EFFECT OF WEIGHT LOSS ON INFLAMMATORY MARKERS IN SEVERELY OBESE ADULTS

Introduction: The role that inflammation plays in the atherosclerotic disease process is well established. Obesity is coupled with a state of chronic inflammation and is associated with increased circulating inflammatory markers including C-Reactive Protein. Purpose: The purpose of this study was to evaluate the additive effect of aerobic or resistance exercise training to caloric restriction for weight loss on high sensitivity C-Reactive Protein changes compared to dietary restriction alone in class II and class III obese individuals. Methods: 24 healthy, sedentary, obese women underwent a 12-week diet and exercise intervention: Caloric restriction weight loss program with no exercise (DIET); Caloric restriction with aerobic endurance training (DIET+AT); and Caloric restriction with resistance training (DIET+RT). Blood was drawn at baseline and 12-weeks and assayed for hs-CRP. Results: Weight was decreased significantly in all groups in the intervention. Hs-CRP was unchanged at 12-weeks.Conclusions: In conclusion, this investigation was successful in producing weight loss, BMI decreases, decreases in body fat percentage, and positive changes in fitness markers, though no changes in hs-CRP were associated with weight loss or weight loss with exercise. Further investigations into the influence of weight loss and exercise on CRP levels among Class II and Class III individuals should be completed to examine and expand upon the results observed in this study

Use of SMS texts for facilitating access to online alcohol interventions: a feasibility study

A41 Use of SMS texts for facilitating access to online alcohol interventions: a feasibility study In: Addiction Science & Clinical Practice 2017, 12(Suppl 1): A4

Effects of sleep deprivation on neural functioning: an integrative review

Sleep deprivation has a broad variety of effects on human performance and neural functioning that manifest themselves at different levels of description. On a macroscopic level, sleep deprivation mainly affects executive functions, especially in novel tasks. Macroscopic and mesoscopic effects of sleep deprivation on brain activity include reduced cortical responsiveness to incoming stimuli, reflecting reduced attention. On a microscopic level, sleep deprivation is associated with increased levels of adenosine, a neuromodulator that has a general inhibitory effect on neural activity. The inhibition of cholinergic nuclei appears particularly relevant, as the associated decrease in cortical acetylcholine seems to cause effects of sleep deprivation on macroscopic brain activity. In general, however, the relationships between the neural effects of sleep deprivation across observation scales are poorly understood and uncovering these relationships should be a primary target in future research

Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990-2050

Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. Findings In 2019, health spending globally reached$8. 8 trillion (95% uncertainty interval UI] 8.7-8.8) or $1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total,$40.4 billion (0.5%, 95% UI 0.5-0.5) was development assistance for health provided to low-income and middle-income countries, which made up 24.6% (UI 24.0-25.1) of total spending in low-income countries. We estimate that $54.8 billion in development assistance for health was disbursed in 2020. Of this,$13.7 billion was targeted toward the COVID-19 health response. $12.3 billion was newly committed and$1.4 billion was repurposed from existing health projects. $3.1 billion (22.4$2.4 billion (17.9%) was for supply chain and logistics. Only $714.4 million (7.7$1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd

Peak Force and Rate of Force Development During Isometric Mid-Thigh Clean Pulls and Dynamic Mid-Thigh Clean Pulls Performed at Various Intensities

Eight male collegiate weightlifters (age: 21.2 ± 0.9 years; height: 177.6 ± 2.3 cm; and body mass: 85.1 ± 3.3 kg) participated in this study to compare isometric to dynamic force-time dependent variables. Subjects performed the isometric and dynamic mid-thigh clean pulls at 30–120% of their one repetition maximum (1RM) power clean (118.4 ± 5.5 kg) on a 61 X 121.9–cm AMTI forceplate. Variables such as peak force (PF) and peak rate of force development (PRFD) were calculated and were compared between isometric and dynamic conditions. The relationships between force-time dependent variables and vertical jump performances also were examined. The data indicate that the isometric PF had no significant correlations with the dynamic PF against light loads. On the one hand, there was a general trend toward stronger relationships between the isometric and dynamic PF as the external load increased for dynamic muscle actions. On the other hand, the isometric and dynamic PRFD had no significant correlations regardless of the external load used for dynamic testing. In addition, the isometric PF and dynamic PRFD were shown to be strongly correlated with vertical jump performances, whereas the isometric PRFD and dynamic PF had no significant correlations with vertical jump performances. In conclusion, it appears that the isometric and dynamic measures of force-time curve characteristics represent relatively specific qualities, especially when dynamic testing involves small external loads. Additionally, the results suggest that athletes who possess greater isometric maximum strength and dynamic explosive strength tend to be able to jump higher. Eight male collegiate weightlifters (age: 21.2 ± 0.9 years; height: 177.6 ± 2.3 cm; and body mass: 85.1 ± 3.3 kg) participated in this study to compare isometric to dynamic force-time dependent variables. Subjects performed the isometric and dynamic mid-thigh clean pulls at 30–120% of their one repetition maximum (1RM) power clean (118.4 ± 5.5 kg) on a 61 X 121.9–cm AMTI forceplate. Variables such as peak force (PF) and peak rate of force development (PRFD) were calculated and were compared between isometric and dynamic conditions. The relationships between force-time dependent variables and vertical jump performances also were examined. The data indicate that the isometric PF had no significant correlations with the dynamic PF against light loads. On the one hand, there was a general trend toward stronger relationships between the isometric and dynamic PF as the external load increased for dynamic muscle actions. On the other hand, the isometric and dynamic PRFD had no significant correlations regardless of the external load used for dynamic testing. In addition, the isometric PF and dynamic PRFD were shown to be strongly correlated with vertical jump performances, whereas the isometric PRFD and dynamic PF had no significant correlations with vertical jump performances. In conclusion, it appears that the isometric and dynamic measures of force-time curve characteristics represent relatively specific qualities, especially when dynamic testing involves small external loads. Additionally, the results suggest that athletes who possess greater isometric maximum strength and dynamic explosive strength tend to be able to jump higher

Key articles and guidelines for the emergency medicine clinical pharmacist: 2011-2018 update.

PURPOSE: To summarize recently published research reports and practice guidelines on emergency medicine (EM)-related pharmacotherapy. SUMMARY: Our author group was composed of 14 EM pharmacists, who used a systematic process to determine main sections and topics for the update as well as pertinent literature for inclusion. Main sections and topics were determined using a modified Delphi method, author and peer reviewer groups were formed, and articles were selected based on a comprehensive literature review and several criteria for each author-reviewer pair. These criteria included the document Oxford Centre for Evidence-based Medicine - Levels of Evidence (March 2009) but also clinical implications, interest to reader, and belief that a publication was a key article for the practicing EM pharmacist. A total of 105 articles published from January 2011 through July 2018 were objectively selected for inclusion in this review. This was not intended as a complete representation of all available pertinent literature. The reviewed publications address the management of a wide variety of disease states and topic areas that are commonly found in the emergency department: analgesia and sedation, anticoagulation, cardiovascular emergencies, emergency preparedness, endocrine emergencies, infectious diseases, neurology, pharmacy services and patient safety, respiratory care, shock, substance abuse, toxicology, and trauma. CONCLUSION: There are many important recent additions to the EM-related pharmacotherapy literature. As is evident with the surge of new studies, guidelines, and reviews in recent years, it is vital for the EM pharmacist to continue to stay current with advancing practice changes