PROJECTING THE IMPACT OF DEMOGRAPHIC CHANGE ON THE DEMAND FOR AND DELIVERY OF HEALTH CARE IN IRELAND. RESEARCH SERIES NUMBER 13 OCTOBER 2009

Primary care is often the first point of contact with the health care system for people requiring care. Primary care is often thought synonymous with general practitioners, but actually encompasses a large range of different professionals and services including nurses/midwives; physiotherapists; occupational therapists; dentists; opticians; chiropodists; psychologists and pharmacists. The list is not exhaustive, but still gives an indication of the wide range of services that can be grouped under the general heading of primary care. Nonetheless, GPs do have a core part to play in primary care as well as performing the role of ‘gate keeper’ to other health services such as accident and emergency or outpatient care in hospitals. The balance of treatment and referral between general practice and secondary care is, therefore, a very important issue and it has been argued that the under development of primary care services in Ireland in recent decades has contributed, and indeed, may be the most important reason, for the over-crowding of accident and emergency services and long waiting lists for elective procedures in Irish health care (Layte et al., 2007b; Tussing and Wren, 2006)

Haemodynamic changes with paracetamol in critically-ill children.

PURPOSE: Paracetamol has been associated with a reduction in blood pressure, especially in febrile, critically-ill adults. We hypothesised that blood pressure would fall following administration of paracetamol in critically-ill children and this effect would be greater during fever and among children with a high body surface area to weight ratio. METHODS: A 12-month prospective observational study of children (0-16years) admitted to paediatric intensive care, who underwent pulse contour analysis and received paracetamol concurrently. RESULTS: Mean arterial blood pressure decreased significantly by 4.7% from baseline (95% CI 1.75-8.07%) in 31 children following 148 doses of paracetamol. The nadir was 2-hour post-dose. The effect was pronounced in children with fever at baseline (6.4%, 95% CI 2.8-10%), although this was not statistically significant. There was no simple relationship between this effect and body surface area to weight ratio. The association between a change in blood pressure and changes in heart rate or measured stroke volume was poor; therefore it was likely that a change in the systemic vascular resistance contributes most to this effect. CONCLUSION: There is a significant but modest reduction in blood pressure post-paracetamol in critically-ill children. This is likely related to a change in systemic vascular resistance

Racing an Opponent Alters Pacing, Performance and Muscle Force Decline, But Not RPE.

Performing against a virtual opponent has been shown to invite a change in pacing and improve time trial (TT) performance. This study explored how this performance improvement is established by assessing changes in pacing, neuromuscular function and perceived exertion.After a peak power output test and a familiarization TT, twelve trained cyclists completed two 4-km TTs in randomized order on a Velotron cycle ergometer. Time trial conditions were riding alone (NO), and riding against a virtual opponent (OP). Knee-extensor performance was quantified before and directly after the TT using maximal voluntary contraction force (MVC), voluntary activation (VA) and potentiated doublet-twitch force (PT). Differences between the experimental conditions were examined using Repeated-measures ANOVAs. Linear regression analyses were conducted to associate changes in pacing to changes in MVC, VA and PT.OP was completed faster than NO (mean power output OP: 289.6±56.1W vs. NO: 272.2±61.6W; p=0.020), mainly due to a faster initial pace. This was accompanied by a greater decline in MVC (MVCpre-vs-post: -17.5±12.4% vs. -11.4±10.9%, P=0.032) and PT (PTpre-vs-post: -23.1±14.0% vs. -16.2±11.4%, P=0.041) after OP compared to NO. No difference between conditions was found for VA (VApre-vs-post: -4.9±6.7% vs. -3.4±5.0%, P=0.274). RPE did not differ between OP and NO.The improved performance when racing against a virtual opponent was associated with a greater decline in voluntary and evoked muscle force compared to riding alone, without a change in perceived exertion, highlighting the importance of human-environment interactions in addition to one's internal state for pacing regulation and performance

Decreasing sprint duration from 20 to 10 s during reduced-exertion high-intensity interval training (REHIT) attenuates the increase in maximal aerobic capacity but has no effect on affective and perceptual responses

Purpose: Recent studies have demonstrated that modifying the ‘classic’ 6x30-s ‘all-out’ sprint interval training (SIT) protocol by incorporating either shorter sprints (6x10-s or 15-s sprints) or fewer sprints (e.g. 2x20-s sprints; reduced-exertion high-intensity interval training (REHIT)) does not attenuate the training-induced improvements in maximal aerobic capacity (V̇O2max). The aim of the present study was to determine whether reducing the sprint duration in the REHIT protocol from 20 s to 10 s per sprint influences acute affective responses and the change in V̇O2max following training. Methods: Thirty-six sedentary or recreationally active participants (17 women; mean±SD age: 22±3 y, BMI: 24.5±4.6 kg·m-2, V̇O2max: 37±8 mL·kg-1·min-1) were randomised to a group performing a ‘standard’ REHIT protocol involving 2x20-s sprints or a group who performed 2x10-s sprints. V̇O2max was determined before and after 6 weeks of 3 weekly training sessions. Acute affective responses and perceived exertion were assessed during training. Results: Greater increases in V̇O2max were observed for the group performing 20-s sprints (2.77±0.75 to 3.04±0.75 L·min-1; +10%) compared to the group performing 10-s sprints (2.58±0.57 vs. 2.67±3.04 L·min-1; +4%; group×time interaction effect: p<0.05; d=1.06). Positive affect and the mood state vigour increased post-exercise, while tension, depression and total mood disturbance decreased, and negative affect remained unchanged. Affective responses and perceived exertion were not altered by training and were not different between groups. Conclusion: Reducing sprint duration in the REHIT protocol from 20 s to 10 s attenuates improvements in V̇O2max, and does not result in more positive affective responses or lower perceived exertion

Strangeness Enhancement in p-A Collisions: Consequences for the Interpretation of Strangeness Production in A-A Collisions

Published measurements of semi-inclusive Lambda production in p-Au collisions at the AGS are used to estimate the yields of singly strange hadrons in nucleus-nucleus A-A collisions. Results of a described extrapolation technique are shown and compared to measurements of K+ production in Si-Al, Si-Au, and Au-Au collisions at the AGS and net Lambda production in Su-Su, S-Ag, Pb-Pb, and inclusive p-A collisions at the SPS. The extrapolations can account for more than 75% of the measured strange particle yields in all of the studied systems except for very central Au-Au collisions at the AGS where RQMD comparisons suggest large re-scattering contributions.Comment: 9 pages, 4 figure

Estimating Intervention Effects in a Complex Multi-Level Smoking Prevention Study

This paper illustrates how to estimate cumulative and non-cumulative treatment effects in a complex school-based smoking intervention study. The Instrumental Variable method is used to tackle non-compliance and measurement error for a range of treatment exposure measures (binary, ordinal and continuous) in the presence of clustering and dropout. The results are compared to more routine analyses. The empirical findings from this study provide little encouragement for believing that poorly resourced school-based interventions can bring about substantial long-lasting reductions in smoking behaviour but that novel components such as a computer game might have some short-term effect

Understanding and reducing photothermal forces for the fabrication of Au nanoparticle dimers by optical printing

Optical printing holds great potential to enable the use of the vast variety of colloidal nanoparticles (NPs) in nano- and microdevices and circuits. By means of optical forces, it enables the direct assembly of NPs, one by one, onto specific positions of solid surfaces with great flexibility of pattern design and no need of previous surface patterning. However, for unclear causes it was not possible to print identical NPs closer to each other than 300 nm. Here, we show that the repulsion restricting the optical printing of close by NPs arises from light absorption by the printed NPs and subsequent local heating. By optimizing heat dissipation, it is possible to reduce the minimum separation between NPs. Using a reduced graphene oxide layer on a sapphire substrate, we demonstrate for the first time the optical printing of Au-Au NP dimers. Modeling the experiments considering optical, thermophoretic, and thermo-osmotic forces we obtain a detailed understanding and a clear pathway for the optical printing fabrication of complex nano structures and circuits based on connected colloidal NPs.Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicada

Psychological determinants of whole-body endurance performance

Background: No literature reviews have systematically identified and evaluated research on the psychological determinants of endurance performance, and sport psychology performance-enhancement guidelines for endurance sports are not founded on a systematic appraisal of endurance-specific research. Objective: A systematic literature review was conducted to identify practical psychological interventions that improve endurance performance and to identify additional psychological factors that affect endurance performance. Additional objectives were to evaluate the research practices of included studies, to suggest theoretical and applied implications, and to guide future research. Methods: Electronic databases, forward-citation searches, and manual searches of reference lists were used to locate relevant studies. Peer-reviewed studies were included when they chose an experimental or quasi-experimental research design, a psychological manipulation, endurance performance as the dependent variable, and athletes or physically-active, healthy adults as participants. Results: Consistent support was found for using imagery, self-talk, and goal setting to improve endurance performance, but it is unclear whether learning multiple psychological skills is more beneficial than learning one psychological skill. The results also demonstrated that mental fatigue undermines endurance performance, and verbal encouragement and head-to-head competition can have a beneficial effect. Interventions that influenced perception of effort consistently affected endurance performance. Conclusions: Psychological skills training could benefit an endurance athlete. Researchers are encouraged to compare different practical psychological interventions, to examine the effects of these interventions for athletes in competition, and to include a placebo control condition or an alternative control treatment. Researchers are also encouraged to explore additional psychological factors that could have a negative effect on endurance performance. Future research should include psychological mediating variables and moderating variables. Implications for theoretical explanations of endurance performance and evidence-based practice are described

Dynamics of Photo‐Induced Surface Oxygen Vacancies in Metal‐Oxide Semiconductors Studied Under Ambient Conditions

Surface‐enhanced Raman spectroscopy (SERS) is a powerful analytical technique commonly used in the detection of traces of organic molecules. The mechanism of SERS is of a dual nature, with Raman scattering enhancements due to a combination of electromagnetic (EM) and chemical contributions. In conventional SERS, the EM component is largely responsible for the enhancement, with the chemical contribution playing a less significant role. An alternative technique, called photo‐induced enhanced Raman spectroscopy (PIERS) has been recently developed, using a photo‐activated semiconductor substrate to give additional chemical enhancement of Raman bands over traditional SERS. This enhancement is assigned to surface oxygen vacancies (Vo) formed upon pre‐irradiation of the substrate. In this work, the exceptional chemical contribution in PIERS allows for the evaluation of atomic Vo dynamics in metal oxide surfaces. This technique is applied to study the formation and healing rates of surface‐active Vo in archetypical metal‐oxide semiconductors, namely, TiO2, WO3, and ZnO. Contrary to conventional analytical tools, PIERS provides intuitive and valuable information about surface stability of atomic defects at ambient pressure and under operando conditions, which has important implications in a wide range of applications including catalysis and energy storage materials