If They\u27d Only Move Old Ireland Over Here

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Hearts Ablaze: Radio Frequency Ablation as Treatment for Cardiac Arrythmia

This project analyzes several of the parameters involved in the use of radiofrequency ablation (RFA) in the treatment of cardiac arrhythmia. Arrhythmia is an irregular beating of the heart that can be caused by improperly timed contractions within the heart, which can, in certain circumstances, be corrected by ablating tissue. One out of every five hundred people is born with an arrhythmia and others acquire the condition through heart disease. For heart attack victims, it is the most common cause of sudden death. RFA is a common way to treat serious arrhythmia cases by cutting the short circuit through the destruction of certain tissues. We used finite element analysis along with prototyping software to determine the duration of treatment, with special attention to the damage caused to surrounding tissue. We found that the optimal parameters for most effective treatment were to administer 30V for 120 seconds ? which happens to be the standard method of operation. This destroys the necessary part of the AV node while maintaining the surrounding tissue at relatively normal temperatures

Flight controller alertness and performance during MOD shiftwork operations

Decreased alertness and performance associated with fatigue, sleep loss, and circadian disruption are issues faced by a diverse range of shiftwork operations. During STS operations, MOD personnel provide 24 hr. coverage of critical tasks. A joint JSC and ARC project was undertaken to examine these issues in flight controllers during MOD shiftwork operations. An initial operational test of procedures and measures was conducted during STS-53 in Dec. 1992. The study measures included a background questionnaire, a subjective daily logbook completed on a 24 hr. basis (to report sleep patterns, work periods, etc.), and an 8 minute performance and mood test battery administered at the beginning, middle, and end of each shift period. Seventeen Flight controllers representing the 3 Orbit shifts participated. The initial results clearly support further data collection during other STS missions to document baseline levels of alertness and performance during MOD shiftwork operations. These issues are especially pertinent for the night shift operations and the acute phase advance required for the transition of day shift personnel into the night for shuttle launch. Implementation and evaluation of the countermeasure strategies to maximize alertness and performance is planned. As STS missions extend to further extended duration orbiters, timelines and planning for 24 circadian disruption will remain highly relevant in the MOD environment

Crew factors in flight operations 9: Effects of planned cockpit rest on crew performance and alertness in long-haul operations

This study examined the effectiveness of a planned cockpit rest period to improve alertness and performance in long-haul flight operations. The Rest Group (12 crew members) was allowed a planned 40 minute rest period during the low workload, cruise portion of the flight, while the No-Rest Group (9 crew members) had a 40 minute planned control period when they maintained usual flight activities. Measures used in the study included continuous ambulatory recordings of brain wave and eye movement activity, a reaction time/vigilance task, a wrist activity monitor, in-flight fatigue and alertness ratings, a daily log for noting sleep periods, meals, exercise, flight and duty periods, and the NASA Background Questionnaire. The Rest Group pilots slept on 93 percent of the opportunities, falling asleep in 5.6 minutes and sleeping for 25.8 minutes. This nap was associated with improved physiological alertness and performance compared to the No-Rest Group. The benefits of the nap were observed through the critical descent and landing phases of flight. The nap did not affect layover sleep or the cumulative sleep debt. The nap procedures were implemented with minimal disruption to usual flight operations and there were no reported or identified concerns regarding safety

Factors influencing the provision of End of Life care for adolescents and young adults with advanced cancer: a scoping review protocol

The objective of this review is to locate and describe literature relating to EoL care provision to adolescents and young adults with cancer. The specific areas of investigation will include: - Care service provision in adolescents and young adults with cancer during the EoL phase of care - Experiences and perceptions of adolescents and young adults with cancer during the EoL phase of care - Experience and perceptions of the health professionals and family members involved in their care. - Practices/intervention

Factors influencing the provision of end-of-life care for adolescents and young adults with advanced cancer: a scoping review

Background There is international recognition that cancer in young people is on the rise and that improvements in outcomes for young people lag well behind advances achieved for both children and older adults over the past 30 years. Cancer is the third leading cause of death in adolescents and young adults; however, little is known about how the end of life unfolds for those who die of the progressive disease. Objective This scoping review sought to locate and describe literature relating to end of life care for adolescents and young adults with cancer

The barriers and facilitators to young people's engagement with bidirectional digital sexual health interventions: A mixed methods systematic review

Background: Sexual health is fundamental to the overall health and wellbeing of individuals and to the social and economic development of communities and countries. However, internationally young people endure a disproportionate burden of sexually transmitted infections and unintended pregnancies which can be associated with poor psycho-social outcomes. Digital sexual health interventions have been developed to increase young people’s access to sexual health services, but are currently underutilised. Aim: This systematic review sought to identify the barriers and facilitators to young people’s engagement with bidirectional digital sexual health interventions, which are standalone two-way tailored interventions between a young person and healthcare professional. Methods: The review was conducted in accordance with the JBI methodology for mixed methods systematic reviews, following a convergent integrated approach to synthesis and integration of qualitative and quantitative evidence. Searches of ten electronic databases were conducted, spanning database inception to January 2022. No restrictions were imposed on language, geographical location or community setting. All included studies were critically appraised with JBI Critical Appraisal tools. Data extraction was performed using standardised tools, followed by data transformation. Data synthesis followed the convergent integrated approach. Each stage was conducted by two independent reviewers. Results: Eight thousand four hundred thirty-nine titles and abstracts and, subsequently, 255 full-texts underwent review. Nine studies were selected for inclusion with no studies added following forward and backward citation tracking. The included studies comprised three qualitative and six quantitative designs. Three meta synthesised findings were identified: (1) The design of a digital intervention for adolescent sexual health needs to reflect the end users’ specific needs (2) Young people need to feel comfortable when using a digital sexual health intervention (3) Potential barriers to engagement need to be addressed. The review identified that although barriers and facilitators to promoting young people’s engagement with bidirectional digital sexual health interventions are nuanced, young people’s privacy and security need to be prioritised for them to engage with digital interventions, regardless of the platform of choice. Conclusions: Co-production of digital sexual health services, in partnership with young people, has shaped many of the insights reported in this systematic review. Further international research which places an emphasis on young people’s perspectives is vital to unleash the full potential of digital technology in this domain

Physiological and molecular responses to an acute bout of reduced-exertion high-intensity interval training (REHIT)

PurposeWe have previously shown that 6 weeks of reduced-exertion high-intensity interval training (REHIT) improves V˙O2V˙O2 max in sedentary men and women and insulin sensitivity in men. Here, we present two studies examining the acute physiological and molecular responses to REHIT.MethodsIn Study 1, five men and six women (age: 26 ± 7 year, BMI: 23 ± 3 kg m−2, V˙O2V˙O2 max: 51 ± 11 ml kg−1 min−1) performed a single 10-min REHIT cycling session (60 W and two 20-s ‘all-out’ sprints), with vastus lateralis biopsies taken before and 0, 30, and 180 min post-exercise for analysis of glycogen content, phosphorylation of AMPK, p38 MAPK and ACC, and gene expression of PGC1α and GLUT4. In Study 2, eight men (21 ± 2 year; 25 ± 4 kg·m−2; 39 ± 10 ml kg−1 min−1) performed three trials (REHIT, 30-min cycling at 50 % of V˙O2V˙O2 max, and a resting control condition) in a randomised cross-over design. Expired air, venous blood samples, and subjective measures of appetite and fatigue were collected before and 0, 15, 30, and 90 min post-exercise.ResultsAcutely, REHIT was associated with a decrease in muscle glycogen, increased ACC phosphorylation, and activation of PGC1α. When compared to aerobic exercise, changes in V˙O2V˙O2 , RER, plasma volume, and plasma lactate and ghrelin were significantly more pronounced with REHIT, whereas plasma glucose, NEFAs, PYY, and measures of appetite were unaffected.ConclusionsCollectively, these data demonstrate that REHIT is associated with a pronounced disturbance of physiological homeostasis and associated activation of signalling pathways, which together may help explain previously observed adaptations once considered exclusive to aerobic exercise

Short-Term Exercise Training Inconsistently Influences Basel Testosterone in Older Men: A Systematic Review and Meta-Analysis

Background The age-associated decrease in testosterone is one mechanism suggested to accelerate the aging process in males. Therefore, approaches to increase endogenous testosterone may be of benefit. The aim of this paper was to undertake a Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA)-accordant meta-analysis concerning the effect of exercise on total (TT), bioavailable (bio-T), free (free-T), and salivary (sal-T) testosterone in older males. Methods Databases were searched up to and including 20th February 2018 for the terms ‘testosterone AND exercise AND aging AND males’, ‘testosterone AND exercise AND old AND males’, ‘testosterone AND training AND aging AND males’ and ‘testosterone AND training AND old AND males’. From 1259 originally identified titles, 22 studies (randomized controlled trials; RCTs; n=9, and uncontrolled trials; UCTs; n=13) were included which had a training component, participants ≥60 years of age, and salivary or serum testosterone as an outcome measure. Meta-analyses were conducted on change to testosterone following training using standardised difference in means (SDM) and random effects models. Results The overall SDM for endurance training, resistance training, and interval training was 0.398 (95% CI = 0.034 – 0.761; P = 0.010), -0.003 (95% CI = -0.330 – 0.324; P = 0.986), and 0.283 (95% CI = 0.030 – 0.535; P = 0.028) respectively. Resistance training exhibited a qualitative effect of hormone fraction whereby free-T resulted in the greatest SDM (0.253; 95% CI = -0.043 – 0.549; P = 0.094), followed by TT (0.028; 95% CI = -0.204 – 0.260; P = 0.813), and resistance training negatively influenced bio-T (-0.373; 95% CI = -0.789 – 0.042; P = 0.078). Due to the small number of studies, subgroup analysis was not possible for endurance training and interval training studies. Conclusions Data from the present investigation suggests that resistance training does not significantly influence basal testosterone in older men. Magnitude of effect was influenced by hormone fraction, even within the same investigation. Aerobic training and interval training did result in small, significant increases in basal testosterone. The magnitude of effect is small but the existing data are encouraging and may be an avenue for further research