Exploring the motivation of health professionals to engage with research at various career stages.

BACKGROUND: Research is crucial for improved healthcare and better patient outcomes, but there is a current shortage of clinician-researchers who can connect research and practice in the health professions field. This study aimed to investigate the effect of career stage, previous training and involvement in research on health professionals' (HPs) motivations to engage in research while in public hospital clinical roles. HPs' perceived motivation concerning the importance, value, and barriers attributed to research during different career stages were examined. METHODS: A mixed methods study design was adopted for this research. An online survey developed based on the Expectancy-Value-Cost (EVC) theory was distributed to HPs (doctors, nurses, midwives, and allied health professionals) in three North Queensland Public Hospitals. Data analysis included descriptive and inferential statistics for the quantitative data and content analysis for the qualitative text responses. RESULTS: Three hundred and fifty-five responses were received. Prior research training and involvement in research influenced respondents' perceptions about the importance, attitude, motivators, and barriers to research. Attainment value was the overarching motivation for involvement in research and research training for all career stages and all professional HP groups. Positive attitude to research was significantly higher (P = 0.003) for the allied health group (27.45 ± 4.05), followed by the medical (26.30 ± 4.12) and then the nursing and midwifery group (25.62 ± 4.21). Perceived importance and attitude attributed to research were significantly higher (P < 0.05) for those who had research training (26.66 ± 3.26 and 28.21 ± 3.73) compared to those who did not have research training (25.77 ± 3.77 and 23.97 ± 3.53). Significantly higher (P < 0.05) perceptions of organisational and individual barriers were reported among early career (50.52 ± 7.30) respondents compared to their mid-career (48.49 ± 8.14) and late career (47.71 ± 8.36) counterparts. CONCLUSION: The findings from this study provide valuable insights into the factors that influence HPs' motivation for research. The results underscore the importance of professional group, involvement in research, exposure to research training, career stage, gender, and organisational support in shaping HPs' attitudes, values, and perceived barriers to research. Understanding these factors can inform the development of targeted strategies to enhance research engagement among HPs and promote evidence-based practice in healthcare.

Effects of Various Recovery Strategies on Repeated Bouts of Simulated Intermittent Activity.

Crowther, FA, Sealey, RM, Crowe, MJ, Edwards, AM, and Halson, SL. Effects of various recovery strategies on repeated bouts of simulated intermittent activity. J Strength Cond Res 33(7): 1781-1794, 2019-A large variety of recovery strategies are used between and after bouts of exercise to maximize performance and perceptual recovery, with limited conclusive evidence regarding the effectiveness of these strategies. The aim of this study was to compare 5 postexercise recovery strategies (cold water immersion, contrast water therapy, active recovery, a combined cold water immersion and active recovery, and a control condition) to determine which is most effective for the recovery of performance, perceptual, and flexibility measures during and after repeated bouts of simulated small-sided team sport demands. Fourteen recreationally active males (mean ± SD; age: 26 ± 6 years; height: 180 ± 5 cm; mass: 81 ± 9 kg) undertook repeated bouts of exercise, simulating a rugby sevens tournament day followed by the above listed recovery strategies (randomized, 1 per week). Perceptual, performance, and flexibility variables were measured immediately before, 5 minutes after all 3 exercise bouts, and at 75 minutes after the first 2 exercise bouts. Contrast water therapy was found to be superior to active at 75 minutes after bout 2 and 5 minutes after bout 3 for repeated-sprint ability and relative average power. The combined recovery strategy was superior to active for repeated-sprint ability at 5 minutes after bout 3; relative best power at 5 minutes after bout 2; total quality recovery before bout 2, 75 minutes after bout 2, and before bout 3; was superior to active for muscle soreness from 75 minutes after bout 1 and for the remainder of the day; and was superior to the control at 75 minutes after bout 1, 75 minutes after bout 2, and before bout 3. The active recovery was detrimental to total sprint time and relative average power at 75 minutes after bout 2 and 5 minutes after bout 3 in comparison with contrast water therapy and the control (not relative average power). Relative average power was decreased after active at 5 minutes after bout 2 in comparison with the combined recovery strategy and the control. Relative average power after cold water immersion was decreased at 75 minutes after bout 2 in comparison with the control and contrast water therapy. Total quality recovery was significantly reduced after active in comparison with the combined recovery strategy before bout 2, 75 minutes after bout 2, and before bout 3. Muscle soreness was also significantly increased after active recovery at 75 minutes after bout 1 and for the remainder of the day in comparison with the combined recovery strategy and was increased at 5 minutes after bout 3 in comparison with the control. Active recovery is not recommended because of the detrimental performance and perceptual results noted. As no recovery strategies were significantly better than the control condition for performance recovery and the combined recovery strategy is the only superior recovery strategy in comparison with the control for perceptual recovery (muscle soreness only), it is difficult to recommend a recovery strategy that should be used for both performance and perceptual recovery. Thus, based on the methodology and findings of this study unless already in use by athletes, no water immersion recovery strategies are recommended in preference to a control because of the resource-intensive (time and equipment) nature of water immersion recovery strategies.

Optimising care coordination strategies for physical activity referral scheme patients by Australian health professionals.

Physical activity (PA) has been identified as an essential tool for the prevention and management of multi-morbidity in patients. Coordination of patients' care through interventions like physical activity referral schemes (PARS) could foster the utilization of PA. This study explored the views of General Practitioners (GPs) and Exercise Physiologists (EPs) as key stakeholders, for optimizing patient care and efficiency of PARS. Sequential explanatory mixed methods design was used to explore the perceptions of these health professionals on PA and coordination strategies for PARS patient care. Data analyses included descriptive and inferential statistics for questionnaires and theoretical framework analysis for the semi-structured interviews. Participants demonstrated a good knowledge of PA and valued PARS. However, the findings unravelled external factors, inter-organisational mechanisms, and relational coordination obstacles that hinder efficient coordination of PARS patient care and delay/limit beneficial health outcomes for patients. Incentivising the PARS initiative and empowering patients to seek referral into the programme, are strategies that could boost PARS efficiency. Improving inter-professional relationships between GPs and EPs could lead to enhanced PARS functionality and efficient coordination of care for patients with chronic diseases.

Impact of Research Training on Newly Graduated Health Professionals' Motivation to Undertake Research.

Background: Clinical research is vital for improved patient health outcomes. However, there has been a decline in the number of new researchers replacing an aging workforce. This is because multiple factors impact on newly graduated health professionals' (HPs) readiness and motivation to engage with research training and undertake research when taking up hospital clinical roles. Methods: Drawing on the Expectancy-Value-Cost (EVC) theory, a sequential explanatory mixed methods design involving cross-sectional survey and purposely sampled participant interview data was utilised to investigate the factors that impact on motivation to undertake research for three newly graduated HP groups (allied health, medical and nursing and midwifery). Survey data were subjected to descriptive and inferential statistical analysis, while interview data were thematically analysed to identify recurring themes. Framework analysis was utilised for triangulation of findings. Results: Participants' previous exposure to research training influenced their expectancy to undertake research. Participants who had previous research training reported significantly higher (P < 0.001) research confidence (Median (IQR) 3.0 (3.0-3.0)) compared to those who had no previous research training (Median (IQR) 0.0 (0.0-1.0)). However, in relation to types of values attached to research, participants who demonstrated intrinsic and attainment values were more engaged and motivated to undertake research despite a myriad of barriers compared to those who demonstrated utility value (P < 0.001). The qualitative data revealed six overarching themes in terms of factors that influence motivation (i) Importance of early immersion into formal research training (ii) Attitude to research (iii) Time constraints (iv) Poor visibility of research training opportunities (v) Lack of organisational support (vi) Low returns on effort. Conclusion: Research training builds confidence, however, to foster motivation for the uptake and continued engagement with research, educators would need to help new HPs see the intrinsic and attainment values of research as they move through the career pipeline.

Rethinking Health Professionals' Motivation to Do Research: A Systematic Review.

BACKGROUND: Health professionals' engagement in translational health and medical research (HMR) is fundamental to evidence-based practice leading to better patient health outcomes. However, there is a decline in the number of health professionals undertaking research which has implications for patient health and the economy. Informed by the motivation-based expectancy-value-cost (EVC) and self determination theories (SDT), this systematic literature review examined the barriers and facilitators of health professionals' (HPs) motivation to undertake research. METHODS: The literature was searched between 2011 and 2021 for relevant peer-reviewed articles written in English, using CINAHL Complete, Informit, Medline Ovid, Medline (PubMed), Scopus, Web of Science and Google Scholar databases. This systematic review was performed and reported in accordance with the PRISMA guidelines. RESULTS: Identified barriers to HPs' engagement with research included the lack of knowledge, skills, and competence to conduct research, lack of protected research time, lack of funding and lack of organisational support. Integration of the findings of this review based on the EVC and SDT theories indicate that research capacity, ie, expectancy and competence is highly influenced by attitude, ie, the type of value (attainment, intrinsic or utility) and connection attributed to research. HPs who had very positive attitude towards research demonstrated all three values and were keen to take up research despite the barriers. Those who had a positive attitude were only motivated to do research because of its utility value and did not necessarily see it as having personal relevance for themselves. HPs who were unmotivated did not see any personal connection or relatedness to the research experience and saw no value in research. CONCLUSION: The attitude HPs hold in their value of research is a catalyst for motivation or amotivation to engage in research as it directly influences the relevance of barriers. Facilitators that expedite the research journey have been attributed to research training, mentorship programs and supportive organisational research culture. Motivation of HPs explored through EVC and SDT is critical to the maintenance of a research culture and the clinician-researcher development pipeline.

The 'PRICE' of Physical Activity Referral Schemes (PARS): Stakeholders' Recommendations for Delivering Quality Care to Patients.

Evidence-based strategies are needed to curb the growing cases of physical inactivity related morbidities. Delivering holistic care through collaborative shared decision making could boost the effectiveness of physical activity referral schemes (PARS) and foster the quality of care for patients with multimorbidity. A qualitative study involving semi-structured telephone interviews was utilised to gain insights from Australian PARS stakeholders (general practitioners, exercise physiologists, and patients). A pluralistic evaluation approach was employed to explore and integrate participants' opinions and experiences of PARS and their recommendations were used to develop a model for quality care delivery in PARS initiatives. Five overarching themes: promote, relate, incentivise, communicate, and educate were identified as the 'PRICE' for developing effective and functional PARS programmes that foster quality patient care. It was evident that PARS programmes or policies aimed at optimising publicity, encouraging incentives, improving interdisciplinary information sharing and professional relationships between patients and healthcare professionals can transform healthcare delivery and provide top quality PARS care services to patients. Therefore, governments, healthcare systems, and PARS administrators can translate and leverage the insights from this study to optimise the delivery of high quality care to PARS patients.

Haematological, Biochemical and Hormonal Biomarkers of Heat Intolerance in Military Personnel.

Heat intolerance is the inability to withstand heat stress and this may occur due to exertional heat stroke (EHS). However, it is unknown if heat intolerance is associated with immune and hormonal disturbances. This study investigates haematological, biochemical and hormonal biomarkers related to heat intolerance and EHS in military and civilian volunteers. A quasi-experimental pre-and post-test design was used, with participants drawn from the Australian Defence Force (ADF) and the general populace. Blood samples were collected and analysed for biomarkers. Inferential statistics compared the biomarkers between the groups. Changes in alanine amino transaminase (p = 0.034), creatine kinase (0.044), cortisol (p = 0.041) and creatinine (p < 0.001) differed between the heat-intolerant and heat-tolerant groups. Participants with a history of EHS showed significant changes in creatinine (p = 0.022) and urea (p = 0.0031) compared to those without EHS history. Predictors of heat intolerance were increasing post-HTT creatinine and cortisol (OR = 1.177, p = 0.011 and OR = 1.015, p = 0.003 respectively). Conclusively, EHS history is associated with changes in creatinine and urea concentrations, while the predictors of heat intolerance are creatinine and cortisol. However, further exploration of other biomarkers, such as genetic polymorphism, is needed.

Australian patients' perception of the efficacy of the physical activity referral scheme (PARS).

BACKGROUND: Optimum physical activity (PA) interventions could be delivered via physical activity referral schemes (PARS) if utilised adequately. However, the evidence supporting PARS effectiveness is weak due to low uptake and non-adherence to interventions. OBJECTIVE: Patients' experiences of PARS were explored to obtain in-depth insight into their perceived quality of care and practical ways to optimise the programme's effectiveness. METHODS: A sequential explanatory mixed methods design was employed to probe cross-sectional quantitative survey data (n = 111) on patients' knowledge and beliefs about PA and PARS and qualitative interview data (n = 15) on their experiences of PARS. Informed by Donabedian framework of healthcare quality assessment, quantitative and qualitative findings were integrated to identify practical ways to enhance PARS effectiveness. RESULTS: Participants displayed good PA knowledge, had positive beliefs and perceived PARS to be useful. Nonetheless, bottlenecks in the structure and process of PARS impact on patient health outcomes and hinder the programme's uptake. CONCLUSION: Exploring other referral mechanisms into PARS such as self or nurse-initiated referrals could improve the programme's visibility and effectiveness. PRACTICE IMPLICATIONS: Improved support, enhanced visibility of EPs, ongoing interactions between GPs and EPs and education about referral pathways would foster improved uptake, adherence and health outcomes for patients.

Functionality of Physical Activity Referral Schemes (PARS): A Systematic Review.

Background: Physical activity (PA) is vital to maintaining good health. However, WHO estimates that 60% of the world's population are inadequately active. To enhance PA, Physical Activity Referral Schemes (PARS) have been established by some countries. Objective: This study examined the functionality of the PARS process across different countries. Methods: This systematic review was performed and reported in accordance with the PRISMA guidelines. Sixteen electronic databases were searched from January 1990 to May 2020. PARS studies, published in English language and in peer-reviewed journals, that reported adherence, outcomes, disease conditions, interventions, facilitators and barriers, were included in this review. Results: Twenty-seven studies conducted across eight countries met the inclusion criteria. Most patients were referred for sedentary/inactivity reasons and supervised group-based activities was the most used intervention. Participants' average adherence rate was 77.5%. Adherence was either facilitated or hindered by type of support provided during and after intervention period. Inclusion of PA allied health specialist in the intervention enhanced positive health outcomes. Conclusion: PARS is a key driver and motivator for individuals to undertake and adhere to PA interventions. Utilization of guidelines on evidence-based interventional PA for different types of diseases, effective use of common group supervised activities and the involvement of PA specialists may aid PA adherence and foster positive health outcomes.

Physical Activity Promotion: A Systematic Review of The Perceptions of Healthcare Professionals.

Physical activity (PA) is a cost-effective and non-pharmacological foundation for the prevention and management of chronic and complex diseases. Healthcare professionals could be viable conduits for PA promotion. However, the evidence regarding the effectiveness and benefits of the current forms of PA promotion are inconclusive. Healthcare professionals' perceptions on key determinants impact on the optimum promotion of PA were explored in this review. Thirty-four (34) studies were identified after systematically searching seven databases for peer-reviewed articles published within the last decade. PA advice or counselling was the most recorded form of PA promotion, limited counselling time was the most reported obstacle while providing incentives was viewed as a key facilitator. There is widespread consensus among healthcare professionals (HCPs) on some aspects of PA promotion. Utilisation of all PA promotional pathways to their full potential could be an essential turning point towards the optimal success of PA promotional goals. Hence, strategies are required to broaden chronic disease treatment methods to include preventive and integrative PA promotion approaches particularly, between frontline HCPs (e.g., GPs) and PA specialists (e.g., EPs). Future studies could explore the functionality of GP to EP referral pathways to determining what currently works and areas requiring further development.

Thermoregulatory responses of junior lifesavers wearing protective clothing.

This study investigated the influence of protective clothing worn to prevent marine stinger envenomation on the thermoregulatory responses of pre-pubescent surf lifesavers exercising in situ under hot and humid conditions (27 degrees C, 78% relative humidity). Participants performed beach and water activities typically associated with junior surf lifesaving competition in a randomised cross-over design on two separate occasions 7 days apart: one wearing a full-length Lycra stinger suit (S) and one wearing normal swimwear (SW). Skin (T(SK)) and core (T(C)) body temperatures, skin blood flow (SKBF), heart rate (HR), body mass, thermal comfort and perceived effort were assessed pre-, mid- (following beach activities) and post-exercise (following water activities). Sweat rates were compared between S and SW. T(C) was greater following beach activities for S (37.78 degrees C+/-0.06) compared to SW (37.60 degrees C+/-0.07; p<0.05) and male participants experienced greater T(C) (37.97 degrees C+/-0.09) than their female counterparts (37.71 degrees C+/-0.07 degrees C). T(SK) following both the beach and water activities were lower than pre-exercise (p<0.05). SKBF was significantly increased for calf across time (p<0.01). Male participants experienced a higher HR for S compared to female participants (p<0.01) while the opposite applied to SW (p<0.01). There were no gender or between-condition differences for sweat rate or perceived effort. There was evidence of heat storage while stinger suits were worn during beach activities in the absence of any differences in exercise intensity or sweat rate. The results of the present study suggest that the stinger suits should be limited to water-based activities.

Pre-pubertal children and exercise in hot and humid environments: a brief review.

The ability of pre-pubertal children to regulate their body temperature under thermoneutral environments is similar to that of an adult albeit via differing routes. However, this ability is challenged when exposed to extreme environments. Thermoregulatory responses of pre-pubertal children differ from adults via adaptations that occur during growth and maturation and disadvantage children when exercising in hot and humid environments. When ambient temperatures exceed that of the skin, an influx of thermal energy from the environment increases thermal stress. When coupled with exercise, the increased thermal stress results in reduced physical performance and an increased risk of developing heat-related illness. Evidence suggesting the severity of heat-related illness is greater in pre-pubertal children than adults is inconclusive because age-related differences in thermoregulatory responses are attributed to either morphologic or functional changes. Additionally, the majority of research on pre-pubertal children exercising in the heat has been maturational or comparative studies with adults conducted in the near absence of convective cooling, complicating extrapolation to field-based environments. However, current consensus is that pre-pubertal children are disadvantaged when exercising in extreme temperatures and that care should be taken in preparing for and conducting sporting activities in hot and humid environments for pre-pubertal children. Key pointsPre-pubertal children's ability to thermoregulate when exposed to hot and humid environments is deficient compared to adults.Research into the severity of heat-related illness in pre-pubertal children is inconclusive.Discretion should be used in applying findings from indoor studies to outdoor activities due to the influence of the velocity of circulating air on thermoregulation.

Effects of six weeks of beta-hydroxy-beta-methylbutyrate (HMB) and HMB/creatine supplementation on strength, power, and anthropometry of highly trained athletes.

This study investigated the effects of 6 weeks of dietary supplementation of beta-hydroxy-beta-methylbutyrate (HMB) and HMB combined with creatine monohydrate (HMBCr) on the muscular strength and endurance, leg power, and anthropometry of elite male rugby league players. The subjects were divided into a control group (n = 8), a HMB group (n = 11; 3 g.d(-1)) or a HMBCr group (n = 11; 12 g.d(-1) with 3 g HMB, 3 g Cr, 6 g carbohydrates). Three repetition maximum lifts on bench press, deadlifts, prone row, and shoulder press, maximum chin-up repetitions, 10-second maximal cycle test, body mass, girths, and sum of skinfolds were assessed pre- and postsupplementation. Statistical analysis revealed no effect of HMB or HMBCr on any parameter compared with presupplementation measures or the control group. HMB and HMBCr were concluded to have no ergogenic effect on muscular strength and endurance, leg power, or anthropometry when taken orally by highly trained male athletes over 6 weeks.

Effects of dietary leucine supplementation on exercise performance.

Branched chain amino acids (BCAA), particularly leucine, have been suggested to be ergogenic for both endurance and strength/power performance. This study investigated the effects of dietary leucine supplementation on the exercise performance of outrigger canoeists. Thirteen (ten female, three male) competitive outrigger canoeists [aged 31.6 (2.2) year, VO(2max) 47.1 (2.0) ml kg(-1) min(-1)] underwent testing before and after 6-week supplementation with either capsulated L: -leucine (45 mg kg(-1) d(-1); n = 6) or placebo (cornflour; n = 7). Testing included anthropometry, 10 s upper body power and work and a row to exhaustion at 70-75% maximal aerobic power where perceived exertion (RPE), heart rate (HR) and plasma BCAA and tryptophan concentrations were assessed. Leucine supplementation resulted in significant increases in plasma leucine and total BCAA concentrations. Upper body power and work significantly increased in both groups after supplementation but power was significantly greater after leucine supplementation compared to the placebo [6.7 (0.7) v. 6.0 (0.7) W kg(-1)]. Rowing time significantly increased [77.6 (6.3)-88.3 (7.3) min] and average RPE significantly decreased [14.5 (1.5)-12.9 (1.4)] with leucine supplementation while these variables were unchanged with the placebo. Leucine supplementation had no effect on the plasma tryptophan to BCAA ratio, HR or anthropometric variables. Six weeks' dietary leucine supplementation significantly improved endurance performance and upper body power in outrigger canoeists without significant change in the plasma ratio of tryptophan to BCAA.

Physiological and cognitive responses to caffeine during repeated, high-intensity exercise.

This study investigated the effects of caffeine on repeated, anaerobic exercise using a double-blind, randomized, crossover design. Seventeen subjects (five female) underwent cognitive (reaction time, number recall) and blood (glucose, potassium, catecholamines, lactate) testing before and after consuming caffeine (6 mg/kg), placebo, or nothing (control). An exercise test (two 60 s maximal cycling bouts) was conducted 90 min after caffeine/placebo consumption. Plasma caffeine concentrations significantly increased after caffeine ingestion, however, there were no positive effects on cognitive or blood parameters except a significant decrease in plasma potassium concentrations at rest. Potentially negative effects of caffeine included significantly higher blood lactate compared to control and significantly slower time to peak power in exercise bout 2 compared to control and placebo. Caffeine had no significant effect on peak power, work output, RPE, or peak heart rate. In conclusion, caffeine had no ergogenic effect on repeated, maximal cycling bouts and may be detrimental to anaerobic performance.

The effects of beta-hydroxy-beta-methylbutyrate (HMB) and HMB/creatine supplementation on indices of health in highly trained athletes.

This study aimed to investigate the effects of 6 wk oral supplementation of beta-hydroxy-beta-methylbutyrate (HMB) and HMB combined with creatine monohydrate (HMBCr) on indices of health in highly trained athletes. Elite, male rugby league players (n=28) were allocated to 1 of 3 groups: a control group (n=6), a HMB group (3 g/d; n=11), or a HMBCr group (3 g/day HMB, 3 g/d Cr; n=11). Testing prior to, and immediately following, supplementation included a full blood count, plasma testosterone and cortisol, blood electrolytes, lipids, urea and glucose, sperm count and motility, and assessment of psychological state. A 3 x 2 factorial ANOVA revealed no effect of HMB or HMBCr on any of the measured parameters except minor changes in blood bicarbonate and blood monocyte and lymphocyte counts. Blood bicarbonate was significantly decreased in the HMB post-supplementation sample compared to the control and HMBCr groups. Blood monocyte and lymphocyte counts showed no within-group changes for HMB or HMBCr supplementation but were significantly different from the control. However, the majority of these readings remained within normal range. HMB and HMBCr were concluded to have no adverse effects on the parameters evaluated in this study when taken orally by highly trained male athletes over a 6-wk period.