Exercise Experience Research Articles

Eye Tracking for Assessment of Situational Awareness in Bridge Resource Management Training.

The purpose of this study is to experiment eye tracking in situational awareness assessment in Bridge Resource Management training of ship officers who play a critical role in maritime accidents. The maritime industry focuses on human factor developing and improving regulations including training requirements to prevent marine casualties. The mandatory Bridge Resource Management training as per international regulations includes assessment of situational awareness of trainees in full mission ship bridge simulators. The study involves capturing and analyzing eye movement data from maritime cadets and ship officers with sea experience in a simulation exercise. An eye tracking analysis software and eye tracking glasses are used for the study. Inferential and descriptive analyses were both used to validate the results. Significant differences were found between fixation duration measurements of novice cadets and experienced officers. Heat map visualizations also revealed differences in focuses of attention among participants. The evaluations of the certified simulator assessors are considered as the ground truth, and the results were compared to and discussed accordingly. The results show that the eye tracking technology is a valuable complementary tool for assessment of situational awareness in a simulator environment, utilized with the existing conventional observation and performance measurement methods. The study reveals that eye tracking provides the assessor with novel data in simulator based maritime training, such as focus of attention, which contributes to the evaluation of the situational awareness. The study, therefore, contributes to maritime education aiming to improve the effectiveness of Bridge Resource Management training. It also contributes to scientific research on eye movement in maritime field by proposing the integration of eye tracking in the Bridge Resource Management training.

Exercise experiences in patients with metastatic lung cancer: A qualitative approach

BackgroundPatients with metastatic lung cancer can have severe cancer-related symptoms and treatment-induced side effects. Exercise is beneficial for patients with metastatic lung cancer; however, little information is available on guiding patients how to perform exercise during hospitalization. The purpose of this qualitative study was to understand exercise experiences in patients with metastatic lung cancer.MethodsPatients with metastatic lung cancer (n = 24) participated in face-to-face in-depth interviews at an inpatient ward of a medical center in central Taiwan. Interview transcripts were evaluated using narrative analysis to extract and validate themes.ResultsThree primary themes were identified: (1) modifying exercise to maximize physical functions; (2) living with symptoms and frustration, but still exercising; and (3) doing exercise to sustain hopes, inner power, and life. Secondary findings included: (1) adopting walking as their main form of exercise because of its convenience; and (2) among patients with severe symptoms, adjusting exercise towards shorter time durations and shorter distances, slower speeds, and higher frequencies.ConclusionsThe study found physically active lung cancer patients, although with metastatic condition, adjusted their exercise activities to balance disease and treatment-induced deteriorations and boost themselves to feel hope and fight for cancer. However, the results may not be applicable to physically inactive patients. Future research to explore experiences from those with even worse physical conditions and further helping them to take some mild exercise to enhance the positive side of cancer experiences are suggested.

Long-Term Physical Exercise and Mindfulness Practice in an Aging Population.

Previous studies have shown that physical exercise and mindfulness meditation can both lead to improvement in physical and mental health. However, it is unclear whether these two forms of training share the same underlying mechanisms. We compared two groups of older adults with 10 years of mindfulness meditation (integrative body-mind training, IBMT) or physical exercise (PE) experience to demonstrate their effects on brain, physiology and behavior. Healthy older adults were randomly selected from a large community health project and the groups were compared on measures of quality of life, autonomic activity (heart rate, heart rate variability, skin conductance response, respiratory amplitude/rate), immune function (secretory Immunoglobulin A, sIgA), stress hormone (cortisol) and brain imaging (resting state functional connectivity, structural differences). In comparison with PE, we found significantly higher ratings for the IBMT group on dimensions of life quality. Parasympathetic activity indexed by skin conductance response and high-frequency heart rate variability also showed more favorable outcomes in the IBMT group. However, the PE group showed lower basal heart rate and greater chest respiratory amplitude. Basal sIgA level was significantly higher and cortisol concentration was lower in the IBMT group. Lastly, the IBMT group had stronger brain connectivity between the dorsal anterior cingulate cortex (dACC) and the striatum at resting state, as well as greater volume of gray matter in the striatum. Our results indicate that mindfulness meditation and physical exercise function in part by different mechanisms, with PE increasing physical fitness and IBMT inducing plasticity in the central nervous systems. These findings suggest combining physical and mental training may achieve better health and quality of life results for an aging population.

Exploring the Experience of Exercise in Older Adults With Chronic Back Pain.

Physical inactivity and chronic back pain are prevalent among older adults; however, there are individuals who persist in exercising despite daily pain. This research explored the meaning of exercise in the lives of older adults with chronic back pain. Hermeneutic phenomenology, valuing everyday experiences and highlighting meaning, was employed. Individual in-depth interviews with 10 adults aged 65 years and older gathered rich descriptions of their experiences. Data collection and analyses were iterative processes. The experience of exercise was inextricably connected with older adults' chronic back pain. The essence of embodied relief from pain offered by exercise was considered through themes reflecting the restoration of existential coherence-enjoying exercise experiences, social engagement, gratitude, learned latitudes, maintaining mobility, and aging. Understanding that older adults can live in their bodies pain-free for some time with regular physical activity may endorse adherence to exercise participation for maintained or improved well-being.

Comparison of Interval vs Continuous Exercise on a Cycle ergometer on Excess Post‐exercise Oxygen Consumption in Middle‐age

PurposeWe conducted measure EPOC in the continuous and interval exercise during or after exercise, and it was required to provide the same pre food intake, and the homogenizing the energy expenditure during exercise to minimize the extra variables to measure accurate EPOC. In addition, the purpose of to provide was prescription of exercise by verifying the effect of EPOC of the continuous and interval exercise in subjects with middle‐age without exercise experience. The purpose of the present study was to confirm that the difference of excess post‐exercise oxygen consumption (EPOC) during exercise of the spending the same amount of calories between the interval and continuous exercise.MethodsNineteen healthy middle‐age, who regularly not exercise trained in volunteered to participate in our study. The continuous exercise (CEx) was performed on a ergometer for 30 minutes at 60% of maximal oxygen consumption (VO2max), and the interval exercise (IEx) was performed on a ergometer with 80% VO2max for 2 minutes at the first time, followed by, exercise with 40% VO2max for 1 minutes and with 80% VO2max for 3 minutes were repeatedly performed 6 times for a total of 26 minutes. All subjects were fully acquainted with the nature of the study and informed of the experimental risks before signing a written consent form to participate. It was explicitly stated to the subjects that they could withdraw from the study at any point. All of them fully explained their pre‐test research and received voluntary consent.ResultsThe major findings were: 1. Energy consumption between continuous and interval exercise on an ergometer was homogenized (p = 0.503). 2. Which showed higher IEx than in the CEx in all variables of VO2_total (11043.58±7767.20 vs 11043.58±7767.20, p = .008), VO2/kg_total (248.21±42.72 vs 281.10±36.64, p <. 001), Kcal_total (53.15±37.18 vs 65.16±37.43, p < .003) and HR_sum was no significant difference. When the results of Oxygen deficient were examined, VO2_total (p < .001), Kcal_total (p < .001) and HR_sum (p = .001) showed a greater value than CEx in IEx.ConclusionOur study confirmed that when homogenizing the energy expenditure between interval and continuous exercise on an ergometer, EPOC is higher in interval exercise than continuous exercise in subjects with middle‐ages. This observation is important as it may help us understand why interval exercise has a greater propensity to induce weight loss than continuous exercise. Furthermore, this evidence provides a metabolic basis for an enhanced fat loss utilising interval training for exercise prescription recommendations for public health guidelines and weight management practices for reducing body fat. This must be qualified as appropriate in all populations, who can perform such exercise protocols weight loss and health promote and results in better health outcomes in “time poor” modern lifestyles.Support or Funding InformationThis work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF‐2019S1A5B8099542)

Does Perceived Stress Affect the Relationship Between Personality and Sports Enjoyment?

Abstract. Background: Sports enjoyment is a prerequisite for continued engagement in sports (e.g., Mullen et al., 2011 ; Woods, Tannehill, & Walsh, 2012 ). To date, it is understudied whether perceived stress and personality relate to the experience of sports enjoyment. Aim: The aim of the present study was to investigate the relationships between perceived stress, personality (the Big Five), and sports enjoyment. Method: Data were collected online from a group of N = 195 adults. There were two points of measurements with an interval of 4 weeks in between. Personality was assessed at t1, while perceived stress and sports enjoyment were measured at t2. Results: The results indicate that perceived stress is significantly related to sports enjoyment: A high amount of perceived stress was associated with less enjoyment of sports. Neuroticism, extraversion, conscientiousness, and agreeableness were related to sports enjoyment, but openness was not. Models testing the mediating effect of perceived stress for personality on sports enjoyment showed significant direct effects for extraversion and conscientiousness and significant indirect effects for neuroticism, extraversion, and conscientiousness. Limitations: Limitations concerning the sample characteristics and some poor fit statistics for the models including openness and extraversion are discussed. Conclusion: Overall, our findings suggest that perceived stress influences the affective experience in physical exercise.

How Do Patients With Axial Spondyloarthritis Experience High-Intensity Exercise?

ObjectiveIn a few studies, high‐intensity exercise has displayed beneficial effects on cardiovascular health among patients with rheumatic diseases, yet the high‐intensity exercise mode is still not fully accepted among health care professionals. The aim of this study was to investigate experiences of high‐intensity exercise among patients with axial spondyloarthritis.MethodsFourteen respondents who had participated in a high‐intensity exercise program for 12 weeks were included in this qualitative study with individual semistructured, in‐depth interviews. The respondents’ median age was 53, ranging from 23 to 63 years old, and both men and women of different ethnicities were represented. Interviews were analyzed by qualitative content analysis, including both manifest content and interpretations of underlying latent meaning.ResultsThe analysis resulted in five categories describing the respondents’ experiences with high‐intensity exercise: 1) high‐intensity exercise as a challenge for both body and mind, 2) increased faith in one's own body, 3) changed attitude toward exercise, 4) taking charge of one's own health by challenging the disease, and 5) exercise in a social context.ConclusionSupervised high‐intensity interval exercise was perceived as challenging for both body and mind but was also described as a positive experience, with rapid bodily effects that strengthened respondents’ faith in their own bodies. The new experience seemed to have changed the respondents’ attitude and motivation for exercise and made them start taking charge of their health by challenging the disease. Exercise in a social context, under professional leadership, enhanced exercise self‐efficacy and helped the respondents to adhere to the exercise program.

Physical activity for people with lung cancer.

International guidelines recommend exercise for all people with cancer. Effective supportive care interventions are required for people diagnosed with lung cancer to reduce morbidity associated with the disease process, frequently occurring comorbidities andtreatment-related side effects. This article summarises the evidence regarding the safety, effectiveness and patient experiences of exercise and physical activity interventions for people with lung cancer. Exercise interventions for people with lung cancer are safe and effective at improving physical fitness, muscle strength and patient-reported outcomes including cancer-related fatigue, dyspnoea and health-related quality of life. Increasing evidence supports the useof exercise prior to treatment (prehabilitation) to improve outcomes following surgery. Individuals with lung cancer should be encouraged to be as physically active as possible. Throughout the patient's cancer journey, consideration and prescription of individualised exercise is an important component of care. General practitioners are well placed to coordinate this care, often in conjunction with exercise physiologists orphysiotherapists.

What is the time cost of exercise? Cost of time spent on exercise in a primary health care intervention to increase physical activity

BackgroundIn health care interventions aimed at increased physical activity, the individual’s time spent on exercise is a substantial input. Time costs should therefore be considered in cost-effectiveness analyses. The aim of this study was to estimate the cost of time spent on exercise among 333 primary health care patients with metabolic risk factors receiving physical activity on prescription.MethodsBased on a theoretical framework, a yardstick was constructed with experience of work (representing claim of salary as compensation) as the lower anchor-point, and experience of leisure activity forgone due to extended exercise time (no claim) as the higher anchor-point. Using this yardstick experience of exercise can be valued. Another yardstick was constructed with experience of cleaning at home in combination with willingness to pay for cleaning as the lowest anchor-point.ResultsThe estimated costs of exercise time were between 14 and 37% of net wages, with physical activity level being the most important factor in determining the cost. Among sedentary individuals, the time cost was 21–51% of net wages while among individuals performing regular exercise it was 2–10%. When estimating the cost of time spent on exercise in a cost-effectiveness analysis, experience of exercise, work, leisure activity forgone, and cleaning at home (or other household work that may be relevant to purchase) should be measured. The individual’s willingness to pay for cleaning at home and their net salary should also be measured.ConclusionsWhen using a single valuation of cost of time spent on exercise in health care interventions, for employed participants 15–30% of net salary should be used. Among unemployed individuals, lower cost estimation should be applied. Better precision in cost estimations can be achieved if participants are stratified by physical activity levels.Trial registration The study was conducted as a survey of existing clinical physical activity on prescription work, and was approved by the Regional Ethical Review Board in Gothenburg, Sweden (ref: 678-14)

Validity and Reliability of a Smartphone Accelerometer for Measuring Lift Velocity in Bench-Press Exercises

The aim of this study was to determine the validity and reliability that a smartphone accelerometer (ACC) used by a mobile basic program (MBP) can provide to measure the mean velocity of a bench-press (BP) lift. Ten volunteers participated in the study (age 23.1 ± 2.5 years; mean ± SD). They had more than one year of resistance training experience in BP exercise. All performed three attempts with different loads: 70%, 90%, and 100% of the estimated value of the one-repetition maximum (1RM). In each repetition, the mean velocity was measured by a validated linear transducer and the ACC. The smartphone accelerometer used by the mobile basic program showed no significant differences between the mean velocities at 70% 1RM lifts (ACC = 0.52 ± 0.11 m/s; transducer = 0.54 ± 0.09 m/s, p > 0.05). However, significant differences were found in the mean velocities for 90% 1RM (ACC = 0.46 ± 0.09 m/s; transducer = 0.31 ± 0.03 m/s, p < 0.001), and 100% 1RM (ACC = 0.33 ± 0.21 m/s; transducer = 0.16 ± 0.04 m/s, p < 0.05). The accelerometer is sensitive enough to measure different lift velocities, but the algorithm must be correctly calibrated.

The Time Course of Inflammatory Biomarkers Following a One-Hour Exercise Bout in Canines: A Pilot Study.

Simple SummaryThe purpose of this study is to generate preliminary data on the inflammatory effects of an hour of hunting in dogs. Four basset hounds were set out to find a scent and freely adopted running or walking over wooded terrain for one hour. Blood samples were obtained before exercise and 1, 2, 4, 6, and 10 h after the end of the exercise for analysis of markers of inflammation (prostaglandin E2 (PGE2), nitric oxide (NO), interleukin 1β (IL-1β)), tumour necrosis factor-α (TNF-α)), and inflammation resolution (resolvin D1 (RvD1)). There was an increase in inflammation one hour after the exercise, shown by a significant increase in PGE2. Following the peak, PGE2 steadily declined at the same time as RvD1 increased, with RvD1 peaking at six hours. This pilot study provides evidence that dogs that undergo an hour of hunt exercise experience transient inflammation that peaks one hour after the end of exercise; inflammation resolution peaks six hours after the end of exercise. Future studies should seek to further understand the distinct and combined roles of PGE2 and RvD1 in dog adaptation to exercise stress.There is little information available to describe the inflammatory consequences of and recovery from moderate-intensity exercise bouts in hunting dogs. The purpose of the current study is to generate pilot data on the appearance and disappearance of biomarkers of inflammation and inflammation resolution following a typical one-hour exercise bout in basset hounds. Four hounds were set out to find a scent and freely adopted running or walking over wooded terrain for approximately one hour. Venous blood samples were obtained before the exercise and at 1, 2, 4, 6, and 10 h following cessation of exercise and were analyzed for biomarkers of inflammation (prostaglandin E2 (PGE2), nitric oxide (NO), interleukin 1β (IL-1β)) tumour necrosis factor-α (TNF-α)), and inflammation resolution (resolvin D1 (RvD1)). There was an increase in inflammation one hour after the exercise, shown by a significant increase in PGE2. Following this peak, PGE2 steadily declined at the same time as RvD1 increased, with RvD1 peaking at six hours. This pilot study provides evidence that dogs that undergo an hour of hunt exercise experience transient inflammation that peaks one hour after the end of exercise; inflammation resolution peaks six hours after the end of exercise. Future studies should seek to further understand the distinct and combined roles of PGE2 and RvD1 in dog adaptation to exercise stress.

Application of Wearables to Facilitate Virtually Supervised Intradialytic Exercise for Reducing Depression Symptoms.

Regular exercise can reduce depression. However, the uptake of exercise is limited in patients with end-stage renal disease undergoing hemodialysis. To address the gap, we designed a gamified non-weight-bearing intradialytic exercise program (exergame). The intradialytic exergame is virtually supervised based on its interactive feedback via wearable sensors attached on lower extremities. We examined the effectiveness of this program to reduce depression symptoms compared to nurse-supervised intradialytic exercise in 73 hemodialysis patients (age = 64.5 ± 8.7years, BMI = 31.6 ± 7.6kg/m2). Participants were randomized into an exergame group (EG) or a supervised exercise group (SG). Both groups received similar exercise tasks for 4 weeks, with three 30 min sessions per week, during hemodialysis treatment. Depression symptoms were assessed at baseline and the fourth week using the Center for Epidemiologic Studies Depression Scale. Both groups showed a significant reduction in depression score (37%, p < 0.001, Cohen’s effect size d = 0.69 in EG vs. 41%, p < 0.001, d = 0.65 in SG) with no between-group difference for the observed effect (p > 0.050). The EG expressed a positive intradialytic exercise experience including fun, safety, and helpfulness of sensor feedback. Together, results suggested that the virtually supervised low-intensity intradialytic exergame is feasible during routine hemodialysis treatment. It also appears to be as effective as nurse-supervised intradialytic exercise to reduce depression symptoms, while reducing the burden of administrating exercise on dialysis clinics.

Supervisees' experiences of a metacommunication intervention in clinical supervision

ObjectiveThis study aimed to explore the experiences of supervisees who completed a metacommunication intervention in supervision.MethodsForty‐eight supervisees completed the supervisory intervention and gave post‐intervention written feedback. Their responses were thematically analysed.ResultsOverall, supervisees responded positively to the intervention, with high willingness to engage in metacommunication again in supervision. Thematic analysis of the reflective written responses completed post‐intervention revealed a rich array of supervisee experiences of the metacommunication exercise. Supervisees spoke of anticipated/intended impacts on supervision and their therapy practice, including: greater depth of reflection, attending to parallel process, discussion of roles, increased closeness, improved openness, and increased confidence in metacommunication. In regard to challenges associated with the supervisory intervention, participants reflected on difficulties with timing, experiences of discomfort and concerns about potential negative reactions from the supervisor, and consideration of power dynamics in supervision.ConclusionThis study shows promising preliminary results of the acceptability and perceived impacts of an experiential intervention involving the use of metacommunication in supervision.

A Study on Breast Cancer Patients’ Commitment to a Plan for Exercise based on Health Beliefs

Purpose: The purpose of this study was to identify the factors relating to commitment to a plan for exercise in the breast cancer patient following a mastectomy and to examine the relationship between these factors.Methods: This study was a correlational research and the participants were 152 patients with breast cancer. Data were collected using a structured questionnaire from June to October, 2015.Results: The final regression model showed that income, experience of exercise and current exercise were significant predictors related to commitment to a plan for exercise in patients with breast cancer and explained for 65.9% of the variance in commitment to a plan for exercise.Conclusion: The findings indicate that patients in breast cancer-oriented intervention programs have an enhancing experience of exercise. Current exercise should be provided for patients with breast cancer in order to promote health and quality of life.

Prescription of individual therapeutic exercises via smartphone app for patients suffering from non-specific back pain : Aqualitative feasibility and quantitative pilot study.

SummaryBackgroundThe purpose of this qualitative study was the assessment of the feasibility and acceptance of orthopedists prescribing individualized therapeutic exercises via a smartphone app to patients suffering from non-specific back pain.MethodsA total of 27 patients (mean age 44.8 ± 13.2 years) diagnosed with acute non-specific back pain were prescribed individually chosen therapy exercises via a smartphone app. Before the patients started and after 4 weeks of exercising all participants went through an assessment protocol consisting of questionnaires (Oswestry Disability Index [ODI], Short Form-36 [SF-36], International Physical Activity Questionnaire [IPAQ], Work Ability Index [WAI], Visual Analogue Scale [VAS] back pain, sociodemographic parameters), assessment of functional parameters (handgrip strength, timed up and go test). With 16 randomly chosen patients semi-structured interviews were undertaken at the end of the intervention period. Interview transcripts were analyzed using thematic analysis. Power analysis and a priori sample size calculations were undertaken with the quantitative data.ResultsFrom the interviews four thematic categories emerged: prior exercise experience, evaluation of exercise intensity, communication with physician via smartphone app, and variability of exercise location. Quantitative analysis of secondary data showed significant improvements in back pain (ODI) as well as quality of life domains “physical functioning”, “bodily pain” and “vitality” (SF-36) of which “bodily pain” was sufficiently powered with the current sample size.ConclusionThe prescription of therapeutic exercises via smartphone app to patients suffering from non-specific back pain is feasible and well-accepted in patients at all ages. Pilot data additionally pointed towards efficacy of the intervention.

Understanding Exercise Adherence: The Predictability of Past Experience and Motivational Determinants.

Background: An unresolved debate lingers over the effect of past behavior on motivational patterns and future behavior stability in the exercise context. Theorists argue that past behavior has a residual effect on future behavior; however, empirical studies have shown that past behavior displays significant power in predicting behavior recurrence in the future. The present research aimed to examine the effect of past behavior and motivational determinants on future exercise adherence. Methods: Data from 437 Portuguese gym exercisers (female = 235; male = 202) aged between 18 and 53 years (M = 31.14; SD = 9.47), with exercise experience ranging from 6 to 12 months (M = 9.41; SD = 1.33) were considered for research. Participants completed a multi-section survey measuring interpersonal behaviors, basic psychological needs, behavioral regulations, and intentions. Data from past behavior and future exercise adherence were collected using computerized records of their attendance at the gym. Results: Positive and significant correlations paths were evidenced among perceived supportive behaviors, needs satisfaction, autonomous motivation, intentions and future exercise adherence. Similar results were presented among perceived thwarting behaviors, needs frustration, and controlled motivation. Regression paths showed that perceived supportive behavior, basic needs satisfaction, and autonomous motivation displayed positive and significant effects on future behaviors; thus, past behavior displayed the highest coefficient on future exercise adherence. Fitness professionals should aim at creating supportive environments, thus, improving the likelihood of being perceived by exercisers as need-supportive individuals. By doing so, as a result, exercisers would experience increased levels of autonomous motivation and higher rates of future exercise attendance at the gym. Hence, exercisers will gradually form their positive past exercise experience, increasing the probability of engaging in an exercise in the future.

Experiences of physical activity and exercise in individuals with systemic sclerosis: A qualitative study.

Exercise is emerging as an important part of the treatment in systemic sclerosis-patients with no-mild lung involvement. However, it has not been studied how patients experience physical activity and exercises. We thus explored and described experiences of physical activity/exercises in systemic sclerosis-individuals. Sixteen systemic sclerosis-patients were purposefully recruited to represent variation in gender, age, and lung disease. Semi-structured individual interviews were performed, transcribed and analyzed with qualitative content analysis. Three themes (categories) emerged: 1) Essential for life and health (An effective treatment, Reduces fear of deterioration, and Feeling healthy and satisfied with oneself); 2) Disease-related hinders and other barriers (Disease consequences, Risk of worsening, and Non-disease related barriers); and 3) Self-care and/or support (Self-confidence in physical activity/exercise, and, Education and support from healthcare and other). Physical activity/exercises were experienced as essential for life and health and as an effective treatment. It reduced fear of deterioration and made the participants feel healthy and satisfied with oneself. However, participants also experienced disease-related barriers like shortness of breath and pain, and they expressed a risk of worsening. Participants felt confidence in their physical activity/exercises and expressed that education and support from healthcare could be facilitating. Our findings add new knowledge about how systemic sclerosis-patients perceive physical activity/exercise and can contribute to the development of patient education and PA/exercise programs.

Enjoyment and acceptability of different exercise modalities to improve bone health in young adult women.

Osteoporosis presents a serious public health issue and physical activity is recognised as the most effective modifiable risk factor for the condition. The reasons behind physical activity participation, however, are complex. We therefore aimed to explore the experiences related to a bone-targeted exercise intervention, determine enjoyment and acceptability of each exercise mode, and identify barriers and facilitators to osteogenic exercise for young adult women. The present study was conducted within the Osteoporosis Prevention Through Impact and Muscle-loading Approaches to Exercise (OPTIMA-Ex) trial, a three-arm RCT comparing musculoskeletal outcomes from two supervised, high-intensity, exercise programs (impact and resistance training) with an unsupervised low-intensity exercise control. A mixed-methods approach was used, including quality of life and physical activity enjoyment questionnaires and qualitative analysis of semi-structured interviews. All groups had improvements in the 'mental health' domain of the quality of life measure; however, the two supervised exercise groups had greater levels of physical activity enjoyment. The qualitative analysis revealed that overall the trial activities were positively, yet the two supervised groups had 'richer' exercise experiences. Motivations for participation, barriers to physical activity and desired continuation of participation differed between all three groups. Findings suggest that bone-targeted exercise interventions for young adult women must address perceived time demands and environmental barriers to participation in order to maximise compliance and adherence. SO WHAT?: As physical activity is the most effective lifestyle strategy to improve bone health and young adulthood an important window for its augmentation, increasing convenience, accessibility and understanding of osteoporosis preventative behaviours in this demographic is vital.

Achieving research impact in tourism: Modelling and evaluating outcomes from the UKs Research Excellence Framework

Abstract The marketisation of higher education has emerged as a global trend with a focus on using metrics to assess performance. This has led to the closer scrutiny by government in assessing value for money and effectiveness of research outcomes in national allocations of research funding. This paper focuses on one controversial strand of assessing research outcomes - the area of research impact. The paper examines the experiences of the UKs Research Assessment Exercise in 2014 and the tourism impact case studies developed as part of institutional submissions on research impact. The paper examines the case studies using Qualitative Comparative Analysis (QCA), which is a set-theoretic method, to identify what a high quality impact case study looks like from a range of criteria. The paper derives a wider range of implications for tourism scholars that has wider application across other areas in which Tourism is located.

The real experience of postoperative functional exercise in PICC patients: a qualitative research

Objective To explore the real experience of functional exercise after PICC operation. Methods Phenomenological methods were used to conduct semi-structured interviews with 15 patients who had different functional exercises after PICC. Colaizzi phenomenological analysis was used to analyze the data. Results Through interviews, four themes were drawn: the exercise characteristics of different postoperative functional exercise, the benefits of postoperative functional exercise, the obstacles to postoperative functional exercise and the suggestions for education related to postoperative functional exercise. Conclusion The patients with PICC think that the postoperative functional exercise is safe and practical, but the recognition and compliance of the postoperative functional exercise are still limited. It is suggested that appropriate training should be carried out among medical staff, so as to rationally select the way of postoperative functional exercise, further promote the application of postoperative functional exercise, and improve the compliance and experience of patients. Key words: Catheterization, central venous; Exercise; Qualitative research; Nursing care