Aerobic exercise training improves not only brachial artery flow-mediated vasodilatation but also carotid artery reactivity: A randomized controlled, cross-over trial in older men.

It is well-known that aerobic exercise training beneficially affects endothelial function as measured by brachial artery flow-mediated vasodilation (FMD). This trial with older sedentary overweight and obese men, therefore, examined the effects of aerobic training on other non-invasive markers of the vasculature, which have been studied in less detail. Seventeen men (67 ± 2 years, BMI: 30.3 ± 2.8 kg/m2 ) participated in this controlled cross-over study. Study participants followed in random order a fully supervised, progressive, aerobic exercise training (three 50-min sessions each week at 70% maximal power) and a no-exercise control period for 8 weeks, separated by a 12-week wash-out period. At the end of each period, endothelial function was assessed by the carotid artery reactivity (CAR) response to a cold pressor test and FMD, and local carotid and regional aortic stiffness by the carotid-to-femoral pulse wave velocity (PWVc-f ). The retinal microvasculature, the serum lipid profile, 24-h ambulatory blood pressure, and 96-h continuous glucose concentrations were also determined. Aerobic training increased CAR from 1.78% to 4.01% (Δ2.23 percentage point [pp]; 95% CI: 0.58, 3.89 pp; p = 0.012) and FMD from 3.88% to 6.87% (Δ2.99 pp; 95% CI: 0.58, 5.41 pp; p = 0.019). The stiffness index β0 increased by 1.1 (95% CI: 0.3, 1.9; p = 0.012), while PWVc-f did not change. Retinal arteriolar width increased by 4 μm (95% CI: 0, 7 μm; p = 0.041). Office blood pressure decreased, but ambulatory blood pressure, and serum lipid and continuous glucose concentrations did not change. Aerobic exercise training improved endothelial function and retinal arteriolar width in older sedentary overweight and obese men, which may reduce cardiovascular risk

Impact of flavonoid-rich black tea and beetroot juice on postprandial peripheral vascular resistance and glucose homeostasis in obese, insulin-resistant men: a randomized controlled trial.

BACKGROUND: Insulin-stimulated muscle blood flow facilitates plasma glucose disposal after a meal, a mechanism that is impaired in obese, insulin-resistant volunteers. Nitrate- or flavonoid-rich products, through their proposed effects on nitric oxide, may improve postprandial blood flow and, subsequently, glucose disposal. To investigate whether a single dose of nitrate-rich beetroot juice or flavonoid-rich black tea lowers postprandial muscle vascular resistance in obese volunteers and alters postprandial glucose or insulin concentrations. METHOD: In a randomised, controlled, cross-over study, 16 obese, insulin-resistant males consumed 75 g glucose, which was combined with 100 ml black tea, beetroot juice or control (water). Peripheral vascular resistance (VR), calculated as mean arterial pressure divided by blood flow, was assessed in the arm and leg conduit arteries, resistance arteries and muscle microcirculation across 3 h (every 30-min) after the oral glucose load. RESULTS: During control, we found no postprandial response in VR in conduit, resistance and microvessels (all P > 0.05). Black tea decreased VR compared to control in conduit, resistance and microvessels (all P < 0.05). Beetroot juice decreased postprandial VR in resistance vessels, but not in conduit artery and microvessels. Although postprandial glucose response was similar after all interventions, postprandial insulin response was attenuated by ~29 % after tea (P < 0.0005), but not beetroot juice. CONCLUSIONS: A single dose of black tea decreased peripheral VR across upper and lower limbs after a glucose load which was accompanied by a lower insulin response. Future studies in insulin-resistant subjects are warranted to confirm the observed effects and to explore whether long-term regular tea consumption affects glucose homeostasis. TRIAL REGISTRATION: The study was registered at clinicaltrials.gov on 30(th) November 2012 (NCT01746329)

‘‘Beet-ing’’ the Mountain: A Review of the Physiological and Performance Effects of Dietary Nitrate Supplementation at Simulated and Terrestrial Altitude

Exposure to altitude results in multiple physiological consequences. These include, but are not limited to, a reduced maximal oxygen consumption, drop in arterial oxygen saturation, and increase in muscle metabolic perturbations at a fixed sub-maximal work rate. Exercise capacity during fixed work rate or incremental exercise and time-trial performance are also impaired at altitude relative to sea-level. Recently, dietary nitrate (NO3-) supplementation has attracted considerable interest as a nutritional aid during altitude exposure. In this review, we summarise and critically evaluate the physiological and performance effects of dietary NO3- supplementation during exposure to simulated and terrestrial altitude. Previous investigations at simulated altitude indicate that NO3- supplementation may reduce the oxygen cost of exercise, elevate arterial and tissue oxygen saturation, improve muscle metabolic function, and enhance exercise capacity/ performance. Conversely, current evidence suggests that NO3- supplementation does not augment the training response at simulated altitude. Few studies have evaluated the effects of NO3- at terrestrial altitude. Current evidence indicates potential improvements in endothelial function at terrestrial altitude following NO3- supplementation. No effects of NO3- supplementation have been observed on oxygen consumption or arterial oxygen saturation at terrestrial altitude, although further research is warranted. Limitations of the present body of literature are discussed, and directions for future research are provided

Cause of Death and Predictors of All-Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation : Data From ROCKET AF

M. Kaste on työryhmän ROCKET AF Steering Comm jäsen.Background-Atrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all-cause mortality may guide interventions. Methods and Results-In the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) study, patients with nonvalvular atrial fibrillation were randomized to rivaroxaban or dose-adjusted warfarin. Cox proportional hazards regression with backward elimination identified factors at randomization that were independently associated with all-cause mortality in the 14 171 participants in the intention-to-treat population. The median age was 73 years, and the mean CHADS(2) score was 3.5. Over 1.9 years of median follow-up, 1214 (8.6%) patients died. Kaplan-Meier mortality rates were 4.2% at 1 year and 8.9% at 2 years. The majority of classified deaths (1081) were cardiovascular (72%), whereas only 6% were nonhemorrhagic stroke or systemic embolism. No significant difference in all-cause mortality was observed between the rivaroxaban and warfarin arms (P=0.15). Heart failure (hazard ratio 1.51, 95% CI 1.33-1.70, P= 75 years (hazard ratio 1.69, 95% CI 1.51-1.90, P Conclusions-In a large population of patients anticoagulated for nonvalvular atrial fibrillation, approximate to 7 in 10 deaths were cardiovascular, whereasPeer reviewe

Identiteitskapitaal als werkkapitaal van sociale stijgers

Identity capital as working capital for social climbers Research shows that university graduates from the working class often have to contend with long lasting constraints on well-being. That is because of the experience of exclusion by their new milieu and because of the inadequate expectations they enter the labor market with. That’s the reason why a number of them are confronted with professional identity problems, although there are a lot of individual differences. In this article we ask ourselves what circumstances have influence on these differences. A central notion in the exploration is identity capital (Coté, 1996). To make this notion operational, we discuss the meaning of some empirical data from the research of Matthys (2010) in an attempt to declare these differences. Analyzing this data the authors deduce three components of identity capital influencing well-being as a possible theoretical assumption to declare differences in well-being of social climbers: social interaction qualities; cognitive reflexivity and a strong orientation on professional expertise. This implies a theoretical model in which the influence of social mobility on well-being is moderated by these three aspects of identity capital. Identiteitskapitaal als werkkapitaal van sociale stijgers Uit onderzoek blijkt dat arbeiderskinderen met een universitaire opleiding vaak langdurig kampen met beperkingen in “well-being”, met name vanwege ervaren uitsluiting door de nieuwe klasse en vanwege de inadequate verwachtingen waarmee zij de arbeidsmarkt betreden. Zij krijgen daardoor te maken met professionele identiteitsproblemen, maar de onderlinge verschillen zijn groot. In dit artikel staat de vraag centraal welke factoren verantwoordelijk zijn voor deze verschillen. Centraal in de exploratie staat de betekenis van identiteitskapitaal (Coté, 1996). Om dit begrip te concretiseren zijn data verkregen uit eerder onderzoek naar sociale stijgers (Matthys, 2010) geanalyseerd. Uit deze analyse zijn drie aspecten van identiteitskapitaal naar voren gekomen als mogelijke theoretische assumptie voor de verklaring van verschillen in de well-being van sociale stijgers: sociaal interactievermogen, cognitieve reflexiviteit en sterke gerichtheid op professioneel vakmanschap. Eén en ander impliceert een theoretisch model waarin de invloed van sociale stijging op well-being wordt gemodereerd door voornoemde drie aspecten van identiteitskapitaal

Human Resource Development in veranderend perspectief

Rond 1980 werd personeelsontwikkeling in Nederland vooral geadopteerddoor een andere discipline, onderwijskunde, waardoor veel nadruk werd gelegd op bedrijfsopleidingen. Die werden gezien als ‘beroepsonderwijs in pocketformaat’: nascholing in cursusverband kreeg mede daardoor een dominante plaats binnen het geheel van HRD-praktijken(Thijssen, 2003). Sindsdien is er veel veranderd. De pas later ook in Nederland doorgebroken term Human Resource Development is daar een exponent van. De veelvormigheid van HRD-activiteiten is toegenomen net als het besef dat investeren in HRD noodzakelijk is. De meest ingrijpende contextuele verandering voor HRD-praktijken betreft de arbeidsmarktturbulentie die met name is ontstaan door de behoefte van organisaties aan personele flexibiliteit, waardoor lifetime employment een marginaal fenomeen is geworden. In verband daarmee is een omslag waar te nemen van een traditioneel naar een modern psychologisch contract, hetgeen met name inhoudt dat het initiatief en de verantwoordelijkheid voor ontwikkelingsinvesteringen niet meer zo zeer bij de arbeidsorganisatie ligt, maar primair bij het individu. Tegen deze achtergrond zal in het navolgende gedeelte worden ingegaan op drie HRD-deeldomeinen: loopbaanmanagement, talent management en management development. Daarbij wordt naast de betekenis van deze deeldomeinen aandacht besteed aan diverse ontwikkelingen in het recente verleden en aan enkele belangrijke agendapunten als verbinding naar de toekoms