Peak oxygen uptake in relation to total heart volume discriminates heart failure patients from healthy volunteers and athletes

Background: An early sign of heart failure (HF) is a decreased cardiac reserve or inability to adequately increase cardiac output during exercise. Under normal circumstances maximal cardiac output is closely related to peak oxygen uptake (VO(2)peak) which has previously been shown to be closely related to total heart volume (THV). Thus, the aim of this study was to derive a VO(2)peak/THV ratio and to test the hypothesis that this ratio can be used to distinguish patients with HF from healthy volunteers and endurance athletes. Thirty-one patients with HF of different etiologies were retrospectively included and 131 control subjects (60 healthy volunteers and 71 athletes) were prospectively enrolled. Peak oxygen uptake was determined by maximal exercise test and THV was determined by cardiovascular magnetic resonance. The VO(2)peak/THV ratio was then derived and tested. Results: Peak oxygen uptake was strongly correlated to THV (r(2) = 0.74, p < 0.001) in the control subjects, but not for the patients (r(2) = 0.0002, p = 0.95). The VO(2)peak/THV ratio differed significantly between control subjects and patients, even in patients with normal ejection fraction and after normalizing for hemoglobin levels (p < 0.001). In a multivariate analysis the VO(2)peak/THV ratio was the only independent predictor of presence of HF (p < 0.001). Conclusions: The VO(2)peak/THV ratio can be used to distinguish patients with clinically diagnosed HF from healthy volunteers and athletes, even in patients with preserved systolic left ventricular function and after normalizing for hemoglobin levels

Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348

Improving Transparency in European Sport Coach Education

Name of Project: Improving Transparency in European Sport Coach Education ( www.itesce.eu ) Presenter: Torsten Buhre, Phd, Malmö University Purpose: The project has a two folded purpose 1) To create structures of coach education in Sweden, Denmark and Hungary that are aligned with the European Framwork for Recognition of Coach Competenci and Qualifications (EFRCCQ) as developed by the European Coaching Council (ECC) and the AEHESIS-project. 2) To test the possibility of financing such a project through Leonardo daVinci “Transfer of Innovations”. Methods and process: To use 6-step model , EQF and EFRCCQ to create transparency for European Sports Coach Education in Hungary, Denmark and Sweden. In addition to this other useful resources has been used i.e. from the International Tennis Federation . The process is a combination of guidance, dialogue, reflexion and work assignments. Two tracks are running parallel to each other 1) at the national level and 2) at the international. Results: In Denmark the coach education is a dual responsibility between the sports confederation and the different national sports federation. Currently we are adjusting the existing program to EQF-levels and analysing the learning outcomes in relation to step four in the 6-step model. In Hungary the coach education is the responsibility of both vocational education institutes and institutions of higher education. The coaching profession requires a coaching certificate regardless of what level of coaching and domain. Currently we are evaluating the existing programs to EQF-levels and analysing learning outcomes to step four in the 6-step model. In Sweden the coach education is the responsibility of the national sport federations. The coaching profession does not require a certificate. Currently we are developing and analyzing learning outcomes in relation to points of reference. Participants: Hungarian Sports Confederation , Danish Sports Confederation , Swedish Sports Confederation, Scania Sport Confederation, Swedish Tennis Federation, Swedish Swimming Federation, Swedish Track and Field Federation , Swedish Soccer Federation, Swedish Floorball Federation, Malmö University and Växjö University

How speed makes a difference : A case study of 100- meter races

Swimming faster has always been of interest to coaches. How we perceive time and swimming speed is vital to how we train, interpret the results of training, plan for completion and evaluate performance. Modern technology has broadened our perspective on how to interpret performance. The data was collected online (www.swim.ee) and statistical tests were used to analyze the results. In all 100 meter events at the European short course and long course championships, The swimmers were swimming slower as a group from 15 to 95 meters, regardless of stroke, course and sex. The differences that occur in swimming speed during 100 m races are larger than the difference that can have an impact on placing at the end of the race. We hypothesize; that the difference in swimming speed between fixed points occurs continuously because of the density of water creates a high resistance that the swimmer has to over-come, thus leading to a reduction in swimming speed between individual stroke-cycles. Interpreting the difference in time at the finish of the race, or differences in split-times during the race increases the the magnitude of improvements that has to be made in order to improve performance. By looking at swimming speed instead of time differences, a reduction of the magnitude in the improvement-gap becomes manageable. This has implications for both training an d competition, because it changes the perception of how performance can be improved from physiological, biomechanical and psychological perspectives

Difference in speed at fixed reference points, and changes in speed between fixed reference points, during 100 meter swimming races at the European Championships, 2010

The purpose was to examine the differences and relationships between speed variables and performance in 100 meter events at the European Championships long course (LC) and short course (SC) for all strokes and gender. Data was collected from the website www.swim.ee, transformed, and analyzed using statistical methods. Swimming speed (SS) at different reference points was significantly different for in both short course (SC) and long course (LC) swimming, SS15>SS35>SS45SS85>SS95. The effect size for all measures was large (Cohen ́s d). The changes in SS between reference points was significantly different in all events for both sexes in both SC and LC swimming, δSS15:35> δSS35:45, but only for SC when comparing δSS85:95> δSS65:85. Correlations of placing at the end of the race, split times for each 50 m segment and SS at different reference points, showed no clear pattern. The differences in the swimming speed variables, can be explained based on the theory of complexity and performance, utilizing previous research findings and the standard equation of drag force in fluids. Thus taking into account all different aspects of performance. The managing of speed through out a race needs to be a special focus in both training and competition. Thus, allowing for a more individualized approach both in utilizing training methods training and analysis of performance in 100 m race

How speed makes a difference : A case study of 100- meter races

Swimming faster has always been of interest to coaches. How we perceive time and swimming speed is vital to how we train, interpret the results of training, plan for completion and evaluate performance. Modern technology has broadened our perspective on how to interpret performance. The data was collected online (www.swim.ee) and statistical tests were used to analyze the results. In all 100 meter events at the European short course and long course championships, The swimmers were swimming slower as a group from 15 to 95 meters, regardless of stroke, course and sex. The differences that occur in swimming speed during 100 m races are larger than the difference that can have an impact on placing at the end of the race. We hypothesize; that the difference in swimming speed between fixed points occurs continuously because of the density of water creates a high resistance that the swimmer has to over-come, thus leading to a reduction in swimming speed between individual stroke-cycles. Interpreting the difference in time at the finish of the race, or differences in split-times during the race increases the the magnitude of improvements that has to be made in order to improve performance. By looking at swimming speed instead of time differences, a reduction of the magnitude in the improvement-gap becomes manageable. This has implications for both training an d competition, because it changes the perception of how performance can be improved from physiological, biomechanical and psychological perspectives

How speed makes a difference : A case study of 100- meter races

Swimming faster has always been of interest to coaches. How we perceive time and swimming speed is vital to how we train, interpret the results of training, plan for completion and evaluate performance. Modern technology has broadened our perspective on how to interpret performance. The data was collected online (www.swim.ee) and statistical tests were used to analyze the results. In all 100 meter events at the European short course and long course championships, The swimmers were swimming slower as a group from 15 to 95 meters, regardless of stroke, course and sex. The differences that occur in swimming speed during 100 m races are larger than the difference that can have an impact on placing at the end of the race. We hypothesize; that the difference in swimming speed between fixed points occurs continuously because of the density of water creates a high resistance that the swimmer has to over-come, thus leading to a reduction in swimming speed between individual stroke-cycles. Interpreting the difference in time at the finish of the race, or differences in split-times during the race increases the the magnitude of improvements that has to be made in order to improve performance. By looking at swimming speed instead of time differences, a reduction of the magnitude in the improvement-gap becomes manageable. This has implications for both training an d competition, because it changes the perception of how performance can be improved from physiological, biomechanical and psychological perspectives

Good practices in transnational coach education development.

Good practice in developing transnational transparency in coach education system. Introduction: The AEHESIS project (Petry, 2007) developed reference points for comparison of coach education in a transnational perspective. Crucial for developing transparency of these different components of coach education systems is both an understanding of the purpose and current outcomes of the Bologna process (European Commission, 2009) and also a competence on educational development in relation to matching learning outcomes with methods of assessment to monitor the competence development of students (Biggs, 1996). Methods: The project has resourced these three areas and applied two types of methodologies, based on both the AEHESIS project (Petry, 2006) and documentation from the European Observatory of Sports employment, (EOSE, 2009) to develop and describe learning outcomes and assessment methods. An additional important question to address when implementing a new educational structure in coach education has been validation of prior learning (CEDEFOP, 2007) , i.e. recognizing the formal, informal and non formal strategies that have been used on an individual basis to develop the competency needed for the coaching profession. Participants: Based on the participation of and cooperation between different types of organisations (institutions of higher education, national confederations, and national sport federations) in Hungary, Denmark and Sweden, the project “Improving transparency in European Sport Coach Education” has resulted in a variety of outcomes that could be described as “good practice” in the area of coach education system development. Results: The outcomes from the project are both of tangible and intangible nature. On one hand there are results pertaining to such concrete issues as learning outcomes and assessment methods based on the concept of constructive alignment (ITESCE, 2010). On the other hand the project experience lead to realizations in regards to more abstract issues such as learning process (ITESCE, 2010), procedure or course of action, in this project funded by the European commission´s life-long learning programmes through the Leonardo da Vinci initiative