The importance of cancer patients' functional recollections to explore the acceptability of an isometric-resistance exercise intervention: A qualitative study

Background and Aims: Although it has been widely recognized the potential of physical activity to help cancer patients' preparation for and recovery from surgery, there is little consideration of patient reflections and recovery experiences to help shape adherence to exercise programs. The aim was to explore the acceptability of our newly proposed isometric exercise program in a large general hospital trust in England providing specialist cancer care by using patient recollections of illness and therapy prior to undertaking a randomized controlled trial. Methods: Four Focus groups (FGs) were conducted with cancer survivors with an explicit focus on patient identity, functional capacity, physical strength, exercise advice, types of activities as well as the timing of our exercise program and its suitability. Thematic framework analysis was used with NVivo 11. Results: FG data was collected in January 2016. A total of 13 patients were participated, 10 were male and 3 were female with participants' ages ranging from 39 to 77. Data saturation was achieved when no new information had been generated reaching “information redundancy.” Participants reflected upon their post-surgery recovery experiences on the appropriateness and suitability of the proposed intervention, what they thought about its delivery and format, and with hindsight what the psychological enablers and barriers would be to participation. Conclusion: Based upon the subjective recollections and recovery experiences of cancer survivors, isometric-resistance exercise interventions tailored to individuals with abdominal cancer has the potential to be acceptable for perioperative patients to help increase their physical activity and can also help with emotional and psychological recovery

Maximal and submaximal cardiopulmonary responses to whole-body simulated swimming

The purpose of this study was to explore the relationship between oxygen uptake and heart rate in response to whole-body simulated swimming. Nine club swimmers (mean ± SD; age: 20 ± 4 years, stature: 1.68 ± 11 m, mass: 63 ± 12 kg) signed an informed consent and participated in the study. All subjects performed a simulated front crawl combined arm-pulling and leg-kicking incremental exercise test to exhaustion using a swim bench and a leg-kicking ergometer. Oxygen uptake (VO2) and heart rate (HR) were recorded at 15 s intervals and at exhaustion (VO2peak; HRpeak). The HR at ventilatory threshold (VT) was determined (VTHR) and the VO2/HR relationship explored. The mean ± SD for VO2peak and HRpeak values were 3.3 ± 0.4 L·min-1 and 174 ± 8 b·min-1 respectively, whereas VTHR occurred at 162 ± 5 b·min-1 at a predicted VO2 of 2.4 ± 0.4 L·min-1. The relationship between VO2 and HR was shown to be linear in all subjects (r=0.94; P<0.05). Previously published data have demonstrated linear relationships between HR/EI and VO2/EI (r=0.99 and r=0.98 respectively; P<0.05) for simulated arm-pulling exercise. The peak values for simulated front-crawl arm-pulling and leg-kicking exercise were: 2.85 ± 0.26 L·min-1, 171 ± 3 b·min-1 and 3.1 L·min-1, 170 ± 3 b·min-1, respectively. Our results suggest that the VO2 and HR responses to full-stroke simulated swimming are higher than the respective responses to arm-pulling or leg-kicking separately. This type of whole-body ergometry might be useful for assessing maximal and submaximal cardiopulmonary responses to exercise in swimmers

Acceptability and feasibility of an isometric resistance exercise program for abdominal cancer surgery: An embedded qualitative study

Although it is recognized in the early stages of cancer recovery that changes in lifestyle including increases in physical activity improves physical function, there are no clear findings whether low versus moderate intensity activity or home or gym exercise offer optimal benefit. Isometric-resistance exercises can be carried out with very little equipment and space and can be performed while patients are bed-bound in hospital or at home. This embedded qualitative study, based in an English hospital trust providing specialist cancer care, was undertaken as a component of a feasibility trial to evaluate the acceptability and feasibility of an isometric-resistance exercise program and explore the suitability of functional assessments by drawing from the experiences of abdominal cancer patients following surgery. Telephone interviews were undertaken with 7 participants in the intervention group, and 8 interviews with the usual care group (n¼ 15). The gender composition consisted of 11 females and 4 males. Participants’ ages ranged from 27 to 84 (M¼ 60.07, SD ¼ 15.40). Interviews were conducted between August 2017 and May 2018, with audio files digitally recorded and data coded using thematic framework analysis. Our results show that blinding to intervention or usual care was a challenge, participants felt the intervention was safe and suitable aided by the assistance of a research nurse, yet, found the self-completion questionnaire tools hard to complete. Our study provides an insight of trial processes, participants’ adherence and completion of exercise interventions, and informs the design and conduct of larger RCTs based on the experiences of abdominal cancer surgery patients

Effects of isometric resistance training and detraining on ambulatory blood pressure and morning blood pressure surge in young normotensives

Isometric resistance training (IRT) has been shown to reduce resting and ambulatory blood pressure (BP), as well as BP variability and morning BP surge (MBPS). However, there are no data available regarding how long after cessation of IRT these effects are maintained. Therefore, the purpose of this study was to determine the effects of 8 weeks of detraining on resting BP, ambulatory BP and MBPS following 8 weeks of IRT in a population of young normotensive individuals and to further substantiate previously reported reductions in MBPS following IRT. Twenty-five apparently healthy participants with resting BP within the normal range (16 men, age=23±6 years; 9 women, age=22±4 years, resting BP: 123±5/69 ±7 mmHg) were randomly assigned to a training-detraining (TRA-DT, n=13) or control (CON, n=12) group. Resting BP, ambulatory BP and MBPS were measured prior to, after 8 weeks of bilateral leg IRT using an isokinetic dynamometer (4 x 2-minute contractions at 20% MVC with 2-minute rest periods, 3 days/week) and following an 8-week detraining period. There were significant reductions in 24-h ambulatory systolic BP (SBP) and calculated SBP average real variability (ARV) following IRT that were maintained after detraining (pre-to-post detraining, -6±4 mmHg, p=0.008, -2±1.5 mmHg, p=0.001). Similarly, the training-induced decreases in daytime SBP and daytime SBP ARV (pre-to-post detraining, -5±6 mmHg, p=0.001; -2±1.2 mmHg, p=0.001, respectively), MBPS (pre-to-post detraining, -6±9 mmHg, 34 p=0.046) and resting SBP (pre-to-post detraining, -4 ± 6 mmHg, P = 0.044) were preserved. There were no changes in night-time or night-time SBP ARV across all time points (pre-to�36 post detraining, -1±8 mmHg, p=1.00, -0.7±2.9 mmHg, p=1.00). These results confirm that IRT causes significant reductions in resting BP, ambulatory BP, ambulatory ARV and MBPS. Importantly, the changes remained significantly lower than baseline for 8 weeks after cessation of training, suggesting a sustained effect of IRT

Consistent patterns of common species across tropical tree communities

Trees structure the Earth’s most biodiverse ecosystem, tropical forests. The vast number of tree species presents a formidable challenge to understanding these forests, including their response to environmental change, as very little is known about most tropical tree species. A focus on the common species may circumvent this challenge. Here we investigate abundance patterns of common tree species using inventory data on 1,003,805 trees with trunk diameters of at least 10 cm across 1,568 locations1,2,3,4,5,6 in closed-canopy, structurally intact old-growth tropical forests in Africa, Amazonia and Southeast Asia. We estimate that 2.2%, 2.2% and 2.3% of species comprise 50% of the tropical trees in these regions, respectively. Extrapolating across all closed-canopy tropical forests, we estimate that just 1,053 species comprise half of Earth’s 800 billion tropical trees with trunk diameters of at least 10 cm. Despite differing biogeographic, climatic and anthropogenic histories7, we find notably consistent patterns of common species and species abundance distributions across the continents. This suggests that fundamental mechanisms of tree community assembly may apply to all tropical forests. Resampling analyses show that the most common species are likely to belong to a manageable list of known species, enabling targeted efforts to understand their ecology. Although they do not detract from the importance of rare species, our results open new opportunities to understand the world’s most diverse forests, including modelling their response to environmental change, by focusing on the common species that constitute the majority of their trees

Relationships between pulse wave velocity and heart rate variability in healthy men with a range of moderate-to-vigorous physical activity levels

Pulse wave velocity (PWV) is associated with heart rate variability (HRV) in 24-39-year-old men. This study of 40-65-year-old men ranging in moderate-to-vigorous physical activity levels investigated w hether (a) PWV is related to spectral HRV, (b) using normalised units for HRV influences that relationship, and (c) HRV predicts PWV when other factors, including age and blood pressure, are accounted for. Subjects were healthy men (N = 115), mean (SD) age 50.8 (7.1) years. Carotid-femoral PWV was measured using Complior. HRV was derived from a 5 min ECG for total, high-frequency, and low-frequency power (TP, HF, and LF, respectively), the LF/HF ratio, and normalised units for HF (HFnu) and LF (LFnu). Non-parametric data were natural log-transformed. PWV was 8.5 (1.4) m s -1. TP, HF, LF, LF/HF, HFnu and LFnu were 1908 (2195) m s 2, 577 (1034) m s 2, 457 (514) m s 2, 1.5 (1.3), 46.8 (17.9), and 49.4 (19.4), respectively. PWV was inversely associated with TP (R 2 = 0.061, p = 0.008), HF (R 2 = 0.095, p = 0.001), LF (R 2 = 0.086, p = 0.002) and HFnu (R 2 = 0.040, p = 0.031), but was not associated with LF/HF (R 2 0.020, p = 0.136) or LFnu (R 2 = 0.028 p = 0.076). Only age and systolic blood pressure (adjusted R 2 = 0.306, p &lt; 0.001) predicted PWV in multivariate analysis. This study has shown that PWV was weakly associated with TP and HF. The use of normalised units only influenced the relationship between PWV and LF. Finally, relationships between PWV and HRV are mediated through age and systolic blood pressure in this population of men ranging in moderate-to-vigorous physical activity level. © Springer-Verlag 2006

Mudanças florísticas e estruturais, após cinco anos, em uma comunidade de Caatinga no estado de Pernambuco, Brasil Floristic and structural changes after five years in a Caatinga community in Pernambuco state, Brazil

A flora e a estrutura da vegetação determinadas em um hectare de Caatinga, em 2001, foram comparadas com as de 2006. O número de espécies passou de 27 para 28, com desaparecimento de uma e surgimento de duas espécies. O número de indivíduos aumentou significativamente, de 3142 para 3567 (13,5% de aumento). Houve crescimento médio em diâmetro de 0,5mm.ano-1 e a biomassa aumentou, mas não significativamente (de 41,2 para 43,8 Mg.ha-1). As dinâmicas das populações diferiram, algumas aumentando em densidade e outras diminuindo, possivelmente por problemas no estabelecimento. As populações de Jatropha mollissima (Pohl) Baill. e Schinopsis brasiliensis Engl. reduziram-se significativamente e a de Mimosa ophthalmocentra Mart. ex Benth. praticamente triplicou, enquanto as da maioria das espécies não tiveram grandes variações. A vegetação parece ainda estar se desenvolvendo após corte raso 20 anos antes de 2001. Este processo, possivelmente afetado pela baixa precipitação em dois dos cinco anos, parece responsável pela maior mudança estrutural que as relatadas em outras áreas de vegetação tropical pouco antropizadas.<br>Floristic and structural characteristics determined in one hectare of caatinga in 2001 were compared to data from 2006. The number of species increased from 27 to 28, one species disappeared and two others arrived. The number of plants increased significantly, from 3142 to 3567 (13.5% increase). Average diameter increased 0.5mm.year-1 and aboveground biomass increased from 41.2 to 43.8 Mg.ha-1, but the difference was not statistically significant. Population dynamics were peculiar to each species, with some increasing and some decreasing in density, possibly due to establishment problems. Jatropha mollissima (Pohl) Baill. and Schinopsis brasiliensis Engl. populations were greatly reduced and that of Mimosa ophthalmocentra Mart. ex Benth. almost tripled, while the dynamics of most species changed little. The vegetation seems to be still developing after clear-cutting 20 years before 2001. This process, possibly affected by low rainfall in two of the five years, may be responsible for the greater structural change reported here than in other, little disturbed tropical vegetation