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Background The physical health comorbidities and premature mortality experienced by people with mental illness has led to an increase in exercise services embedded as part of standard care in hospital-based mental health services. Despite the increase in access to exercise services for people experiencing mental illness, there is currently a lack of guidelines on the assessment and triage of patients into exercise therapy. Aims To develop guidelines for the pre-exercise screening and health assessment of patients engaged with exercise services in hospital-based mental healthcare and to establish an exercise therapy triage framework for use in hospital-based mental healthcare. Method A Delphi technique consisting of two online surveys and two rounds of focus group discussions was used to gain consensus from a multidisciplinary panel of experts. Results Consensus was reached on aspects of pre-exercise health screening, health domain assessment, assessment tools representing high-value clinical assessment, and the creation and proposed utilisation of an exercise therapy triage framework within exercise therapy. Conclusions This study is the first of its kind to provide guidance on the implementation of exercise therapy within Australian hospital-based mental healthcare. The results provide recommendations for appropriate health assessment and screening of patients in exercise therapy, and provide guidance on the implementation and triage of patients into exercise therapy via a stepped framework to determine (a) the timeliness of exercise therapy required and (b) the level of support required in the delivery of their exercise therapy.

Abstract Background Surf lifesavers and lifeguards have provided essential education, preventative, and rescue services to the Australian community for over 110 years. In this first responder role, surf lifesavers and lifeguards are inadvertently exposed to high risk and trauma related experiences, which may negatively impact mental well-being. To date however, there has been limited research into the mental health of surf lifesavers and lifeguards, and no studies at all on the mental health of adolescent surf lifesavers. The preliminary study aimed to measure the exposure of potentially traumatic events (PTEs), post-traumatic stress symptoms (PTSS), self-efficacy, social support, and attitudes towards mental health problems in Surf Life Saving (SLS) members. Methods An anonymous, online survey was developed (adolescent and adult versions) and created to measure the domain of mental health in surf lifesavers and lifeguards. Pearson’s correlations investigated relationships between PTEs, PTSS, self-efficacy, social support, attitudes towards mental health problems, age, years as a SLS member, and years patrolling. Spearman’s Rank was used for violations of normality. Results A total of 57 surf lifesavers/lifeguards aged 13–59 years were included in the final analysis. There was a significant positive relationship between exposure to direct trauma and PTSS, which in turn, were associated with greater negative attitudes towards mental health problems towards the mental health of others, and lower levels of self-efficacy. Male and female adults with PTSS reported lower social support, whereas for adolescent males, a positive relationship between direct trauma and PTSS was observed. Conclusion This research is the first to explore the mental health of Australian surf lifesavers and lifeguards. The results highlight the potential risks to mental health and well-being associated with this first responder role. More research to protect the vulnerability of this population is warranted.

Abstract Background Exercise during pregnancy is associated with various health benefits for both mother and child. Despite these benefits, most pregnant women do not meet physical activity recommendations. A known barrier to engaging in exercise during pregnancy is a lack of knowledge about appropriate and safe exercise. In our current era of social media, many pregnant women are turning to online information sources for guidance, including social media influencers. Little is known about attitudes towards pregnancy exercise information provided by influencers on social media platforms. This study aimed to explore attitudes towards exercise during pregnancy depicted by social media influencers on Facebook, and user engagement with posted content. Methods A mixed-methods approach was used to analyse data from 10 Facebook video posts of social media influencers exercising during pregnancy. Quantitative descriptive analyses were used to report the number of views, shares, comments and emotive reactions. Qualitative analysis of user comments was achieved using an inductive thematic approach. Results The 10 video posts analysed were viewed a total of 12,117,200 times, shared on 11,181 occasions, included 13,455 user comments and 128,804 emotive icon reactions, with the most frequently used icon being ‘like’ (81.48%). The thematic analysis identified three themes associated with attitudes including [1] exercise during pregnancy [2] influencers and [3] type of exercise. A fourth theme of community was also identified. Most user comments were associated with positive attitudes towards exercise during pregnancy and the influencer. However, attitudes towards the types of exercise the influencer performed were mixed (aerobic and body weight exercises were positive; resistance-based exercise with weights were negative). Finally, the online community perceived by users was mostly positive and recognised for offering social support and guidance. Conclusions User comments imply resistance-based exercise with weights as unsafe and unnecessary when pregnant, a perception that does not align with current best practice guidelines. Collectively, the findings from this study highlight the need for continued education regarding exercise during pregnancy and the potential for social media influencers to disseminate evidence-based material to pregnant women who are highly receptive to, and in need of reliable health information.

Introduction: Poor mental health is an under-recognised burden in rural locations. This is evident in suicide rates that are 40% higher in rural communities than in urban ones, despite a similar prevalence of mental disorders. The level of readiness and engagement of rural communities to adapt or even acknowledge poor mental health can impact effective interventions. For interventions to be culturally appropriate, community engagement should include individuals, their support networks and relevant stakeholders. Community participation guides people living in rural communities to be aware of and take responsibility for community mental health. Community engagement and participation foster empowerment. This review examines how community engagement, participation and empowerment were used in the development and implementation of interventions aimed at improving mental health of adults residing in rural communities. Methods: Databases CINAHL, EmCare, Google Scholar, Medline, PsychInfo, PubMed and Scopus were systematically searched from database inception to July 2021. Eligible studies included adults living in a rural cohort where community engagement was used to develop and implement a mental health intervention. Results: From 1841 records identified, six met the inclusion criteria. Methods were both qualitative and quantitative, including participatory-based research, exploratory descriptive research, community-built approach, community-based initiative and participatory appraisal. Studies were located in rural communities of the USA, UK and Guatemala. Sample size ranges was 6-449 participants. Participants were recruited using prior relationships, project steering committee, local research assistants and local health professionals. All six studies underwent various strategies of community engagement and participation. Only two articles progressed to community empowerment where locals influenced one another independently. The underlying purpose of each study was to improve community mental health. The duration of the interventions ranged from 5 months to 3 years. Studies on the early stages of community engagement discovered a need to address community mental health. Studies where interventions were implemented resulted in improved community mental health. Conclusion: This systematic review found similarities in community engagement when developing and implementing interventions for community mental health. Community engagement should involve adults residing in rural communities when developing interventions - if possible, both with a diverse gender representation and a background in health. Community participation can include upskilling adults living in rural communities and providing appropriate training materials to do so. Community empowerment was achieved when the initial contact with rural communities was through local authorities and there was support from community management. Future use of the strategies of engagement, participation and empowerment could determine if they can be replicated across rural communities for mental health.

Abstract Background COVID-19 has resulted in substantial global upheaval. Resilience is important in protecting wellbeing, however few studies have investigated changes in resilience over time, and associations between resilience with depression, anxiety, stress, and physical activity during the COVID-19 pandemic. Methods Online surveys were conducted to collect both longitudinal and cross-sectional data at three time points during 2020. Australian adults aged 18 years and over were invited to complete the online surveys. Measures include the six-item Brief Resilience Scale, the 21-item Depression, Anxiety and Stress Scale, and the Active Australia Survey which have eight items identifying the duration and frequency of walking, and moderate and vigorous physical activities (MVPA), over the past 7 days. General linear mixed models and general linear models were used in the analysis. Results In the longitudinal sample, adjusted differences (aDif) in resilience scores did not significantly change over time (time 2 vs. time 1 [aDif = − 0.02, 95% CI = − 0.08, 0.03], and time 3 vs. time 1 [aDif =

BackgroundThe COVID-19 pandemic has led to a worsening of mental health and health behaviors. While physical activity is positively associated mental health, there is limited understanding of how mental health and physical activity evolve throughout the COVID-19 pandemic. This study aimed to examine changes in depression, anxiety and stress and physical activity, and associations between depression, anxiety, and stress with physical activity in Australian adults across three-time points during the COVID-19 pandemic.Materials and methodsThis study collected both longitudinal and cross-sectional data at three-time points during the COVID-19 pandemic in Australia (i.e., April, July/August, and December 2020). Australians aged 18 years and over were invited to complete online surveys hosted on Qualtrics survey platform. Linear mixed models with random subject effect and general linear models were used to analyze the longitudinal and repeated cross-sectional data respectively.ResultsThe number of participants in cross-sectional surveys and longitudinal surveys was 1,877 and 849, respectively. There was an overall reduction between time 2 vs. time 3 in depression (d = 1.03, 95% CI = 0.20, 1.85), anxiety (d = 0.57, 95% CI = 0.02, 1.12), and stress (d = 1.13, 95% CI = 0.21, 2.04) scores but no significant differences in physical activity across three-time points. On average, participants who met the physical activity guidelines had lower depression (d = −2.08, 95% CI = −2.90, −1.26), anxiety (d = −0.88, 95% CI = −1.41, −0.34), and stress (d = −1.35, 95% CI = −2.13, −0.56) scores compared to those not meeting the guidelines.ConclusionIn the context of the ongoing COVID-19 pandemic, both governments and service providers should continue to provide the public with timely mental health support and promote the benefits of physical activity, as a cost-effective strategy to improve mental health and wellbeing.

This study investigates differences in physical activity between weekdays and weekend days, and its associations with sociodemographic and anthropometric characteristics in the U.S population using the NHANES 2011–2014 data. Physical activity was measured using ActiGraph GT3X+. Raw acceleration data were converted to Monitor-Independent Movement Summary units (MIMS-units) that account for inter-device variability and eliminates non-human movement. The daily MIMS-units were averaged for weekdays and weekend days. Demographic characteristics were self-reported. Height and weight were objectively measured. The sample included 6611 adults aged ≥ 20 years and 3520 children aged between 6 and 19 years. The results show that more MIMS-units were registered on weekdays compared to weekend days for adults (652, 95%CI = 533, 770) and children (889, 95%CI = 702, 1076). Factors associated with physical activity in adults (gender, age, marital status, ethnicity, education level, and weight status) were similar for weekdays and weekend days. In children, physical activity was associated with ethnicity, weight status, and age. The level of differences in physical activity between weekdays and weekend days among adults was larger for men, Hispanic Americans, and those with lower education levels. Differences among children were similar across subgroups, except for those aged 16–19 years who had smaller level of difference compared to those aged 12–15 years. In conclusion, adults and children were more active on weekdays than weekend days. The effects of structured days (i.e., weekdays) on physical activity appeared to be similar across most child subgroups but more heterogeneous for adult subgroups. Interventions increasing physical activity opportunities during weekend days are warranted.

Abstract Objective: This study investigated the association between COVID‐19 prevention knowledge and concern and practising preventive behaviour in Australian adults. Methods: Using an online survey, knowledge of Australian COVID‐19 guidelines, concerns about pandemic impact, the practice of preventive behaviours, and sociodemographic variables (i.e. age, gender, information source) were measured. Bivariate analysis and linear regression models were used. Results: A total of 1,491 participants (age 50.5 ±14.9 years, 32.3% males) completed the survey. Higher knowledge and concern scores were associated with a higher practice of preventive behaviour scores (βs:0.47 & 0.08 respectively, p65 years) and women had higher knowledge and practice scores compared to their counterparts. Being younger (

To investigate associations between acute workload and in-game performance in basketball. Eight semi-professional, male basketball players were monitored during all training sessions (N = 28) and games (N = 18) across the season. External workload was determined using absolute (arbitrary units[AU]) and relative (AU·min-1) PlayerLoadTM (PL), and absolute (count) and relative (count·min-1) low-intensity, medium intensity, high-intensity, and total Inertial Movement Analysis (IMA) events (accelerations, decelerations, changes of-direction, and jumps). Internal workload was determined using absolute and relative Summated-Heart-Rate Zones workload, session-rating of perceived exertion, rating of perceived exertion, and time (min) spent working > 90% of maximal heart rate. In-game performance was indicated by the player efficiency statistic. Repeated measures correlations were used to determine associations between acute workload variables (across the previous 7 days) and player efficiency. Relative PL (r = 0.13, small) and high-intensity IMA events (r = 0.13, small) possessed the strongest associations with player efficiency of the investigated workload variables (P > 0.05). All other associations were trivial in magnitude (P > 0.05). Given the trivial-small associations between all external and internal workload variables and player efficiency, basketball practitioners should not rely solely on monitoring acute workloads to determine performance potential in players.

The purpose of this study was to examine player monitoring approaches used by basketball practitioners with a specific focus on the use of microsensors. An online survey was disseminated to basketball practitioners via international basketball-related organisations and social media channels. Multiple response, Likert-scale level of agreement, and open-ended questions captured data regarding if, and how player monitoring was performed, as well as barriers and facilitators to player monitoring, with an emphasis on the use of microsensors. Forty-four basketball practitioners completed the survey. Twenty-seven respondents (61%) implement player monitoring and thirteen (30%) use microsensors. Despite implementing player monitoring, over 85% of practitioners modify training based on their own observation. Respondents not currently monitoring players (39%) would commence monitoring if the tools or equipment were provided. 74% of respondents agree that microsensors are expensive. Only 56% of practitioners who use microsensors feel they have support for using the technology and analysing/interpreting the data. These findings suggest a low uptake of microsensors for player monitoring in basketball. Coaches and practitioners perceive player monitoring approaches to be cost-prohibitive and appear unsure of how player monitoring data should be used to optimise training outcomes for players.

Abstract Background The advent of Next Generation Sequencing has allowed transcriptomes to be profiled with unprecedented accuracy, but the high costs of full-length mRNA sequencing have posed a limit on the accessibility and scalability of the technology. To address this, we developed 3’Pool-seq: a simple, cost-effective, and scalable RNA-seq method that focuses sequencing to the 3′-end of mRNA. We drew from aspects of SMART-seq, Drop-seq, and TruSeq to implement an easy workflow, and optimized parameters such as input RNA concentrations, tagmentation conditions, and read depth specifically for bulk-RNA. Results Thorough optimization resulted in a protocol that takes less than 12 h to perform, does not require custom sequencing primers or instrumentation, and cuts over 90% of the costs associated with TruSeq, while still achieving accurate gene expression quantification (Pearson’s correlation coefficient with ERCC theoretical concentration r = 0.96) and differential gene detection (ROC analysis of 3’Pool-seq compared to TruSeq AUC = 0.921). The 3’Pool-seq dual indexing scheme was further adapted for a 96-well plate format, and ERCC spike-ins were used to correct for potential row or column pooling effects. Transcriptional profiling of troglitazone and pioglitazone treatments at multiple doses and time points in HepG2 cells was then used to show how 3’Pool-seq could distinguish the two molecules based on their molecular signatures. Conclusions 3’Pool-seq can accurately detect gene expression at a level that is on par with TruSeq, at one tenth of the total cost. Furthermore, its unprecedented TruSeq/Nextera hybrid indexing scheme and streamlined workflow can be applied in several different formats, including 96-well plates, which allows users to thoroughly evaluate biological systems under several conditions and timepoints. Care must be taken regarding experimental design and plate layout such that potential pooling effects can be accounted for and corrected. Lastly, further studies using multiple sets of ERCC spike-ins may be used to simulate differential gene expression in a system with known ground-state values.

The application of viscoelastic hemostatic assays (VHAs) (e.g., thromboelastography (TEG) and rotational thromboelastometry (ROTEM)) in orthopedics is in its relative infancy when compared with other surgical fields. Fortunately, several recent studies describe the emerging use of VHAs to quickly and reliably analyze the real-time coagulation and fibrinolytic status in both orthopedic trauma and elective orthopedic surgery. Trauma-induced coagulopathy—a spectrum of abnormal coagulation phenotypes including clotting factor depletion, inadequate thrombin generation, platelet dysfunction, and dysregulated fibrinolysis—remains a potentially fatal complication in severely injured and/or hemorrhaging patients whose timely diagnosis and management are aided by the use of VHAs. Furthermore, VHAs are an invaluable compliment to common coagulation tests by facilitating the detection of hypercoagulable states commonly associated with orthopedic injury and postoperative status. The use of VHAs to identify hypercoagulability allows for an accurate venous thromboembolism (VTE) risk assessment and monitoring of VTE prophylaxis. Until now, the data have been insufficient to permit an individualized approach with regard to dosing and duration for VTE thromboprophylaxis. By incorporating VHAs into routine practice, orthopedic surgeons will be better equipped to diagnose and treat the complete spectrum of coagulation abnormalities faced by orthopedic patients. This work serves as an educational primer and up-to-date review of the current literature on the use of VHAs in orthopedic surgery.

Abstract Fibrous Dysplasia / McCune Albright syndrome (FD/MAS) represents a wide spectrum of diseases due to somatic gain-of-function mutations of the GNAS gene. The mutation leads to overactivity in the target tissues and to a wide phenotype of clinical features that vary in severity and age of onset. The rarity of the disease and its variable presentation to multiple specialities often leads to misdiagnosis and inappropriate variability in investigations and treatments. To address this, our international consortium of clinicians, researchers, and patients’ advocates has developed pragmatic clinical guidelines for best clinical practice for the definition, diagnosis, staging, treatment and monitoring for FD/MAS to empower patients and support clinical teams in both general and specialised healthcare settings. With the lack of strong evidence to inform care, the guidelines were developed based on review of published literature, long-standing extensive experience of authors, input from other healthcare professionals involved in the care of FD/MAS patients and feedback from patients and patient groups across the globe. This has led to the formulation of a set of statements to inform healthcare professionals, patients, their families, carers and patient groups of the best practice of care. It is anticipated the implementation of these recommendations will lead to improvement in the care of patients with FD/MAS internationally.

CRISPR base editors are powerful tools for large-scale mutagenesis studies. This kind of approach can elucidate the mechanism of action of compounds, a key process in drug discovery. Here, we explore the utility of base editors in an early drug discovery context focusing on G-protein coupled receptors. A pooled mutagenesis screening framework was set up based on a modified version of the CRISPR-X base editor system. We determine optimized experimental conditions for mutagenesis where sgRNAs are delivered by cell transfection or viral infection over extended time periods (>14 days), resulting in high mutagenesis produced in a short region located at -4/+8 nucleotides with respect to the sgRNA match. The β2 Adrenergic Receptor (B2AR) was targeted in this way employing a 6xCRE-mCherry reporter system to monitor its response to isoproterenol. The results of our screening indicate that residue 184 of B2AR is crucial for its activation. Based on our experience, we outline the crucial points to consider when designing and performing CRISPR-based pooled mutagenesis screening, including the typical technical hurdles encountered when studying compound pharmacology.

This study investigates changes in willingness to vaccinate against COVID-19 and the effect of the extended restrictions in metropolitan Victoria on this change. Longitudinal and repeated cross-sectional data were collected from online surveys distributed in April, between July and August, and December 2020. Australian adults who were ≥18 years old were recruited through email lists, social media networks, and paid Facebook advertisement. Willingness to vaccinate against COVID-19 was self-reported. The results showed that participants were more willing to vaccinate if the vaccine was safe at survey 1 (longitudinal: adjusted OR (aOR) = 1.88, 95%CI = 1.38, 2.56; cross-sectional: aOR = 3.73, 95%CI = 2.55, 5.45) and survey 2 (longitudinal: aOR = 1.54, 95%CI = 1.19, 2.00; cross-sectional: aOR = 2.48, 1.67, 3.67), compared to survey 3. The change in willingness to vaccinate if the vaccine was safe and effective was not significant for those in Metropolitan Victoria; but was for those living in other Australian locations at survey 1 (OR = 2.13, 95%CI = 1.64, 2.76) and survey 2 (OR = 1.62, 95%CI = 1.30, 2.01), compared to survey 3. Willingness to vaccinate even if a vaccine had not been proven safe decreased at survey 3 (OR = 2.02, 95%CI = 1.14, 3.57) for those living in Metropolitan Victoria. In conclusion willingness to vaccinate against COVID-19 decreased over time among Australians, except for those living in metropolitan Victoria, where an additional strict and prolonged lockdown was implemented around the time of survey 2. Either the experience of the lockdown, or the presence of the COVID-19 virus itself had a positive influence on participants’ willingness to vaccinate, even if such a vaccine was not yet proven to be safe and effective.

The original version of this article [1] unfortunately included an error to an author’s name. Paul Arundel was inadvertently presented as Paul Arunde.

People with mental illness have higher rates of physical health problems and consequently live significantly shorter lives. This issue is not yet viewed as a national health priority and research about mental health consumer views on accessing physical health care is lacking. The aim of this study is to explore the experience of mental health consumers in utilizing health services for physical health needs. Qualitative exploratory design was utilized. Semistructured focus groups were held with 31 consumer participants. Thematic analysis revealed that three main themes emerged: scarcity of physical health care, with problems accessing diagnosis, advice or treatment for physical health problems; disempowerment due to scarcity of physical health care; and tenuous empowerment describing survival resistance strategies utilized. Mental health consumers were concerned about physical health and the nonresponsive health system. A specialist physical health nurse consultant within mental health services should potentially redress this gap in health care provision.

Recent innovations in smartphone technology have led to the development of a number of applications for the valid and reliable measurement of physical performance. Smartphone applications offer a number of advantages over laboratory based testing including cost, portability, and absence of postprocessing. However, smartphone applications for the measurement of running speed have not yet been validated. In the present study, the iOS smartphone application, SpeedClock, was compared to conventional timing lights during flying 10 m sprints in recreationally active women. Independent samples t-test showed no statistically significant difference between SpeedClock and timing lights (t(190)=1.83, p=0.07), while intraclass correlations showed excellent agreement between SpeedClock and timing lights (ICC (2,1) = 0.93, p=0.00, 95% CI 0.64–0.97). Bland-Altman plots showed a small systematic bias (mean difference = 0.13 seconds) with SpeedClock giving slightly lower values compared to the timing lights. Our findings suggest SpeedClock for iOS devices is a low-cost, valid tool for the assessment of mean flying 10 m sprint velocity in recreationally active females. Systematic bias should be considered when interpreting the results from SpeedClock.

Background Comorbid chronic illnesses, such as cardiovascular disease, respiratory conditions, and type 2 diabetes are common among people with serious mental illness. Management of comorbid illness in the mental health setting is sometimes ad hoc and poorly delivered. Use of a cardiometabolic health nurse (CHN) is proposed as one strategy to improve the delivery of physical health care to this vulnerable population. Objective To report the CHN's utilization of primary care and allied health referrals from a trial carried out in a regional community mental health service. Design Feasibility study. Mental health consumers were referred by their case manager or mental health nurse to the CHN. The CHN coordinated the physical health care of community-based mental health consumers by identifying the need for, and providing referrals to, additional services, including primary care, allied health, and community-based services. Results Sixty-two percent of participants referred to the CHN received referrals for primary care, allied health, and community-based services. Almost all referrals received follow-up by the CHN. Referrals were most commonly directed to a general practitioner and for nurse-delivered services. Conclusion The CHN role shows promise in coordinating the physical health of community-based mental health consumers. More studies on role integration and development of specific outcome measurement tools are needed.

Objective: The aim of this study was to understand the knowledge, beliefs, barriers, and behaviors of mental health professionals about physical activity and exercise for people with mental illness. Methods: The Portuguese version of The Exercise in Mental Illness Questionnaire was used to assess knowledge, beliefs, barriers, and behaviors about exercise prescription for people with mental illness in a sample of 73 mental health professionals (68.5% women, mean age = 37.0 years) from 10 Psychosocial Care Units (Centros de Atenção Psicossocial) in Porto Alegre and Canoas, state of Rio Grande do Sul, Brazil. Results: Most of respondents had received no formal training in exercise prescription. Exercise ranked fifth as the most important treatment, and most of the sample never or occasionally prescribed exercise. The most frequently reported barriers were lack of training in physical activity and exercise prescription and social stigma related to mental illness. Professionals who themselves met recommended physical activity levels found fewer barriers to prescribing physical activity and did so with greater frequency. Conclusion: Exercise is underrated and underused as a treatment. It is necessary to include physical activity and exercise training in mental health curricula. Physically active professionals are more likely to prescribe exercise and are less likely to encounter barriers to doing so. Interventions to increase physical activity levels among mental health professionals are necessary to decrease barriers to and increase the prescription of physical activity and exercise for mental health patients.