Person-Centered Health Promotion: Learning from 10 Years of Practice within Long Term Conditions

The utilization of person-centered care is highlighted as essential for health promotion, yet implementation has been inconsistent and multiple issues remain. There is a dearth of applied research exploring the facets of successful implementation. In this paper, a person-centered wellbeing program spanning various groups is discussed, outlining the central principles that have allowed for successful outcomes. Ten years of pragmatic pre–post service evaluation have shown consistent improvement in measures of functional capacity and wellbeing. The method for this paper is a reflective exploration of the theory and practices that can explain the continual improvement the clinics have achieved over 10 years. Core principles relate to connecting with people, connecting through groups, and connecting with self. The operationalization and theoretical explanation of these principles is outlined. The discussion of these principles posits essential factors to prioritize to advance the implementation of person-centered care in health promotion for long-term conditions

Reliability of gastrointestinal barrier integrity and microbial translocation biomarkers at rest and following exertional heat stress

Purpose:Exertional heat stress adversely distrupts (GI) barrier integrity and, through subsequent microbial translocation (MT), negativly impacts health. Despite widespread application, the temporal reliability of popular GI barrier integity and MT biomarkers is poorly characterised. Method: Fourteen males completed two 80‐min exertional heat stress tests (EHST) separated by 7–14 days. Venous blood was drawn pre, immediately‐ and 1‐hr post both EHSTs. GI barrier integrity was assessed using the serum Dual‐Sugar Absorption Test (DSAT), Intestinal Fatty‐Acid‐Binding Protein (I‐FABP) and Claudin‐3 (CLDN‐3). MT was assessed using plasma Lipopolysaccharide Binding Protein (LBP), total 16S bacterial DNA and Bacteroides DNA. Results: No GI barrier integrity or MT biomarker, except absolute Bacteroides DNA, displayed systematic trial order bias (p ≥ .05). I‐FABP (trial 1 = Δ 0.834 ± 0.445 ng ml−1; trial 2 = Δ 0.776 ± 0.489 ng ml−1) and CLDN‐3 (trial 1 = Δ 0.317 ± 0.586 ng ml−1; trial 2 = Δ 0.371 ± 0.508 ng ml−1) were increased post‐EHST (p ≤ .01). All MT biomarkers were unchanged post‐EHST. Coefficient of variation and typical error of measurement post‐EHST were: 11.5% and 0.004 (ratio) for the DSAT 90‐min postprobe ingestion; 12.2% and 0.004 (ratio) at 150‐min postprobe ingestion; 12.1% and 0.376 ng ml−1 for I‐FABP; 4.9% and 0.342 ng ml−1 for CLDN‐3; 9.2% and 0.420 µg ml−1 for LBP; 9.5% and 0.15 pg µl−1 for total 16S DNA; and 54.7% and 0.032 for Bacteroides/total 16S DNA ratio. Conclusion: Each GI barrier integrity and MT translocation biomarker, except Bacteroides/total 16S ratio, had acceptable reliability at rest and postexertional heat stress

Gastrointestinal Tolerance of Low, Medium and High Dose Acute Oral l-Glutamine Supplementation in Healthy Adults: A Pilot Study

l-Glutamine (GLN) is a conditionally essential amino acid which supports gastrointestinal (GI) and immune function prior to catabolic stress (e.g., strenuous exercise). Despite potential dose-dependent benefits, GI tolerance of acute high dose oral GLN supplementation is poorly characterised. Fourteen healthy males (25 ± 5 years; 1.79 ± 0.07 cm; 77.7 ± 9.8 kg; 14.8 ± 4.6% body fat) ingested 0.3 (LOW), 0.6 (MED) or 0.9 (HIGH) g·kg·FFM−1 GLN beverages, in a randomised, double-blind, counter-balanced, cross-over trial. Individual and accumulated GI symptoms were recorded using a visual analogue scale at regular intervals up to 24-h post ingestion. GLN beverages were characterised by tonicity measurement and microscopic observations. 24-h accumulated upper- and lower- and total-GI symptoms were all greater in the HIGH, compared to LOW and MED trials (p 0.05). All beverages were isotonic and contained a dose-dependent number of GLN crystals. Acute oral GLN ingestion in dosages up to 0.9 g·kg·FFM−1 are generally well-tolerated. However, the severity of mild GI symptoms appeared dose-dependent during the first two hours post prandial and may be due to high-concentrations of GLN crystals

Multiwavelength Monitoring of the BL Lacertae Object PKS 2155-304 in May 1994. I. The Ground-Based Campaign

Optical, near-infrared, and radio observations of the BL Lac object PKS2155-304 were obtained simultaneously with a continuous UV/EUV/X-ray monitoring campaign in 1994 May. Further optical observations were gathered throughout most of 1994. The radio, millimeter, and near-infrared data show no strong correlations with the higher energies. The optical light curves exhibit flickering of 0.2-0.3 mag on timescales of 1-2 days, superimposed on longer timescale variations. Rapid variations of ~0.01 mag/min, which, if real, are the fastest seen to date for any BL Lac object. Small (0.2-0.3 mag) increases in the V and R bands occur simultaneously with a flare seen at higher energies. All optical wavebands (UBVRI) track each other well over the period of observation with no detectable delay. For most of the period the average colors remain relatively constant, although there is a tendency for the colors (in particular B-V) to vary more when the source fades. In polarized light, PKS 2155-304 showed strong color dependence and the highest optical polarization (U = 14.3%) ever observed for this source. The polarization variations trace the flares seen in the ultraviolet flux.Comment: 45 pages, latex file with encapsulated postscript, accepted to the Astrophysical Journa

Influence of aerobic fitness on gastrointestinal barrier integrity and microbial translocation following a fixed-intensity military exertional heat stress test

Purpose: Exertional-heat stress adversely disrupts gastrointestinal (GI) barrier integrity, whereby subsequent microbial translocation (MT) can result in potentially serious health consequences. To date, the influence of aerobic fitness on GI barrier integrity and MT following exertional-heat stress is poorly characterised. Method: Ten untrained (UT; VO2max = 45 ± 3 ml·kg−1·min−1) and ten highly trained (HT; VO2max = 64 ± 4 ml·kg−1·min−1) males completed an ecologically valid (military) 80-min fixed-intensity exertional-heat stress test (EHST). Venous blood was drawn immediately pre- and post-EHST. GI barrier integrity was assessed using the serum dual-sugar absorption test (DSAT) and plasma Intestinal Fatty-Acid Binding Protein (I-FABP). MT was assessed using plasma Bacteroides/total 16S DNA. Results: UT experienced greater thermoregulatory, cardiovascular and perceptual strain (p < 0.05) than HT during the EHST. Serum DSAT responses were similar between the two groups (p = 0.59), although Δ I-FABP was greater (p = 0.04) in the UT (1.14 ± 1.36 ng·ml−1) versus HT (0.20 ± 0.29 ng·ml−1) group. Bacteroides/Total 16S DNA ratio was unchanged (Δ; -0.04 ± 0.18) following the EHST in the HT group, but increased (Δ; 0.19 ± 0.25) in the UT group (p = 0.05). Weekly aerobic training hours had a weak, negative correlation with Δ I-FABP and Bacteroides/total 16S DNA responses. Conclusion: When exercising at the same absolute workload, UT individuals are more susceptible to small intestinal epithelial injury and MT than HT individuals. These responses appear partially attributable to greater thermoregulatory, cardiovascular, and perceptual strain

The metabolic and thermal response of humans exposed to acute cold : exposure during sustained sub-maximal cycle exercise

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Fat oxidation after acipimox-induced reduction in plasma nonesterified fatty acids during exercise at 0°C and 20°C

The main aim of this study was to investigate if whole body fat oxidation, after acipimox administration, during submaximal exercise in the cold, is different from that at temperate environments. Seven healthy recreationally active male subjects cycled at 70% 2peak for 60 minutes; once at 0°C and once at 20°C. To exclude availability, and therefore oxidation of plasma-derived nonesterified fatty acids (NEFA), 90 minutes before each cycling bout, subjects ingested 250 mg of the antilipolytic drug, acipimox. Blood and expired gas measurements were obtained at rest, immediately before exercise, and at 15, 30, 45, and 60 minutes of exercise. In both trials, after the ingestion of acipimox, plasma NEFA concentrations fell dramatically and immediately before and during exercise were lower than 0.05 mmol · L−1 in both trials. Pre-exercise and exercise values of glycerol, glucose, triacylglycerol (TG), and rectal temperature (Tre) were not different between the 0°C and 20°C trials. During exercise at 0°C, skin temperature (Tsk) was significantly reduced from pre-exercise values (P < .05) and at all time points was significantly lower than during exercise at 20°C. Muscle temperature did not differ between trials but in both trials was lower (P < .05) at 1 cm depth than at 3 cm and 2 cm. Gross energy expenditure of cycling (0°C trial, 3.6 ± 0.1 MJ; 20°C trial, 3.6 ± 0.1 MJ), the oxidation rates of carbohydrate (0°C, 32.4 ± 0.5 KJ · min−1; 20°C, 32.6 ± 0.7 KJ · min−1) and fat (0°C, 24.6 ± 1.2 KJ · min−1; 20°C, 23.0 ± 1.8 KJ · min−1), and the proportion of energy derived from fat (0°C, 45 ± 1 %; 20°C, 40 ± 4%) and carbohydrate (0°C, 55 ± 1%; 20°C, 58 ± 3%) were not different between the 2 trials. In conclusion, after acipimox administration, whole body fat oxidation during exercise, designed to avoid adjustment of core temperature or thermogenesis, is not different at 0°C compared with 20°C. This allows the inference that during submaximal exercise, cold has no effect on the utilization of intramuscular TG (IMTG)