Predictors of healthcare professionals' intention and behaviour to encourage physical activity in patients with cardiovascular risk factors

<p>Abstract</p> <p>Background</p> <p>Healthcare professionals can play a crucial role in optimizing the health status of patients with cardiovascular risk factors (abdominal obesity, high blood pressure, low HDL cholesterol, elevated triglycerides and elevated blood glucose). In order to do this, it is imperative that we understand the social-cognitive determinants (including habits) that underlie healthcare professionals' intention and the corresponding behavior of actually encouraging patients with cardiovascular risk factors to engage in physical activity.</p> <p>Methods</p> <p>In this longitudinal Professionals' Intention and Behavior (PIB) study, healthcare professionals (N = 278, aged 20-61 years with approximately 60% having attained an education level exceeding bachelor's degree, types of healthcare professionals 60% in physiotherapy and 40% in nursing) completed online surveys measuring the social-cognitive determinants of healthcare professionals' intention and the corresponding behavior of actually encouraging patients with cardiovascular risk factors to engage in physical activity.</p> <p>Results</p> <p>Social-cognitive determinants accounted for 41% (p < .001) of the variance in healthcare professionals' intention to encourage physical activity among cardiovascular patients. Important correlates of intention were attitude (β = .443, p < .001), subjective norms (β = .201, p < .001) and perceived behavioral control (β = .137, p < .01). With respect to the self-reported behavior of encouraging patients, social-cognitive determinants accounted for 29% (p < .001) of the variance. Intentions (β = .311 p < .001), habit (β = .163 p < .01), and barriers (β = -.239 p < .001) were significant correlates of professionals' behavior of encouraging patients to engage in physical activity.</p> <p>We explored the congruence between healthcare professionals' intention to encourage patients and the self-reported behavior of encouraging patients. We found that intention and behavior were congruent in 39.7% of the healthcare professionals. Additionally, the intention to encourage and the corresponding behavior of encouraging was incongruent in 31.7% of the healthcare professionals.</p> <p>Conclusions</p> <p>In the prevention of cardiovascular disease, healthcare professionals' intention to encourage physical activity among patients and subsequent behavior of encouraging patients is important for the improvement of patients' cardiovascular risk profiles. We found that the intentions and self-reported behavior of healthcare professionals working with patients with cardiovascular risk factors can be predicted by social-cognitive determinants thus implying that efforts to change and strengthen the intention-behavior relationship of healthcare professionals may have beneficial effects for cardiovascular risk patients (Trial ID: ECP-92).</p

Микротопонимика воинской части. Часть 1.

Целью же данной статьи является выяснение места и значения микротопонимики воинской части в структуре военной субкультуры

Risk of sports: do we need a pre-participation screening for competitive and leisure athletes?

Sudden cardiac arrest is most often the first clinical manifestation of an underlying cardiovascular disease and usually occurs in previously asymptomatic athletes. The risk benefit ratio of physical exercise differs between young competitive athletes and middle-age/senior individuals engaged in leisure-time sports activity. Competitive sports are associated with an increase in the risk of sudden cardiovascular death (SCD) in susceptible adolescents and young adults with underlying cardiovascular disorders. In middle-age/older individuals, physical activity can be regarded as a ‘two-edged sword': vigorous exertion increases the incidence of acute coronary events in those who did not exercise regularly, whereas habitual physical activity reduces the overall risk of myocardial infarction and SCD. Although cardiovascular pre-participation evaluation offers the potential to identify athletes with life-threatening cardiovascular abnormalities before onset of symptoms and may reduce their risk of SCD, there is a significant debate among cardiologists about efficacy, impact of false-positive results and cost-effectiveness of routine screening. This review presents an appraisal of the available data and criticisms concerning screening programmes aimed to prevent SCD of either young competitive athletes or older individuals engaged in leisure-time sports activit

A genetic predisposition score for muscular endophenotypes predicts the increase in aerobic power after training: the CAREGENE study

<p>Abstract</p> <p>Background</p> <p>It is widely accepted that genetic variability might explain a large part of the observed heterogeneity in aerobic capacity and its response to training. Significant associations between polymorphisms of different genes with muscular strength, anaerobic phenotypes and body composition have been reported. Muscular endophenotypes are positively correlated with aerobic capacity, therefore, we tested the association of polymorphisms in twelve muscular related genes on aerobic capacity and its response to endurance training.</p> <p>Methods</p> <p>935 Coronary artery disease patients (CAD) who performed an incremental exercise test until exhaustion at baseline and after three months of training were included. Polymorphisms of the genes were detected using the invader assay. Genotype-phenotype association analyses were performed using ANCOVA. Different models for a genetic predisposition score (GPS) were constructed based on literature and own data and were related to baseline and response VO₂scores.</p> <p>Results</p> <p>Carriers of the minor allele in the R23K polymorphism of the glucocorticoid receptor gene (<it>GR</it>) and the ciliary neurotrophic factor gene (<it>CNTF</it>) had a significantly higher increase in peakVO₂after training (p < 0.05). Carriers of the minor allele (C34T) in the adenosine monophosphate deaminase (<it>AMPD1</it>) gene had a significantly lower relative increase (p < 0.05) in peakVO₂. GPS of data driven models were significantly associated with the increase in peakVO₂after training.</p> <p>Conclusions</p> <p>In CAD patients, suggestive associations were found in the <it>GR, CNTF </it>and the <it>AMPD1 </it>gene with an improved change in aerobic capacity after three months of training. Additionally data driven models with a genetic predisposition score (GPS) showed a significant predictive value for the increase in peakVO₂.</p

Home-based exercise with telemonitoring guidance in patients with coronary artery disease; Does it improve long-term physical fitness?

Background: Exercise and physical activity are an essential part of contemporary coronary artery disease (CAD) management. However, evidence shows that patients experience clear difficulties in maintaining a physically active lifestyle following completion of a structured and supervised phase II exercise-based CR program. Home-based (HB) interventions have been shown to enhance a patient’s self-efficacy and might facilitate the lifelong uptake of a physically active lifestyle. Yet, data on the long-term effectiveness of HB exercise training on physical activity (PA) and exercise capacity (EC) are scarce. Objective: The main purpose of the TeleRehabilitation in Coronary Heart disease (TRiCH) study was to compare the long-term effects of the implementation of a short HB phase III exercise program with telemonitoring guidance to a prolonged center-based (CB) phase III program in patients with CAD. Primary outcome measure was exercise capacity. Secondary outcome measures included physical activity behaviour, cardiovascular risk profile and health related quality of life. Methods: Ninety CAD patients were randomized to three months of HB (=30), CB (=30) or a control group (CG) (=30) on a 1:1:1 basis after completion of their phase II ambulatory CR program. Outcome measures were assessed at discharge of the phase II program and after one year. Results: Eighty patients (91%, 72 men and mean age 62.6 years old) completed the one-year follow-up measurements. Exercise capacity (VO2P), cardiovascular risk factors and health related quality of life were preserved in all three groups (p-time >0.05 for all), irrespective of the intervention (p-interaction >0.05 for all). 85 % of patients met the international guidelines for PA (p-time < 0.05). No interaction effect was found for PA (steps, amount of active time, and amount of sedentary time) over the one-year period after discharge of a phase II program. Conclusion: Although exercise capacity remained stable over time, our HB exercise intervention did not result in higher levels of fitness or PA at one year of FU compared to the other two interventions

Landowners’ Сolonization of Bashkiria

The “closed city” practice, exercised in Ufa province before 1735, together with the unfavourable political situation led to the bad crisis of estate landownership of the Ufa district. The population polls of the mid-XVII — beginning of XVIII cc. justify the fact that Ufa noblemen had to succumb to the fate of socially deprived Siberian nobility, practically devoid of serf peasants. The beginning of the largest-scale Bashkir insurrection of 1735–1736 made the administration review its attitude to the former ban on Bashkir estate lands sale. In the history of Bashkir landowners’ colonization the edict dated February 11th, 1736, allowing the local officers and officials to buy lands from Bashkir communities, was of principal importance. This procedure was exercised simultaneously with the establishment of the Russian government military control over the south-eastern border, separating Bashkir estate lands from Kazakh migratory tribes. From this moment on there is a stop in diplomatic contacts of the Bashkir elite with the governors of the Middle Asia, Kazakhstan and Turkey that meant the complete loss of political subjection by the Bashkirs. Bashkir communities become active participants of economic relations with Russian landowners, plant owners and the state institutions. Russian government preserved estate dynastic rights with the Bashkirs and refused from large-scale operations on the expropriation of Bashkir lands, transferring the mission of colonization to private persons, who had to arrange the issue with the local communities by themselves. The permission to sell estate lands forced landowners to active participation in the system of Russian legal relations, to contact the Russian government and customers

Differential effects of resveratrol on the dilator responses of femoral arteries, ex vivo

Resveratrol is a plant-derived phytoalexin with antioxidant, anti-inflammatory and cardio-protective properties and may be a promising therapeutic intervention strategy in cardiovascular disease. Here, we investigated the acute direct effects of trans-resveratrol (RV), on acetylcholine (ACh)-induced and flow-mediated dilation (FMD) of isolated pressurized femoral arteries of young (4-month-old) and old (26-month-old) mice. Vessel exposure to RV enhanced ACh (0.01- 1.0 mM)-induced dilation (p<0.05), but not FMD (@ 5-10 Lmin-1) (p<0.05) in both young and old mice. After RV incubation, acute nitric oxide (NO) production by cultured endothelial cells was increased in response to 0.01 mM ACh, but reduced by flow (5-10 Lmin-1; p<0.05). In isolated femoral arteries from endothelial nitric oxide synthase knockout (eNOS-/-) mice, RV had no overall effect on flow mediated dilation, but potentiated ACh induced dilation, that was completely abolished by potassium channel blockers, Apamin and Tram 34 (p<0.01). We demonstrate that the non-metabolised form of RV stimulates ACh-induced dilation via the NO and EDHF pathways, but not FMD by interaction with the cyclo-oxygenase pathway. Our findings have important implications in the use of RV (for both young and aged) under ‘normal’ non-diseased physiological states

Ankle proprioception is not targeted by exercises on an unstable surface

Item does not contain fulltextLaboratory study using a repeated measures design. The aim of this study was to determine if ankle proprioception is targeted in exercises on unstable surfaces. Lateral ankle sprain (LAS) has recurrence rates over 70%, which are believed to be due to a reduced accuracy of proprioceptive signals from the ankle. Proprioceptive exercises in rehabilitation of LAS mostly consist of balancing activities on an unstable surface. The methods include 100 healthy adults stood barefoot on a solid surface and a foam pad over a force plate, with occluded vision. Mechanical vibration was used to stimulate proprioceptive output of muscle spindles of triceps surae and lumbar paraspinal musculature. Each trial lasted for 60 s; vibration was applied from the 15th till the 30th second. Changes in mean velocity and mean position of the center of pressure (CoP) as a result of muscle vibration were calculated. Results show that on foam, the effect of triceps surae vibration on mean CoP velocity was significantly smaller than on a solid surface, while for paraspinal musculature vibration the effect was bigger on foam than on solid surface. Similar effects were seen for mean CoP displacement as outcome. Exercises on unstable surfaces appear not to target peripheral ankle proprioception. Exercises on an unstable surface may challenge the capacity of the central nervous system to shift the weighting of sources of proprioceptive signals on balance