An exploration of context and learning in endurance sports coaching

Introduction

This study explored contextual factors which influence coach learning of an international cohort of endurance sports coaches.

Methods

Following ethical approval, 839 coaches, 612 coached athletes and 8,352 non-coached athletes participated in the research. A critical realist research philosophy was adopted, in which self-completion surveys were developed in consultation with coaches and industry end-users.

Results and Discussion

The context was dominated by remote coaching practices and digital technology which shaped how coaches learn and thus, what it meant to be a coach. Unmediated learning sources were biophysically biased and largely delivered through marketised platforms designed to sell products. The study findings have broader implications within sport and education, in which it is suggested that remote coaching and learning platforms may sometimes create a sense of psycho-emotional detachment in which capacity for learning can be limited.

"… Exercise opportunities became very important": Scottish older adults' changes in physical activity during Covid19'

BACKGROUND

The purpose of this study was to explore perceived changes in physical activity (PA) due to Covid19 stay-at-home and social distancing guidance among older adults.

METHODS

Participants (n = 1429, 77% female, 84% ≥60 years) living in Scotland completed an online survey in Summer 2020 measuring PA and wellbeing (indexed through loneliness, and health-related quality of life). The survey included open- and closed-ended questions about how these variables changed in response to Covid19 social distancing and 'shielding' guidelines.

RESULTS

From the International Physical Activity Questionnaire (IPAQ), the majority reported high volumes of PA, indicative of being 'moderately' or 'highly' active. When asked specifically about strength training, 12% reported engagement on ≥2d/wk. Most participants reported that PA had changed during this time, citing reduced use of exercise facilities, increased active travel, and online PA classes; although only 16% reported engaging in PA online.

CONCLUSIONS

Higher levels of PA were found to be associated with better health-related quality of life. Additional efforts should be made to support PA engagement in older adults, including strength training and other tailored approaches to support individual needs.

Loneliness, Wellbeing, and Social Activity in Scottish Older Adults Resulting from Social Distancing during the COVID-19 Pandemic

This study examined the impact of social distancing during the COVID-19 pandemic on loneliness, wellbeing, and social activity, including social support, in Scottish older adults. A mixed methods online survey was used to examine these factors during social distancing mid-lockdown, July 2020. Participants were asked to state whether loneliness, wellbeing, social activity, and social support had changed since pre-social distancing, and to provide details of strategies used to keep socially active. A total of 1429 adults (84% aged 60+ years) living in Scotland took part. The majority reported that social distancing regulations made them experience more loneliness and less social contact and support. Loneliness during lockdown was higher than reported norms for this age group before the pandemic. A larger social network, more social contact, and better perceived social support seemed to be protective against loneliness and poor wellbeing. Positive coping strategies reported included increasing online social contact with both existing social networks and reconnecting with previous networks, as well as increasing contact with neighbours and people in the community. This underlines the importance of addressing loneliness and social support in older adults but particularly during situations where risk of isolation is high.

Using the theoretical domains framework to explore primary health care practitioner's perspectives and experiences of preconception physical activity guidance and promotion

Preconception physical activity is one of the main predictors of continued engagement in physical activity during and after pregnancy and subsequently, improves the health of women and their child. In the UK, guidance states that Primary Care health Professionals (PCPs) should assess and discuss the lifestyle of preconception women, in routine appointments, in order to address potentially modifiable risk factors. However, knowledge and provision of this guidance in the UK is unknown. It is not clear if individuals actively seek preconception guidance from PCPs, what guidance they request, and whether PCPs have the knowledge and skills to provide this support in line with current guidelines. This research aimed to explore current practice and the perspectives of PCPs in delivering physical activity guidance to preconception patients. Fifteen semi-structured interviews were conducted with PCPs (GPs and community pharmacists) in the UK. Data was analysed using the Theoretical Domains Framework (TDF). Our findings showed patients did not frequently present solely for preconception physical activity guidance, but occasionally enquired when consulting about another issue. PCPs lacked motivation to implement physical activity guidance due to the perception that their advice would have no impact on behaviour change. There were a number of perceived opportunities to implement preconception physical activity guidance. These findings illustrate the need for consistent and specific preconception lifestyle and PA guidance for PCPs.

Where science meets practice: Olympic coaches' crafting of the tapering process

Although there is research providing physiologically-based guidance for the content of the taper, this study was the first to examine how coaches actually implement the taper. The purpose of this study was to examine the taper planning and implementation processes of successful Olympic coaches leading up to major competitions and how they learned about tapering. Seven track and field coaches participated in semi-structured interviews exploring their tapering processes. To be considered for inclusion, coaches were required to have coached one or more athletes to an Olympic or Paralympic medal. Through a process of axial and open coding interview transcripts were analysed and lower and higher order themes developed describing the coaches' tapering processes. Our findings indicate that the strategies employed to achieve the desired physiological adaptions of the taper were consistent with research (e.g., reduction in volume whilst maintaining intensity and frequency). However, our findings also suggest that tapering is far from a straight forward "textbook" process. The taper was not restricted to physiological outcomes with coaches considering athletes' psychological as well as physical state. Coaches also involved the athlete in the process, adapted the taper to the athlete, continually monitored its progress, and adapted it further as required.

The OptIPuter microscopy demonstrator: enabling science through a transatlantic lightpath

The OptIPuter microscopy demonstrator project has been designed to enable concurrent and remote usage of world-class electron microscopes located in Oxford and San Diego. The project has constructed a network consisting of microscopes and computational and data resources that are all connected by a dedicated network infrastructure using the UK Lightpath and US Starlight systems. Key science drivers include examples from both materials and biological science. The resulting system is now a permanent link between the Oxford and San Diego microscopy centres. This will form the basis of further projects between the sites and expansion of the types of systems that can be remotely controlled, including optical, as well as electron, microscopy. Other improvements will include the updating of the Microsoft cluster software to the high performance computing (HPC) server 2008, which includes the HPC basic profile implementation that will enable the development of interoperable clients.

Validity and reliability of the Ergomopro powermeter

The aim of this investigation was to assess the validity and reliability of the Ergomopro powermeter. Nine participants completed trials on a Monark ergometer fitted with Ergomopro and SRM powermeters simultaneously recording power output. Each participant completed multiple trials at power outputs ranging from 50 to 450 W. The work stages recorded were 60 s in duration and were repeated three times. Participants also completed a single trial on a cycle ergometer designed to assess bilateral contributions to work output (Lode Excaliber Sport PFM). The power output during the trials was significantly different between all three systems, (p < 0.01) 231.2 +/- 114.2 W, 233.0 +/- 112.4 W, 227.8 +/- 108.8 W for the Monark, SRM and Ergomopro system, respectively. When the bilateral contributions were factored into the analysis, there were no significant differences between the powermeters (p = 0.58). The reliability of the Ergomopro system (CV%) was 2.31 % (95 % CI 2.13 - 2.52 %) compared to 1.59 % (95 % CI 1.47 to 1.74 %) for the Monark, and 1.37 % (95 % CI 1.26 - 1.50 %) for the SRM powermeter. These results indicate that the Ergomopro system has acceptable accuracy under these conditions. However, based on the reliability data, the increased variability of the Ergomopro system and bilateral balance issues have to be considered when using this device.

Studies of antibodies in the sera of patients who have made red cell autoantibodies

BACKGROUND

In patients in whom autoantibodies of broad specificity (panagglutinins) are present in the serum, adsorption studies are often necessary to identify alloantibodies that are simultaneously present.

STUDY DESIGN AND METHODS

Samples from 138 patients in whom the direct antiglobulin test was positive and antibody was present in the serum were studied. When antibody identification studies before or after initial adsorption suggested the presence of an alloantibody, additional alloadsorptions were performed.

RESULTS

Among the samples from 138 patients, 71 contained only panagglutinating autoantibody, and another 19 contained either autoantibodies or alloantibodies that were not accompanied by panagglutinins. The remaining 48 samples contained both panagglutinins and a total of 62 antibodies that appeared to be alloimmune in nature. Alloadsorption with antigen-negative red cells showed that 29 (47%) of the apparent alloantibodies were in fact partially adsorbed autoantibodies that mimicked alloantibodies by their reactions.

CONCLUSION

Initial autoadsorption often left unadsorbed alloantibodies and autoantibodies with mimicking specificities. Initial alloadsorption more often left only true alloantibodies unadsorbed. From the screening tests, it appeared that 43 percent of the 138 patients were alloimmunized. Recognition of the mimicking nature of the partially adsorbed autoantibodies found that the real incidence of alloimmunization in the patients was 23 percent. Recognition of this phenomenon considerably simplifies the selection of blood for transfusion to these patients.

Endometrial thickness: a predictor of implantation in ovum recipients?

In a retrospective study, the relationship between endometrial thickness and pregnancy rate has been studied in 59 ovum recipient women. Transvaginal ultrasound assessment of endometrial thickness was performed immediately prior to ovum transfer: 19 pregnant recipients had a mean endometrial thickness of 10.24 mm +/- 2.63 SD, 40 nonpregnant recipients had an endometrial thickness of 8.62 mm +/- 3.49 SD (t = 1.805, P = 0.0382). Only two pregnancies occurred in 15 recipients with an endometrial thickness < 7.5 mm, and none when the endometrial thickness was < 5 mm. Our results indicate that endometrial thickness is related to the functional receptivity of the endometrium.

Age, pregnancy and miscarriage: uterine versus ovarian factors

This study was performed to evaluate the relative contribution of oocyte and uterine factors to the age-related reduction in fecundity. The pregnancy and miscarriage rates in women receiving donated oocytes were compared to those in women using their own oocytes in in-vitro fertilization (IVF) and gamete intra-Fallopian transfer (GIFT) procedures. Oocyte donation with embryo transfer was performed on 241 women in 371 cycles; 116 of these women became pregnant (48% per patient and 31.5% per cycle) of whom 40 (35%) miscarried, giving a live birth rate of 20.5%. Assisted conception, in the form of IVF/GIFT procedures, was performed on 1331 women using their own oocytes in 2194 cycles; 627 of these women became pregnant (47% per patient and 28.7% per cycle), of whom 228 (36%) miscarried, giving a live birth rate of 18.2%. Neither the age of the donor nor the age of the recipient was related to pregnancy rate. The age of the donor, however, was directly related to the miscarriage rate. On the other hand, the age of patients undergoing IVF/GIFT was inversely related to the pregnancy rate and directly related to the miscarriage rate. In women of 40 years or over, the overall pregnancy and live birth rates were significantly higher and the miscarriage rate was significantly lower in the group receiving donated oocytes compared to the group using their own oocytes. In summary, we suggest that the age-related decline in fecundity is associated with the age of the oocytes rather than the age of the uterus.

The role of oocyte donation in women who are unsuccessful with in-vitro fertilization treatment

Oocyte donation improves the chances of becoming pregnant in some women who are unsuccessful with in-vitro fertilization (IVF) treatment. A total of 119 IVF cycles achieved a pregnancy rate per cycle of 2.5% whereas the same women, when treated with 45 cycles of oocyte donation, achieved a 24.5% pregnancy rate per cycle. To ascertain which women may be helped by oocyte donation, IVF data were analysed according to the outcome of oocyte donation. There was a difference in the number of previous natural conceptions and live births, and in the IVF fertilization rate. There was no difference in the age of the women and the numbers of oocytes collected per cycle of IVF. New criteria are therefore suggested for recommending oocyte donation to women who have previously failed to become pregnant with IVF treatment.

Comparison of attitudes of donors and recipients to oocyte donation

The attitudes of volunteer donors and recipients undergoing treatment in an ovum donation programme were studied in order to assess both the psychological and psycho-social aspects of the procedure. A questionnaire was sent to 35 donors and 60 recipients. All donations were unpaid. Fifty-eight were anonymous donations and three were known. Eighty-six per cent of recipients and 74% of donors had told at least one person other than their partner. Eighty per cent of donors and 66% of recipients agreed that donors should not be paid. Sixty-three per cent of donors would donate if the recipient was told their name but only 26% of recipients would accept if the donor was given their name. Seventy per cent of the donors would donate to someone they knew but would rather donate anonymously. Ninety per cent of recipients were strongly against the donor contacting the child later in life but 54% of donors had no objection to the child contacting them. Eighty-six per cent of recipients and 56% of donors felt that if they had been born from a donated oocyte, they would not want to know.

Relaxin levels in ovum donation pregnancies

STUDY OBJECTIVE

To investigate the relative contributions of the corpus luteum (CL) and the placenta to the circulating levels of relaxin during pregnancy.

PATIENTS

Forty-one patients in whom pregnancy had been achieved by ovum donation.

RESULTS

Relaxin was not detected in the serum of 36 patients; in the remaining 5, although it was detectable, the levels were markedly reduced when compared with those in normal pregnancies.

CONCLUSION

These results demonstrate that the CL is essential for the maintenance of normal circulating levels of relaxin during pregnancy.

The Metropolitan Toronto Regional Geriatric Program: an innovative method of health care delivery

The co-ordination of hospital services in large metropolitan areas presents a formidable challenge. History, university relationships, geography and a tradition of independence and autonomy mitigate against co-operative regional ventures. A new program is evolving in Metropolitan Toronto which represents a significant change in the delivery of specialized geriatric services. The regional geriatric program has been established with direct funding from the Ontario Ministry of Health and contractual agreements with participating hospitals to provide specific geriatric services. It is a collaborative venture with the participating hospitals and the University of Toronto voluntarily participating in its management and policy direction. Although many issues have yet to be resolved regarding the relationship of the program to the Ministry, between the hospitals and with the community, this model may become prevalent in other areas of specialty services, such as trauma and oncology.

A report on 100 cycles of oocyte donation; factors affecting the outcome

Eighty-two patients had 100 cycles of oocyte donation from 68 donors resulting in 27 clinical pregnancies. The source of donated oocytes was 42 fertile volunteers and 26 patients from the assisted conception programme. The pregnancy rate was significantly higher when intra-Fallopian transfer was performed (36%; 21/59), compared with intrauterine transfer (15%; 6/41). The pregnancy rate following fresh gamete/embryo transfer (39%; 15/39) was slightly higher than for frozen embryo transfer (20%; 12/61). The age of the recipient significantly affected the pregnancy rate. The pregnancy rate was 50% in the 25-29 years age group and steadily dropped to 9.7% in the 45-49 age group. The pregnancy rate in patients with primary ovarian failure (50%; 8/16) was significantly higher than in patients with secondary ovarian failure (18%; 9/50). The pregnancy rate was significantly greater when parous donors (33%; 23/69) were used compared with non-parous donors (13%; 4/31). The number of gametes/embryos transferred significantly affected the pregnancy rate regardless of the treatment used. If one or two gametes/embryos were transferred, the pregnancy rate was 11% compared with 33% if three to four embryos were transferred. The age of the donors did not affect the pregnancy rate. The majority of the donors were under the age of 35 years. The best results (50% per cycle) were therefore achieved using gametes from parous donors and transferring three to four oocytes fresh to the Fallopian tubes of a young recipient.

A comparison of the attitudes of volunteer donors and infertile patient donors on an ovum donation programme

The attitudes of anonymous volunteer donors (n = 20) and infertile patients who were undergoing treatment in an IVF programme and who donated oocytes (n = 15) towards the donation, the recipient, the potential children conceived, the recording of information and their experience of the procedures were sought by posted questionnaires. All donations were made for altruistic reasons and no payments other than expenses were made. Both groups agree that donors should not be paid and they both deny any connection with the child resulting from their donation. The majority in both groups also did not object if their eggs were donated to unmarried single women and they did not wish to meet with the recipient. The majority of both groups would however agree to donate to known recipients. Over 80% had told others of their donation and a similar number in the volunteer group held no objection to the recipients knowing their name whilst only 40% held the same view in the patient donor group (17/20 versus 6/15 P less than 0.02). The feelings of the groups was also different in relation to their desire to know if a child was born from their eggs. Eighty five per cent in the volunteer group (17/20) would like to know the outcome and only 40% (6/15) of the patient donor would want to know the outcome, P less than 0.02. Although greater than 50% in both groups experienced side effects, 60% of volunteers and 90% of patient donors expressed a willingness to donate eggs again.(ABSTRACT TRUNCATED AT 250 WORDS)

Timed oocyte collection in an assisted conception programme using GnRH analogue

Three-hundred-and-twenty-five patients on an assisted conception programme underwent 378 cycles of oocyte retrieval (OPU) following ovarian stimulation using a GnRH analogue and human menopausal gonadotrophins (HMG), a regimen which allows programmed cycles and delayed oocyte retrieval. Eighteen cycles were excluded (failed OPU in three and failure of fertilization in 15). In 360 cycles, patients completed their treatment with either in-vitro fertilization/embryo transfer (IVF/ET) (116) or gamete intra-Fallopian transfer (GIFT) (244), of which 241 took place at the normal time and 119 were delayed for 24 h or more to avoid weekend operating. The overall pregnancy rate per OPU was 29.5%, with the IVF group being 24.1% and the GIFT group being 32.8%. In the group of patients in whom OPU was delayed, the pregnancy rate was significantly higher in each sub-group than in the corresponding non-delayed sub-group (overall, 37.0 versus 25.7%; IVF/ET, 38.5 versus 16.9%; GIFT, 36.3 versus 31.1%). There was a significantly higher number of oocytes collected, gametes/embryos transferred in the group whose OPU had been delayed. In patients receiving GnRH analogue and HMG for ovarian stimulation, delaying oocyte retrieval is not harmful, may result in an improved outcome and allows OPU to be performed on routine operating lists. This facility, together with the improved pregnancy rates associated with this protocol of ovarian stimulation should improve the cost-effectiveness of assisted conception programmes.

Pregnancy in women with premature ovarian failure using tubal and intrauterine transfer of cryopreserved zygotes

Twenty-nine women, mean age 36.3 (SD 5.5) years, with premature ovarian failure received donated ova on an ovum donation programme. Three had Turner's syndrome, four a surgical menopause, one a chemotherapy-induced menopause and 21 had idiopathic premature ovarian failure. All donated oocytes were fertilized with frozen-thawed spermatozoa from the recipient's partner, and the resulting zygotes were frozen until transfer had been arranged. Overall, 19 women had intrauterine embryo transfer (ET) and a mean of 2.7 (SD 0.9) embryos were transferred on 20 occasions; 10 women underwent zygote intrafallopian transfer (ZIFT) and a mean of 3.5 (SD 0.5) zygotes were transferred on 10 occasions. Both groups were matched for age. The pregnancy rate per transfer was 20% in the ET group and 40% in the ZIFT group. After excluding the 10 women in the ET group who had fewer than three embryos transferred, the pregnancy rates were similar in the two groups, 30% in the ET group and 40% in the ZIFT group. Cryopreserved embryos may be used for ovum donation to preserve anonymity and still show a high pregnancy rate of at least 30% per transfer.

Ultrasound measurement of endometrial thickness on different ovarian stimulation regimens during in-vitro fertilization

Endometrial thickness was measured ultrasonographically in three groups of patients undergoing in-vitro fertilization (IVF) on three different ovulation induction regimens. The endometrial thickness was comparable on all three regimens and similar to that observed in a group of spontaneously ovulating, normal, fertile controls. These patterns of endometrial thickness were observed despite significantly higher levels of serum oestradiol-17 beta in all of the hyperstimulated cycles, suggesting that in the normal cycle a maximum response in terms of endometrial development may be achieved. In the three conception cycles endometrial thickness continued to increase throughout the luteal phase, whilst in non-conception cycles plateauing of thickness increase occurred in the mid-luteal phase and reduction in late luteal phase. Whether ultrasonographic evaluation of endometrium during IVF stimulation cycles has any prognostic value regarding prediction of conception has yet to be determined.