Are we adequately preparing the next generation of physicians to prescribe exercise as prevention and treatment? Residents express the desire for more training in exercise prescription

Background: Physical activity (PA) is a key intervention for chronic disease, yet few physicians provide exercise prescription (EP). EP is an important component in larger strategies of reducing non-communicable disease (NCD). Our objective was to assess Family Medicine Residents (FMR) knowledge, competence, and perspectives of EP to help inform future curriculum development.Methods: A 49-item cross-sectional survey was administered to 396 University of British Columbia FMR. Residents’ EP knowledge, competence, attitudes/beliefs, current practices, personal physical activity levels, and perspectives of training were assessed using, primarily, a 7-point Likert scale.Results: The response rate was 80.6% (319/396). After eliminating 25 that failed to meet the inclusion criteria, 294 were included in the final analysis. The majority 95.6% of FMR reported EP as important in their future practice, despite having low knowledge of the Canadian PA Guidelines (mean score 1.77/4), low self-reported competence prescribing exercise as prevention (mean score 13.35/21), and rating themselves “somewhat incompetent” prescribing exercise to patients with chronic disease (mean score 11.26/21). FMR believe PA is integral to their patients’ health (98.0%), sedentary behaviour is harmful (97.9%), and feel a responsibility to discuss PA with patients (99.7%). Few FMR (14.9%) perceived their training in EP as adequate and 91.0% desire more.Conclusions: FMR report EP is important, yet do not perceive they are sufficiently prepared to provide EP. In future curricular development, medical educators should consider residents’ low knowledge, competence, perceived program support, and their expressed desire for more training in exercise prescription

Immersion Pulmonary Edema in Female Triathletes

Pulmonary edema has been reported in SCUBA divers, apnea divers, and long-distance swimmers however, no instances of pulmonary edema in triathletes exist in the scientific literature. Pulmonary edema may cause seizures and loss of consciousness which in a water environment may become life threatening. This paper describes pulmonary edema in three female triathletes. Signs and symptoms including cough, fatigue, dyspnea, haemoptysis, and rales may occur within minutes of immersion. Contributing factors include hemodynamic changes due to water immersion, cold exposure, and exertion which elevate cardiac output, causing pulmonary capillary stress failure, resulting in extravasation of fluid into the airspace of the lung. Previous history is a major risk factor. Treatment involves immediate removal from immersion and in more serious cases, hospitalization, and oxygen administration. Immersion pulmonary edema is a critical environmental illness of which triathletes, race organizers, and medical staff, should be made aware

The Critical Power Model as a Potential Tool for Anti-Doping

Existing doping detection strategies rely on direct and indirect biochemical measurement methods focused on detecting banned substances, their metabolites, or biomarkers related to their use. However, the goal of doping is to improve performance, and yet evidence from performance data is not considered by these strategies. The emergence of portable sensors for measuring exercise intensities and of player tracking technologies may enable the widespread collection of performance data. How these data should be used for doping detection is an open question. Herein, we review the basis by which performance models could be used for doping detection, followed by critically reviewing the potential of the critical power (CP) model as a prototypical performance model that could be used in this regard. Performance models are mathematical representations of performance data specific to the athlete. Some models feature parameters with physiological interpretations, changes to which may provide clues regarding the specific doping method. The CP model is a simple model of the power-duration curve and features two physiologically interpretable parameters, CP and W0 . We argue that the CP model could be useful for doping detection mainly based on the predictable sensitivities of its parameters to ergogenic aids and other performance-enhancing interventions. However, our argument is counterbalanced by the existence of important limitations and unresolved questions that need to be addressed before the model is used for doping detection. We conclude by providing a simple worked example showing how it could be used and propose recommendations for its implementation

Psychotria nuda (Cham. & Schltdl.) Wawra: Enraizamento de matrizes em diferentes fenofases e ambientes

http://dx.doi.org/10.5902/1980509814574Psychotria nuda (Cham. & Schltdl.) Wawra (Rubiaceae) is a native species from the Dense Ombrophylous Forest (dense tropical rain forest), typical in the low altitude areas of the forest, with occurrence in the states of Minas Gerais, Rio de Janeiro, São Paulo, Paraná and Santa Catarina. Due to the presence of yellow flowers with red receptacle and anise colored fruits, the plant has an ornamental potential, such as a pharmaceutical potential, thanks to the variety of alkaloids that have already been isolated demonstrating structural diversity of its active components. This work aimed to verify the effect on stem cuttings rooting of different collection environments and of different phenophases of Psychotria nuda stock plants at the time of collection, and to verify what is the correlation between variables defined as percentage of rooted cuttings, number of roots per cutting and average length of the three longest roots per each cutting (cm) with permanence of two half leaves and formation of callus. Phenophases are intended as different times of the year in which stock plants presented distinct phenological characteristics. In the two phenophases studied (phenophases 1 and 2) canopy sprouts were collected in Antonina, Paraná state, from two different environments (plain and hillside) of the Dense Ombrophylous Forest (dense tropical rain forest). Cuttings were prepared with 10 to 13 cm length and two halved leaves. After 60 days in a greenhouse, the percentage of cuttings with roots, with callus, alive, dead, the number of roots per cutting and the length of the three longer roots per each rooted cutting were evaluated. The collection environments and the phenophases at the time of collection influenced the percentage of rooting, such that the phenophase 1 and the hillside environment were the conditions that resulted in the best rooting percentage (90%). The permanence of leaves during rooting period helped, in most cases, the formation of adventitious roots. Anticipated formation of callus supported rooting in phenophase 2, while in phenophase 1 the formation of adventitious roots was independent from callus formation.http://dx.doi.org/10.5902/1980509814574 Psychotria nuda (Cham. & Schltdl.) Wawra (Rubiaceae) é uma espécie nativa da Floresta Ombrófila Densa, restrita às florestas de baixa altitude, com ocorrência nos estados de Minas Gerais, Rio de Janeiro, São Paulo, Paraná e Santa Catarina. Possui potencial ornamental, devido à presença de flores amarelas, cálice vermelho e frutos cor anis, e farmacêutico, visto que vários alcaloides já foram isolados, demonstrando diversidade estrutural de compostos ativos. O presente trabalho teve como objetivo verificar o efeito de diferentes ambientes de coleta e da fenofase em que se encontravam as plantas matrizes de Psychotria nuda no enraizamento de estacas caulinares, além de verificar a correlação entre as variáveis porcentagem de estacas enraizadas, número de raízes por estaca e comprimento médio das três maiores raízes por estaca (cm) com a permanência de duas meias folhas e formação de calos. Entende-se por fenofases, as épocas com características fenológicas distintas em que se encontravam as plantas matrizes. Nas duas fenofases estudadas (Fenofases 1 e 2), brotações de copa foram coletadas em Antonina-PR em dois ambientes distintos (planície e encosta) da Floresta Ombrófila Densa. Estacas foram confeccionadas com 10-13 cm de comprimento e duas folhas reduzidas à metade. Após 60 dias em casa de vegetação, foram avaliadas a porcentagem de estacas enraizadas, com calos, vivas, mortas, número de raízes/estaca e comprimento das três maiores raízes/estaca. Os ambientes de coleta e as fenofases influenciaram na porcentagem de enraizamento, onde a fenofase 1 e o ambiente encosta foram as condições que apresentaram o melhor enraizamento (90%). A manutenção das folhas nas estacas durante o período de enraizamento, na maioria das situações, favoreceu a formação de raízes adventícias, e a formação antecipada de calos favoreceu o enraizamento na fenofase 2. Já na fenofase 1, a formação de raízes adventícias foi independente da formação de calos.

A comparison of two methods of heart rate variability assessment at high altitude.

Heart rate variability (HRV) is a useful index of autonomic function and has been linked to the development of high altitude (HA) related illness. However, its assessment at HA has been undermined by the relative expense and limited portability of traditional HRV devices which have mandated at least a minute heart rate recording. In this study, the portable ithlete(™) HRV system, which uses a 55 s recording, was compared with a reference method of HRV which utilizes a 5 min electrocardiograph recording (CheckMyHeart(™) ). The root mean squares of successive R-R intervals (RMSSD) for each device was converted to a validated HRV score (lnRMSSD × 20) for comparison. Twelve healthy volunteers were assessed for HRV using the two devices across seven time points at HA over 10 days. There was no significant change in the HRV values with either the ithlete (P = 0·3) or the CheckMyHeart(™) (P = 0·19) device over the seven altitudes. There was also a strong overall correlation between the ithlete(™) and CheckMyHeart(™) device (r = 0·86; 95% confidence interval: 0·79-0·91). The HRV was consistently, though non-significantly higher with ithlete(™) than with the CheckMyHeart(™) device [mean difference (bias) 1·8 l; 95% CI -12·3 to 8·5]. In summary, the ithlete(™) and CheckMyHeart(™) system provide relatively similar results with good overall agreement at HA

Water production in arid surroundings: alternative solutions coming from ecosystems study

The scarcity of raw water natural resources for human consumption, global warming and the increasing human population lead to developing alternative solutions to exploit atmospheric water. The observing of ecosystems in arid environments makes it possible to submit various strategies for fog and dew use. Water nets and passive dew collectors are characterized by low production costs, but their productivity remains limited and depends on meteorological conditions. They must be regarded as helper solutions for the most vulnerable populations. Active atmospheric water condensing devices make great autonomous water production possible, if air hygrometry is sufficient. They are to be considered as a major perspective for water production in the futureDans le contexte actuel de raréfaction des ressources naturelles en eaux douces exploitables pour la consommation humaine, de réchauffement climatique et de croissance de la population mondiale, des approches alternatives sont développées en vue de capter l’eau présente dans l’atmosphère. L’observation des écosystèmes des milieux arides permet de proposer différentes stratégies d’exploitation des brouillards et rosées. Les filets à brouillard et condenseurs passifs de rosée se caractérisent par de faibles coûts de production, mais leurs rendements restent limités et très dépendants des conditions météorologiques. Ils représentent des solutions d’appoint pour l’approvisionnement en eau de populations économiquement défavorisées. Les condenseurs actifs de vapeur d’eau atmosphérique permettent une production d’eau en quantités importantes, de manière totalement autonome, sous réserve d’une hygrométrie suffisante. Ils constituent une perspective majeure pour l’avenir de la production d’ea

An Overview of Recent Application of Medical Infrared Thermography in Sports Medicine in Austria

Medical infrared thermography (MIT) is used for analyzing physiological functions related to skin temperature. Technological advances have made MIT a reliable medical measurement tool. This paper provides an overview of MIT’s technical requirements and usefulness in sports medicine, with a special focus on overuse and traumatic knee injuries. Case studies are used to illustrate the clinical applicability and limitations of MIT. It is concluded that MIT is a non-invasive, non-radiating, low cost detection tool which should be applied for pre-scanning athletes in sports medicine

Chronic adaptations of lung function in breath-hold diving fishermen

Objectives: The aim of this study was to verify and analyze the existence of chronic adaptations of lung function in freediving fishermen whose occupation is artisanal fishing. Material and Methods: This was a cross-sectional study involving 11 breath-hold diving fishermen and 10 non-breath-hold diving fishermen (control) from the village of Bitupitá in the municipality of Barroquinha (Ceará - Brazil). Anthropometric measurements, chest and abdominal circumferences as well as spirometric and respiratory muscle strength tests were conducted according to the specifications of the American Thoracic Society/European Respiratory Society (ATS/ERS). In order to compare the measured values versus the predicted values, Student t test was used in the case of parametric test and Wilcoxon test in the case of nonparametric test. To compare the inter-group means Student t test was used for parametric test and Mann-Whitney test for the nonparametric one. The level of significance was set at α = 5%. Results: The forced vital capacity (FVC) (4.9±0.6 l vs. 4.3±0.4 l) and forced expiratory volume in 1 s (FEV1) (4.0±0.5 l vs. 3.6±0.3 l) were, respectively, higher in the group of divers compared to the control group (p ≤ 0.05). Furthermore, in the group of free divers, the measured FVC, FEV1 and FEV1/FVC ratios were significantly greater than the predicted ones. No differences were found between the measured respiratory pressures. Conclusions: These results indicate that breath-hold diving seems to produce chronic adaptations of the respiratory system, resulting in elevated lung volumes with no airway obstruction

Floods, drying, habitat connectivity, and fish occupancy dynamics in restored and unrestored oxbows of West Central Iowa, USA

1. In the agricultural landscape of the Midwestern USA, waterways are highly altered. Oxbows are among the few remaining off‐channel habitats associated with streams, supporting fish assemblages that include the endangered Topeka shiners Notropis topeka in portions of their remaining range. Oxbow restorations seek to increase the number and quality of oxbows for Topeka shiners. For oxbows to provide optimal habitat, periods of isolation from streams and connection with streams during floods are necessary. 2. Water levels and patterns of drying and hydrological connectivity between 12 oxbows and their neighboring streams in West Central Iowa were continuously monitored from May to October 2011, and fish assemblages were assessed for responses to the differing hydrodynamics using dynamic occupancy modelling. 3. The 12 oxbows exhibited varied hydrodynamics and connectivity with streams. Two oxbows never contained fish; these oxbows never flooded and were among the three oxbows that were dry for the longest periods. 4. Occupancy modelling suggested that connection with the stream via floods significantly increased the probability of colonization, and low water level increased the probability of local extinction from oxbows. Thirteen of the 16 fish species encountered had detection probabilities over 60%, and eight had detection probabilities over 90%, including Topeka shiners. 5. None of the five previously restored oxbows flooded; all five contained fish, but only one contained Topeka shiners. Three of the four oxbows containing Topeka shiners flooded and all four dried at least once. 6. These results suggest that planning for future oxbow restorations should consider: (i) sites that flood frequently; and (ii) construction methods promoting alternating periods of isolation from and connection with streams