Letter in response to 'The conceptual model of advanced practice does include research'

This letter refutes the suggestion made the authors of other letters to the Editor that the proposed model of the characteristics of advanced practitioners excludes research International Journal of Experimental Patholog

Dose-response of sodium bicarbonate ingestion highlights individuality in time course of blood analyte responses

To defend against hydrogen cation accumulation and muscle fatigue during exercise, sodium 20 bicarbonate (NaHCO3) ingestion is commonplace. The individualised dose-response relationship 21 between NaHCO3 ingestion and blood biochemistry is unclear. The present study investigated the 22 bicarbonate, pH, base excess and sodium responses to NaHCO3 ingestion. Sixteen healthy males (23±2 23 years; 78.6±15.1 kg) attended three randomised order-balanced, non-blinded sessions, ingesting a single 24 dose of either 0.1, 0.2 or 0.3 g.kg-1BM of NaHCO3 (Intralabs, UK). Fingertip capillary blood was 25 obtained at baseline and every 10 min for 1 h, then every 15 min for a further 2 h. There was a significant 26 main effect of both time and condition for all assessed blood analytes (P≤0.001). Blood analyte 27 responses were significantly lower following 0.1 g.kg-1BM compared with 0.2 g.kg-1BM; bicarbonate 28 concentrations and base excess were highest following ingestion of 0.3 g.kg-1BM (P≤0.01). Bicarbonate 29 concentrations and pH significantly increased from baseline following all doses; the higher the dose the 30 greater the increase. Large inter-individual variability was shown in the magnitude of the increase in 31 bicarbonate concentrations following each dose (+2.0-5; +5.1-8.1; and +6.0-12.3 mmol·L-1 for 0.1, 0.2 32 and 0.3 g.kg-1BM) and in the range of time to peak concentrations (30-150; 40-165; and 75-180 min for 33 0.1, 0.2 and 0.3 g.kg-1BM). The variability in bicarbonate responses was not affected by normalisation 34 to body mass. These results challenge current practices relating to NaHCO3 supplementation and clearly 35 show the need for athletes to individualise their ingestion protocol and trial varying dosages prior to 36 competition

Pregnancy in the female athlete - Part 1: antenatal

As female participation in sport and exercise continues to increase, there is a strong likelihood that a strength and conditioning (S&C) coach will work with a pregnant athlete. High profile athletes such as Serena Williams and Dame Jessica Ennis-Hill have shown recently that it is not uncommon for female athletes to become mothers during their careers, rather than after they have retired. However, historically pregnancy was perceived as time spent away from sport and being active was wrongly associated with a high, unreasonable risk to the unborn foetus. The challenge for the S&C coach working with pregnant athletes is navigating the wide range of global recommendations that are often aimed at active or inactive individuals, but not at elite athletes. It is fundamental that any coach working with pregnant athletes is knowledgeable about the physiological and anatomical changes that occur throughout the trimesters, the nutritional demands of pregnancy, and its effect on weight management in order to appropriately facilitate athlete and foetal health during the antenatal period. Therefore, the aim of this initial review is to summarise current literature and provide key insights that promote best practice for practitioners working with pregnant athletes. The use of ‘women’ throughout this paper will refer to the general population and ‘sportswomen’ to the athletic population. ‘Antenatal’ refers to a pregnant woman before childbirth and the term ‘postnatal’ means after childbirth, something which will be covered in part 2 of this review series

Budesonide Foam Has a Favorable Safety Profile for Inducing Remission in Mild-to-Moderate Ulcerative Proctitis or Proctosigmoiditis.

BackgroundBudesonide foam, a rectally administered, second-generation corticosteroid with extensive hepatic first-pass metabolism, is efficacious for the treatment of mild-to-moderate ulcerative proctitis and ulcerative proctosigmoiditis.AimThe aim of this study was to comprehensively assess the safety and pharmacokinetic profile of budesonide foam.MethodsData from five phase III studies were pooled to further evaluate safety, including an open-label study (once-daily treatment for 8 weeks), an active-comparator study (once-daily treatment for 4 weeks), and two placebo-controlled studies and an open-label extension study (twice-daily treatment for 2 weeks, then once daily for 4 weeks). Data from the placebo-controlled studies and two phase I studies (i.e., patients with mild-to-moderate ulcerative colitis and healthy volunteers) were pooled to evaluate the pharmacokinetics of budesonide foam.ResultsA similar percentage of patients reported adverse events in the budesonide foam and placebo groups, with the majority of adverse events being mild or moderate in intensity (93.3 vs 96.0%, respectively). Adverse events occurred in 41.4 and 36.3% of patients receiving budesonide foam and placebo, respectively. Mean morning cortisol concentrations remained within the normal range for up to 8 weeks of treatment; there were no clinically relevant effects of budesonide foam on the hypothalamic-pituitary-adrenal axis. Population pharmacokinetic analysis demonstrated low systemic exposure after budesonide foam administration.ConclusionsThis integrated analysis demonstrated that budesonide foam for the induction of remission of distal ulcerative colitis is safe overall, with no clinically relevant effects on the hypothalamic-pituitary-adrenal axis

Geological investigation of palaeotsunamis in the Samoan islands: interim report and research directions

The Komandorsky seismic gap has distinctive boundaries and a length of 650 km. Its period of “seismic silence” comes close to the maximum recurrence interval for great earthquakes in the Aleutian Island Arc - the stress concentration here probably having reached the critical value. So,estimation of possible earthquake and tsunami characteristics within this gap becomes a significant problem. The closest analog of a similar gap is the area where the 2004 Sumatra-Andaman catastrophic event occurred. Thus, for the present study we used the same modeling scheme as we used for that event. It was assumed that a source length of 650 km, consisting of 9 blocks, and an earthquake with a moment magnitude MW=8.5. Several block motion scenarios were considered. The tsunami generation and propagation in the Pacific Ocean and the possible wave characteristics on near and far-field coasts were estimated. Modeling of such an event showed that the wave heights on different Pacific coasts will vary from 3 to 9 meters. A tsunami wave with a 9-meter height is capable in causing significant loss of human life and economic damage.© 2013, Tsunami Society International