Recent Submissions

  • Relative energy deficiency in dance (RED-D): a consensus method approach to REDs in dance

    Allen, Nick; Kelley, Shane; Lanfear, Martin; Mountjoy, Margo; Reynolds, Andy; Clarke, Richard; Wyon, Matthew; Wolman, Roger (BMJ Publishing Group, 2024-12-31)
    Relative Energy Deficiency in Sport (REDs) is a potentially severe, challenging, broad-spectrum syndrome with potential negative health and performance outcomes. The numerous research publications and International Olympic Committee consensus statements relating to REDs testify to the challenges faced in early identification or screening, diagnosis, and management. Like sport, dance, in its simplest form, can be identified as an activity resulting in physiological energy demands and, as such, requires appropriate energy availability concerning energy expenditures. However, the specificity of physiological and psychological demands in dance must be considered when considering REDs. An environment where physical activity can exceed 30 hours per week and where culture may instil a value that thinness is required puts dancers at increased risk for REDs. The purpose of this study was to provide dance specific guidance dance on this complex condition. A RAND/UCLA Delphi Panel method with nominal group technique was used to review the literature from REDs to evaluate how it may relate to dance. In addition to the EP, which was assembled from a multidisciplinary background with expertise in REDs and multiple genres of dance, six focus groups were commissioned. Four of the focus groups were drawn from the EP members and two additional focus groups formed by dancers and artistic leaders. These panels were used to guide the development of a RED-D Diagnosis Pathway, Management Plan and Risk stratification and Return to Dance Pathway. The dance specific pathways are designed to be a practical tool for guiding and supporting clinicians managing RED-D. Furthermore, this paper represents an important focus of this area in dance and serves to stimulate discussion and further research within the sector.
  • A peer-led walking intervention for adolescent girls (the WISH study): a cluster-randomised controlled trial

    Murphy, Marie H.; O'Kane, S. Maria; Carlin, Angela; Lahart, Ian; Doherty, Leanne C.; Jago, Russell; McDermott, Gary; Faulkner, Maria; Gallagher, Alison M.; Centre for Exercise Medicine, Physical Activity and Health, Sports and Exercise Sciences Research Institute, Ulster University, Belfast, UK; Physical Activity for Health Research Centre (PHARC), Institute for Sport, Physical Education and Health Sciences, University of Edinburgh, Edinburgh, UK. (Elsevier, 2023-11-23)
    BACKGROUND: Adolescent girls in the UK and Ireland fail to meet physical activity (PA) guidelines. PA behaviours track from childhood into adulthood. The effects of walking interventions on adult health are known; however, the potential of walking to promote PA in adolescents is less known. This study evaluated the effectiveness of a novel, school-based walking intervention aimed at increasing PA levels of adolescent girls. METHODS: In this cluster-randomised controlled trial, female pupils aged 12-14 years were recruited from 18 (mixed or single-sex) schools across the border region of Ireland and Northern Ireland. Schools were randomly assigned to either the control group (usual physical activity; n=9) or the intervention group (n=9) by independent faculty staff using an online randomisation tool ( In intervention schools, female pupils aged 15-18 years were trained as walk leaders and led the younger pupils in 10-15 min walks before school, at break, and at lunchtime. Walks were in school grounds and pupils were encouraged to join as many walks as possible. The intervention was delivered for a full school year excluding holidays (for a total of 18-21 weeks). Accelerometers measured PA, and the primary outcome was total PA (counts per minute [cpm]). Ethics approval was granted by Ulster University Research Ethics Committee and written informed consent (parent or guardian) and assent (pupils) was obtained. This study is registered with the ISRCTN Registry, 12847782. FINDINGS: The study took place from Sept 1, 2021, to May 31, 2023. In total, 589 pupils were recruited (n=286 in intervention group; n=303 in control group). Median moderate-vigorous PA (MVPA) at baseline was 36·1 min/day (IQR 23·0) for the intervention group and 35·3 min/day (19·8) for the control group. Only 37 (15%) girls in the intervention group and 29 (10%) girls in the control group met PA guidelines (60 min/day of MVPA). The mean total PA after intervention was 676 cpm (SD 18·7) for the intervention group and 710 cpm (SD 17·7) for the control group. Post-intervention total PA did not differ between groups when adjusted for age, body-mass index, z-scores, and baseline PA (mean difference -33·5, 95% CI -21·2 to 88·1; p=0·213). INTERPRETATION: Scaling up PA interventions is challenging. Despite a promising feasibility study, the results of this fully powered trial indicate that in this context, the walking programme did not increase PA. Since the COVID-19 pandemic, school environments have changed, and although pupils enjoyed the programme, attendance at walks was low. There is a need to better understand the implementation of interventions such as this within schools. FUNDING: Cross-border Healthcare Intervention Trials in Ireland Network (CHITIN).
  • Dietary restraint and emotional eating among elite/international combat sport athletes

    Barker, Laura; Ruiz, Montse C.; Nevill, Alan M.; Cloak, Ross; Lane, Andrew; Devonport, Tracey (Taylor & Francis, 2024-01-31)
    In one-on-one combat sport, weight classifications are enforced to promote fair fights and minimise injury risk. Most combat sport athletes try to fight at weight much lower than their natural weight necessitating use of weight loss strategies including restrained eating prior to competition. Previous research indicates that individuals self-reporting as high in dietary restraint also self-report a higher desire to emotionally eat, which if acted upon would compromise weight management goals. This mixed-methods exploratory study examined associations between dietary restraint and emotional eating among elite/international combat sport athletes. Nineteen elite/international competitors in Brazilian Jiu Jitsu and Mixed Martial Arts completed the emotional eating scale, a revised restraint scale, and a rapid weight loss questionnaire. A subsample of six participants then completed individual interviews to explore emotional eating, particularly during the lead-up to and post-competition. Quantitative findings via non-parametric tests found high scores in restrained eating associated with a greater urge to emotionally eat. Qualitative findings via content analysis of interview data identified three themes that helped understand this association, ‘emotions eliciting an urge to eat’, ‘outcomes of emotional eating’, and ‘resisting emotional eating’. Participants described a cycle of restrained eating pre-competition followed by an increased tendency toward emotional eating post-competition, with the extent of emotional eating influenced by the degree of restrained eating required and competition outcomes.
  • The Influence of polycystic ovary syndrome (PCOS) and other related factors upon health-related quality of life in women of reproductive age: a case-control study

    Kite, Chris; Lahart, Ian; Randeva, Harpal S.; Kyrou, Ioannis; Brown, James E. P. (Taylor & Francis, 2024-01-09)
    This study aimed to assess the impact of a polycystic ovary syndrome (PCOS) diagnosis and other factors on health-related quality of life (HRQoL) in women of reproductive age. Online questionnaires were completed and study groups compared. Potential causal relationships were evaluated using path analysis. Analyses revealed that a PCOS diagnosis alongside BMI had the largest effect on HRQoL. Higher levels of physical activity (PA) were not associated with greater HRQoL, and PA was not directly affected by any other outcome. However, reduced self-esteem was identified as a key factor in the promotion of physical and mental health.
  • Understanding the experiences of post-diagnostic dementia support for South Asians living in England: the need for co-production

    Jutlla, Karan; Arblaster, Kielan (Opast Publishing Group, 2023-04-19)
    Background: The increase in the numbers of South Asians in the United Kingdom (UK) is likely to lead to an increased need for dementia services yet; they are currently under-represented in dementia services. Furthermore, little is known about the prevalence, experience and treatment of dementia in the UK South Asian population, including their experiences of post-diagnostic support. Consequently, a project was commissioned by Alzheimer’s Society in the UK to gather insight into the experiences of post-diagnostic dementia support for the South Asian community in England to identify whether their post-diagnostic support needs were being met and what they needed from post-diagnostic support services. Methodology/Methods: As this project sought to understand experiences, a qualitative case-study approach was adopted. Twelve South Asian carers of a person with dementia and one South Asian person living with dementia took part in an on-line in-depth, topic-guided conversation. All conversations were audio recorded with consent and analysed using a thematic analysis. Findings: Analysis revealed that the South Asian community are doubly affected by dementia in relation to post-diagnostic support because 1) they received very little post-diagnostic support and 2) even when they did, it wasn’t culturally appropriate and therefore ineffective. Essentially, the lack of culturally inclusive care compounds the lack of access further. Consequently, people discussed current gaps in service provision, making recommendations that will result in better support, and more positive experiences for South Asians when diagnosed with dementia in England. In order to achieve this, South Asians in need of dementia support should be involved in the planning, development and delivery of post-diagnostic support services. Conclusions: This paper discusses findings that highlight the importance and benefits of co-production whereby people who use services and carers work with professionals in equal partnerships towards shared goals.
  • ‘Including us, talking to us and creating a safe environment’—youth patient and public involvement and the Walking In ScHools Study (WISH): lessons learned

    Gallagher, Alison M.; O'Kane, S. Maria; Doherty, Leanne C.; Faulkner, Maria; McDermott, Gary; Jago, Russell; Lahart, Ian; Murphy, Marie H.; Carlin, Angela (Wiley, 2023-10-06)
    Background: Young people have the right to be informed and consulted about decisions affecting their lives. Patient and public involvement (PPI) ensures that research is carried out ‘with’ or ‘by’ young people rather than ‘to’, ‘about’ or ‘for’ them. The aim of this paper is to outline how youth PPI can be embedded within a physical activity intervention, reflect on the impact of PPI and provide recommendations for future PPI in a similar context. Methods: A Youth Advisory Group (YAG) was set up within the Walking In ScHools (WISH) Study to involve adolescent girls in the delivery, implementation and dissemination of a physical activity intervention targeted at adolescents. Schools invited pupils aged 12–14 years and 15–18 years to YAG meetings (n3, from 2019 to 2023). Participative methods were used to inform recruitment strategies and data collection methods for the WISH Study. Results: Across the three YAG meetings, n51 pupils from n8 schools were involved. Pupils enjoyed the YAG meetings, felt that their feedback was valued and considered the meetings a good way to get young people involved in research. The YAG advised on specific issues and although measuring impact was not the primary aim of the YAG meetings, over the course of the study there were many examples of the impact of PPI. Recruitment targets for the WISH Study were exceeded, the attrition rate was low and pupils were engaged in data collection. Conclusion: Youth PPI is a developing field and there are few physical activity studies that report the PPI work undertaken. Within the WISH Study, three YAG meetings were held successfully, and the views of adolescent girls were central to the development of the study. Considering the specific issues that the YAG advised on (study recruitment, attrition and data collection), there was evidence of a positive impact of PPI. Patient or Public Contribution: Pupils from post-primary schools interested/participating in the WISH Study were invited to attend YAG meetings. YAG meetings were set up to consult adolescent girls on the delivery, implementation and dissemination of the WISH intervention.
  • Teaching professionalism during and posta pandemic to surgical trainees: A survey of the impact of a workshop on trainers and trainees

    Ashwood, Neil; Stanhope, Edward; Lahart, Ian; Dekker, Andrew; Hind, Jamie; Carmichael, Amtul Razzaq; University of Wolverhampton, Research Institute, Wulfruna St, Wolverhampton WV1 1LY, United Kingdom. (Shiraz University of Medical Sciences, 2023-10-31)
    Introduction: Focussed professionalism training improves surgical trainees’ communication, information gathering, and counselling skills. This study reviews the impact of a professionalism workshop for surgical trainees within a large trust in the United Kingdom developed during the pandemic to support the trainees and help them develop resilience and appropriate behaviours during the time of increased pressure. Methods: A workshop involving case-based discussions and reflections on professionalism was developed from the themes and methods of training noted to be effective on a literature search of Medline, EMBASE, and PsycINFO databases carried out in May 2020. The impact of Covid on surgical trainees and educator’s professionalism training and the techniques of training preferred by trainees was evaluated by a survey of trainees and trainers after the intervention to evolve future training initiatives. During the workshop, a behavioural marker checklist was used to improve feedback on the observed behaviours. Results: 83 trainers and trainees were surveyed following a professional behaviour workshop training 63 surgeons at various stages of training. Surgical list availability had reduced by at least 5-10 a month for all the trainees within the trust during the pandemic. Most trainees surveyed (49 (60%)) felt that this had reduced the opportunities to train technical skills and develop professional non-technical skills like teamwork and communication skills, adversely impacting the trainee’s clinical performance. The increased support offered by the workshop helped 50 trainees (80%) to improve non-technical skill performance objectively by referencing to behavioural markers and this was felt to have become embedded in practice when surveyed 4 weeks later in 38 trainees (60%). The majority of those surveyed (47 (75%)) felt trainers and trainees had acted professionally during the pandemic and subsequently. The workshop discussions also helped (56 (67%)) trainers and trainees to consider how best to engage professionally with new ways of working as work, and training switched to virtual or telemedicine platforms during the pandemic. Conclusion: Professionalism-based education facilitates surgical trainee development, making them stronger team members and helping to restore team working skills and embrace new working practices.
  • ‘I’m not the same person now’: The psychological implications of online contact risk experiences for adults with intellectual disabilities

    Clements, Fiona; Chadwick, Darren; Orchard, Lisa (SAGE, 2023-12-22)
    Understanding online risk for adults with intellectual disabilities is important to improve digital inclusion in society. Perceptions of online risk can determine behaviours that obstruct or facilitate Internet access and use. This current study aimed to qualitatively investigate the psychological implications of online victimisation risks, including online negative comments and/or messages for adults with intellectual disabilities, as a novel area yet explored in-depth. Semi-structured interview data was collected remotely. Template analysis found there to be both negative and positive psychological implications experienced in response to online risks. Specifically, participants reported a wide range of negative emotions but also positive growth in the form of learning from the experience and increased confidence. The attribution of blame process in cybervictimisation can involve both blaming the perpetrator but also internalised victim-blaming which may be a consequence of the type of online risk (i.e. sexual risks). Implications for both practice and research are suggested.
  • Dementia: a call for a paradigm shift in pre-registration nurse education

    Tuffour, Isaac; Ganga, Griffin (Cambridge University Press, 2023-12-04)
    Dementia is a progressive brain disorder that affects memory, thinking, and behaviour. It is a major global public health concern, with an estimated 55 million people worldwide living with the condition. In the UK there is an estimated 944,000 people with dementia. This number is expected to double by 2050. Dementia is a major cause of disability and dependency, and it places a significant burden on families and carers. The current level of dementia education in pre-registration nursing programmes in the UK is inadequate. There are no pre-registration nursing educational programmes that offer dementia as a speciality. This is a major concern, as nurses are the primary providers of care to people with dementia. This paper argues that dementia should be established as a branch of pre-registration nursing education that leads to a Registered Nurse (RN) – Dementia. This could help to address the shortage of specialist dementia nurses in the country. This article provides an important suggestion for countries with a shortage of specialist dementia nurses to consider establishing a stand-alone pre-registration branch of dementia nurse education. This would result in a more specialised workforce with the skills and knowledge to provide high-quality care to people with dementia.
  • The efficacy of strength and conditioning training on dance injury in pre-professional dancers

    Dang, Yanan; Koutedakis, Yiannis; Chen, Ruoling; Wyon, Matthew (Unpublished, 2023-10-13)
  • Navigating the tensions of dance and science in an emerging research field

    Clarke, Frances; Lefebvre-Sell, Naomi; Brown, Derrick; Wyon, Matthew (Unpublished, 2023-10-15)
  • Injury incidence and severity in Chinese pre-professional dancers: a prospective monitoring survey

    Dang, Yanan; Koutedakis, Yiannis; Chen, Ruoling; Wyon, Matthew (Unpublished, 2023-10-13)
  • British Universities and Colleges Sport: Race and Equality Research

    Ward, Gavin; Scott, David; Hill, Joanne; Richards, Ronnie; Hardman, Alun; Edwards, Lisa; Akinola, Abiodun; Allen, Jesse; Banks, Alysean; Burnett-Charles, Nadiya; et al. (University of Wolverhampton and British Universities and Colleges Sport, 2023-11-06)
  • Injury incidence and severity in Chinese pre-professional dancers: a prospective weekly monitoring survey

    Dang, Yanan; Koutedakis, Yiannis; Chen, Ruoling; Wyon, Matthew (Elsevier, 2023-12-04)
    Objective: To determine dance injury incidence and severity in full-time Chinese pre-professional dancers. Study Design: Prospective weekly online monitoring survey Methods: Respondents were asked to record all dance-injury incidences between September 2020 to July 2021 using a remote weekly self-report injury monitoring tool. An inclusive definition of injury was used in this study to record all injuries, even if they didn’t cause a cessation of training. Data were excluded if respondents completed less than 90% of the survey period and had over 3 consecutive weeks of missing data. Results: 450 individuals from 11 different schools were included in the analyses. A total of 1157 injuries were reported over a 30-week academic year. Injury prevalence was 64.9% and injury incidence was 5.51 injuries per 1000 hours. Forty-eight percentage of the injuries were minor severity and 41% were of moderate severity, and the main injury sites were knees (0.89/1000hrs), lower back (0.80/1000hr), feet (0.58/1000hrs), groin (0.56/1000hrs). Female dancers reported significantly higher injury prevalence and injury incidence, and higher rates of moderate to severe injuries than males. The university group reported higher injury incidence than the adolescent group (p<0.05), whereas the latter reported higher rates of moderate to severe injuries than the former (p<0.001). Conclusion: The injury incidence found in this study (5.1 injuries/1000hrs) is higher than most previous sets of data. Female dancers are at a higher risk of injury and reported higher levels of injury severity than male dancers, especially for the female adolescent group.
  • Can culinary capital be (re) produced in school?

    Lalli, Gurpinder Singh (Taylor & Francis, 2023-08-21)
    Drawing on ethnographic fieldwork, the paper draws on conceptions of culinary capital and socialisation to explore children’s experiences of mealtime in one academy school. In this paper, the author argues how ‘healthy eating’ interventions have led to the neglect of the social significance of dining together. The paper highlights how children’s culinary capital is reproduced in schools, whilst recognising the rising tensions between how eating spaces designed for children become consumed by adults. The findings from the study outline the growing power relationships in relation to school food spaces.
  • Doing qualitative research: Methodological reflections on researching teachers work

    Jayantilal, Kumar; Lalli, Gurpinder Singh (Wiley, 2023-09-18)
    Reflexive commitments tend to be lacking, particularly from the perspective of early career scholars. This is particularly true in relation to published research, but evident in doctoral studies exploring teachers work. Using principles of phenomenological reflexivity, this methodological paper explores the critical incidents that have come to shape a qualitative, ethnographical case study before entering the field. Key findings highlight four implications for novice researchers: an engagement with critical independent reflection, critical friendship, skills development through academic modules and reflexive reading, and communities of practice. The paper calls for continued attention to the methodological framing of research, particularly during and after entering the field.
  • ‘Why are they making us rush?’ The school dining hall as surveillance mechanism, social learning, or child’s space?

    Lalli, Gurpinder Singh; Weaver-Hightower, Marcus B. (Taylor & Francis, 2023-11-07)
    School mealtimes, for many schools, are characterized by behavioural difficulties, a problematic time of day requiring much attention and resources. Yet for many school food reformers, those wanting food environments to be educative and pleasant, strict behavioural interventions are contrary to the ideals of social learning. This paper presents an ethnographic case study of Peartree Academy, an all-through academy school in England, to explore how school personnel used the dining hall simultaneously as a community space and as surveillance mechanism. We deliberate on causes and variations of how this manifests. A Foucauldian lens, viewing dining space as ‘heterotopia’ and ‘heterochronies’ [Foucault, M. 1986. “‘Of Other Spaces.” Translated by J. Miskowiec. Diacritics 16 (1): 22.], highlights tensions that shape the everyday for both students and staff in the school. As counter-spaces used differently by administrators, pupils, and food reformers, we show how rules and regulations imposed by staff work against the original intentions to develop the dining hall into a community forum in which children develop positive eating behaviours and good citizenship. The children became subjected to power relations through which bodies became docile or resistant, with less opportunity for social learning. True progressive food reform thus requires, ultimately, deeply understanding and negotiating the multiple, overlapping functions of dining spaces.
  • Culinary capital and conceptualisations of school mealtime

    Lalli, Gurpinder Singh; Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK (Wiley-Blackwell, 2023-12-11)
    This paper presents ethnographic work conducted to investigate how notions of culinary capital have the potential to shape the everyday experiences of children during mealtime in school. Children’s early experiences with mealtimes and food are critical determinants for eating behaviour over the life course. The paper presents an account of conceptual debates based on longstanding ethnographic work on school food with a particular focus on a case study of Maple Field Academy to frame the research. Research methods used included semi-structured interviews, fieldnotes and photographs with the aim of capturing a rich picture of the school. This paper introduces Laird’s (1985) sensory theory to frame the discussion. This research calls for the need to recognize the social good that can be realized from participating in mealtimes and school is a microcosm of society, which means it can function as a driver for social change. The paper calls for more engagement with social theorising on studies which focus on researching food in school.
  • Force plate coverings significantly affect measurement of ground reaction forces

    Smith, Tina; Ditroilo, Massimiliano; Faculty of Education, Health & Wellbeing, University of Wolverhampton, Walsall, United Kingdom; Faculty of Education, Health & Wellbeing, University of Wolverhampton, Walsall, United Kingdom. (Public Library of Science (PLoS), 2023-11-03)
    The purpose of this study was to carry out a material test to investigate the effect of different force plate coverings on vertical and horizontal ground reaction force and derived parameters. Four surface conditions were analysed; bare plate, vinyl, sportflex, and astroturf on a Kistler force plate. Vertical data were collected by dropping a 2 kg rigid, textured medicine ball from a low (61 cm) and a high (139 cm) height. Horizontal data were collected using a custom-built, rigid, metal pendulum device. A one-way ANOVA revealed a significant main effect of surface on peak force and rate of force development for high height, low height, and horizontal force conditions (all p<0.001), with effect sizes in the post-hoc analysis being mostly large to very large. Interestingly, sportflex yielded the highest vertical but the lowest horizontal ground reaction forces. This study showed the use of current force platform coverings had a significant effect on peak force and rate of force development measurements during a standardised testing procedure. Future research should try to obtain rate of force development values that more closely replicate aspects of human performance during standardised testing procedures. Also further investigate the effect of the different surfaces on ground reaction forces during human movement.
  • Effects of a transoceanic rowing challenge on cardiorespiratory function and muscle fitness

    Ellis, Chris; Ingram, Thomas; Kite, Chris; Taylor, Sue; Howard, Liz; Pike, Joanna; Lee, Eveline; Buckley, John (Thieme, 2023-11-06)
    Ultra-endurance sports and exercise events are becoming increasingly popular for older age groups. We aimed to evaluate changes in cardiac function and physical fitness in males aged 50-60 years who completed a 50-day transoceanic rowing challenge. This case account of four self-selected males included electro- and echo-cardiography (ECG, echo), cardiorespiratory and muscular fitness measures recorded nine-months prior to and three weeks after a transatlantic team-rowing challenge. No clinically significant changes to myocardial function were found over the course of the study. The training and race created expected functional changes to left ventricular and atrial function; the former associated with training, the latter likely due to dehydration, both resolving towards baseline within three weeks post-event. From race-start to finish all rowers lost 8.4-15.6 kg of body mass. Absolute cardiorespiratory power and muscular strength were lower three weeks post-race compared to pre-race, but cardiorespiratory exercise economy improved in this same period. A structured programme of moderate-vigorous aerobic endurance and muscular training for &gt;6 months, followed by 50-days of transoceanic rowing in older males proved not to cause any observable acute or potential long-term risks to cardiovascular health. Pre-event screening, fitness testing, and appropriate training is recommended, especially in older participants where age itself is an increasingly significant risk factor.

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