Metacognitions in heterosexual, bisexual, and homosexual men: with or without premature ejaculation and erectile dysfunction.

BACKGROUND: Premature ejaculation (PE) and erectile dysfunction (ED) are prevalent sexual problems, with evidence to suggest variation across sexual orientation. Contributing factors have traditionally been divided into organic and psychological categories. While limited research has found support for the influence of metacognitive beliefs, these studies did not investigate potential differences in sexual orientation. AIM: The current study aimed to investigate the differences in metacognitive beliefs in men with or without PE and/or ED and whether these varied according to sexual orientation. METHOD: A sample of 531 men was recruited (65 met criteria for PE only, 147 for ED, 83 with PE and ED, and 236 healthy controls). Within this sample, 188 men identified as heterosexual, 144 as bisexual, and 199 as homosexual. Participants completed a cross-sectional online survey consisting of psychometric measures. RESULTS: Participants with PE and ED were significantly higher in cognitive confidence, thoughts concerning uncontrollability and danger, and need to control thoughts than PE only, ED only, and healthy controls. Furthermore, the PE only group was significantly higher than healthy controls for cognitive confidence, with the ED significantly higher for thoughts concerning uncontrollability and danger. There were no significant differences between differing sexual orientations for men with/or without PE and/or ED. CONCLUSIONS: Congruent with previous research, metacognitive beliefs play a role in PE and/or ED, although this is not exclusive to sexual orientation. The findings highlight that assessment and intervention regarding metacognitive beliefs may be beneficial for men of all sexual orientations with PE and/or ED.

Successfully treating refugees' post-traumatic stress symptoms in a Ugandan settlement with group cognitive behaviour therapy.

BACKGROUND: High rates of post-traumatic stress disorder (PTSD) are documented within refugee populations. Although research supports effectiveness of trauma-focused cognitive behaviour therapy (TF-CBT) among Western populations, little research exists for its efficacy among refugees living in camps and settlements in developing nations. AIMS: To investigate whether a culturally sensitive, group-based TF-CBT programme (EMPOWER) delivered in a Ugandan refugee settlement effectively reduced refugees' post-traumatic stress symptoms (PTSS), and whether sociodemographic factors, trauma characteristics, or PTSS severity related to programme completion or treatment outcomes. METHOD AND RESULTS: Data linkages were conducted on information provided by 174 Congolese refugees living in a Ugandan settlement (mean age = 33.4 years, SD = 11.7; 49% male). Using a quasi-experimental design, participants who initially completed the intervention (n = 43) delivered across nine 90-minute sessions, reported significant reductions in self-reported PTSS with a large effect size. The delayed treatment group (n = 55) also reported significant treatment gains once they received the intervention. Participants who completed the programme reported significantly greater initial PTSS severity than those who dropped out, while no sociodemographic factors, trauma characteristics or PTSS were associated with better treatment outcomes. DISCUSSION: A culturally sensitive, group-based TF-CBT programme delivered in a refugee settlement meaningfully reduces refugees' PTSS severity and is equally effective for all participants, with the highest retention rates found among those in greatest need of treatment. Programmes such as this, with capacity to treat hundreds of people simultaneously, represent highly cost-effective, accessible, disseminable and effective treatment for PTSS among refugees living in humanitarian settings in developing nations.

Psychosocial strategies for physiotherapy: A qualitative examination of physiotherapists' reported training preferences.

Physiotherapists report using a range of psychosocial strategies in their practice, yet, barriers to implementation include lack of time, limited knowledge, and minimal training. This research aimed to establish what training physiotherapists have had with regards to psychosocial strategies, why they think they would benefit from more training, what training they want, and delivery preferences. Content analysis of answers to four open-ended, online survey questions collected from Australian physiotherapists (N = 208) was conducted. Physiotherapists reported having minimal training specific to psychosocial strategies. Physiotherapists reported wanting training in assessment and management of psychosocial issues, and practical application of specific psychosocial strategies. Didactic and interactive training delivered by experts who understand the psychosocial needs of their patients, and the constraints of physiotherapy practice was preferred. These findings suggest that training in psychosocial strategies at the undergraduate level and continued professional development are necessary. Specifically, training in the assessment and management of psychosocial factors, and in referral processes is warranted, and should be applicable and appropriate for rehabilitation settings. Training should be both didactic and interactive as outlined in the proposed framework.

The Effect of Short- and Long-Term Aerobic Training Years on Systemic O2 Utilization, and Muscle and Prefrontal Cortex Tissue Oxygen Extraction in Young Women.

Buzza, G, Lovell, GP, Askew, CD, and Solomon, C. The effect of short- and long-term aerobic training years on systemic O2 utilization, and muscle and prefrontal cortex tissue oxygen extraction in young women. J Strength Cond Res 33(8): 2128-2137, 2019-This study aimed to determine if systemic O2 utilization (VO2) and tissue oxygen extraction (deoxyhemoglobin [HHb]) in the vastus lateralis (VL), gastrocnemius (GAST), and prefrontal cortex were different during exercise between short-term trained (STT, 6-24 months) and long-term trained (LTT, >5 years) young women while controlling for current training load. Thirteen STT and 13 LTT participants completed ramp incremental (RI) and square-wave constant load (SWCL) tests on a cycle ergometer. In LTT compared with STT: (a) VO2 was higher during the RI (p = 0.024) and SWCL (p = 0.001) tests; (b) HHb in the VL (p = 0.044) and GAST (p = 0.027) was higher in the RI test; and (c) there were significant group × intensity interactions for VO2 in the SWCL test. The additional years of aerobic training in LTT compared with STT (LTT 7.1 ± 1.9 vs. STT 1.5 ± 0.4 years) resulted in higher VO2 and HHb in the VL and GAST. These results indicate that in young women, independent of current training load, systemic VO2 and peripheral muscle O2 extraction during exercise continues to increase beyond 24 months of aerobic training.

Occupational therapists' perceptions of psychosocial strategies for clients with Parkinson's disease.

Psychological strategies are a promising adjunct to pharmacological treatment for symptoms, including depression and anxiety associated with Parkinson's disease. In this study, we investigated perceptions and reported behaviors of occupational therapists regarding the use of psychosocial strategies during their practice with clients with Parkinson's disease. The results of a cross-sectional online survey (n = 115 occupational therapists) demonstrated that the majority of participants (83%) reported using psychosocial strategies with their clients living with Parkinson's disease, with goal setting the most frequent. Almost all occupational therapists (99.1%) reported that it was moderately to extremely important to have knowledge about psychosocial strategies for practice with clients living with Parkinson's disease, and 96.5% rated it important to be able to offer these strategies in practice with their clients living with Parkinson's disease. The majority (91.3%) felt incorporating psychosocial strategies into their practice was moderately to extremely beneficial, and 93.9% reported that psychosocial strategies have a moderate-to-extremely positive effect on Parkinson's disease management outcomes. These findings have important implications for the education and training of occupational therapists working with clients living with Parkinson's disease to help ensure the best possible outcomes for people with Parkinson's disease.

A knock to the system: A new sociotechnical systems approach to sport-related concussion.

Broader contextual factors that influence concussion management have tended to be overlooked. To address this, the present study used a sociotechnical systems approach to identify perceived responsibilities and applied strategies for three domains of concussion management (i.e., prevention, identification and treatment). Participants were 118 members of the community rugby union system in Australia (69.2% male). Participants from throughout the rugby system (e.g., players, parents, coaches, club management) were asked open-ended questions about their perceived responsibilities and the strategies they use for concussion management. It was found that (a) proper training, technique correction and education were recurrent prevention themes; (b) the majority of key stakeholders felt that they could consistently identify concussion; however, medical aids (medics) were the only system actors who stated a responsibility to use standardised concussion assessment measures and (c) less than one third of the respondents indicated their involvement in treating concussion. This study identifies specific junctures in the system that prevents effective concussion management strategies. A sociotechnical systems approach improves the understanding of concussion prevention, and management beliefs and behaviours.

Barriers and enablers to malnutrition screening of community-living older adults: a content analysis of survey data by Australian dietitians.

Many older adults living in their own homes are at nutrition risk which, left untreated, can lead to the state of malnutrition. To reduce the prevalence of malnutrition among community-living older adults (CLOAs), risk factors should be identified and addressed early via malnutrition screening. The aim of this study was to identify barriers and enablers to malnutrition screening of CLOAs from the perspective of dietitians. Ninety-two dietitians working for government, not-for-profit and private organisations in Australia provided written comments to open-ended survey questions. Textual data were analysed using content analysis, resulting in four key categories of organisational, staff, screening and CLOA factors. Insufficient time to screen and lack of knowledge by non-dietetic staff and CLOAs about malnutrition were identified as the strongest barriers. Organisational factors of screening policy and procedures and the provision of education and training emerged as the strongest enablers. The findings from this study can provide guidance to organisations and healthcare practitioners considering the implementation of routine malnutrition screening of CLOAs. Increased awareness about malnutrition and the associated outcomes may help to reduce nutrition risk among CLOAs.

Satisfaction of Basic Psychological Needs, Self-Determined Exercise Motivation, and Psychological Well-Being in Mothers Exercising in Group-Based Versus Individual-Based Contexts.

We compared mothers who exercised predominantly in group settings, those who exercised predominantly in individual settings, and those who exercised equally in group and individual contexts among the following: (a) satisfaction of basic psychological needs (autonomy, competence, and relatedness); (b) self-determined exercise motivation; and (c) psychological well-being. With clear implications for mothers' exercise interventions we found that exercising either predominantly in group contexts or in mixed group and individual settings was associated with mothers having significantly higher satisfaction of basic psychological needs and self-determined exercise motivation than those exercising predominantly alone.

Food addiction symptomology, impulsivity, mood, and body mass index in people with type two diabetes.

This research explored how food addiction (FA) and impulsivity (non-planning, motor, and attentional) relate to body mass index (BMI) in a sample of people with type 2 diabetes (t2d). Participants with t2d (N = 334, Mage = 41.0, SDage = 9.5, 66% female, MBMI = 37.6 kg/m(2), SDBMI = 8.0 kg/m(2)) completed an online survey including the Depression Anxiety Stress Scale (DASS-21), the Barratt Impulsiveness Scale (BIS-II), and the Yale Food Addiction Scale (YFAS). Results demonstrated that over 70% of the sample with t2d met the YFAS criteria for FA. Results also demonstrated that participants classified as FA had significantly higher BMI, t (332) = 12.11, p < .001. The food addict classification group also had a significantly higher percentage of obese participants, χ(2) (2) = 87.1, p < .001, phi = .511. Utilising a cross-sectional design to predict BMI, significant forward stepwise multiple regression demonstrated that FA (ß = .386) and impulsivity (non-planning) (ß = .286) were significant predictors. In combination FA and impulsivity (non-planning) significantly explained 38% of BMI variance; however depression, anxiety, and stress did not significantly improve the model. These results suggest FA and impulsivity (non-planning) are more salient cross-sectional predictors of BMI, in people with t2d, than indices of depression, anxiety, stress and impulsivity (motor and attentional). These results, implicating FA in the development of obesity, have important ramifications for potential future treatment methods of t2d where FA symptomology could be routinely screened, and if present, treated via addiction models rather than purely attempting to treat the potential consequences of FA.

Surrogate End-of-Life Care Decision Makers' Postbereavement Grief and Guilt Responses.

This article examined differences in familial/friend surrogate decision makers' (N = 93) postbereavement grief and guilt associated with decisions to either prioritize comfort or longevity in determining end-of-life care for decisionally incapacitated adult palliative loved ones. Results demonstrated that participants prioritizing the longevity of loved ones experienced significantly and meaningfully higher levels of grief, complicated grief, and trauma related guilt than those who prioritized comfort.

Physical activity behavior and role overload in mothers.

We examined physical activity stages of change, physical activity behavior, and role overload in different stages of motherhood in a predominantly Australian sample. Neither physical activity behavior, stages of physical activity change, nor role overload significantly differed across motherhood groups. Role overload was significantly higher for mothers in the contemplation, planning, and action stages of physical activity than in the maintenance stage of change. Role overload had a weak, although significant, negative correlation with leisure-time physical activity. We conclude that strategies focused upon reducing role overload or perceived role overload have only limited potential to meaningfully increase leisure-time physical activity in mothers.

A cross-sectional investigation of depressive, anxiety, and stress symptoms and health-behavior participation in Australian university students.

Transitioning to university involves a major life change that can have implications for physical and mental health. This study had three objectives: first, assess the mental health and health-behavior participation of Australian university students; second, evaluate clustering of health behaviors; and third, examine how mental health relates to health behaviors. University students (n = 751) enrolled at an Australian regional university completed an online survey containing the Depression, Anxiety, and Stress Scales and a health-behavior questionnaire. Over one-third of students reported mild or higher mental illness symptoms and most reported engaging in multiple unhealthy behaviors. Furthermore, mental health was associated with unhealthy behaviors. For males, depressive symptoms were associated with skipping breakfast and poor sleep quality. For females, depressive symptoms were associated with skipping breakfast, inadequate vigorous physical activity, and short or long sleep hours. Stress symptoms in females were associated with healthy sleep hours, but poor sleep quality. Future research may consider whether an intervention targeting one or two key health behaviors has utility in improving participation in other health behaviors and mental health.

Psychological distress, depression, anxiety, stress, and exercise in Australian and New Zealand mothers: A cross-sectional survey.

Postnatal psychological well-being is a complex issue characterized by major changes in physical, social, and emotional health. In response to addressing limitations of previous research this study aimed to: (i) quantify psychological distress, depression, anxiety, and stress in a large sample of Australian and New Zealand mothers and to compare to Australian norm data; and (ii) identify any significant differences in psychological distress, depression, anxiety, and stress of the mothers when grouped according to their self-reported exercise incidence. Self-reported short-form version Depression Anxiety Stress Scale data were collected from 3601 Australia and New Zealand mothers with at least one child under the age of 5 years. Results demonstrated that this sample of mothers had significantly poorer psychological well-being than the general Australian population. Furthermore, with the exception of anxiety, psychological well-being of mothers who reported exercising three to four times per week was significantly and meaningfully more positive compared to those mothers that reported not to exercise.

Effect of an obesity pamphlet on parental perception and knowledge of excess weight in their children: results of a randomised controlled trial.

ISSUES ADDRESSED: This study examined the effectiveness of a brief educational intervention in increasing parental knowledge of childhood obesity risk factors and ability to correctly identify their child's weight status. METHODS: Eighty parents were randomly allocated to an experimental group given an obesity pamphlet or a control group given a stress management pamphlet. A survey measured parents' knowledge about risk factors, cause and consequences of childhood obesity, and perception of their child's weight. RESULTS: Parents with overweight or obese children increased their understanding of childhood obesity immediately after receiving the intervention, but did not differ significantly on perception of their child's weight. CONCLUSION: The experimental intervention increased knowledge of health risks associated with childhood obesity in parents of overweight or obese children. Parental perception of their child's weight status did not improve, suggesting that other factors have a role to play. SO WHAT? The obesity pamphlet may be a useful tool in a multifaceted approach targeting childhood obesity.

Influence of female sports dietitians' physical characteristics on athlete perception of effectiveness.

UNLABELLED: Research in sports-science disciplines such as sport psychology has demonstrated that practitioners' physical characteristics influence clients' perceptions of their effectiveness, potentially mediating the efficacy of subsequent interventions. However, very little research has been directed toward this issue for sports dietitians (SDs), the health professionals whom athletes are likely to engage to assist with manipulation of traits of physique. Therefore, the purpose of this investigation was to determine whether SDs' phenotype, specifically body-mass index (BMI), and type of dress influence potential clients' preference to consult them for dietetic support and if this affects their perceived effectiveness. METHODS: One hundred volunteers (mean age 18.7 ± 0 .8 years) all participating in regular competitive sport, classified by gender (male, n = 55, or female, n = 45) and competitive standard (elite/subelite, n = 68, or club/recreational, n = 32) viewed slides representing four concurrently presented computer-generated images of the same female SD manipulated to represent different BMIs and dress types. Participants were asked to rank the SDs in order of their preference to work with them and, second, to rate their perceived effectiveness of each of the SDs. RESULTS: Key findings included the observation of a significant BMI main effect F(6, 91) = 387.39, p < .001 (effect size .96), with participants' ranking of preference and rating of perceived effectiveness of female SDs decreasing with increasing BMI. CONCLUSION: SDs should consider their physical appearance when meeting with athletes, as this may affect their perceived efficacy.

Sleep as a mediator of the relationship between social class and health in higher education students.

A substantial body of research indicates that higher education students from lower social class backgrounds tend to have poorer health than those from higher social class backgrounds. To investigate sleep as a potential mediator of this relationship, online survey responses of students from five large Australian universities, one Irish university and one large Australian technical college were analysed in three studies (Study 1 N = 628; Study 2 N = 376; Study 3 N = 446). The results revealed that sleep quality, sleep duration, sleep disturbances, pre-sleep worries and sleep schedule variability mediated the relationship between social class and physical and mental health. Sleep remained a significant mediator when controlling for related variables and other mediators. Thus, the findings suggest that sleep partly explains social class differences in health. We discuss the importance of addressing sleep issues among students from lower social class backgrounds.

Mood profiles of amateur triathletes: Implications for mental health and performance.

Moods have been shown to be predictive of athletic performance and a reflection of mental health status. The aims of our study were (a) to compare pre-race mood scores of triathletes with population norms; (b) to compare pre-race mood scores of triathletes grouped by gender and age bands; (c) to explore whether six distinct mood profile clusters reported in the literature were evident among triathletes and their respective prevalence; (d) to determine if pre-race mood scores predicted triathlon performance; and (e) to interpret our findings in terms of the risk of mental health issues for triathletes. Participants were 592 age-group triathletes (also referred to as recreational or amateur triathletes) who completed the Brunel Mood Scale pre-race and recorded their time goal for the race. Mean mood scores deviated significantly from population norms, with Tension and Vigor scores at the 55th and 54th percentile, respectively, and Depression, Anger, Fatigue, and Confusion scores between the 42nd and 46th percentile. Females reported higher Tension scores than males (p < 0.001), and those in the 18-25 years and 26-35 years age bands reported higher Tension scores than those in the 46-55 years age band (p < 0.008). Using k-means cluster analysis, six distinct mood profiles were identified, the distribution of which approximated the general population, except for a low prevalence of very negative profiles. Mean scores for Depression and Anger were exceptionally low and only 1.5% of triathletes, compared to the normal prevalence of ~5%, reported an "inverse Everest" profile, which is associated with elevated risk of psychopathology. Mood scores did not predict triathlon performance, assessed by finish time as a percentage of time goal. Results showed an association between triathlon participation and psychological well-being. Findings will inform future investigations of mood responses among triathletes and provide a relevant point of reference for applied practitioners who work with triathletes.

Physiotherapists' views, perceived knowledge, and reported use of psychosocial strategies in practice.

Background: Research has addressed the usefulness of psychosocial strategies within physiotherapy, as part of a biopsychosocial model. A lack of current research in Australia concerning the views of physiotherapists, from a range of practice areas, regarding a variety of strategies, suggests the need for broader exploration. Methods: This research employed a cross-sectional survey asking Australian physiotherapists (n = 251) to rate their perceived importance and perceived benefits of psychosocial strategies; perceived positive effects on rehabilitation outcomes and adherence; confidence in applying strategies, and perceived benefits of further training. Data were analyzed using descriptive statistics, Crosstabs with Chi-Squared Tests of Contingencies and Spearman's Rank-Order Correlations. Results: Physiotherapists reported that having knowledge of such strategies was important and considered them beneficial for practice. Respondents rated highly their perceived knowledge about goal setting and positive reinforcement, both of which were reported as most used in practice. Approximately one quarter of physiotherapists reported using cognitive behavioral therapy and motivational interviewing. Physiotherapists communicated a lack of confidence to apply psychosocial strategies in their practice, and desired further training. Conclusion: Physiotherapists could benefit from tailored instruction regarding psychosocial strategies at a level appropriate to, and within their scope of practice. This could enhance their practice from a biopsychosocial perspective, subsequently improving outcomes for their patients.

Mental toughness and self-efficacy of elite ultra-marathon runners.

Minimal research has examined psychological processes underpinning ultra-marathon runners' performance. This study examined the relationships between mental toughness and self-efficacy with performance in an elite sample of ultra-marathon runners competing in the 2019 Hawaiian Ultra Running Team's Trail 100-mile endurance run (HURT100). The Mental Toughness Questionnaire (SMTQ) and the Endurance Sport Self-Efficacy Scale (ESSES) were completed by 56 elite ultra-marathon runners in the HURT100 (38 males, 18 females; Mage = 38.86 years, SDage = 9.23). Findings revealed mental toughness and self-efficacy are highly related constructs (r(54) = 0.72, p < 0.001). Mental toughness and self-efficacy did not significantly relate to ultra-marathon performance (mental toughness and self-efficacy with Ultra-Trail World Tour (UTWT) rank F(2, 53) = 0.738, p = 0.483; mental toughness and self-efficacy with likelihood would finish the HURT100 χ2 = 0.56, p = 0.756; mental toughness and self-efficacy with HURT100 placing and time F(2, 53) = 1.738, p = 0.186 and F(2, 30) = 2.046, p = 0.147, respectively). However, participants had significantly and meaningfully higher mental toughness (M = 45.42, SD = 4.26, medium and large effect sizes) than athletes from other sports previously published. Our interpretation is that these results taken in conjunction, suggest a threshold of mental toughness that performers require to be of the standard needed to be able to prepare for and compete in elite ultra-marathon events such as the HURT100; once this mental toughness threshold is met, other factors are likely to be more influential in determining elite level ultra-marathon performance.

An exploration of physiotherapists' perceived benefits and barriers towards using psychosocial strategies in their practice.

BACKGROUND: This study aimed to determine what physiotherapists perceive are the benefits of using psychosocial strategies in their own practice, and whether perceived barriers extend beyond practitioner and contextual barriers. METHODS: Content analysis of two open-ended questions was conducted. Australian physiotherapists (n = 206) provided written comments. RESULTS: Three key categories of benefits emerged: patient benefits, shared patient and physiotherapist benefits, and physiotherapist benefits. Patient benefits included improved rehabilitation experience, improved patient wellbeing and improvement of psychosocial responses. Specifically, increased patient enjoyment, improved self-management and improved understanding of the links between their physical and psychological health. Therapeutic alliance appeared as a shared patient and physiotherapist benefit, with specific reference to enhanced partnerships and improved patient-centred practice. Physiotherapist benefits comprised of improved needs assessment and occupational benefits such as reduced load. Three key categories of physiotherapist barriers, contextual barriers, and patient barriers emerged. Time, knowledge, confidence, lack of expertise, and limited formal training, were the main barriers, specifically a lack of practical training, and for more complex strategies. Physiotherapists acknowledged patient barriers such as patient resistance, lack of understanding, and complex mental health needs. CONCLUSIONS: These findings contribute novel information with regard to the benefits and barriers of psychosocial approaches from a physiotherapist perspective. Physiotherapists may benefit from further support in their use of psychosocial approaches, to emphasize the benefits for their own practice. Furthermore, to potentially reduce patient barriers and improve outcomes, patient education concerning a biopsychosocial model of care could be valuable.