Age, sex and (the) race: gender and geriatrics in the ultra-endurance age

Ultra-endurance challenges were once the stuff of legend isolated to the daring few who were driven to take on some of the greatest physical endurance challenges on the planet. With a growing fascination for major physical challenges during the nineteenth century, the end of the Victorian era witnessed probably the greatest ultra-endurance race of all time; Scott and Amundsen’s ill-fated race to the South Pole. Ultra-endurance races continued through the twentieth century; however, these events were isolated to the elite few. In the twenty-first century, mass participation ultra-endurance races have grown in popularity. Endurance races once believed to be at the limit of human durability, i.e. marathon running, are now viewed as middle-distance races with the accolade of true endurance going to those willing to travel significantly further in a single effort or over multiple days. The recent series of papers in Extreme Physiology & Medicine highlights the burgeoning research data from mass participation ultra-endurance events. In support of a true ‘mass participation’ ethos Knetchtle et al. reported age-related changes in Triple and Deca Iron-ultra-triathlon with an upper age of 69 years! Unlike their shorter siblings, the ultra-endurance races appear to present larger gender differences in the region of 20% to 30% across distance and modality. It would appear that these gender differences remain for multi-day events including the ‘Marathon des Sables’; however, this gap may be narrower in some events, particularly those that require less load bearing (i.e. swimming and cycling), as evidenced from the ‘Ultraman Hawaii’ and ‘Swiss Cycling Marathon’, and shorter (a term I used advisedly!) distances including the Ironman Triathlon where differences are similar to those of sprint and endurance distances i.e. c. 10%. The theme running through this series of papers is a continual rise in participation to the point where major events now require selection races to remain within reasonable limits. With the combination of distance and environment placing a significant physiological bordering on pathophysiological burden on the participants of such events, one question remains: Are we destined for another Scott vs. Amundsen? How long is too long

A Comparative Analysis of the Major Religions in Japan and Korea During the Colonial Period

To understand why the Christian gospel has success amid one culture, while seeming to fail in similar, neighboring cultures, one must look to additional factors than those often cited by missionary sources. Some of these factors would include the socio -political and religious context of each of those cultures in question, in addition to the prior encounters with Christianity and the reactions to the gospel by the receiving cultures. To illustrate this need, this paper analyzes the contexts of Japan and Korea during the period of Japanese expansion and wartime (1894 – 1945), and looks specifically at what was happening in the other major religions present at the time (Confucianism, Buddhism, and Shintoism), which would include their responses to the Christian missionary presence

Acute impact of inhaled short acting b2-agonists on 5 km running performance

Whilst there appears to be no ergogenic effect from inhaled salbutamol no study has investigated the impact of the acute inhalation of 1600 µg, the World Anti-Doping Agency (WADA) daily upper limit, on endurance running performance. To investigate the ergogenic effect of an acute inhalation of short acting ?2-agonists at doses up to 1600 µg on 5 km time trial performance and resultant urine concentration. Seven male non-asthmatic runners (mean ± SD; age 22.4 ± 4.3 years; height 1.80 ± 0.07 m; body mass 76.6 ± 8.6 kg) provided written informed consent. Participants completed six 5 km time-trials on separate days (three at 18 °C and three at 30 °C). Fifteen minutes prior to the initiation of each 5 km time-trial participants inhaled: placebo (PLA), 800 µg salbutamol (SAL800) or 1600 µg salbutamol (SAL1600). During each 5 km time-trial HR, VO2, VCO2, VE, RPE and blood lactate were measured. Urine samples (90 ml) were collected between 30-180 minutes post 5 km time-trial and analysed for salbutamol concentration. There was no significant difference in total 5 km time between treatments (PLA 1714.7 ± 186.2 s; SAL800 1683.3 ± 179.7 s; SAL1600 1683.6 ± 190.7 s). Post 5 km time-trial salbutamol urine concentration between SAL800 (122.96 ± 69.22 ug·ml(-1)) and SAL1600 (574.06 ± 448.17 ug·ml(-1)) were not significantly different. There was no improvement in 5 km time-trial performance following the inhalation of up to 1600 µg of salbutamol in non-asthmatic athletes. This would suggest that the current WADA guidelines, which allow athletes to inhale up to 1600 µg per day, is sufficient to avoid pharmaceutical induced performance enhancement. Key pointsInhaling up to 1600 µg of Salbutamol does not result in improved 5 km time trial performance.The position of Salbutamol on the World Anti-Doping Agency list of prohibited appears justified.Athletes who use up to 1600 µg Salbutamol in one day need to review their therapy as it would suggest their respiratory condition is not under control

Global and regional cardiac function in lifelong endurance athletes with and without myocardial fibrosis

The aim of the present study was to compare cardiac structure as well as global and regional cardiac function in athletes with and without myocardial fibrosis (MF). Cardiac magnetic resonance imaging with late gadolinium enhancement was used to detect MF and global cardiac structure in nine lifelong veteran endurance athletes (58 ± 5 years, 43 ± 5 years of training). Transthoracic echocardiography using tissue-Doppler and myocardial strain imaging assessed global and regional (18 segments) longitudinal left ventricular function. MF was present in four athletes (range 1–8 g) and not present in five athletes. MF was located near the insertion points of the right ventricular free wall on the left ventricle in three athletes and in the epicardial lateral wall in one athlete. Athletes with MF demonstrated a larger end diastolic volume (205 ± 24 vs 173 ± 18 ml) and posterior wall thickness (11 ± 1 vs 9 ± 1 mm) compared to those without MF. The presence of MF did not mediate global tissue velocities or global longitudinal strain and strain rate; however, regional analysis of longitudinal strain demonstrated reduced function in some fibrotic regions. Furthermore, base to apex gradient was affected in three out of four athletes with MF. Lifelong veteran endurance athletes with MF demonstrate larger cardiac dimensions and normal global cardiac function. Fibrotic areas may demonstrate some co-localised regional cardiac dysfunction, evidenced by an affected cardiac strain and base to apex gradient. These data emphasize the heterogeneous phenotype of MF in athletes

The Effect of 400 µg Inhaled Salbutamol on 3 km Time Trial Performance in a Low Humidity Environment

The Objectives of the study were to investigate whether 400 µg inhaled salbutamol influences 3 km running time-trial performance and lung function in eucapnic voluntary hyperpnoea positive (EVH+ve) and negative (EVH-ve) individuals. Fourteen male participants (22.4 ± 1.6yrs; 76.4 ± 8.7kg; 1.80 ± 0.07 m); (7 EVH+ve; 7 EVH-ve) were recruited following written informed consent. All participants undertook an EVH challenge to identify either EVH+ve (?FEV1>10%) or EVH-ve (?FEV110% from baseline) in FEV1 following any time-trial. Administration of 400µg inhaled salbutamol does not improve 3 km time-trial performance in either mild EVH+ve or EVH–ve individuals despite significantly increased HR and FEV1

A multidisciplinary consensus on dehydration: definitions, diagnostic methods and clinical implications

Background: Dehydration appears prevalent, costly and associated with adverse outcomes. We sought to generate consensus on such key issues and elucidate need for further scientific enquiry. Materials and Methods: A modified Delphi process combined expert opinion and evidence appraisal. 12 relevant experts addressed dehydration’s definition, objective markers and impact on physiology and outcome. Results: Fifteen consensus statements and seven research recommendations were generated. Key findings, evidenced in detail, were that there is no universally-accepted definition for dehydration; hydration assessment is complex and requires combining physiological and laboratory variables; ‘dehydration’ and ‘hypovolaemia’ are incorrectly used interchangeably; abnormal hydration status includes relative and/or absolute abnormalities in body water and serum/plasma osmolality (pOsm); raised pOsm usually indicates dehydration; direct measurement of pOsm is the gold standard for determining dehydration; pOsm >300 and ≤280 mOsm/kg classifies a person as hyper or hypo-osmolar; outside extremes, signs of adult dehydration are subtle and unreliable; dehydration is common in hospitals and care homes and associated with poorer outcomes. Discussion: Dehydration poses risk to public health. Dehydration is under-recognised and poorly managed in hospital and community-based care. Further research is required to improve assessment and management of dehydration and the authors have made recommendations to focus academic endeavours

The Impact of Environmental Tobacco Smoke Exposure on Cardiorespiratory Fitness in Children: A Pilot Study

Environmental tobacco smoke (ETS) in indoor air is a substantial risk factor for many health issues. Children are particularly susceptible to ETS with increased risk of asthma attacks, respiratory infections and sudden infant death syndrome. The health effects of ETS are well researched in adults, but few studies examine the impact on children’s cardiorespiratory fitness (CRF). CRF has been shown to be a useful biomarker for monitoring health effects which would normally be too subtle to identify at rest. In adults, ETS has been shown to reduce CRF, and children may be at greater risk due to high respiration rates and developing organs. This preliminary research tests the hypothesis that ETS has a detrimental impact on CRF in children. Twenty-five children (9–11 years) from one Merseyside primary school were recruited. ETS exposure was determined by parental surveys and coupled with children’s exhaled carbon monoxide concentration. CRF was determined using a VO2 peak test, with lung function assessed using standard spirometry, and fractional exhaled nitric oxide (FeNO) provided an indication of lung inflammation. Initial results show that children exposed to ETS had statically lower CRF scores (p = 0.048) and were more likely to be classified as ‘unfit’ compared to children not exposed. A negative correlation was found between the number of cigarettes smoked at home and children’s CRF (r = −0.526, p = 0.008), suggesting a possible dose–response relationship. Spirometry and FeNO values were not statistically different between groups. Results indicate that ETS exposure is likely to be detrimental to children’s CRF. They highlight the need for further work, on a larger dataset that will allow more robust analysis with greater statistical power. To the author’s knowledge, this study is the first of its kind to use laboratory-based fitness measurements to explore associations between ETS and CRF in childre

The Long-Term Ergogenic Effect of Long Acting ?2-Agonists

Background: The WADA List of Banned Substances and Methods stipulates that athletes can use up to 54 µg inhaled Formoterol and inhaled Salmeterol as directed by the manufacturer. It is unknown whether large daily therapeutic doses of Formoterol and Salmeterol can improve sprint and strength performance. Purpose: To investigate the impact of inhaling 100 µg of Salmeterol (SAL) or 12 µg of Formoterol (FOR) twice daily over a 5 week period on sprint, strength and power performance. Methods: In a randomised single blind study 24 male and 15 female non-asthmatic and active participants were recruited (mean ± SD; Males age 28.0 ± 5.5 years; weight 72.1 ± 10.5 Kg; height 164.7 ± 7.1 cm; Females age 24.1 ± 4.1 years; weight 65.4 ± 9.5 Kg; height 168.0 ± 4.3 cm). Participants completed three standardised whole body strength and power training sessions per week for five weeks. All the training sessions were supervised by a personal trainer who recorded work performed in each session. During the five week training period participants were assigned to either SAL, FOR or a placebo (PLA) group. Participants took their inhaler twice per day as instructed. Participants completed assessments of sprint, strength and power at week 0 and after 5 weeks of strength and power training. The assessments included 30 m sprint, vertical jump, 1 RM bench press, 1 RM leg press, peak torque flexion and extension, anthropometric evaluation and Rest-Q questionnaires. Mixed Model Repeated Measures ANOVA were performed to investigate the changes in the sprint, strength and power assessments between groups over the course of the 5 week training session. Results: 30 m Sprint time was significantly lower in FOR group (– 0.29 ± 0.11 s; p=0.049) and SAL (– 0.35 ± 0.05 s; p=0.04) when compared with compared with Placebo (+0.01 ± 0.11 s; P=0.000). No significant change was found in 1RM Leg, Squat and Bench Press or during Isokinetic evaluation performed at 60° range in flex/ext movement. Jump performance as well as anthropometric measures didn’t differ between groups. Discussion: The significant changes in FOR and SAL 30m sprint time when compared to PLA suggest the long term use of inhaled ?2-agonnists may provide ergogenic advantage. This finding suggests a review of the use of inhaled doses of FOR and SAL by athletes in training and official competition may be necessary

Pragmatic evaluation of a coproduced physical activity referral scheme:a UK quasi-experimental study

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