis and (2) a thematic summary.Results and discussion6658 records were identified, and 198 studies met the inclusion criteria. All forms of rugby union can provide health-enhancing physical activity (PA). ‘Non-contact’ and wheelchair rugby in particular provide a wide range of physical and mental health and well-being benefits. The evidence is either mixed or unclear in relation to ‘contact’ rugby union and its effects on a range of physical health domains. Injury and concussion incidence rates are high for contact rugby union relative to other sports.ConclusionsA wide range of stakeholders as well as existing and potential participants can use this information to make a more informed decision about participating in and promoting rugby union as a health-enhancing activity. Industry and policy-makers can use this review to inform policies and strategies that look to increase participation rates and use rugby union as a vehicle to contribute positively to population health. Further research understanding rugby union’s contribution to PA as well as to muscle-strengthening and balance is indicated, as well as research examining more health and well-being outcomes across more diverse cohorts.

IntroductionCricket is a popular sport played by 2.5 billion people of all ages and abilities. However, cricket participation is decreasing in the UK, despite an increased focus of governments on increasing sport participation to enhance public health. Understanding the health benefits and mitigating the health risks of cricket participation may help cricket organisations promote cricket participation while optimising the long-term health of cricket participants. Currently, there is no literature review on the relationship between cricket participation, health and well-being; thus, this relationship remains unclear. Therefore, the aims of this scoping review were (1) to investigate the relationship between cricket participation, health and well-being and (ii) to identify the research gaps related to cricket, health and well-being.Methods and analysisDue to the broad nature of our research question and the large number of health outcomes assessed within the cricket literature and to facilitate identification of research gaps, a scoping review methodology was used. The methodology of this paper was informed by previous scoping review protocols and best practice methodological frameworks. MEDLINE, CINAHL, Embase, Scopus, PsycINFO, SPORTDiscus, Cochrane Library, EBSCO, Web of Science and PEDro and grey literature sources (Google Scholar, ClinicalTrials.gov, ISRCTN Registry and ProQuest) will be systematically searched. Studies that assess a construct related to health and/or well-being in current and/or former cricketers from all ages and standards of play will be eligible. Two reviewers will independently screen full texts of identified studies for eligibility and will perform data extraction. Results will be presented in tabular and graphical forms and will be reported descriptively.Ethics and disseminationThis research is exempt from ethics approval due to the data being available through published and public available resources. Results will be published in a peer-reviewed sports and exercise medicine journal regardless of positive or negative findings. In addition, results will be disseminated through multiple platforms, including conference presentations and social media using multimedia resources (eg, infographics, animations, videos, podcasts and blogs), to engage stakeholder groups, including cricketers, cricket coaches, sporting bodies, sports medicine professionals and policy makers. There findings will inform clinical decision making, policy changes and future research agendas.

ObjectiveThe distribution of injuries affecting professional golfers is yet to be fully understood. We performed a systematic review of the clinical literature to establish the epidemiology of musculoskeletal injuries affecting professional golfers.DesignSystematic review.Data sourcesSearched databases in July 2018 were PubMed, SPORTDiscus and Embase.Eligibility criteriaPublished observational research articles relating to the incidence or prevalence of musculoskeletal injuries in professional golfers, which were written in the English language and not restricted by age or gender.ResultsOf the 1863 studies identified on the initial search, 5 studies were found to satisfy the inclusion criteria for analysis. The mean age of the golfers in these studies was 34.8 (±3.6) years. The gender of patients in included studies compromised 72% males and 28% females. Four studies reported that lumbar spine injuries were the most common (range 22%–34%). Excluding injuries to the spine (lumbar, thoracic and cervical), the hand/wrist was the next most common region of injury (range 6%–37%). The quality of the studies was relatively poor with no study satisfying >50% of the quality assessment tool questions and only one study giving a clear definition of how they defined injury.ConclusionThere is a paucity of well-designed epidemiological studies evaluating musculoskeletal injuries affecting professional golfers. Injuries to the spine are the most frequently affected region, followed by the hand/wrist. This study has identified targeted areas of future research that aims to improve the management of injuries among professional golfers.

New knowledge from research findings rarely produces rapid efficient changes in practice.1 Barton and Merolli2 proposed a model which may help improve knowledge translation via the addition of two novel contemporary steps: multimedia creation and subsequent dissemination (see figure 1). Figure 1 Visual representation of a process to improve knowledge translation based on Barton and Merolli’s model.2 Following this model, we recently produced digital/multimedia resources to help communicate and disseminate the International Consensus on Golf and Health.3 A systematic literature review and modified Delphi process underpinned the International Consensus on Golf and Health and this was published in the British Journal of Sports Medicine in 2018.3 The Consensus is intended to support (1) golfers and potential golfers; (2) golf facilities and the golf industry; and (3) policy makers to make evidence-informed decisions that can maximise the health benefits of golf and minimise the health risks associated with this sport. Articles containing visual information are …

IntroductionThe dissemination of research, and evaluation of its impact is an increasing priority for the scientific community and funders. We take the topic of golf and health and aim to outline processes that may contribute to improved research uptake, use and impact proposing a research impact (RI) tool. We then evaluate our published research using the Research Contributions Framework (RCF).MethodsBuilding on existing research and frameworks we i) assessed the need for, ii) carried out and iii) published research, before iv) creating digital resources, v) sharing these resources widely and vi) evaluating our research.To evaluate uptake, use and impact of our three principal golf and health research outputs, we performed a contributions analysis, using the RCF first proposed by Morton.Results/DiscussionWe developed a specific six-step Research Impact tool. Having implemented this, research uptake and use included over 300 press articles, a dedicated website and social media channels. Golf’s global industry leadership dispersed information across >150 countries, embedded golf and health into curricula for industry professionals and used leading tournaments to promote health. National policy makers hosted dedicated meetings regarding golf and health and began to implement policy change.ConclusionTo date, strong uptake and use can be demonstrated for these studies, while a final contribution to impact requires further time to determine.Frameworks we used aiming to maximise impact (Research Impact tool) and evaluate its contribution to uptake, use and impact (Research Contribution Framework) could potentially add value to public health/sports medicine researchers.

Our scoping review was the first ‘big picture’ review to identify the relationships between rugby union, and health and well-being. Data suggest that all forms of rugby union (contact, non-contact and wheelchair) can provide moderate to vigorous physical activity, and can contribute to non-sedentary time, both of which have a raft of associated health and well-being benefits.1 National population surveys also consider rugby union as an activity that can provide muscle-strengthening/balance improvement when accrued for period of over 10 minutes,2 and ‘ball sports’ are generally considered to improve muscle function, bone health and balance.3 ‘Non-contact’ and …

There you are, spending hours, days, months maybe even years on your research. You go ahead and publish it and alas! Those stress-filled seasons turn into a meagre 10 downloads. ‘ No one gets how important this is!’ you cry. Let us at the B ritish Journal of Sports Medicine (BJSM), prepare cushions around you and break it to you: it’s not them, it’s you! You expected a dopamine reward kick, but you have missed out because you’ve only done two-thirds of the work—the research part and the publish part. That last part is communicating your work. Why? Well, for you. It’s part of your personal growth- the more people your work reaches, the better engagement you’ll have1 2 and the better the discourse around your topic will be! We believe it’s your professional duty to get the word out in a way that works for your audience. And it’s not only us. Funding agencies, academic institutions and …

Illnesses can impair sports participation and performance in athletics training or competition (including major championships).1 Travel, jet lag, changes in climatic/environmental conditions and changes in food habits, in addition to the competition per se, could predispose athletes to illness in major championships context.2–4 During international athletics championships, an incidence of illnesses between 20 and 68 per 1000 registered athletes have been reported.2 3 5 6 However, extended and deeper epidemiological analyses are needed to develop effective illness prevention strategies. Therefore, this study aimed to describe the occurrence and characteristics of illnesses at international athletics championships with regards to sex (male and female athletes), disciplines (explosive and endurance) and championships type (indoor and outdoor). In major athletics championships between 2009 …

The first Global Action Plan for Physical Activity1 (GAPPA) has been launched by the World Health Organisation. The cover is shown in figure 1. Increasing physical activity (PA) will improve health. The science is strong on the benefits for people of all ages. The role PA plays in reducing the risk of non-communicable diseases, such as cardiovascular disease, type 2 diabetes and depression, is well recognised.2 3 Increasing PA is a global health priority and can also contribute towards attaining many of the 17 United Nations Sustainable Development Goals set for 2030.4 Many countries have produced quality research and good policy frameworks on PA but large gaps remain between what we know/advise and what we do. These gaps were neatly described by Brownson et al as ‘parallel universes’.5 What is needed is a coherent route map to guide policy action and to support partnerships and help implement approaches that increase PA across the globe. GAPPA now provides that common road map. GAPPA did not happen overnight. Over a decade of …

Infographics are attracting attention as a mechanism for conveying health messages to the general population and healthcare professionals.1 Infographics are also appearing within traditional scientific publications as a form of a ‘visual abstract’ to summarise findings,2 or as a stand-alone publication.3 This suggests that students as well as professionals1 should be aware of these forms of visual communication. Therefore, it seems logical to incorporate infographics within academic courses where they could have a range of teaching, learning and assessment roles. Producing an infographic may be an effective way of helping students appreciate their value. This editorial describes how production of an infographic was used as part of an assessment task on a sport nutrition course delivered to sport and exercise science students, and seeks to raise awareness of their use in academic courses. It is important that students in the sport and exercise sciences develop the ability to communicate their knowledge effectively. This includes scientific audiences and athletes and patients, as well as …

Much of the professional development offered to school teachers centers on quantifiable aspects of teaching and learning that correlate to external inspection processes. Insufficient attention is given to the student-teacher relationship and the dynamics contained within; in more “challenging” schools, this is central to the progress of students. Current models of reflective practice offer little in considering the emotional impact of teaching and learning on all parties involved. Training in psychoanalytic observation allows classroom teachers to consider both personality development and the psychodynamics of the institution itself in greater detail, allowing them an alternate focus through which to practice reflectively and creating a more containing learning environment for both their students and themselves.

The changes in daily countermovement jump (CMJ) and activity profile of male rugby 7 players during the 3-week period immediately before international competition were examined. Velocity and distance data were measured via a 10-Hz global positioning system from 12 international-level athletes on 11 ± 1 occasions. Work rate (m∣min), total distance (TD), high-intensity distance (HID, >5.00 m·s(-1)), high-intensity work rate (meter per minute, >5.00 m·s(-1)), tackle number, and repeated high-intensity efforts (RHIEs) defined the activity profile along with session duration (minutes). CMJ performance was measured via percentage change from an individual best using a 5-jump protocol. A one-way repeated-measures ANOVA was selected to determine any change in CMJ performance across the training mesocycle. Effect sizes (ESs) were calculated to determine the magnitude of effects. No significant differences were noted in CMJ percentage change (p = 0.27). Significant differences were noted in work rate (p = 0.001, ES [range across the 3-week mesocycle]: 0.13-0.68), HID work rate (p = 0.001, ES: 0.35-0.75), RHIEs count (p = 0.002, ES: 0.03-0.61), tackle count (p < 0.001, ES: 0.13-0.90), HID (p < 0.003, ES: -0.32 to 0.32), and training duration (p < 0.001, ES: 0.37-1.36). No significant differences were noted in HI accelerations, player load, or TD. Rugby sevens players maintain CMJ performance throughout the final preparation period when the training load is managed.

Programme card #### Country/coverage #### Target population #### What modes/types/domains of physical activity does the programme promote? #### Which of the seven best investments does the programme address? #### What sectors does it involve? #### What is special about this programme? #### Key contact #### Programme website The Scottish Government recognises that increasing physical activity is crucially important for the mental and physical health of our country. Big health gains come from getting inactive people more active, particularly in the outdoors. The argument is compelling, and our aim to get more people active, more often is clear. The question we face in Scotland, and indeed worldwide, is ‘how do we achieve this’. We recognise no single intervention will work for all, and that cross-sectoral …

Objectives: Establish current practice and attitudes towards recovery in a group of Division-1 Collegiate athletes from North America.Design: A 16-item questionnaire was administered via custom software via an electronic format.Participants: 152 student athletes from a Division-1 Collegiate school across 3 sports (Basketball, American Football, Soccer).Main Outcome Measures: The approaches and attitudes to recovery in both training and competition.Results: Sleep, cold water immersion (CWI) and nutrition were perceived to be the most effective modalities (88, 84 and 80% of the sample believed them to have a benefit respectively). Over half the sample did not believe in using compression for recovery. With regard to actual usage, CWI was the most used recovery modality and matched by athletes believing in, and using, the approach (65%). Only 24% of student athletes believed in, and used, sleep as a recovery modality despite it being rated and perceived as the most effective.Conclusions: Collectively, there is a discrepancy between perception and use of recovery modalities in Collegiate athletes.

Fowler, PM, Murray, A, Farooq, A, Lumley, N, and Taylor, L. Subjective and objective responses to two rugby sevens world series competitions. J Strength Cond Res 33(4): 1043-1055, 2019-The purpose was to examine the utility of subjective and objective measures of player preparedness, interpreted at both group level and individual level, during 2 consecutive competitions of the World Rugby Sevens Series (WRSS). Subjective (sleep, energy, and muscle soreness ratings) and objective (heart rate [HR] at rest [HRREST] and in response to submaximal exercise [HREX]) measures were obtained from 16 male rugby 7s players from 1 team for 3 consecutive days (D1-3) at home (HOME) and on arrival at 4 tournament (T1-4) locations (T1-New Zealand; T2-USA; T3-Hong Kong; and T4-Tokyo) across 2 WRSS competitions (2 tournaments per competition) separated by 1 month. At a group level, energy ratings were significantly lower in T2 and T4 compared with HOME, and on D1 T2 compared with D1 T1 (p ≤ 0.05). Greatest variability in subjective ratings was observed during T1 and T3 at an individual level, particularly for sleep quality. Although at a group level HRREST and HREX significantly decreased in T1-4 compared with HOME (p ≤ 0.05), there was only a ∼50% agreement between the direction of change in HR indices at an individual level. Results from this study suggest that relocation between tournaments within WRSS competitions disrupts player preparedness measures to the largest degree. Hence, this period could be targeted by practitioners with appropriate recovery and/or sleep-promoting interventions or modulation of match-/training-load. Moreover, subjective rather than objective measures seem to be of greater use to inform player preparedness decision making, particularly at an individual level compared with a group level.

The authors wish to thank Paths for All, the European Tour Golf, and 4sports for their input and collaboration at the Paul Lawrie Matchplay tournament. Tournament host Paul Lawrie, as a player provided …

Attendance at international sports and physical activity conferences is extremely useful for networking but can be expensive in terms of professional time, conference fees, accommodation and travel. The use of social media, especially Twitter,1 has increased in many global meetings. It is now possible to map, virtually attend, influence and interact with a meeting, remotely making savings in terms of time and travel, as well as opening up opportunities for sharing research and facilitating global networking. Data science has progressed rapidly to create complex forms of visualisation to help us understand interactions between humans. The speed and rate at which data are produced can be phenomenal. ‘Big Data’ is now an acknowledged specialist area of science. Processing, analysing and relaying data present challenges. The main goal of visualisation is to present data clearly by graphical means without distortion.2 Twitter hashtags and handles (eg, @BJSM_BMJ) are a useful way of grouping data, studying and ultimately building networks.3 For example, the 6th ISPAH International Congress on Physical Activity and Public Health4 ran between 16 and 19 November 2016 in Thailand. For the @ISPAH2016 meeting, the …

Increasing greenhouse gas emissions, and physical inactivity are major global challenges of the 21st century.1 Tackling climate change and increasing physical activity are key priorities at local, national and international level. We need to act now to prevent or limit the impacts on our children and future generations (figure 1). Figure 1 Best Investments for Physical Activity, includes active travel and suggests “working together to make it happen”. The Scottish Government has committed to doubling spend on the active travel budget from £40 million per year to £80 million per year from 2018 to 2019 (figure …

Physical inactivity's propensity to cause preventable morbidity and mortality grossly is under-recognized by both the public and by health care professionals. If health care professionals are serious about doing the best for every patient every patient visit, then we must be skilled in assessing physical activity levels as well as providing appropriate advice and must be able to guide patients through options and to activity. We have a professional duty and responsibility to know and deliver best treatments as well as keep ourselves up to date with and strive for the current best practice. Physical activity is central to health, and doing nothing is not a responsible option for our patients or health care professionals. More importantly, there is an urgent need for all health care professionals to embrace physical activity and strive for systems change, at governmental, organizational, educational, and medical leadership levels.

Make physical activity a part of daily life during all stages of life. That is the clear message from the World Health Organisation in this infographic. Regular physical activity is a fundamental means …

AimsThis study aimed to determine the prevalence of hip pain in professional golfers, comparing the lead (left hip in right-handed golfer) and trail hips, and to establish what player characteristics predicted hip symptoms.MethodsMale elite professional golf players were invited to complete questionnaires and undergo clinical and MR examinations while attending the Scottish Hydro Challenge 2015. Questionnaires determined player demographics, self-reported hip pain and an International Hip Outcome Tool 12 (iHOT12) score (hip-related quality of life). Clinical examinations determined hip range of motion and the presence of a positive impingement test. MR scans determined the presence of labral pathology and player hip morphology with measures of α angle (cam), acetabular depth (pincer) and femoral neck antetorsion.ResultsA total of 109 (70% of tournament field) of players completed questionnaires, 73 (47%) underwent clinical examination and 55 (35%) underwent MR examination. 19.3% of players reported of hip pain. 11.9% of lead and 9.1% of trail hips were painful (p=0.378), iHOT12 scores were lower in the lead (94.1) compared to the trail hip (95.3) (p=0.007). Stepwise multiple linear regression modelling was able to predict 20.7% of the variance in iHOT12 scores with mean α angles between 12 and 3 o'clock, and increasing age-significant variables (R2=0.207, pConclusions19.3% of male professional golfers reported hip pain. The presence of an increasing α angle and increasing age were significant predictors of reduced hip-related quality of life.

Objectives: Assess current practice and attitudes towards recovery in adolescent athletes.Design: Questionnaires were administered either via print or online questionnaire.Participants: Athletes and coaches from within Asia were surveyed (n = 112 & 53), with a comparative sample in the UK (n = 53 & 8).Main Outcome Measures: The approaches and attitudes to recovery in both training and competition.Results: Adolescent athletes perceive a variety of recovery modalities as important, though prioritise active recovery, nutrition and sleep. Attitudes towards recovery differed between athletes in Asia and the UK with respect to the perceived benefits of: sleep (96% believe in it in the UK v 69% in Asia, p < 0.01); nutrition (92 v 58%, p < 0.01); and active recovery (70 v 52%, p = 0.03). The number of recovery techniques used with Asian athletes was higher after training (p = 0.009) and competition (p < 0.01). Asian athletes rely more on ‘feel’ to justify interventions.Conclusions: There was a major disconnect amongst athletes’ belief in particular strategies and their behaviours. The results of this study show the need for educating coaches and athletes.

The need to increase global levels of physical activity to benefit population health is now incontrovertible.1 ,2 Policy that recommends a voluntary target by countries to reduce global inactivity by 10% by the year 2025 has been adopted by the WHO. Given the compelling argument, and clear aim to increase physical activity, what is required are methods and tangible actions to achieve this goal. Global experts reviewed the evidence for the most effective ways to increase population levels of physical activity and produced a guide to investments that work.3 This has provided a north star for many individuals, organisations, communities and countries aiming to increase physical activity levels. However, there is still a need for examples of how these investments have been implemented and evaluated. Here we offer Scotland's experiences. ### Policy In 2003 a long-term, cross-sector and cross-party policy called ‘Let's make Scotland more active’ was endorsed by the Scottish Government.4 This set a 20-year framework and aimed to have 80% of children achieving 60 min of activity every day and …

Number of citations, number of views, Altmetric. To be a relevant and respected researcher, and to succeed in the current ‘publish or perish’ climate, it is important to publish, and to communicate and disseminate research widely to increase its likelihood of influencing clinical and research practice. With over two million scientific articles being produced each year1 (and rising), how can you ensure your contribution is impactful? The number of citations in other published articles and ‘number of views’ has long been used as a guide to assess the impact of a paper.2 This may not be an effective ‘real-time’ measure as some impactful papers take years to generate citations. A journal’s impact factor (IF) has also been viewed as a measure of respectability and an indirect proxy of an article’s impact. However, questions arise regarding such ‘journal-level’ metrics when it comes …

Visual data are all around us. A clear purpose of information graphics (infographics) is to communicate key messages in an engaging fashion.1 They are increasingly being used to complement and add value to scientific papers. Some infographics are completely ignored or not given a second glance, while others draw people in and efficiently convey a message to the engaged reader.2 While people are able to form an opinion of infographic content in a split second, the process of successful infographic design can be much more time-consuming. Knowledge, good ingredients and an oven are helpful in making a delicious cake to suit consumer taste. There is an increasing appetite for infographics. We describe some theory and key ingredients, and discuss infographic computer programs that can help you produce outstanding infographics, and consider how to help effectively share infographics (figure 1). Sufficient knowledge of the topic area is as important as artistic skill. Thus, as health professionals and scientists we can be encouraged …

Background: Many couples do not complete IVF treatment. There is little published data regarding this issue and also what changes might lead to better compliance rates. Aims: To investigate what proportion of patients discontinue IVF prematurely, why they stop treatment, and what factors are important for them to restart. Materials & Methods: Survey of 1310 patients undergoing IVF treatment over a 3-year period at a single IVF provider. Information was collection on demographics and the outcomes of treatment. For those who discontinued treatment two further questions were completed: reasons why treatment was discontinued (primary outcome measure) and factors required to reactivate fertility treatment (secondary outcome measure). Results: 40.2% response rate. 15.0% of patients discontinued IVF prematurely; 77.0% had a live birth or were currently pregnant. Those who discontinued treatment were more likely to be older and have a trade qualification. Of those who discontinued treatment; failing to become pregnant, cost, and stress were identified as factors. Less expensive treatment and a guaranteed baby were important factors for patients to restart treatment. Numerous comments were made regarding having readily available counselling services and continuity of care. Discussion: Reasons for stopping treatment are multifactorial. Our data set is limited by a low response rate. Further research is needed to into this issue, including differences between private and public cessation rates are barriers to completion of treatment. Conclusions: The majority of patients having IVF achieve either a live birth or fall pregnant through IVF. Service may be improved by decreasing cost, optimising outcomes and increasing availability of counselling services.

Background Education of health professionals is a key element of the wider strategy to increase society9s physical activity levels. To date, no study has directly assessed UK medical students’ knowledge of physical activity guidelines or their ability/willingness to prescribe exercise. Methods A questionnaire survey of final year medical students in Scottish Universities was conducted prior to a presentation on the current UK guidelines. Results Completed questionnaires (n=177) represented 37% of the final year cohorts. Physical inactivity was incorrectly perceived to be the least important risk factor to global mortality. 40% stated they were aware of current guidelines, but in a forced choice, 68% were able to correctly identify them for adults. In comparison, 97% correctly identified the UK9s alcohol guidelines. 52% stated they felt adequately trained to give physical activity advice to the general public. Conclusions The medical students in this study underestimated the risk of physical inactivity, and did not know the physical activity guidelines as well as other health promotion guidelines. A large proportion remained unconfident about giving physical activity advice. Improved education of this group is required.

In Scotland we aim to increase life expectancy by 5 years in the next 10 years and decrease health inequalities. These ambitions are bold. If life expectancy trends continue, Scotland will fall further behind the rest of Western Europe. Although premature mortality continues to fall, the trajectory of our improvement is currently more modest than that being achieved by other countries. And despite all efforts, health inequalities continue to grow. The gap between the rich and the poor is widening, with the richest 20% now living 10 years longer than the poorest 20% in Scotland. Albert Einstein defined insanity as ‘doing the same thing over and over again and expecting a different result.’ The excess mortality in Scotland requires something new to be done. It may partly stem from the social breakdown and loss of jobs when heavy industry (dominated by shipbuilding, coal mining and steel) declined, particularly in West Central Scotland in the latter half of the 20th century. Those affected were given housing and benefit, and remained predominantly in the region. Although the collapse of heavy industry happened in other countries in Europe, for example, Katowice in Poland, alternative suitable work was found and the sense of control, and community that goes with purpose and employment was preserved. The net result is that Scotland's excess mortality when compared with the rest of Europe can be partly attributed to causes such as violence, drug misuse, alcohol excess and suicide. Interestingly, similar patterns of excess mortality have been noticed in other population groups …

Physical inactivity may well be THE fundamental public health challenge of our age. Despite compelling evidence on the health benefits of physical activity (PA),1 the combination of increasing mechanisation, digitisation, motorisation and urbanisation continues to inexorably squeeze essential PA out of our daily lives. There is a new global target for all countries to reduce inactivity by 10% …

Golf is a hugely popular sport played across the world by people of all ages and abilities and offers a large number of physical and mental health benefits and social opportunities. The elite amateur and professional game has seen a huge rise in recent …