Motives for Sport Participation of Athletes with Intellectual Disability

The present study aimed at knowing the reasons which led Brazilian athletes with intellectual disability to engage in sports practice and to take part in competitions promoted by the Special Olympics Brazil. A hundred and two athletes, between 21 and 49 years old, were evaluated through the Sport Motivation Questionnaire developed by Shapiro (2003). The data showed that the athletes took part mainly to get ribbons and medals, to play with other people from the team, to go to new and different places and to feel like an important person. The order of importance given to the motives differs when the results are compared according to gender. It was noticed a significant difference between men and women and the group aged from 30 to 49 years considering the reason: to practice. The results of the present study reflect that the motives towards the sport practice of the athletes with intellectual disability are predominantly oriented by personal and environmental factors

Motives for Sport Participation of Athletes with Intellectual Disability

The present study aimed at knowing the reasons which led Brazilian athletes with intellectual disability to engage in sports practice and to take part in competitions promoted by the Special Olympics Brazil. A hundred and two athletes, between 21 and 49 years old, were evaluated through the Sport Motivation Questionnaire developed by Shapiro (2003). The data showed that the athletes took part mainly to get ribbons and medals, to play with other people from the team, to go to new and different places and to feel like an important person. The order of importance given to the motives differs when the results are compared according to gender. It was noticed a significant difference between men and women and the group aged from 30 to 49 years considering the reason: to practice. The results of the present study reflect that the motives towards the sport practice of the athletes with intellectual disability are predominantly oriented by personal and environmental factors

The association between processes, structures and outcomes of secondary prevention care among VA ischemic heart disease patients

BACKGROUND: Hyperlipidemia and hypertension are well-established risk factors for recurrent cardiovascular events among patients with ischemic heart disease (IHD). Despite national recommendations, concordance with guidelines for LDL cholesterol and blood pressure remains inadequate. The objectives of this study were to 1) determine concordance rates with LDL cholesterol and BP recommendations; and 2) identify patient factors, processes and structures of care associated with guideline concordance among VA IHD patients. METHODS: This was a cross sectional study of veterans with IHD from 8 VA hospitals. Outcomes were concordance with LDL guideline recommendations (LDL<100 mg/dl), and BP recommendations (<140/90 mm Hg). Cumulative logit and hierarchical logistic regression analyses were performed to identify patient factors, processes, and structures of care independently associated with guideline concordance. RESULTS: Of 14,114 veterans with IHD, 55.7% had hypertension, 71.5% had hyperlipidemia, and 41.6% had both conditions. Guideline concordance for LDL and BP were 38.9% and 53.4%, respectively. However, only 21.9% of the patients achieved both LDL <100 mg/dl and BP <140/90 mm Hg. In multivariable analyses, patient factors including older age and the presence of vascular disease were associated with worse guideline concordance. In contrast, diabetes was associated with better guideline concordance. Several process of care variables, including higher number of outpatient visits, higher number of prescribed medications, and a recent cardiac hospitalization were associated with better guideline concordance. Among structures of care, having on-site cardiology was associated with a trend towards better guideline concordance. CONCLUSION: Guideline concordance with secondary prevention measures among IHD patients remains suboptimal. It is hoped that the findings of this study can serve as an impetus for quality improvement efforts to improve upon secondary prevention measures and reduce the morbidity and mortality of patients with known IHD

Blood pressure-lowering effects of nifedipine/candesartan combinations in high-risk individuals: Subgroup analysis of the DISTINCT randomised trial

The DISTINCT study (reDefining Intervention with Studies Testing Innovative Nifedipine GITS - Candesartan Therapy) investigated the efficacy and safety of nifedipine GITS/candesartan cilexetil combinations vs respective monotherapies and placebo in patients with hypertension. This descriptive sub-analysis examined blood pressure (BP)-lowering effects in high-risk participants, including those with renal impairment (estimated glomerular filtration rate<90 ml min-1, n=422), type 2 diabetes mellitus (n=202), hypercholesterolaemia (n=206) and cardiovascular (CV) risk factors (n=971), as well as the impact of gender, age and body mass index (BMI). Participants with grade I/II hypertension were randomised to treatment with nifedipine GITS (N) 20, 30, 60 mg and/or candesartan cilexetil (C) 4, 8, 16, 32 mg or placebo for 8 weeks. Mean systolic BP and diastolic BP reductions after treatment in high-risk participants were greater, overall, with N/C combinations vs respective monotherapies or placebo, with indicators of a dose-response effect. Highest rates of BP control (ESH/ESC 2013 guideline criteria) were also achieved with highest doses of N/C combinations in each high-risk subgroup. The benefits of combination therapy vs monotherapy were additionally observed in patient subgroups categorised by gender, age or BMI. All high-risk participants reported fewer vasodilatory adverse events in the pooled N/C combination therapy than the N monotherapy group. In conclusion, consistent with the DISTINCT main study outcomes, high-risk participants showed greater reductions in BP and higher control rates with N/C combinations compared with respective monotherapies and lesser vasodilatory side-effects compared with N monotherapy

Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes

BACKGROUND: Data are lacking on the long-term effect on cardiovascular events of adding sitagliptin, a dipeptidyl peptidase 4 inhibitor, to usual care in patients with type 2 diabetes and cardiovascular disease. METHODS: In this randomized, double-blind study, we assigned 14,671 patients to add either sitagliptin or placebo to their existing therapy. Open-label use of antihyperglycemic therapy was encouraged as required, aimed at reaching individually appropriate glycemic targets in all patients. To determine whether sitagliptin was noninferior to placebo, we used a relative risk of 1.3 as the marginal upper boundary. The primary cardiovascular outcome was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. RESULTS: During a median follow-up of 3.0 years, there was a small difference in glycated hemoglobin levels (least-squares mean difference for sitagliptin vs. placebo, -0.29 percentage points; 95% confidence interval [CI], -0.32 to -0.27). Overall, the primary outcome occurred in 839 patients in the sitagliptin group (11.4%; 4.06 per 100 person-years) and 851 patients in the placebo group (11.6%; 4.17 per 100 person-years). Sitagliptin was noninferior to placebo for the primary composite cardiovascular outcome (hazard ratio, 0.98; 95% CI, 0.88 to 1.09; P<0.001). Rates of hospitalization for heart failure did not differ between the two groups (hazard ratio, 1.00; 95% CI, 0.83 to 1.20; P = 0.98). There were no significant between-group differences in rates of acute pancreatitis (P = 0.07) or pancreatic cancer (P = 0.32). CONCLUSIONS: Among patients with type 2 diabetes and established cardiovascular disease, adding sitagliptin to usual care did not appear to increase the risk of major adverse cardiovascular events, hospitalization for heart failure, or other adverse events

Letter to the editor entitled “fairness and scientific correctness is needed in the debate on transgender athletes”

editorial reviewe

Screening of refractive errors and ocular disorders of professional soccer players

To improve their performance, many athletes already invest a significant amount of time and effort in training camps, personal trainers, and equipment, while neglecting to invest in their vision. However, improving visual performance can help improve overall performance in a way that other training regiments cannot. Even for athletes without vision problems, improving visual performance - such as increasing dynamic visual acuity, decreasing reaction times, and improving eye-hand coordination - is an integral component of improving overall performance. To verify if the changes found in soccer players exceeded the 40% found in the literature. The athletes were all submitted to visual acuity (VA) tests without correction using the Snellen eye chart and the noncontact intraocular pressure (IOP) by means of a computerized tonometer. They also underwent a self-refraction examination through a self-refractor. Among the 54 athletes that presented to the screening (108 eyes) 93/108 (86%) had refractive errors in one or both eyes. In 108 eyes there was 50 (46%) hyperopic eye with astigmatism; 19/108 (18%) of myopic astigmatism, 15/108 (14%) with myopia, 6/108 (6%) with hypermetropy and 15/108 (14%) were emmetropes. The prevalence of refractive errors was hyperopic astigmatism followed by myopic astigmatism (50 vs 19 cases). The left eye was the one that presented more hyperopic and myopic astigmatism in relation to the right eye, 52% and 58%, respectively. There were no differences in mean VA and IOP between in the right and left eyes, respectively. The changes verified in the screening of the present study exceeded 40% of ophthalmological alterations found in soccer players and contemplates the hypothesis of the study