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Abstract Background Medical training program and hospital response to the COVID-19 pandemic has varied greatly and has impacted trainee well-being. Which factors have specifically related to trainee wellness, however, has not yet been examined in depth. The aim of the study was to understand trainee perspectives on the individual psychiatry trainee programs’ hospitals’ objective COVID-19 preparedness management. We also sought and to gauge how program changes, and general pandemic-related concerns, have been associated with trainee satisfaction and burnout. Methods A cross-sectional survey study of psychiatric trainees was distributed electronically throughout the country via various psychiatry residency program listservs in April 2020. Statistical analyses were performed utilizing simple linear regression. Results From 352 respondents (346 complete responses and 6 partial responses), the most frequent program changes were “decreased number of rotations requiring in-person patient care” and “increased call hours or duties.” Of pandemic-related concerns surveyed, the two greatest were “spreading COVID-19 to family/friends” and “co-residents’ burnout and anxiety.” A positive relationship was found between trainee satisfaction with perceived COVID-19 departmental response and comfort level of residents/fellows in expressing concerns with attending clinicians and department leadership. Conclusions Since the start of the COVID-19 pandemic, trainees have experienced a variety of changes to trainee program policies and guidelines. Overall, poor communication and trainee dissatisfaction with departmental response correlated with concern of infection and anxiety/burnout. Insights garnered from this study could provide scaffolding for the best practices to reduce trainee physician anxiety/burnout for the current and future pandemics of this variety and magnitude.

Background: In team games situations, the ability to make fast and accurate decisions is crucial to performance. As such, effective decision making, characterised by the consistent and efficient ability to choose the right course of action at the right moment, is a key component of match performance in team sports such as rugby union. Previous research has identified pedagogical approaches to enhance decision making. However, there is dearth in research to investigate how coaches evaluate tactical decision making and subsequently develop context specific 'on' and 'off-field' coaching practices to improve it. Further, the value coaches place on decision making is under explored. Purpose: The aim of this study was to explore coaches' perceptions of decision making in rugby union. The specific objectives to meet this aim were to: (i) Explore coaches' perceptions of the value and importance of decision making in rugby union; (ii) Identify coaches' opinions of the key decision making moments in games and how to evaluate them; and (iii) Investigate coaches' on and off field methods for improving players' tactical and strategic decision making.Participants: Purposive sampling was used to select five male coaches, whose ages ranged from 25 to 41 years, from a regional rugby union club in Wales to participate in the study. Coaching experience ranged from two years to 16 years. Methods: The interpretative paradigm was used within the study with data collected through semi-structured interviews with academy rugby union coaches. This type of interview gathered rich, detailed and complex accounts of coaches' opinions of players' in-game decision making in rugby union in order to inform practice and theory. Inductive and deductive qualitative thematic analysis was used to analyse and interpret the data. Findings: All five coaches agreed that decision making was a crucial part of the modern game of rugby union. There was some disagreement between them about the players' autonomy to make their own decisions on the pitch and a general lack of clarity between 'game plan', 'strategy' and 'tactics' amongst the coaches. All the coaches agreed that the process of evaluation of players' decision making should involve a joint discussion with the players. They also agreed that developing decision making was one of the hardest things to coach. Finally, they used a variety of 'on' and 'off-field' coaching methods to achieve this including video analysis, questioning and the use of games based scenarios. Conclusion: This study acquired the coaches' voice on players' decision making in rugby union by exploring its perceived importance to them and how they evaluated and attempted to improve it. A clear attempt was made among the coaches to develop a 'non-judgemental' atmosphere in the evaluation and improvement of players' decision making. Future research should consider the use of explicitation interviewing, where the interviewer (coach) aims to get the player into a state of evocation, to relive the key decision making moments in an attempt to improve it.

The purpose of this position paper is to promote the interest, usefulness and specificity of a coherent system that is based on psychophenomenology as a theoretical framework [Vermersch, P. (2012). "Explicitation et phénoménologie." Paris: PUF], and the explicitation interview [Vermersch, P. (2009). Describing the practice of introspection. "Journal of Consciousness Studies," 16(10-12), 20-57] as an appropriate and original method for studying the subjective lived experience of participants in sport situations. This original approach is associated with an epistemological posture which accords significant importance to the first-person point of view (i.e. what is appearing to a person about his own subjective lived experience in a past situation). After presenting some limitations in other phenomenological approaches and interview methods, we highlight the specificity of the theoretical background and the method of explicitation interview, for describing in detail the actions and understanding the lived experience of a person in a past and singular situation. To demonstrate the potential of this approach, we provide two specific examples of explicitation interview data from an in-match player decision-making situation and an in-game half-time speech of a coach. In concluding, we contend that psychophenomenology and the explicitation interview present new perspectives and opportunities for coach education, by developing the analysis of the subjective lived experience. This may have important implications for sport-related research and the development of coaching practice and formal coach education, through closer links to real life experiences.

Objective: Endoplasmic reticulum aminopeptidase 1 (ERAP‐1) and ERAP‐2, encoded on chromosome 5q15, trim endogenous peptides for HLA‐mediated presentation to the immune system. Polymorphisms in ERAP1 and/or ERAP2 are strongly associated with several immune‐mediated diseases with specific HLA backgrounds, implicating altered peptide handling and presentation as prerequisites for autoreactivity against an arthritogenic peptide. Given the thorough characterization of disease risk–associated polymorphisms that alter ERAP activity, this study aimed instead to interrogate the expression effect of chromosome 5q15 polymorphisms to determine their effect on ERAP isoform and protein expression. Methods: RNA sequencing and genotyping across chromosome 5q15 were performed to detect genetic variants in ERAP1 and ERAP2 associated with altered total gene and isoform‐specific expression. The functional implication of a putative messenger RNA splice‐altering variant on ERAP‐1 protein levels was validated using mass spectrometry. Results: Polymorphisms associated with ankylosing spondylitis (AS) significantly influenced the transcript and protein expression of ERAP‐1 and ERAP‐2. Disease risk–associated polymorphisms in and around both genes were also associated with increased gene expression. Furthermore, key risk‐associated ERAP1 variants were associated with altered transcript splicing, leading to allele‐dependent alternate expression of 2 distinct isoforms and significant differences in the type of ERAP‐1 protein produced. Conclusion: In accordance with studies demonstrating that polymorphisms that increase aminopeptidase activity predispose to immune disease, the increased risk also attributed to increased expression of ERAP1 and ERAP2 supports the notion of using aminopeptidase inhibition to treat AS and other ERAP‐associated conditions. [ABSTRACT FROM AUTHOR]

Background: Ankylosing spondylitis (AS) is characterised by immune-mediated arthritis and osteoproliferation, ultimately leading to joint ankylosis. Whether inflammation is necessary for osteoproliferation is controversial, fuelled by the unclear efficacy of anti-inflammatory treatments on radiographic progression. In proteoglycan-induced spondylitis (PGISp), a mouse model of AS, inflammation is the prerequisite for osteoproliferation as osteoproliferation was only observed following inflammation-driven intervertebral disc (IVD) destruction. We hypothesised that early intervention with a potent anti-inflammatory therapy would protect IVD integrity and consequently alter disease progression.Methods: PGISp mice received vehicle or a combination of etanercept (ETN) plus prednisolone (PRD) therapy for 2 or 6 weeks initiated at an early disease stage. Peripheral arthritis was scored longitudinally. Spinal disease was assessed using a semi-quantitative histological scoring regimen including inflammation, joint destruction and excessive tissue formation.Results: ETN + PRD therapy significantly delayed the onset of peripheral arthritis. IVD integrity was significantly protected when treatment was commenced in early disease. Six-weeks of treatment resulted in trends towards reductions in intervertebral joint damage and excessive tissue formation. IVD score distribution was dichotomized, likely reflecting the extent of axial disease at initiation of therapy. In the sub-group of mice with high IVD destruction scores, ETN + PRD treatment significantly reduced IVD destruction severity, inflammation and bone erosion and reduced cartilage damage and excessive tissue formation.Conclusions: Early intervention with anti-inflammatory treatment not only improved inflammatory symptoms but also ameliorated structural damage of spine in PGISp mice. This preclinical observation suggests that early anti-inflammatory intervention may slow radiographic progression in AS patients. [ABSTRACT FROM AUTHOR]