This case study involves the progression from a cognitive-behavioral, psychological skills training approach with a rugby football player experiencing adjustment and mood disorder to a psychodynamic and interpersonal engagement with the client using themes from Buddhist psychotherapy. The study charts the development of the psychologist’s understanding of his relationships with clients and with his supervisor. We present a study of three people (i.e., the client, the psychologist, the supervisor) and how their stories and interpersonal interactions are interwoven from a Buddhist-psychodynamic perspective. We examine the influences of the dominant White culture on the male psychologist’s perceptions contrasted with the client’s background as a Pacific Islander. In addition, we present a projective test, which was central to the unfolding of this case study, designed for use with athletes. This case study is a confessional tale (Sparkes, 2002) told in the first-person from the psychologist’s viewpoint.
Campbell Thompson and Mark B. Andersen
Travis Saunders, Nerissa Campbell, Timothy Jason, Gail Dechman, Paul Hernandez, Kara Thompson, and Chris M. Blanchard
Although individual studies have reported on the number of steps/day taken by individuals with chronic obstructive pulmonary disease (COPD), this evidence has not been systematically reviewed or synthesized.
MEDLINE and PsycINFO were searched for studies reporting objectively-measured steps/day and percent predicted forced expiratory volume in 1 second (FEV1%) in patients with COPD. Meta-analyses were used to estimate steps/day across studies, while metaregression was used to estimate between-study variance based on clinical and demographic factors (year and location of study, activity monitor brand, number of days wearing the monitor, whether participants were about to enter pulmonary rehabilitation, 6-minute walk distance (6MWD), FEV1%, age, and sex).
38 studies including 2621 participants met inclusion criteria. The pooled mean estimate was 4579 steps/day (95% CI:4310 to 5208) for individuals with COPD. Only 6MWD, FEV1% and whether patients were about to undergo pulmonary rehabilitation explained a significant portion of the variance (P < 0.1) in univariate meta-regression. In a multivariate model including the above risk factors, only FEV1% was associated with steps/day after adjustment for other covariates.
These results indicate that patients with COPD achieve extremely low levels of physical activity as assessed by steps/day, and that severity of airflow obstruction is associated with activity level.