Now showing items 21-40 of 1377

    • Challenges to concordance: theories that explain variations in patient response

      Jester, Rebecca; Green, Julie (Mark Allen Publishing Ltd., 2019-12-31)
      The meet the challenges of an increasingly ageing and multimorbid population, there is an urgent need to fully engage the patient to work in partnership with their health care professional in the management of their condition(s). Without this consistent approach to partnership working with the patient, there is a real concern that the National Health Service (NHS) will not be able to cope with demand. The NHS Long Term Plan (2019) outlines a range of envisioned goals to manage these increasing demands, including hospital admission avoidance, shorter length of hospital stays through enhanced recovery pathways, increased management of patients within primary care and the need to ensure a person-centred approach to care provision. The Plan (NHS, 2019) suggests that these goals will, at least in part, be achieved by patient empowerment, informed shared decision-making, and enhanced self-management. This is predicated on health care professionals (HCP) being equipped to empower patients using the skills of motivational interviewing, a person-centred focus care delivery and a willingness to share decision making. Alongside HCP requirements, there needs to be a willingness on the part of the patient to engage in shared decision making and self- management is also necessary. With the impact of effective patient engagement being significant and concordance being the goal, why do some patients engage with advice and agreed treatment plans whereas others seem to do everything possible, or so it appears, to follow a different plan? This article presents a range of psychological theories that go some way to explaining the day to day challenges that are faced in the delivery of care. Awareness of these theories may provide an insight that enables health care professionals to target their approach to care delivery more effectively, to understand patient responses and, therefore, optimise the provision of person-centred care.
    • Factors influencing a secondary school physical education teacher’s role as a pastoral head of year

      Burrows, Adam; O’Leary, Nick (Informa UK Limited, 2019-09-11)
      Utilising the occupational socialisation theoretical framework, this United Kingdom based case study explored how a secondary school physical education teacher fulfilled the head of year role and what childhood, university and on-the-job experiences influenced execution of this role. Data were collected from interviews, lesson observations and a self-reflective journal. Inductive data analysis and constant comparison identified that the participant attempted to be an ‘administrative finisher’ and ‘empower’ staff, parents and pupils. These aims were influenced by the de-prioritisation of physical education, a desire to retain control of administrative situations, and the influence of past and present teachers. To overcome the issues that the dual roles of head of year and subject teacher present, it is recommended that a ‘timetabled’ period at the beginning and/or end of the day be utilised for important head of year tasks, and greater formal responsibility is given to the assistant head of year. The findings of this study suggest further research possibilities. Firstly, there is a need to examine the influence of teaching other subjects whilst undertaking the head of year role. Secondly, investigating the impact of childhood and university socialisation upon teachers’ fulfilment of other pastoral and/or leadership roles such as head of department, deputy head or head teacher appears warranted.
    • Enabling employability through inclusive placement learning: final report

      Brewster, Stephanie; Thompson, David; Scott, David (University of Wolverhampton, 2019-07-31)
      Employability plays a significant part in most modern universities' policies and practices, with placements and work-based learning now forming a core part of the course menu. At the University of Wolverhampton employability forms a key component of its strategic plan, as do equality, diversity and inclusion. However, a graduate with a work limiting disability is less likely to have a job compared to an unqualified person with no disability (Smith, 2016) and disabled people are more likely to be unemployed than nondisabled people. While placement learning pays a key part in employability for all students, this may be even more important for disabled students. The College of Learning and Teaching (CoLT) and the Education Observatory funded an exploratory research project to investigate students’ potential barriers to a successful placement. Ninety-eight students on academic courses in the Institute of Education completed a pre-placement questionnaire, and seven participated in post-placement interviews. Staff were also invited to participate, selected for their involvement in placement learning, employability or disability support. Individual interviews and focus groups (11 staff) were conducted.
    • Association between the HSPA1B ±1267A/G polymorphism and cancer risk: a meta-analysis of 14 case-control studies

      Kuang, Dan; Chen, Wei; Song, Yue-Zhang; Yu, Yan-Yan; Zhang, Dong-Ying; Wu, Lang; Tang, Jie (Asian Pacific Organization for Cancer Prevention, 2014-08-30)
      Background: Previous epidemiological studies have suggested a potential role of the HSPA1B±1267A/G polymorphism in risk of developing cancer. However, the results were inconsistent. Therefore, we performed this meta-analysis to summarize the possible association with cancer risk. Materials and Methods: We retrieved relevant articles from PubMed, EMBASE, ISI Web of Science, Chinese Biomedical Literature and Chinese National Knowledge Infrastructure. Studies were selected using specific criteria. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess those associations. All analyses were performed using STATA software. Results: Fourteen case-control studies, including 1, 834 cancer cases and 2, 028 controls were included in this meta-analysis. Overall, the results indicated that the G allele of HSPA1B gene ±1267A/G was significantly associated with an increased cancer risk in all genetic models (G vs A: OR=1.51, 95%CI 1.17-1.95, p=0.001; GG vs AA: OR=2.93, 95%CI 1.50-5.74, p=0.002; AG vs AA: OR=1.48, 95%CI 1.10-1.98, p=0.009; GG/AG vs AA: OR=1.69, 95%CI 1.22-2.33, p=0.001; GG vs AG/AA: OR=2.31, 95%CI 1.24-4.32, p=0.009). In the subgroup analysis stratified by ethnicity, a significant association was identified in Caucasians (G vs A: OR=1.35, 95%CI 1.08-1.69, p=0.008; GG/AG vs AA: OR=1.36, 95%CI 1.09-1.70, p=0.007), but not in Asians. In the stratified analysis by cancer types, individuals with the G allele showed an increased risk of hepatocellular carcinoma compared with carriers of the A allele (OR=2.40, 95%CI 1.47-3.91, p<0.001). Inversely, individuals with the GG genotype showed a decreased risk of gastric cancer compared with carriers of the AG/GG genotypes (GG vs AG/AA: OR=0.39, 95%CI 0.20-0.70, p=0.007). Conclusions: This meta-analysis suggests associations between the HSPA1B ±1267A/G polymorphism and risk of cancer. However, this association might be Caucasian-specific and the G allele of this polymorphism probably increases risk of hepatocellular carcinoma while decreasing risk of gastric cancer. Further well-designed studies based on larger sample sizes are needed to validate these findings.
    • A study of suicidal ideation in acute ischemic stroke patients

      Dou, Jin; Tang, Jie; Lu, Chu-Hong; Jiang, En-She; Wang, Pei-Xi (Springer Nature, 2015-01-23)
      Background Increasing evidences indicate that stroke confers a substantial risk for suicidal ideation. The aim of this study was to identify risk factors of suicidal ideation in acute ischemic stroke patients. Method A total of 271 consecutive patients with acute ischemic stroke were recruited in Huai-He hospital or the First People’s Hospital, Kaifeng City, China. Demographic and clinical variables were collected and evaluated. Suicidal ideation was assessed using the Beck Scale for Suicide Ideation (BSI). Multivariate logistic regression was applied to determine the risk factors of suicidal ideation. Results Suicidal ideation was identified in 29 patients (10.7%). It was more frequent in patients who lived in rural region, with pre-/post-stroke depression or diabetes, had a higher NIHSS score, had no confidence in disease treatment, or had a poor coping style. Living in rural region (OR 2.59, 95% CI 1.02-6.58), the presence of pre-stroke depression (OR 11.74, 95% CI 4.45-31.01), stroke severity (OR 1.20, 95% CI 1.08-1.33), having no confidence in disease treatment (OR 14.70, 95% CI 2.60-83.15), and post-stroke depression (OR 16.22, 95% CI 6.40-41.10) were independent risk factors of suicidal ideation. Conclusion Several factors may be associated with an increased risk of suicidal ideation in acute ischemic stroke patients, including pre-/post-stroke depression, more severe stroke, having no confidence in treatment, as well as living in rural region. Our findings may have implication in risk assessment and intervention for acute ischemic stroke patients in reducing the burdens of suicidal ideation.
    • Beneficial effect of higher dietary fiber intake on plasma HDL-C and TC/HDL-C ratio among Chinese rural-to-urban migrant workers

      Zhou, Quan; Wu, Jiang; Tang, Jie; Wang, Jia-Ji; Lu, Chu-Hong; Wang, Pei-Xi (MDPI AG, 2015-04-29)
      Research has shown that high-dose supplemental dietary fiber intake has beneficial effects on cardiovascular risk factors. To clarify such a relationship, we examined the association between daily dietary fiber intake and plasma lipids using a cross-sectional design including 1034 (M 502, F 532) rural-to-urban workers in China. We found a dose-response relationship between increased dietary fiber intakes and increase of HDL cholesterol in male workers. There was also a dose-response relationship between increased dietary fiber intake and decreased total cholesterol to HDL cholesterol (TC/HDL-C) ratio in both male and female workers, after adjusting for potential confounders (p for trend, all p < 0.05). When the average dietary fiber intake increased from less than 18 g/day to over 30 g/day, the average HDL cholesterol level increased by 10.1%, and the TC/HDL-C ratio decreased by 14.4% for males (p = 0.020) and by 11.1% for females (p = 0.048). In conclusion, higher daily dietary fiber consumption is associated with beneficial effect on cholesterol for rural-to-urban workers in China, suggesting its potential beneficial effect on decreasing the risk of cardiovascular diseases.
    • Factors associated with fatigue among men aged 45 and older: A cross-sectional study

      Lin, Wei-Quan; Jing, Meng-Juan; Tang, Jie; Wang, Jia-Ji; Zhang, Hui-Shan; Yuan, Le-Xin; Wang, Pei-Xi (MDPI AG, 2015-09-02)
      Background and Purpose: Fatigue is one of the most common symptoms reported in several studies; but few studies have concentrated on the male population, especially for the middle-aged and older men who are exposed to greater fatigue risk. The purpose of this study was to explore the prevalence of fatigue and identify the risk factors of fatigue among men aged 45 and older in China. Methods: This study was part of a cross-sectional study on community health in Shunde (Guangdong Province, China). A total sample of 1158 men aged 45 and older were included. Sociodemographic characteristics, health and lifestyle factors and the Chalder Fatigue Scale (CFS) were measured by structured questionnaires through face-to-face interviews. Multivariate logistic regression was applied to determine the risk factors of fatigue. Results: Approximately 30% of participants experienced fatigue. Older age (≥75 years: adjusted OR 3.88, 95% CI 2.09–7.18), single marital status (1.94, 1.04–3.62), unemployed status (1.68, 1.16–2.43), number of self-reported chronic diseases (≥2 chronic diseases: 2.83, 1.86–4.31), number of individuals’ children (≥4 children: 2.35, 1.33–4.15), hospitalization in the last year (1.61, 1.03–2.52) were all significantly associated with increased risk of fatigue, while regular exercise (0.46, 0.32–0.65) was a protective factor against fatigue. Conclusions: Fatigue was usual in males and several factors were associated with the fatigue. These findings may have implication in risk assessment of fatigue and help in developing and implementing targeted interventions in middle-aged and elderly males.
    • Stressful life events as a predictor for nonsuicidal self-injury in southern Chinese adolescence

      Tang, Jie; Yang, Wei; Ahmed, Niman Isse; Ma, Ying; Liu, Hui-Yan; Wang, Jia-Ji; Wang, Pei-Xi; Du, Yu-Kai; Yu, Yi-Zhen (Ovid Technologies (Wolters Kluwer Health), 2016-03-31)
      Stressful life events have been implicated in the etiology of kinds of psychopathology related to nonsuicidal self-injury (NSSI); however, few studies have examined the association between NSSI and stressful life events directly in Chinese school adolescents. In this study, we aim to estimate the prevalence rate of NSSI and examine its association with stressful life events in Southern Chinese adolescents. A total sample of 4405 students with age ranged from 10 to 22 years was randomly selected from 12 schools in 3 cities of Guangdong Province, China. NSSI, stressful life events, self-esteem, emotional management, and coping methods were measured by structured questionnaires. Multinomial logistic regression was used to examine the association of NSSI with stressful life events. Results showed the 1 year self-reported NSSI was 29.2%, with 22.6% engaged in ‘‘minor’’ NSSI (including hitting self, pulling hair, biting self, inserting objects under nails or skin, picking at a wound) and 6.6% in ‘‘moderate/sever’’ NSSI (including cutting/carving, burning, self-tattooing, scraping, and erasing skin). Self-hitting (15.9%), pulling hair out (10.9%), and self-inserting objects under nails or skin picking areas to dram blood (18.3%) were the most frequent types of NSSI among adolescents. Results also showed that ‘‘Minor NSSI’’ was associated with stressful life events on interpersonal, loss and health adaption, and ‘‘moderate/severe NSSI’’ was associated with life events on interpersonal, health adaption in Southern Chinese adolescents, even after adjusted for sex, age, residence, selfesteem, coping style, and emotional management. Results further suggested stressful life events were significantly associated with less risk of NSSI in those who had good emotional management ability.
    • Possible association between SIRT1 single nucleotide polymorphisms and predisposition to antisocial personality traits in Chinese adolescents

      Chang, Hongjuan; Yan, Qiuge; Tang, Jie; Huang, Juan; Zhang, Yanmei; Ma, Yuqiao; Ye, Xiaozhou; Tang, Lina; Wu, Linguo; Wu, Chunxia; et al. (Springer Nature, 2017-04-24)
      Accumulating evidence suggests an association between the SIRT1 gene and human psychiatric disorders. The aim of the study was to investigate the association between SIRT1 and predisposition to antisocial personality traits (ASP) in Chinese adolescents. Participants consisted of 327 controls and 261 juvenile offenders who were diagnosed with predisposition to ASP according to the Personality Diagnostic Questionnaire. Four tag single nucleotide polymorphisms (tagSNPs) of SIRT1, namely rs12778366, rs7896005, rs10823112, and rs4746720, were genotyped. Association analysis between individual SNPs and ASP risk revealed the CC genotype of rs4746720 to be significantly associated with reduced risk of ASP (OR = 0.51, 95% CI = 0.33–0.77, adjusted P = 0.007). Haplotype analysis showed the TAAC haplotype was associated with reduced susceptibility to ASP (OR = 0.72, 95% CI = 0.57–0.91, P = 0.005). Moreover, rs4746720 variants were found to not only have a direct impact on ASP susceptibility but also modulate the effect of alcohol consumption (Y = 0.022X + 0.431 vs. Y = −0.066X + 0.387). The present study is the first to report a significant association between SIRT1 polymorphisms and ASP in adolescents. This finding is expected to aid in the development of effective interventions for this socially and personally costly disorder.
    • Long noncoding RNA and its contribution to autism spectrum disorders

      Tang, Jie; Yu, Yizhen; Yang, Wei (Wiley, 2017-06-20)
      Recent studies have indicated that long noncoding RNAs (lncRNAs) play important roles in multiple processes, such as epigenetic regulation, gene expression regulation, development, nutrition‐related and other diseases, toxic response, and response to drugs. Although the functional roles and mechanisms of several lncRNAs have been discovered, a better understanding of the vast majority of lncRNAs remains elusive. To understand the functional roles and mechanisms of lncRNAs is critical because these transcripts represent the majority of the transcriptional output of the mammalian genome. Recent studies have also suggested that lncRNAs are more abundant in the human brain and are involved in neurodevelopment and neurodevelopmental disorders, including autism spectrum disorders (ASDs). In this study, we review several known functions of lncRNAs and the potential contribution of lncRNAs to ASDs and to other genetic syndromes that have a similar clinical presentation to ASDs, such as fragile X syndrome and Rett syndrome.
    • Reliability and construct validity of two versions of Chalder Fatigue Scale among the general population in Mainland China

      Jing, Meng-Juan; Lin, Wei-Quan; Wang, Qiang; Wang, Jia-Ji; Tang, Jie; Jiang, En-She; Lei, Yi-Xiong; Wang, Pei-Xi (MDPI AG, 2016-01-21)
      The 14-item Chalder Fatigue Scale (CFS) is widely used, while the 11-item version is seldom to be found in current research in mainland China. The objectives of the present study is to compare the reliability and construct validity between these two versions and to confirm which may be better for the mainland Chinese setting. Based on a cross-sectional health survey with a constructive questionnaire, 1887 individuals aged 18 years or above were selected. Socio-demographic, health-related, gynecological data were collected, and 11-item and 14-item Chalder Fatigue Scale (CFS) were used to assess fatigue. Confirmatory factor analysis and exploratory structural equation modeling (ESEM) were performed to test the fit of models of the two versions. Confirmatory factor analysis of the two versions of CFS did not support the two-factor theorized models. In addition, a three-factor ESEM model of the 11-item version, but not the 14-item version, showed better factor structure and fitness than the other models examined. Both the versions had good internal consistency reliability and a satisfactory internal consistency (Ω = 0.78–0.96, omega coefficient indicates the internal consistency reliability) was obtained from the optimal model. This study provided evidence for satisfactory reliability and structural validity for the three-factor model of the 11-item version, which was proven to be superior to the 14-item version for this data.
    • Towards bridging the belongingness, progression and attainment gap for our BAME students

      Cureton, Debra; Hughes, Julie; Jones, Jenni (Higher Education Race Action Group, 2019)
      The ethnic based differential degree outcome and lower rates of BAME student retention are an education inequities that has received substantive attention and inquiry (Connor et. al, 2004; Buckley-Irvine, 2017). Although these works offer some explanations to why these gaps occur, these findings have generated minimal impact on the continuing national outcomes picture. This indicates that there is still a strong need to better understand and bridge the gap between strategic intention and intervention, and how this learning is embedded within learning and teaching environments. This is especially important within the current HE climate where the Teaching Excellence Framework considers student satisfaction, continuation and employment outcomes; all of which are metrics that can be negatively affected by differential HE experiences and outcomes.
    • Young Dad's TV collaborative impact evaluation

      Royle, Karl (University of Wolverhampton, 2012-10)
      The Centre for Development and Applied Research in Education (CeDARE) is pleased to submit this proposal for a collaborative impact evaluation of the Young Dad’s TV project. CeDARE is based within the School for Education Futures at the University of Wolverhampton. We have an ethos of participatory research and aim to work in partnership with funders in order to produce research that can inform both practice and policy. CeDARE combine the professional experience of staff from across the university with the knowledge and expertise of highly experienced researchers in order to develop innovative methodologies and produce research outputs that impact on policy and practice.
    • International students in the era of Trump and Brexit: Implications, constructions and trends

      Bartram, Brendan (Journal of International Students, 2018-10-01)
      © Journal of International Students. We are living in troubling and uncertain times. Xenophobia is on the rise as right-wing, authoritarian nationalism has witnessed significant electoral gains and the very ideals of democratic inclusiveness and international pluralism are under direct attack. With the election of Donald Trump as President of the United States, the country with the largest share of international students globally is increasingly becoming an unwelcoming place to study abroad. (p. i).
    • What do people with a learning disability say about orthopaedic and trauma hospital care?

      Drozd, Mary; Chadwick, Darren; Eggison, Peter; Clinch, Christine (Royal College of Nursing, 2016-09-08)
      Aim: To share the results of a study about the experiences of people with a learning disability who have received orthopaedic and trauma hospital care Learning outcomes: Explain the rationale for the research Discuss the key themes from the study Consider how YOU can embrace the future for people with a learning disability in our care
    • We Belong: differential sense of belonging and its meaning for different ethnicity groups in higher education

      Cureton, Debra; Gravestock, Phil (University of Greenwich, Educational Development Unit, 2019-06-30)
      This paper covers two studies that explore student belonging in higher education and how a sense of belonging differs between ethnicity groups. The research took a mixed methodology approach, collecting both quantitative data via a survey and qualitative data via focus groups. Study One explored the differential experiences of belonging via the Belongingness Survey (Yorke, 2016), with a group of 941 students. This was followed by Study Two, which used focus groups to generate a greater understanding of what belonging meant to the students, how belonging developed and to identify barriers to developing a sense of belonging. This work concluded that ethnicity-based differences in students sense of belonging are apparent, which mirror the differences that are witnessed at a sector level in degree outcomes. Additionally, belongingness is found to have an unstable nature in that it waxes and wanes, and can be lost or developed at any part of the student lifecycle. Some student-identified initiatives to support the development of belonging are presented. The findings are discussed in the light of the current literature on differential outcomes.
    • From local to institutional attainment change: scaling-up local initiatives

      Gravestock, Phil; Cureton, Debra (Educational Development Unit, University of Greenwich, 2019-06-30)
      Ethnicity-based gaps in degree outcomes are a pervasive sector issue. At the University of Wolverhampton, substantial investments have been made a) to fund research into why the outcomes gap occurs, the better to understand it, and then b) to implement and evaluate initiatives to reduce it. However, upscaling smaller initiatives to university-wide actions can be fraught with issues. This case study will provide a synthesis of the research carried out at Wolverhampton and the ways this was used as an evidence-base to inform institutional change. The study will also consider some of the lessons learnt from our attempts to embed the outcomes into institutional business as usual.
    • The effects of physical exercise on cardiometabolic outcomes in women with polycystic ovary syndrome not taking the oral contraceptive pill: a systematic review and meta-analysis

      Woodward, A; Broom, D; Harrop, D; Lahart, I; Carter, A; Dalton, C; Metwally, M; Klonizakis, M (Springer Science and Business Media LLC, 2019-07-29)
      © 2019, The Author(s). Purpose: Women with polycystic ovary syndrome (PCOS) exhibit many metabolic abnormalities that are associated with an increased cardiovascular disease risk. Exercise may promote improvements in lipid profile and insulin sensitivity in women with PCOS. There is however, a knowledge gap on the optimal dose of exercise, regarding duration, intensity, type, and frequency of exercise. The aim of this systematic review and meta-analysis was to define effective types of exercise to improve cardiometabolic profile in PCOS. Methods: We included randomised controlled trials (RCT), quasi-RCT, and controlled clinical trials focusing on reproductive-aged women diagnosed with PCOS. Eligible interventions included those with at least two weeks of supervised exercise sessions. Primary outcomes were blood lipids, blood glucose, blood pressure, measures of abdominal adiposity, and inflammation markers. Secondary outcomes were total and free testosterone, sex hormone binding globulin, and measures of insulin resistance. Nine electronic databases were searched from inception to present for English language publications. The Cochrane Risk Assessment tool was used to assess bias in the included studies. Outcomes were quantitatively synthesised and a meta- analysis was performed. Pooled effect estimates and 95% confidence intervals were presented. Results: This systematic review identified three trials, including 231 participants with PCOS, that examined the effect of structured, supervised exercise on cardiometabolic outcomes. Analysis of pooled data indicated statistical favourable effects of exercise on total cholesterol, fasting glucose, waist circumference and waist-to-hip ratio, systolic blood pressure, C-reactive protein, total testosterone, and sex hormone binding globulin using post-intervention scores. Conclusions: Moderate aerobic exercise interventions ≥3 months in duration, with a frequency of 3/week for at least 30-min, may have favourable effects on various cardiometabolic risk factors in women with PCOS. However, results should be interpreted with caution. Many of the outcomes were based on studies with serious methodological limitations, and only one “gold-standard” RCT was identified. PROSPERO ID: CRD42018086117.
    • The effects of exercise on cardiometabolic outcomes in women with polycystic ovary syndrome not taking the oral contraceptive pill: Protocol for a systematic review and meta-analysis

      Woodward, A; Klonizakis, M; Lahart, I; Carter, A; Dalton, C; Metwally, M; Broom, D; Faculty of Health and Wellbeing, Sheffield Hallam University, Collegiate Crescent, Sheffield, S10 2BP, UK. Amie.woodward@shu.ac.uk. (Springer Science and Business Media LLC, 2019-05-16)
      © 2019 The Author(s). Background: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy, affecting 4-12% of reproductive-aged women. Women with PCOS often exhibit many metabolic abnormalities that are associated with an increased cardiovascular disease (CVD) risk, independent of obesity. Exercise interventions from 12 to 24 weeks have been shown to have positive effects on blood lipid profile, ovulation and insulin resistance in women with PCOS. However, no consensus on which exercise interventions are effective (i.e. duration, type of exercise, frequency), including for different phenotypes, currently exists. The aim of this systematic review and meta-analysis is to define effective types of exercise interventions to improve cardiometabolic profile, across the range of phenotypes of PCOS. Methods: We will conduct electronic database searches, including randomised-controlled trials (RCT), quasi-RCT and clinical trials. Primary outcomes sought will be lipid profile, carotid-intima media thickness, fasting blood glucose, %HbA1c, blood pressure, waist circumference, waist-to-hip ratio, abdominal adiposity and inflammation markers. Secondary outcomes sought will be free and total testosterone, sex hormone binding globulin and insulin resistance. The Cochrane Risk Assessment Tool will be used to assess study quality. Data will be analysed in RevMan. Analysis of heterogeneity will be undertaken using the I 2 statistic. Significant heterogeneity will be explored, and sensitivity analyses carried out as appropriate. A subgroup analysis based on androgen profile will be undertaken if data are sufficient. Discussion: A large proportion of women are affected by PCOS. It is prudent to examine how CVD risk can be mitigated in this high-risk population, and this review aims to provide evidence-driven recommendations on the types of exercise interventions that are effective for this. The review will seek to provide recommendations regarding type, frequency and duration of exercise interventions to improve cardiometabolic profile in PCOS. The subgroup analysis may be able to highlight difference in intervention effects between normo-androgenic and hyper-androgenic profile. Limitations include heterogeneity across studies and a scarcity of clinical trials involving a PCOS control group not undertaking any intervention.
    • The effects of continuous compared to accumulated exercise on health: A meta-analytic review

      Murphy, MH; Lahart, I; Carlin, A; Murtagh, E; Centre for Exercise, Physical Activity, Medicine and Health, Ulster University, Jordanstown, Northern Ireland, UK. mh.murphy@ulster.ac.uk. (Springer Science and Business Media LLC, 2019-07-02)
      © 2019, The Author(s). Background: Public health guidelines suggest that physical activity can be accumulated in multiple short bouts dispersed through the day. A synthesis of the evidence for this approach is lacking. Objective: Our objective was to undertake a systematic review and meta-analysis to examine if exercise interventions consisting of a single bout of exercise compared with interventions comprising the same total duration, mode, and intensity of exercise accumulated over the course of the day have different effects on health outcomes in adults. Methods: Six electronic databases were searched (Jan 1970–29 August 2018). Two authors identified studies that evaluated the effects of a single bout of exercise compared with the same intensity, total duration, and mode of exercise accumulated in multiple bouts over the course of a day, in community-dwelling adults. Risk of bias was assessed using the Cochrane Collaboration tool. Pooled effects were reported as standardised mean differences (MDs) and 95% confidence intervals (CIs) using a random effects model. Results: A total of 19 studies involving 1080 participants met the inclusion criteria. There were no differences between accumulated and continuous groups for any cardiorespiratory fitness or blood pressure outcomes. A difference was found in body mass changes from baseline to post-intervention in favour of accumulated exercise compared with continuous (MD − 0.92 kg, 95% CI − 1.59 to − 0.25, I2 = 0%; five studies, 211 participants). In subgroup analyses, accumulating > 150 min of weekly exercise in multiple bouts per day resulted in small effects on body fat percentage (combined post-intervention and change from baseline values: MD − 0.87%, 95% CI − 1.71 to − 0.04, I2 = 0%; three studies, 166 participants) compared with 150 min of exercise amassed via single continuous bouts per day. There was a decrease in low-density lipoprotein (LDL) cholesterol with accumulated versus continuous exercise (MD − 0.39 mmol/l, 95% CI − 0.73 to − 0.06, I2 = 23%; two studies, 41 participants). No differences were observed for any other blood biomarker (total cholesterol, high-density lipoprotein cholesterol, triglycerides, fasting blood glucose, and fasting insulin). Conclusions: There is no difference between continuous and accumulated patterns of exercise in terms of effects on fitness, blood pressure, lipids, insulin and glucose. There is some evidence from a small number of studies that changes in body mass and LDL cholesterol are more favourable following the accumulated condition. Collectively our findings suggest that adults are likely to accrue similar health benefits from exercising in a single bout or accumulating activity from shorter bouts throughout the day. This review will inform public health guidelines for physical activity at the global and national levels (PROSPERO 2016 CRD42016044122).