Is it time to turn our attention toward central mechanisms for post-exertional recovery strategies and performance?

• Central fatigue is accepted as a contributor to overall athletic performance, yet little research directly investigates post-exercise recovery strategies targeting the brain • Current post-exercise recovery strategies likely impact on the brain through a range of mechanisms, but improvements to these strategies is needed • Research is required to optimize post-exercise recovery with a focus on the brain Post-exercise recovery has largely focused on peripheral mechanisms of fatigue, but there is growing acceptance that fatigue is also contributed to through central mechanisms which demands that attention should be paid to optimizing recovery of the brain. In this narrative review we assemble evidence for the role that many currently utilized recovery strategies may have on the brain, as well as potential mechanisms for their action. The review provides discussion of how common nutritional strategies as well as physical modalities and methods to reduce mental fatigue are likely to interact with the brain, and offer an opportunity for subsequent improved performance. We aim to highlight the fact that many recovery strategies have been designed with the periphery in mind, and that refinement of current methods are likely to provide improvements in minimizing brain fatigue. Whilst we offer a number of recommendations, it is evident that there are many opportunities for improving the research, and practical guidelines in this area

Evaluation of the on-the-job training program at Company X

Includes bibliographical references

Lucky Girls: Unintentional Avoidance of Adolescent Pregnancy Among Low-Income African-American Females

To describe lucky adolescents who unintentionally avoid pregnancy. DESIGN AND METHODS . The second phase of a descriptive qualitative study in which 17 low-income African-American females ages 19 to 26 participated in open-ended interviews on how they avoided pregnancy as adolescents. RESULTS . Constant comparative analysis revealed that five of the girls avoided pregnancy because they were “lucky“ that others insisted they use contraceptives. These lucky girls were unaware of sexual risks, but used contraceptives because they complied with decisions made by their parents, grandparents, and partners. PRACTICE IMPLICATIONS . Lucky girls are at risk for adolescent pregnancy because they abdicate decision making to others and are likely to be overlooked in practice because they are using contraceptives. Promoting self-protection includes assessment, knowledge, skills-building strategies, and health-promoting contracts between the nurse and adolescent.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73296/1/j.1744-6155.2002.tb00171.x.pd

Workplace mental health: An international review of guidelines

The aim of this systematic review was to determine the quality and comprehensiveness of guidelines developed for employers to detect, prevent, and manage mental health problems in the workplace. An integrated approach that combined expertise from medicine, psychology, public health, management, and occupational health and safety was identified as a best practice framework to assess guideline comprehensiveness. An iterative search strategy of the grey literature was used plus consultation with experts in psychology, public health, and mental health promotion. Inclusion criteria were documents published in English and developed specifically for employers to detect, prevent, and manage mental health problems in the workplace. A total of 20 guidelines met these criteria and were reviewed. Development documents were included to inform quality assessment. This was performed using the AGREE II rating system. Our results indicated that low scores were often due to a lack of focus on prevention and rather a focus on the detection and treatment of mental health problems in the workplace. When prevention recommendations were included they were often individually focused and did not include practical tools or advice to implement. An inconsistency in language, lack of consultation with relevant population groups in the development process and a failure to outline and differentiate between the legal/minimum requirements of a region were also observed. The findings from this systematic review will inform translation of scientific evidence into practical recommendations to prevent mental health problems within the workplace. It will also direct employers, clinicians, and policy-makers towards examples of best-practice guidelines

Effectiveness of Acceptance and Commitment Therapy self-help for carers of people with multiple sclerosis: a feasibility randomised controlled trial

Objective: Acceptance and Commitment Therapy (ACT) may be a feasible, accessible and effective intervention to ‘informal’ carers of people with Multiple Sclerosis (MS) who may be experiencing strain as a result of their caring duties. The aim of this study was to assess the feasibility of randomised controlled trial (RCT) of ACT self-help, telephone-supported ACT self-help, compared to usual care (UC). Study objectives related to feasibility and acceptability of the study design and the two chosen interventions and assessing potential effectiveness at both individual and group level. Design: This study was a feasibility, mixed-methods, parallel three-armed RCT design. The three arms were: (1) ACT self-help workbook (SH), (2) ACT self-help workbook alongside weekly telephone calls (SH+), and (3) usual care. The SH group received an ACT self-help text over eight weeks, with chapters sent week-by-week via email or post. Those in the SH+ group received the intervention as those in the SH group, with the addition of weekly telephone support calls to guide them through the self-help text. Participants across all groups completed measures at baseline, at three-months and six-months post randomisation. Measures included were two measures of carer strain (Zarit Burden Interview; (ZBI) and Modified Carer Strain Index; (MCSI)), carer health-related quality of life measure (CAREQOL-MS) alongside two ACT process measures (Acceptance and Action Questionnaire; AAQ-II) and Comprehensive Assessment of Acceptance and Commitment Therapy; (CompACT). All participants randomised to the two intervention groups were invited to complete a feedback interview, which was analysed using a framework analysis to inform feasibility of the study. Results: Twenty-four self-defined primary carers of people with MS were randomised to one of the three groups previously described above. Overall, participants found the RCT design of the study to be feasible, although there were difficulties with the self-help text itself, as well as the timing of the intervention. The measures were predominantly feasible with one notable difficulty, whereby a measure of service use was omitted from the analysis and was deemed not feasible in its current form. A mixed linear model analysis showed improvement on only one outcome measure for the SH group (ZBI at 6-month follow-up), and participants reported difficulties engaging with the SH intervention in its current format. The SH+ group showed improvements on both measures of carer strain (consistent across both follow-ups) and attributed improvements both to the text as well as the telephone support. Both groups showed multiple significant improvements on process measures. Conclusions: A full trial of ACT-based, telephone-supported self-help is warranted, further to significant changes to the study design and protocol. Notably, the SH group (without telephone support) was not deemed a feasible intervention to progress to a full scale RCT, and therefore a two-armed RCT is recommended. Further work needs to be completed ahead of progressing to full trial, the major changes required would be to the intervention material and recruitment strategy. An internal pilot would, therefore, be necessary in order to assess the feasibility of the study after the suggested changes had been made. Personal reflections on the research process, chosen methodology, and intervention are offered

On the Deployment of DHCP

Constant-time symmetries and e-business have garnered great interest from both researchers and developers in the last several years. In this paper, authors confirm the analysis of interrupts. We describe a heuristic for stable models, which we call ViagePadge

Descriptions of memory rehabilitation group interventions for neurological conditions: a systematic review

Objective: To establish what aspects of group-based cognitive rehabilitation for memory problems are reported, and to develop a checklist for authors, which may to improve reporting of these interventions in future studies. Data sources: A systematic search was conducted on Web of Knowledge, CINAHL, MEDLINE, AMED, EMBASE and PsycINFO electronic databases (last search: 01/05/2015). Review methods: Articles were included if the sample were adults with a neurological disorder, the intervention was group-based cognitive rehabilitation for memory problems, and if the study was a randomised controlled trial. Articles were independently screened for inclusion and data extracted by two researchers, with the third researcher arbitrating any disputes. Results: Fourteen studies were included in this review. The reporting of certain aspects of an intervention was found to be poor, particularly in relation to: duration of the programme (6 of 14 studies did not report), the development of the intervention (7 of 14 studies did not discuss), and the content and structure of intervention (7 of the 14 studies did not provide details). Conclusion: This review found that the overall reporting of memory rehabilitation content and format is poor. Refinement and adaption of pre-existing checklists to capture aspects of cognitive rehabilitation programmes may help authors when reporting complex interventions. A draft checklist is provided that could be refined and validated in further research

The rising cost of anticancer drugs in Australia

Background: Anticancer drugs are often expensive and are contributing to the growing cost of cancer care. Concerns have been raised about the effect rising costs may have on availability of new anticancer drugs. Aim: This study aims to determine the recent changes in the costs of anticancer drugs in Australia. Methods: Publicly available expenditure and prices paid by the Australian Pharmaceutical Benefits Scheme (PBS) for anticancer drugs from 2000 to 2012 were reviewed. The measures used to determine changes in cost were total PBS expenditure and average price paid by the PBS per prescription for anticancer drugs and for all PBS listed drugs. An estimated monthly price paid for newly listed anticancer drugs was also calculated. Results: Annual PBS expenditure on anticancer drugs rose from A$65 million in 1999–2000 to A$466 million in 2011–2012; an average increase of 19% per annum. The average price paid by the PBS per anticancer drug prescription, adjusted for inflation, increased 133% from A$337 to A$786. The real average annual increase in the price per anticancer drug prescription was more than double that for all other PBS drugs combined (7.6% vs 2.8%, difference 4.8%, 95% confidence interval −0.4% to 10.1%, P = 0.07). The median price for a month’s treatment of the new anticancer drugs listed was A$4919 (range A$1003 to A$12 578, 2012 prices). Conclusions: PBS expenditure and the price of anticancer drugs in Australia rose substantially from 2000 to 2012. Dealing with these burgeoning costs will be a major challenge for our health system and for those affected by cancer

Genomic prediction of preliminary yield trials in chickpea: Effect of functional annotation of SNPs and environment

Abstract Achieving yield potential in chickpea (Cicer arietinum L.) is limited by many constraints that include biotic and abiotic stresses. Combining next-generation sequencing technology with advanced statistical modeling has the potential to increase genetic gain efficiently. Whole genome resequencing data was obtained from 315 advanced chickpea breeding lines from the Australian chickpea breeding program resulting in more than 298,000 single nucleotide polymorphisms (SNPs) discovered. Analysis of population structure revealed a distinct group of breeding lines with many alleles that are absent from recently released Australian cultivars. Genome-wide association studies (GWAS) using these Australian breeding lines identified 20 SNPs significantly associated with grain yield in multiple field environments. A reduced level of nucleotide diversity and extended linkage disequilibrium suggested that some regions in these chickpea genomes may have been through selective breeding for yield or other traits. A large introgression segment that introduced from C. echinospermum for phytophthora root rot resistance was identified on chromosome 6, yet it also has unintended consequences of reducing yield due to linkage drag. We further investigated the effect of genotype by environment interaction on genomic prediction of yield. We found that the training set had better prediction accuracy when phenotyped under conditions relevant to the targeted environments. We also investigated the effect of SNP functional annotation on prediction accuracy using different subsets of SNPs based on their genomic locations: regulatory regions, exome, and alternative splice sites. Compared with the whole SNP dataset, a subset of SNPs did not significantly decrease prediction accuracy for grain yield despite consisting of a smaller number of SNPs