An evaluation of the multidisciplinary approach to psychiatric diagnosis in elderly people.

OBJECTIVE--To determine the accuracy of psychiatric diagnoses made by two community psychogeriatric teams operating a multidisciplinary assessment procedure. DESIGN--Comparison of team diagnosis with independent formal assessment and consensus diagnosis by research psychiatrists. SETTING--Two community psychogeriatric teams with similar operational policies in an inner London health district. SUBJECTS--100 people aged 65-90 (70 women) newly referred to the teams. MAIN OUTCOME MEASURES--Concordance between team and research diagnoses. RESULTS--Agreement between team and research diagnoses ranged from 90% to 99% for the specific psychiatric disorders studied. There was no significant difference between medical and non-medical team members in their diagnostic performance compared with the research psychiatrists. Increased diagnostic accuracy by team members was associated with longer experience of team working, regardless of the team members'' professional background. CONCLUSIONS--The multidisciplinary approach to the assessment of referrals to these community teams for the elderly is not associated with misdiagnosis of psychiatric disorder.     

Competing with Lower Level Opponents Decreases Intra-Team Movement Synchronization and Time-Motion Demands during Pre-Season Soccer Matches

This study aimed to quantify the time-motion demands and intra-team movement synchronization during the pre-season matches of a professional soccer team according to the opposition level. Positional data from 20 players were captured during the first half of six pre-season matches of a Portuguese first league team. Time-motion demands were measured by the total distance covered and distance covered at different speed categories. Intra-team coordination was measured by calculating the relative phase of all pairs of outfield players. Afterwards, the percentage of time spent in the −30° to 30° bin (near-in-phase mode of coordination) was calculated for each dyad as a measure of space-time movement synchronization. Movement synchronization data were analyzed for the whole team, according to each dyad average speed and by groups of similar dyadic synchronization tendencies. Then, these data were compared according to the opponent team level (first league; second league; amateurs). Time-motion demands showed no differences in total distance covered per opposition levels, while matches opposing teams of superior level revealed more distance covered at very high intensity. Competing against superior level teams implied more time in synchronized behavior for the overall displacements and displacements at higher intensities. These findings suggest that playing against higher-level opponents (1^st league teams) increased time-motion demands at high intensities in tandem with intra-team movement synchronization tendencies.     

Transitive inference and awareness in humans

Thirty-nine participants performed a transitive inference task. During training, they were shown six pairs of imaginary sports teams and learnt which team was better in each pair. The pairs of teams were adjacent members of a seven-term series of team rankings (A-G). The participants were not explicitly informed of this underlying stimulus hierarchy. Once a participant reached the training criterion, they were tested on the six training pairs and three novel pairs (BD, CE, and DF) that required the participant to make a transitive inference. The participants completed a post-experimental questionnaire that measured their awareness of the stimulus hierarchy. A more-aware group and a less-aware group were created from answers to the questionnaire. The less-aware group were significantly less accurate than the more-aware group on some training pairs and all three novel pairs, and the less-aware group's pattern of performance bore similarities to non-human animal performance.     

Using information from asthma patients: a trial of information feedback in primary care.

OBJECTIVE--To test the effects of feedback of information about patients'' asthma to primary care teams. DESIGN--Patients'' reports of morbidity, use of health services, and drug use on questionnaire was given to primary care teams. Randomised controlled trial with general practices as the subject of the intervention was used to test effectiveness of supplying information. SETTING--Primary care in district health authority, London. SUBJECTS--23 general practices, each of which notified at least 20 asthmatic patients aged 15-60 years for each principal. Practices were randomly allocated to an invention group (receiving feedback of information on control of asthma) or a control group (no feedback). INTERVENTION--Information on cards inserted in patients'' medical records; booklet copies of information for team members; formal presentation to primary care teams; poster displays of data on patients in each practice. MAIN OUTCOME MEASURES--Type and frequency of asthma symptoms, use of health services, use of asthma drugs. RESULTS--Reported morbidity at entry to the study was substantial: 45% (818) patients reported breathlessness at least once a week. Less than half these patients were using inhaled steroids regularly. Intervention and control groups did not differ in practice or patient characteristics on entry to the study. In spite of the potential for improvement no differences were observed between the two practice groups at the end of the study--for example, breathlessness at least once a week in last six months was experienced by 36% in intervention group v 35% in control group (t = -0.27, P < 0.79); surgery attendance in last six months by 48% v 48% (t = -0.05, P < 0.96); regular use of inhaled steroids by 60% v 58% (t = 0.51, P < 0.62). CONCLUSION--Feedback to general practitioners of information about patients'' asthma does not on its own lead to change in the outcome of clinical care.     

Do Coaches Perceive Themselves as Influential on Physical Activity for Girls in Organised Youth Sport?

Participation in organised youth sports (OYS) has been recommended as an opportunity to increase young peoples'' physical activity (PA) levels. While coaches can potentially influence athletes'' PA levels, what has not been explored is the question; do coaches perceive themselves as influential on PA for girls in OYS? Participants were 30 coaches of girls OYS teams aged 9–17 years in the Greater Sydney Metropolitan Area, Australia. Participants took part in a semi-structured interview that lasted approximately 30 minutes. They responded to questions regarding their perceived role as coaches, their perceptions of themselves as role models for PA, their views on their athletes'' current PA levels, their opinions on improving their athletes'' PA levels, and their perceived challenges as coaches in OYS. Many coaches considered themselves role models for PA due to their own involvement in organised sports. Coaches felt that they were conscious of girls'' PA levels during training and could accurately gauge how active girls were. Coaches perceived their training sessions to provide sufficient PA and thus, did not feel the need to try to increase PA during training. Many coaches were cautious about conducting training sessions where the PA intensity was high for prolonged periods because they believed that it could potentially result in dropout from OYS. Coaches'' perceived time commitment to OYS, variability of skill/experience amongst girls, and poor parental support as major challenges they experienced in OYS. This study provided a unique insight from the perspective of coaches in OYS. Most coaches felt that they had the potential to influence PA for girls in OYS; however, coaches may underestimate or not fully realise the impact they can have on the girls they coach. Future research should focus on educating coaches to capitalise on the opportunity they have to promote PA through OYS.     

High-performance vision training improves batting statistics for University of Cincinnati baseball players

Purpose

Baseball requires an incredible amount of visual acuity and eye-hand coordination, especially for the batters. The learning objective of this work is to observe that traditional vision training as part of injury prevention or conditioning can be added to a team''s training schedule to improve some performance parameters such as batting and hitting.

Methods

All players for the 2010 to 2011 season underwent normal preseason physicals and baseline testing that is standard for the University of Cincinnati Athletics Department. Standard vision training exercises were implemented 6 weeks before the start of the season. Results are reported as compared to the 2009 to 2010 season. Pre season conditioning was followed by a maintenance program during the season of vision training.

Results

The University of Cincinnati team batting average increased from 0.251 in 2010 to 0.285 in 2011 and the slugging percentage increased by 0.033. The rest of the Big East''s slugging percentage fell over that same time frame 0.082. This produces a difference of 0.115 with 95% confidence interval (0.024, 0.206). As with the batting average, the change for University of Cincinnati is significantly different from the rest of the Big East (p = 0.02). Essentially all batting parameters improved by 10% or more. Similar differences were seen when restricting the analysis to games within the Big East conference.

Conclusion

Vision training can combine traditional and technological methodologies to train the athletes'' eyes and improve batting. Vision training as part of conditioning or injury prevention can be applied and may improve batting performance in college baseball players. High performance vision training can be instituted in the pre-season and maintained throughout the season to improve batting parameters.     

Cervical Cancer—Use of a Non-Physician Health Team for Screening Procedures

A team of non-physician personnel has been trained in cytologic screening for cervical cancer. In a county hospital clinic setting among low income women whose annual pelvic examinations were being by-passed by physicians, this three-person team has performed pelvic examinations and screening under physician supervision for one year.Results of the first year''s experience, measured in cancer detection and in recognition and referral of benign gynecological disease as well, would suggest that a non-physician team, with a registered nurse doing a pelvic examination of screening type, can screen for cervical cancer and other pelvic disease efficiently and without a significant lowering of the quality of medical care.The training and use of teams of allied health care personnel directed by physicians is suggested as a practical means of overcoming the increasing shortage of physician services in annual screening for cervical cancer among low income women.     

Palliative care: views of patients and their families.

OBJECTIVE--To investigate the current problems and needs of terminally ill cancer patients and their family members, and to discover their views of hospital, community, and support team services. DESIGN--Prospective study of patients and families by questionnaire interviews in the patients'' homes. SETTING--Inner London and north Kent (London suburbs). SUBJECTS--65 Patients, each with a member of their family or a career. MAIN OUTCOME MEASURES--Ratings of eight current problems and ratings and comments on three services-hospital doctors and nurses, general practitioners and district nurses, and the support team staff-obtained after a minimum of two weeks'' care from palliative care support teams. RESULTS--Effect of anxiety on the patient''s nearest career. and symptom control were rated as the most severe current problems by both patients and families; a few patients and families identified other severe problems. Families'' ratings of pain control, symptom control, and effect of anxiety on the patient were significantly worse than the patients'' ratings (p less than 0.05). Support teams received the most praise, being rated by 58 (89%) patients and 59 (91%) of family members as good as excellent. General practitioners and district nurses were rated good or excellent by 46 (71%) patients and 46 (71%) family members, but six (9%) in each group rated the service as poor or very bad, and ratings in the inner London district were significantly worse than those in the outer London district. Hospital doctors and nurses were rated good or excellent by 22 (34%) patients and 35 (54%) of family members, and 14 (22%) patients and 15 (23%) family members rated this service as poor or very bad. Negative comments referred to communication (especially at diagnosis), coordination of services, the attitude of the doctor, delays in diagnosis, and difficulties in getting doctors to visit at home. Family members were more satisfied with the services than were patients. CONCLUSIONS--Palliative care needs to include both the patient and family because the needs of the family may exceed those of the patient. Support teams and some hospital and community doctors and nurses met the perceived needs of dying patients and families, but better education and organisation of services are needed.     

The Effects of a 6-Week Strength Training on Critical Velocity,Anaerobic Running Distance, 30-M Sprint and Yo-Yo Intermittent Running Test Performances in Male Soccer Players

The objectives of this study were to examine the effects of a moderate intensity strength training on changes in critical velocity (CV), anaerobic running distance (D''), sprint performance and Yo-Yo intermittent running test (Yo-Yo IR1) performances. Methods: two recreational soccer teams were divided in a soccer training only group (SO; n = 13) and a strength and soccer training group (ST; n = 13). Both groups were tested for values of CV, D'', Yo-Yo IR1 distance and 30-m sprint time on two separate occasions (pre and post intervention). The ST group performed a concurrent 6-week upper and lower body strength and soccer training, whilst the SO group performed a soccer only training. Results: after the re-test of all variables, the ST demonstrated significant improvements for both, YoYo IR1 distance (p = 0.002) and CV values (p<0.001) with no significant changes in the SO group. 30-m sprint performance were slightly improved in the ST group with significantly decreased performance times identified in the SO group (p<0.001). Values for D'' were slightly reduced in both groups (ST -44.5 m, 95% CI = -90.6 to 1.6; SO -42.6 m, 95% CI = -88.7 to 3.5). Conclusions: combining a 6-week moderate strength training with soccer training significantly improves CV, Yo-Yo IR1 whilst moderately improving 30-m sprint performances in non-previously resistance trained male soccer players. Critical Velocity can be recommended to coaches as an additional valid testing tool in soccer.     

Person (mis)perception: functionally biased sex categorization of bodies

Social perception is among the most important tasks that occur in daily life, and perceivers readily appreciate the social affordances of others. Here, we demonstrate that sex categorizations are functionally biased towards a male percept. Perceivers judged body shapes that varied in waist-to-hip ratio to be men if they were not, in reality, exclusive to women, and male categorizations occurred more quickly than female categorizations (studies 1 and 4). This pattern was corroborated when participants identified the average body shapes of men and women (study 2) and when we assessed participants'' cognitive representations (study 3). Moreover, these tendencies were modulated by emotion context (study 4). Thus, male categorizations occurred readily and rapidly, demonstrating a pronounced categorization bias and temporal advantage for male judgements.     

How Psychological and Behavioral Team States Change during Positive and Negative Momentum

In business and sports, teams often experience periods of positive and negative momentum while pursuing their goals. However, researchers have not yet been able to provide insights into how psychological and behavioral states actually change during positive and negative team momentum. In the current study we aimed to provide these insights by introducing an experimental dynamical research design. Rowing pairs had to compete against a virtual opponent on rowing ergometers, while a screen in front of the team broadcasted the ongoing race. The race was manipulated so that the team’s rowing avatar gradually progressed (positive momentum) or regressed (negative momentum) in relation to the victory. The participants responded verbally to collective efficacy and task cohesion items appearing on the screen each minute. In addition, effort exertion and interpersonal coordination were continuously measured. Our results showed negative psychological changes (perceptions of collective efficacy and task cohesion) during negative team momentum, which were stronger than the positive changes during positive team momentum. Moreover, teams’ exerted efforts rapidly decreased during negative momentum, whereas positive momentum accompanied a more variable and adaptive sequence of effort exertion. Finally, the interpersonal coordination was worse during negative momentum than during positive momentum. These results provide the first empirical insights into actual team momentum dynamics, and demonstrate how a dynamical research approach significantly contributes to current knowledge on psychological and behavioral processes.     

Hormonal responses differ when playing violent video games against an ingroup and outgroup

For 14 teams of three young men, salivary testosterone and cortisol were assessed twice before and twice after competing in within-group and between-group video games that simulated violent male–male competition. Men who contributed the most to their teams' between-group victory showed testosterone increases immediately after the competition, but only if this competition was played before the within-group tournament. High-scoring men on losing teams did not show this immediate effect, but they did show a delayed increase in testosterone. In contrast, high-ranking men tended to have lower testosterone and higher cortisol during within-group tournaments. The results are consistent with the hypothesis that men's competitive testosterone response varies across ingroup and outgroup competitions and is muted during the former. The testosterone response during the between-group competition also suggests that violent multiplayer video games may be appealing to young men because they simulate male–male coalitional competition.     

Facilitating care of patients with HIV infection by hospital and primary care teams.

To complement the role of primary care teams working with patients with HIV disease and AIDS within greater London and to ease the load on the special hospital units a home support team was developed. It comprises six specialist nurses, a general practitioner trained medical officer, and a receptionist and is funded from regional and district sources and charities. A nurse is available for out of hours and emergency weekend calls, with support from the patient''s general practitioner or the attached medical officer. During the first 18 months 249 patients were seen; the mean duration of care was five months. Nearly a third (18/50, 30%) of patients who were terminally ill died at home. The team''s activities included practical nursing care, emotional support for carers and patients, and advice and guidance to primary care teams. Problems in providing care in patients'' homes included issues relating to confidentiality and 24 hour cover. With the increasing incidence of HIV infection the home support team may be a useful model for care of large numbers of patients with symptomatic HIV disease, especially in large urban areas.     

稳定期慢性阻塞性肺疾病患者家庭运动训练现状调查及其影响因素的Logistic回归分析

目的:探讨稳定期慢性阻塞性肺疾病(COPD)患者家庭运动训练现状调查及其影响因素的Logistic回归分析。方法:收集2018年1月～2019年12月期间于本院进行治疗的稳定期COPD患者172例为调查研究对象,根据患者家庭运动训练进行情况将患者分为非运动训练组和运动训练组,对两组患者的一般资料、临床资料等进行统计对比,并采用单因素和多因素Logistic回归分析对影响稳定期COPD患者家庭运动训练进行情况的因素进行分析探讨。结果:在随访调查中,有59例患者进行了家庭运动训练,运动康复训练的普及率为34.30%。经单因素分析,两组患者在性别、年龄、体质指数(BMI)、居住地、婚姻状况、基础疾病、职业对比无显著性差异(P0.05),而两组患者在住院次数、病程、文化程度、照顾情况、肺康复指导对比有显著性差异(P0.05)。经多因素Logistic回归分析显示,COPD患者的住院次数、病程、文化程度、照顾情况、肺康复指导是影响患者进行家庭运动训练的主要因素(P0.05)。结论:我院稳定期COPD患者随访期间家庭运动训练的普及率普遍偏低,且运动方式、强度、频率、规律性等均欠佳。运动训练现状受到患者的住院次数、病程长短、文化程度高低、有无照顾者、有无肺康复指导等因素影响。     

Genomic analysis reveals association of specific SNPs with athletic performance and susceptibility to injuries in professional soccer players

The development of specific and individualized training programs is a possible way to improve athletic performance and minimize injuries in professional athletes. The information regarding the sport's physical demands and the athletes’ physical profile have been, so far, considered as exhaustive for the design of effective training programs. However, it is currently emerging that the genetic profile has to be also taken into consideration. By merging medical and genetic data, it is thus possible to identify the athlete's specific attitude to respond to training, diet, and physical stress. In this context, we performed a study in which 30 professional soccer players, subjected to standard sport medical evaluation and practices, were also screened for genetic polymorphism in five key genes (ACTN3, COL5A1, MCT1, VEGF, and HFE). This genetic analysis represents the central point of a multidisciplinary method that can be adopted by elite soccer teams to obtain an improvement in athletic performance and a concomitant reduction of injuries by tailoring training and nutritional programs. The genetic fingerprinting of single athletes led to the identification of two performance-enhancing polymorphisms (ACTN3 18705C>T, VEGF-634C>G) significantly enriched. Moreover, we derived a genetic model based on the gene set analyzed, which was tentatively used to reduce athletes’ predisposition to injuries, by dictating a personalized nutrition and training program. The potential usefulness of this approach is concordant with data showing that this team has been classified as the healthiest and least injured team in Europe while covering the highest distance/match with the highest number of high-intensity actions/match.     

Development and Validation of an Instrument for Measuring the Quality of Teamwork in Teaching Teams in Postgraduate Medical Training (TeamQ)

Background

Teamwork between clinical teachers is a challenge in postgraduate medical training. Although there are several instruments available for measuring teamwork in health care, none of them are appropriate for teaching teams. The aim of this study is to develop an instrument (TeamQ) for measuring teamwork, to investigate its psychometric properties and to explore how clinical teachers assess their teamwork.

Method

To select the items to be included in the TeamQ questionnaire, we conducted a content validation in 2011, using a Delphi procedure in which 40 experts were invited. Next, for pilot testing the preliminary tool, 1446 clinical teachers from 116 teaching teams were requested to complete the TeamQ questionnaire. For data analyses we used statistical strategies: principal component analysis, internal consistency reliability coefficient, and the number of evaluations needed to obtain reliable estimates. Lastly, the median TeamQ scores were calculated for teams to explore the levels of teamwork.

Results

In total, 31 experts participated in the Delphi study. In total, 114 teams participated in the TeamQ pilot. The median team response was 7 evaluations per team. The principal component analysis revealed 11 factors; 8 were included. The reliability coefficients of the TeamQ scales ranged from 0.75 to 0.93. The generalizability analysis revealed that 5 to 7 evaluations were needed to obtain internal reliability coefficients of 0.70. In terms of teamwork, the clinical teachers scored residents'' empowerment as the highest TeamQ scale and feedback culture as the area that would most benefit from improvement.

Conclusions

This study provides initial evidence of the validity of an instrument for measuring teamwork in teaching teams. The high response rates and the low number of evaluations needed for reliably measuring teamwork indicate that TeamQ is feasible for use by teaching teams. Future research could explore the effectiveness of feedback on teamwork in follow up measurements.     

Comparing jumping ability among athletes of various sports: vertical drop jumping from 60 centimeters

Drop jumping performance (DJP) is of high importance in order to achieve sporting performance in both team and individual sports. The purpose of the present study was to compare DJP among athletes from various sports. One hundred thirty-eight male athletes (age: 22.3 +/- 3.6 years, body height: 1.87 +/- 0.08 m, body mass: 81.8 +/- 10.8 kg) from 6 different sports performed drop jumps from 60 cm (DJ60) on a force plate. Results revealed that volleyball players jumped higher (p < 0.001) than other athletes. However, track and field athletes produced higher peak force and higher power output using a shorter upward phase (p < 0.001). Further examination using principal components analysis (PCA) revealed that team sport athletes and single scull rowers exhibited DJP utilizing force and time parameters differently than track and field athletes. Conclusively, DJP was different among athletes of various sports. Furthermore, PCA can be a useful method for evaluating the above mentioned differences and for monitoring drop jumping training programs.     

A longitudinal analysis of technical-tactical and physical performance of the teams in the Spanish LaLiga Santander: An eight-season study

The aim of this study was to describe in the way teams played for the last eight seasons (from 2011–12 to 2018–19) in the Spanish Football First Division (Spanish LaLiga Santander), taking into account team match performances (n = 5,518). Ten technical-tactical and physical variables grouped into five dimensions were used: final behaviour (shots and crosses), set piece (corners and fouls), match volume (passes), physical performance (total distance covered) and collective use of the space (team width, team length, team defence height and distance from the goalkeeper to their defence). The main results were that the number of passes and team width showed a stable trend as the seasons passed. Nevertheless, the number of shots, crosses and corners, total distance covered, team length and distance from the goalkeeper to their defence showed a descending trend. The main conclusion was that over the seasons studied, the Spanish LaLiga Santander teams were characterized by an indirect style of play that, being the usual in this league, presented some evolution. The trend in the evolution of the game is that defence is put before attack. The findings of the study may be of interest to professional football staff to know more about the particular way teams play in competition, as well as its evolution, so as to focus on the training process according to the trend that is taking place in the game.     

Caseload or workload? Scoring complexity of operative procedures as a means of analysing workload.

OBJECTIVE--To present a more realistic assessment of surgical workload than that provided by a case count. DESIGN--Prospective study of all the operative procedures performed in one year, classified according to the British United Provident Association''s schedule of procedures and scored by the "intermediate equivalent" value (taking the recommended fee value of an intermediate operation as 1.0) compared with the number of operations performed. SETTING--General surgical unit of Taunton and Somerset Hospital, comparing four consultant surgeons and their teams. PATIENTS--Inpatients and day patients admitted under the care of general surgeons during 1989. MAIN OUTCOME MEASURE--Difference between the apparent workload represented by simple case counting (caseload) and the actual workload represented by calculation of the total "intermediate equivalent" value. RESULTS--The workload assessed in terms of intermediate equivalent values was greater than that suggested by case counting for complex operations (12% v 4%), operations at the district hospital (82% v 74%), and operations performed by consultants (53% v 35%) and was lower for minor operations (20% v 42%), operations at the community hospitals (18% v 26%), and operations performed by surgeons in training grades and clinical assistants (47% v 66%). CONCLUSIONS--The use of the intermediate equivalent values as an indicator of complexity allows a more realistic assessment of the operative workload than a simple case count of the number of different operations and is recommended for comparing workload in different hospitals and departments.     

Developing a Performance Brain Training™ Approach for Baseball: A Process Analysis with Descriptive Data

Neurofeedback may be useful for improving sports performance but few studies have examined this potential. Here we present data of five development players from a major league baseball team. The aims were to evaluate the feasibility of conducting sessions within a professional organization, assess changes in quantitative electroencephalograph (QEEG), NeuroPerformance Profile?, and report qualitative self-report data before and after brain training. The EEG was recorded with 19 electrodes for 20 min of baseline conditions and approximately 21 min of a continuous performance test. The fast Fourier transform analysis provided average cross-spectral matrices for bands delta (1–3.5 Hz), theta (4–7.5 Hz), alpha (8–12 Hz), low beta (13–16 Hz), beta 1 (13–21 Hz), beta 2 (22–32 Hz), and gamma (32–45 Hz) from the pre and post intervention evaluations in the baseline condition of eyes open. The continuous performance test metrics included the errors of omission, errors of commission, response time and response time variability. The 9 scales of the NeuroPerformance Profile? were examined. The QEEG data, CPT data and NeuroPerformance Profile? data were all compared between the pre and post 15 sessions of brain training using a within subject paired t test design corrected for multiple comparisons using false discovery rate method. Following brain training, comparative QEEG, CPT and NeuroPerformance Profile? analyses illustrated significant differences. The QEEG findings of all participants illustrated significant changes within the training parameters but also across other frequency bands and electrode sites. Overall, the positive findings in both objective and subjective measures suggest further inquiry into the utility of brain training for performance enhancement with the specific application of sport is warranted. Particularly QEEG and CPT gains were noted in the areas that correspond to client self-report data demonstrating improvement in attention, decreased intrusive thought patterns and improvements in sleep patterns.