Showing papers by "Australian Catholic University published in 2015"

Assessment of lower limb muscle strength and power using hand-held and fixed dynamometry: A reliability and validity study

Abstract: © 2015 Mentiplay et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Introduction Hand-held dynamometry (HHD) has never previously been used to examine isometric muscle power. Rate of force development (RFD) is often used for muscle power assessment, however no consensus currently exists on the most appropriate method of calculation. The aim of this study was to examine the reliability of different algorithms for RFD calculation and to examine the intra-rater, inter-rater, and inter-device reliability of HHD as well as the concurrent validity of HHD for the assessment of isometric lower limb muscle strength and power. Methods 30 healthy young adults (age: 23±5yrs, male: 15) were assessed on two sessions. Isometric muscle strength and power were measured using peak force and RFD respectively using two HHDs (Lafayette Model-01165 and Hoggan microFET2) and a criterion-reference Kin-Com dynamometer. Statistical analysis of reliability and validity comprised intraclass correlation coefficients (ICC), Pearson correlations, concordance correlations, standard error of measurement, and minimal detectable change. Results Comparison of RFD methods revealed that a peak 200ms moving window algorithm provided optimal reliability results. Intra-rater, inter-rater, and inter-device reliability analysis of peak force and RFD revealed mostly good to excellent reliability (coefficients o 0.70) for all muscle groups. Concurrent validity analysis showed moderate to excellent relationships between HHD and fixed dynamometry for the hip and knee (ICCs o 0.70) for both peak force and RFD, with mostly poor to good results shown for the ankle muscles (ICCs = 0.31-0.79). \Conclusions Hand-held dynamometry has good to excellent reliability and validity for most measures of isometric lower limb strength and power in a healthy population, particularly for proximal muscle groups. To aid implementation we have created freely available software to extract these variables from data stored on the Lafayette device. Future research should examine the reliability and validity of these variables in clinical populations.

The psychology of passion: A meta-analytical review of a decade of research on intrapersonal outcomes.

Abstract: It is just over a decade since Vallerand et al. (J Personal Soc Psychol 85:756–767, 2003) introduced the dualistic model of passion. In this study, we conduct a meta-analytical review of relationships between Vallerand et al’s two passions (viz. harmonious and obsessive), and intrapersonal outcomes, and test the moderating role of age, gender, domain, and culture. A systematic literature search yielded 94 studies, within which 27 criterion variables were reported. These criterion variables derived from four research areas within the intrapersonal sphere: (a) well-/ill-being, (b) motivation factors, (c) cognitive outcomes and, (d) behaviour and performance. From these areas we retrieved 1308 independent effect sizes and analysed them using random-effects models. Results showed harmonious passion positively corresponded with positive intrapersonal outcomes (e.g., positive affect, flow, performance). Obsessive passion, conversely, showed positive associations with positive and negative intrapersonal outcomes (e.g., negative affect, rumination, vitality). Correlations were largely invariant across age and gender, but certain relationships were moderated by domain and culture. Implications are discussed.

The use of wearable microsensors to quantify sport-specific movements

Abstract: Background: Microtechnology has allowed sport scientists to understand the locomotor demands of various sports. While wearable global positioning technology has been used to quantify the locomotor demands of sporting activities, microsensors (i.e. accelerometers, gyroscopes and magnetometers) embedded within the units also have the capability to detect sport-specific movements. Objective: The objective of this study was to determine the extent to which microsensors (also referred to as inertial measurement units and microelectromechanical sensors) have been utilised in quantifying sport-specific movements. Methods: A systematic review of the use of microsensors and associated terms to evaluate sport-specific movements was conducted; permutations of the terms used included alternate names of the various technologies used, their applications and different applied environments. Studies for this review were published between 2008 and 2014 and were identified through a systematic search of six electronic databases: Academic Search Complete, CINAHL, PsycINFO, PubMed, SPORTDiscus, and Web of Science. Articles were required to have used athlete-mounted sensors to detect sport-specific movements (e.g. rugby union tackle) rather than sensors mounted to equipment and monitoring generic movement patterns. Results: A total of 2395 studies were initially retrieved from the six databases and 737 results were removed as they were duplicates, review articles or conference abstracts. After screening titles and abstracts of the remaining papers, the full text of 47 papers was reviewed, resulting in the inclusion of 28 articles that met the set criteria around the application of microsensors for detecting sport-specific movements. Eight articles addressed the use of microsensors within individual sports, team sports provided seven results, water sports provided eight articles, and five articles addressed the use of microsensors in snow sports. All articles provided evidence of the ability of microsensors to detect sport-specific movements. Results demonstrated varying purposes for the use of microsensors, encompassing the detection of movement and movement frequency, the identification of movement errors and the assessment of forces during collisions. Conclusion: This systematic review has highlighted the use of microsensors to detect sport-specific movements across a wide range of individual and team sports. The ability of microsensors to capture sport-specific movements emphasises the capability of this technology to provide further detail on athlete demands and performance. However, there was mixed evidence on the ability of microsensors to quantify some movements (e.g. tackling within rugby union, rugby league and Australian rules football). Given these contrasting results, further research is required to validate the ability of wearable microsensors containing accelerometers, gyroscopes and magnetometers to detect tackles in collision sports, as well as other contact events such as the ruck, maul and scrum in rugby union.

Systematic Review of Guidelines for the Management of Asymptomatic and Symptomatic Carotid Stenosis

Abstract: Background and Purpose—We systematically compared and appraised contemporary guidelines on management of asymptomatic and symptomatic carotid artery stenosis. Methods—We systematically searched for...

E-Cigarettes and Smoking Cessation: Evidence from a Systematic Review and Meta-Analysis

Abstract: Background E-cigarettes are currently being debated regarding their possible role in smoking cessation and as they are becoming increasingly popular, the research to date requires investigation. Objectives To investigate whether the use of e-cigarettes is associated with smoking cessation or reduction, and whether there is any difference in efficacy of e-cigarettes with and without nicotine on smoking cessation. Data Sources A systematic review of articles with no limit on publication date was conducted by searching PubMed, Web of Knowledge and Scopus databases. Methods Published studies, those reported smoking abstinence or reduction in cigarette consumption after the use of e-cigarettes, were included. Studies were systematically reviewed, and meta-analyses were conducted using Mantel-Haenszel fixed-effect and random-effects models. Degree of heterogeneity among studies and quality of the selected studies were evaluated. Results Six studies were included involving 7,551 participants. Meta-analyses included 1,242 participants who had complete data on smoking cessation. Nicotine filled e-cigarettes were more effective for cessation than those without nicotine (pooled Risk Ratio 2.29, 95%CI 1.05-4.97). Amongst 1,242 smokers, 224 (18%) reported smoking cessation after using nicotine-enriched e-cigarettes for a minimum period of six months. Use of such e-cigarettes was positively associated with smoking cessation with a pooled Effect Size of 0.20 (95%CI 0.11-0.28). Use of e-cigarettes was also associated with a reduction in the number of cigarettes used. Limitations Included studies were heterogeneous, due to different study designs and gender variation. Whilst we were able to comment on the efficacy of nicotine vs. non-nicotine e-cigarettes for smoking cessation, we were unable to comment on the efficacy of e-cigarettes vs. other interventions for cessation, given the lack of comparator groups in the studies included in this meta-analysis. Conclusions Use of e-cigarettes is associated with smoking cessation and reduction. More randomised controlled trials are needed to assess effectiveness against other cessation methods.

Support surfaces for pressure ulcer prevention

Abstract: BACKGROUND: Pressure ulcers (also known as bedsores, pressure sores, decubitus ulcers) are areas of localised damage to the skin and underlying tissue due to pressure, shear or friction. They are common in the elderly and immobile and costly in financial and human terms. Pressure-relieving beds, mattresses and seat cushions are widely used as aids to prevention in both institutional and non-institutional settings. OBJECTIVES: This systematic review seeks to answer the following questions: to what extent do pressure-relieving cushions, beds, mattress overlays and mattress replacements reduce the incidence of pressure ulcers compared with standard support surfaces? how effective are different pressure-relieving surfaces in preventing pressure ulcers, compared to one another? SEARCH STRATEGY: The Specialised Trials Register of the Cochrane Wounds Group (compiled from regular searches of many electronic databases including MEDLINE, CINAHL and EMBASE plus handsearching of specialist journals and conference proceedings) was searched up to January 2004, Issue 3, 2004 of the Cochrane Central Register of Controlled Trials was also searched. The reference sections of included studies were searched for further trials. SELECTION CRITERIA: Randomised controlled trials (RCTs), published or unpublished, which assessed the effectiveness of beds, mattresses, mattress overlays, and seating cushions for the prevention of pressure ulcers, in any patient group, in any setting. RCTs were eligible for inclusion if they reported an objective, clinical outcome measure such as incidence and severity of new of pressure ulcers developed. Studies which only reported proxy outcome measures such as interface pressure were excluded. DATA COLLECTION AND ANALYSIS: Trial data were extracted by one researcher and checked by a second. The results from each study are presented as relative risk for dichotomous variables. Where deemed appropriate, similar studies were pooled in a meta analysis. MAIN RESULTS: 41 RCTs were included in the review. Foam alternatives to the standard hospital foam mattress can reduce the incidence of pressure ulcers in people at risk. The relative merits of alternating and constant low pressure devices, and of the different alternating pressure devices for pressure ulcer prevention are unclear.Pressure-relieving overlays on the operating table have been shown to reduce postoperative pressure ulcer incidence, although one study indicated that an overlay resulted in adverse skin changes. One trial indicated that Australian standard medical sheepskins prevented pressure ulcers. There is insufficient evidence to draw conclusions on the value of seat cushions, limb protectors and various constant low pressure devices as pressure ulcer prevention strategies.A study of Accident & Emergency trolley overlays did not identify a reduction in pressure ulcer incidence. There are tentative indications that foot waffle heel elevators, a particular low air loss hydrotherapy mattress and an operating theatre overlay are harmful. REVIEWERS' CONCLUSIONS: In people at high risk of pressure ulcer development, consideration should be given to the use of higher specification foam mattresses rather than standard hospital foam mattresses. The relative merits of higher-tech constant low pressure and alternating pressure for prevention are unclear. Organisations might consider the use of pressure relief for high risk patients in the operating theatre, as this is associated with a reduction in post-operative incidence of pressure ulcers. Seat cushions and overlays designed for use in Accident & Emergency settings have not been adequately evaluated.

Achievement, motivation, and educational choices: A longitudinal study of expectancy and value using a multiplicative perspective

Abstract: Drawing on the expectancy-value model, the present study explored individual and gender differences in university entry and selection of educational pathway (e.g., science, technology, engineering, and mathematics [STEM] course selection). In particular, we examined the multiplicative effects of expectancy and task values on educational outcomes during the transition into early adulthood. Participants were from a nationally representative longitudinal sample of 15-year-old Australian youths (N = 10,370). The results suggest that (a) both math self-concept and intrinsic value interact in predicting advanced math course selection, matriculation results, entrance into university, and STEM fields of study; (b) prior reading achievement has negative effects on advanced math course selection and STEM fields through math motivational beliefs; and (c) gender differences in educational outcomes are mediated by gender differences in motivational beliefs and prior academic achievement, while the processes underlying choice of educational pathway were similar for males and females.

Correlates of weight stigma in adults with overweight and obesity: A systematic literature review

Abstract: Objective While evidence regarding associations between weight stigma and biopsychosocial outcomes is accumulating, outcomes are considered in isolation. Thus, little is known about their complex relationships. This article extends existing work by systematically reviewing the biopsychosocial consequences of stigma in adults with overweight/obesity. Methods Articles were identified through Medline, CINAHL, PsycINFO, Embase, Web of Science, and Cochrane databases. Independent extraction of articles was conducted using predefined data fields, including data on biopsychosocial correlates in each study. Results Twenty-three studies published from 2001 and addressing correlates of stigma in adults with overweight/obesity (body mass index ≥25 kg m−2; 18-65 years) were identified. Numerous biopsychosocial correlates of weight stigma were studied, particularly in treatment-seeking individuals. Available research shows that weight stigma is consistently associated with medication non-adherence, mental health, anxiety, perceived stress, antisocial behavior, substance use, coping strategies, and social support. Biopsychosocial correlates were not considered in combination in research. Psychological correlates were well documented in comparison to biological and social correlates for each weight stigma type. There were some indications that associations are stronger once stigma is internalized. Conclusions While there is evidence for biopsychosocial correlates of weight stigma, these are not considered in combination in research; thus their inter-relationships are unknown. Conclusions from the review are limited by this and the small number of studies, types of designs, and variables considered.

Mindfulness, Work Climate, and Psychological Need Satisfaction in Employee Well-being

Abstract: The present study investigated how both mindfulness and managerial autonomy support affect work adjustment. Two hundred and fifty-nine working adults were recruited online, and they were assessed for individual differences in mindfulness and the autonomy-supportive versus controlling style of their management at work. Also assessed were indicators of work-related adjustment, namely, burnout, turnover intention, and absenteeism. Results showed that both autonomy support and mindfulness had direct relations with employee work well-being. Less autonomy-supportive work climates thwarted employee’s basic psychological needs at work, which partially explained the association of lower autonomy support at work and decreased work adjustment. These indirect effects were moderated by mindfulness. Specifically, people higher in mindfulness were less likely to feel need frustration, even in unsupportive managerial environments. Mindfulness thus appears to act as a protective factor in controlling work environments. These results not only highlight mindfulness as a potential pathway to wellness at the workplace, but also speak to the relevance of autonomy support in work environments in promoting employee work well-being.

Disentangling Shape from Level Effects in Person-Centered Analyses: An Illustration Based on University Teachers’ Multidimensional Profiles of Effectiveness

Abstract: This study compares alternative ways of disentangling the effects of level (the tendency for a person to be high, medium, or low across all factors) and shape (the tendency for a person to have a distinct pattern of factors on which they are high, medium, or low) in profile analyses. This issue is particularly relevant to performance appraisals where it is often useful to identify specific strengths and weaknesses over and above a person global performance, but also to person-centered analyses more generally where the observation of qualitative (shape) differences between profiles is often used as justification for the added value of profiles. Substantively, this study illustrates these issues in the identification of profiles of teachers based on multidimensional students’ ratings of their effectiveness, using an archival data set of 31,951 class-average ratings based on the Students’ Evaluations of Educational Quality (SEEQ) instrument collected over a 13-year period. The results show the superiority of...

Dermal Matrices and Bioengineered Skin Substitutes: A Critical Review of Current Options

Abstract: For many centuries, skin grafts have been used to restore wound defects after trauma, vascular disease, or cancer. However, availability of sufficient healthy skin can be an issue, as well as the additional health risks associated with the procedure. The deforming donor-site morbidity should also be considered when opting for skin grafting. Disadvantages as such have led to innovations in skin tissue engineering. Over recent decades, scientists and surgeons have collaborated to develop various bioengineered and synthetic alternatives to promote healing in superficial and deep skin wounds. Tissue-engineered skin scaffolds are 3-dimensional structures that are positioned within the defect and provide immediate protection against dehydration, microorganisms, and toxins.1 The scaffold then gradually becomes incorporated in the wound bed, a process aided by natural wound healing mechanisms such as local inflammation, cell infiltration (neutrophils, macrophages, and fibroblasts), and neovascularization of the scaffold. More recent advances in skin substitutes involve prepopulation of scaffolds with living cells of autologous or allogeneic origin, usually keratinocytes or fibroblasts. The choice of an appropriate scaffold is important to guide cell behavior, and cytotoxic products or materials that induce extensive scar formation should be avoided. Scaffolds often have unique physical characteristics due to differences in manufacturing techniques such as decellularization, sterilization, freeze drying, and cross-linking protocols.2 To resist in vivo forces like wound contraction, scaffold materials are, for example, often freeze dried and/or chemically cross-linked to enhance strength. However, it has been demonstrated that chemical cross-linking can alter clinical results. Non-cross-linked materials exhibit greater cellular infiltration, extracellular matrix deposition, and neovascularization compared with their chemically cross-linked alternatives.2 They also become less encapsulated3 and thus more incorporated. Cross-linking a product is a means to enhance strength, but can seriously affect clinical properties. Despite the numerous articles and reviews written about dermal skin substitutes, there is no general consensus. This article reviews dermal skin scaffolds used in clinical applications and experimental settings. For scaffold evaluation, we focused on clinical and/or histological results, and conclusions are listed. Explanations for general trends were sought based on existing knowledge about tissue engineering principles and wound healing mechanisms.

The NAVIGATE Program for First-Episode Psychosis: Rationale, Overview, and Description of Psychosocial Components

Abstract: Comprehensive coordinated specialty care programs for first-episode psychosis have been widely implemented in other countries but not in the United States. The National Institute of Mental Health’s Recovery After an Initial Schizophrenia Episode (RAISE) initiative focused on the development and evaluation of first-episode treatment programs designed for the U.S. health care system. This article describes the background, rationale, and nature of the intervention developed by the RAISE Early Treatment Program project—known as the NAVIGATE program—with a particular focus on its psychosocial components. NAVIGATE is a team-based, multicomponent treatment program designed to be implemented in routine mental health treatment settings and aimed at guiding people with a first episode of psychosis (and their families) toward psychological and functional health. The core services provided in the NAVIGATE program include the family education program (FEP), individual resiliency training (IRT), supported employment an...

Application of Exploratory Structural Equation Modeling to Evaluate the Academic Motivation Scale

Abstract: In this research, the authors examined the construct validity of scores of the Academic Motivation Scale using exploratory structural equation modeling. Study 1 and Study 2 involved 1,416 college students and 4,498 high school students, respectively. First, results of both studies indicated that the factor structure tested with exploratory structural equation modeling provides better fit to the data than the one tested with confirmatory factor analysis. Second, the factor structure was gender invariant in the exploratory structural equation modeling framework. Third, the pattern of convergent and divergent correlations among Academic Motivation Scale factors was more in line with theoretical expectations when computed with exploratory structural equation modeling rather than confirmatory factor analysis. Fourth, the configuration of convergent and divergent correlations connecting each Academic Motivation Scale factors to a validity criterion was more in line with theoretical expectations with exploratory structural equation modeling than with confirmatory factor analysis.

Wearable Sensor Use for Assessing Standing Balance and Walking Stability in People with Parkinson’s Disease: A Systematic Review

Abstract: Background Postural instability and gait disability threaten the independence and well-being of people with Parkinson’s disease and increase the risk of falls and fall-related injuries. Prospective research has shown that commonly-used clinical assessments of balance and walking lack the sensitivity to accurately and consistently identify those people with Parkinson’s disease who are at a higher risk of falling. Wearable sensors provide a portable and affordable alternative for researchers and clinicians who are seeking to objectively assess movements and falls risk in the clinical setting. However, no consensus currently exists on the optimal placements for sensors and the best outcome measures to use for assessing standing balance and walking stability in Parkinson’s disease patients. Hence, this systematic review aimed to examine the available literature to establish the best sensor types, locations and outcomes to assess standing balance and walking stability in this population. Methods Papers listed in three electronic databases were searched by title and abstract to identify articles measuring standing balance or walking stability with any kind of wearable sensor among adults diagnosed with PD. To be eligible for inclusion, papers were required to be full-text articles published in English between January 1994 and December 2014 that assessed measures of standing balance or walking stability with wearable sensors in people with PD. Articles were excluded if they; i) did not use any form of wearable sensor to measure variables associated with standing balance or walking stability; ii) did not include a control group or control condition; iii) were an abstract and/or included in the proceedings of a conference; or iv) were a review article or case study. The targeted search of the three electronic databases identified 340 articles that were potentially eligible for inclusion, but following title, abstract and full-text review only 26 articles were deemed to meet the inclusion criteria. Included articles were assessed for methodological quality and relevant data from the papers were extracted and synthesized. Results Quality assessment of these included articles indicated that 31% were of low methodological quality, while 58% were of moderate methodological quality and 11% were of high methodological quality. All studies adopted a cross-sectional design and used a variety of sensor types and outcome measures to assess standing balance or walking stability in people with Parkinson’s disease. Despite the typically low to moderate methodological quality, 81% of the studies reported differences in sensor-based measures of standing balance or walking stability between different groups of Parkinson’s disease patients and/or healthy controls. Conclusion These data support the use of wearable sensors for detecting differences in standing balance and walking stability between people with PD and controls. Further high-quality research is needed to better understand the utility of wearable sensors for the early identification of Parkinson’s disease symptoms and for assessing falls risk in this population. PROSPERO Registration CRD42014010838

The theory of planned behaviour and discrete food choices: a systematic review and meta-analysis.

Abstract: The combination of economic and social costs associated with non-communicable diseases provide a compelling argument for developing strategies that can influence modifiable risk factors, such as discrete food choices. Models of behaviour, such as the Theory of Planned Behaviour (TPB) provide conceptual order that allows program designers and policy makers to identify the substantive elements that drive behaviour and design effective interventions. The primary aim of the current review was to examine the association between TPB variables and discrete food choice behaviours. A systematic literature search was conducted to identify relevant studies. Calculation of the pooled mean effect size (r + ) was conducted using inverse-variance weighted, random effects meta-analysis. Heterogeneity across studies was assessed using the Q- and I2-statistics. Meta-regression was used to test the impact of moderator variables: type of food choice behaviour; participants’ age and gender. A total of 42 journal articles and four unpublished dissertations met the inclusion criteria. TPB variables were found to have medium to large associations with both intention and behaviour. Attitudes had the strongest association with intention (r + = 0.54) followed by perceived behavioural control (PBC, r + = 0.42) and subjective norm (SN, r + = 0.37). The association between intention and behaviour was r + = 0.45 and between PBC and behaviour was r + = 0.27. Moderator analyses revealed the complex nature of dietary behaviour and the factors that underpin individual food choices. Significantly higher PBC-behaviour associations were found for choosing health compromising compared to health promoting foods. Significantly higher intention-behaviour and PBC-behaviour associations were found for choosing health promoting foods compared to avoiding health compromising foods. Participant characteristics were also found to moderate associations within the model. Higher intention-behaviour associations were found for older, compared to younger age groups. The variability in the association of the TPB with different food choice behaviours uncovered by the moderator analyses strongly suggest that researchers should carefully consider the nature of the behaviour being exhibited prior to selecting a theory.

Qualitative research with families living with autism spectrum disorder: Recommendations for conducting semistructured interviews

Abstract: In this paper, the insights and experiences of a research team involved in conducting qualitative research with families living with autism spectrum disorder are drawn upon to provide reflections and recommendations across all stages of the qualitative research process. Particular attention is given to the steps involved in semistructured interviews, specifically, interview guide preparation, participant recruitment, obtaining informed and voluntary consent/assent, conducting effective interviews, accurate analysis and interpretation of data, ways to involve participants in data analysis, effective communication of research findings, and providing feedback to participants. In addition, reflections and recommendations are provided for maintaining researcher health throughout the qualitative research process.

Ciprofloxacin resistance in community- and hospital-acquired Escherichia coli urinary tract infections: a systematic review and meta-analysis of observational studies.

Abstract: During the last decade the resistance rate of urinary Escherichia coli (E. coli) to fluoroquinolones such as ciprofloxacin has increased. Systematic reviews of studies investigating ciprofloxacin resistance in community- and hospital-acquired E. coli urinary tract infections (UTI) are absent. This study systematically reviewed the literature and where appropriate, meta-analysed studies investigating ciprofloxacin resistance in community- and hospital-acquired E. coli UTIs. Observational studies published between 2004 and 2014 were identified through Medline, PubMed, Embase, Cochrane, Scopus and Cinahl searches. Overall and sub-group pooled estimates of ciprofloxacin resistance were evaluated using DerSimonian-Laird random-effects models. The I2 statistic was calculated to demonstrate the degree of heterogeneity. Risk of bias among included studies was also investigated. Of the identified 1134 papers, 53 were eligible for inclusion, providing 54 studies for analysis with one paper presenting both community and hospital studies. Compared to the community setting, resistance to ciprofloxacin was significantly higher in the hospital setting (pooled resistance 0.38, 95 % CI 0.36-0.41 versus 0.27, 95 % CI 0.24-0.31 in community-acquired UTIs, P < 0.001). Resistance significantly varied by region and country with the highest resistance observed in developing countries. Similarly, a significant rise in resistance over time was seen in studies reporting on community-acquired E. coli UTI. Ciprofloxacin resistance in E. coli UTI is increasing and the use of this antimicrobial agent as empirical therapy for UTI should be reconsidered. Policy restrictions on ciprofloxacin use should be enhanced especially in developing countries without current regulations.

Re-Examining High-Fat Diets for Sports Performance: Did We Call the ‘Nail in the Coffin’ Too Soon?

Abstract: During the period 1985–2005, studies examined the proposal that adaptation to a low-carbohydrate ( 60 % energy) diet (LCHF) to increase muscle fat utilization during exercise could enhance performance in trained individuals by reducing reliance on muscle glycogen. As little as 5 days of training with LCHF retools the muscle to enhance fat-burning capacity with robust changes that persist despite acute strategies to restore carbohydrate availability (e.g., glycogen supercompensation, carbohydrate intake during exercise). Furthermore, a 2- to 3-week exposure to minimal carbohydrate (<20 g/day) intake achieves adaptation to high blood ketone concentrations. However, the failure to detect clear performance benefits during endurance/ultra-endurance protocols, combined with evidence of impaired performance of high-intensity exercise via a down-regulation of carbohydrate metabolism led this author to dismiss the use of such fat-adaptation strategies by competitive athletes in conventional sports. Recent re-emergence of interest in LCHF diets, coupled with anecdotes of improved performance by sportspeople who follow them, has created a need to re-examine the potential benefits of this eating style. Unfortunately, the absence of new data prevents a different conclusion from being made. Notwithstanding the outcomes of future research, there is a need for better recognition of current sports nutrition guidelines that promote an individualized and periodized approach to fuel availability during training, allowing the athlete to prepare for competition performance with metabolic flexibility and optimal utilization of all muscle substrates. Nevertheless, there may be a few scenarios where LCHF diets are of benefit, or at least are not detrimental, for sports performance.

Affective Dynamics in Psychopathology

Abstract: We discuss three varieties of affective dynamics (affective instability, emotional inertia, and emotional differentiation). In each case, we suggest how these affective dynamics should be operationalized and measured in daily life using time-intensive methods, like ecological momentary assessment or ambulatory assessment, and recommend time-sensitive analyses that take into account not only the variability but also the temporal dependency of reports. Studies that explore how these affective dynamics are associated with psychological disorders and symptoms are reviewed, and we emphasize that these affective processes are within a nexus of other components of emotion regulation.

Eccentric Knee Flexor Strength and Risk of Hamstring Injuries in Rugby Union: A Prospective Study

Abstract: Background:Hamstring strain injuries (HSIs) represent the most common cause of lost playing time in rugby union. Eccentric knee flexor weakness and between-limb imbalance in eccentric knee flexor strength are associated with a heightened risk of HSIs in other sports; however, these variables have not been explored in rugby union.Purpose:To determine if lower levels of eccentric knee flexor strength or greater between-limb imbalance in this parameter during the Nordic hamstring exercise are risk factors for HSIs in rugby union.Study Design:Cohort study; Level of evidence, 2.Methods:This prospective study was conducted over the 2014 Super Rugby and Queensland Rugby Union seasons. In total, 178 rugby union players (mean age, 22.6 ± 3.8 years; mean height, 185.0 ± 6.8 cm; mean weight, 96.5 ± 13.1 kg) had their eccentric knee flexor strength assessed using a custom-made device during the preseason. Reports of previous hamstring, quadriceps, groin, calf, and anterior cruciate ligament injuries were also obtaine...

Safety of Intravenous Thrombolysis in Stroke Mimics Prospective 5-Year Study and Comprehensive Meta-Analysis

Abstract: Background and Purpose—Shortening door-to-needle time may lead to inadvertent intravenous thrombolysis (IVT) administration in stroke mimics (SMs). We sought to determine the safety of IVT in SMs using prospective, single-center data and by conducting a comprehensive meta-analysis of reported case-series. Methods—We prospectively analyzed consecutive IVT-treated patients during a 5-year period at a tertiary care stroke center. A systematic review and meta-analysis of case-series reporting safety of IVT in SMs and confirmed acute ischemic stroke were conducted. Symptomatic intracerebral hemorrhage was defined as imaging evidence of ICH with an National Institutes of Health Stroke scale increase of ≥4 points. Favorable functional outcome at hospital discharge was defined as a modified Rankin Scale score of 0 to 1. Results—Of 516 consecutive IVT patients at our tertiary care center (50% men; mean age, 60±14 years; median National Institutes of Health Stroke scale, 11; range, 3–22), SMs comprised 75 cases. Sy...