• Vitamin B12 insufficiency induces cholesterol biosynthesis by limiting s-adenosylmethionine and modulating the methylation of SREBF1 and LDLR genes

      Adaikalakoteswari, A; Finer, S; Voyias, P.D; McCarthy, C.M; Vatish, M; Moore, J; Smart-Halajko, M; Bawazeer, N; Al-Daghri, N.M; McTernan, P.G; et al. (BMC, 27/02/2015)
      The dietary supply of methyl donors such as folate, vitamin B12, betaine, methionine, and choline is essential for normal growth, development, and physiological functions through the life course. Both human and animal studies have shown that vitamin B12 deficiency is associated with altered lipid profile and play an important role in the prediction of metabolic risk, however, as of yet, no direct mechanism has been investigated to confirm this.
    • Vitamin B12 deficiency is associated with adverse lipid profile in Europeans and Indians with type 2 diabetes.

      Adaikalakoteswari, A; Jayashri, R; Sukumar, N; Venkataraman, H; Pradeepa, R; Gokulakrishnan, K; Anjana, R.M; McTernan, P.G; Tripathi, G; Patel, V; et al. (BMC, 26/09/2014)
      Metformin, a standard therapy in type 2 diabetes, reduces vitamin B12 levels. Studies linking low vitamin B12 levels and cardiovascular disease are equivocal and suggest improving B12 levels may help in primary prevention. The role of vitamin B12 deficiency on cardiovascular risk factors, especially in type 2 diabetes has not been explored. The aim of this study is to investigate whether vitamin B12 deficiency in type 2 diabetes patients is associated with cardiovascular risk factors in two different ethnic groups in UK and India. Type 2 diabetes patients from two secondary care diabetic centres (Europeans - UK and Indians - India) were studied. Serum vitamin B12, folate and biochemical parameters were measured. The prevalence rates of vitamin B12 deficiency (<191 ng/L) were 27% and 12% in Europeans and Indians, respectively and higher in metformin treated type 2 diabetes patients. In linear regression analysis, after adjusting for all likely confounding factors, vitamin B12 independently associated with triglycerides in both the populations and cholesterol/HDL ratio in Indians. Logistic regression showed type 2 diabetes patients with vitamin B12 deficiency were at significantly higher odds of having coexisting coronary artery disease (CAD) in Europeans with similar but non-significant trend in Indians, after adjusting for all likely confounding factors. The prevalence of vitamin B12 deficiency is common in type 2 diabetes patients and is associated with adverse lipid parameters. Type 2 diabetes management guidelines should include the recommendation for regular testing for B12 levels, especially for those on metformin.
    • PWE-254 Is the macroscopically normal mucosa (MNM) around colorectal cancer really ‘normal’?

      Patel, A; Fang, Y; Moore, J; Williams, N; Tripathi, G; Arasaradnam, R; University of Westminster (BMJ, 22/06/2015)
      Field cancerisation refers to the process whereby cells acquire pro-tumourigenic mutations that predispose to malignant transformation but do not produce morphological change.1Previous colorectal cancer studies have assumed that the macroscopically normal mucosa (MNM) adjacent to a cancer is biologically unaltered. The aim of this study was to determine if the genetic expression profile of the MNM around a cancer or adenoma is different to that found in healthy controls. 15 patients undergoing colonoscopy were recruited over 12 months; 5 healthy controls, 5 with colorectal adenomas and 5 with adenocarcinoma. Two mucosal pinch biopsies were taken in the rectum, right colon and adjacent to polyp or cancer. mRNA was extracted and gene expression was assessed using standard whole genome micro-array analysis. Differentially expressed genes were identified using three methods of analysis: LIMMA (fold change ratio >1.5 and p value <0.05), Robust Regression (RR) (adjusted p value <0.05) and genes that ‘overlap’ when LIMMA (p value <0.001) and RR (adjusted p value <0.1) are used. Functional analysis was performed using DAVID2software to identify important biological processes that were dysregulated. A large number of genes were dysregulated in the MNM adjacent to cancer or adenoma compared with controls (Table 1). Interestingly, the greatest differences were seen between MNM adjacent to cancer and polyp in chromatin organisation, nucleosome processing, nuclear transport and histone assembly. The most significantly upregulated genes consisted of FUT2, CTSA, MUC2 and SDS and downregulated genes consisted of GREM1, SFRP, HIST1H, IL17B and TFF1.
    • Habitual physical activity is associated with circulating irisin in healthy controls but not in subjects with diabetes mellitus type 2

      Al‐Daghri, N.M; Alokail, M.S; Rahman, S; Amer, O.E; Al‐Attas, O.S; Alfawaz, H; Tripathi, G; Sabico, S.; Chrousos, G.P; McTernan, P.G; et al. (Wiley, 22/05/2015)
      Irisin, a novel myokine, has been shown to increase following vigorous exercise, with studies suggesting that it mediates some of the beneficial effects of exercise. Irisin might play a role in ‘browning’ of white adipocytes, thus increasing energy expenditure. The role of irisin in exercise and energy expenditure in subjects with diabetes mellitus type 2 (DMT2) remains largely unknown. We aimed to investigate the association between circulating irisin and habitual physical activity in subjects with and without DMT2. In this cross‐sectional study, 164 Saudi adults: 81 non‐DMT2 controls [age: (mean ± SD) 51·6 ± 10·9; BMI: 29·6 ± 4·3 kg/m2] and 83 DMT2 subjects [age: 54·3 ± 10·3 year; BMI: 29·4 ± 4·7 kg/m2] were studied. Anthropometric and fasting serum biochemical data were collected. Circulating irisin was measured using an enzyme‐linked immunosorbent assay (ELISA). Frequency intensity time (FIT) index was used to assess the level of habitual physical activity. We observed significantly higher levels of irisin in DMT2 subjects than in controls (P < 0·001). FIT index was positively associated (r = 0·20, P = 0·03) with circulating irisin in controls only. Additionally, irisin levels were significantly higher in tertile 3 (0·75 ± 0·07 μg/mL) than tertile 1 (0·49 ± 0·06 μg/mL) of the FIT index in healthy controls, whilst no such relation with physical activity was observed in DMT2 subjects. This cross‐sectional study has shown a weak association of irisin with physical activity levels in healthy controls but not in DMT2 subjects, suggesting the possibility of discordant regulation in the condition of DMT2.
    • Telmisartan reverses antiretroviral-induced adipocyte toxicity and insulin resistance in vitro

      Pushpakom, S.P; Adaikalakoteswari, A; Owen, A; Back, D.J; Tripathi, G; Kumar, S; McTernan, P; Pirmohamed, M; University of Warwick (Sage, 21/02/2018)
      Antiretroviral therapy in HIV-positive patients leads to insulin resistance which is central to the pathogenesis of various metabolic abnormalities and cardiovascular disease seen in this patient group. We have investigated the dose–response relationship of telmisartan, an antihypertensive, on adipocytes in vitro in order to determine whether it may have metabolic beneficial effects. Using in vitro chronic toxicity models (3T3-F442A murine and primary human adipocytes), we evaluated the effects of different concentrations of telmisartan on adipocyte differentiation and adipogenic gene expression using lipid accumulation assays and real-time polymerase chain reaction, respectively. Adipokine secretion and expression of insulin signalling mediators were evaluated using enzyme-linked immunosorbent assays. Telmisartan partially reversed the deleterious effects of antiretrovirals on adipocyte lipid accumulation, expression of adipogenic regulators (peroxisome proliferator receptor-gamma and lipin 1), adipokine secretion and expression of the insulin signalling mediator pAktSer473. The metabolic effects of telmisartan followed a non-monotonic response with the maximal effect observed at 5 µM in the primary human adipocyte model. Telmisartan has beneficial metabolic effects in adipocytes in vitro, but its potential to reduce antiretroviral-induced cardiometabolic disease in HIV-infected individuals needs to be evaluated in a well-designed adequately powered clinical trial.
    • Integrated sports and respiratory medicine in the aftermath of COVID-19

      Faghy, Mark; Ashton, Ruth; Maden-Wilkinson, Tom; Copeland, Robert; Bewick, Thomas; Andy, Smith; Loosemore, Mike; University of Derby (Elsevier, 2020-07-09)
    • The compassionate vagus: A meta-analysis on the connection between compassion and heart rate variability

      Di Bello, Maria; Carnevali, Luca; Petrocchi, Nicola; Thayer, Julian F.; Gilbert, Paul; Ottaviani, Cristina; Sapienza University of Rome; University of Parma; John Cabot University, Rome; The University of California, Irvine; et al. (Elsevier BV, 2020-06-15)
      In recent years, increasing interest has been devoted to the physiological basis of self and other-oriented compassion. Heart rate variability (HRV) represents a promising candidate for such a role, given its association with soothing emotions and context appropriate prefrontal inhibitory control over threat-defensive responses. The aim of this study was to meta-analyze available studies on the association between compassion and HRV. Random-effect models were used. The analysis performed on sixteen studies that met inclusion criteria, yielded a significant association with a medium effect size (g = .54 95% CI [.24, .84], p < .0001). Results were not influenced by publication bias. After an extreme outlier’s exclusion, the size of the association was still larger in studies that used time or frequency-domain indices of vagally-mediated HRV compared to those that used peak to trough estimates of respiratory sinus arrhythmia. Results are limited by the small number of studies included in the meta-analysis (n = 16) and are discussed in terms of indications for future research, given that existing data are highly heterogeneous and of poor methodological rigor.
    • Cardiopulmonary exercise testing in the COVID-19 endemic phase

      Faghy, Mark; Hull, James; Cooper, Brendan; Sylvester, Karl; University of Derby (Elsevier, 2020-06-11)
      The COVID-19 pandemic has presented significant challenges to healthcare systems across the world. The substantial need to provide acute COVID-19-related care resulted in non-COVID-19 care being immediately curtailed, with significant implications for the provision of normal or ‘routine’ healthcare. As the pressure from acute COVID-19 care begins to regress, it is timely to consider how certain services, including those undertaking physiological measurements, will re-open and how they will function within the constraints dictated by a COVID-19 endemic working environment. Over the past decade, there has been evolving recognition of the importance and value of clinical cardiopulmonary exercise testing (CPET) within healthcare settings.1 Primarily, CPET is used to evaluate the integrative response to incremental exercise, enabling clinicians to characterise cardiorespiratory fitness and reasons for physical impairment. 2 It is recognised that CPET plays an important role in clinical arenas including determining surgical operability and evaluating the risk of perioperative death and postoperative complications.3 It also has a function in supporting pre-operative planning algorithms,4 as well as developing management strategies for pathological conditions (e.g. heart failure)5 and in disease prognostication (e.g. pulmonary hypertension).6 Whilst there is considerable uncertainty regarding the ability to safely undertake CPET at the current time, it remains an integral investigative tool in clinical practice and urgent consideration needs to be given to determine how best to deliver CPET services in the COVID-19 endemic phase.
    • Compassion‐focused therapy for body weight shame: A mixed methods pilot trial

      Carter, Alicia; Gilbert, Paul; Kirby, James N.; The University of Queensland, Brisbane, Queensland, Australia; University of Derby (Wiley, 2020-06-08)
      Individuals with bigger bodies (body mass index greater than 30) often experience body weight shame and are at increased risk for mental health vulnerabilities such as depression and anxiety. To date, there have been no studies specifically designed and pilot tested to help with body weight shame for individuals with bigger bodies that do not have a diagnosed clinical condition. The aim of current study is to investigate the initial feasibility of compassion‐focused therapy (CFT) as a 12‐session group intervention for the reduction in body weight shame for individuals with bigger bodies. The study used a mixed method repeated measure design, with both quantitative and qualitative measures, to assess the initial feasibility of the CFT group‐based intervention. Participants (N = 5) attended a 12‐session/2‐h group CFT programme aimed to directly target body weight shame by cultivating compassion. Measurements were conducted at three time points (pre‐, post‐ and 3‐month follow‐up intervention). Results indicated that CFT had a positive impact on reducing body weight shame, increasing compassion and improving health‐engaging behaviours. Qualitative feedback indicated the importance of the group dynamics to help with the de‐shaming of body appearance for individuals. Results from this feasibility trial are promising, and future research using randomized controlled trial methodologies should be conducted to evaluate the effectiveness of CFT as a treatment option for body weight shame for individuals with bigger bodies.
    • The use of a smartphone app and an activity tracker to promote physical activity in the management of chronic obstructive pulmonary disease: randomized controlled feasibility study

      Bentley, Claire L; Powell, Lauren; Potter, Stephen; Parker, Jack; Mountain, Gail A; Bartlett, Yvonne Kiera; Farwer, Jochen; O'Connor, Cath; Burns, Jennifer; Cresswell, Rachel L; et al. (JMIR Publications Inc., 2020-06-03)
      Chronic obstructive pulmonary disease (COPD) is highly prevalent and significantly affects the daily functioning of patients. Self-management strategies, including increasing physical activity, can help people with COPD have better health and a better quality of life. Digital mobile health (mHealth) techniques have the potential to aid the delivery of self-management interventions for COPD. We developed an mHealth intervention (Self-Management supported by Assistive, Rehabilitative, and Telehealth technologies-COPD [SMART-COPD]), delivered via a smartphone app and an activity tracker, to help people with COPD maintain (or increase) physical activity after undertaking pulmonary rehabilitation (PR). This study aimed to determine the feasibility and acceptability of using the SMART-COPD intervention for the self-management of physical activity and to explore the feasibility of conducting a future randomized controlled trial (RCT) to investigate its effectiveness. We conducted a randomized feasibility study. A total of 30 participants with COPD were randomly allocated to receive the SMART-COPD intervention (n=19) or control (n=11). Participants used SMART-COPD throughout PR and for 8 weeks afterward (ie, maintenance) to set physical activity goals and monitor their progress. Questionnaire-based and physical activity–based outcome measures were taken at baseline, the end of PR, and the end of maintenance. Participants, and health care professionals involved in PR delivery, were interviewed about their experiences with the technology. Overall, 47% (14/30) of participants withdrew from the study. Difficulty in using the technology was a common reason for withdrawal. Participants who completed the study had better baseline health and more prior experience with digital technology, compared with participants who withdrew. Participants who completed the study were generally positive about the technology and found it easy to use. Some participants felt their health had benefitted from using the technology and that it assisted them in achieving physical activity goals. Activity tracking and self-reporting were both found to be problematic as outcome measures of physical activity for this study. There was dissatisfaction among some control group members regarding their allocation. mHealth shows promise in helping people with COPD self-manage their physical activity levels. mHealth interventions for COPD self-management may be more acceptable to people with prior experience of using digital technology and may be more beneficial if used at an earlier stage of COPD. Simplicity and usability were more important for engagement with the SMART-COPD intervention than personalization; therefore, the intervention should be simplified for future use. Future evaluation will require consideration of individual factors and their effect on mHealth efficacy and use; within-subject comparison of step count values; and an opportunity for control group participants to use the intervention if an RCT were to be carried out. Sample size calculations for a future evaluation would need to consider the high dropout rates.
    • Self-compassion, social rank, and psychological distress in athletes of varying competitive levels

      Walton, Courtney C.; Baranoff, John; Gilbert, Paul; Kirby, James; The University of Queensland, Brisbane; University of Derby (Elsevier BV, 2020-05-29)
      Self-Compassion may be seen as a concept contrary to the aims of athletes engaged in competitive sport. This could be accentuated at more elite levels, where athletes may view concepts like self-criticism and self-judgement as more important for improvement. The current study aimed to better understand how athletes of different competitive levels (from social to international) relate to concepts of self-compassion. Further, we aimed to explore how factors relating to social rank and self-compassion contribute to psychological distress. Cross-sectional online survey. An online survey was distributed, including the following validated questionnaires: Depression Anxiety and Stress Scales, the Self-Compassion Scale, Fears of Compassion Scales, Social Comparison Scale, Forms of Self-Criticising/Attacking & Self-Reassuring Scale, and the Striving to Avoid Inferiority Scale. Two hundred and fifty-three participants responded to the survey, including 115 recreational and 79 competitive athletes. There were no differences between groups on any measure of compassion or social rank. In a multiple linear regression model, lower self-compassion, higher fears of compassion (for self), and higher feelings of inadequacy predicted more pronounced psychological distress in athletes. Contrary to expectation, the results suggest that even highly elite athletes may be open to using self-compassion. Given that reduced self-compassion and sense of social rank contributed to psychological distress in athletes, the results suggest that compassion-based approaches to treating psychological distress in this population may be valid.
    • The visual search strategies underpinning effective observational analysis in the coaching of climbing movement

      Mitchell, James; Maratos, Frances, A; Giles, David; Taylor, Nicola; Butterworth, Andrew; Sheffield, David; University of Derby; Lattice Training Ltd., Chesterfield (Frontiers, 2020-05-28)
      Despite the importance of effective observational analysis in coaching the technical aspects of climbing performance, limited research informs this aspect of climbing coach education. Thus, the purpose of the present research was to explore the feasibility and the utility of a novel methodology, combining eye tracking technology and cued retrospective think-aloud (RTA), to capture the cognitive–perceptual mechanisms that underpin the visual search behaviors of climbing coaches. An analysis of gaze data revealed that expert climbing coaches demonstrate fewer fixations of greater duration and fixate on distinctly different areas of the visual display than their novice counterparts. Cued RTA further demonstrated differences in the cognitive–perceptual mechanisms underpinning these visual search strategies, with expert coaches being more cognizant of their visual search strategy. To expand, the gaze behavior of expert climbing coaches was underpinned by hierarchical and complex knowledge structures relating to the principles of climbing movement. This enabled the expert coaches to actively focus on the most relevant aspects of a climber’s performance for analysis. The findings demonstrate the utility of combining eye tracking and cued RTA interviewing as a new, efficient methodology of capturing the cognitive–perceptual processes of climbing coaches to inform coaching education/strategies.
    • Development and psychometric evaluation of the Birmingham Relationship Continuity Measure for acquired brain injury

      Yasmin, Natasha; Keeble, Hayley; Riley, Gerard; University of Birmingham (Taylor and Francis, 2020-05-23)
      Relationship continuity/discontinuity refers to whether a spouse/partner experiences their current relationship with someone with an acquired brain injury (ABI) as a continuation of their loving pre-injury relationship or as radically changed. The aim of this study was to adapt a questionnaire measure of continuity/discontinuity from dementia research for use in an ABI context and to evaluate the psychometric properties of this adaptation. The questionnaire was adapted in response to feedback from a focus group of ABI caregivers. Its psychometric properties were then evaluated in two studies involving partners of people with ABI. The measure showed high internal consistency (alpha = .956 in Study 1 and .963 in Study 2), test-retest reliability (intra-class correlation = .960 in Study 1) and discriminative power (Ferguson’s delta = .975 in Study 1 and .963 in Study 2). Evidence of construct validity was provided by a predicted pattern of correlations with other relationship questionnaires. Exploratory factor analysis suggested that the questionnaire is unidimensional. A valid and reliable quantitative measure of relationship continuity/discontinuity will enable more robust evaluation of suggestions about this construct that have been made in qualitative studies (e.g. that discontinuity is associated with a greater sense of caregiver burden).
    • Tunicamycin-induced Endoplasmic Reticulum stress mediates mitochondrial dysfunction in human adipocytes.

      Jackisch, Laura; Murphy, Alice M; Kumar, Sudhesh; Randeva, Harpal; Tripathi, Gyanendra; McTernan, Philip G; University of Warwick; Nottingham Trent University; University of Derby (Oxford University Press, 2020-05-15)
      Dysfunctional ER and mitochondria are known to contribute to the pathology of metabolic disease. This damage may occur, in part, as a consequence of ER-mitochondria cross-talk in conditions of nutrient excess such as obesity. To date insight into this dynamic relationship has not been characterised in adipose tissue. Therefore, this study investigated whether ER stress contributes to the development of mitochondrial inefficiency in human adipocytes from lean and obese participants. Human differentiated adipocytes from Chub-S7 cell line and primary abdominal subcutaneous adipocytes from lean and obese participants were treated with tunicamycin to induce ER stress. Key parameters of mitochondrial function were assessed, including mitochondrial respiration, membrane potential (MMP) and dynamics. ER stress led to increased respiratory capacity in a model adipocyte system (Chub-S7 adipocytes) in a concentration and time dependent manner (24hr: 23%↑; 48hr: 68%↑, (p<0.001); 72hr: 136%↑, (p<0.001)). This corresponded with mitochondrial inefficiency and diminished MMP, highlighting the formation of dysfunctional mitochondria. Morphological analysis revealed reorganisation of mitochondrial network, specifically mitochondrial fragmentation. Furthermore, p-DRP1, a key protein in fission, significantly increased (p<0.001). Additionally, adipocytes from obese subjects displayed lower basal respiration (49%↓, p<0.01) and were unresponsive to tunicamycin in contrast to their lean counterparts, demonstrating inefficient mitochondrial oxidative capacity. These human data suggest that adipocyte mitochondrial inefficiency is driven by ER stress and exacerbated in obesity. Nutrient excess induced ER stress leads to mitochondrial dysfunction that may therefore shift lipid deposition ectopically and thus have further implications on the development of related metabolic disorders.
    • Calibration and cross-validation of accelerometery for estimating movement skills in children aged 8–12 years

      Duncan, MJ; Dobell, A; Noon, M; Clark, CT; Roscoe, CMP; Stodden, D; Sacko, R; Eyre, ELJ; Faghy, Mark; Coventry University; et al. (MDPI, 2020-05-13)
      This study sought to calibrate triaxial accelerometery, worn on both wrists, waist and both ankles, during children’s physical activity (PA), with particular attention to object control motor skills performed at a fast and slow cadence, and to cross-validate the accelerometer cut-points derived from the calibration using an independent dataset. Twenty boys (10.1 ±1.5 years) undertook seven, five-minute bouts of activity lying supine, standing, running (4.5kmph−1) instep passing a football (fast and slow cadence), dribbling a football (fast and slow cadence), whilst wearing five GENEActiv accelerometers on their non-dominant and dominant wrists and ankles and waist. VO2 was assessed concurrently using indirect calorimetry. ROC curve analysis was used to generate cut-points representing sedentary, light and moderate PA. The cut-points were then cross-validated using independent data from 30 children (9.4 ± 1.4 years), who had undertaken similar activities whilst wearing accelerometers and being assessed for VO2. GENEActiv monitors were able to discriminate sedentary activity to an excellent level irrespective of wear location. For moderate PA, discrimination of activity was considered good for monitors placed on the dominant wrist, waist, non-dominant and dominant ankles but fair for the non-dominant wrist. Applying the cut-points to the cross-validation sample indicated that cut-points validated in the calibration were able to successfully discriminate sedentary behaviour and moderate PA to an excellent standard and light PA to a fair standard. Cut-points derived from this calibration demonstrate an excellent ability to discriminate children’s sedentary behaviour and moderate intensity PA comprising motor skill activity.
    • The use and perceived value of telestration tools in elite football

      Jones, Dylan; Rands, Steve; Butterworth, Andrew; University of Derby (Taylor & Francis, 2020-04-30)
      The proliferation of technology allowing performance analysis practices to become more efficient and effective has grown rapidly in recent years. One such tool that has become widespread amongst elite football clubs is the use of telestration software which allow annotations to be drawn over video footage to illustrate key tactical, technical, physiological or psychological facets in an interactive manner. The purpose of this study is to investigate the use and application of telestration tools in elite football. A descriptive research approach was employed, using detailed questionnaires to gain the views and perceptions of elite analysts, coaches and players. Findings confirm the widespread use of telestration tools in elite football with 93% of respondents stating that it is “essential-very important” to their practice. In particular, telestration is found to play an integral role in oppositional analysis, especially when introducing key tactical information in pre-match meetings. Numerous barriers associated with the use of telestration were also uncovered in this novel, contemporary research which may help set the foundations for further research into telestration tools in sports not limited to football.
    • Evaluating Interventions

      Pringle, Andy; Kime, Nicky; Lozano, Lorena; Zwolinsky, Stephen; Bradford Royal Infirmary; Leeds Beckett University; West Yorkshire and Harrogate Cancer Alliance (Routledge, 2020-04-22)
      Physical inactivity has been described as a global pandemic (Andersen, Mota, & DiPetro, 2016; Tremblay et al., 2017, World Health Organisation, 2018). It is then unsurprising that bold societal and government action has been recommended to make physical activity opportunities, such as sport and exercise, desirable and accessible for all groups (Ding et al., 2016, Reis et al., 2016). Indeed, policy and initiatives have highlighted the need for investigations into both the effectiveness and cost-effectiveness of community physical activity interventions (e.g., Canada Chief Medical Officer, 2016; National Institute of Health and Care Excellence, 2014; UK Chief Medical Officers’, 2019; World Health Organisation, 2018). The importance of evaluating the impact and the implementation of physical activity and public health interventions is also reported in the literature (Dunton, 2018, Mansfield 2018, Pringle, McKenna & Zwolinsky, 2018), yet putting this into practice can sometimes be challenging (Dugdill and Stratton, 2007, Department of Health, 2007, Pringle et al., 2018). Guidance is available on evaluation (Centre for Disease Control, 1999, Dugdill and Stratton, 2007, Hayes et al., 2012, Medical Research Council 2006, National Obesity Observatory, 2012, Sport England, 2006), as are several useful texts on the evaluation of physical activity interventions. In this entry, the practicalities of actually ‘doing’ the evaluation of sport and exercise-led interventions, and key learning from this process, including examples of evaluating interventions that have been reported in the peer reviewed literature, are presented. Examples of the ‘good’, and ‘not so good’ are provided with key considerations at three critical time periods of the evaluation process, including planning, implementing, and disseminating which are phases that are not mutually exclusive since many of these issues cross-over within the intervention-evaluation lifespan. However, these phases are used as an organising framework for this entry.
    • Neurophysiological and behavioural markers of compassion

      Kim, Jeffrey J.; Parker, Stacey L.; Doty, James R.; Cunnington, Ross; Gilbert, Paul; Kirby, James N.; The University of Queensland; Stanford University; University of Derby (Springer Science and Business Media LLC, 2020-04-22)
      The scientific study of compassion is burgeoning, however the putative neurophysiological markers of programs which actively train distress tolerance, such as Compassionate Mind Training (CMT), are less well known. Herein we offer an integrative, multi-method approach which investigated CMT at neural, physiological, self-report, and behavioural levels. Specifically, this study first assessed participants’ neural responses when confronted with disappointments (e.g., rejection, failure) using two fundamental self-regulatory styles, self-criticism and self-reassurance. Second, participant’s heart-rate variability (HRV) – a marker of parasympathetic nervous system response – was assessed during compassion training, pre- and post- a two-week self-directed engagement period. We identified neural networks associated with threat are reduced when practicing compassion, and heightened when being self-critical. In addition, cultivating compassion was associated with increased parasympathetic response as measured by an increase in HRV, versus the resting-state. Critically, cultivating compassion was able to shift a subset of clinically-at risk participants to one of increased parasympathetic response. Further, those who began the trial with lower resting HRV also engaged more in the intervention, possibly as they derived more benefits, both self-report and physiologically, from engagement in compassion.
    • The development of the Japanese version of the compassionate engagement and action scales

      Asano, Kenichi; Kotera, Yasuhiro; Tsuchiya, Masao; Ishimura, Ikuo; Lin, Shuzhen; Matsumoto, Yuki; Matos, Marcela; Basran, Jaskaran; Gilbert, Paul; Mejiro University; et al. (Public Library of Science (PLoS), 2020-04-01)
      The last few years have seen increasing research on self-report measures of compassion. The Compassionate Engagement and Action Scale (CEAS) is rooted in an evolutionary approach to compassion, which focuses on the competencies of compassion those are engagement with distress or suffering, and taking action to alleviate and prevent it. This study sought to validate the CEAS in a Japanese population using a cross-sectional design. A total of 279 students (82 males, 191 females, 6 unknown) answered self-report questionnaires, including the Japanese version of CEAS. We found single-factor structures for compassion for others scales, compassion from others scales, and compassion for self scales. All scales were found to have acceptable internal consistency, test-retest reliability, content validity, and construct validity. Even though some limitations, these results indicate that the Japanese version of CEAS is an adequately constructed and useful measure to assess compassionate engagement and action toward others, from others, and for the self with Japanese population.
    • Engaging with distress: training in the compassionate approach

      McEwan, Kirsten; Minou, Lina; Moore, Hamish; Gilbert, Paul; University of Derby; Wellbeing Works, UK (Wiley, 2020-03-18)
      Compassionate care involves providing a welcoming environment, promoting bidirectional compassion, providing training in compassion and creating supportive organisations. To date there has not been a study evaluating Compassion interventions for the high‐threat profession of mental health nursing. Neither has there been a study providing an in‐depth qualitative evaluation of training and implementation. The current study aims to address these gaps in the literature. The aims were to evaluate Compassionate Mind Training‐CMT for mental health nurses and to assess implementation. Focus groups were conducted (N=28) one year later to evaluate CMT and implementation. Results: Content analysis revealed four training themes: i) Useful framework; ii) Thought‐provoking and exciting; iii) Appreciation of person‐centred approach; iv) Need for ongoing training and supervision. Three implementation themes emerged: i) Applied approach with patients and staff themselves; ii) Environmental challenges to implementation; iii) Attitudinal challenges to implementation. Consistent with previous studies, professionals experienced reduced self‐criticism and an increased self‐compassion, which extended to increased compassion and reduced criticism of colleagues and patients; and professionals applying training directly to reduce patient self‐criticism. For successful implementation formal adoption of Compassion‐approaches are needed with strategic integration at all levels.