Investigating the effects of typical rowing strength training practices on strength and power development and 2,000m rowing performance

This study aimed to determine the effects of a short-term, strength training intervention, typically undertaken by club-standard rowers, on 2,000 m rowing performance and strength and power development. Twenty-eight male rowers were randomly assigned to intervention or control groups. All participants performed baseline testing involving assessments of muscle soreness, creatine kinase activity (CK), maximal voluntary contraction (leg-extensors) (MVC), static-squat jumps (SSJ), counter-movement jumps (CMJ), maximal rowing power strokes (PS) and a 2,000 m rowing ergometer time-trial (2,000 m) with accompanying respiratory-exchange and electromyography (EMG) analysis. Intervention group participants subsequently performed three identical strength training (ST) sessions, in the space of five days, repeating all assessments 24 h following the final ST. The control group completed the same testing procedure but with no ST. Following ST, the intervention group experienced significant elevations in soreness and CK activity, and decrements in MVC, SSJ, CMJ and PS (p < 0.01). However, 2,000 m rowing performance, pacing strategy and gas exchange were unchanged across trials in either condition. Following ST, significant increases occurred for EMG (p < 0.05), and there were non-significant trends for decreased blood lactate and anaerobic energy liberation (p = 0.063 – 0.086). In summary, club-standard rowers, following an intensive period of strength training, maintained their 2,000 m rowing performance despite suffering symptoms of muscle damage and disruption to muscle function. This disruption likely reflected the presence of acute residual fatigue, potentially in type II muscle fibres as strength and power development were affected

Chemoprophylaxis after oncological resections

BackgroundNational societies recommend extended-duration VTE chemoprophylaxis for up to 4 weeks following major oncologic resections with the literature demonstrating an incidence of approximately 2% for symptomatic VTE. Despite this, patients are not routinely discharged on VTE chemoprophylaxis at our institution. MethodsA retrospective chart review was performed for major abdominal oncologic resections, including esophagectomy, at an academic community cancer center between 2016 and 2021. The primary outcome was the incidence of clinically evident VTE events (defined as lower extremity deep vein thrombosis (LE DVT) or pulmonary embolism (PE)) within 30 days of discharge and diagnosed on re-presentation. Exclusion criteria included in-hospital mortality, in-hospital VTE, or discharge on anti-coagulation. Comparisons were performed using Fisher’s Exact and Mann-Whitney test.ResultsAfter exclusion criteria were applied, 458 patients were identified. A total of 6 (1.3%) patients developed symptomatic VTEs, 5 (1.1%) PEs and 3 (0.7%) DVTs. No procedural interventions were required. On average, patients re-presented 14.3 (±8.4) days after discharge. There were no mortalities within 30 days of discharge. Intraoperatively, estimated blood loss in VTE group was decreased (150 vs 88 mL, p=0.01), while length of inpatient hospitalization (6.5 vs 10 days, p=0.05) was increased. Type of operation demonstrated an increased proportion of esophagectomy (9.6% vs 16.7%, p=0.57), palliative bypass (8.1% vs 33.3%, p=0.08) and small bowel resection (7.9% vs 33.3%, p=0.08) in the VTE group. Conclusion   The percentage of symptomatic VTEs in our patients was not higher then reported averages despite no patient receiving chemoprophylaxis. Questions remain as to which subset of patients would benefit from chemoprophylaxis after major abdominal oncologic resection. Further investigation into long term effects of asymptomatic DVT should be undertaken. 

Optimising skill-mix in the primary health care workforce for the care of older Australians: a systematic review

Australia has an ageing population resulting in demand for extensive and comprehensive care of chronic disease. This demand has required new thinking about primary health care workforce re-modelling to meet the health care needs of community dwelling older Australians. Sibbald and others have developed a model of skill-mix change to discuss workforce redesign. We conducted a systematic literature review to identify skill-mix changes needed in the primary health care workforce to successfully meet the health care needs of older Australians. Sibbald's concept that skill-mix changes could be obtained through task substitution, enhancement, delegation and innovation formed the conceptual framework for the review.The research reported in this paper is a project of the Australian Primary Health Care Research Institute, which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research, Evaluation and Development Strategy

An exploration of how young people and parents use online support in the context of living with cystic fibrosis

Background: There is increasing recognition of the Internet's potential role in providing information and support for people living with long-term conditions. However, how young people and parents use online forms of self-care support in the context of living with childhood chronic illness has been under-researched. Objective: To explore how online peer support is used by young people and parents to support self-care in relation to cystic fibrosis (CF). Setting and participants: Online forum for young people and parents based on a CF charity website. A total of 279 individuals participated in the forum during the study. Design: An online ethnographical approach, involving observing, downloading and analysing discussion group postings. All postings made over a random 4-month period were included (151 discussion threads). Results: The online setting enabled a physically disconnected group to connect and create a safe space to collectively share experiences and receive support to manage and live with cystic fibrosis. Participants exchanged experientially derived advice and views on how to manage treatments, emotions, relationships, identity and support from services. While parents sought information and support on managing specific therapies/services and ways of maintaining their child's health, the information and support young people desired appeared to be more directed at how to 'fit' CF into their everyday lives. Discussion and conclusions: Online support groups appear to supplement professional support in relation to self-management. They enable young people and parents to share experiences, feelings and strategies for living with long-term conditions with peers and develop the expertise to empower them in interactions with health-care professionals

Speech and language therapy for aphasia following stroke

Background  Aphasia is an acquired language impairment following brain damage that affects some or all language modalities: expression and understanding of speech, reading, and writing. Approximately one third of people who have a stroke experience aphasia.  Objectives  To assess the effects of speech and language therapy (SLT) for aphasia following stroke.  Search methods  We searched the Cochrane Stroke Group Trials Register (last searched 9 September 2015), CENTRAL (2015, Issue 5) and other Cochrane Library Databases (CDSR, DARE, HTA, to 22 September 2015), MEDLINE (1946 to September 2015), EMBASE (1980 to September 2015), CINAHL (1982 to September 2015), AMED (1985 to September 2015), LLBA (1973 to September 2015), and SpeechBITE (2008 to September 2015). We also searched major trials registers for ongoing trials including ClinicalTrials.gov (to 21 September 2015), the Stroke Trials Registry (to 21 September 2015), Current Controlled Trials (to 22 September 2015), and WHO ICTRP (to 22 September 2015). In an effort to identify further published, unpublished, and ongoing trials we also handsearched theInternational Journal of Language and Communication Disorders(1969 to 2005) and reference lists of relevant articles, and we contacted academic institutions and other researchers. There were no language restrictions.  Selection criteria  Randomised controlled trials (RCTs) comparing SLT (a formal intervention that aims to improve language and communication abilities, activity and participation) versus no SLT; social support or stimulation (an intervention that provides social support and communication stimulation but does not include targeted therapeutic interventions); or another SLT intervention (differing in duration, intensity, frequency, intervention methodology or theoretical approach).  Data collection and analysis  We independently extracted the data and assessed the quality of included trials. We sought missing data from investigators.  Main results  We included 57 RCTs (74 randomised comparisons) involving 3002 participants in this review (some appearing in more than one comparison). Twenty-seven randomised comparisons (1620 participants) assessed SLT versus no SLT; SLT resulted in clinically and statistically significant benefits to patients' functional communication (standardised mean difference (SMD) 0.28, 95% confidence interval (CI) 0.06 to 0.49, P = 0.01), reading, writing, and expressive language, but (based on smaller numbers) benefits were not evident at follow-up. Nine randomised comparisons (447 participants) assessed SLT with social support and stimulation; meta-analyses found no evidence of a difference in functional communication, but more participants withdrew from social support interventions than SLT. Thirty-eight randomised comparisons (1242 participants) assessed two approaches to SLT. Functional communication was significantly better in people with aphasia that received therapy at a high intensity, high dose, or over a long duration compared to those that received therapy at a lower intensity, lower dose, or over a shorter period of time. The benefits of a high intensity or a high dose of SLT were confounded by a significantly higher dropout rate in these intervention groups. Generally, trials randomised small numbers of participants across a range of characteristics (age, time since stroke, and severity profiles), interventions, and outcomes.  Authors' conclusions  Our review provides evidence of the effectiveness of SLT for people with aphasia following stroke in terms of improved functional communication, reading, writing, and expressive language compared with no therapy. There is some indication that therapy at high intensity, high dose or over a longer period may be beneficial. HIgh-intensity and high dose interventions may not be acceptable to all

Reciprocity as a foundation of financial economics

This paper argues that the subsistence of the fundamental theorem of contemporary financial mathematics is the ethical concept ‘reciprocity’. The argument is based on identifying an equivalence between the contemporary, and ostensibly ‘value neutral’, Fundamental Theory of Asset Pricing with theories of mathematical probability that emerged in the seventeenth century in the context of the ethical assessment of commercial contracts in a framework of Aristotelian ethics. This observation, the main claim of the paper, is justified on the basis of results from the Ultimatum Game and is analysed within a framework of Pragmatic philosophy. The analysis leads to the explanatory hypothesis that markets are centres of communicative action with reciprocity as a rule of discourse. The purpose of the paper is to reorientate financial economics to emphasise the objectives of cooperation and social cohesion and to this end, we offer specific policy advice

ROS-dependent signaling pathways in plants and algae exposed to high light: Comparisons with other eukaryotes

Abstract Like all aerobic organisms, plants and algae co-opt reactive oxygen species (ROS) as signaling molecules to drive cellular responses to changes in their environment. In this respect, there is considerable commonality between all eukaryotes imposed by the constraints of ROS chemistry, similar metabolism in many subcellular compartments, the requirement for a high degree of signal specificity and the deployment of thiol peroxidases as transducers of oxidizing equivalents to regulatory proteins. Nevertheless, plants and algae carry out specialised signaling arising from oxygenic photosynthesis in chloroplasts and photoautotropism, which often induce an imbalance between absorption of light energy and the capacity to use it productively. A key means of responding to this imbalance is through communication of chloroplasts with the nucleus to adjust cellular metabolism. Two ROS, singlet oxygen (1O2) and hydrogen peroxide (H2O2), initiate distinct signaling pathways when photosynthesis is perturbed. 1O2, because of its potent reactivity means that it initiates but does not transduce signaling. In contrast, the lower reactivity of H2O2 means that it can also be a mobile messenger in a spatially-defined signaling pathway. How plants translate a H2O2 message to bring about changes in gene expression is unknown and therefore, we draw on information from other eukaryotes to propose a working hypothesis. The role of these ROS generated in other subcellular compartments of plant cells in response to HL is critically considered alongside other eukaryotes. Finally, the responses of animal cells to oxidative stress upon high irradiance exposure is considered for new comparisons between plant and animal cells