The assessment of cardiac function is essential in the athletic population not only as part of the screening process for underlying cardiac disease, but also to longitudinally assess performance and training adaptations - Source: Toshiba's VISIONS Magazine #26 | www.toshiba-medical.eu/visions
Differences in strength and speed demands between 4v4 and 8v8 SSGFernando Farias
Small-sided games (SSGs) have been extensively used in training
footballers worldwide and have shown very good efficacy in
improving player performance (Hill-Haas, Dawson, Impellizzeri,
& Coutts, 2011). As an example, it has been shown that the
technical performance (Owen, Wong del, McKenna, & Dellal,
2011) and physical performance (Chaouachi et al., 2014; Dellal,
Varliette, Owen, Chirico, & Pialoux, 2012) of footballers can be
enhanced using SSG-based football training programmes.
In the last two decades, extensive research has been pub-
lished on physical and physiological response during SSGs in
football (for refs, see Halouani, Chtourou, Gabbett, Chaouachi,
& Chamari, 2014). It was found that the time-motion charac-
teristics of SSGs could vary greatly depending on certain
structural (e.g., pitch size, number of players, type and number
of goals) and rule (e.g., number of ball touches) constraints.
For example, it was observed that higher maximum speeds are
reached during SSGs played on bigger pitches (Casamichana &
Castellano, 2010). Furthermore, heart rate (HR) and lactate
concentrations were shown to be sensitive to structural and
rule changes in SSGs.
Effects of Addition of Sprint, Strength and Agility Training On Cardiovascula...IOSR Journals
Abstract: To find training related physiological and cardiovascular changes and adaptations in field hockey
players, this interventional study was conducted with 30 male field hockey trainees (age: 15.7±1.55 years,
range: 13-20 years) undergoing training in preparation phase. In addition to the their usual routine of 2 hours
per day, 6 times a week of aerobic, anaerobic and skill training session of field hockey; a specialized additional
training of 2 hours per day- 3 times a week, consisting of sprint, strength-power and agility was incorporated in
the schedule. Selected variables measured before and after the 6 week training were compared with paired t
test. Upon analysis we found that lean body mass (LBM) of the participants showed significant improvement
(P<0.05)><0.05)><0.05) in the echocardiographic parameters – increase in left ventricular
posterior wall thickness, left ventricular ejection fraction; and decrease in left ventricular end-systolic volume.
However when these parameters were expressed relative to LBM, no significant change was seen. Left
ventricular end-diastolic diameter and volume, body weight and body mass index too did not change
significantly after the training. This 6 week specialized additional training resulted in improvement of body
composition and cardiovascular functions of the participants, indicating favorable physiological, morphological
and functional adaptations.
Key words: field hockey; physiological adaptations; sports physiology; body composition; echocardiography;
lean body mass.
Melhorar ou até mesmo manter o desempenho atlético em jogadores de esportes de equipe competitivos durante o longo período da temporada é um dos maiores desafios para qualquer treinador comprometido. Tempo muito limitado está disponível entre as partidas semanais para introduzir sessões intensivas de treinamento de força e poder, com uma freqüência normal de 1-2 unidades por semana. Este fato estimula a busca de métodos de treinamento mais eficientes capazes de melhorar uma ampla variedade de habilidades funcionais, evitando ao mesmo tempo os efeitos de fadiga.
Effects of Velocity Loss During Resistance Training on Performance in Profess...Fernando Farias
To analyze the effects of two resistance training (RT) programs that used the same relative loading but different repetition volume, using the velocity loss during the set as the independent variable: 15% (VL15) vs. 30% (VL30). Methods: Sixteen professional soccer players with RT experience (age 23.8 ± 3.5 years, body mass 75.5 ± 8.6 kg) were randomly assigned to two groups: VL15 (n = 8) or VL30 (n = 8) that followed a 6-week (18 sessions) velocity-based squat training program. Repetition velocity was monitored in all sessions. Assessments performed before (Pre) and after training (Post) included: estimated one- repetition maximum (1RM) and change in average mean propulsive velocity (AMPV) against absolute loads common to Pre and Post tests; countermovement jump (CMJ); 30-m sprint (T30); and Yo-yo intermittent recovery test (YYIRT).
Bilateral and unilateral vertical ground reaction forcesFernando Farias
The purposes of this study were to assess unilateral and bilateral vertical jump performance
characteristics, and to compare the vertical ground reaction force characteristics of the impulse and landing
phase of a vertical jump between the dominant and non-dominant leg in soccer players.
Hamstring injuries are among the most com-
mon non-contact injuries in sports. The Nordic hamstring
(NH) exercise has been shown to decrease risk by
increasing eccentric hamstring strength.
Epidemiological studies have consistently shown hamstring
strain injuries (HSIs) to have a high prevalence rate in many
sports, such as sprinting (11%; Lysholm & Wiklander, 1987),
Australian Rules Football (16–23%; Orchard, 2001; Orchard,
Marsden, Lord, & Garlick, 1997) and football (12–14%:
Ekstrand, Hagglund, & Walden, 2011; Hawkins, Hulse,
Wilkinson, Hodson, & Gibson, 2001). The epidemiology and
aetiology of HSI in football has received extensive attention in
the scientific literature (Ekstrand et al., 2011; Woods et al., 2004),
given the economic burden associated with professional
players missing training and competitive fixtures (Woods,
Hawkins, Hulse, & Hodson, 2002). b
Nossos dados sugerem que um macrociclo com ênfase na capacidade técnica e tática foi capaz de promover aumentos no desempenho físico e tático de jovens jogadores de futebol em situações reais de disputa. Assim, a distribuição das cargas de treinamento utilizadas neste estudo, além de possibilitar uma formação mais específica e contextual, proporcionou um aumento da intensidade do jogo no final da temporada, variável diretamente relacionada ao resultado do jogo (17). Além disso, verificou-se que o protocolo de treinamento causou reduções nos marcadores de danos musculares, revelando um estímulo benéfico para o sistema muscular, o que pode contribuir para a prevenção de lesões por sobreentrenamento ao longo da temporada. Apesar da importância bem documentada da avaliação de parâmetros sangüíneos (ie, marcadores de dano) durante a prática de futebol (3, 4, 23, 29), verificamos que a redução relacionada foi associada com maior taxa de trabalho durante o jogo, Através de um treinamento técnico-tático de periodização, mostrando a importância do monitoramento desses parâmetros em longo prazo.
Differences in strength and speed demands between 4v4 and 8v8 SSGFernando Farias
Small-sided games (SSGs) have been extensively used in training
footballers worldwide and have shown very good efficacy in
improving player performance (Hill-Haas, Dawson, Impellizzeri,
& Coutts, 2011). As an example, it has been shown that the
technical performance (Owen, Wong del, McKenna, & Dellal,
2011) and physical performance (Chaouachi et al., 2014; Dellal,
Varliette, Owen, Chirico, & Pialoux, 2012) of footballers can be
enhanced using SSG-based football training programmes.
In the last two decades, extensive research has been pub-
lished on physical and physiological response during SSGs in
football (for refs, see Halouani, Chtourou, Gabbett, Chaouachi,
& Chamari, 2014). It was found that the time-motion charac-
teristics of SSGs could vary greatly depending on certain
structural (e.g., pitch size, number of players, type and number
of goals) and rule (e.g., number of ball touches) constraints.
For example, it was observed that higher maximum speeds are
reached during SSGs played on bigger pitches (Casamichana &
Castellano, 2010). Furthermore, heart rate (HR) and lactate
concentrations were shown to be sensitive to structural and
rule changes in SSGs.
Effects of Addition of Sprint, Strength and Agility Training On Cardiovascula...IOSR Journals
Abstract: To find training related physiological and cardiovascular changes and adaptations in field hockey
players, this interventional study was conducted with 30 male field hockey trainees (age: 15.7±1.55 years,
range: 13-20 years) undergoing training in preparation phase. In addition to the their usual routine of 2 hours
per day, 6 times a week of aerobic, anaerobic and skill training session of field hockey; a specialized additional
training of 2 hours per day- 3 times a week, consisting of sprint, strength-power and agility was incorporated in
the schedule. Selected variables measured before and after the 6 week training were compared with paired t
test. Upon analysis we found that lean body mass (LBM) of the participants showed significant improvement
(P<0.05)><0.05)><0.05) in the echocardiographic parameters – increase in left ventricular
posterior wall thickness, left ventricular ejection fraction; and decrease in left ventricular end-systolic volume.
However when these parameters were expressed relative to LBM, no significant change was seen. Left
ventricular end-diastolic diameter and volume, body weight and body mass index too did not change
significantly after the training. This 6 week specialized additional training resulted in improvement of body
composition and cardiovascular functions of the participants, indicating favorable physiological, morphological
and functional adaptations.
Key words: field hockey; physiological adaptations; sports physiology; body composition; echocardiography;
lean body mass.
Melhorar ou até mesmo manter o desempenho atlético em jogadores de esportes de equipe competitivos durante o longo período da temporada é um dos maiores desafios para qualquer treinador comprometido. Tempo muito limitado está disponível entre as partidas semanais para introduzir sessões intensivas de treinamento de força e poder, com uma freqüência normal de 1-2 unidades por semana. Este fato estimula a busca de métodos de treinamento mais eficientes capazes de melhorar uma ampla variedade de habilidades funcionais, evitando ao mesmo tempo os efeitos de fadiga.
Effects of Velocity Loss During Resistance Training on Performance in Profess...Fernando Farias
To analyze the effects of two resistance training (RT) programs that used the same relative loading but different repetition volume, using the velocity loss during the set as the independent variable: 15% (VL15) vs. 30% (VL30). Methods: Sixteen professional soccer players with RT experience (age 23.8 ± 3.5 years, body mass 75.5 ± 8.6 kg) were randomly assigned to two groups: VL15 (n = 8) or VL30 (n = 8) that followed a 6-week (18 sessions) velocity-based squat training program. Repetition velocity was monitored in all sessions. Assessments performed before (Pre) and after training (Post) included: estimated one- repetition maximum (1RM) and change in average mean propulsive velocity (AMPV) against absolute loads common to Pre and Post tests; countermovement jump (CMJ); 30-m sprint (T30); and Yo-yo intermittent recovery test (YYIRT).
Bilateral and unilateral vertical ground reaction forcesFernando Farias
The purposes of this study were to assess unilateral and bilateral vertical jump performance
characteristics, and to compare the vertical ground reaction force characteristics of the impulse and landing
phase of a vertical jump between the dominant and non-dominant leg in soccer players.
Hamstring injuries are among the most com-
mon non-contact injuries in sports. The Nordic hamstring
(NH) exercise has been shown to decrease risk by
increasing eccentric hamstring strength.
Epidemiological studies have consistently shown hamstring
strain injuries (HSIs) to have a high prevalence rate in many
sports, such as sprinting (11%; Lysholm & Wiklander, 1987),
Australian Rules Football (16–23%; Orchard, 2001; Orchard,
Marsden, Lord, & Garlick, 1997) and football (12–14%:
Ekstrand, Hagglund, & Walden, 2011; Hawkins, Hulse,
Wilkinson, Hodson, & Gibson, 2001). The epidemiology and
aetiology of HSI in football has received extensive attention in
the scientific literature (Ekstrand et al., 2011; Woods et al., 2004),
given the economic burden associated with professional
players missing training and competitive fixtures (Woods,
Hawkins, Hulse, & Hodson, 2002). b
Nossos dados sugerem que um macrociclo com ênfase na capacidade técnica e tática foi capaz de promover aumentos no desempenho físico e tático de jovens jogadores de futebol em situações reais de disputa. Assim, a distribuição das cargas de treinamento utilizadas neste estudo, além de possibilitar uma formação mais específica e contextual, proporcionou um aumento da intensidade do jogo no final da temporada, variável diretamente relacionada ao resultado do jogo (17). Além disso, verificou-se que o protocolo de treinamento causou reduções nos marcadores de danos musculares, revelando um estímulo benéfico para o sistema muscular, o que pode contribuir para a prevenção de lesões por sobreentrenamento ao longo da temporada. Apesar da importância bem documentada da avaliação de parâmetros sangüíneos (ie, marcadores de dano) durante a prática de futebol (3, 4, 23, 29), verificamos que a redução relacionada foi associada com maior taxa de trabalho durante o jogo, Através de um treinamento técnico-tático de periodização, mostrando a importância do monitoramento desses parâmetros em longo prazo.
Acute cardiopulmonary and metabolic responses to high intensity interval trai...Fernando Farias
Results from the present study quantify the effects of altering either the intensity of the
work or the recovery interval when performing interval sessions consisting of 60s of work and
60s of recovery for multiple repetitions. The information provided may aid those interested in
designing interval training sessions by providing ranges of values that could be expected for
individuals who possess moderate levels of cardiopulmonary fitness. Using a work intensity of
80% or 100% VGO2peak and a recovery intensity of 0% or 50% VGO2peak, subjects were able to
exercise within the ACSM recommended range for exercise intensity. Based upon the data it
would appear that a protocol such as the 80/0 may be appropriate for those individuals who
are just beginning a program or have little experience with interval-type activity. By contrast, a
100/50 protocol could not be completed by all of the subjects and therefore may be too intense
for some individuals.
Impact of the Nordic hamstring and hip extension exercises on hamstring archi...Fernando Farias
The architectural and morphological adaptations of the hamstrings in response to training
33 with different exercises have not been explored. PURPOSE: To evaluate changes in biceps
34 femoris long head (BFLH) fascicle length and hamstring muscle size following 10-weeks of
35 Nordic hamstring exercise (NHE) or hip extension (HE) training. METHODS: Thirty
36 recreationally active male athletes (age, 22.0 ± 3.6 years, height, 180.4 ± 7 cm, weight, 80.8 ±
37 11.1 kg) were allocated to one of three groups: 1) HE training (n=10), NHE training (n=10),
38 or no training (CON) (n=10). BFLH fascicle length was assessed before, during (Week 5) and
39 after the intervention with 2D-ultrasound. Hamstring muscle size was determined before and
40 after training via magnetic resonance imaging.
Short inter-set rest blunts resistance exercise-inducedFernando Farias
Manipulating the rest-recovery interval between sets of resistance exercise may influence
training-induced muscle remodelling. The aim of this study was to determine the acute muscle
anabolic response to resistance exercise performed with short or long inter-set rest intervals.
In a study with a parallel-group design, 16 males completed four sets of bilateral leg-press and
knee-extension exercise at 75% of one-repetition maximum to momentary muscular failure,
followed by ingestion of 25 g of whey protein. Resistance exercise sets were interspersed by
1 min (n = 8) or 5 min of passive rest (n = 8). Muscle biopsies were obtained at rest, 0, 4, 24
and 28 h postexercise during a primed continuous infusion of l-[ring-13C6]phenylalanine to
determine myofibrillar protein synthesis and intracellular signalling.
Machine-Learning Estimation of Body Posture and Physical Activity by Wearable...sipij
We aimed to develop the method for estimating body posture and physical activity by acceleration signals from a Holter electrocardiographic (ECG) recorder with built-in accelerometer. In healthy young subjects, triaxial-acceleration and ECG signal were recorded with the Holter ECG recorder attached on their chest wall. During the recording, they randomly took eight postures, including supine, prone, left and right recumbent, standing, sitting in a reclining chair, sitting in chairs with and without backrest, and performed slow walking and fast walking. Machine learning (Random Forest) was performed on acceleration and ECG variables. The best discrimination model was obtained when the maximum values and standard deviations of accelerations in three axes and mean R-R interval were used as feature values. The overall discrimination accuracy was 79.2% (62.6-90.9%). Supine, prone, left recumbent, and slow and fast walk were discriminated with >80% accuracy, although sitting and standing positions were not discriminated by this method.
Sprint running acceleration is a key feature of physical performance in team sports, and recent
literature shows that the ability to generate large magnitudes of horizontal ground reaction force
and mechanical effectiveness of force application are paramount. We tested the hypothesis that
very-heavy loaded sled sprint training would induce an improvement in horizontal force
production, via an increased effectiveness of application. Training-induced changes in sprint
performance and mechanical outputs were computed using a field method based on velocity-
time data, before and after an 8-week protocol (16 sessions of 10x20-m sprints). 16 male
amateur soccer players were assigned to either a very-heavy sled (80% body-mass sled load)
or a control group (unresisted sprints). The main outcome of this pilot study is that very-heavy
sled resisted sprint training, using much greater loads than traditionally recommended, clearly
increased maximal horizontal force production compared to standard unloaded sprint training
(effect size of 0.80 vs 0.20 for controls, unclear between-group difference) and mechanical
effectiveness (i.e. more horizontally applied force; effect size of 0.95 vs -0.11, moderate
between-group difference)
Training Load and Fatigue Marker Associations with Injury and IllnessFernando Farias
This paper provides a comprehensive review of the litera-
ture that has reported the monitoring of longitudinal
training load and fatigue and its relationship with injury
and illness. The current findings highlight disparity in the
terms used to define training load, fatigue, injury and ill-
ness, as well as a lack of investigation of fatigue and
training load interactions. Key stages of training and
competition where the athlete is at an increased risk of
injury/illness risk were identified. These included periods
of training load intensification, accumulation of training
load and acute change in load. Modifying training load
during these periods may help reduce the potential for
injury and illness.
Hamstring strain prevention in elite soccer playersFernando Farias
Hamstring strains are among the most
common injury in sport and are most
often observed in sports that involve
sprinting, turning, and jumping
(8,38,63). The prevalence of hamstring
strains has been measured between 11
and 16% in studies of soccer, Australian
rules football, and cricket (92). This can
result in an average of 6 players per squad
suffering a hamstring injury (defined as
“preventing player participation in
a match”) each season in professional
soccer and Australian rules football
The effectiveness of exercise interventions to prevent sports injuriesFernando Farias
Strength training reduced sports injuries to less
than one-third. We advocate that multiple exposure interven-
tions should be constructed on the basis of well-proven single
exposures and that further research into single exposures, par-
ticularly strength training, remains crucial. Both acute and
overuse injuries could be significantly reduced, overuse injuries
by almost a half.
Maximal sprinting speed of elite soccer playersFernando Farias
Current findings might help individuals involved within the physical preparation of players (e.g. technical coaches, fitness coaches, and sport science staff) when developing training programs and training sessions in line with the playing positions, and with the levels of high speed running targeted to reach during specific training drills like sided-games.
Indeed, the closer to match-play situations regarding the rules with goals, goalkeepers, the larger pitch sizes and greater number of players involved, the higher sprinting speed running players would reach during sided-games. However, coaches are advised to add specific speed drills to sided-games in order to elicit a stimulus of high-speed running high enough to prepare players for competition.
The work evaluates the response of the heart rate of non-mechanics handling some specific loads in the common postures employed during road-side repair of automobile and later, the result was validated with the auto-mechanics during repair activities. The purpose is to specify the safe work-impulse of auto-mechanics in the common postures, such as, bending, stooping and supine posture, used during roadside repair. The safe work-impulse was determined for preselected healthy non-mechanics of the classified age groups who gave informed consent. Increase in heart rates at exhaustion of non-mechanics in each age group, in lifting predetermined loads were measured using digital premium pressure monitor with a comfit cuff. Consequently, the work-impulse charts for the load classifications and different age-groups were developed for the different postures. The heart rates of the auto-mechanics performing specific tasks during engine repairs were then measured to determine the equivalent work-impulse, using the developed charts. The result revealed that, auto-mechanics handling the same mass of load under the same conditions have lower safe work-impulse. In conclusion, the study reveals that roadside auto-mechanics have the capacity to sustain higher safe work-impulse in bending and supine postures than in stooping posture.
Eccentric training using external loads greater than the
relative concentric training intensity is a potent stimulus for
enhancements in muscle mechanical function, and MTU
morphological and architectural adaptations. The inclusion
of eccentric loads above maximal concentric strength is
therefore an avenue to induce novel training stimuli and
effect change in key determinants, and functional metrics,
of strength, power and speed performance. Strength
improvements are largely mode-specific and arise from a
combination of neural, morphological and architectural
adaptations [8]. Increased agonist volitional drive is posited
as the primary contributing factor to the marked increases
in eccentric strength observed following training [54].
Eccentric training improves concentric muscle power and
SSC performance to a greater extent than concentric or
traditional modalities
To examine the acute effects of generic (Running Drills, RD) and specific (Small-
Sided Games, SSG) Long Sprint Ability (LSA) drills on internal and external load of male
soccer-players. Methods: Fourteen academy-level soccer-players (mean±SD; age 17.6±0.61
years, height 1.81±0.63 m, body-mass 69.53±4.65 kg) performed four 30s LSA bouts for
maintenance (work:rest, 1:2) and production (1:5) with RD and SSG drills. Players’ external-
load was tracked with GPS technology (20Hz) and heart-rate (HR), blood-lactate
concentrations (BLc) and rate of perceived exertion (RPE) were used to characterize players’
internal-load. Individual peak BLc was assessed with a 30s all-out test on a non-motorized
treadmill (NMT). Results: Compared to SSGs the RDs had a greater effect on external-load
and BLc (large and small, respectively). During SSGs players covered more distance with
high-intensity decelerations (moderate-to-small). Muscular-RPE was higher (small-to-large)
in RD than in SSG. The production mode exerted a moderate effect on BLc while the
maintenance condition elicited higher cardiovascular effects (small-to-large). Conclusion:
The results of this study showed the superiority of generic over specific drills in inducing
LSA related physiological responses. In this regard production RD showed the higher post-
exercise BLc. Interestingly, individual peak blood-lactate responses were found after the
NMT 30s all-out test, suggesting this drill as a valid option to RD bouts. The practical
physiological diversity among the generic and specific LSA drills here considered, enable
fitness trainers to modulate prescription of RD and SSG drills for LSA according to training
schedule.
Mechanics of the human hamstring muscles during sprintingFernando Farias
As peak musculotendon
force and strain for BF
LH
, ST, and SM occurred around the same time during terminal swing, it is suggested that this period in the
stride cycle may be when the biarticular hamstrings are at greatest injury risk. On this basis, hamstring injury prevention or rehabilitation
programs should preferentially target strengthening exercises that involve eccentric contractions performed with high loads at longer
musculotendon lengths.
High chronic training loads and exposure to bouts of maximal velocity running...Fernando Farias
The ability to produce high speeds is considered an important
quality for performance, with athletes shown to achieve 85–94% of
maximal velocity during team sport match-play.3 Well-developed
high-speed running ability and maximal velocity are required of
players during competition in order to beat opposition players
to possession and gain an advantage in attacking and defensive
situations.
Os resultados atuais indicaram que a ocorrência de lesões de isquiotibiais podem estar associadas a uma mudança hierárquica na distribuição da atividade metabólica dentro do complexo muscular do isquiotibial após o trabalho excêntrico em que o Semitendinoso provavelmente deveria tomar a parte principal, seguido pelo BÍceps Femural e Semimembranoso. Quando o BF aumenta sua contribuição e é ativado em uma extensão proporcionalmente maior, o risco de sofrer uma lesão do isquiotibial pode aumentar substancialmente.
Acute cardiopulmonary and metabolic responses to high intensity interval trai...Fernando Farias
Results from the present study quantify the effects of altering either the intensity of the
work or the recovery interval when performing interval sessions consisting of 60s of work and
60s of recovery for multiple repetitions. The information provided may aid those interested in
designing interval training sessions by providing ranges of values that could be expected for
individuals who possess moderate levels of cardiopulmonary fitness. Using a work intensity of
80% or 100% VGO2peak and a recovery intensity of 0% or 50% VGO2peak, subjects were able to
exercise within the ACSM recommended range for exercise intensity. Based upon the data it
would appear that a protocol such as the 80/0 may be appropriate for those individuals who
are just beginning a program or have little experience with interval-type activity. By contrast, a
100/50 protocol could not be completed by all of the subjects and therefore may be too intense
for some individuals.
Impact of the Nordic hamstring and hip extension exercises on hamstring archi...Fernando Farias
The architectural and morphological adaptations of the hamstrings in response to training
33 with different exercises have not been explored. PURPOSE: To evaluate changes in biceps
34 femoris long head (BFLH) fascicle length and hamstring muscle size following 10-weeks of
35 Nordic hamstring exercise (NHE) or hip extension (HE) training. METHODS: Thirty
36 recreationally active male athletes (age, 22.0 ± 3.6 years, height, 180.4 ± 7 cm, weight, 80.8 ±
37 11.1 kg) were allocated to one of three groups: 1) HE training (n=10), NHE training (n=10),
38 or no training (CON) (n=10). BFLH fascicle length was assessed before, during (Week 5) and
39 after the intervention with 2D-ultrasound. Hamstring muscle size was determined before and
40 after training via magnetic resonance imaging.
Short inter-set rest blunts resistance exercise-inducedFernando Farias
Manipulating the rest-recovery interval between sets of resistance exercise may influence
training-induced muscle remodelling. The aim of this study was to determine the acute muscle
anabolic response to resistance exercise performed with short or long inter-set rest intervals.
In a study with a parallel-group design, 16 males completed four sets of bilateral leg-press and
knee-extension exercise at 75% of one-repetition maximum to momentary muscular failure,
followed by ingestion of 25 g of whey protein. Resistance exercise sets were interspersed by
1 min (n = 8) or 5 min of passive rest (n = 8). Muscle biopsies were obtained at rest, 0, 4, 24
and 28 h postexercise during a primed continuous infusion of l-[ring-13C6]phenylalanine to
determine myofibrillar protein synthesis and intracellular signalling.
Machine-Learning Estimation of Body Posture and Physical Activity by Wearable...sipij
We aimed to develop the method for estimating body posture and physical activity by acceleration signals from a Holter electrocardiographic (ECG) recorder with built-in accelerometer. In healthy young subjects, triaxial-acceleration and ECG signal were recorded with the Holter ECG recorder attached on their chest wall. During the recording, they randomly took eight postures, including supine, prone, left and right recumbent, standing, sitting in a reclining chair, sitting in chairs with and without backrest, and performed slow walking and fast walking. Machine learning (Random Forest) was performed on acceleration and ECG variables. The best discrimination model was obtained when the maximum values and standard deviations of accelerations in three axes and mean R-R interval were used as feature values. The overall discrimination accuracy was 79.2% (62.6-90.9%). Supine, prone, left recumbent, and slow and fast walk were discriminated with >80% accuracy, although sitting and standing positions were not discriminated by this method.
Sprint running acceleration is a key feature of physical performance in team sports, and recent
literature shows that the ability to generate large magnitudes of horizontal ground reaction force
and mechanical effectiveness of force application are paramount. We tested the hypothesis that
very-heavy loaded sled sprint training would induce an improvement in horizontal force
production, via an increased effectiveness of application. Training-induced changes in sprint
performance and mechanical outputs were computed using a field method based on velocity-
time data, before and after an 8-week protocol (16 sessions of 10x20-m sprints). 16 male
amateur soccer players were assigned to either a very-heavy sled (80% body-mass sled load)
or a control group (unresisted sprints). The main outcome of this pilot study is that very-heavy
sled resisted sprint training, using much greater loads than traditionally recommended, clearly
increased maximal horizontal force production compared to standard unloaded sprint training
(effect size of 0.80 vs 0.20 for controls, unclear between-group difference) and mechanical
effectiveness (i.e. more horizontally applied force; effect size of 0.95 vs -0.11, moderate
between-group difference)
Training Load and Fatigue Marker Associations with Injury and IllnessFernando Farias
This paper provides a comprehensive review of the litera-
ture that has reported the monitoring of longitudinal
training load and fatigue and its relationship with injury
and illness. The current findings highlight disparity in the
terms used to define training load, fatigue, injury and ill-
ness, as well as a lack of investigation of fatigue and
training load interactions. Key stages of training and
competition where the athlete is at an increased risk of
injury/illness risk were identified. These included periods
of training load intensification, accumulation of training
load and acute change in load. Modifying training load
during these periods may help reduce the potential for
injury and illness.
Hamstring strain prevention in elite soccer playersFernando Farias
Hamstring strains are among the most
common injury in sport and are most
often observed in sports that involve
sprinting, turning, and jumping
(8,38,63). The prevalence of hamstring
strains has been measured between 11
and 16% in studies of soccer, Australian
rules football, and cricket (92). This can
result in an average of 6 players per squad
suffering a hamstring injury (defined as
“preventing player participation in
a match”) each season in professional
soccer and Australian rules football
The effectiveness of exercise interventions to prevent sports injuriesFernando Farias
Strength training reduced sports injuries to less
than one-third. We advocate that multiple exposure interven-
tions should be constructed on the basis of well-proven single
exposures and that further research into single exposures, par-
ticularly strength training, remains crucial. Both acute and
overuse injuries could be significantly reduced, overuse injuries
by almost a half.
Maximal sprinting speed of elite soccer playersFernando Farias
Current findings might help individuals involved within the physical preparation of players (e.g. technical coaches, fitness coaches, and sport science staff) when developing training programs and training sessions in line with the playing positions, and with the levels of high speed running targeted to reach during specific training drills like sided-games.
Indeed, the closer to match-play situations regarding the rules with goals, goalkeepers, the larger pitch sizes and greater number of players involved, the higher sprinting speed running players would reach during sided-games. However, coaches are advised to add specific speed drills to sided-games in order to elicit a stimulus of high-speed running high enough to prepare players for competition.
The work evaluates the response of the heart rate of non-mechanics handling some specific loads in the common postures employed during road-side repair of automobile and later, the result was validated with the auto-mechanics during repair activities. The purpose is to specify the safe work-impulse of auto-mechanics in the common postures, such as, bending, stooping and supine posture, used during roadside repair. The safe work-impulse was determined for preselected healthy non-mechanics of the classified age groups who gave informed consent. Increase in heart rates at exhaustion of non-mechanics in each age group, in lifting predetermined loads were measured using digital premium pressure monitor with a comfit cuff. Consequently, the work-impulse charts for the load classifications and different age-groups were developed for the different postures. The heart rates of the auto-mechanics performing specific tasks during engine repairs were then measured to determine the equivalent work-impulse, using the developed charts. The result revealed that, auto-mechanics handling the same mass of load under the same conditions have lower safe work-impulse. In conclusion, the study reveals that roadside auto-mechanics have the capacity to sustain higher safe work-impulse in bending and supine postures than in stooping posture.
Eccentric training using external loads greater than the
relative concentric training intensity is a potent stimulus for
enhancements in muscle mechanical function, and MTU
morphological and architectural adaptations. The inclusion
of eccentric loads above maximal concentric strength is
therefore an avenue to induce novel training stimuli and
effect change in key determinants, and functional metrics,
of strength, power and speed performance. Strength
improvements are largely mode-specific and arise from a
combination of neural, morphological and architectural
adaptations [8]. Increased agonist volitional drive is posited
as the primary contributing factor to the marked increases
in eccentric strength observed following training [54].
Eccentric training improves concentric muscle power and
SSC performance to a greater extent than concentric or
traditional modalities
To examine the acute effects of generic (Running Drills, RD) and specific (Small-
Sided Games, SSG) Long Sprint Ability (LSA) drills on internal and external load of male
soccer-players. Methods: Fourteen academy-level soccer-players (mean±SD; age 17.6±0.61
years, height 1.81±0.63 m, body-mass 69.53±4.65 kg) performed four 30s LSA bouts for
maintenance (work:rest, 1:2) and production (1:5) with RD and SSG drills. Players’ external-
load was tracked with GPS technology (20Hz) and heart-rate (HR), blood-lactate
concentrations (BLc) and rate of perceived exertion (RPE) were used to characterize players’
internal-load. Individual peak BLc was assessed with a 30s all-out test on a non-motorized
treadmill (NMT). Results: Compared to SSGs the RDs had a greater effect on external-load
and BLc (large and small, respectively). During SSGs players covered more distance with
high-intensity decelerations (moderate-to-small). Muscular-RPE was higher (small-to-large)
in RD than in SSG. The production mode exerted a moderate effect on BLc while the
maintenance condition elicited higher cardiovascular effects (small-to-large). Conclusion:
The results of this study showed the superiority of generic over specific drills in inducing
LSA related physiological responses. In this regard production RD showed the higher post-
exercise BLc. Interestingly, individual peak blood-lactate responses were found after the
NMT 30s all-out test, suggesting this drill as a valid option to RD bouts. The practical
physiological diversity among the generic and specific LSA drills here considered, enable
fitness trainers to modulate prescription of RD and SSG drills for LSA according to training
schedule.
Mechanics of the human hamstring muscles during sprintingFernando Farias
As peak musculotendon
force and strain for BF
LH
, ST, and SM occurred around the same time during terminal swing, it is suggested that this period in the
stride cycle may be when the biarticular hamstrings are at greatest injury risk. On this basis, hamstring injury prevention or rehabilitation
programs should preferentially target strengthening exercises that involve eccentric contractions performed with high loads at longer
musculotendon lengths.
High chronic training loads and exposure to bouts of maximal velocity running...Fernando Farias
The ability to produce high speeds is considered an important
quality for performance, with athletes shown to achieve 85–94% of
maximal velocity during team sport match-play.3 Well-developed
high-speed running ability and maximal velocity are required of
players during competition in order to beat opposition players
to possession and gain an advantage in attacking and defensive
situations.
Os resultados atuais indicaram que a ocorrência de lesões de isquiotibiais podem estar associadas a uma mudança hierárquica na distribuição da atividade metabólica dentro do complexo muscular do isquiotibial após o trabalho excêntrico em que o Semitendinoso provavelmente deveria tomar a parte principal, seguido pelo BÍceps Femural e Semimembranoso. Quando o BF aumenta sua contribuição e é ativado em uma extensão proporcionalmente maior, o risco de sofrer uma lesão do isquiotibial pode aumentar substancialmente.
Effect of Exercise on CVS and Exercise Rx.pptxSoniya Lohana
A guide to effects of exercise on cardiovascular system and exercise prescription to conditions related to the human heart such as hypertension, CHF and even COVID.
ANS Testing Device University of Miami Study PresentationMaxiMedRx
Visit www.maximedrx.com
Sudopath Sudoscan testing device diabetic study by university of miami. Evaluating a New Approach to Detect Type 2 Diabetes Mellitus using the ES Complex-TSS
Investigation of the changes on muscular endurance in response to aerobic and...Sports Journal
The rationale of the study is to investigate the changes on muscular endurance in response to aerobic and
anaerobic training among type 2 diabetic patients. To achieve the purpose of the study 45 male type 2
diabetic patients from Ongole, in the southern state of Andhra Pradesh, India, were selected as subjects.
The subjects were selected in the age group of 45 to 50 years and they were randomly assigned into three
equal groups of 15 each. Experimental group-I performed aerobic training, experimental group-II
performed anaerobic training and group III acted as control. The muscular endurance was selected as
dependent variable. The data collected from the three groups prior to and post experimentation on
selected dependent variable was statistically analyzed to find out the significant difference if any, by
applying the analysis of covariance (ANCOVA). Whenever the obtained ‘F’ ratio value was found to be
significant for adjusted post-test means, the Scheffe’s test was applied as post hoc test. In all the cases the
level of confidence was fixed at 0.05 level for significance. The result of the study produced 20.48%
percentage of improvement due to aerobic training and 15.32% of improvement due to anaerobic training
in muscular endurance of the diabetic patients
Introduction: The measurement of capillary blood to assess the lactate inflection point is used for health-fitness application and to predict sports performance. However, it is unknown if capillary blood sampling impacts physiological, psychological or perceptual responses during exercise testing.
Purpose: To compare the effect of capillary blood sampling on physiological, psychological, and perceptual during a load incremented cycle protocol.
Methods: A multiple observation, within subject, cross-sectional design was employed. Twenty males (20.4±2.76 years), and twenty females (22.3±3.31 years) performed two load incremented cycle ergo meter tests (Trial A and Trial B) to obtain VO2 peak (lmin-1), Ventilation (Ve) (lmin-1), VCO2 (lmin-1). VO2 (lmin-1), and HR (bmin-1) were recorded each minute. The Vpt was determined as the %VO2peak at which Ve: VO2 increased without an accompanying increase in Ve: VCO2. Trial A included capillary blood lactate (BLa) measures taken during the last minute of each stage. Trial B used an identical protocol without BLa measures. The order of administration of Trial A and Trial B were counter-balanced. The psychological/perceptual dependent variables measured during the last 30 seconds of each stage were:
1) Affect Valence (AV)
2) Felt-Arousal (FAS)
3) Rating of Perceived Exertion for the overall body (RPE- O)
4) Exercise Enjoyment (EE) and
5) Perceived intensity level (INT). A paired samples t-test was used to examine between trial differences in psychological and perceptual variables measured at the Vpt along with physiological variables.
Results: There were no significant differences in VO2 peak, HRp, TCT, and Vpt between Trial A and Trial B (p>0.05). There were no statistically significant between trial differences found for AV, FAS, RPE-O and EE measured at the Vpt. The perceived INT at the Vpt was significantly (*p<0.05) higher in Trial A than Trial B.
Conclusion: Capillary blood sampling does not appear to influence aerobic fitness variables during exercise testing or most psychological and perceptual variables. This can provide reassurance when incorporating capillary blood sampling into exercise testing protocols.
Exercise stress echocardiography in patients with aortic stenosis: impact of baseline diastolic dysfunction and functional capacity on mortality and aortic valve replacement
Authors: Andrew N. Rassi, Wael AlJaroudi, Sahar Naderi, M Chadi Alraies, Venu Menon, Leonardo Rodriguez, Richard Grimm, Brian Griffin, Wael A. Jaber
http://www.thecdt.org/article/view/2855
Exercise and Heart Rate Recovery 38Journal of Exer.docxMARRY7
Exercise and Heart Rate Recovery
38
Journal of Exercise Physiologyonline
(JEPonline)
Volume 11 February 1 June 2008
Fitness and Training Managing Editor
Tommy Boone, Ph.D.
Editor-in-Chief
Jon K. Linderman, Ph.D.
Review Board
Todd Astorino, Ph.D.
Julien Baker, Ph.D.
Tommy Boone, Ph.D.
Lance Dalleck, Ph.D.
Dan Drury, DPE.
Hermann Engals, Ph.D.
Eric Goulet, Ph.D.
Robert Gotshall, Ph.D.
Melissa Knight-Maloney,
Ph.D.
Len Kravitz, Ph.D.
James Laskin, Ph.D.
Derek Marks, Ph.D.
Cristine Mermier, Ph.D.
Daryl Parker, Ph.D.
Robert Robergs, Ph.D.
Brent Ruby, Ph.D.
Jason Siegler, Ph.D.
Greg Tardie, Ph.D.
Chantal Vella, Ph.D.
Lesley White, Ph.D.
Ben Zhou, Ph.D.
Official Research Journal
of The American Society of
Exercise Physiologists
(ASEP)
ISSN 1097-9751
EFFECT OF EXERCISE PROTOCOL (“WARM-UP”) ON
POST-EXERCISE HEART RATE RECOVERY
GORDON PIERPONT1
1Minneapolis VA Medical Center and University of Minnesota/
Minneapolis, MN, USA
ABSTRACT
Pierpont GL. Effect of Exercise Protocol (“warm-up”) on Post-Exercise
Heart Rate Recovery JEPonline 2008 11(1):38-44. Delayed heart rate
recovery (HRR) from exercise indicates poor prognosis, but effects of
variations in exercise protocol on HRR are unclear. This study was
therefore designed to test the hypothesis that HRR could vary
depending on the protocol used to achieve maximum exercise. Sixteen
healthy volunteers exercised to exhaustion using 2 widely disparate
protocols. Protocol WmUp used a gradually progressive increase in
treadmill speed and elevation, while protocol Sdn was a sudden onset
high level exercise. WmUp resulted in a higher peak heart rate (178 + 6
bpm) than Sdn (170 + 6, p<.001). HRR at 1 min was not significantly
different from the post WmUp (- 41+14 vs. - 44+15 bpm, p = .07).
However, when converted to percent change from maximum (36+10 vs.
42+12%, p = .002), it was significant. By 2 minutes post-exercise there
was no difference in HRR (absolute or percent change). These findings
demonstrate that exercise protocol can affect maximum achievable heart
rate, but the subsequent effect on HRR is too small to be clinically
relevant.
Key Words: Cardiovascular Physiology, Exercise Prescription, Intensity,
Maximal Heart Rate
Exercise and Heart Rate Recovery
39
INTRODUCTION
It is now fairly well established that a delay in heart rate recovery (HRR) following exercise predicts
poor prognosis. This includes risk of sudden death as well as all cause mortality (1). The risk can be
demonstrated in asymptomatic individuals (1-5), the elderly, (6) patients referred for exercise
screening (7-10), and patients with known coronary artery disease (11-13), diabetes mellitus (14),
congestive heart failure (15), and post myocardial infarction (16). It has also been used to predict
subsequent ischemic heart disease (17), ischemic cardiac or cerebrovascular even ...
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No part of this publication may be reproduced in whole or in part, stored in an automated storage and retrieval
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Canon Medical does not guarantee the accuracy or reliability of the information provided herein.
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Canon Medical Systems VISIONS Magazine - issue 35
VISIONS magazine is a publication of Canon Medical Europe and is offered free of charge to medical and health professionals. The magazine is published twice a year.
Registration to access full, previously published, digital editions can be done via the web site: https://nl.medical.canon/visions-magazine.
VISIONS magazine is covering Canon Medical’s European region and as such reflects products, technologies and services for this particular area. The mentioned products may not be available in other geographic regions. Please consult your Canon Medical representative sales office in case of any questions.
No part of this publication may be reproduced in whole or in part, stored in an automated storage and retrieval system or transmitted in any manner whatsoever without written permission of the publisher. The opinions expressed in this publication are solely those of the authors and not necessarily those of Canon Medical. Canon Medical does not guarantee the accuracy or reliability of the information provided herein.
News items and articles are announced firstly, as pre-publication, via the dedicated VISIONS LinkedIn Group: https://www.linkedin.com/groups/3698045. In this group you can actively participate in discussions about the content and future direction of the magazine.
This MR Special edition of VISIONS magazine is a publication of Canon Medical Europe and is offered
free of charge to health professionals. To download the digital edition of this MR Special, please visit:
https://eu.medical.canon/visions.
VISIONS magazine is covering Canon Medical’s European region and as such reflects products, technologies
and services for this particular area. The mentioned products may not be available in other geographic regions.
Please consult your Canon Medical representative sales office in case of any questions.
VISIONS magazine is a publication of Canon Medical Europe and is offered free of charge to health professionals.
The magazine is published twice a year. Registration to access full, previously published, digital editions can
be done via the web site: https://nl.medical.canon/visions-magazine. Canon Medical stores and uses personal
data of the registration to send out the magazine and inform members about new developments. Members can
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Canon Medical Systems VISIONS Magazine - issue 31
VISIONS magazine is a publication of Canon Medical Europe and is offered free of charge to medical and health professionals. The magazine is published twice a year.
Registration to access full, previously published, digital editions can be done via the web site: https://nl.medical.canon/visions-magazine.
VISIONS magazine is covering Canon Medical’s European region and as such reflects products, technologies and services for this particular area. The mentioned products may not be available in other geographic regions. Please consult your Canon Medical representative sales office in case of any questions.
No part of this publication may be reproduced in whole or in part, stored in an automated storage and retrieval system or transmitted in any manner whatsoever without written permission of the publisher. The opinions expressed in this publication are solely those of the authors and not necessarily those of Canon Medical. Canon Medical does not guarantee the accuracy or reliability of the information provided herein.
News items and articles are announced firstly, as pre-publication, via the dedicated VISIONS LinkedIn Group: https://www.linkedin.com/groups/3698045. In this group you can actively participate in discussions about the content and future direction of the magazine.
Post contrast iodine maps were introduced as part of dual-energy imaging over 10 years ago but these have never become part of routine practice in most centres for the investigation of pulmonary thromboembolic disease.
CASE: 58 year old male presented with a liver lesion seen on prior imaging. A dual energy scan was performed to further characterize the lesion. Volumetric Dual Energy scans were performed following the injection of 80mls of contrast. Scans were performed during Arterial Phase, early Portal Phase and Delayed at 3mins. Monochromatic images, iodine maps and virtual non contrast images were generated for review.
Computed tomography angiography (CTA) of the coronary arteries is a useful noninvasive tool to rule out significant coronary artery disease (CAD) in many clinical situations. Recent guidelines of stable CAD and non-ST segment elevation myocardial infarction endorse the use of CTA in symptomatic patients with low to intermediate likelihood of the disease, given the particularly high negative predictive value of the technique. However, in patients with high pre-test likelihood of CAD, the technique is not recommended, and one of the reasons is the high probability of coronary calcification in these patients, which interferes with the analysis of the images and reduces the specificity and negative predictive value of CTA.
(TOSHIBA CTEU140095) - Article from Toshiba's VISIONS Magazine#25, March 2015
What Is Smart Fusion?
Smart Fusion presents volume-to-volume fusion of two different imaging modalities, using previ- ously acquired images with real-time ultrasound. CT is the most commonly used modality for ultra- sound fusion with the other option being MRI.
Read our tips for using Smart Fusion effectively in this white paper.
Find out more about our solutions in ultrasound at http://www.toshiba-medical.eu/eu/product-solutions/diagnostic-ultrasound/
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
2. VISIONS27 | 57ULEU160048
strain data is time efficient and easy to obtain. Unlike
Tissue Doppler Imaging, 2D WMT also shows angle
independency, paramount when acquiring echocar-
diographic images during exercise. Echocardiographic
hardware and software however have to be robust and
able to allow tracking at high heart rates and challeng-
ing conditions during exercise and further development
work is required.
Combined, 2DWMT and CPET can provide a comprehen-
sive and direct description of cardio-pulmonary exercise
response and might also help differentiate between
normal and pathological myocardial function during
exercise. Here we present pilot data of a synergistic and
time efficient comprehensive assessment of cardio-
pulmonary response to incremental exercise, using
2D WMT to assess myocardial function in conjunction
with simultaneous assessment of metabolic gas analysis
by CPET, in adolescent elite athletes.
METHODS
14 male adolescent professional football academy
players (mean age 15.4 ± 0.8 y) underwent echo-
cardiography at rest, during exercise and recovery
while completing an incremental CPET on a
recumbent cycle ergometer (Fig. 1). Echocardio-
graphy at rest was performed following England
Football Association screening guidelines. LV
myocardial performance was serially assessed
during exercise and recovery measuring LV peak
systolic longitudinal (LV Sl) and LV peak systolic circum-
ferential (LV Sc) 2D strain. The study was conducted
in collaboration with our research partners Toshiba
Medical Systems and Manchester United Football Club
Youth Academy, UK.
EXERCISE ECHOCARDIOGRAPHY AND 2D WMT
Exercise echocardiography was performed using the
Artida for image acquisition and UltraExtend ACP soft-
ware for 2D WMT analysis. Analysis is also possible using
the AplioCV system and the on-board analysis software.
A LV focused 4-chamber view (Fig. 2) and a paraster-
nal short axis view (Fig. 3) were captured for 2D WMT
analysis at rest, at several exercise stages and
at recovery. Three cardiac cycles were acquired
at rates of 30–90 frames per second in raw
DICOM format and analysis was performed on
one manually selected cardiac cycle. The endo-
cardial borders were manually contoured at end-
diastole with the range of interest adjusted to
include the whole myocardium. Peak strain was defined
as the maximal deformation of a segment in systole
and represented as a percentage of the original size.
Standard nomenclature was used to describe the
Figure 2: Representative 2D image sequence during exercise for LV Sl. A: rest at HR = 87 bpm; B: 50 W at HR = 90 bpm; C: 100 W at HR = 117 bpm
Figure 3: Representative 2D image sequence during exercise for LV Sc. A: rest at HR = 84 bpm; B: 50 W at HR = 96 bpm; C: 100 W at HR = 99 bpm
4. VISIONS27 | 59
Sl rec (r = 0.57, p = 0.04) and LV Sc peak and LV Sc rec
(r = 0.56, p = 0.04). These findings point towards a direct
relationship between myocardial performance during
exercise and recovery and this will need to be explored
further, as recovery 2D strain parameters could serve as
a useful tool in assessing cardiac function and reserve.
MYOCARDIAL PERFORMANCE METABOLIC
RELATIONSHIP
Our combined methodology also allows for assessment
of the relationship between myocardial performance
and exercise oxygen consumption. In our small cohort
we found only a weak correlation between LV Sl peak
and LV Sc peak to VO2max, (r = -0.20 – 0.40, p 0.05) and
larger populations will need to be studied to assess the
relationship between myocardial exercise performance
and metabolic exercise parameters in more detail.
DISCUSSION
2D WMT echocardiography during exercise is
feasible to describe myocardial performance and in com-
bination with simultaneous CPET can enhance our under-
standing and interpretation on the complex cardiac and
metabolic exercise adaptations during exercise and recov-
ery.To our knowledge this is the first time that the relation-
ship between myocardial performance as measured by 2D
WMT and the metabolic exercise parameters have been
assessed simultaneously in adolescent elite athletes.
We have determined that LV myocardial performance
increases significantly and incrementally through
different exercise stages without reaching a plateau.
We have also described an accentuated force-frequency
relationship during exercise. The exercise force-
frequency relationship has not been demonstrated
using 2D strain during exercise. Direct measurement of
the force-frequency relationship during exercise stress
could particularly be of importance to discover early
ventricular dysfunction in patients with near normal
resting function.
Overall, our data indicate that myocardial perfor-
mance assessment by 2D WMT is a sensitive and
responsive tool for the quantification of cardiac
adaptation during exercise and in recovery. The
advantage of our combined protocol compared
to other methods, e. g., inotropic stimulation or
pacing to increase myocardial performance, lies
in its non-invasiveness and more importantly has a
higher external validity, in that it mimics physical activity
and its effect on cardiac performance.
LIMITATIONS
It should be noted that 2D strain assesses only unidi-
rectional myocardial deformation forces and cannot
therefore capture the complex multi-dimensional and
directional cardiac myofibre deformation4. We have
attempted to address the multi-dimensional LV myocar-
dial deformation by analyzing the two most widely used
deformation planes, longitudinal and circumferential
strain analysis. The recent development of 3D WMT5 will
allow us to address this limitation in the future. Image
optimization during exercise to obtain adequate 2DWMT
data should include reduction of artefacts, noise and
image window focus with the view to obtain sufficient
frame rates.
CONCLUSION
Direct assessment of ventricular function parameters by
using 2D WMT during exercise can be utilized to directly
describe myocardial exercise performance and can
overcome the limited predictive value of exercise
capacity on myocardial function. In the clinical setting,
this protocol could serve as a tool to better quantify
myocardial reserve, which is an important concept in
patient risk stratification of ventricular dysfunction.
Our current study as introduced in this paper will use
2D WMT to compare myocardial performance in three
paediatric groups, non-trained but healthy children,
elite youth athletes and children with CHD to deter-
mine the mechanisms of exercise limitations and
cardiac dysfunction in children with CHD.
ACKNOWLEDGEMENTS
This study is part of a research partnership between
Toshiba Medical Systems UK, Manchester United
Football Club and the Universities of Bristol and Exeter.
The research partnership between Toshiba and the
University of Bristol is a contractual research partner-
ship that determines the independence of the research
from either parties’ interests. The research is supported
by the University of Exeter and the University of Bristol
NIHR Biomedical Research Unit for Cardiovascular
Disease. GEP holds a National Institute for Health
Research (NIHR) Academic Clinical Lectureship. We
would like to thank the athletes and staff at Manchester
United Football Club Youth Academy.
ULEU160048
Credits
Mark Hitchman, Tim Palarm Mair Howe
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