• Biomarkers associated with lower limb muscle function in individuals with sarcopenia: a systematic review

      Jones, Rebecca Louise; Paul, Lorna; Steultjens, Martijn P.M.; Smith, Stephanie Louise; University of Bedfordshire; University of Lincoln; Glasgow Caledonian University; University of Nottingham (Wiley, 2022-08-17)
      Lower limb muscle dysfunction is a key driver for impaired physical capacity and frailty status, both characteristics of sarcopenia. Sarcopenia is the key pathway between frailty and disability. Identifying biological markers for early diagnosis, treatment, and prevention may be key to early intervention and prevention of disability particularly mobility issues. To identify biological markers associated with lower limb muscle (dys)function in adults with sarcopenia, a systematic literature search was conducted in AMED, CINAHL, Cochrane Library, EMBASE, Medline, PubMed, Scopus, SPORTDiscus, and Web of Science databases from inception to 17 November 2021. Title, abstract, and full-text screening, data extraction, and methodological quality assessment were performed by two reviewers independently and verified by a third reviewer. Depending on available data, associations are reported as either Pearson's correlations, regression R2 or partial R2 , P value, and sample size (n). Twenty eligible studies including 3306 participants were included (females: 79%, males: 15%, unreported: 6%; mean age ranged from 53 to 92 years) with 36% in a distinct sarcopenic subgroup (females: 73%, males: 19%, unreported: 8%; mean age range 55-92 years). A total of 119 biomarkers were reported, categorized into: genetic and microRNAs (n = 64), oxidative stress (n = 10), energy metabolism (n = 18), inflammation (n = 7), enzyme (n = 4), hormone (n = 7), bone (n = 3), vitamin (n = 2), and cytokine (n = 4) markers) and seven lower limb muscle measures predominately focused on strength. Seven studies reported associations between lower limb muscle measures including (e.g. power, force, and torque) and biomarkers. In individuals with sarcopenia, muscle strength was positively associated with free testosterone (r = 0.40, P = 0.01; n = 46). In analysis with combined sarcopenic and non-sarcopenic individuals, muscle strength was positively associated with combined genetic and methylation score (partial R2 = 0.122, P = 0.03; n = 48) and negatively associated with sarcopenia-driven methylation score (partial R2 = 0.401, P < 0.01; n = 48). Biomarkers related to genetics (R2 = 0.001-0.014, partial R2 = 0.013-0.122, P > 0.05; n = 48), oxidative stress (r = 0.061, P > 0.05; n ≥ 77), hormone (r = 0.01, ρ = 0.052 p > 0.05, n ≥ 46) and combined protein, oxidative stress, muscle performance, and hormones (R2 = 22.0, P > 0.05; n ≥ 82) did not report significant associations with lower limb muscle strength. Several biomarkers demonstrated associations with lower limb muscle dysfunction. The current literature remains difficult to draw clear conclusions on the relationship between biomarkers and lower limb muscle dysfunction in adults with sarcopenia. Heterogeneity of biomarkers and lower limb muscle function precluded direct comparison. Use of international classification of sarcopenia and a set of core standardized outcome measures should be adopted to aid future investigation and recommendations to be made.
    • Postprandial glucose responses to standardised meals consumed after moderate- and high-intensity exercise bouts across standard school days in healthy adolescents

      Afeef, Sahar M.O.; Barrett, Laura A.; Zakrzewski-Fruer, Julia K.; Tolfrey, Keith; Loughborough University; King Abdulaziz University; University of Bedfordshire (Lidsen Publishing, 2022-08-15)
      Exercise-induced moderation of postprandial glycaemia in adolescents is unclear and has not been examined under free-living conditions. We assessed the effect of moderate-intensity exercise (MIE) and high-intensity intermittent exercise (HIIE) bouts on subsequent postprandial glycaemic responses across three standard school days. Fourteen healthy adolescents (13 ± 1 years) completed three conditions in the following order across consecutive days: MIE, 30-min continuous brisk walking; CON, no-exercise control; HIIE, 30- min of 10 × 30-s sprints interspersed with 2.5-min brisk walking bouts. Participants consumed three standardised meals (breakfast, lunch and dinner) at standardised times. Interstitial glucose, energy intake, sedentary time and physical activity were assessed under free-living conditions. Linear mixed models compared glucose outcomes between conditions, and Cohen’s d effect sizes were calculated. Although non-significant, the reduction in postbreakfast glucose iAUC was moderate for MIE (-0.24 mmol·L -1 ; P = 0.59; d = 0.77) and large for HIIE (-0.26 mmol·L -1 ; P = 0.44; d = 0.86) compared with CON. Non-significant, moderate (0.37 mmol·L -1 ; P = 0.22; d = 0.70) and large (0.42 mmol·L -1 ; P = 0.20; d = 0.81) increases in postlunch glucose iAUC were observed for MIE and HIIE compared with CON. Nevertheless, the 24-h mean glucose was stable at ~5.4 mmol·L -1 across conditions. The glycaemic variability indices calculated over 24-h after the onset of exercise for each condition including standard deviation (P = 0.59) and mean amplitude of glycaemic excursion (P = 0.82) were not different between conditions. Thirty-minute bouts of MIE and HIIE did not change postprandial glycaemia or 24-h glycaemic variability significantly in the small sample of healthy adolescents. However, the moderate and large effect sizes suggest both MIE and HIIE reduced breakfast glucose iAUC compared with CON, yet led to increases in post-lunch iAUC in the two exercise conditions. The mismatch between the probability values and effect sizes was a consequence of our COVID-reduced sample. The ramifications of these exercise effects are unclear and need to be confirmed in a larger sample of adolescents.
    • Social justice knowledge construction among physical education teacher educators: the value of personal, professional, and educational experiences

      Hill, Joanne; Walton-Fisette, Jennifer L.; Flemons, Michelle; Philpot, Rod; Sutherland, Sue; Phillips, Sharon; Flory, Sara B.; Ovens, Alan; ; University of Bedfordshire; et al. (Taylor and Francis, 2022-08-08)
      Background: The imperative for social justice in education means that pre-service teachers should learn how to teach for and about social justice, including pedagogical and content knowledge. Understanding of how physical education pre-service teachers and teacher educators construct and develop their knowledge of social justice pedagogies and critical content, intertwined with values based on social justice and equity, is needed to best support future teachers. Purpose: The focus of this paper is how physical education teacher educators and physical education and sport pedagogy university faculty have developed their knowledge of teaching for and about social justice: where their knowledge came from and how they draw upon it in their teaching and programme design. Method: Seventy-two faculty from seven countries engaged in an in-depth interview about their conceptualisation of social justice, their knowledge, practices, institutions, and policy contexts; and completed a demographic survey on their social identity and professional experiences. Using a social justice pedagogical and content knowledge model, thematic analysis generated formal educational study, workplace experience, and personal or social identity bases of social justice knowledge. Findings: Many of those who expressed a commitment to teaching about and for social justice had personal and professional experiences that had provided ‘eye-opening’ moments. For instance, some had encountered marginalisation and discrimination based on their identity. If social justice issues were not a part of a participant’s lived experience, but they had professional experience in the field, they were struck by what they did not know and subsequently sought out postgraduate or professional development. Professional experiences in the field were much more likely than formal education experiences to provide recognition that participants needed to learn more about social justice. Social justice is both knowledge and an ideological stance, so learning about social justice is as much about values and disposition as about content. Social justice must be important enough for teacher educators to embed in their belief system so that it becomes part of their pedagogical practice. Conclusion: This study prompts consideration of the professional development needs of teacher educators concerning social justice, that goes beyond acknowledging the existence of sociocultural issues by moving towards changes in pedagogical practices in PETE and PESP programmes. We advocate collaborative and reflective professional development for educators if social justice pedagogical and content knowledge is to be woven throughout teacher education programmes and not just incumbent on educators with personal experience of social justice issues.
    • Outcome evaluation of Active Herts: a community-based physical activity programme for inactive adults at risk of cardiovascular disease and/or low mental wellbeing

      Chater, Angel M.; Schulz, Joerg; Jones, Andy; Burke, Amanda; Carr, Shelby; Kukucska, Dora; Troop, Nicholas A.; Trivedi, Daksha; Howlett, Neil; University of Bedfordshire; et al. (Frontiers, 2022-08-07)
      Background: A high proportion of UK adults are inactive, which can lead to a range of physical and mental health concerns. Active Herts is a community-based physical activity programme for inactive adults at risk of cardiovascular disease and/or low mental wellbeing. This paper provides a pragmatic evaluation of this programme. Method: This longitudinal study observed 717 adults (68% female, mean age = 56.9 years) from the ‘Active Herts’ programme. Programme users were provided with a 45-minute consultation with a ‘Get Active Specialist’, who talked them through an Active Herts self-help booklet and then signposted them to free or subsidised local exercise sessions. Programme users were followed up with a booster call two weeks later. The Get Active Specialist was a registered exercise professional (REPS Level 3), with additional training from the study team in motivational interviewing, health coaching, COM-B behavioural diagnosis and delivery of behaviour change techniques (BCTs) in practice. The Active Herts booklet contained theoretically-driven and evidence-based BCTs to translate behavioural science into public health practice. Physical activity (Metabolic Equivalent Time [METs], measured using the International Physical Activity Questionnaire (IPAQ), perceived health (EQ-5D-5L) and mental wellbeing (Warwick-Edinburgh Mental Wellbeing Scale: WEMWBS) were measured at baseline, three, six and twelve months. Results: At the end of the 12-month programme, users showed sustained improvements in physical activity (by +1331 METS), exceeding weekly recommendations. Sitting (reducing by over an hour per day), sporting participation, and perceptions of health were also improved, with improvements in mental wellbeing in the first three months. Conclusion: Designing and delivering a community-based physical activity programme that is theoretically-driven and evidence-based with frequent behaviour change training and supervision can yield a significant increase in self-reported physical activity, reduction in sitting behaviour and improvements to perceived health and mental wellbeing. Future research should extend this approach, utilising a real-world, pragmatic evaluation. Trial registration: ClinicalTrials.gov identifier (NCT number): NCT03153098
    • A-REST (Activity to Reduce Excessive Sitting Time): a feasibility trial to reduce prolonged sitting in police staff

      Brierley, Marsha Lynn; Smith, Lindsey Rachel; Chater, Angel M.; Bailey, Daniel Paul; University of Bedfordshire; Brunel University; University College London (MDPI, 2022-07-27)
      The aim of this study was to evaluate the acceptability and feasibility of a theory-derived sedentary workplace intervention for police office staff. Twenty-four staff participated in an 8-week intervention (single arm, pre-post design) incorporating an education session, team competition with quick response (QR) codes, team trophy, weekly leaderboard newsletters, a self-monitoring phone app, and electronic prompt tools. The intervention supported participants to reduce and break up their sitting time with three minutes of incidental movement every 30 min at work. Feasibility and acceptability were assessed using mixed methods via the RE-AIM QuEST and PRECIS-2 frameworks. The intervention was highly pragmatic in terms of eligibility, organisation, adherence, outcome, and analysis. It was slightly less pragmatic on recruitment and setting. Delivery and follow-up were more explanatory. Reach and adoption indicators demonstrated feasibility among police staff, across a range of departments, who were demographically similar to participants in previous office-based multi-component interventions. The intervention was delivered mostly as planned with minor deviations from protocol (implementation fidelity). Participants perceived the intervention components as highly acceptable. Results showed improvements in workplace sitting and standing, as well as small improvements in weight and positive affect. Evaluation of the intervention in a fully powered randomised controlled trial to assess behaviour and health outcomes is recommended.
    • Association of ankle sprain frequency with body mass and self-reported function: a pooled multisite analysis

      Rosen, Adam B.; Jaffri, Abbis; Mitchell, Andrew C.S.; Koldenhoven, Rachel M.; Powden, Cameron J.; Fraser, John J.; Simon, Janet E.; Hoch, Matthew; Burcal, Christopher J.; University of Nebraska; et al. (Human Kinetics, 2022-05-26)
      Context: Ankle sprains result in pain and disability. While factors such as body mass and prior injury contribute to subsequent injury, the association of the number of ankle sprains on body anthropometrics and self-reported function are unclear in this population. Therefore, the purpose of this investigation was to assess differences in anthropometric measurements and selfreported function between the number of ankle sprains utilizing a large, pooled data set. Design: Cross-sectional. Methods: Data were pooled from 14 studies (total N = 412) collected by the Chronic Ankle Instability Outcomes Network. Participants were categorized by the number of self-reported sprains. Anthropometric data and self-reported function were compared between those who reported a single versus >1 ankle sprain as well as among groups of those who had 1, 2, 3, 4, and ≥5 ankle sprains, respectively. Results: Those who had >1 ankle sprain had higher mass (P = .001, d = 0.33) and body mass index (P = .002, d = 0.32) and lower Foot and Ankle Ability Measure-Activities of Daily Living (P < .001, r = .22), Foot and Ankle Ability Measure-Sport (P < .001, r = .33), and Cumberland Ankle Instability Tool (P < .001, r = .34) scores compared to the single ankle sprain group. Those who had a single ankle sprain weighed less than those who reported ≥5 sprains (P = .008, d = 0.42) and had a lower body mass index than those who reported 2 sprains (P = .031, d = 0.45). Conclusions: Some individuals with a history of multiple ankle sprains had higher body mass and self-reported disability compared to those with a single sprain, factors that are likely interrelated. Due to the potential for long-term health concerns associated with ankle sprains, clinicians should incorporate patient education and interventions that promote physical activity, healthy dietary intake, and optimize function as part of comprehensive patient-centered care.
    • A commentary on soccer match-play simulations for applied research and practice

      Field, Adam C.; Harper, Liam D.; Aldous, Jeffrey William Frederick; Page, Richard M. (Taylor and Francis Online, 2022-05-09)
      Soccer is a fast-growing area of research, demonstrated by a 10-fold increase in the number of PubMed articles derived from the search term ‘soccer’ between 2001 and 2021. The scope of contemporary soccer related articles ranges from match-play observations to laboratory evaluations of performance. The activity profile of soccer match-play is variable and techniques to collect data within matches are limited. Soccer-specific simulations have been developed to simulate the evolving demands of match-play. The evolutionary designs of novel simulations provide a reproducible exercise stimulus for varying researcher and practitioner objectives. The applied researcher can utilise simulations to investigate the efficacy of nutritional interventions and environmental stress on performance, while assessing the physiological and biomechanical responses to representations of match-play. Practitioners can adopt simulations for rehabilitation to progressively facilitate return-to-play processes, while implementing extra top-up conditioning sessions for unused and partial-match players. However, there are complexities involved with the selection of varying simulations which are dependent on the research question or practical application. There also remains a paucity of published information to support researchers and practitioners in selecting from differing simulation models. To assist with researcher and practitioner interpretations, we present a commentary of the current simulations to inform decision-making processes for research and training purposes and enhance the application of future research. An objective scoring system was adopted for rating the research and practical applications of each simulation design. Overall scores of 22, 16 and 18 out of 36 were revealed for free-running (n = 7), non-motorised- (n = 4) and motorisedtreadmill-based simulations (n = 4), respectively.
    • Exploring the notion of literacy within physical literacy: a discussion paper

      Durden-Myers, Elizabeth Jayne; Bartle, Gillian; Whitehead, Margaret; Dhillon, Karamjeet K.; ; Bath Spa University; University of Gloucestershire; University of Dundee; University of Stirling; University of Bedfordshire; et al. (Frontiers, 2022-05-03)
      The concept of physical literacy is continuing to gain traction internationally. This increasing interest has also given rise to concerns about the use, interpretation and meaning of the term "literacy" within the context of physical literacy. This paper explores the development of the terms literate, illiterate, literacy, and illiteracy identifying their historical origin and contemporary meaning. This provides the backdrop to explore the use of the term literacy within the context of physical literacy. In the final part of this introductory section the recent popularity of the literacies movement is explored. Our discussion identifies key intersections and areas of tension associated with the use, interpretation and meaning of literacy in the context of physical literacy. We adopt Whitehead's philosophy of physical literacy and discussion is informed further by Derrida's notion of differance, and Barad's challenge to singular representations of concepts. Once harnessing these concepts, we reach a juncture of an in-between space; entry points of nonidentity (sameness) and points where multiple effects of difference are created. Key discussion topics include: discourse, language and interpretations of literacy; in/tangibility of literacy; capturing literacy; literacy as a process or a product; connotations of the terms literate and illiterate; neoliberalism and literacy and finally literacy as learning. We believe that when understood as the productive and meaningful interaction with/in/through the world, literacy is still the appropriate term within the context of physical literacy. Our discussion leads us to conclude that as embodied individuals, physical literacy is often the literacy through which other literacies have to pass. Through physical activity individuals can not only nurture their own physical literacy but also contribute toward a global or holistic literacy that helps us navigate, connect and make sense of ourselves, others and the world around us. However, the paper acknowledges that this meaning is not always grasped with the historical understanding of literacy as well as it's translations into other languages presenting challenges in articulating the intended use, meaning and connotations of the contemporary understanding of physical literacy.
    • A randomised, double-blind, placebo-controlled trial evaluating concentrated phytochemical-rich nutritional capsule in addition to a probiotic capsule on clinical outcomes among individuals with COVID-19— the UK Phyto-V Study

      Thomas, Robert; Williams, Madeleine; Aldous, Jeffrey William Frederick; Yanagisawa, Yuuki; Kumar, Rajeev; Forsyth, Rachel; Chater, Angel M.; ; Bedfordshire Hospital NHS Trusts; University of Bedfordshire; et al. (MDPI, 2022-03-22)
      Gut microflora dysbiosis affects the majority of individuals after COVID-19, contributing to both gastro-intestinal (GI) and non-GI symptoms. Natural phytochemicals have reported anti-viral properties and favourable effects on inflammatory and oxidative pathways, both important for tissue damage post-viral pneumonia. This study involved 147 participants with symptomatic COVID-19, randomised to receive a placebo (P) or a phytochemical-rich concentrated food capsule (PC) in addition to a pre/probiotic lactobacillus capsule. Participants taking the PC had an almost two-fold reduction in mean fatigue scores compared to P [p = 0.02], a three-fold reduction in cough score and more than a double improvement in overall well-being scores [p = 0.02]. Two (1.5%) participants reported mild, increased bloating which they felt was attributable to the capsules, although GI symptoms improved in 25 of 31 participants (82%) who reported them at baseline. Sedentary, older, previously hospitalised men with GI symptoms had a statistically significantly improvement among those given the probiotic. Although some participants with early disease would have improved spontaneously, such a rapid improvement observed in the majority of participants, who had been suffering for an average of 108 days, was clinically relevant and welcomed, especially among those more likely to have pre-existing gut dysbiosis. We are now evaluating whether this blend could also enhance antibody titres post-COVID-19 vaccination.
    • Evaluating a multi-component intervention to reduce and break up office workers’ sitting with sit-stand desks using the APEASE criteria

      Brierley, Marsha L.; Smith, Lindsey Rachel; Bailey, Daniel Paul; Ojo, Samson Oluseye; Hewson, David; Every, Sofie A.; Staines, Taylor A.; Chater, Angel M.; University of Bedfordshire; Brunel University; et al. (BMC Public Health, 2022-03-07)
      Objective: Sedentary workplace interventions have had success in reducing excessive sitting time in office workers, but barriers to implementation and uptake remain. This study formally assessed a theory-derived, sit-stand desk intervention using the APEASE (Acceptability, Practicability, Effectiveness, Affordability, Side effects, Equity) criteria. Methods: Thirteen adults (eight female, mean age 38±10 years) from the treatment arm of a sedentary behaviour intervention participated in semi-structured interviews. Thematic codes were inductively assigned to data items followed by deductive charting using the APEASE framework. Results: The intervention was highly acceptable, practicable, safe to deploy, and helped workers reduce workplace sitting time, though individual preferences and workload mediated engagement. Affordability of sit-stand desks and Equity of access were potential barriers to uptake. Conclusions: This theory-derived, multi-component sit-stand desk intervention was highly acceptable to office workers, safe to deploy, and useful in reducing and breaking up sedentary time at work. Further tailoring and personalisation may help workers achieve greater reductions in workplace sitting.
    • Relationships between highly skilled golfers’ clubhead velocity and kinetic variables during a countermovement jump

      Wells, Jack E.T.; Mitchell, Andrew C.S.; Charalambous, Laura H.; Fletcher, Iain M.; ; Professional Golfers’ Association; University of Bedfordshire (Routledge, 2022-02-28)
      Previous research has sought to establish the relationship countermovement jump (CMJ) performance has with clubhead velocity (CHV). However, these investigations either assessed lower skilled golfers, or utilised field-based protocols which are unable to assess a number of biomechanical variables. Fifty highly skilled golfers performed CMJs on Kistler force platforms in laboratory conditions. The CMJ variables included positive impulse, net impulse, average power, peak power, peak force, force at zero velocity and jump height. Clubhead velocity was measured using a TrackMan 3e launch monitor at a driving range. A Pearsons correlation was employed to measure the strength and direction of the relationships between CHV and CMJ derived performance variables. Results indicated strong positive relationships (all p’s &lt;0.001) between CHV and positive impulse (r = 0.695), net impulse (r = 0.689), average power (r = 0.645), peak power (r = 0.656), peak force (r = 0.517) and force at zero velocity (r = 0.528) with no significant relationship with jump height. However, if investigators only have access to field-based protocols, it is recommended that they measure jump height and utilise inverse dynamics to calculate take-off velocity. By multiplying take-off velocity by mass, this allows the attainment of net impulse. Key words: Golf, Physical Profiling, Impulse, Power, Peak Force, Vertical Jump
    • Reflections on experiencing parental bereavement as a young person: a retrospective qualitative study

      Chater, Angel M.; Howlett, Neil; Shorter, Gillian; Zakrzewski-Fruer, Julia K.; Williams, Jane; ; University of Bedfordshire; University College London; University of Hertfordshire; Queen’s University Belfast (MDPI, 2022-02-13)
      Background: It is estimated that approximately 41,000 children and young people experience the death of a parent each year. Grief responses, such as anxiety and depression, can follow. This research investigated the adult reflections of experiencing parental death as a young person. Methods: Semi-structured interviews were conducted with adults (N = 14; female n = 8) who experienced parental death as a young person, which occurred over 5 years ago (time since death, M = 12.9 years; age at death, M = 16.4 years; age at interview, M = 30.9 years). The data were analysed inductively using thematic analysis. Results: Seven themes revealed that parental bereavement can lead to (1) “Distance and isolation” and is an (2) “Emotional journey” with (3) a “Physical impact”. Many experienced (4) “Post-traumatic growth” but acknowledged that (5) “Life will never be the same”, highlighting the importance of (6) “Support and understanding” and triggers for (7) “Re-grief”. Conclusions: Parental bereavement has significant emotional and physical consequences, but can also lead to personal growth. Talking therapies were rarely accessed, often due to a lack of awareness or desire to engage, revealing a translational gap between existing support services and uptake. Enabling open conversations about grief and identifying suitable support is a public health priority. This need has been amplified since the start of the COVID-19 pandemic, which may be a trigger for grief empathy and re-grief in those who have already been bereaved.
    • Lower amounts of daily and prolonged sitting do not lower free-living continuously monitored glucose concentrations in overweight and obese adults: a randomised crossover study

      Bailey, Daniel Paul; Stringer, Charlotte Anne; Maylor, Benjamin David; Zakrzewski-Fruer, Julia K.; ; Brunel University; University of Bedfordshire; University of Leicester (MDPI, 2022-01-30)
      This study compared the short-term continuously monitored glucose responses between higher and lower amounts of prolonged sitting in overweight and obese adults under free-living conditions. In a randomised crossover design, 12 participants (age 48 ± 10 years, body mass index 33.3 ± 5.5 kg/m2 ) completed two four-day experimental regimens while wearing a continuous glucose monitor, as follows: (1) uninterrupted sitting (participants were instructed to sit for ≥10 h/day and accrue ≥7, 1 h sitting bouts each day), and (2) interrupted sitting (participants were instructed to interrupt sitting every 30 min during ten of their waking hours with 6–10 min of activity accrued in each hour). Linear mixed models compared outcomes between regimens. None of the continuously monitored glucose variables differed between regimens, e.g., 24 h net incremental area under the glucose curve was 5.9 [95% CI: −1.4, 13.1] and 5.6 [95% CI: −1.7, 12.8] mmol/L·24 h, respectively (p = 0.47). Daily sitting (−58 min/day, p = 0.001) and sitting bouts lasting ≥30 min (−99 min/day, p &lt; 0.001) were significantly lower and stepping time significantly higher (+40 min/day, p &lt; 0.001) in the interrupted sitting than the uninterrupted sitting regimen. In conclusion, lower amounts of daily and prolonged sitting did not improve free-living continuously measured glucose among overweight and obese adults
    • Breakfast consumption suppresses appetite but does not increase daily energy intake or physical activity energy expenditure when compared with breakfast omission in adolescent girls who habitually skip breakfast: a 7-day randomised crossover trial

      Zakrzewski-Fruer, Julia K.; Seall, Claire; Tolfrey, Keith; ; University of Bedfordshire; Loughborough University (MDPI, 2021-11-26)
      With concerns that adolescent girls often skip breakfast, this study compared the effects of breakfast consumption versus breakfast omission on free-living physical activity (PA) energy expenditure (PAEE) and dietary intakes among adolescent girls classified as habitual breakfast skippers. The participants went through two 7-day conditions in a trial with a crossover design: daily standardised breakfast consumption (energy content: 25% of resting metabolic rate) before 09:00 (BC) and daily breakfast omission (no energy-providing nutrients consumed) until 10:30 (BO). Free-living PAEE, dietary intakes, and perceived appetite, tiredness, and energy levels were assessed. Analyses were linear mixed models. Breakfast manipulation did not affect PAEE or PA duration. Daily fibre intake was higher (p = 0.005; d = 1.31), daily protein intake tended to be higher (p = 0.092; d = 0.54), post-10:30 carbohydrate intake tended to be lower (p = 0.096; d = 0.41), and pre-10:30 hunger and fullness were lower and higher, respectively (p ≤ 0.065; d = 0.33–1.01), in BC versus BO. No other between-condition differences were found. Breakfast-skipping adolescent girls do not compensate for an imbalance in energy intake caused by breakfast consumption versus omission through subsequent changes in PAEE but may increase their carbohydrate intakes later in the day to partially compensate for breakfast omission. Furthermore, breakfast can make substantial contributions to daily fibre intake among adolescent girls.
    • Perceived influences on reducing prolonged sitting in police staff: a qualitative investigation using the Theoretical Domains Framework and COM-B model

      Brierley, Marsha L.; Smith, Lindsey Rachel; Bailey, Daniel Paul; Every, Sofie A.; Staines, Taylor A.; Chater, Angel M.; ; University of Bedfordshire; University College London; Brunel University (Biomed Central, 2021-11-19)
      Background: Workplace interventions have shown promise for reducing sitting in office workers. Police office staff remain an understudied population group that work within a disciplined organisation with distinctive work tasks around public safety, potentially affecting their capability, opportunity, and motivation to change sitting behaviour. This study aimed to assess the perceived influences on reducing workplace sitting in non-operational, desk-based police staff in order to derive theoretical determinants for behaviour change. Methods: Ten police staff from a single police force in Bedfordshire, England [eight female; 39.5±11.5 years] took part in face-to-face semi-structured interviews lasting 46±11 minutes on average. Thematic analysis identified key themes which were then mapped onto the Theoretical Domains Framework (TDF) and linked to the Capability, Opportunity, Motivation-Behaviour (COM-B) model. Results: Seven themes were identified: ‘Work tasks are seated’, ‘Social norm is to sit’, ‘Belief in ability to regulate behaviour’, ‘Knowledge of health risks’, ‘Organisational support’, ‘Impact on productivity’, and ‘Perceived autonomy for sitting reduction’. Conclusions: Awareness of behaviour and health impacts (Capability), social and physical support to sit less (Opportunity), and habit formation techniques (Motivation) are recommended considerations in sitting reduction workplace interventions for police staff.
    • The influence of a blend of probiotic lactobacillus and prebiotic inulin on the duration and severity of symptoms among individuals with COVID-19

      Thomas, Robert; Aldous, Jeffrey William Frederick; Forsyth, Rachel; Chater, Angel M.; Williams, Madeleine; ; Bedford & Addenbrooke’s Cambridge University NHS Trusts; University of Bedfordshire; Cambridge University; Bedford Hospital (Gavin Publishers, 2021-11-16)
      Background: Gut microfloral dysbiosis is known to affect the majority individuals suffering with a Covid-19 infection. This study evaluated whether a specific lactobacillus and inulin blend, which aimed to improve gut health, could reduce the severity of early and chronic Covid-19 symptoms. Methods: From May 2020 to May 2021, we evaluated 126 participants with Covid-19, with an average duration of symptoms of 108 days, who were given 30 days of this pre and probiotic capsule within the ongoing UK national Phyto-v study. Symptoms were recorded using the validated Cough Symptom Score, the Subjective Well-Being questionnaire and the Chandler fatigue questionnaire. The group was analysed as a whole and then subdivided into 40 (32%) in an early phase of infection (average symptoms 10 days before baseline) and the 86 (68%) in a chronic phase (average symptoms 120 days before trial baseline). Results: Cough, fatigue and subjective well-being scores significantly improved over the 30 days in both the early and chronic phase cohorts. Participants who were more likely to have gut dysbiosis at trial entry, such as sedentary, hospitalised, older males with GI symptoms, had a statistically significantly better response to the probiotics. Gut symptoms improved in 25 of 31 (82%) who reported them at baseline. Two (1.5%) patients reported mild increased bloating and diarrhoea. Discussion: Following this nutritional intervention, participants had a significant improvement in GI and non-GI symptoms resulting in a meaningful improvement in overall well-being. Although some participants with early disease would have improved spontaneously, such a rapid improvement in the majority who had been experiencing symptoms for over 6 months, was clinically relevant and welcomed, especially among those more likely to have pre-existing gut dysbiosis. Going forward, our research group are now evaluating whether intake of this blend now known as yourgutplus+, could also enhance antibody titres levels post Covid vaccination.
    • Left ventricular remodeling in rugby is a physiological adaptation to exercise: a pilot study conducted with high-level athletes

      Rato, Nuno Dias; Richards, Joanna C.; University of Bedfordshire; University of Maia (Springer, 2021-10-11)
      Purpose Literature examining left ventricular (LV) structural adaptations to combined strength and endurance training is inconsistent. Rugby is a sport that combines these two exercise modalities, both during training and match play. This study aimed to explore differences in LV structure between high-level rugby players and untrained controls. Body composition analysis was performed to determine the most appropriate indexing variable for LV mass (LVM) and understand if increases in LV represent either a training-related physiological adaptation or reflect the groups’ anthropometric differences. Methods A cross-sectional design compared 10 rugby players and 10 untrained age-matched, male controls. Body composition was obtained by bioelectrical impedance. M-mode echocardiographic imaging was performed on the LV from the parasternal long axis view. Results Significantly greater end-diastolic interventricular septum, LV internal diameter, posterior wall thickness, LVM and LVM/fat-free mass (FFM) (p &lt; 0.05) were found in rugby players compared to age-matched controls. Moreover, Pearson’s correlation tests revealed FFM to be the body composition variable with the strongest correlation to LVM (r = 0.775, p &lt; 0.001). Conclusion The differences in LV structure between groups suggest that the combined endurance and strength training that rugby athletes are subjected to, induce a process of concentric and eccentric enlargement of the LV structure. Furthermore, the association found with FFM, suggests it to be the most appropriate body scaling variable to index to LVM and, thus, should be considered when describing increases in LVM. The present research suggests that increased LVM in the athletes group represents true physiological adaptations to training.
    • What influences people’s responses to public health messages for managing risks and preventing infectious diseases? a rapid systematic review of the evidence and recommendations

      Ghio, Daniela; Lawes-Wickwar, Sadie; Tang, Mei Yee; Epton, Tracy; Howlett, Neil; Jenkinson, Elizabeth; Stanescu, Sabina; Westbrook, Juliette; Kassianos, Angelos P.; Watson, Daniella; et al. (BMJ, 2021-10-05)
      Background Individual behaviour changes, such as hand hygiene and physical distancing, are required on a population scale to reduce transmission of infectious diseases such as COVID-19. However, little is known about effective methods of communicating risk reducing information, and how populations might respond. Objective To synthesise evidence relating to what: a) characterises effective public health messages for managing risk and preventing infectious disease, b) influences people’s responses to messages. Design A rapid systematic review was conducted. Protocol is published on Prospero CRD42020188704. Data sources Electronic databases were searched: Ovid Medline, Ovid PsycINFO and Healthevidence.org, and grey literature (PsyarXiv, OSF Preprints) up to May 2020. Study selection All study designs were included that: (a) evaluated public health messaging interventions targeted at adults, (b) concerned a communicable disease spread via primary route of transmission of respiratory and/or touch. Outcomes included preventative behaviours, perceptions/awareness and intentions. Non-English language papers were excluded. Synthesis Due to high heterogeneity studies were synthesised narratively focusing on determinants of intentions in the absence of measured adherence/preventative behaviours. Themes were developed independently by two researchers and discussed within team to reach consensus. Recommendations were translated from narrative synthesis to provide evidence-based methods in providing effective messaging. Results Sixty-eight eligible papers were identified. Characteristics of effective messaging include delivery by credible sources, community engagement, increasing awareness/knowledge, mapping to stage of epidemic/pandemic. To influence intent effectively, public health messages need to be acceptable, increase understanding/perceptions of health threat and perceived susceptibility. Discussion There are four key recommendations: (1) engage communities in development of messaging, (2) address uncertainty immediately and with transparency, (3) focus on unifying messages from sources, and (4) frame messages aimed at increasing understanding, social responsibility and personal control. Embedding principles of behavioural science into public health messaging is an important step towards more effective health-risk communication during epidemics/pandemics.
    • 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.