1,721,078 research outputs found
Is exercise training safe and effective for ALL heart failure patients: A retrospective service evaluation of a hospital based cardiac rehabilitation programme
Get PDFThe main purpose of this study was to investigate whether exercise training is safe and effective for all classifications of heart failure, female and elderly (70 years and above) heart failure patients and also those heart failure patients with significant co-morbidity. Much of the research into exercise training and heart failure has been carried out on middle aged men in NYHA II-III classification of heart failure who have no other significant co-existing conditions. This is not reflective of the population of heart failure patients in general. The cardiac rehabilitation records (n=1000) of heart failure patients who had attended an exercise programme at a hospital based NHS service over a period of ten years were retrospectively evaluated to investigate the safety and efficacy of exercise training. Analysis of baseline statistics and repeated outcome measures were used to investigate the significance of the service and to ascertain where similarities and differences lay with the research. 74% were male, the age range was 17-90 years and 52% of patients had one or more significant co-morbidity. The acute event incidence was recorded at four per 1000 patients. NYHA I patients, female, elderly heart failure patients and those with significant co-morbidity showed significant improvements in functional capacity and quality of life measures with exercise training (p< 0.05). However no conclusion on the effectiveness of exercise could be drawn for NYHA IV heart failure patients due to insufficient recorded data and reduced adherence to exercise sessions for this group. A hospital based exercise programme, therefore may not be the most appropriate setting for the NYHA IV patient. This study supports previous research of the benefit of exercise training in heart failure but broadens it further to show that exercise is safe for all heart failure patients and is also effective for all heart failure patients with the exception of NYHA IV patients where further investigation is needed
A post trek exploratory study on the physical and psychological ill health effects of trekking to Everest base camp following observations by the author
Get PDFThe purpose of this retrospective study was to understand and test the theory that multiple physical and psychological ill health effects occur when trekking at high altitude to Everest Base Camp (EBC), Nepal. The tour operator, The Adventure Company, agreed to send out 100 questionnaires to clients who had undertaken either the 11 day trek via Tengboche or the 16 day via Goyko Lakes, to EBC. The questionnaires also considered: age, gender, general levels of fitness and previous experience of trekking at altitude. The respondents (n=49) were 53% male (n = 26) and 45% female (n=22) and one unknown. Of the 49 participants, 36 lost weight (p < 0.001) sd ± 2.95 of which 17 were males (p < 0.001) sd ± 2.6 and 19 were females (p <0.001) sd ± 3.3. Altitude sickness was experienced by 38 trekkers or 78% (p < 0.001) using the Lake Louise Score for Acute Mountain Sickness (AMS); 35% (n=17) had mild AMS, 43% (n=21) had severe AMS. The incidence of other conditions was: bacterial infections = (n= 31) or 57% (p < 0.001); general heart rate (n=26) or 55% (p<0.0001); and 71% (n=35) heart rate at night (p <0.0001); low mood = (n=16) or 33% (p< 0.001). The incidence of AMS was higher on reaching 4000m and was consistent with the literature. Other factors identified and consistent with the literature included: significant weight loss; bacterial infections; increase in heart rate in general and at night. Low mood was present during the trek and for some people continued on returning home and has not been well documented in other studies reviewed. Further research on the multiple ill health effects of trekking and how they may be prevented or better managed is needed to reduce risk and aid overall enjoyment
Psychosocial characteristics of patients seeking weight loss surgery
Get PDFThis study investigated the relationships between BMI, gender and depression, anxiety, self-esteem and disordered eating in people seeking weight loss (bariatric) surgery. The aim was to increase understanding of these relationships to improve selection of patients suitable for surgery. The study was a retrospective audit of data from 199 females and 59 males (mean BMI 48.3 ± 8.1kg/m²) who attended for surgical pre-assessment. Subjects completed the Hospital Anxiety and Depression Scale (HADS), The Impact of Weight on Quality of Life-Lite (IWQOL-Lite) and the Bulimic Investigatory Test, Edinburgh (BITE). Spearman’s correlations were used to investigate the relationships between BMI and the HADS anxiety and depression scores, the IWQOL-Lite self-esteem scores and the BITE symptom scale disordered eating scores. Mann-Whitney U tests were used to investigate gender differences in the psychosocial scores. There was no significant relationship between BMI and anxiety (r=-0.39; p=0.532), BMI and depression (r=-0.101; p=0.106), BMI and self- esteem (r=-0.017; p=0.788) or BMI and disordered eating (r=-0.109; p=0.081). There was a significant difference in HADS anxiety scores (p=0.004) between males (median=9) and females (median=12) and in IWQOL-Lite self-esteem scores (p=0.0005) between males (median=28) and females (median=33). There was no significant gender difference in HADS depression scores (p=0.03) or in BITE disordered eating scores (p=0.028). There was a significant difference in BMI (p=0.001) between males (median 49.5 kg/m²) and females (median 46.0 kg/m²). The results indicated that females seeking bariatric surgery were significantly more anxious and had lower self-esteem than males, and they had significantly lower BMIs than males. There was a weak negative correlation between BMI and the psychosocial scores indicating that people may be less distressed at higher BMIs but these results were not significant. Further research should investigate the relationships between the psychosocial variables in greater depth, to improve patient selection and outcomes after bariatric surgery
Does a particular sporting background provide an advantage to an athlete entering the sport of triathlon?
Get PDFThe goal of this dissertation is to establish what sporting background do age group triathletes come to the sport of triathlon from and if a particular sporting background results in faster finishing times. It will also examine the impact of training hours, periodisation and strength training on finishing times. The research in this study is questionnaire based and 401 completed surveys from triathletes of both sexes across 26 countries and ranging in age from 16-19 years to 70-74 years. In all statistical comparison tests, a significant value indicates p<0.05 unless a Bonferroni adjustment was required. For the purposes of data analysis, the data was been broken up into four categories, i.e. Male and Female Sprint distance triathletes and Male and Female Olympic Distance triathletes and these were subdivided into “High Performer” and “Regular” triathletes. Athletes from a swimming background had the lowest mean finishing time in three data groups, and statistically significant differences in two data groups but in no case was there a statistically significant difference between athletes from a swimming background and those from a running background. Training hours proved to be very significant with “High Performers” having a significantly higher volume of weekly training than their “Regular” counterparts. Triathletes had a very high awareness of the concept of periodisation with statistical differences in finishing times between those who employed periodisation, those who did not and those who were unaware of the concept, in three of the four groups. There was some evidence that early learning was advantageous but only to the extent of becoming involved in sport; specialization at a young age did not appear to be a criterion for success at age group level in the sprint and Olympic distance triathlons
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Evaluation of a community group weight management scheme: Are outcomes influenced by who delivers it?
Get PDFThis dissertation aimed to investigate if clinical outcomes, attendance rates and the demographics of patients vary according to the type of health worker who delivered a primary care group weight management scheme. An observational, retrospective evaluation: a before and after analysis of twelve week group weight management programmes. A dataset containing 974 suitable entries was examined according to three cohorts of primary care health workers; administrative assistants (AA), health care assistants (HCA) and nurses. Comparisons between these worker groups included: differences in worker outcomes for weight, waist circumference, body mass index (BMI), and blood pressure after 12 weeks; percentage attendance at week 12; gender, age, ethnicity and the registered general practice (GP) indices of multiple deprivation score (IMD) of patients who enrolled. Patients seen by personnel in health assistant roles lost more weight (-1kg, p=0.008) lowered their BMI (- 0.3 kg/m², p=0.008) and decreased their waist circumference (-2cm, p<0.001) significantly more than those seen by nurses. Poor data entry for blood pressure recordings hampered analysis of this outcome. Attendance was 38% and not significantly different between any workers (p=0.444). Those who completed the programme were predominantly white (99.5%) women (82%), significantly older (median age 61years compared to 57 years, p<0.001) and from GP practices with significantly lower IMD scores (27.3 compared to 31.5, p<0.001). Patient characteristics were generally similar, irrespective of the deliverer. Health care workers in supporting clinical roles were able to help patients achieve greater weight loss outcomes than nurses. High levels of erroneous and missing clinical data were problematic for less qualified deliverers and indicative of a lack of more advanced clinical abilities. High attrition and limited appeal were difficulties for all three health worker groups and jeopardised the overall efficacy of the scheme
A comprehensive review into the efficacy of chromium supplementation on enhancement of body composition and physical performance
Get PDFThe objective of this dissertation was to investigate the hypothesis that supplementation with chromium is capable of positively influencing changes in body composition, through increased muscle mass accretion or preservation and reduction of body fat mass in exercising and sedentary individuals. The efficacy of chromium supplementation will be evaluated through a systematic review of scientific, peer-reviewed, research papers. Chromium is an essential mineral required by the body for adequate insulin function and has been proposed as an effective weight loss agent. With the increasing prevalence of overweight and obesity in developed countries, an effective weight loss supplement which could aid exercise and dietary regimes would be valuable. The suggestion that chromium excretion is increased with physical activity and a high carbohydrate diet indicates that chromium deficiency may be an issue for athletes. The systematic search returned nineteen relevant studies which satisfied the selection criteria. Of these a total of six studies reported a significant effect of chromium supplementation either increasing or decreasing body weight, increasing or preserving lean body mass and decreasing body fat mass. Studies which were unable to find a significant effect utilised similar dosages of chromium and made attempts to assess the effects of chromium supplementation on serum chromium concentration and urinary chromium excretion. No significant effects of chromium supplementation were found on physical performance parameters. In conclusion, no significant effect of chromium supplementation on body composition in healthy, non-diabetic individuals have been found in well-designed and bias controlled studies. In terms of insulin potentiation, availability of chromium from the normal dietary intake is not the limiting factor to potentiation of insulin. Of all the studies reviewed none reported adverse effects to chromium supplementation when provided greatly in excess of recommended daily intakes. The claims that chromium supplements on the market are capable of enhancing body fat loss and muscle mass accretion are not supported by the findings of well-designed and bias controlled studies
East Sussex school nurses' experiences of the National Child Measurement programme in 2008/09 and their views on the role of school nurses in tackling childhood obesity
Get PDFThe National Child Measurement Porgramme (NCMP) is one element of the government's Healthy Weight, Healthy Lives strategy. It aims to gather population level data to analyse trends in childhood obesity, inform local planning and engage with families about healthy livestyles and weight issues. Routine feedback of NCMP results has recently been introduced in order to inform parents if their child's weight is unhealthy. Moreover, Primary Care Trusts are being encouraged to proactively follow up children with unhealthy weights and offer parents appropriate advice and referral.School nurses are instrumental in weighting and measuring reception and year 6 aged children for the NCMP on an annual basis. As health professionals working in an educational setting, they also have a unique position in schools and are viewed as playing a pivital role in tackling childhood obesity, often being the first point of contact for parents who are concerned abouth their child's weight. Yet there is a dearth of studies into their experiences of how the NCMP is working in practice, how they perceive their role in the routine feedback of results and how they view their wider role in tackling childhood obesity in school settings. This study undertook one-to-one interviews with a sampe of 15 school nurses working in East Sussex primary schools. It aimed to find out their experiences of the NCMP in 2008/09, how the programme is working in practice and their views of the role of school nurses in tackling childhood obesity, particuarly when routine feedback of results is introduced in the county in 2010. Findings suggest that measuring children has impacts on school nurse workloads and is often viewed as an inappropriate use of time. Moreover, it is not always easy to adhere to some of the NCMP guidelines for measuring children. The findings also suggest that issues suck as a lack of training provision and care pathways for childhood obesity undermine the competence and confidence school nurses to tackle childhood obesity in East Sussex. recommendations are made as how this might be addressed
P.E. teachers : Their knowledge and opinions related to exercise management of pupils with diabetes
No full textThis study investigated Physical Education (PE) teachers' experiences, knowledge and attitudes towards exercise management of pupils with Type I diabetes. It was hypothesised that because of the specialist nature of Type I diabetes, PE teachers with experience of, or education in the condition, would score higher in a knowledge test then those without; additionally, PE teachers in this country would exhibit a similar lack of knowledge and understanding of Type I diabetes as their contemporaries in the USA. A cross-sectional postal questionnaire was issued to 100 PE teachers from partnership schools of St. Martin's College. 34 respondents, (19 male and 15 female, mean age 38 years, standard deviation (SD) = 9.5 years, mean years teaching experience 13.4 years, SD = 10.7 years) completed open questions assessing opinions and closed multiple-choice knowledge questions. Mann-Whitney U tests demonstrated no significant differences in the knowledge test scores for those with personal experience of, or previous education in Type I diabetes compared to those without prior experience (Z = -0.935, p = 0.35 or p > 0.05). Similarly, no significant differences in the overall group mean scores for the UK teachers compared to their USA peers were detected (Z = -1.061, p = 0.289 or p > 0.05). Overall, knowledge scores were low with the UK teachers' group mean score 15.3 % correct. This study has established a need for Initial Teacher Training (ITT) Institutions to include a knowledge and understanding of diabetes and exercise management as part of a student's training
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