• Template for Rapid Iterative Consensus of Experts (TRICE)

      Chater, Angel M.; Shorter, Gillian; Swanson, Vivien; Kamal, Atiya; Epton, Tracy; Arden, Madelynne A.; Hart, Jo; Byrne-Davis, Lucie; Drury, John; Whittaker, Ellie; et al. (MDPI, 2021-09-29)
      Background: Public health emergencies require rapid responses from experts. Differing viewpoints are common in science, however, “mixed messaging” of varied perspectives can undermine credibility of experts; reduce trust in guidance; and act as a barrier to changing public health behaviours. Collation of a unified voice for effective knowledge creation and translation can be challenging. This work aimed to create a method for rapid psychologically-informed expert guidance during the COVID-19 response. Method: TRICE (Template for Rapid Iterative Consensus of Experts) brings structure, peer-review and consensus to the rapid generation of expert advice. It was developed and trialled with 15 core members of the British Psychological Society COVID-19 Behavioural Science and Disease Prevention Taskforce. Results: Using TRICE; we have produced 18 peer-reviewed COVID-19 guidance documents; based on rapid systematic reviews; co-created by experts in behavioural science and public health; taking 4–156 days to produce; with approximately 18 experts and a median of 7 drafts per output. We provide worked-examples and key considerations; including a shared ethos and theoretical/methodological framework; in this case; the Behaviour Change Wheel and COM-B. Conclusion: TRICE extends existing consensus methodologies and has supported public health collaboration; co-creation of guidance and translation of behavioural science to practice through explicit processes in generating expert advice for public health emergencies.
    • Community pharmacists' views on providing a reproductive health service to women receiving opioid substitution treatment: a qualitative study using the TDF and COM-B

      Alhusein, Nour; Scott, Jenny; Neale, Jo; Chater, Angel M.; Family, Hannah; University of Bristol; University of Bath; King's College London; University of New South Wales; University of Bedfordshire (Elsevier, 2021-09-21)
      Background The absence of menstruation is common in women who use drugs. This can give a belief that conception is unlikely. When stabilised on Opioid Substitution Treatment (OST), fertility often returns, initially without realisation as ovulation precedes menstruation. This leaves women vulnerable to unplanned pregnancies. Community pharmacists (CPs) are frequently in contact with this patient group through the Supervised Consumption of OST service. This provides a timely opportunity to provide reproductive health (RH) advice. The aim of this study was to investigate pharmacists' views on providing a RH service to women receiving OST. Methods Twenty semi-structured interviews based on the Capability-Opportunity-Motivation to Behaviour (COM-B) model and the Theoretical Domains Framework (TDF) were conducted between 2016 and 2017. Data analysis involved deductive coding using the TDF domains. The TDF domains were mapped onto the elements of the COM-B and used in the second step to create the framework and chart the data. The third step involved re-reading and clustering the codes, and inductive themes were generated to explain the data in depth. Results Nine of the 14 TDF domains, mapped into five elements of the COM-B, were identified. Five inductive themes were generated: 1) The pharmacists' experience and knowledge of reproductive health (RH) needs of women receiving OST, 2) The pharmacists' approach to providing advice, 3) The pharmacists' perception of the relationship with women receiving OST, 4) Social influences, and 5) Environmental factors. Community pharmacists feared causing offense to women receiving OST and described requiring cues as to when the service was needed. Pharmacists' highlighted a power imbalance in the relationship with women receiving OST. This could influence how receptive this patient group would be to pharmacy RH interventions. Conclusions CPs' concerns of providing RH service could hinder a proactive service provision. Supporting good rapport and providing a structured consultation would increase the accessibility of such a service.
    • Warm-up intensity does not affect the ergogenic effect of sodium bicarbonate in adult men

      Jones, Rebecca Louise; Stellingwerff, Trent; Artioli, Guilherme Giannini; Saunders, Bryan; Sale, Craig; Swinton, Paul; ; University of Bedfordshire; Canadian Sport Institute–Pacific; University of Victoria; et al. (Human Kinetics, 2021-09-03)
      This study determined the influence of a high (HI) vs. low-intensity (LI) cycling warm-up on blood acid-base responses and exercise capacity following ingestion of sodium bicarbonate (SB; 0.3 g·kg-1 body-mass (BM)) or a placebo (PLA; maltodextrin) 3-hours prior to warm-up. Twelve men (21±2 years, 79.2±3.6 kg BM, maximum power output (Wmax) 318±36 W) completed a familiarisation and four double-blind trials completed in a counterbalanced order: HI warm-up with SB (HISB); HI warm-up with PLA (HIPLA); LI warm-up with SB (LISB); and LI warm-up with PLA (LIPLA). LI warm-up was 15-minutes at 60%Wmax, while the HI warm-up (typical of elites) featured LI followed by 2 x 30-sec (3-minute break) at Wmax, finishing 30-minute prior to a cycling capacity test at 110%Wmax (CCT110%). Blood bicarbonate and lactate were measured throughout. SB supplementation increased blood bicarbonate (+6.4 [95%CI: 5.7 to 7.1 mmol·L-1]) prior to greater reductions with high intensity warm-up (-3.8 [95%CI: -5.8 to -1.8 mmol·L-1]). However, during the 30-minute recovery, blood bicarbonate rebounded and increased in all conditions, with concentrations ~5.3mmol·L-1 greater with SB supplementation (P<0.001). Blood bicarbonate significantly declined during the CCT110% with greater reductions following SB supplementation (-2.4 [95%CI: -3.8 to -0.90 mmol·L-1]). Aligned with these results, SB supplementation increased total work done during the CCT110% (+8.5 [95%CI: 3.6 to 13.4 kJ], ~19% increase) with no significant main effect of warm-up intensity (+0.0 [95%CI: -5.0 to 5.0 kJ). Collectively, the results demonstrate that SB supplementation can improve HI cycling capacity irrespective of prior warm-up intensity, likely due to blood alkalosis.
    • The prevalence of daily sedentary time in south Asian adults: a systematic review

      Dey, Kamalesh C.; Zakrzewski-Fruer, Julia K.; Smith, Lindsey Rachel; Jones, Rebecca Louise; Bailey, Daniel Paul (MDPI, 2021-09-01)
      This study aimed to systematically review total daily sedentary time in South Asian adults. Seven electronic databases were searched, identifying relevant articles published in peer-reviewed journals between March 1990 and March 2021. The study was designed in accordance with PRISMA guidelines. Prospective or cross-sectional design studies reporting total daily sedentary time in South Asian adults (aged ≥18 years), reported in English, were included. Study quality and risk of bias were assessed, and the weighted mean total daily sedentary time was calculated. Fourteen full texts were included in this systematic review from studies that were conducted in Bangladesh, India, Norway, Singapore, and the United Kingdom. Pooled sedentary time across all studies was 424 ± 8 min/day. Sedentary time was measured using self-report questionnaires in seven studies, with a weighted mean daily sedentary time of 416 ± 19 min/day. Eight studies used accelerometers and inclinometers with a weighted mean sedentary time of 527 ± 11 min/day. South Asian adults spend a large proportion of their time being sedentary, especially when recorded using objective measures (~9 h/day). These findings suggest that South Asians are an important target population for public health efforts to reduced sedentary time, and researchers and practitioners should seek to standardise and carefully consider the tools used when measuring sedentary time in this population.
    • An evolving model of best practice in a community physical activity programme: a case study of ‘Active Herts’

      Carr, Shelby; Burke, Amanda; Chater, Angel M.; Howlett, Neil; Jones, Andy (Human Kinetics, 2021-08-23)
      Background: Community-based physical activity programmes typically evolve to respond to local conditions and feedback from stakeholders. Process evaluations are essential for capturing how programmes are implemented, yet often fail to capture delivery evolution over time, meaning missed opportunities for capturing lessons learnt. Methods: This research paper reports on a staged approach to a process evaluation undertaken within a community-based UK 12-month physical activity programme that aimed to capture change and adaptation to programme implementation. Twenty-five one-to-one interviews, and twelve focus groups took place over the three years of programme delivery. Participants included programme participants, management, and service deliverers. Results: Programme adaptations that were captured through the ongoing process evaluation included changes to the design of promotional material, programme delivery content, ongoing training in behaviour change and the addition of regular participant community events. We address how these strands evolved over programme delivery, and how the process evaluation was able to capture them. Conclusion: The pragmatic evaluation approach enabled changes in response to the local context, as well as improvements in the programme to be captured in a timely manner, allowing the delivery to be responsive and the evaluation flexible.
    • Contraceptive choice and power amongst women receiving opioid replacement therapy: qualitative study

      Werthern, Helena; Alhusein, Nour; Chater, Angel M.; Scott, Jenny; Family, Hannah; Neale, Joanne; King’s College London; University of New South Wales; University of Bristol; University of Bedfordshire; et al. (Taylor & Francis, 2021-07-26)
      ABSTRACT Background: Women receiving treatment for opioid use disorder have low levels of contraception use and high rates of unintended pregnancies, abortion and children being adopted or fostered. This paper aims to understand the relationship between contraceptive choice and power amongst women receiving Opioid Replacement Therapy (ORT). Methods: During 2016/17, semi-structured interviews were undertaken with 40 women (aged 22–49 years) receiving ORT in the South of England. Data relating to the latent concept of power were inductively coded and analysed via Iterative Categorisation. Findings: The power manifested itself through six interconnected ‘fields’: i. ‘information about fertility and contraception’; ii. ‘access to contraception’; iii. ‘relationships with professionals and services’; iv. ‘relationships with male partners’; v. ‘relationships with sex work clients’; and vi. ‘life priorities and preferences’. Each field comprised examples of women’s powerlessness and empowerment. Even whenwomen appeared to have limited power or control, they sometimes managed to assert themselves. Conclusions: Power in relation to contraceptive choice is multi-faceted and multi-directional, operating at both individual and structural levels. Informed decision-making depends on the provision of clear, non-judgemental information and advice alongside easy access to contraceptive options. Additional strategies to empower women to make contraceptive choices and prevent unplanned pregnancies are recommended.
    • The prevalence and predictors of hypertension and the metabolic syndrome in police personnel

      Yates, James; Aldous, Jeffrey William Frederick; Bailey, Daniel Paul; Chater, Angel M.; Mitchell, Andrew C.S.; Richards, Joanna C.; University of Bedfordshire; Brunel University (MDPI, 2021-06-22)
      Hypertension and metabolic syndrome (METSYN) are reportedly high in police forces. This may contribute to health deterioration and absenteeism in police personnel. Police forces comprise of staff in 'operational' and 'non-operational' job types but it is not known if job type is associated to hypertension and METSYN prevalence. This study aimed to explore the prevalence of hypertension and METSYN, the factors associated with the risk of hypertension and METSYN, and compare physiological, psychological, and behavioural factors between operational and non-operational police personnel. Cross-sectional data was collected from 77 operational and 60 non-operational police workers. Hypertension and METSYN were prevalent in 60.5% and 20% of operational and 60.0% and 13.6% of non-operational police personnel, respectively (p > 0.05). Operational job type, moderate organisational stress (compared with low stress) and lower high-density lipoprotein cholesterol were associated with lower odds of hypertension, whereas increasing body mass index was associated with increased odds of hypertension (p < 0.05). None of the independent variables were significantly associated with the odds of METSYN. Operational police had several increased cardiometabolic risk markers compared with non-operational police. Given the high prevalence of hypertension and METSYN in operational and non-operational personnel, occupational health interventions are needed for the police and could be informed by the findings of this study.
    • Effects of a competitive soccer match on jump performance and interlimb asymmetries in elite academy soccer players

      Bromley, Tom; Turner, Anthony; Read, Paul; Lake, Jason; Maloney, Sean J.; Chavda, Shyam; Bishop, Chris (Lippincott, Williams & Wilkins, 2021-06-01)
      The purpose of this study was to investigate the effects of a competitive soccer match on jump performance and interlimb asymmetries over incremental time points during a 72-hour period. Fourteen elite adolescent players from a professional English category 3 academy performed single-leg countermovement jumps pre, post, 24-, 48-, and 72-hour post-match on a single force platform. Eccentric impulse, concentric impulse, peak propulsive force, jump height, peak landing force, and landing impulse were monitored throughout. Interlimb asymmetries were also calculated for each metric as the percentage difference between limbs. Significant negative changes (p < 0.05) in jump performance were noted for all metrics at all time points, with the exception of jump height. Interlimb asymmetries were metric-dependent and showed very large increases, specifically post-match, with a trend to reduce back toward baseline values at the 48-hour time point for propulsive-based metrics. Asymmetries for landing metrics did not peak until the 24-hour time point and again reduced toward baseline at 48-hour time point. This study highlights the importance of monitoring distinct jump metrics, as jump height alone was not sensitive enough to show significant changes in jump performance. However, interlimb asymmetries were sensitive to fatigue with very large increases post-match. More frequent monitoring of asymmetries could enable practitioners to determine whether existing imbalances are also associated with reductions in physical performance or increased injury risk.
    • “Small steps, or giant leaps?” Comparing game demands of U23, U18, and U16 English academy soccer and their associations with speed and endurance

      Smalley, Ben; Bishop, Chris; Maloney, Sean J.; Middlesex University; Queens Park Rangers Football Club (SAGE Publications Inc., 2021-05-26)
      The current study aimed to compare locomotive outputs across English U16, U18 and U23 academy soccer and investigate possible relationships with neuromuscular and aerobic capacities. Participants included 46 outfield players from an English Category Two soccer academy. Global positioning system (18 Hz) data were utilised to analyse locomotive outputs across twenty eleven-a-side matches in each age group. Maximal sprinting speed (MSS) and aerobic speed (MAS) were assessed at the beginning of the season. Absolute total distance (TD), high-speed running (HSR), acceleration and deceleration workloads were higher in U18’s and U23’s vs. U16’s (g = 1.09–2.58; p < 0.05), and absolute sprinting distances were higher in U23’s vs. U16’s (g = 0.96; p < 0.05). In addition, relative HSR outputs were higher in U23’s vs. U18’s (g = 1.84–2.07; p < 0.05). Across the whole cohort, players’ MSS was positively associated with absolute HSR and sprinting distances (ρ = 0.53–0.79; p < 0.05) but not with relative parameters. MAS was positively associated with total distance, decelerations, and both absolute and relative HSR outputs (ρ = 0.33–0.56; p < 0.05). Overall, absolute locomotive outputs were significantly higher in U23’s and U18’s vs. U16’s. Locomotive outputs were also associated with maximal sprinting and aerobic speeds. Thus, training programmes should be tailored to competition demands to optimally prepare each age group for competition and reflect the increasing demands of each level of competition. Further, improving physical fitness (speed and endurance) is likely to drive greater outputs in competition.
    • Energy matching of a high‑intensity exercise protocol with a low‑intensity exercise protocol in young people

      Bottoms, Lindsay; Howlett, Neil; Chater, Angel M.; Jones, Andy; Jones, Julia; Wyatt, Solange; Mengoni, Silvana E.; Sharma, Shivani; Irvine, Karen; Trivedi, Daksha; et al. (Springer, 2021-05-12)
    • The effect of pre and per-cooling on intermittent-sprint exercise in the heat: a systematic review and meta-analysis

      Scott, Jake; Gordon, Ralph; Tyler, Chris; Aldous, Jeffrey William Frederick; University of Bedfordshire (University of Bedfordshire, 2021-05)
      Systematic review and meta-analysis protocol for a PhD study.
    • Reliability of salivary cortisol and testosterone to a high-intensity cycling protocol to highlight overtraining

      Hough, John; Leal, Diogo Luis Campos Vaz; Scott, Gemma; Taylor, Lee; Townsend, Dominic; Gleeson, Michael; Nottingham Trent University; University of Bedfordshire; University Institute of Maia; Loughborough University; et al. (Taylor & Francis, 2021-04-27)
      Athletes physically overload to improve performance. Unbalanced stress/recovery may induce overtraining, which is difficult to diagnosis as no diagnostic marker exists. Hormonal responses to a 55/80 cycle (30-min of alternating blocks of 1-min at 55% and 4-min at 80% maximum work rate) may highlight early-stage overtraining (overreaching), as blunted cortisol and testosterone responses to 55/80 follows intensified training. However, the reliability of hormonal responses to 55/80 when not overreached is unknown. Therefore, reported blunted hormonal responses could be due to inconsistent cortisol and testosterone responses to 55/80. Participants (n = 23) completed three 55/80 bouts, >7 days apart, with no exercise 24 h pre-trials. Pre-exercise urine osmolality and stress questionnaire responses were measured. Pre, post, and 30-min post-exercise saliva samples were collected for cortisol and testosterone assessment. Salivary cortisol and testosterone responses, osmolality and well-being were not different between trials. Salivary cortisol and testosterone elevated from pre- to post-exercise [by 4.2 nmol.L-1 (cortisol) and 307 pmol.L-1 (testosterone)], and 30 min post-exercise [by 160 pmol.L-1 (testosterone) only]. Intraclass correlation coefficients for pre to peak post-exercise cortisol (0.89; good) and testosterone (0.53; moderate) were calculated. This demonstrates that 55/80 induces reliable elevations of salivary cortisol and testosterone when in a healthy state.
    • Antimicrobial stewardship: a competency framework to support the role of nurses

      Courtenay, Molly; Chater, Angel M.; Cardiff University; University of Bedfordshire (RCN Publishing, 2021-03-24)
      Antimicrobial resistance is a global threat that has prompted a global response. One strategy used to tackle antimicrobial resistance is known as antimicrobial stewardship, its main goal being to optimise antibiotic use and avoid unnecessary antibiotic prescribing. There is an increase in the number of nurse prescribers as well as in the percentage of antibiotics dispensed in primary care precribed by non-medical prescribers such as nurses. Nurses, both prescribers and non-prescribers, play an important role in antimicrobial stewardship, including during the COVID-19 pandemic. To be able to fulfil that role, nurses need the right knowledge, skills, resources and behaviours. This article explores the role of nurses in antimicrobial stewardship and describes a competency framework designed to underpin it.
    • The relationship between vertical stiffness during bilateral and unilateral hopping tests performed with different strategies and vertical jump performances

      Mohammadian, Mohammadamin; Sadeghi, Heydar; Khaleghi Tazji, Mehdi; Maloney, Sean J.; Kharazmi University; University of Bedfordshire (Taylor and Francis, 2021-03-20)
      Vertical stiffness has been highlighted as a potential determinant of performance and may be estimated across a range of different performance tasks. The aim of the current study was to investigate the relationship between vertical stiffness determined during 9 different hopping tests and performance of vertical jumps. Twenty healthy, active males performed vertical hopping tests with three different strategies (self-selected, maximal, and controlled) and three different limb configurations (bilateral, unilateral preferred, and unilateral non-preferred), resulting in nine different variations, during which vertical stiffness was determined. In addition, participants performed squat jump (SQJ) and countermovement jump (CMJ) during which jump height, CMJ stiffness, and eccentric utilization ratio (EUR) were determined. Vertical stiffness in bilateral and unilateral preferred tasks performed with a self-selected and maximal, but not controlled, strategy was associated with stiffness in the CMJ (r = 0.61-0.64; p < 0.05). However, stiffness obtained during unilateral preferred and non-preferred hopping with self-selected strategy was negatively associated with performance in SQJ and CMJ tasks (r = -0.50 to -0.57; p < 0.05). These findings suggest that high levels of vertical stiffness may be disadvantageous to static vertical jumping performance. In addition, unilateral hopping with a self-selected strategy may be the most appropriate task variation if seeking to determine relationships with vertical jumping performance. HighlightsStiffness obtained during unilateral hopping with a preferred strategy was negatively associated with vertical jumping performancesStiffness obtained during hopping with preferred and maximal strategies was associated with stiffness obtained during a countermovement jumpIn this population, hopping stiffness may therefore be reflective of an individual's countermovement jump strategyHigh levels of stiffness may be disadvantageous to static-start vertical jumping.
    • Can physical activity support grief outcomes in individuals who have been bereaved? a systematic review

      Williams, Jane; Shorter, Gillian; Howlett, Neil; Zakrzewski-Fruer, Julia K.; Chater, Angel M.; University of Bedfordshire; Queen’s University Belfast; University of Hertfordshire (Springer, 2021-03-06)
      Background: In 2018, there were 616,014 registered deaths in the United Kingdom (UK). Grief is a natural consequence. Many mental health concerns, which can be identified as grief outcomes (e.g. anxiety and depression) in those who have experienced a bereavement, can be improved through physical activity. The objective of this review was to identify from the existing literature if physical activity can benefit grief outcomes in individuals who have been bereaved. Methods: A systematic review of nine databases was performed. Included studies (qualitative and quantitative) explored physical activity to help individuals (of any age) who had experienced a human bereavement (excluding national loss). Results: From 1299 studies screened, 25 met the inclusion criteria, detailing eight types of bereavement (parental (n=5), spousal (n=6), patient (n=4), pre-natal (n=3), later life (n=1), caregiver (n=1), multiple (n=4) and non-defined (n=1). Activities including yoga, running, walking, and martial arts were noted as beneficial. Physical activity allowed a sense of freedom, to express emotions, provided a distraction, and an escape from grief, while enhancing social support. Conclusion: There is some evidence that physical activity may provide benefit for the physical health and psychological wellbeing of those who have been bereaved, including when the loss has happened at a young age. This review is timely, given the wide-scale national loss of life due to COVID-19 and extends knowledge in this area. More research is needed to explore the benefits of physical activity for those who have been bereaved. In particular there is a need for well-designed interventions which are tailored to specific activities, populations and grief outcomes.
    • Polymorphonuclear leucocyte phagocytic function, γδ T-lymphocytes and testosterone as separate stress-responsive markers of prolonged, high-intensity training programs

      Leal, Diogo Luis Campos Vaz; Standing, Ariane S.I.; Furmanski, Anna L.; Hough, John; University of Bedfordshire; University Institute of Maia; University of Florida; Nottingham Trent University (Elsevier, 2021-03-06)
      Excessive exercise with limited recovery may lead to detrimental states of overreaching or the overtraining syndrome. Chronic maladaptation in endocrine and immune mechanisms occur with the incidence of these states. Exercise-induced cortisol and testosterone responses have been proposed as biomarkers of overreaching, with blunted responses following intensified-training periods. Yet, limited information on the effects of overreaching in immunity is available. Healthy individuals completed a 30-min running protocol (the RPETP) before and after a 12-day intensified-training period. Blood and saliva were collected before, after and 30min after RPETP at pre-training and post-training. Plasma and salivary cortisol and testosterone, leucocyte proliferation and polymorphonuclear leucocyte phagocytic activity were examined. Plasma and salivary cortisol were acutely unaffected pre-training (−14% and 0%, p > 0.05) and post-training (−14% and +46%, p > 0.05). Comparing pre-training with post-training, blunted responses were observed in plasma testosterone (43%–19%, p < 0.05) and salivary testosterone (55%–24%, p > 0.05). No acute or resting changes in total leucocyte counts or most leucocyte subsets occurred pre-training or post-training. Yet, a 194% acute elevation in γδ T-lymphocyte number occurred pre-training (p < 0.05), and average resting concentrations were 174% higher post-training. Baseline phagocytic activity was 47% lower post-training (p < 0.05). Intensified training was detrimental, significantly reducing phagocytic activity. Testosterone blunted post-training, indicating an excessive training-related hypothalamic-pituitary gonadal dysfunction. The γδ T-lymphocytes sensitivity to exercise was noted, rendering it as a potential stress-responsive cellular marker. The usefulness of the RPETP to track the onset of overreaching is proposed.
    • The impact of neurological disability and sensory loss on mindfulness practice

      Finlay, K. A.; Chater, Angel M.; Hearn, J.; University of Reading; University of Bedfordshire; Manchester Metropolitan University (Taylor and Francis, 2021-02-23)
      Objectives Mindfulness-based approaches are increasingly recommended in the management of medical conditions associated with sensory loss and absence, such as Spinal Cord Injury (SCI), Multiple Sclerosis (MS) and Functional Neurological Disorder (FND). Yet the implications of undertaking practices such as body scanning when living with sensory loss have not been considered. This study aimed to explore the impact of sensory loss on the practice and experience of mindfulness in qualified mindfulness teachers with SCI/FND/MS. Methods Eight mindfulness teachers (5 females, 3 males) with SCI/FND/MS, sensory loss and wheelchair use were recruited from mindfulness teacher databases. In-depth, semi-structured interviews were undertaken, lasting between 50 and 93 min. Interviews were transcribed verbatim and analysed using Interpretative Phenomenological Analysis. Idiographic analyses for descriptive, linguistic and conceptual themes were completed before cross-case analyses. Results Analyses resulted in two superordinate themes: (1) Adopting your Body; and (2) Sensation without Loss. These themes reflected the challenge of overcoming initial resistance to areas of the body with sensory disruption, building a relationship with the whole body, such that sensory awareness could be visualised and experienced without proprioception. Conclusions Mindfulness offers a unique approach to accepting and working with the body after paralysis or sensory loss. Fundamental to the use of mindfulness with such populations, is the prioritisation of inclusive sensory language and exploring sensory absence as well as sensory presence. The cognitive and emotional outcomes of body scanning may be uniquely elevated in populations with neurophysiological disorders, highlighting the benefits of mindfulness for adaptive and protective self-management.
    • Factors influencing the prescribing behaviour of independent prescriber optometrists: a qualitative study using the Theoretical Domains Framework

      Spillane, Daniel; Courtenay, Molly; Chater, Angel M.; Family, Hannah; Whitaker, Angela; Acton, Jennifer H. (Wiley, 2021-02-20)
      Purpose: Whilst the number of independent prescriber optometrists in the United Kingdom is increasing, there is limited evidence describing the experiences of these individuals. The Theoretical Domains Framework (TDF) provides an evidence-based approach to understand determinants of behaviour. This conceptual framework can enable mapping to the COM-B behaviour change model and the wider Behaviour Change Wheel to develop interventions to optimise behaviourchange and healthcare processes more systematically. The study aimed to use the TDF to identify the factors that influence independent prescribing behaviour, and to map these findings to the COM-B system to elucidate the relevant intervention functions, in order to identify the support required by optometrist prescribers. Methods: Using a qualitative design, semi-structured interviews based on the TDF were undertaken with independent prescriber optometrists. Thematic analysis was used to identify themes inductively, which were then deductively mapped to the TDF and then linked to the COM-B. Results: Sixteen participants (9 male; median age 45 years, range 28–65 years), based in community (n = 10) and hospital (n = 6) settings, were interviewed. Eleven of the TDF domains were found to influence prescribing behaviour. Findings highlighted the need for good communication with patients (TDF domain: Skills, COM-B: Capability); confidence (TDF domain: Beliefs about capabilities, COM-B: Motivation); good networks and relationships with other healthcare professionals, e.g., general practitioners (TDF domain: Social influences, COM-B: Opportunity; TDF domain: Social/professional role and identity, COM-B: Motivation); the need for appropriate structure for remuneration (TDF domain: Reinforcement, COM-B: Motivation; TDF domain: Social/professional role and identity, COM-B: Motivation); and the provision of professional guidelines (TDF domain: Knowledge, COM-B: Capability; TDF domain: Environmental context and resources, COM-B Opportunity). Conclusions: Having identified theory-derived influencers on prescribing decisions by optometrists, the findings can be used to develop a structured intervention, such as a support package to help optimise prescribing by optometrists, with the ultimate goal of eye care quality improvement.
    • Replacing sugary snacks with fruit, nuts and seeds at nurses’ stations within a UK oncology unit: a pilot intervention study

      Thomas, Robert; Williams, Madeleine; Smit, Graham; Chater, Angel M.; Bedford Hospital NHS Trust; University of Bedfordshire (2021-02-02)
      Aim - This real-world service intervention study evaluated NHS staff weight and subjective happiness over a three-month period, by replacing processed, sugary foodstuffs with fruit, nuts and seeds. Method - Forty four staff at the Primrose Oncology Unit, Bedford Hospital, volunteered to abstain from cakes, biscuits, sweets, sugary drinks and chocolates whilst at work between June 2019 and September 2019. Participants’ weight and subjective happiness scores were recorded at baseline, three months (completion) and five months (post-completion). Fresh and dried fruit, and bags of raw nuts and seeds were made available to all staff (including those not participating). Participants resumed their usual diet outside of working hours. One hundred consecutive patients attending the department during the intervention were asked whether removing sugary food from public view was a positive move and whether it would have a likely influence on their future eating habits. Results - At five months, twenty (46%) participants lost weight >1kg (average 3.01 kg), seven participants gained >1kg (average 2.23 kg), and 17 remained the same weight (T-test p< 0.03). Average happiness score increased from 21.65 to 23.44 (+6.6%), T-test p< 0.04). Amongst those who lost >1kg weight, average happiness score increased from 21.54 to 23.75 (+9.3%), p<0.03. In those who gained >1 kg weight, average happiness score decreased from 22.28 to 21.43 (-3.8%), p< 0.08. There was a 13.1% difference in the happiness score in those loosing >1kg compared to those gaining >1kg in weight p< 0.001). 94 (94%) patients indicated that this initiative gave a good impression and ninety seven (97%) indicated that the initiative would encourage them to reduce sugar in their own diet. Conclusion - The results demonstrated a statistically significant reduction in weight loss and increase in mood in just under half of the participants. Whilst this level of weight loss was similar to the best designed weight loss programmes, a larger study is required to validate these results.
    • Reflecting on the Stage 2 Health Psychology independent training route: a survey of trainee and graduate experiences of employability

      Bull, Eleanor; Newman, Kristina; Cassidy, Tony; Anderson, Niall; Chater, Angel M. (British Psychological Society, 2021-02-02)
      ‘This is a pre-publication version of the following article: [Bull E, Newman K, Cassidy T, Anderson N, Chater A (2020) 'Reflecting on the Stage 2 Health Psychology independent training route: a survey of trainee and graduate experiences of employability', Health Psychology Update, (in press).]’ A couple of the most common questions we may encounter from psychology students thinking about their career choices are: “What roles are there in health psychology?” and “How do I become a health psychologist?” Our discipline has made many advances into diverse spheres of employment, which then often leads to a response: “How long have you got?!” Health psychologists offer their knowledge and skills in psychological intervention, research, training and consultancy to improve health and wellbeing in a wealth of different settings, working at all levels from one-to-one with patients/clients/healthcare professionals, to groups, whole communities and populations. An increasingly wide range of stakeholders are recognising that they may benefit from collaborating with and employing a Health Psychologist, with Health Psychologists working in health and social care, education, culture, justice, and military, as well as working within global health partnerships through volunteering collaboratives (e.g. Byrne-Davis et al. 2017). The development of the Health Psychology and Public Health Network (HPPHN: Chater, 2014; McManus, 2014; Chater & McManus, 2016; renamed the Behavioural Science and Public Health Network, BSPHN in 2018) is also importantly strengthening our links with public health colleagues and creating new opportunities. Recent initiatives have also had success in raising the profile of Health Psychologists working in diverse areas, nationally and internationally. Some of these include Health Psychology Update’s new ‘Teaching, training and consultancy’ section (Cross, 2020), accounts of trainees’ experiences (e.g. Smith, 2018), the British Psychological Society (BPS) Division of Health Psychology’s (DHP) social media hashtag #DayInLifeOfHealthPsychology, the Oral History of UK Health Psychology project (Quinn, Morrison & Chater, 2020) and the BPS DHP Scotland’s case studies of Health Psychologists. Reflecting this diversity, in the UK there are currently several different options for training in health psychology.