This new edition of Ann Bowling's well-known and highly respected text has been thoroughly revised and updated to reflect key methodological developments in health research. It is a comprehensive, easy to read, guide to the range of methods used to study and evaluate health and health services. It describes the concepts and methods used by the main disciplines involved in health research, including: demography, epidemiology, health economics, psychology and sociology.The research methods described cover the assessment of health needs, morbidity and mortality trends and rates, costing health services, sampling for survey research, cross-sectional and longitudinal survey design, experimental methods and techniques of group assignment, questionnaire design, interviewing techniques, coding and analysis of quantitative data, methods and analysis of qualitative observational studies, and types of unstructured interviewing. With new material on topics such as cluster randomization, utility analyses, patients' preferences, and perception of risk, the text is aimed at students and researchers of health and health services. It has also been designed for health professionals and policy makers who have responsibility for applying research findings in practice, and who need to know how to judge the value of that research.

Research Methods in Health. Investigating health and health services

Protecting the health of the athlete is a goal of the International Olympic Committee (IOC). The IOC convened an expert panel to update the 2005 IOC Consensus Statement on the Female Athlete Triad. This Consensus Statement replaces the previous and provides guidelines to guide risk assessment, treatment and return-to-play decisions. The IOC expert working group introduces a broader, more comprehensive term for the condition previously known as ‘Female Athlete Triad’. The term ‘Relative Energy Deficiency in Sport’ (RED-S), points to the complexity involved and the fact that male athletes are also affected. The syndrome of RED-S refers to impaired physiological function including, but not limited to, metabolic rate, menstrual function, bone health, immunity, protein synthesis, cardiovascular health caused by relative energy deficiency. The cause of this syndrome is energy deficiency relative to the balance between dietary energy intake and energy expenditure required for health and activities of daily living, growth and sporting activities. Psychological consequences can either precede RED-S or be the result of RED-S. The clinical phenomenon is not a ‘triad’ of the three entities of energy availability, menstrual function and bone health, but rather a syndrome that affects many aspects of physiological function, health and athletic performance. This Consensus Statement also recommends practical clinical models for the management of affected athletes. The ‘Sport Risk Assessment and Return to Play Model’ categorises the syndrome into three groups and translates these classifications into clinical recommendations.

https://bjsm.bmj.com/content/bjsports/48/7/491.full.pdf

The IOC consensus statement: beyond the Female Athlete Triad—Relative Energy Deficiency in Sport (RED-S)

The medical effects of modest weight reduction (approximately 10% or less) in patients with obesity-associated medical complications were reviewed. The National Library of Medicine MEDLINE database and the Derwent RINGDOC database were searched to identify English language studies that examined the effects of weight loss in obese patients with serious medical complications commonly associated with obesity (non-insulin dependent diabetes mellitus (NIDDM or type II), hypertension, hyperlipidemia, hypercholesterolemia, and cardiovascular disease). Studies in which patients experienced approximately 10% or less weight reduction were selected for review. Studies indicated that, for obese patients with NIDDM, hypertension or hyperlipidemia, modest weight reduction appeared to improve glycemic control, reduce blood pressure, and reduce cholesterol levels, respectively. Modest weight reduction also appeared to increase longevity in obese individuals. In conclusion, a large proportion of obese individuals with NIDDM, hypertension, and hyperlipidemia experienced positive health benefits with modest weight loss. For patients who are unable to attain and maintain substantial weight reduction, modest weight loss should be recommended; even a small amount of weight loss appears to benefit a substantial subset of obese patients.

Beneficial health effects of modest weight loss.

The role of social media in higher education classes (real and virtual) – A literature review

The prevalence of obesity in combination with sarcopenia (the age-related loss of muscle mass and strength or physical function) is increasing in adults aged 65 years and older. A major subset of adults over the age of 65 is now classified as having sarcopenic obesity, a high-risk geriatric syndrome predominantly observed in an ageing population that is at risk of synergistic complications from both sarcopenia and obesity. This Review discusses pathways and mechanisms leading to muscle impairment in older adults with obesity. We explore sex-specific hormonal changes, inflammatory pathways and myocellular mechanisms leading to the development of sarcopenic obesity. We discuss the evolution, controversies and challenges in defining sarcopenic obesity and present current body composition modalities used to assess this condition. Epidemiological surveys form the basis of defining its prevalence and consequences beyond comorbidity and mortality. Current treatment strategies, and the evidence supporting them, are outlined, with a focus on calorie restriction, protein supplementation and aerobic and resistance exercises. We also describe weight loss-induced complications in patients with sarcopenic obesity that are relevant to clinical management. Finally, we review novel and potential future therapies including testosterone, selective androgen receptor modulators, myostatin inhibitors, ghrelin analogues, vitamin K and mesenchymal stem cell therapy.

Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies.

Smoothies are a popular breakfast option. However, liquids may evoke weaker satiation than nutritionally comparable semi-solid and solid foods. This study examined consumption of cereal and milk (C...

/pdf/consumption-of-a-smoothie-or-cereal-based-breakfast-impact-11g2p8oi7p.pdf

Consumption of a smoothie or cereal-based breakfast: impact on thirst, hunger, appetite and subsequent dietary intake.

Nutrition in Patient Care Survey--Practice Nurse Adaptation

Metabolic adaptations following fat adaptation persist despite carbohydrate availability during prolonged exercise

Background:

Breath alcohol responses may be affected by the presence of carbohydrate (CHO) in a beverage. This study investigated the impact of consuming alcohol with mixers containing various doses of CHO or an artificial sweetener on breath alcohol concentration (BrAC), ratings of intoxication and impairment, and cognitive performance in females.
Methods:

Twenty-six females (age 25.1 ± 0.7 years, mean ± standard deviation) completed a crossover study involving 4 trials. A dose of alcohol was consumed in each trial mixed with water (W), artificial sweetener (150 ± 1 mg aspartame [AS]), or CHO (15 g sucrose [15CHO] and 50 g sucrose [50CHO]). BrAC was sampled for 210 minutes following beverage ingestion and analyzed for peak BrAC and other parameters using WinNonlin noncompartmental pharmacokinetic modeling (cmax, tmax, area under the curve to the last measured time point [AUClast]). An objective measure of cognitive performance was assessed using a 4-choice reaction time (CRT) task. Estimation of BrAC, self-reported ratings of intoxication, and willingness to drive were recorded.
Results:

Mean peak BrAC was reduced in a dose–response manner when alcohol was consumed with CHO compared to both W and AS treatments (W: 0.054 ± 0.015%, AS: 0.052 ± 0.011%, 15CHO: 0.049 ± 0.008%, 50CHO: 0.038 ± 0.007%). No difference in peak BrAC was observed between W and AS treatments. WinNonlin parameters revealed significant differences in cmax and AUClast (W: 4.80 ± 1.12 g/dl/h, AS: 4.61 ± 0.92 g/dl/h, 15CHO: 4.10 ± 0.86 g/dl/h, 50CHO: 3.11 ± 0.58 g/dL/h) when CHO-containing beverages were consumed compared to W and AS treatments. No difference in tmax or CRT was observed between treatments. Participants were able to detect subtle differences in peak BrAC and reported greater ability to drive after consuming 50CHO compared to W. However, participant's willingness to drive and CRT did not differ between treatments.
Conclusions:

Consuming alcohol with CHO-containing mixers attenuates peak BrAC and reduces total alcohol exposure in a dose–response manner compared to drinks containing artificial sweetener or no additives. The effect of adding CHO to alcoholic beverages may translate to reduced risk of alcohol-related harms.

/pdf/the-influence-of-mixers-containing-artificial-sweetener-or-463wfy3oq9.pdf

The Influence of Mixers Containing Artificial Sweetener or Different Doses of Carbohydrate on Breath Alcohol Responses in Females

Motor-racing drivers are often exposed to hot environments and may be susceptible to fluid loss and hydration issues, which could influence driving performance This study assessed the effect of dehydration and heat stress on performance during a short, simulated motor-racing task Nine healthy males (age: 266 ± 75 y, body mass: 788 ± 125 kg, mean ± SD) completed two passive dehydration (sauna) procedures (targeting -1% and -3% body mass loss (BML)) on separate occasions Driving performance was assessed pre-dehydration (Baseline), immediately post-dehydration (Hot) and following a cooling period (Cool) Measures of driving performance included lap time and sector-time for one section of the track Subjective ratings of mood, thermal stress and comfort were also collected during trials Mean lap times were not different between Baseline, Hot, Cool conditions for both 1% (6844 ± 143 s, 6806 ± 117 s, 6823 ± 125 s) and 3% (6833 ± 168 s, 6801 ± 115 s, 6806 ± 126 s) trials respectively In addition, mean sector times were not different between Baseline, Hot, Cool conditions for both 1% (1161 ± 028 s, 1155 ± 045 s, 1159 ± 035 s) and 3% (1149 ± 033 s, 1156 ± 033 s, 1163 ± 071 s) trials respectively Changes in participants’ subjective ratings (ie decreased alertness, concentration and comfort; increased tiredness and light-headedness) were observed at both levels of dehydration (1% and 3% BML), irrespective of heat stress Thus, fluid loss and heat stress are unlikely to affect driver’s motor-racing performance during short duration events However, the impact of dehydration and heat stress on tasks of longer duration that accurately represent the demands associated with motor-racing requires further consideration

/pdf/no-impact-of-heat-stress-and-dehydration-on-short-duration-1jdtn3zk4t.pdf

Ben Desbrow

Papers

Consumption of a smoothie or cereal-based breakfast: impact on thirst, hunger, appetite and subsequent dietary intake.

Nutrition in Patient Care Survey--Practice Nurse Adaptation

Metabolic adaptations following fat adaptation persist despite carbohydrate availability during prolonged exercise

The Influence of Mixers Containing Artificial Sweetener or Different Doses of Carbohydrate on Breath Alcohol Responses in Females

No Impact of Heat Stress and Dehydration on Short Duration Simulated Motor-Racing Performance.