Performance Differences in High Intensity Training Participants

High intensity training has become increasingly popular over the last 20 years with the advent of well-known training regimens such as P90X, CrossFit, Beachbody, PiYo, and Camp Gladiator. As such, it is important to understand the differences among individuals who participate in high intensity training. PURPOSE: The purpose of this research was to examine differences in Functional Movement Screen (FMS) scores, strength, power, and dynamic exercise in a cohort of male and female high intensity trained athletes (HIT). METHODS: A total of thirty participants (males, n=15; and females, n=15) (mean ± SD; age = 30.7 ± 9.9 years) with minimum two-years of HIT experience were recruited to participate in this study. On the first day of data collection each subject provided informed consent and then participated in a height and weight measurement, body composition measurement (7-site skinfold), FMS screening, and 1-Repetition Maximal (1-RM) lifts for deadlift (DL), shoulder press (SP), and power clean (PC). A minimum of 5 days later each subject performed a standardized test of dynamic exercise (DE) that involved performing as many repetitions as possible of 5 pullups, 10 pushups, and 15 unloaded squats in 20 minutes. Mann-Whitney U tests were performed to compare differences between the males and females for FMS scores and ANOVA was used to determine differences between the males and females for all other variables with p £ 0.05 for all analysis. RESULTS: Results of the Mann-Whitney tests comparing FMS scores between males and females indicated that the females had higher straight leg raise (SLR) scores (2.9 vs. 2.1, p= 0.001) and sum of all scores (FMSSUM) (16.9 vs. 15.4, p = 0.045) than the males. Results of the ANOVA indicated that the males demonstrated greater muscular strength per kilogram of body weight on the DL (1.99 vs. 1.65 kg/kgBW, p = 0.007) and the SP (0.833 vs. 0.513 kg/kgBW, p \u3c 0.001) exercises. Results of the ANOVA also indicated that the males demonstrated greater muscular power per kilogram of body weight on the PC (1.146 vs. 0.766, p \u3c 0.001) exercise. There was no statistically significant difference between groups for DE. CONCLUSION: The findings of this study support the need for a greater emphasis on mobility training, specifically the hips, for males that participate in high intensity training. Performance differences were shown between the genders for maximal muscular strength and power but not for dynamic exercise. These results indicate that these differences should be considered when designing training programs for maximal muscular strength and power training but same sport athletes of different gender could participate in the same dynamic exercise programming

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Creating change in government to address the social determinants of health: how can efforts be improved?

Background - The evidence base for the impact of social determinants of health has been strengthened considerably in the last decade. Increasingly, the public health field is using this as a foundation for arguments and actions to change government policies. The Health in All Policies (HiAP) approach, alongside recommendations from the 2010 Marmot Review into health inequalities in the UK (which we refer to as the ‘Fairness Agenda’), go beyond advocating for the redesign of individual policies, to shaping the government structures and processes that facilitate the implementation of these policies. In doing so, public health is drawing on recent trends in public policy towards ‘joined up government’, where greater integration is sought between government departments, agencies and actors outside of government. Methods - In this paper we provide a meta-synthesis of the empirical public policy research into joined up government, drawing out characteristics associated with successful joined up initiatives. - We use this thematic synthesis as a basis for comparing and contrasting emerging public health interventions concerned with joined-up action across government. Results - We find that HiAP and the Fairness Agenda exhibit some of the characteristics associated with successful joined up initiatives, however they also utilise ‘change instruments’ that have been found to be ineffective. Moreover, we find that – like many joined up initiatives – there is room for improvement in the alignment between the goals of the interventions and their design. Conclusion - Drawing on public policy studies, we recommend a number of strategies to increase the efficacy of current interventions. More broadly, we argue that up-stream interventions need to be ‘fit-for-purpose’, and cannot be easily replicated from one context to the next

Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p&lt;0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p&lt;0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p&lt;0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP &gt;5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification

SARS-CoV-2 Omicron is an immune escape variant with an altered cell entry pathway

Vaccines based on the spike protein of SARS-CoV-2 are a cornerstone of the public health response to COVID-19. The emergence of hypermutated, increasingly transmissible variants of concern (VOCs) threaten this strategy. Omicron (B.1.1.529), the fifth VOC to be described, harbours multiple amino acid mutations in spike, half of which lie within the receptor-binding domain. Here we demonstrate substantial evasion of neutralization by Omicron BA.1 and BA.2 variants in vitro using sera from individuals vaccinated with ChAdOx1, BNT162b2 and mRNA-1273. These data were mirrored by a substantial reduction in real-world vaccine effectiveness that was partially restored by booster vaccination. The Omicron variants BA.1 and BA.2 did not induce cell syncytia in vitro and favoured a TMPRSS2-independent endosomal entry pathway, these phenotypes mapping to distinct regions of the spike protein. Impaired cell fusion was determined by the receptor-binding domain, while endosomal entry mapped to the S2 domain. Such marked changes in antigenicity and replicative biology may underlie the rapid global spread and altered pathogenicity of the Omicron variant

Investigation of hospital discharge cases and SARS-CoV-2 introduction into Lothian care homes

Background The first epidemic wave of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in Scotland resulted in high case numbers and mortality in care homes. In Lothian, over one-third of care homes reported an outbreak, while there was limited testing of hospital patients discharged to care homes. Aim To investigate patients discharged from hospitals as a source of SARS-CoV-2 introduction into care homes during the first epidemic wave. Methods A clinical review was performed for all patients discharges from hospitals to care homes from 1st March 2020 to 31st May 2020. Episodes were ruled out based on coronavirus disease 2019 (COVID-19) test history, clinical assessment at discharge, whole-genome sequencing (WGS) data and an infectious period of 14 days. Clinical samples were processed for WGS, and consensus genomes generated were used for analysis using Cluster Investigation and Virus Epidemiological Tool software. Patient timelines were obtained using electronic hospital records. Findings In total, 787 patients discharged from hospitals to care homes were identified. Of these, 776 (99%) were ruled out for subsequent introduction of SARS-CoV-2 into care homes. However, for 10 episodes, the results were inconclusive as there was low genomic diversity in consensus genomes or no sequencing data were available. Only one discharge episode had a genomic, time and location link to positive cases during hospital admission, leading to 10 positive cases in their care home. Conclusion The majority of patients discharged from hospitals were ruled out for introduction of SARS-CoV-2 into care homes, highlighting the importance of screening all new admissions when faced with a novel emerging virus and no available vaccine

The Effects of Mindful Meditation on Self-Esteem and Self-Compassion in Female Collegiate Dance Majors

Body image and self-esteem is an everchanging mindset that occurs in everyone, and in recent years the idea of positive thinking has become more prevalent. In physical activities such as dance, that focuses on the way the body moves and looks, perceptions of one’s body image can become distorted. PURPOSE: The purpose of this study was to determine the effects of a mindful meditation intervention on self-esteem and self-compassion in female collegiate dance majors. METHODS: A total of ten female participants (age = 22.1 ± 1.5 years) with an average of 12.6 ± 5.9 years of dance experience were recruited to participate in this study. Each participant’s height, weight, body composition by Dual Energy X-Ray Absorptiometry (DEXA) scan, and body image and self-esteem measures Rosenberg Self-Esteem Scale, and the Self-Compassion Scale were collected prior to the mindful meditation intervention. Over a 15-day (3, 5 day/week) period the participant group was led through a 20-minute mindful meditation session and body image and self-esteem measures were collected at the end of the week. Wilcoxon Signed-Ranks test was used to determine significant differences between the assessments over the course of the intervention with p £ 0.05 set for all analyses. RESULTS: There were no significant differences for the Pre-Wk1 assessments for either the Rosenberg or the Self-Compassion Scales. Analysis indicated significant differences for the Rosenburg Pre-Wk2 (14.8 ± 4.6, 18.2 ± 5.9, p = 0.05) and Pre-Wk3 (14.8 ± 4.6, 19.0 ± 5.6, p = 0.02) assessments. Analysis indicated significant differences for the Self-Compassion Scale Pre-Wk2 (60.9 ± 15.6, 71.4 ± 12.8, p \u3c 0.01) and Pre-Wk3 (60.9 ± 71.4, 83.9 ± 6.9, p = 0.01) assessments. CONCLUSION: The findings of this study support the efficacy of mindful meditation practice for enhancing both self-esteem and self-compassion in female collegiate dance majors. The major limitation of this research is the relatively small cohort from which the data was collected. A practical implication from this investigation is that the implementation of mindfulness practice could potentially positively impact both self-esteem and self-compassion by enhancing both of these parameters in this at-risk group. @font-face {font-family: Cambria Math ; panose-1:2 4 5 3 5 4 6 3 2 4; mso-font-charset:0; mso-generic-font-family:roman; mso-font-pitch:variable; mso-font-signature:-536869121 1107305727 33554432 0 415 0;}@font-face {font-family:Calibri; panose-1:2 15 5 2 2 2 4 3 2 4; mso-font-charset:0; mso-generic-font-family:swiss; mso-font-pitch:variable; mso-font-signature:-536859905 -1073697537 9 0 511 0;}@font-face {font-family: Book Antiqua ; panose-1:2 4 6 2 5 3 5 3 3 4; mso-font-charset:0; mso-generic-font-family:roman; mso-font-pitch:variable; mso-font-signature:647 0 0 0 159 0;}@font-face {font-family:Cambria; panose-1:2 4 5 3 5 4 6 3 2 4; mso-font-charset:0; mso-generic-font-family:roman; mso-font-pitch:variable; mso-font-signature:-536870145 1073743103 0 0 415 0;}p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-unhide:no; mso-style-qformat:yes; mso-style-parent: ; margin-top:0in; margin-right:0in; margin-bottom:10.0pt; margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family: Calibri ,sans-serif; mso-fareast-font-family:Calibri; mso-bidi-font-family: Times New Roman ;}p.MsoHeader, li.MsoHeader, div.MsoHeader {mso-style-priority:99; mso-style-link: Header Char ; margin-top:0in; margin-right:0in; margin-bottom:10.0pt; margin-left:0in; line-height:115%; mso-pagination:widow-orphan; tab-stops:center 3.0in right 6.0in; font-size:11.0pt; font-family: Calibri ,sans-serif; mso-fareast-font-family:Calibri; mso-bidi-font-family: Times New Roman ;}p.MsoFooter, li.MsoFooter, div.MsoFooter {mso-style-priority:99; mso-style-link: Footer Char ; margin-top:0in; margin-right:0in; margin-bottom:10.0pt; margin-left:0in; line-height:115%; mso-pagination:widow-orphan; tab-stops:center 3.0in right 6.0in; font-size:11.0pt; font-family: Calibri ,sans-serif; mso-fareast-font-family:Calibri; mso-bidi-font-family: Times New Roman ;}span.HeaderChar {mso-style-name: Header Char ; mso-style-priority:99; mso-style-unhide:no; mso-style-locked:yes; mso-style-link:Header; mso-ansi-font-size:11.0pt; mso-bidi-font-size:11.0pt;}span.FooterChar {mso-style-name: Footer Char ; mso-style-priority:99; mso-style-unhide:no; mso-style-locked:yes; mso-style-link:Footer; mso-ansi-font-size:11.0pt; mso-bidi-font-size:11.0pt;}.MsoChpDefault {mso-style-type:export-only; mso-default-props:yes; font-size:10.0pt; mso-ansi-font-size:10.0pt; mso-bidi-font-size:10.0pt; font-family: Calibri ,sans-serif; mso-ascii-font-family:Calibri; mso-fareast-font-family:Calibri; mso-hansi-font-family:Calibri;}div.WordSection1 {page:WordSection1;

Can volunteer companions prevent falls among inpatients? A feasibility study using a pre-post comparative design

Background: Falls in hospital are frequent and their consequences place an increased burden on health services. We evaluated a falls prevention strategy consisting of the introduction of volunteers to 'sit' with patients identified as being at high risk of falling. Methods: Two four bed 'safety bays' located on medical wards in two hospitals within southern Adelaide were used. Ward fall rates (expressed as falls per 1000 occupied bed days) were compared in the baseline period (February-May 2002) with the implementation period (February – May 2003) using incident rate ratios and 95% confidence intervals. The number of hours of volunteered time was also collected. Results: No patient falls occurred on either site when volunteers were present. However, there was no significant impact on overall ward fall rates. In the baseline period, there were 70 falls in 4828 OBDs (14.5 falls per 1000 OBDs). During the implementation period, there were 82 falls in 5300 OBDs (15.5 falls per 1000 OBD). The IRR for falls in the implementation versus baseline period was 1.07 (95%CI 0.77 – 1.49; P = 0.346). Volunteers carried out care activities (e.g. cutting up food), provided company, and on occasions advocated on behalf of the patients. Volunteers donated 2345 hours, at an estimated value to the hospitals of almost $57,000. Conclusion: Volunteers may play an important and cost-effective role in enhancing health care and can prevent falls in older hospital patients when they are present. Full implementation of this program would require the recruitment of adequate numbers of volunteers willing to sit with all patients considered at risk of falling in hospital. The challenge for future work in this area remains the sustainability of falls prevention strategies.Lynne C Giles, Denise Bolch, Robyn Rouvray, Beth McErlean, Craig H Whitehead, Paddy A Phillips and Maria Crott