Showing papers by "Teesside University published in 2017"

Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews.

Abstract: Background Chronic pain is defined as pain lasting beyond normal tissue healing time, generally taken to be 12 weeks. It contributes to disability, anxiety, depression, sleep disturbances, poor quality of life, and healthcare costs. Chronic pain has a weighted mean prevalence in adults of 20%. For many years, the treatment choice for chronic pain included recommendations for rest and inactivity. However, exercise may have specific benefits in reducing the severity of chronic pain, as well as more general benefits associated with improved overall physical and mental health, and physical functioning. Physical activity and exercise programmes are increasingly being promoted and offered in various healthcare systems, and for a variety of chronic pain conditions. It is therefore important at this stage to establish the efficacy and safety of these programmes, and furthermore to address the critical factors that determine their success or failure. Objectives To provide an overview of Cochrane Reviews of adults with chronic pain to determine (1) the effectiveness of different physical activity and exercise interventions in reducing pain severity and its impact on function, quality of life, and healthcare use; and (2) the evidence for any adverse effects or harm associated with physical activity and exercise interventions. Methods We searched theCochrane Database of Systematic Reviews (CDSR) on the Cochrane Library (CDSR 2016, Issue 1) for systematic reviews of randomised controlled trials (RCTs), after which we tracked any included reviews for updates, and tracked protocols in case of full review publication until an arbitrary cut-off date of 21 March 2016 (CDSR 2016, Issue 3). We assessed the methodological quality of the reviews using the AMSTAR tool, and also planned to analyse data for each painful condition based on quality of the evidence. We extracted data for (1) self-reported pain severity, (2) physical function (objectively or subjectively measured), (3) psychological function, (4) quality of life, (5) adherence to the prescribed intervention, (6) healthcare use/attendance, (7) adverse events, and (8) death. Due to the limited data available, we were unable to directly compare and analyse interventions, and have instead reported the evidence qualitatively. Main results We included 21 reviews with 381 included studies and 37,143 participants. Of these, 264 studies (19,642 participants) examined exercise versus no exercise/minimal intervention in adults with chronic pain and were used in the qualitative analysis. Pain conditions included rheumatoid arthritis, osteoarthritis, fibromyalgia, low back pain, intermittent claudication, dysmenorrhoea, mechanical neck disorder, spinal cord injury, postpolio syndrome, and patellofemoral pain. None of the reviews assessed 'chronic pain' or 'chronic widespread pain' as a general term or specific condition. Interventions included aerobic, strength, flexibility, range of motion, and core or balance training programmes, as well as yoga, Pilates, and tai chi. Reviews were well performed and reported (based on AMSTAR), and included studies had acceptable risk of bias (with inadequate reporting of attrition and reporting biases). However the quality of evidence was low due to participant numbers (most included studies had fewer than 50 participants in total), length of intervention and follow-up (rarely assessed beyond three to six months). We pooled the results from relevant reviews where appropriate, though results should be interpreted with caution due to the low quality evidence. Pain severity: several reviews noted favourable results from exercise: only three reviews that reported pain severity found no statistically significant changes in usual or mean pain from any intervention. However, results were inconsistent across interventions and follow-up, as exercise did not consistently bring about a change (positive or negative) in self-reported pain scores at any single point. Physical function: was the most commonly reported outcome measure. Physical function was significantly improved as a result of the intervention in 14 reviews, though even these statistically significant results had only small-to-moderate effect sizes (only one review reported large effect sizes). Psychological function and quality of life: had variable results: results were either favourable to exercise (generally small and moderate effect size, with two reviews reporting significant, large effect sizes for quality of life), or showed no difference between groups. There were no negative effects. Adherence to the prescribed intervention: could not be assessed in any review. However, risk of withdrawal/dropout was slightly higher in the exercising group (82.8/1000 participants versus 81/1000 participants), though the group difference was non-significant. Healthcare use/attendance: was not reported in any review. Adverse events, potential harm, and death: only 25% of included studies (across 18 reviews) actively reported adverse events. Based on the available evidence, most adverse events were increased soreness or muscle pain, which reportedly subsided after a few weeks of the intervention. Only one review reported death separately to other adverse events: the intervention was protective against death (based on the available evidence), though did not reach statistical significance. Authors' conclusions The quality of the evidence examining physical activity and exercise for chronic pain is low. This is largely due to small sample sizes and potentially underpowered studies. A number of studies had adequately long interventions, but planned follow-up was limited to less than one year in all but six reviews. There were some favourable effects in reduction in pain severity and improved physical function, though these were mostly of small-to-moderate effect, and were not consistent across the reviews. There were variable effects for psychological function and quality of life. The available evidence suggests physical activity and exercise is an intervention with few adverse events that may improve pain severity and physical function, and consequent quality of life. However, further research is required and should focus on increasing participant numbers, including participants with a broader spectrum of pain severity, and lengthening both the intervention itself, and the follow-up period.

Standards for Ethics in Sport and Exercise Science Research: 2018 Update

Abstract: For publication in the International Journal of Sports Medicine (IJSM), studies involving human participants or animals must have been conducted in accordance with recognised ethical standards and national/international laws. At the very first stage of paper submission, authors are required to adhere to these and all other relevant standards and laws. In the 21st Century, research opportunities, approaches and environments are in a continual state of flux, and this is also the case for the associated ethical issues. In the original 2009 IJSM editorial [2], we described the ethical considerations embedded into national/international laws and provided specific guidance on the ethical issues which commonly arise in Sports Medicine research. In 2011, this information was updated to recognise the ethical principles of other professional associations and treaties when conducting research involving human participants [3]. Additional information was also provided on the use of Laboratory Animals in research, and on the links between sample size and research ethics. In the second update, published in 2013, we elaborated on the ethical issues relating to the investigation of doping agents; the use of animals for answering research questions that appear to be solely focussed on the enhancement of athletic performance; and sample size in the context of the burden to individual research participants [4]. In 2015, we updated some of the guidelines to account for the changes made to the Declaration of Helsinki in 2013, covered the use of social media in research, provided guidance on how researchers can feed back their incidental and pertinent findings to research participants, covered some of the issues relating to studies involving children, and outlined the difference between a full and pilot study in terms of desired number of participants [5]. In this, our new update for 2018 onwards, we provide the following revisions and additions, labelled with the word “Update” in bold text at various points in this paper; ▪ Clarification of the issues surrounding the use of a gatekeeper for accessing personal information on participants. ▪ Clarification of some of the requirements for research with participants who are either too young to give a valid consent (under relevant local Statute) themselves and/or who lack the mental capacity to give an informed consent. ▪ Clarification of the expectations for the presentation and content of information given to facilitate informed consent/ assent. ▪ Highlighting of the obligation to breach confidentiality in certain circumstances and the importance of communicating all relevant process to the potential participant. ▪ Clarification on the use of person identifiable information including a reminder of the upcoming (May 2018) changes to legislation governing how personal data may be accessed and processed in research in the European Union (https://www. eugdpr.org/). ▪ Provision of advice surrounding the increasing calls for open access data, including the resulting data storage issues. ▪ Update on the ethical and legal considerations involved in secondary analysis (retrospective data) studies. ▪ Clarification on the use of placebos in research. ▪ Coverage of the expectations for studies that involve participant deception (i. e. where fully informed consent is not obtained in advance of participation). ▪ Elaboration of the sample size issues relevant to research ethics. Harriss DJ et al. Standards for Ethics in ... Int J Sports Med 2017; 00: 00–00

Diet, physical activity and behavioural interventions for the treatment of overweight or obese children from the age of 6 to 11 years

Abstract: Background: Child and adolescent overweight and obesity has increased globally, and can be associated with significant short- and longterm health consequences This is an update of a Cochrane Review published first in 2003, and updated previously in 2009 However, the update has now been split into six reviews addressing different childhood obesity treatments at different ages Objectives: To assess the effects of diet, physical activity and behavioural interventions (behaviour-changing interventions) for the treatment of overweight or obese children aged 6 to 11 years Search methods: We searched CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, LILACS as well as trial registers ClinicalTrialsgov and RsdI1401 Diet, physical activity and behavioural interventions for the treatment of overweight or obese children from th 2 / 499 ICTRP Search Portal We checked references of studies and systematic reviews We did not apply any language restrictions The date of the last search was July 2016 for all databases Selection criteria: We selected randomised controlled trials (RCTs) of diet, physical activity, and behavioural interventions (behaviour-changing interventions) for treating overweight or obese children aged 6 to 11 years, with a minimum of six months' follow-up We excluded interventions that specifically dealt with the treatment of eating disorders or type 2 diabetes, or included participants with a secondary or syndromic cause of obesity Data collection and analysis Two review authors independently screened references, extracted data, assessed risk of bias, and evaluated the quality of the evidence using the GRADE instrument We contacted study authors for additional information We carried out metaanalyses according to the statistical guidelines in the Cochrane Handbook for Systematic Reviews of Interventions Main results: We included 70 RCTs with a total of 8461 participants randomised to either the intervention or control groups The number of participants per trial ranged from 16 to 686 Fifty-five trials compared a behaviour-changing intervention with no treatment/usual care control and 15 evaluated the effectiveness of adding an additional component to a behaviour-changing intervention Sixty-four trials were parallel RCTs, and four were cluster RCTs Sixty-four trials were multicomponent, two were diet only and four were physical activity only interventions Ten trials had more than two arms The overall quality of the evidence was low or very low and 62 trials had a high risk of bias for at least one criterion Total duration of trials ranged from six months to three years The median age of participants was 10 years old and the median BMI z score was 22 Primary analyses demonstrated that behaviour-changing interventions compared to no treatment/usual care control at longest follow-up reduced BMI, BMI z score and weight Mean difference (MD) in BMI was -053 kg/m2 (95% confidence interval (CI) -082 to -024); P < 000001; 24 trials; 2785 participants; low-quality evidence MD in BMI z score was -006 units (95% CI -010 to -002); P = 0001; 37 trials; 4019 participants; low-quality evidence and MD in weight was -145 kg (95% CI -188 to -102); P < 000001; 17 trials; 1774 participants; low-quality evidence Thirty-one trials reported on serious adverse events, with 29 trials reporting zero occurrences RR 057 (95% CI 017 to 193); P = 037; 4/2105 participants in the behaviour-changing intervention groups compared with 7/1991 participants in the comparator groups) Few trials reported health-related quality of life or behaviour change outcomes, and none of the analyses demonstrated a substantial difference in these outcomes between intervention and control In two trials reporting on minutes per day of TV viewing, a small reduction of 66 minutes per day (95% CI -1288 to -031), P = 004; 2 trials; 55 participants) was found in favour of the intervention No trials reported on all-cause mortality, morbidity or socioeconomic effects, and few trials reported on participant views; none of which could be meta-analysed As the meta-analyses revealed substantial heterogeneity, we conducted subgroup analyses to examine the impact of type of comparator, type of intervention, risk of attrition bias, setting, duration of post-intervention follow-up period, parental involvement and baseline BMI z score No subgroup effects were shown for any of the subgroups on any of the outcomes Some data indicated that a reduction in BMI immediately post-intervention was no longer evident at follow-up at less than six months, which has to be investigated in further trials Authors' conclusions: Multi-component behaviour-changing interventions that incorporate diet, physical activity and behaviour change may be beneficial in achieving small, short-term reductions in BMI, BMI z score and weight in children aged 6 to 11 years The evidence suggests a very low occurrence of adverse events The quality of the evidence was low or very low The heterogeneity observed across all outcomes was not explained by subgrouping Further research is required of behaviourchanging interventions in lower income countries and in children from different ethnic groups; also on the impact of behaviour-changing interventions on health-related quality of life and comorbidities The sustainability of reduction in BMI/BMI z score and weight is a key consideration and there is a need for longer-term follow-up and further research on the most appropriate forms of post-intervention maintenance in order to ensure intervention benefits are sustained over the longer term

Diet, physical activity and behavioural interventions for the treatment of overweight or obese adolescents aged 12 to 17 years.

Abstract: Background Adolescent overweight and obesity has increased globally, and can be associated with short- and long-term health consequences. Modifying known dietary and behavioural risk factors through behaviour changing interventions (BCI) may help to reduce childhood overweight and obesity. This is an update of a review published in 2009. Objectives To assess the effects of diet, physical activity and behavioural interventions for the treatment of overweight or obese adolescents aged 12 to 17 years. Search methods We performed a systematic literature search in: CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, LILACS, and the trial registers ClinicalTrials.gov and ICTRP Search Portal. We checked references of identified studies and systematic reviews. There were no language restrictions. The date of the last search was July 2016 for all databases. Selection criteria We selected randomised controlled trials (RCTs) of diet, physical activity and behavioural interventions for treating overweight or obesity in adolescents aged 12 to 17 years. Data collection and analysis Two review authors independently assessed risk of bias, evaluated the overall quality of the evidence using the GRADE instrument and extracted data following the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions. We contacted trial authors for additional information. Main results We included 44 completed RCTs (4781 participants) and 50 ongoing studies. The number of participants in each trial varied (10 to 521) as did the length of follow-up (6 to 24 months). Participants ages ranged from 12 to 17.5 years in all trials that reported mean age at baseline. Most of the trials used a multidisciplinary intervention with a combination of diet, physical activity and behavioural components. The content and duration of the intervention, its delivery and the comparators varied across trials. The studies contributing most information to outcomes of weight and body mass index (BMI) were from studies at a low risk of bias, but studies with a high risk of bias provided data on adverse events and quality of life. The mean difference (MD) of the change in BMI at the longest follow-up period in favour of BCI was -1.18 kg/m2 (95% confidence interval (CI) -1.67 to -0.69); 2774 participants; 28 trials; low quality evidence. BCI lowered the change in BMI z score by -0.13 units (95% CI -0.21 to -0.05); 2399 participants; 20 trials; low quality evidence. BCI lowered body weight by -3.67 kg (95% CI -5.21 to -2.13); 1993 participants; 20 trials; moderate quality evidence. The effect on weight measures persisted in trials with 18 to 24 months' follow-up for both BMI (MD -1.49 kg/m2 (95% CI -2.56 to -0.41); 760 participants; 6 trials and BMI z score MD -0.34 (95% CI -0.66 to -0.02); 602 participants; 5 trials). There were subgroup differences showing larger effects for both BMI and BMI z score in studies comparing interventions with no intervention/wait list control or usual care, compared with those testing concomitant interventions delivered to both the intervention and control group. There were no subgroup differences between interventions with and without parental involvement or by intervention type or setting (health care, community, school) or mode of delivery (individual versus group). The rate of adverse events in intervention and control groups was unclear with only five trials reporting harms, and of these, details were provided in only one (low quality evidence). None of the included studies reported on all-cause mortality, morbidity or socioeconomic effects. BCIs at the longest follow-up moderately improved adolescent's health-related quality of life (standardised mean difference 0.44 ((95% CI 0.09 to 0.79); P = 0.01; 972 participants; 7 trials; 8 comparisons; low quality of evidence) but not self-esteem. Trials were inconsistent in how they measured dietary intake, dietary behaviours, physical activity and behaviour. Authors' conclusions We found low quality evidence that multidisciplinary interventions involving a combination of diet, physical activity and behavioural components reduce measures of BMI and moderate quality evidence that they reduce weight in overweight or obese adolescents, mainly when compared with no treatment or waiting list controls. Inconsistent results, risk of bias or indirectness of outcome measures used mean that the evidence should be interpreted with caution. We have identified a large number of ongoing trials (50) which we will include in future updates of this review.

Prediction of whole-body fat percentage and visceral adipose tissue mass from five anthropometric variables

Abstract: Background: The conventional measurement of obesity utilises the body mass index (BMI) criterion. Although there are benefits to this method, there is concern that not all individuals at risk of obesity-associated medical conditions are being identified. Whole-body fat percentage (%FM), and specifically visceral adipose tissue (VAT) mass, are correlated with and potentially implicated in disease trajectories, but are not fully accounted for through BMI evaluation. The aims of this study were (a) to compare five anthropometric predictors of %FM and VAT mass, and (b) to explore new cut-points for the best of these predictors to improve the characterisation of obesity. Methods: BMI, waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and waist/height0.5 (WHT.5R) were measured and calculated for 81 adults (40 women, 41 men; mean (SD) age: 38.4 (17.5) years; 94% Caucasian). Total body dual energy X-ray absorptiometry with Corescan (GE Lunar iDXA, Encore version 15.0) was also performed to quantify %FM and VAT mass. Linear regression analysis, stratified by sex, was applied to predict both %FM and VAT mass for each anthropometric variable. Within each sex, we used information theoretic methods (Akaike Information Criterion; AIC) to compare models. For the best anthropometric predictor, we derived tentative cut-points for classifying individuals as obese (>25% FM for men or >35% FM for women, or > highest tertile for VAT mass). Results: The best predictor of both %FM and VAT mass in men and women was WHtR. Derived cut-points for predicting whole body obesity were 0.53 in men and 0.54 in women. The cut-point for predicting visceral obesity was 0.59 in both sexes. Conclusions: In the absence of more objective measures of central obesity and adiposity, WHtR is a suitable proxy measure in both women and men. The proposed DXA-%FM and VAT mass cut-offs require validation in larger studies, but offer potential for improvement of obesity characterisation and the identification of individuals who would most benefit from therapeutic intervention. Key words: Fat mass; Visceral Fat; Measurement; DXA

Longitudinal development of the gut microbiome and metabolome in preterm neonates with late onset sepsis and healthy controls

Abstract: Late onset sepsis (LOS) in preterm infants is associated with considerable morbidity and mortality. While studies have implicated gut bacteria in the aetiology of the disease, functional analysis and mechanistic insights are generally lacking. We performed temporal bacterial (n = 613) and metabolomic (n = 63) profiling on extensively sampled stool from 7 infants with LOS and 28 matched healthy (no LOS or NEC) controls. The bacteria isolated in diagnostic blood culture usually corresponded to the dominant bacterial genera in the gut microbiome. Longitudinal changes were monitored based on preterm gut community types (PGCTs), where control infants had an increased number of PGCTs compared to LOS infants (P = 0.011). PGCT 6, characterised by Bifidobacteria dominance, was only present in control infants. Metabolite profiles differed between LOS and control infants at diagnosis and 7 days later, but not 7 days prior to diagnosis. Bifidobacteria was positively correlated with control metabolites, including raffinose, sucrose, and acetic acid. Using multi-omic analysis, we show that the gut microbiome is involved in the pathogenesis of LOS. While the causative agent of LOS varies, it is usually abundant in the gut. Bifidobacteria dominance was associated with control infants, and the presence of this organism may directly protect, or act as a marker for protection, against gut epithelial translocation. While the metabolomic data is preliminary, the findings support that gut development and protection in preterm infants is associated with increased in prebiotic oligosaccharides (e.g. raffinose) and the growth of beneficial bacteria (e.g. Bifidobacterium).

Physical fitness and academic performance in youth: A systematic review

Abstract: Physical fitness (PF) is a construct of health- and skill-related attributes which have been associated with academic performance (AP) in youth. This study aimed to review the scientific evidence on the association among components of PF and AP in children and adolescents. A systematic review of articles using databases PubMed/Medline, ERIC, LILACS, SciELO, and Web of Science was undertaken. Cross-sectional and longitudinal studies examining the association between at least one component of PF and AP in children and adolescents, published between 1990 and June 2016, were included. Independent extraction of articles was carried out by the two authors using predefined data fields. From a total of 45 studies included, 25 report a positive association between components of PF with AP and 20 describe a single association between cardiorespiratory fitness (CRF) and AP. According to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines: 12 were classified as low, 32 as medium risk, and 1 as high risk of bias. Thirty-one studies reported a positive association between AP and CRF, six studies with muscular strength, three studies with flexibility, and seven studies reported a positive association between clustered of PF components and AP. The magnitude of the associations is weak to moderate (β = 0.10–0.42 and odds = 1.01–4.14). There is strong evidence for a positive association between CRF and cluster of PF with AP in cross-sectional studies; and evidence from longitudinal studies for a positive association between cluster of PF and AP; the relationship between muscular strength and flexibility with AP remains uncertain.

Match Physical Performance of Elite Female Soccer Players During International Competition

Abstract: The purpose of the present study was to provide a detailed analysis of the physical demands of competitive international female soccer match-play. A total of 148 individual match observations were undertaken on 107 outfield players competing in competitive international matches during the 2011-2012 and 2012-2013 seasons, using a computerized tracking system (Prozone Sports Ltd., Leeds, England). Total distance (TD) and total high-speed running distances (THSR) were influenced by playing position, with central midfielders (CM) completing the highest (10985±706 m and 2882±500 m) and central defenders (CD) the lowest (9489±562 m and 1901±268 m) distances, respectively. Greater total very high-speed running (TVHSR) distances were completed when a team was without (399±143 m) compared to with (313±210 m) possession of the ball. The majority of sprints were over short distances with 76 % and 95 % being less than 5 m and 10 m, respectively. Between half reductions in physical performance were present for all variables, independent of playing position. The current study provides novel findings regarding the physical demands of different playing positions in competitive international female match-play and provides important insights for physical coaches preparing elite female players for competition.

Uberworked and underpaid: How workers are disrupting the digital economy

Abstract: ‘Solo workers shoulder the material backbone for crowd work while platform owners provide the cloud-computing infrastructure’ (p. 131). This neatly encapsulates the two strands of Scholz’s work on ...

Five-year follow-up results of the PROFHER trial comparing operative and non-operative treatment of adults with a displaced fracture of the proximal humerus

Abstract: AimsThe PROximal Fracture of the Humerus Evaluation by Randomisation (PROFHER) randomised clinical trial compared the operative and non-operative treatment of adults with a displaced fracture of the proximal humerus involving the surgical neck. The aim of this study was to determine the long-term treatment effects beyond the two-year follow-up.Patients and MethodsOf the original 250 trial participants, 176 consented to extended follow-up and were sent postal questionnaires at three, four and five years after recruitment to the trial. The Oxford Shoulder Score (OSS; the primary outcome), EuroQol 5D-3L (EQ-5D-3L), and any recent shoulder operations and fracture data were collected. Statistical and economic analyses, consistent with those of the main trial were applied.ResultsOSS data were available for 164, 155 and 149 participants at three, four and five years, respectively. There were no statistically or clinically significant differences between operative and non-operative treatment at each follow-up poi...

A higher effort-based paradigm in physical activity and exercise for public health: making the case for a greater emphasis on resistance training

Abstract: It is well known that physical activity and exercise is associated with a lower risk of a range of morbidities and all-cause mortality. Further, it appears that risk reductions are greater when physical activity and/or exercise is performed at a higher intensity of effort. Why this may be the case is perhaps explained by the accumulating evidence linking physical fitness and performance outcomes (e.g. cardiorespiratory fitness, strength, and muscle mass) also to morbidity and mortality risk. Current guidelines about the performance of moderate/vigorous physical activity using aerobic exercise modes focuses upon the accumulation of a minimum volume of physical activity and/or exercise, and have thus far produced disappointing outcomes. As such there has been increased interest in the use of higher effort physical activity and exercise as being potentially more efficacious. Though there is currently debate as to the effectiveness of public health prescription based around higher effort physical activity and exercise, most discussion around this has focused upon modes considered to be traditionally ‘aerobic’ (e.g. running, cycling, rowing, swimming etc.). A mode customarily performed to a relatively high intensity of effort that we believe has been overlooked is resistance training. Current guidelines do include recommendations to engage in ‘muscle strengthening activities’ though there has been very little emphasis upon these modes in either research or public health effort. As such the purpose of this debate article is to discuss the emerging higher effort paradigm in physical activity and exercise for public health and to make a case for why there should be a greater emphasis placed upon resistance training as a mode in this paradigm shift.

Etiological Theories of Adolescent Idiopathic Scoliosis: Past and Present

Abstract: Adolescent idiopathic scoliosis is one of the most common spinal deformities, yet its cause is unknown. Various theories look to biomechanical, neuromuscular, genetic, and environmental origins, yet our understanding of scoliosis etiology is still limited. Determining the cause of a disease is crucial to developing the most effective treatment. Associations made with scoliosis do not necessarily point to causality, and it is difficult to determine whether said associations are primary (playing a role in development) or secondary (develop as a result of scoliosis). Scoliosis is a complex condition with highly variable expression, even among family members, and likely has many causes. These causes could be similar among homogenous groups of AIS patients, or they could be individual. Here, we review the most prevalent theories of scoliosis etiology and recent trends in research.

The Influence of Changes in Acute Training Load on Daily Sensitivity of Morning-Measured Fatigue Variables in Elite Soccer Players.

Abstract: Purpose:To determine the sensitivity of a range of potential fatigue measures to daily training load accumulated over the previous 2, 3, and 4 d during a short in-season competitive period in elite senior soccer players (N = 10). Methods:Total highspeed-running distance, perceived ratings of wellness (fatigue, muscle soreness, sleep quality), countermovement-jump height (CMJ), submaximal heart rate (HRex), postexercise heart-rate recovery (HRR), and heart-rate variability (HRV: Ln rMSSD) were analyzed during an in-season competitive period (17 d). General linear models were used to evaluate the influence of 2-, 3-, and 4-d total high-speed-running-distance accumulation on fatigue measures. Results:Fluctuations in perceived ratings of fatigue were correlated with fluctuations in total high-speed-running-distance accumulation covered on the previous 2 d (r = –.31; small), 3 d (r = –.42; moderate), and 4 d (r = –.28; small) (P < .05). Changes in HRex (r = .28; small; P = .02) were correlated with changes in ...

New insights on the complex dynamics of two-phase flow in porous media under intermediate-wet conditions

Abstract: Multiphase flow in porous media is important in a number of environmental and industrial applications such as soil remediation, CO2 sequestration, and enhanced oil recovery. Wetting properties control flow of immiscible fluids in porous media and fluids distribution in the pore space. In contrast to the strong and weak wet conditions, pore-scale physics of immiscible displacement under intermediate-wet conditions is less understood. This study reports the results of a series of two-dimensional high-resolution direct numerical simulations with the aim of understanding the pore-scale dynamics of two-phase immiscible fluid flow under intermediate-wet conditions. Our results show that for intermediate-wet porous media, pore geometry has a strong influence on interface dynamics, leading to co-existence of concave and convex interfaces. Intermediate wettability leads to various interfacial movements which are not identified under imbibition or drainage conditions. These pore-scale events significantly influence macro-scale flow behaviour causing the counter-intuitive decline in recovery of the defending fluid from weak imbibition to intermediate-wet conditions.

A review of photovoltaic module technologies for increased performance in tropical climate

Abstract: The global adoption and use of photovoltaic modules (PVMs) as the main source of energy is the key to realising the UN Millennium Development Goals on Green Energy. The technology – projected to contribute about 20% of world energy supply by 2050, over 60% by 2100 and leading to 50% reduction in global CO2 emissions – is threatened by its poor performance in tropical climate. Such performance discourages its regional acceptance. The magnitude of crucial module performance influencing factors (cell temperature, wind speed and relative humidity) reach critical values of 90 °C, 0.2 m/s and 85%, respectively in tropical climates which negatively impact module performance indices which include power output (PO), power conversion efficiency (PCE) and energy payback time (EPBT). This investigation reviews PVM technologies which include cell, contact and interconnection technologies. It identifies critical technology route(s) with potential to increase operational reliability of PVMs in the tropics when adopted. The cell performance is measured by PO, PCE and EPBT while contacts and interconnections performance is measured by the degree of recombination, shading losses and also the rate of thermo-mechanical degradation. It is found that the mono-crystalline cell has the best PCE of 25% while the Cadmium Telluride (CdTe) cell has the lowest EPBT of 8-months. Results show that the poly-crystalline cell has the largest market share amounting to 54%. The CdTe cell exhibits 0% drop in PCE at high-temperatures and low irradiance operations – demonstrating least affected PO by the conditions. Further results establish that back contacts and back-to-back interconnection technologies produce the least recombination losses and demonstrate absence of shading in addition to possessing longest interconnection fatigue life. Based on these findings, the authors propose a PVM comprising CdTe cell, back contacts and back-to-back interconnection technologies as the technology with latent capacity to produce improved performance in tropical climates.

Understanding Risky Behavior: The Influence of Cognitive, Emotional and Hormonal Factors on Decision-Making under Risk

Abstract: Financial risky decisions and evaluations pervade many human everyday activities. Scientific research in such decision-making typically explores the influence of socio-economic and cognitive factors on financial behavior. However, very little research has explored the holistic influence of contextual, emotional, and hormonal factors on preferences for risk in insurance and investment behaviors. Accordingly, the goal of this review article is to address the complexity of individual risky behavior and its underlying psychological factors, as well as to critically examine current regulations on financial behavior.

What is best practice in sex and relationship education? A synthesis of evidence, including stakeholders' views.

Abstract: OBJECTIVES: Sex and relationship education (SRE) is regarded as vital to improving young people's sexual health, but a third of schools in England lacks good SRE and government guidance is outdated. We aimed to identify what makes SRE programmes effective, acceptable, sustainable and capable of faithful implementation. DESIGN: This is a synthesis of findings from five research packages that we conducted (practitioner interviews, case study investigation, National Survey of Sexual Attitudes and Lifestyles, review of reviews and qualitative synthesis). We also gained feedback on our research from stakeholder consultations. SETTINGS: Primary research and stakeholder consultations were conducted in the UK. Secondary research draws on studies worldwide. RESULTS: Our findings indicate that school-based SRE and school-linked sexual health services can be effective at improving sexual health. We found professional consensus that good programmes start in primary school. Professionals and young people agreed that good programmes are age-appropriate, interactive and take place in a safe environment. Some young women reported preferring single-sex classes, but young men appeared to want mixed classes. Young people and professionals agreed that SRE should take a 'life skills' approach and not focus on abstinence. Young people advocated a 'sex-positive' approach but reported this was lacking. Young people and professionals agreed that SRE should discuss risks, but young people indicated that approaches to risk need revising. Professionals felt teachers should be involved in SRE delivery, but many young people reported disliking having their teachers deliver SRE and we found that key messages could become lost when interpreted by teachers. The divergence between young people and professionals was echoed by stakeholders. We developed criteria for best practice based on the evidence. CONCLUSIONS: We identified key features of effective and acceptable SRE. Our best practice criteria can be used to evaluate existing programmes, contribute to the development of new programmes and inform consultations around statutory SRE.

Recent developments in metal-supported solid oxide fuel cells

Abstract: Metal-supported solid oxide fuel cells (MSCs) offer certain strategic advantages over the more conventional solid oxide fuel cells (SOFCs), which comprise only ceramic materials. Since alloys such as ferritic steels are very similar in their coefficient of thermal expansion (CTE) with ceramic components, viz., cerias, zirconias, and nickel oxide doped with either of them, they could provide excellent thermal cyclability while maintaining a strong interlayer bond. Therefore, in an anode-supported cell the entire NiO-ceramic support can be replaced by a ferritic steel porous support—the catalytically active NiO is therefore, a functional layer only. A huge savings in materials cost is achievable, because cerias and zirconias [usually doped with Y, Gd, Sm rare earth (RE) elements] are considerably more expensive that ferritic steels. Lowering the capital costs for SOFCs is an extensive global undertaking with US Department of Energy (DOE) laying down targets such as ~$ 200/kW for the stack itself, in order for SOFCs to become competitive with grid power costs and to offer a power source that promises 24 × 7 power supply for critical applications. This will eventually lead to a premier electricity generation device in the distributed power space, with the highest known electrical efficiencies (>50%). MSCs need very robust, high precision, and cost-effective manufacturing techniques, which are scalable to high volumes. One of the main goals in this review is to showcase some of the work done in this area since the last review (2010), and to assess the technology challenges, and new solutions that have emerged over the past few years. WIREs Energy Environ 2017, 6:e246. doi: 10.1002/wene.246 For further resources related to this article, please visit the WIREs website.

Inter-Individual Responses of Maximal Oxygen Uptake to Exercise Training: A Critical Review

Abstract: It has recently been reported how to quantify inter-individual differences in the response to an exercise intervention using the standard deviation of the change scores, as well as how to appraise these differences for clinical relevance. In a parallel-group randomised controlled trial, the key trigger for further investigation into inter-individual responses is when the standard deviation of change in the intervention sample is substantially larger than the same standard deviation derived from a suitable comparator sample. ‘True’ and clinically relevant inter-individual differences in response can then be plausibly expected, and potential moderators and mediators of the inter-individual differences can be explored. We now aim to critically review the research on the inter-individual differences in response to exercise training, focusing on maximal oxygen uptake (VO2max). A literature search through the relevant bibliographic databases resulted in the identification of six relevant studies that were published prior to the influential HEalth, RIsk factors, exercise Training And GEnetics (HERITAGE) Family Study. Only one of these studies was found to include a comparator arm. Re-analysis of the data from this study, accounting for random within-subjects variation, revealed an absence of clinically important inter-individual differences in the response of VO2max to exercise training. The standard deviation of change was, in fact, larger (±5.6 mL/kg/min) for the comparator than the intervention group (±3.7 mL/kg/min). We located over 180 publications that resulted from the HERITAGE Family Study, but we could not find a comparator arm in any of these studies. Some authors did not explain this absence, while others reasoned that only inter-individual differences in exercise response were of interest, thus the intervention sample was investigated solely. We also found this absence of a comparator sample in on-going studies. A perceived high test–retest reliability is offered as a justification for the absence of a comparator arm, but the test–retest reliability analysis for the HERITAGE Family Study was over a much shorter term than the length of the actual training period between baseline and follow-up measurements of VO2max. We also scrutinised the studies in which twins have been investigated, resulting in concerns about how genetic influences on the magnitude of general within-subjects variability has been partitioned out (again in the absence of a comparator no-training group), as well as with the intra-class correlation coefficient approach to data analysis. Twin pairs were found to be sometimes heterogeneous for the obviously influential factors of sex, age and fitness, thereby inflating an unadjusted coefficient. We conclude that most studies on inter-individual differences in VO2max response to exercise training have no comparator sample. Therefore, true inter-individual differences in response cannot be quantified, let alone appraised for clinical relevance. For those studies with a comparator sample, we found that the inter-individual differences in training response were not larger than random within-subjects variation in VO2max over the same time period as the training intervention.

Menthol: A Fresh Ergogenic Aid for Athletic Performance

Abstract: The application of menthol has recently been researched as a performance-enhancing aid for various aspects of athletic performance including endurance, speed, strength and joint range of motion. A range of application methods has been used including a mouth rinse, ingestion of a beverage containing menthol or external application to the skin or clothing via a gel or spray. The majority of research has focussed on the use of menthol to impart a cooling sensation on athletes performing endurance exercise in the heat. In this situation, menthol appears to have the greatest beneficial effect on performance when applied internally. In contrast, the majority of investigations into the external application of menthol demonstrated no performance benefit. While studies are limited in number, menthol has not yet proven to be beneficial for speed or strength, and only effective at increasing joint range of motion following exercise that induced delayed-onset muscle soreness. Internal application of menthol may provoke such performance-enhancing effects via mechanisms related to its thermal, ventilatory, analgesic and arousing properties. Future research should focus on well-trained subjects and investigate the addition of menthol to nutritional sports products.

Cesarean or Vaginal Birth Does Not Impact the Longitudinal Development of the Gut Microbiome in a Cohort of Exclusively Preterm Infants

Abstract: The short and long-term impact of birth mode on the developing gut microbiome in neonates has potential implications for the health of infants. In term infants, the microbiome immediately following birth across multiple body sites corresponds to birth mode, with increased Bacteroides in vaginally delivered infants. We aimed to determine the impact of birth mode of the preterm gut microbiome over the first 100 days of life and following neonatal intensive care unit (NICU) discharge. In total, 867 stool samples from 46 preterm infants (21 cesarean and 25 vaginal), median gestational age 27 weeks, were sequenced (V4 region 16S rRNA gene, Illumina MiSeq). Of these, 776 samples passed quality filtering and were included in the analysis. The overall longitudinal alpha-diversity and within infant beta-diversity was comparable between cesarean and vaginally delivered infants. Vaginally delivered infants kept significantly more OTUs from 2 months of life and following NICU discharge, but OTUs lost, gained, and regained were not different based on birth mode. Furthermore, the temporal progression of dominant genera was comparable between birth modes and no significant difference was found for any genera following adjustment for covariates. Lastly, preterm gut community types (PGCTs) showed some moderate differences in very early life, but progressed toward a comparable pattern by week 5. No PGCT was significantly associated with cesarean or vaginal birth. Unlike term infants, birth mode was not significantly associated with changes in microbial diversity, composition, specific taxa, or overall microbial development in preterm infants. This may result from the dominating effects of NICU exposures including the universal use of antibiotics immediately following birth and/or the lack of Bacteroides colonizing preterm infants.

The association between obesity and academic performance in youth: a systematic review

Abstract: Previous studies have found that obesity could influence academic performance The aim of this study was to systematically review the scientific evidence on the association between obesity and academic performance in school children A systematic review of English articles was undertaken by using databases PubMed/Medline, ERIC, LILACS, SciELO and Web of Science Cross-sectional and longitudinal studies examining the association between obesity and academic performance in children and adolescents, published between January 1990 and December 2016, were included Risk of bias was assessed by using Strengthening the Reporting of Observational Studies in Epidemiology Thirty-four studies (23 cross-sectional and 11 longitudinal) matched all inclusion criteria and were included Seven studies were classified as low risk of bias, 23 as medium risk and four as high risk After controlling for covariates such as socio-economic status, parental education and physical activity, the association between obesity and academic performance becomes uncertain for most of the studies (559%) Therefore, at present, there is insufficient evidence to support a direct link between obesity and poor academic performance in school age children In order to clarify this issue, we need more longitudinal studies with adequate sample sizes and that control for potential confounders

Perspectives on high-intensity interval exercise for health promotion in children and adolescents.

Abstract: Physical activity lowers future cardiovascular disease (CVD) risk; however, few children and adolescents achieve the recommended minimum amount of daily activity. Accordingly, there is virtue in identifying the efficacy of small volumes of high-intensity exercise for health benefits in children and adolescents for the primary prevention of CVD risk. The purpose of this narrative review is to provide a novel overview of the available literature concerning high-intensity interval-exercise (HIIE) interventions in children and adolescents. Specifically, the following areas are addressed: 1) outlining the health benefits observed following a single bout of HIIE, 2) reviewing the role of HIIE training in the management of pediatric obesity, and 3) discussing the effectiveness of school-based HIIE training. In total, 39 HIIE intervention studies were included in this review. Based upon the available data, a single bout of high-intensity exercise provides a potent stimulus for favorable, acute changes across a range of cardiometabolic outcomes that are often superior to a comparative bout of moderate-intensity exercise (14 studies reviewed). HIIE also promotes improvements in cardiorespiratory fitness and cardiometabolic health status in overweight and obese children and adolescents (10 studies reviewed) and when delivered in the school setting (15 studies reviewed). We thus conclude that high-intensity exercise is a feasible and potent method of improving a range of cardiometabolic outcomes in children and adolescents. However, further work is needed to optimize the delivery of HIIE interventions in terms of participant enjoyment and acceptability, to include a wider range of health outcomes, and to control for important confounding variables (eg, changes in diet and habitual physical activity). Finally, research into the application of HIIE training interventions to children and adolescents of different ages, sexes, pubertal status, and sociocultural backgrounds is required.

Ziconotide Monotherapy: A Systematic Review of Randomised Controlled Trials.

Abstract: Introduction Chronic neuropathic pain is difficult to treat and is often refractory to most modalities of treatment. Ziconotide is a novel, potent, non-opioid, calcium channel blocking agent which has been shown in clinical trials to be effective in treating chronic neuropathic pain. Methods EMBASE, MEDLINE, CINAHL Plus and Web of Science electronic databases were searched for English language studies. Reference sections of articles were examined for further papers and the manufacturer of ziconotide was contacted for further unpublished data. Three randomised controlled trials in ziconotide monotherapy were included and subjected to a random effects meta-analysis. Results All three studies used the similar main outcome measure (visual analogue scale of pain intensity; VASPI) and were therefore comparable. A Jadad score was performed for each paper. Frequent serious adverse events (SAEs) were observed which resulted in two of the studies revising the protocol. The metaanalysis revealed a pooled odds ratio (responders on ziconotide vs. placebo) of 2.77 (95% CI, 1.37 to 5.59). Discussion The results suggest that ziconotide is beneficial for pain reduction in chronic neuropathic pain. However, there remain some methodological issues that may call into question the validity of the results. It is evident that more work needs to be conducted to further validate the efficacy of ziconotide and to discover new areas of use.

Edutaining Audio: An Exploration of Education Podcast Design Possibilities.

Abstract: The versatility, intimacy and ease of production of podcasting make it a logical technology to apply to flexible education contexts. As a result, there has been increasing scholarly interest in the...