Effectiveness of short-term isothermic-heat acclimation (4 days) on physical performance in moderately trained males.

INTRODUCTION: A typical heat acclimation (HA) protocol takes 5-7 d of 60-90 minutes of heat exposure. Identifying the minimum dose of HA required to elicit a heat adapted phenotype could reduce financial constraints on participants and aid in the tapering phase for competition in hot countries. Therefore, the aim of this study was to investigate a 4 d HA regimen on physical performance. METHODS: Twelve moderately trained males were heat acclimated using controlled hyperthermia (Tre>38.5°C), with no fluid intake for 90 min on 4 consecutive days, with a heat stress test (HST) being completed one week prior to (HST2), and within one-week post (HST3) HA. Eleven completed the control study of HST1 versus HST2, one week apart with no intervention. Heat stress tests comprised of cycling for 90 min @ 40% Peak Power Output (PPO); 35°C; 60%RH followed by 10 minutes of passive recovery before an incremental test to exhaustion. Physical performance outcomes time to exhaustion (TTE), PPO, end rectal temperature (Tre END), and heart rate (HREND) was measured during the incremental test to exhaustion. RESULTS: Physiological markers indicated no significant changes in the heat; however descriptive statistics indicated mean resting Tre lowered 0.24°C (-0.54 to 0.07°C; d = 2.35: very large) and end-exercise lowered by 0.32°C (-0.81 to 0.16; d = 2.39: very large). There were significant improvements across multiple timepoints following HA in perceptual measures; Rate of perceived exertion (RPE), Thermal Sensation (TS), and Thermal Comfort (TC) (P<0.05). Mean TTE in the HST increased by 142 s (323±333 to 465±235s; P = 0.04) and mean PPO by 76W (137±128 to 213±77 W; P = 0.03). CONCLUSION: Short-term isothermic HA (4 d) was effective in enhancing performance capacity in hot and humid conditions. Regardless of the level of physiological adaptations, behavioural adaptations were sufficient to elicit improved performance and thermotolerance in hot conditions. Additional exposures may be requisite to ensure physiological adaptation.

Offenders With Personality Disorder Who Fail to Progress: A Case-Control Study Using Partial Least Squares Structural Equation Modeling Path Analysis.

BACKGROUND: Offenders with personality disorder can be challenging to engage and retain in treatment. The UK Offender Personality Disorder (OPD) pathway aims to proactively and responsively identify and engage offenders with personality disorder. However, a subpopulation of offenders on the pathway have been found to not be accepted into any OPD service and therefore fail to progress. OBJECTIVE: This study aims to identify and describe offenders on the OPD pathway who fail to progress and to understand the causal drivers by which individuals fail to progress in the pathway. METHODS: A sample of 50 offenders on the OPD pathway who had been refused from at least two OPD services (nonprogression group) were compared to 100 offenders accepted into OPD services (control group). Partial least squares structural equation modeling was used to model the causal factors involved in not being accepted into OPD services. RESULTS: The path coefficients in the structural model showed that the most influential factor in nonprogression was attitude toward treatment (ß=.41; P<.001; f2=0.25) alongside those with psychopathology (ß=.41; P<.001; f2=0.25), specifically, psychopathy, psychosis, and co-occurring personality disorder. CONCLUSIONS: The findings of the study provide a basis of how to work with this population in the future to increase the likelihood of acceptance into OPD services.

Agreement over content of case formulation in offender personality disorder pathway prison services.

BACKGROUND: Case formulation plays a key role in effective management of offenders' needs, particularly on the Offender Personality Disorder Pathway (OPDP). AIMS: To validate a method of investigating formulations with offenders still in prison but in the OPD Pathway and investigate agreement over the content of formulations between each of the main dyadic pairs: offender-clinician, offender-key worker and clinician-key worker. METHODS: We developed a checklist of the main features of a formulation from a review of initial formulations in the files of prisoners in two prisons which operate within the OPD Pathway system. We then recruited 30 violent offenders in each OPD wing of two prisons, and asked each of them, their clinically qualified worker (usually a psychologist) and the criminal justice system key worker to complete a formulation summary according to a card-sort process based on this checklist. We calculated the level of agreement between pairs of raters (e.g. offender and key worker) about the importance of aspects of each domain to the case using intraclass correlation coefficients. RESULTS: The rating tool showed good internal validity. Analysis of inter-rater ratings showed agreement among teams on aspects relating to prisoners' observable actions, experiences and external support domains, but little agreement on cognitions, feelings, risky situations or staff/self-support, mainly affecting the prisoner-key worker dyad. There were, however, significant differences in agreement rates between the two sites. CONCLUSIONS: Agreement within teams about formulations is strong where content relates to overt behaviours and points of fact, but weaker on risk, cognitions and support. The appropriateness of this approach to formulation across cultural groups may need further evaluation as the main measured difference between the prisons was in distribution of ethnic and cultural groups.

Effectiveness of Short-Term Heat Acclimation on Intermittent Sprint Performance With Moderately Trained Females Controlling for Menstrual Cycle Phase.

INTRODUCTION: Investigate the effectiveness of short-term heat acclimation (STHA), over 5-days (permissive dehydration), on an intermittent sprint exercise protocol (HST) with females. Controlling for menstrual cycle phase. MATERIALS AND METHODS: Ten, moderately trained, females (Mean [SD]; age 22.6 [2.7] y; stature 165.3 [6.2] cm; body mass 61.5 [8.7] kg; V . ⁢ O 2 ⁢ peak 43.9 [8.6] mL⋅kg-1⋅min-1) participated. The HST (31.0°C; 50%RH) was 9 × 5 min (45-min) of intermittent exercise, based on exercise intensities of female soccer players, using a motorized treadmill and Wattbike. Participants completed HST1 vs. HST2 as a control (C) trial. Followed by 90 min, STHA (no fluid intake), for five consecutive days in 39.5°C; 60%RH, using controlled-hyperthermia (∼rectal temperature [Tre] 38.5°C). The HST3 occurred within 1 week after STHA. The HST2 vs HST3 trials were in the luteal phase, using self-reported menstrual questionnaire and plasma 17ß-estradiol. RESULTS: Pre (HST2) vs post (HST3) STHA there was a reduction at 45-min in T re by 0.20°C (95%CI -0.30 to -0.10°C; d = 0.77); T ¯ s ⁢ k (-0.50; -0.90 to -0.10°C; d = 0.80); and T ¯ b (-0.25; -0.35 to -0.15°C; d = 0.92). Cardiac frequency reduced at 45-min (-8; -16 to -1 b⋅min-1; d = 1.11) and %PV increased (7.0; -0.4 to 14.5%: d = 1.27). Mean power output increased across all nine maximal sprints by 56W (-26 to 139W; d = 0.69; n = 9). There was limited difference (P > 0.05) for these measures in HST1 vs HST2 C trial. DISCUSSION: Short-term heat acclimation (5-days) using controlled-hyperthermia, leads to physiological adaptation during intermittent exercise in the heat, in moderately trained females when controlling for menstrual cycle phase.

An evaluation of case formulation training and consultation with probation officers.

BACKGROUND: Formulation is a core competency of mental health professionals, drawing on a variety of sources of information. In England and Wales, the current strategy for offenders with personality disorder places formulation-led management, generally by probation staff, at its core, but reliability and validity of the process remain unclear. AIMS: The first aim was to evaluate a checklist previously designed to establish quality of formulation, and the second to measure the impact of training and consultation on the ability of probation officers to formulate cases. METHODS: The inter-rater reliability, test-re-test reliability and internal consistency of the McMurran formulation checklist were calculated from the scores derived from randomised formulations completed by probation officers from fictitious case vignettes. The impact of training was measured by comparing pre- and post-training formulations of these vignettes. Practice cases formulated by probation officers at psychologist-facilitated consultation meetings over a 6-month period were used to measure the impact of consultation. All formulations were scored blind by independent experts. RESULTS: Inter-rater reliability, test-re-test reliability and internal consistency of the scale were all acceptable. Training and practice did not significantly improve the probation officers' formulations. CONCLUSIONS: The purpose and utility of formulation may vary according to the context in which it is applied. Progress in developing formulation skills may depend on the nature and length of the previous experience of this skill. Future research should take account of such variance, with this scale as a potentially useful aid in monitoring progress. IMPLICATIONS: The capacity for teaching formulation to probation officers could be investigated further by comparing the process with formulation development by mental health experts with previously extensive formulation experience. Formulation will probably need to be adapted to meet the needs of the context in which it is developed. The relationship between formulation and management outcome was not investigated here and would be a further important step.

The London Pathways Project: evaluating the effectiveness of a consultation model for personality disordered offenders.

BACKGROUND: A recent government strategy has been developed to meet the challenges posed by personality disordered offenders. A 'pathways project' was piloted in four London boroughs to assess the implementation of some elements of the strategy. AIMS: This paper focuses on the scope and the effectiveness of 2 years of the project. METHOD: Probation caseloads were screened for personality disorder. Risk information and pathways were monitored and recorded over 2 years. Psychologists provided consultation, training and direct co-working as interventions. RESULTS: The findings include a description of the samples identified, the range of project activity, pathway outcomes and factors associated with or predictive of successes and failures. CONCLUSIONS: The findings supported the implementation of the pathways model to fulfil aspects of the offender personality disorder strategy, such as facilitating entry into treatment and interventions and to a lesser extent planning safer return to the community. The consultation model, including low-intensity direct contact with project psychologists, improved outcomes for personality disordered offenders. IMPLICATIONS: Observations from experiences of the 2-year pilot and ideas to assist with a wider implementation of the strategy are provided.