Planning for healthcare services during the COVID-19 pandemic in the Southeast of England: a system dynamics modelling approach.

OBJECTIVES: To develop, test, validate and implement a system dynamics model to simulate the pandemic progress and the impact of various interventions on viral spread, healthcare utilisation and demand in secondary care. DESIGN: We adopted the system dynamics model incorporating susceptible, exposed, infection and recovery framework to simulate the progress of the pandemic and how the interventions for the COVID-19 response influence the outcomes with a focus on secondary care. SETTING: This study was carried out covering all the local health systems in Southeast of England with a catchment population of six million with a specific focus on Kent and Medway system. PARTICIPANTS: Six local health systems in Southeast of England using Kent and Medway as a case study. INTERVENTIONS: Short to medium 'what if' scenarios incorporating human behaviour, non-pharmaceutical interventions and medical interventions were tested using the model with regular and continuous feedback of the model results to the local health system leaders for monitoring, planning and rapid response as needed. MAIN OUTCOME MEASURES: Daily output from the model which included number infected in the population, hospital admissions needing COVID-19 care, occupied general beds, continuous positive airway pressure beds, intensive care beds, hospital discharge pathways and deaths. RESULTS: We successfully implemented a regional series of models based on the local population needs which were used in healthcare planning as part of the pandemic response. CONCLUSIONS: In this study, we have demonstrated the utility of system dynamics modelling incorporating local intelligence and collaborative working during the pandemic to respond rapidly and take decisions to protect the population. This led to strengthened cooperation among partners and ensured that the local population healthcare needs were met.

Evaluating the "Optimal Competition Parenting Workshop" Using the RE-AIM Framework: A 4-Year Organizational-Level Intervention in British Junior Tennis.

The purpose of the current study was to utilize the RE-AIM (i.e., reach, effectiveness, adoption, implementation, and maintenance) framework to evaluate the national-level scale-out of the Lawn Tennis Association's "Optimal Competition Parenting Workshop" (OCPW) across a 4-year period. During 2018, 65 workshops were run across the United Kingdom, 1,043 parents registered, and 933 parents attended. Adopting a quasi-experimental design, multilevel analyses revealed significant increases in parents' (n = 130) task goal orientation and competition tennis parenting efficacy, as well as significant decreases in ego goal orientation and unpleasant emotions. Children's perceptions of both mother- and father-initiated ego-involving motivational climate and their own ego goal orientation significantly decreased across time. From 2019 to 2021, a further 64 workshops were delivered to 1,110 parents with no significant differences in parents' satisfaction, enjoyment, instructor evaluation, or transfer intention over time when compared against workshop evaluations in 2018. Overall, the OCPW represents a well-received, practical, and effective brief intervention for enhancing parental involvement in junior tennis.

Advancing Our Understanding of Psychological Stress and Coping Among Parents in Organized Youth Sport.

The current study investigated psychological stress among parents of competitive British tennis players. Adopting a multipart concurrent mixed method design, 135 British tennis parents completed a cross sectional online questionnaire to examine their primary appraisals, emotions, and coping strategies associated with self-disclosed stressors. Hierarchical content analysis was conducted on open ended questionnaire responses to identify key stressors and coping strategies, and descriptive and inferential statistics were utilized to explore the differences between various components of the process. The findings revealed a range of organizational, competitive, and developmental stressors. These stressors were predominantly appraised as harm or challenge, and anxiety and anger were the most prominent emotions that the parents experienced. Statistically, parents experienced greater anger in relation to competition (compared to organizational and developmental) stressors, whilst harm appraisal increased negative emotions, and challenge appraisal increased positive emotions. Findings also highlighted how parents used a number of mastery, internal regulation, and goal withdrawal coping strategies, which varied statistically in degrees of reported effectiveness. The contribution of these findings to the stress literature and their applied implications are discussed.

Development and Validation of the Parent-Initiated Motivational Climate in Individual Sport Competition Questionnaire.

This paper presents a series of studies that progresses the development and validation of the Parent-Initiated Motivational Climate in Individual Sport Competition Questionnaire (MCISCQ-Parent). Study 1 examined the face and content validity of an initial pool of 26 items based on the principles of achievement goal theory and prior research. In Study 2, data from an adolescent sample of individual sport athletes was subjected to an exploratory factor analysis (EFA) of items pertaining to the perceived task and ego involving characteristics of fathers and mothers in the competition setting. Study 3 tested the factor structure of the MCISCQ-Parent through confirmatory factor analysis (CFA) in a further youth athlete sample. Following appropriate CFA-related modifications, good goodness of fit indices emerged for the father- (three factor-model) and mother-related (two factor-model) dimensions of motivational climate. In Study 4, a further CFA was conducted and provided additional evidence for the revised factor structure of the MCISCQ-Parent, convergent and discriminant validity, and internal consistency. Finally, Study 5 provided support for the concurrent validity of the MCISCQ-Parent by demonstrating significant relationships between MCISCQ-Parent subscales and task and ego orientation, athlete engagement, and perceived social support. In sum, we present the MCISCQ-Parent as a measure with promising psychometric properties, and specifically to those applied researchers interested in assessing the quality of motivation-related parental involvement perceived by young athletes in the competition setting.

Psychological support for sport coaches: an exploration of practitioner psychologist perspectives.

In the present study we add to the literature by exploring the degree to which UK practitioner psychologists perceive themselves able to support sport coaches, and how professional training prepares psychologists for coach work across performance domains. Ten participants comprising seven sport and exercise psychologists with Health Care Professions Council (HCPC) practitioner psychologist status and three trainee psychologists studying towards the British Psychological Society (BPS) qualification in sport and exercise psychology (QSEP) were individually interviewed. All participants reported prior experience of working with coaches across all performance domains. We explored: practitioner's understanding of the challenges coaches face within their job; practitioner's experiences of coach work; perspectives about the ways in which practitioners could and should support coaches; and, the degree to which professional training prepares practitioners for coach work. Using recommended procedures of Connelly and Peltzer, content analysis revealed practitioners perceived the challenges faced by coaches are different at grassroots level compared to those working with elite athletes, and that practitioners require skills to provide one-to-one coach support and group-based interventions. All practitioners perceived that training programmes do not adequately equip trainees with skills required for coach work. We discuss the implications for enhancing practitioner training in the UK.

On understanding the nature of interpersonal conflict between coaches and athletes.

Conflict is a part of coach-athlete relationships and should be carefully considered as it can have effects on the quality of coaching and the level of performance. Despite its practical relevance, there is a dearth of research around coach-athlete conflict. Therefore, the current study aimed to explore the characteristics and topics of conflict, as well as coaches and athletes' emotional, cognitive and behavioural experiences during conflict. A total of 22 independent coaches and athletes participated in semi-structured interviews evolving around the nature of interpersonal conflict. After all interviews were transcribed, a deductive-inductive content analysis was conducted. This was guided by the interview schedule as well as the by the conceptual framework of conflict in sport relationships (Wachsmuth, Jowett, & Harwood, 2017). Data were divided into five main categories: Conflict characteristics and conflict topics, as well as conflict cognitions, emotions, and behaviours. Findings highlighted the variety of ways in which participants understood and interpreted interpersonal conflict and how their impressions of conflict influenced its evolving process. Considering the participants' cognitive, emotional and behavioural expressions of conflict, it became apparent that conflict can be described through uncertain, escalating and problem-orientated responses. Practical applications concerning (mal-) adaptive responses to conflict are discussed. (199/200).

Parenting in sport.

This paper provides a brief summary and commentary on the growing literature on parenting in sport, with a particular emphasis on literature from the last 2-3 years. Following a brief introduction overviewing the topic area, we firstly focus on the influence of parental involvement on children. Specifically, we examine the range of factors that influence children's perceptions of parental involvement and the consequences of different behaviors. Next we discuss the factors influencing parental involvement, such as the challenges and stressors associated with parenting children in sport and the culture within different sports. Finally, our review focuses upon the strategies developed by parents to facilitate their involvement in their children's sport, as well as the few papers focused upon parent education and support. We conclude by examining the need for further research and examination of support strategies for parents.

Rising unemployment and increasing spatial health inequalities in England: further extension of the North-South divide.

BACKGROUND: Unemployment negatively affects health. In this study, we quantify the impact of current and rising levels of unemployment on limiting long-term illness (LLTI), mental health problems and mortality in North and South England. METHODS: Excess cases of LLTI and mental health problems in the unemployed were calculated as the difference in the prevalence between the employed and unemployed using data from large population surveys for England. Mortality due to unemployment was calculated using the formula for the population-attributable fraction. RESULTS: Current levels of unemployment were estimated to be causing 1145 deaths per year and a total of 221 020 cases of mental health problems and 275 409 cases of LLTI in England. Rates of mortality, mental health problems and LLTI due to unemployment were distinctively higher in the North compared with the South. Considering hidden unemployment in the calculations considerably increased the proportion of women suffering from ill health due to unemployment. CONCLUSIONS: Our study quantifies the detrimental effect of unemployment on health in England. There is a clear difference between North and South England highlighting the contribution of unemployment to spatial health inequalities. A public health priority should be to (i) prevent unemployment in the first place and (ii) provide support for the unemployed.

Identifying factors perceived to influence the development of elite youth football academy players.

Based on the developmental theory presented by Gagné (2009), we examined the factors perceived to influence the development of elite youth football players at a critical stage in their progression to the professional level. Transcribed interviews with ten expert development coaches were inductively and deductively content analysed. Conceptualisation of the data revealed six interrelated higher-order categories that represented the factors perceived to either positively or negatively influence player development. These were: awareness (e.g. self-awareness, awareness of others); resilience (e.g. coping with setbacks, optimistic attitude); goal-directed attributes (e.g. passion, professional attitude); intelligence (e.g. sport intelligence, emotional competence); sport-specific attributes (e.g. coachability, competitiveness); and environmental factors (e.g. significant others, culture of game). In this investigation, awareness emerged as a fundamental and mediating element for understanding how young players are able to transition to the professional level. Collectively, the findings underline the multidimensional nature of talent development and suggest that an intricate combination of stage-specific factors must manifest for gifted young players to translate their potential into excellence. Mechanisms by which academies could be helped to shape the characteristics and conditions associated with effective development are discussed.

S-Carboxyethylcysteine (a constituent of Acacia seed) negatively affects casein protein utilization by rats.

OBJECTIVE: Two rat bioassay experiments are reported. The first investigated the first limiting amino acid in Acacia colei and the second experiment investigated the effect of S-carboxyethylcysteine (CEC; a compound present in acacia seed) on protein use. METHODS: In the first experiment, Wistar rats were fed A. colei seed supplemented with three levels of methionine, cysteine, and tryptophan (0.1%, 0.2%, and 0.4%). In the second experiment, the Wistar rats were fed CEC-incorporated casein diets. RESULTS: Supplementation of A. colei with tryptophan had no significant effect on the protein efficiency ratio, cysteine showed the highest protein efficiency ratio value at the 0.4% level, and the protein efficiency ratio increased significantly with the increase in methionine content, making methionine the first limiting amino acid. The methionine-induced growth rate was suppressed by the incorporation of CEC, which also had a negative effect on the plasma amino acid levels. CONCLUSION: The results indicated that methionine is the first limiting amino acid in A. colei and that CEC could affect the seed's protein use. Acacia colei seed can be used effectively as famine food only if it is complemented with other cereals known to be rich in sulfur amino acids.

Pectin Methylesterase genes influence solid wood properties of Eucalyptus pilularis.

This association study of Eucalyptus pilularis populations provides empirical evidence for the role of Pectin Methylesterase (PME) in influencing solid wood characteristics of Eucalyptus. PME6 was primarily associated with the shrinkage and collapse of drying timber, which are phenotypic traits consistent with the role of pectin as a hydrophilic polysaccharide. PME7 was primarily associated with cellulose and pulp yield traits and had an inverse correlation with lignin content. Selection of specific alleles in these genes may be important for improving trees as sources of high-quality wood products. A heterozygote advantage was postulated for the PME7 loci and, in combination with haplotype blocks, may explain the absence of a homozygous class at all single-nucleotide polymorphisms investigated in this gene.

Genetic and environmental contributions to variation and population divergence in a broad-spectrum foliar defence of Eucalyptus tricarpa.

BACKGROUND AND AIMS: Both environmental and genetic effects contribute to phenotypic variation within and among populations. Genetic differentiation of quantitative traits among populations has been shown in many species, yet it can also be accompanied by other genetic changes, such as divergence in phenotypic plasticity and in genetic variance. Sideroxylonal (a formylated phloroglucinol compound or FPC) is an important chemical defence in eucalypts. The effect of environmental variation on its production is a critical gap in our understanding of its genetics and evolution. METHODS: The stability of genetic variation in sideroxylonal was assessed within and among populations of Eucalyptus tricarpa in three replicated provenance/progeny trials. The covariance structure of the data was also modelled to test whether genetic variances were consistent among populations and Fain's test was applied for major gene effects. KEY RESULTS: A significant genotype x environment interaction occurred at the level of population, and was related to temperature range and seasonality in source populations. Within-population genetic variation was not affected by genotype x environment effects or different sampling years. However, within-population genetic variance for sideroxylonal concentration differed significantly among source populations. Regression of family variance on family mean suggested that this trait is subject to major gene effects, which could explain the observed differences in genetic variances among populations. CONCLUSIONS: These results highlight the importance of replicated common-garden experiments for understanding the genetic basis of population differences. Genotype x environment interactions are unlikely to impede evolution or responses to artificial selection on sideroxylonal, but the lack of genetic variation in some populations may be a constraint. The results are broadly consistent with localized selection on foliar defence and illustrate that differentiation in population means, whether due to selection or to drift, can be accompanied by changes in other characteristics, such as plasticity and genetic variance.

On the same page in sporting dyads: does dissimilarity on 2 x 2 achievement goal constructs impair relationship functioning?

This study examined the extent to which 2 x 2 achievement goal constructs (Elliot, 1999) were associated with key relational perceptions (i.e., relationship commitment, relationship satisfaction) for members of athlete-athlete dyads. Both members from 82 regional-level partnerships (mean age = 22.72, SD = 3.83) were recruited from a variety of dyadic sports (e.g., tennis, badminton, rowing). Actor-partner interdependence model analyses revealed that greater dissimilarity between partners on mastery-approach and performance-approach goals was associated with lower commitment and satisfaction. Mastery goals displayed positive actor effects with respect to both relationship perceptions, whereas performance-avoidance goals were negatively related to commitment (i.e., actor and partner effects) and satisfaction (i.e., partner effect). These results indicate that achievement goal constructs may align with important interpersonal perceptions in athlete dyads.

Understanding parental stressors: an investigation of British tennis-parents.

In this study, we examined the stressors experienced by British tennis-parents. The parents (n = 123) completed an extensive survey focused on the internal and external demands that they had encountered through having a child compete in the sport. The survey consisted of open-ended questions related to competition, coaching, organizational, personal, and developmental issues. Inductive and deductive content analysis resulted in the development of seven core themes of tennis-parental stressor: competition, coaches, finance, time, siblings, organization-related, and developmental. Parents experienced a diverse number of competitive stressors indicating the particular difficulties they faced before, during, and after matches involving their child, opponents, other parents, and officials. They also reported a wide range of organizational stressors that paralleled the financial, social, and personal investments that accompanied their support roles. The results of this research reinforce the importance of parents possessing the necessary skills to cope with the psychological, developmental, and logistical demands of competitive tennis. Implications with respect to induction workshops and education for coaches and parents are presented, as well as consideration for governing bodies to enhance their communication channels and logistical support. Future research recommendations are posed to build upon the study of this domain in youth sport.

The performance environment of the England youth soccer teams: a quantitative investigation.

We examined the performance environment of the England youth soccer teams. Using a conceptually grounded questionnaire developed from the themes identified by Pain and Harwood (2007), 82 players and 23 national coaches and support staff were surveyed directly following international tournaments regarding the factors that positively and negatively influenced performance. The survey enabled data to be captured regarding both the extent and magnitude of the impact of the factors comprising the performance environment. Overall, team and social factors were generally perceived to have the greatest positive impact, with players and staff showing high levels of consensus in their evaluations. Team leadership and strong team cohesion were identified by both groups as having the greatest positive impact. Overall, far fewer variables were perceived to have a negative impact on performance, especially for players. The main negatives common to both groups were players losing composure during games, player boredom, and a lack of available activities in the hotel. The major findings support those of Pain and Harwood (2007) and in using a larger sample helped to corroborate and strengthen the generalizability of the findings.

The performance environment of the England youth soccer teams.

In the present study, we examined the performance environment of the England youth soccer teams. Using a semi-structured protocol with a prospective sample, national coaches (n = 6), sport scientists (n = 3), and players (n = 4) were interviewed directly following international tournaments about the factors that positively and negatively influenced performance. Qualitative content analysis revealed the following factors as major positive influences on performance: adhering to a consistent tournament strategy, player understanding, strong team cohesion, organized entertainment activities, detailed knowledge of opposition, an effective physical rest/recovery strategy, and previous tournament experience. Major factors perceived to have negatively influenced performance included: over-coaching, player boredom, player anxiety, physical superiority of the opposition, physical fatigue over the tournament, problems sleeping, and lack of information on the opposition. Eight overall dimensions emerged to describe the performance environment: planning and organization, physical environment, tactical factors, development and performance philosophy, psychological factors, physical factors, social factors, and coaching. The findings support recent work that suggests the performance environment is multifaceted, with performance being contingent upon a broad range of interacting factors that go beyond the traditional psychosocial and physical domains.

Heritable variation in the foliar secondary metabolite sideroxylonal in Eucalyptus confers cross-resistance to herbivores.

Plants encounter a broad range of natural enemies and defend themselves in diverse ways. The cost of defense can be reduced if a plant secondary metabolite confers resistance to multiple herbivores. However, there are few examples of positively correlated defenses in plants against herbivores of different types. We present evidence that a genetically variable chemical trait that acts as a strong antifeedant to mammalian herbivores of Eucalyptus also deters insect herbivores, suggesting a possible mechanism for cross-resistance. We provide field confirmation that sideroxylonal, an important antifeedant for mammalian herbivores, also determines patterns of damage by Christmas beetles, a specialist insect herbivore of Eucalyptus. In a genetic progeny trial of Eucalyptus tricarpa, we found significant heritabilities of sideroxylonal concentration (0.60), overall insect damage (0.34), and growth traits (0.30-0.53). Population of origin also had a strong effect on each trait. Negative phenotypic correlations were observed between sideroxylonal and damage, and between damage and growth. No relationship was observed between sideroxylonal concentration and any growth trait. Our results suggest that potential for evolution by natural selection of sideroxylonal concentrations is not strongly constrained by growth costs and that both growth and defense traits can be successfully incorporated into breeding programs for plantation trees.

Traditional and Acacia colei seed-incorporated diets in Maradi, Niger Republic.

A survey of dietary habits of 83 male and 35 female volunteers from rural villages around Maradi, southern Niger, revealed that fura and tuwo were basic staples, the former being consumed up to 21 times weekly and the latter about once daily. Local recipes were modified to incorporate a prospective new food, Acacia colei seed flour, at 0, 15 and 25% (w/w) and the resulting diets fed ad libitum to volunteers for three weeks under controlled conditions. Acacia incorporation at 25% increased the crude protein content of most meals and the per capita crude protein intake to 136 g/day, 56% above the control. Lipid intake was similar in the three trial groups. Dietary fibre intake and per capita energy consumption for the 25% acacia diet was 93% and 18% above the control respectively. Daily vitamin consumption was above RDA from all the diets. The results showed that the supplementation of the traditional foods of the people of Maradi with acacia increased the nutritional value of each food.

Cyclic loading of rotator cuff repairs: an in vitro biomechanical comparison of bioabsorbable tacks with transosseous sutures.

PURPOSE: This study compares rotator cuff repair strength after cyclic loading of bioabsorbable tacks and traditional transosseous sutures, and correlates the results with bone density, age, and gender. The hypotheses were that tack repair strength would be inferior to transosseous sutures and that repair strength would be directly related to bone quality. TYPE OF STUDY: In vitro randomized biomechanical study. METHODS: Eight paired cadaveric shoulders with a standardized supraspinatus defect were randomized to tack or suture repair and subjected to step-wise cyclic loading. Repair migration was measured by quantifying the motion of markers affixed to tendon and bone using a digital camera. Failure mode, cycles, and load were measured for 50% and 100% loss of repair. Results were correlated with bone density, age, and gender. RESULTS: Tack repairs failed at the tack-tendon interface, whereas suture rupture was the mode of failure for the suture repairs. Mean values for 50% loss of repair were 206 +/- 88 cycles and 44 +/- 15 N for the sutures, and 1,193 +/- 252 cycles and 156 +/- 20 N for the tacks (P < .05). The corresponding values for 100% loss of repair were 2,458 +/- 379 cycles and 294 +/- 27 N for the sutures, and 2,292 +/- 333 cycles and 263 +/- 28 N for the tacks (P > .05). These results did not correlate with bone density, age, or gender. CONCLUSIONS: This study has shown that bioabsorbable tacks provide improved repair strength in comparison with traditional suture techniques. Repair strength did not correlate with bone quality, and this may be attributed to failure primarily through the repair construct or at the tack-tendon interface and not through bone. This report describes a new high-resolution optical method of measuring tendon repair strength that should be a useful model for future studies. CLINICAL RELEVANCE: This study demonstrates the biomechanical advantages of a sutureless tack device for rotator cuff repair compared with a traditional augmented suture repair technique.

Confirmatory factor analysis of the Test of Performance Strategies (TOPS) among adolescent athletes.

The aim of the present study was to examine the factorial validity of the Test of Performance Strategies (TOPS; Thomas et al., 1999) among adolescent athletes using confirmatory factor analysis. The TOPS was designed to assess eight psychological strategies used in competition (i.e. activation, automaticity, emotional control, goal-setting, imagery, negative thinking, relaxation and self-talk,) and eight used in practice (the same strategies except negative thinking is replaced by attentional control). National-level athletes (n = 584) completed the 64-item TOPS during training camps. Fit indices provided partial support for the overall measurement model for the competition items (robust comparative fit index = 0.92, Tucker-Lewis index = 0.88, root mean square error of approximation = 0.05) but minimal support for the training items (robust comparative fit index = 0.86, Tucker-Lewis index = 0.81, root mean square error of approximation = 0.06). For the competition items, the automaticity, goal-setting, relaxation and self-talk scales showed good fit, whereas the activation, emotional control, imagery and negative thinking scales did not. For the practice items, the attentional control, emotional control, goal-setting, imagery and self-talk scales showed good fit, whereas the activation, automaticity and relaxation scales did not. Overall, it appears that the factorial validity of the TOPS for use with adolescents is questionable at present and further development is required.