• Addition of docetaxel to hormonal therapy in low- and high-burden metastatic hormone sensitive prostate cancer: long-term survival results from the STAMPEDE trial.

      Clarke, NW; Ali, A; Ingleby, FC; Hoyle, A; Amos, CL; Attard, G; Brawley, CD; Calvert, J; Chowdhury, S; Cook, A; et al. (Elsevier, 2019-09-27)
      BACKGROUND:STAMPEDE has previously reported that the use of upfront docetaxel improved overall survival (OS) for metastatic hormone naïve prostate cancer patients starting long-term androgen deprivation therapy. We report on long-term outcomes stratified by metastatic burden for M1 patients. METHODS:We randomly allocated patients in 2 : 1 ratio to standard-of-care (SOC; control group) or SOC + docetaxel. Metastatic disease burden was categorised using retrospectively-collected baseline staging scans where available. Analysis used Cox regression models, adjusted for stratification factors, with emphasis on restricted mean survival time where hazards were non-proportional. RESULTS:Between 05 October 2005 and 31 March 2013, 1086 M1 patients were randomised to receive SOC (n = 724) or SOC + docetaxel (n = 362). Metastatic burden was assessable for 830/1086 (76%) patients; 362 (44%) had low and 468 (56%) high metastatic burden. Median follow-up was 78.2 months. There were 494 deaths on SOC (41% more than the previous report). There was good evidence of benefit of docetaxel over SOC on OS (HR = 0.81, 95% CI 0.69-0.95, P = 0.009) with no evidence of heterogeneity of docetaxel effect between metastatic burden sub-groups (interaction P = 0.827). Analysis of other outcomes found evidence of benefit for docetaxel over SOC in failure-free survival (HR = 0.66, 95% CI 0.57-0.76, P < 0.001) and progression-free survival (HR = 0.69, 95% CI 0.59-0.81, P < 0.001) with no evidence of heterogeneity of docetaxel effect between metastatic burden sub-groups (interaction P > 0.5 in each case). There was no evidence that docetaxel resulted in late toxicity compared with SOC: after 1 year, G3-5 toxicity was reported for 28% SOC and 27% docetaxel (in patients still on follow-up at 1 year without prior progression). CONCLUSIONS:The clinically significant benefit in survival for upfront docetaxel persists at longer follow-up, with no evidence that benefit differed by metastatic burden. We advocate that upfront docetaxel is considered for metastatic hormone naïve prostate cancer patients regardless of metastatic burden.
    • An integrative review of the hospital experiences of people with an intellectual disability: Lack of orthopaedic and trauma perspectives.

      Drozd, Mary; Chadwick, Darren; Jester, Rebecca (Elsevier, 2022-01-01)
      The United Nations Convention on the Rights of Persons with Disabilities (2006) states the rights of disabled people to ‘enjoyment of the highest standards of health without discrimination on the basis of disability’ (article 25). Despite this, the level of care provided for people with intellectual disabilities (PWID) in general hospitals has been an area of concern due to evidence of abuse, neglect and discrimination (Disability Rights Commission, 2006) as well as evidence of premature deaths in hospitals (Heslop et al., 2013). Following the harrowing report, ‘Death by Indifference’ (Mencap, 2007) in which it was highlighted that PWID died as a result of poor hospital care in the UK, there have been numerous reports, policy guidance and legal requirements issued to provide direction for hospital services, for example: Michael (2008); Emerson et al. (2012a; 2012b).
    • ‘Make not your prisons your prisons’: Participant-percieved potential outcomes of a Shakespeare focussed alternative to juvenile incarceration in the USA

      Nicklin, Laura L. (Informa UK Limited, 2017-02-13)
      For over two decades, there has been a progressive emergence of Shakespeare-focussed, performance-based programmes intended for use as criminal rehabilitation in the USA. Prison based criminal retribution, though historically prevalent, remains controversial. Although it is still used as a common method for rehabilitation, evidence demonstrates that alternative sentences have a consistently more positive impact on reducing rates of recidivism. Some criminal justice organisations and institutions in the United States of America have invested in enabling Shakespeare courses to become supplements or, in some juvenile cases, alternatives to incarceration. In particular, some state judiciary courts have introduced a series of Shakespeare courses to serve as alternative sentences for juvenile crime. The Shakespeare focussed alternative programme considered in this research is celebrating its seventeenth anniversary in 2017. This article considers the specific programme practices and reported outcomes of one now well established, yet widely underreported, Shakespeare-based alternative programme for juveniles in the USA, exploring the juvenile perspectives of the outcomes of activities that are designed for them by adults working in performing arts and/or juvenile criminal services. Key outcomes from participants related specifically to programme content, the selection and use of Shakespeare, skills acquisition and personal development culminating in overall behavioural change.
    • What constitutes high quality higher education pedagogical research

      Evans, Carol; Kandiko-Howson, Camile; Forsythe, Alexandra; Edwards, Corony (Taylor & Francis, 2022-01-01)
      Over the last 20 years there has been significant growth in the volume of higher education pedagogical research across disciplines and national contexts, but inherent tensions in defining quality remain. In this paper we present a framework to support understanding of what constitutes internationally excellent research, drawing on a range of conceptual frameworks, international and national performance-based research funding systems, discipline/professional body frameworks, and research council guidance. While acknowledging the contested nature of excellence in higher education pedagogical research, we provide criteria to guide discussion and to support individual and organisational learning. A key premise is that if learning and teaching in higher education are to be enhanced, considerable investment is required in supporting the development of integrated academics where emphasis is on both research and practice to inform pedagogy. Research and evaluation are essential aspects of teaching and need to be embedded within it. The framework is designed to enable colleagues to develop the necessary tools and approaches to support understanding of educational research and adapt these within their disciplinary context.
    • Does recent research evidence support the hyperpersonal model of online impression management?

      Scott, Graham G; Fullwood, Chris (Elsevier BV, 2020-05-30)
      The hyperpersonal model of communication was conceived in the 1990s and has driven much of the research into online impression management. Based on four principal tenets (increased control, asynchronicity of communication, increased physical distance and reallocation of cognitive resources) it has largely received empirical support, especially by research involving text-only communication. This review briefly summarises this research before identifying four areas in which it is not supported by findings: the wider context of online communication, the expanding nature of online platforms to include pictures and video, use of language in online environments, and online self-disclosure. We suggest that the model is modified and updated, or its limitations defined, with respect to this evidence.
    • A visual scan analysis protocol for postural assessment at school in young students

      Alves, ME; Marinho, DA; Carneiro, DN; Alves, J; Forte, P; Nevill, AM; Morais, JE; Department of Sports, Higher Institute of Educational Sciences of the Douro, 4560-708 Penafiel, Portugal. (MDPI, 2020-04-23)
      © 2020 by the authors. Licensee MDPI, Basel, Switzerland. The aim of this study was to compare the X-ray diagnosis with a non-invasive method for spine alignment assessment adopting a visual scan analysis with a plumb line and simetograph in middle-school students. The sample of this study was composed of 31 males and 50 females with an average age of 14.23 (± 3.11) years. The visual scan analysis was assessed at a school; whereas, the X-ray was performed in a hospital. The Wilcoxon signed-rank test was used to assess the differences between methods and scoliosis classifications (non-accentuated <10º and scoliosis >10º), and the Kappa was used to assess the agreement between methods. The comparisons between the methods revealed non-significant differences (z = −0.577; p = 0.564), with almost perfect agreement between tests (K = 0.821; p < 0.001). Moreover, no statistical significance was observed between methods by the scoliosis classification (z = −1.000; p = 0.317), with almost perfect agreement between tests (K = 0.888; p < 0.001). This research supports the conclusion that there are no significant differences between the two methods. Therefore, it should be highlighted that this field test should be used by physical education teachers in their classes, or in a school context, in order to determine misalignments or scoliosis prevalence among middle-school students.
    • Oral health Inequalities in 0-17-year-old children referred for dental extractions under general anaesthesia in Wolverhampton, 2013-2017

      Harper, RS; Khan, I; Chen, R; Neville, A; Head and Neck, The Royal Wolverhampton Hospital NHS Trust, United Kingdom. (Dennis Barber, 2020-04-20)
      OBJECTIVE:Describe the inequalities in oral health in children treated in a hospital located in a deprived urban area in the UK. RESEARCH DESIGN:Case-note review of 1911 0-17-year-olds who underwent dental extractions under a general anaesthetic (DGA). MAIN OUTCOME MEASURES:Associations between Age, Ethnicity, Year-of-Treatment and Index of Multiple Deprivation (IMD) with the number of teeth extracted. Analysis used multilevel modelling assuming a Poisson distribution. RESULTS:Mean number of teeth extracted was higher in the youngest children treated aged 0-5 years (relative risk coefficient, (RR=exp(β)=1.39; 95% CI 1.24 to 1.56) compared to those aged 6-17 years and in 'Other Whites' (predominantly immigrants from Eastern Europe) (RR=exp(β)=1.34; 95% CI 1.25 to 1.43), 'South Asians' (RR=exp(β)=1.15; 95% CI 1.08 to 1.23) but fewer in the 'Black' ethnic group (RR=exp(β)=0.85; 95% CI 0.76 to 0.95). DGA increased during the study with more teeth extracted in 2015, 2016 and 2017 (RR=exp(β)=1.12, 95% CI 1.22, 1.25) and with a negative gradient in the rate of DGA's (per decile) in children from the most deprived to most affluent locations (RR=exp(β)=0.98; 95% CI 0.97 to 0.99). CONCLUSIONS:Significant oral health inequalities exist in children from a deprived urban area in the UK. A preventive approach to children's oral health is needed to reduce such inequalities, including public health and healthcare agencies to informing parents of children whose first language is not English about dental caries.
    • The school restaurant: Ethnographic reflections in researching children’s food space

      Lalli, Gurpinder (Taylor & Francis, 2020-12-31)
      This paper presents a theoretically influenced discussion of methodological issues in carrying out ethnographic work at Peartree Academy. Food is central to our sense of identity. It draws on notions of the school restaurant and presents an account of the complexities surrounding the disorderliness of fieldwork in researching children’s food space. The aim of this paper is to explore how researcher identity needs to be considered within the relationship between discipline and social learning spaces for eating. Foucault’s concept of discipline is introduced in conceptualising the study. Key reflections place emphasis on the messiness of researching such spaces and offer recommendations for navigation.
    • Measurement of sedentary time and physical activity in rheumatoid arthritis: an ActiGraph and activPAL™ validation study

      O’Brien, CM; Duda, JL; Kitas, GD; Veldhuijzen van Zanten, JJCS; Metsios, GS; Fenton, SAM; School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, UK. (Springer Science and Business Media LLC, 2020-05-29)
      © 2020, The Author(s). Accurate measurement of sedentary time and physical activity (PA) is essential to establish their relationships with rheumatoid arthritis (RA) outcomes. Study objectives were to: (1) validate the GT3X+ and activPAL3μ™, and develop RA-specific accelerometer (count-based) cut-points for measuring sedentary time, light-intensity PA and moderate-intensity PA (laboratory-validation); (2) determine the accuracy of the RA-specific (vs. non-RA) cut-points, for estimating free-living sedentary time in RA (field-validation). Laboratory-validation: RA patients (n = 22) were fitted with a GT3X+, activPAL3μ™ and indirect calorimeter. Whilst being video-recorded, participants undertook 11 activities, comprising sedentary, light-intensity and moderate-intensity behaviours. Criterion standards for devices were indirect calorimetry (GT3X+) and direct observation (activPAL3μ™). Field-validation: RA patients (n = 100) wore a GT3X+ and activPAL3μ™ for 7 days. The criterion standard for sedentary time cut-points (RA-specific vs. non-RA) was the activPAL3μ™. Results of the laboratory-validation: GT3X—receiver operating characteristic curves generated RA-specific cut-points (counts/min) for: sedentary time = ≤ 244; light-intensity PA = 245–2501; moderate-intensity PA ≥ 2502 (all sensitivity ≥ 0.87 and 1-specificity ≤ 0.11). ActivPAL3μ™—Bland–Altman 95% limits of agreement (lower–upper [min]) were: sedentary = (− 0.1 to 0.2); standing = (− 0.7 to 1.1); stepping = (− 1.2 to 0.6). Results of the field-validation: compared to the activPAL3μ™, Bland–Altman 95% limits of agreement (lower–upper) for sedentary time (min/day) estimated by the RA-specific cut-point = (− 42.6 to 318.0) vs. the non-RA cut-point = (− 19.6 to 432.0). In conclusion, the activPAL3μ™ accurately quantifies sedentary, standing and stepping time in RA. The RA-specific cut-points offer a validated measure of sedentary time, light-intensity PA and moderate-intensity PA in these patients, and demonstrated superior accuracy for estimating free-living sedentary time, compared to non-RA cut-points.
    • The Early Years Pupil Premium: practitioners’ perspectives on if the funding supports ‘closing the gap’ for looked after children?

      Williams-Brown, Z (Taylor & Francis (Routledge), 2020-02-18)
      © 2020, © 2020 Informa UK Limited, trading as Taylor & Francis Group. The paper investigates practitioners’ perspectives on the Early Years Pupil Premium (EYPP) and its use for looked after children (LAC) in England. The paper considers what practitioners in one Local Authority (LA) think now that the funding has passed its infancy. Specifically, does EYPP funding help ‘close the gap’ for LAC? Q-methodology was used to investigate 19 practitioners’ perspectives; all were owners or managers in 19 different settings. This approach was complemented with a questionnaire survey and focus groups held with 14 practitioners in 13 different settings in the same LA. The findings revealed that practitioners consistently focused on whether all LAC should be eligible for this funding and/or whether the funding is able to ‘close the gap’ between them and their peers. It concludes that EYPP funding can support ‘closing the gap’ for LAC with developmental delay, but its purpose needs to be clarified.
    • Bilateral differences on dancers’ dynamic postural stability during jump landing

      Clarke, Frances; Koutedakis, Yiannis; Wilson, Margaret; Wyon, Matthew (J.Michael Ryan Publishing Inc., 2020-12-31)
      Purpose: Although traditional dance training aims to train dancers’ legs equally, the recognised practice of predominately starting and repeating exercises on one side more than the other has led to suggestions that technique classes may cause lateral bias. Such an imbalance could lead to a greater risk of injury, however, despite this potential risk, little is known about the effects of bilateral differences on dancers’ postural stability during jump landings, a key dynamic action in dance. Therefore, the aim of this study was to examine the effects of possible bilateral differences on dynamic postural stability during single-leg landing using a time to stabilisation protocol. Methods: Thirty-two injury-free female dance university undergraduates (19+1.9 years; 164.8+6.7cm; 62.6+13.6kg) volunteered. They completed a two foot to one-foot jump over a bar onto a force platform stabilising as quickly as possible. The landing leg was randomly assigned, and participants completed three trials for each leg. Results: No significant differences in dynamic postural stability between the right and left leg were revealed and poor effect size was noted (p>0.05): MLSI: t= -.04, df= 190, p= .940 (CI= -.04,.04, r2 = 0); APSI: t= .65, df= 190, p= .519 (CI= -.06-,.12, r2 =.09); VSI: t= 1.85, df= 190, p= .066 (CI= -.02,.68, r2 = .27); DPSI: t= 1.88, df= 190, p= .061 (CI= -.02, .70, r2 30 = .27). Conclusion: The results of this study on jump landings do not support the notion that dance training may cause lateral bias with its associated risk of injury, although lateral bias may be present elsewhere. Furthermore, dancers’ perceptions of their leg dominance did not correlate with their ability to balance in single-leg landings or to absorb GRFs often associated with injury. Even when unequal training exists, it may not have detrimental effects on the dancer’s postural stability
    • Towards optimal intensity

      Metsios, George (BMJ Publishing Group Ltd and European League Against Rheumatism, 2019-05-27)
      Background: There is ample evidence now to suggest that exercise can help ameliorate RMD symptoms and comorbidities. Similar to the prescription of medication, the dosage of exercise should be optimized to achieve the best health benefits. However, a consensus on the dosage of exercise prescription for RMD patients is currently missing. Objectives: This talk will explore the data required from RMD patients to develop the best exercise prescription, exercise principles and current state-of-the-art, as well as how we can use the current evidence to identify the optimum dosage for the exercise prescription in people with RMDs. Methods: Suggestions have been synthesized using existing evidence-based resources, including recent systematic reviews and meta-analyses (EULAR, Cochrane Library and peer-reviewed journals publications) as well as randomized controlled trials. Data for the effectiveness of exercise dosage on various different outcomes has been extracted and will be explored. Results: Different dosages of exercise have differing effects on symptoms of RMDs. The optimal dosage depends on various factors and on the outcome that the exercise prescription aims to improve. Conclusion: Despite the increasing research on exercise in RMDs, a currently a consensus for the optimal exercise dosage is currently missing. More interdisciplinary research, with a heavy patient involvement, is required in the area. Disclosure of Interests: None declared
    • Physical activity, exercise and rheumatoid arthritis: Effectiveness, mechanisms and implementation

      Metsios, GS; Kitas, GD; Faculty of Education, Health and Wellbeing, University of Wolverhampton, UK; Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley, UK; School of Physical Education and Sport Science, University of Thessaly, Greece. Electronic address: g.metsios@wlv.ac.uk. (Elsevier, 2018-10-31)
      © 2019 Elsevier Ltd Rheumatoid arthritis (RA) is characterised by functional disability, pain, fatigue and body composition alterations that can further impact on the physical dysfunction seen in RA. RA is also associated with systemic manifestations, most notably an increased risk for cardiovascular disease. There is strong evidence to suggest that increasing physical activity and/or exercise can simultaneously improve symptoms and reduce the impact of systemic manifestations in RA. However, implementation of interventions to facilitate increased physical activity and/or exercise within routine clinical practice is slow because of not only patient-specific and healthcare professional-related barriers but also lack of relevant infrastructure and provision. We review the evidence supporting the physiological adaptations and beneficial effects occurring as a result of increased physical activity and/or exercise in RA and propose an implementation model for facilitating the long-term engagement of patients with RA. We propose that implementation should be led, in a pragmatic manner, by rheumatology healthcare practitioners and supported by social innovation.
    • Undergraduate examination and assessment of knowledge and skills is crucial in capacity planning for the future healthcare workforce in physical activity interventions

      Gates, AB; Swainson, MG; Moffatt, F; Kerry, R; Metsios, GS; Ritchie, I (BMJ, 2020-01-14)
      Background The WHO Global Action Plan on Physical Activity (GAPPA) (#GAPPA)1 highlights the importance of a systems-wide approach to achieving the global goals for reducing physical inactivity at the national, community, individual and patient levels. Within this scope, objective 1.4 of that plan details the vision and strategy for capacity planning for the health workforce and the collaborations required for success. This objective is closely linked to existing global and national efforts to enable the future healthcare professional (HCP) workforce to have the capability and competencies to make every contact count for physical activity support and advice (via brief interventions). A significant part of these goals is to enable the future and current healthcare workforce to meet the challenges of non-communicable diseases (NCDs), sustainable development goals (SDGs) and person-centred healthcare, exemplars of which have been identified in most European countries.2 3 Indeed, a physical activity resource focused approach in undergraduate healthcare courses such as medicine, nursing and allied health is critical in higher education institutes’ (HEIs) strategies2 4 5 to deliver on these directives.
    • Should patients with rheumatic diseases take pain medication in order to engage in exercise?

      Metsios, GS; Kitas, GD; Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK. (Taylor & Francis, 2020-01-28)
      Pain is the main symptom in most rheumatic and musculoskeletal diseases (RMDs). It has debilitating effects in terms of mobility, physical function, sleep, mood, fatigue, and overall quality of life. This is why pain and its associates are some of the predominant outcomes evaluated regularly in response to pharmaceutical or any other interventions involved in the management of RMDs.
    • Gender differences in the relationship between sleep problems and suicide attempt in adolescents

      Wan, Y; Xu, H; Wang, S; Boyda, D; McFeeters, D; Sun, Y; Zhang, S; Chen, R; Tao, F; Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China. (Frontiers Media SA, 2020-02-28)
      © Copyright © 2020 Wan, Xu, Wang, Boyda, Mcfeeters, Sun, Zhang, Chen and Tao. There are few studies examining which types of sleep problems are independently associated with suicide attempt (SA) and gender difference in adolescents. The aim of the present study was to examine whether specific sleep problems were uniquely associated with suicide attempt in adolescents and explore gender differences in the association. A school-based health survey was conducted in four provinces within China from November 2014 to January 2015. A total of 15,132 students aged 10–21 years completed standard questionnaires assessing past 12 month suicide attempt in addition to measures of sleep quality, quantity and sleep beliefs. 5.4% of participants reported a suicide attempt within the last 12 months. After adjustment for sociodemographic variables and psychological symptoms, almost all sleep problems remained significantly associated with a greater endorsement of suicide attempt. Further adjustment for co-occurring sleep problems revealed that weekday sleep duration (<6, 8–10, and ≥10 h), insomnia (often), and nightmares (sometimes and often) remained independently associated with suicide attempt in boys (p < 0.05). However in girls, weekday sleep duration (<6 and ≥10 h), weekend sleep duration (<6 h), midday nap (0 or 1–2 d/week), insomnia (sometimes and often), nightmare (often) and sleep beliefs (high) were independently associated with suicide attempt (p < 0.05). Multiple sleep problems are associated with suicide attempt in adolescents, however the relationship varies by gender.
    • Effect of force plate coverings on vertical ground reaction forces

      Ditroilo, Massimiliano; Smith, Tina (International Society of Electrophysiology & Kinesiology, 2018-06-30)
    • Effect of walking surface and late-cueing on turn strategy preferences in older adults

      Dixon, Philippe; Smith, Tina; Taylor, Matthew; Jacobs, Jesse; Dennerlein, Jack; Schiffman, Jeffrey (World Congress of Biomechanics 2018, 2018-07-09)
    • The effects of applying a transmissibility correction to data collected by a strap mounted accelerometer

      Smith, Tina; Foster, Richard; Baker, Michael (World Congress of Biomechanics, 2018-07-12)
    • The AIR model (Activities, Internal world, Relationships): a pragmatic framework for evaluating co-design

      Gosling, Julie; Craven, Michael; Dening, Tom; Coleston-Shields, Dons; Aberturas, Adriana; Martin, Sandra; Munoz, Marcos; Ruiz, Guillermo; Bueno, Yolanda; Almedia, Rosa; et al. (TUD press, 2019-11-13)
      A pragmatic model, AIR (Activities; Internal world; Relationships), is presented for co-design of technologies and products to support well-being of people living with dementia. This model, co-developed with people with lived experience, is aimed at including psychosocial aspects in the prototype development process. The model is then related to a form of mindful evaluation framework that can be employed during the prototype testing of co-designed solutions. The components of this evaluation framework and associated instruments are described.