Search

Corynebacterium striatum is an emerging nosocomial pathogen. This is the first report showing the presence of three distinct multidrug resistant lineages of C. striatum among patients in a UK hospital. The presence of ErmX, Tet(W), Bla and AmpC proteins, and mutations in gyrA gene are associated with the resistance to clindamycin, doxycycline, penicillin and moxifloxacin, respectively. These strains are equipped with several corynebacterial virulence genes including two SpaDEF-type and a novel pilus gene cluster, which needs further molecular characterisation. This study highlights a need of developing an active surveillance strategy for routine monitoring and preventing potential cross-transmission among susceptible patients. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the utility of CHROMID® Colistin R for direct detection of colistin-resistant Gram-negative bacteria from positive blood cultures. A total of 390 blood cultures from hospitalised patients containing Gram-negative bacteria were included in this study. These blood cultures were referred to clinical laboratories in the United Kingdom and Türkiye. A further 16 simulated positive blood culture bottles were included that contained a range of colistin-resistant strains as well as susceptible control strains. Fluid from each positive blood culture was diluted 1/200 in saline and 10 µL aliquots cultured onto cystine-lactose-electrolyte-deficient agar and CHROMID® Colistin R. All recovered bacteria were identified, and for Gram-negative bacteria, their minimum inhibitory concentration of colistin was measured using the broth microdilution method. From a total of 443 Gram-negative isolates, 57 colistin-resistant isolates were recovered, of which 53 (93%) grew on CHROMID® Colistin R within 18 h. Of the 377 isolates determined to be colistin-susceptible, only 9 isolates were able to grow, including 6 isolates of Pseudomonas aeruginosa. For positive blood cultures that are shown to contain Gram-negative bacteria, culture on CHROMID® Colistin R is a useful diagnostic tool to detect susceptibility or resistance to colistin within 18 h. [ABSTRACT FROM AUTHOR]

Purpose: A new measure of sportspersonship, which differentiates between compliance and principled approaches, was developed and initially validated in 3 studies. Method: Study 1 developed items, assessed content validity, and proposed a model. Study 2 tested the factorial validity of the model on an independent sample. Study 3 further tested the factorial validity on another independent sample as well as the construct validity. Results: In Study 1, a 71-item questionnaire was developed. Exploratory factor analysis reduced the questionnaire to a 6-factor, 33-item scale explaining 47.70% of the variance. Study 2 tested this revised questionnaire in a series of confirmatory factor analyses, presenting a 24-item and 5-factor model with acceptable fit, ?[superscript 2](242) = 455.9, comparative fit index = 0.93, Tucker-Lewis Index = 0.92, standardized root mean square residual = 0.05, root mean square error of approximation = 0.04. Study 3 provided some evidence to support the construct validity of the 24-item scale using theoretically associated measures. Conclusions: This series of studies provided some initial validity evidences of the Compliant and Principled Sportspersonship Scale.

Despite the limitations of overgeneralizing cutoff values for confirmatory factor analysis (CFA; e.g., Marsh, Hau, & Wen, 2004), they are still often employed as golden rules for assessing factorial validity in sport and exercise psychology. The purpose of this study was to investigate the appropriateness of using the CFA approach with these cutoff values for typical multidimensional measures. Furthermore, we ought to examine how a model could be respecified to achieve acceptable fit and explored whether exploratory structural equation modeling (ESEM) provides a more appropriate assessment of model fit. Six multidimensional measures commonly used in sport and exercise psychology research were examined using CFA and ESEM. Despite demonstrating good validity in previous research, all eight failed to meet the cutoff values proposed by Hu and Bentler. ESEM improved model fit in all measures. In conclusion, we suggest that model misfit in this study demonstrates the problem with interpreting cutoff values rigidly. Furthermore, we recommend ESEM as a preferred approach to examining model fit in multidimensional measures.

Clonal hematopoiesis (CH)—age-related expansion of mutated hematopoietic clones—can differ in frequency and cellular fitness by CH type (e.g., mutations in driver genes (CHIP), gains/losses and copy-neutral loss of chromosomal segments (mCAs), and loss of sex chromosomes). Co-occurring CH raises questions as to their origin, selection, and impact. We integrate sequence and genotype array data in up to 482,378 UK Biobank participants to demonstrate shared genetic architecture across CH types. Our analysis suggests a cellular evolutionary trade-off between different types of CH, with LOY occurring at lower rates in individuals carrying mutations in established CHIP genes. We observed co-occurrence of CHIP and mCAs with overlap at TET2, DNMT3A, and JAK2, in which CHIP precedes mCA acquisition. Furthermore, individuals carrying overlapping CH had high risk of future lymphoid and myeloid malignancies. Finally, we leverage shared genetic architecture of CH traits to identify 15 novel loci associated with leukemia risk. Types of clonal hematopoiesis (CH) differ in frequency and fitness. These findings uncover shared genetic architecture, suggest evolutionary trade-offs between CH types, and detail elevated leukemia risk in individuals with overlapping types of CH. [ABSTRACT FROM AUTHOR]

Higher cardiorespiratory fitness is associated with lower risk of type 2 diabetes. However, the causality of this relationship and the biological mechanisms that underlie it are unclear. Here, we examine genetic determinants of cardiorespiratory fitness in 450k European-ancestry individuals in UK Biobank, by leveraging the genetic overlap between fitness measured by an exercise test and resting heart rate. We identified 160 fitness-associated loci which we validated in an independent cohort, the Fenland study. Gene-based analyses prioritised candidate genes, such as CACNA1C, SCN10A, MYH11 and MYH6, that are enriched in biological processes related to cardiac muscle development and muscle contractility. In a Mendelian Randomisation framework, we demonstrate that higher genetically predicted fitness is causally associated with lower risk of type 2 diabetes independent of adiposity. Integration with proteomic data identified N-terminal pro B-type natriuretic peptide, hepatocyte growth factor-like protein and sex hormone-binding globulin as potential mediators of this relationship. Collectively, our findings provide insights into the biological mechanisms underpinning cardiorespiratory fitness and highlight the importance of improving fitness for diabetes prevention. Being fit has been linked to a lower risk of type 2 diabetes, but it is unclear whether this relationship is causal. Using large scale studies with genetic data and measurements of cardiorespiratory fitness, the authors show evidence that higher genetically predicted fitness is causally associated with lower risk of type 2 diabetes independent of adiposity. [ABSTRACT FROM AUTHOR]

Diet is considered as one of the most important modifiable factors influencing human health, but efforts to identify foods or dietary patterns associated with health outcomes often suffer from biases, confounding, and reverse causation. Applying Mendelian randomization in this context may provide evidence to strengthen causality in nutrition research. To this end, we first identified 283 genetic markers associated with dietary intake in 445,779 UK Biobank participants. We then converted these associations into direct genetic effects on food exposures by adjusting them for effects mediated via other traits. The SNPs which did not show evidence of mediation were then used for MR, assessing the association between genetically predicted food choices and other risk factors, health outcomes. We show that using all associated SNPs without omitting those which show evidence of mediation, leads to biases in downstream analyses (genetic correlations, causal inference), similar to those present in observational studies. However, MR analyses using SNPs which have only a direct effect on the exposure on food exposures provided unequivocal evidence of causal associations between specific eating patterns and obesity, blood lipid status, and several other risk factors and health outcomes. Author summary: Food and drink consumption is one of the most important factors influencing human health and wellbeing. The role of diet in human physiology and disease has been widely studied, but challenges in accurately assessing long term diet result in contradicting findings. Mendelian randomization is a statistical technique that uses genetic variants associated with modifiable exposures to estimate the causal effect of an exposure to a health outcome and could be extremely useful in the context of diet-health relationships. In our study, we initially identified genetic variants associated to 29 measures of food and drink consumption. We then show that genetic variants associated with food and drink consumption are subject to reverse causation and confounding. We have thus developed a statistical genetics method to identify genetic variants directly associated with food and drink consumption. By using these genetic variants (and their corresponding direct effects) in Mendelian randomization analyses we provided consistent evidence of causal associations of food and drink consumption with obesity, blood lipid status, and several other risk factors and health outcomes. [ABSTRACT FROM AUTHOR]

Research into temporal psychology, and in particular its relationship with health behaviors, has grown exponentially in recent years. Accordingly, studies have shown that how individuals think and feel about the past, present, and future, is significantly related to alcohol-use behaviors. This has been shown to be particularly true where studies have applied person-centered analyses rather than just bivariate analyses. The present study sought to examine the relationship between scores on one temporal psychology measure (The Domain-Specific Consideration of Future Consequences [CFC] scale) and alcohol use behaviors in a large sample of adolescents in the United Kingdom (N = 2,199; 42.4% female). Scores on the CFC measure were operationalized both domain-specifically, and by means of cluster analyses. In bivariate analyses, reduced likelihood of past month consumption of a full drink and Heavy Episodic Drinking were significantly associated with CFC-scores, but did not appear to be domain-specific. In unadjusted analyses, CFC cluster membership was significantly related to alcohol use variables. However, when adjusted for sex, location, and sensation seeking, the result for Heavy Episodic Drinking became non-significant. Results are discussed in the context of current temporal psychology. [ABSTRACT FROM AUTHOR]

Background: Anterior cruciate ligament (ACL) injuries are a common injury that occurs in both the sporting and non‐sporting population. Goal setting is said to be an effective psychological tool within ACL rehabilitation and is commonly used by physiotherapists. To date, literature surrounding goal setting practices is under analysed in relation to qualitative research. Purpose: The central aim of this study was to explore UK physiotherapists understanding, experiences and training towards goal setting practices used in ACL rehabilitation and whether they are effective. Method: Semi‐structured interviews involving 24 participants across three specific areas including: National Health Service, elite sport and academia were conducted using an inductive approach. Data analysis included thematic analysis with triangulation and a comprehensive multi‐staged analysis process to enhance trustworthiness, whilst respecting ethical considerations. Results/Discussion: Participants from all three areas of practice tended to use the same approach which was SMART goals. All participants lacked any theoretical understanding of goals but would welcome further training in the field. Participants were missing important aspects of setting goals such as not addressing expectations and underutilising feedback. Conclusion: These findings suggest that a call for more psychological training is clearly warranted in both the physiotherapy curriculum and within post graduate CPD training. Creating a specialist interest group (e.g. physiotherapists interested in psychology) may help share good psychological practices and overall enhance understanding in this field. [ABSTRACT FROM AUTHOR]

Background: Mosaic chromosomal alterations (mCAs) are large chromosomal gains, losses and copy-neutral losses of heterozygosity (LOH) in peripheral leukocytes. While many individuals with detectable mCAs have no notable adverse outcomes, mCA-associated gene dosage alterations as well as clonal expansion of mutated leukocyte clones could increase susceptibility to disease. Results: We performed a phenome-wide association study (PheWAS) using existing data from 482,396 UK Biobank (UKBB) participants to investigate potential associations between mCAs and incident disease. Of the 1290 ICD codes we examined, our adjusted analysis identified a total of 50 incident disease outcomes associated with mCAs at PheWAS significance levels. We observed striking differences in the diseases associated with each type of alteration, with autosomal mCAs most associated with increased hematologic malignancies, incident infections and possibly cancer therapy-related conditions. Alterations of chromosome X were associated with increased lymphoid leukemia risk and, mCAs of chromosome Y were linked to potential reduced metabolic disease risk. Conclusions: Our findings demonstrate that a wide range of diseases are potential sequelae of mCAs and highlight the critical importance of careful covariate adjustment in mCA disease association studies. [ABSTRACT FROM AUTHOR]

Mosaic loss of chromosome Y (LOY) in leukocytes is the most common form of clonal mosaicism, caused by dysregulation in cell-cycle and DNA damage response pathways. Previous genetic studies have focussed on identifying common variants associated with LOY, which we now extend to rarer, protein-coding variation using exome sequences from 82,277 male UK Biobank participants. We find that loss of function of two genes—CHEK2 and GIGYF1—reach exome-wide significance. Rare alleles in GIGYF1 have not previously been implicated in any complex trait, but here loss-of-function carriers exhibit six-fold higher susceptibility to LOY (OR = 5.99 [3.04–11.81], p = 1.3 × 10−10). These same alleles are also associated with adverse metabolic health, including higher susceptibility to Type 2 Diabetes (OR = 6.10 [3.51–10.61], p = 1.8 × 10−12), 4 kg higher fat mass (p = 1.3 × 10−4), 2.32 nmol/L lower serum IGF1 levels (p = 1.5 × 10−4) and 4.5 kg lower handgrip strength (p = 4.7 × 10−7) consistent with proposed GIGYF1 enhancement of insulin and IGF-1 receptor signalling. These associations are mirrored by a common variant nearby associated with the expression of GIGYF1. Our observations highlight a potential direct connection between clonal mosaicism and metabolic health. Mosaic loss of chromosome Y (LOY) is a common form of clonal mosaicism in leukocytes. Here, the authors extend genetic association analyses to rare variation using exome-sequence data from 82,277 males, finding that loss-of-function alleles in GIGYF1 are associated with six-fold higher susceptibility to both LOY and Type 2 Diabetes. [ABSTRACT FROM AUTHOR]

Research has demonstrated that induced mental fatigue impairs soccer-specific technical, tactical and physical performance in soccer players. The findings are limited by the lack of elite players and low ecological validity of the tasks used to induce mental fatigue, which do not resemble the cognitive demands of soccer. The current study collected survey data from English academy soccer players (n = 256; age groups - U14 – U23), with questions comprising of five themes (descriptors of physical and mental fatigue, travel, education, match-play and fixture congestion). The survey consisted of multiple choice responses, checkboxes and blinded/unblinded (for duration based questions) 0-100 arbitrary unit (AU) slider scales. Listening to music (81.6% of players), using social media (58.3%) and watching videos (34.3%) were the most common pre-match activities. Pre-match subjective mental fatigue was low (18.7±18.8 AU), and most frequently reported at the end of a match (47±26 AU) and remained elevated 24-hours post-match (36±27 AU). Travel (29±24 AU), fixture congestion (44±25 AU) and education (30±26 AU) demonstrated a low to moderate presence of subjective mental fatigue. These findings provide an overview of activities performed by English academy soccer players pre-match, and demonstrate that mental fatigue is experienced as a result of match-play. [ABSTRACT FROM AUTHOR]

The article focuses on the need to promote mental and emotional health among children and young adult in Great Britain. It talks about the British government trying to introduce laws inorder to protect the mental health of young adults. It tells about the government providing mental health services through teacher groups, police and voluntary organizations. It speaks about the need to change the education system inorder to promote mental health in children and young adults.

Background:Scores on temporal psychology measures continue to be associated with alcohol-related problems; however, few studies have examined these associations using more than one temporal psychology instrument. This omission is potentially problematic as not all instruments measure the same dimensions of temporal psychology. The present study aimed to address this gap in the literature. Methods:Participants (N = 410) were opportunistically sampled from a University in the United Kingdom and completed the following questionnaires: The Alcohol Use Disorders Identification Test; The Hospital Anxiety and Depression Scale; The Zimbardo Time Perspective Inventory; The Temporal Focus Scale; The Adolescent Time Inventory-Time Attitudes Scale; and The Consideration of Future Consequences Scale-14. Results:Results showed weak to moderate correlations (with one exception, CFC-F and ZTPI-F) between scores on the various temporal scales, indicating that they measure related but distinct constructs. Structural equation modelling and linear regression revealed that AUDIT scores were most strongly associated with present hedonism, symptoms of anxiety were most strongly associated with negative feelings about the present, and symptoms of depression were more moderately associated with a broader range of indicators. Conclusions:Cognitive and affective dimensions of temporal psychology relate differently to different health outcomes, and researchers need to be explicit and clear in reporting findings. [ABSTRACT FROM PUBLISHER]

This section offers special education-related news briefs in Great Britain as of December 1, 2017. Two additional needs consultations were closed, including an updated Supporting Children's Learning Code of Practice (3rd Edition) 2017 and associated regulations. The Read, Write, Count campaign was extended to include P4-7. The Department for Education Special Education and Inclusion Review Team in Northern Ireland has issued an update on the new special educational needs legislation.

The article offers reports related to politics in Great Britain. Topics discussed include the referendum and elections in various countries such as Wales, Northern Ireland, and Scotland, the proposed academisation of local authority schools by 2022 under the country's government, and the establishment of taskforce which are tasked to improve the access to apprenticeship programs among people with learning disabilities.

The article offers information on the efforts by British government for special education needs. Topics discussed include early draft of the Additional Learning Needs (ALN) Code from Welsh Government, the 'Read, Write, Count' campaign in Scotland, and improve literacy standards by government in England.

The article discusses the draft Special Educational Needs Code of Practice 0-25 approved by the British Parliament. The House of Commons Legislation Committee discussed in code. Children's Minister Edward Timpson had responded to comments from committee members. Some concerns had been raised by committee members, including the timescale for implementation and the absence of supplementary sections for parents and practitioners.

The article discusses various developments related to teacher training in Great Britain as of 2013. In England, postgraduate school-based initial teacher training is continuing; and the network of Teaching Schools, and Teaching School Alliances is expanding. In Scotland, training is continuing for traditional higher education; and in February 2013, an additional 2.9 million pounds were allocated for eight Scottish universities providing initial teacher training.

The article offers news brief related to politics from Great Britain as of November 2012. National Parenting Strategy program has been launched in Scotland in October 2012 which provides improvement at access to information, services and advices for parents. Action plan related to education for travelers has been introduced by the Department for Education in Northern Ireland. A draft legislation related to special educational needs for children and young has been published in England.

In this paper, we present evidence relating to the existence of high levels of stress within medical students, and then consider a range of possible solutions with reference to various curriculum definitions and models. Throughout the paper, the definition of stress we have in mind is that provided by the Health and Safety Executive:'Stress is the adverse reaction people have to excessive pressure or other types of demand placed upon them' (www.hse.gov.uk/stress).This is distinguished from healthy levels of pressure, which are experienced as motivating rather than debilitating. [ABSTRACT FROM AUTHOR]

The Government has called for a strategic approach to support services for people given refugee status, and has itself adopted a new strategy, Integration Matters. This article discusses the implications of such a strategy at local level, and the difficulties and challenges faced by local authorities and other public services setting out to deliver a strategic approach to services for refugees. It argues that government policy is only partially supportive of such approaches, and that much more could be done to ensure that integrated services are in place at local level. [ABSTRACT FROM AUTHOR]

Background: The parental rules about alcohol questionnaire (Van der Vorst et al., 2005, 2006) uses 10 items to assess how strictly adolescents believe the rules set by their parents about drinking are. An increasing body of literature has attested to the importance of rule setting in the prevention of problematic alcohol use among adolescents. A recent study proposed a two-factor solution in place of the hypothesized unidimensional one, with factors assessing non-normative, and normative rules.Methods: The present study used five waves of data to examine the structure of the scale, and how well it relates to a measure of heavy episodic drinking (HED). Participants in Waves one to four {10,954-9,383} were substantively more numerous than those at wave five (N = 2,332).Results: Confirmatory Factor Analyses did not support either the ten-item hypothesized model, nor the proposed two-factor solution. Results of exploratory factor analyses all pointed to a one factor solution. Using Modification Indices, we obtained a good-fitting, five-item unidimensional model in Waves one to four. At wave five, a good fitting unidimensional model was obtained with the dropping of a further item. Scores on this shortened scale were internally consistent, correlated highly with scores on the original ten-item version, and correlated to a similar degree as the original 10-item measure, with scores on a HED measure.Conclusion: Further work is required in assessing the properties of this scale across cultures and samples before definitively determining that two factors best represent parental rules. [ABSTRACT FROM AUTHOR]

In the UK construction industry there are different strategies used in practice for the insurance of subcontracted work of which two predominate: one is for subcontracted work to be insured by both main contractor and subcontractor (model A) and the other is for only the main contractor to insure the subcontracted work (model B). The extent of use of these approaches is discussed and the rationales for them are presented in the context of research undertaken by questionnaire surveys and structured interviews. The paper provides a background to the requirements for subcontractor insurance found in commonly used forms of contract, including FIDIC. Four possible models of subcontractor insurance are identified and their relationships to the contract provisions in model forms is outlined. Two of the models have little practical relevance to subcontractor insurance and the reasons for this are given. About 75% of the main contractors in the research sample were found to adopt model A for all disciplines, although the reasons given were not entirely consistent. About 15% of the sample adopt model B for all disciplines and the remainder use different models for different disciplines. Again, the rationales for these choices were not found to be robust. The main conclusions are first that the choice of strategy for subcontractor insurance is highly independent of both the discipline and the selected form of subcontract, and second that some commercial decisions in this area may be sub-optimal. There is an unreconciled argument over the immediate commercial advantages claimed by many for model A and the potential for longer term reduction in insurance costs which might arise from the widespread adoption of model B. [ABSTRACT FROM AUTHOR]

Describes how the Office of Fair Trading in Great Britain set out to produce and distribute information and advice to consumers using a variety of media. Lessons learnt about the consumer's reaction to and absorption of consumer advice material; Reasons for consumers'ignorance of their rights; Formation of Consumers' Association in 1957; Trends in the demand for consumer information material.

The article discusses a study which examined the urinary pneumococcal antigen test in childhood pneumonia in North East England from October 2009 to March 2011. Extensive microbiological and virological testing was conducted as part of the study. It suggests that the testing is important in diagnosing the disease, especially in low-resource countries in which polymerase-chain reaction (PCR) based assays are not widely available.

The article offers news briefs related to politics and education in Great Britain. The Scottish Government's national development and improvement agency for education, Education Scotland, has been established. The Government discussion document on initial teacher training (ITT), Training our next generation of outstanding teachers, has been launched. A joint SNAP Cymru and Barnardo's Cymru study on illegal exclusions has been published.

This section presents updates on politics in Great Britain. The public sector deficit reduction in Great Britain led to budget reductions in Wales, Scotland and Northern Ireland. The Coalition Government established the Department for Education (DfE), headed by Michael Gove. Consultation is ongoing for a secondary legislation that will allow the Additional Support Needs Tribunals for Scotland (ASNTS) to hear disability claims.

A table of contents for the September 2016 issue of the "British Journal of Special Education" is presented.

The capacity to undertake systematic surveys of common variation through genome-wide association analysis has the potential to deliver substantial insights into type 2 diabetes (T2D) pathogenesis. We recently completed genotyping of 1954 T2D cases (enriched for positive family history/early onset) and 2922 population-based controls (all UK origin) on the Affymetrix 500k chip as part of the Wellcome Trust Case-Control Consortium. The preliminary analyses reported here are based on ∼309,000 SNPs with exemplary quality control and minor allele frequency (MAF)>5% [estimated to provide ∼60% coverage of CEU HapMap (MAF>5%, pairwise, r²>0.8)]. Variants within TCF7L2 emerge as the strongest cluster of susceptibility variants (12 SNPs, best = rs7901695, p=9.9x 10[sup -13]), but we find an additional 5 signals achieving nominal genome-wide significance with additive model p<6x10[sup -6] (controlling the false discovery rate at 0.05). These signals (located on chromosomes 1, 2, 6, 12 and 16) include a cluster of 5 SNPs with p< 10[sup -4] at ∼20.8Mbp on chr6, in a region including the CDK5 regulatory subunit associated protein 1-like 1 gene (CDKAL1) [for example, rs9465871, OR(95%CIs) for allele T (MAF∼80%) dominance: 0.51(0.37-0.70), exact p=1x10[sup -5]]. Extensive replication studies in 3073 T2D cases and 3879 controls (0.70(0.53-0.92), exact p=0.005) and meta-analysis across all ∼11800 subjects (0.61 (0.49-0.75), exact p=5.7x 10[sup -7]) provide supporting evidence for this finding. Haplotype-based analyses across a 2Mb region surrounding rs9465871 show no additional signal. Based on HapMap CEU data, rs9465871 is in perfect LD with several other intronic variants within CDKAL1; we have thus far covered ∼60% of common variation in the region (r²>0.8). Whilst further replication studies and fine-mapping will be required to refine the allelic architecture of this locus, these findings provide strong preliminary evidence that the CDKAL1 region harbours a novel locus affecting T2D risk. [ABSTRACT FROM AUTHOR]

Objectives We examined a model, informed by self-regulation theories from the health psychology literature, which included goal adjustment capacities, appraisals of challenge and threat, coping, and well-being. Design Prospective. Methods Two-hundred and twelve athletes from the United Kingdom ( n = 147) or Australia ( n = 65), who played team ( n = 135) or individual sports ( n = 77), and competed at international ( n = 7), national ( n = 11), county ( n = 67), club ( n = 84), or beginner ( n = 43) levels participated in this study. Participants completed measures of goal adjustment capacities and stress appraisals two days before competing. Athletes also completed coping and well-being questionnaires within 3 h of their competition ending. Results The way an athlete responded to an unattainable goal was associated with his or her well-being in the period leading up to and including the competition. Goal reengagement positively predicted well-being, whereas goal disengagement negatively predicted well-being. Further, goal reengagement was positively associated with challenge appraisals, which in turn was linked to task-oriented coping, and task-oriented coping positively associated with well-being. Conclusion When highly-valued goals become unattainable, consultants and coaches could encourage athletes to generate alternative approaches to achieve the same goal or help them develop a completely new goal in order to promote well-being among athletes. [ABSTRACT FROM AUTHOR]

Infective endocarditis (IE) remains a difficult condition to diagnose and treat and is an infection of high consequence for patients, causing long hospital stays, life-changing complications and high mortality. A new multidisciplinary, multiprofessional, British Society for Antimicrobial Chemotherapy (BSAC)-ledWorking Party was convened to undertake a focused systematical review of the literature and to update the previous BSAC guidelines relating delivery of services for patients with IE. A scoping exercise identified new questions concerning optimal delivery of care, and the systematic review identified 16 231 papers of which 20 met the inclusion criteria. Recommendations relating to endocarditis teams, infrastructure and support, endocarditis referral processes, patient follow-up and patient information, and governance are made as well as research recommendations. This is a report of a joint Working Party of the BSAC, British Cardiovascular Society, British Heart Valve Society, British Society of Echocardiography, Society of Cardiothoracic Surgeons of Great Britain and Ireland, British Congenital Cardiac Association and British Infection Association., Competing Interests: Competing interests: The British Society for Antimicrobial Chemotherapy provided funds for literature search, administrative support and meeting space. JATS (JS) received research funding from the National Institute for Health Research, the Medical Research Council, Welcome Trust, Engineering and Physical Sciences Council, and Jon Moulton Charity Trust. JS received consulting fees from Tillotts Pharma and Medtron. BDP and JBC are on the Editorial Board for BMJ Heart. BDP received consulting fees from Anteris and Microport, honoraria from Medtronic, Abbott, Edwards Lifesciences and Anteris and is on the data safety monitoring committee of Colibri. He is a board member of PCR and has received writing fees from Edwards Lifesciences., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: The study aimed to systematically ascertain male sex chromosome abnormalities, 47,XXY (Klinefelter syndrome [KS]) and 47,XYY, and characterize their risks of adverse health outcomes., Methods: We analyzed genotyping array or exome sequence data in 207,067 men of European ancestry aged 40 to 70 years from the UK Biobank and related these to extensive routine health record data., Results: Only 49 of 213 (23%) of men whom we identified with KS and only 1 of 143 (0.7%) with 47,XYY had a diagnosis of abnormal karyotype on their medical records or self-report. We observed expected associations for KS with reproductive dysfunction (late puberty: risk ratio [RR] = 2.7; childlessness: RR = 4.2; testosterone concentration: RR = -3.8 nmol/L, all P < 2 × 10 -8 ), whereas XYY men appeared to have normal reproductive function. Despite this difference, we identified several higher disease risks shared across both KS and 47,XYY, including type 2 diabetes (RR = 3.0 and 2.6, respectively), venous thrombosis (RR = 6.4 and 7.4, respectively), pulmonary embolism (RR = 3.3 and 3.7, respectively), and chronic obstructive pulmonary disease (RR = 4.4 and 4.6, respectively) (all P < 7 × 10 -6 )., Conclusion: KS and 47,XYY were mostly unrecognized but conferred substantially higher risks for metabolic, vascular, and respiratory diseases, which were only partially explained by higher levels of body mass index, deprivation, and smoking., Competing Interests: Conflict of Interest The authors declare no conflicts of interest., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)