A Practical, One-Clinic Visit Protocol for Pharmacokinetic Profile Generation with the ADVATE myPKFiT Dosing Tool in Severe Hemophilia A Subjects.

Standard pharmacokinetic (PK) assessments are demanding for persons with hemophilia A, requiring a 72-hour washout and 5 to 11 timed blood samples. A no-washout, single-clinic visit, sparse sampling population PK (PPK) protocol is an attractive alternative. Here, we compared PK parameters obtained with a traditional washout, 6-sampling time point PPK protocol with a no-washout, single-clinic visit, reverse 2-sampling time point PPK protocol in persons with severe hemophilia A (SHA) receiving ADVATE. A total of 39 inhibitor-negative males with SHA (factor VIII activity [FVIII:C] < 2%) were enrolled in a prospective sequential design PK study. Participants completed a washout, 6-sampling time point PPK protocol as well as a no-washout, reverse 2-sampling time point protocol, with samples taken during a single 3-hour clinic visit 24 hours post home infusion of FVIII and then 3 hours post infusion in clinic. FVIII:C levels were analyzed by one-stage and chromogenic assays; blood group and von Willebrand factor antigen (VWF:Ag) were determined; and PK parameters were analyzed using the ADVATE myPKFiT dosing tool. There was moderate to almost perfect agreement for the PK parameters obtained with the 2- and the 6- point PPK protocols using a one-stage FVIII:C assay and a substantial to almost perfect agreement using a chromogenic FVIII:C assay. Significant associations between specific PK parameters and blood group and VWF:Ag were observed. The no-washout, single-clinic visit, reverse 2-sampling time point PPK protocol can be used in the routine clinical setting since it demonstrates sufficient accuracy compared with the more demanding and less practical washout, 6-sampling time point PPK protocol in persons with SHA receiving ADVATE.

Children and youth with impairments in social skills and cognition in out-of-school time inclusive physical activity programs: a scoping review.

Children and youth with impairments in social skills and/or cognition face many barriers to community participation specifically physical activity (PA) (e.g., limited staff training). Inclusive PA settings may provide opportunities for children and youth with and without impairments to engage together and promote physical and social skill development. The purpose of this scoping review was to critically evaluate the literature on out-of-school PA programs (i.e., non-curriculum programming) that included children and/or youth with impairments in social skills and/or cognition. A keyword search of seven databases followed by eligibility screening led to ten articles for this scoping review. For each included study, two research team members independently extracted and synthesized the data, and appraised the study reporting quality using the published quality assessment tool (QATSDD). Experts' evaluation of the research literature was obtained. Ten studies, which varied from low to high reporting quality, collectively addressed the following outcomes, with all showing mixed impacts: anthropometrics and fitness; motor and sport skills; psychological well-being; and socialization. Experts suggested routes forward for research and practice including longitudinal designs and programming variety to meet individual needs. Out-of-school PA programs that include children and/or youth with impairments in social skills and/or cognition provide an opportunity to improve multiple areas of health and wellness. However, limited high-quality research has been conducted to-date. Further evaluation of program effectiveness is warranted.

A Scoping Review of Inclusive Out-of-School Time Physical Activity Programs for Children and Youth With Physical Disabilities.

The objective of this study was to comprehensively evaluate inclusive out-of-school time physical activity programs for children/youth with physical disabilities. A search of the published literature was conducted and augmented by international expertise. A quality appraisal was conducted; only studies with quality ratings ≥60% informed our best practice recommendations. Seventeen studies were included using qualitative (n = 9), quantitative (n = 5), or mixed (n = 3) designs. Programs had a diversity of age groups, group sizes, and durations. Most programs were recreational level, involving both genders. Rehabilitation staff were the most common leaders. Outcomes focused on social skills/relationships, physical skill development, and psychological well-being, with overall positive effects shown in these areas. The best practice recommendations are consistent with an abilities-based approach emphasizing common group goals and interests; cooperative activities; mastery-oriented, individualized instruction; and developmentally appropriate, challenging activities. Results indicate that inclusive out-of-school time physical activity programs are important for positive psychosocial and physical skill development of children/youth with physical disabilities.

The relationship between moderate-to-vigorous physical activity and executive function among individuals with schizophrenia: differences by illness duration

Objective: Schizophrenia is a chronic mental illness characterized by positive and negative symptoms. Cognitive impairment continues to be a core and consistent deficit. Previous studies have shown that physical activity (PA) is positively associated with cognitive performance. Thus, it may play a supportive role in mitigating cognitive impairments among individuals with schizophrenia. The aim of this study was to analyze the relationship between moderate-to-vigorous physical activity (MVPA) and executive function among adults with schizophrenia. Methods: The weekly amount of MVPA (assessed using accelerometers) and executive function (as per Brief Neurocognitive Assessment for Schizophrenia) of 78 adults with schizophrenia (mean [SD] age 42.4 [11.4] years; illness duration 17.0 [11.0] years; 58.2% male) were assessed in this cross-sectional study. Pearson correlations were calculated, followed by a linear regression. Participants were first analyzed together and then dichotomized on the basis of illness duration. Results: There was no significant association between MVPA and executive function, independent of the duration of illness. For individuals with < 15 years of illness, there was a significant association between weekly MVPA and working memory performance. Conclusion: PA appears to be associated with executive function in some, but not all, individuals with schizophrenia.

The relationship between moderate-to-vigorous physical activity and executive function among individuals with schizophrenia: differences by illness duration.

OBJECTIVE: Schizophrenia is a chronic mental illness characterized by positive and negative symptoms. Cognitive impairment continues to be a core and consistent deficit. Previous studies have shown that physical activity (PA) is positively associated with cognitive performance. Thus, it may play a supportive role in mitigating cognitive impairments among individuals with schizophrenia. The aim of this study was to analyze the relationship between moderate-to-vigorous physical activity (MVPA) and executive function among adults with schizophrenia. METHODS: The weekly amount of MVPA (assessed using accelerometers) and executive function (as per Brief Neurocognitive Assessment for Schizophrenia) of 78 adults with schizophrenia (mean [SD] age 42.4 [11.4] years; illness duration 17.0 [11.0] years; 58.2% male) were assessed in this cross-sectional study. Pearson correlations were calculated, followed by a linear regression. Participants were first analyzed together and then dichotomized on the basis of illness duration. RESULTS: There was no significant association between MVPA and executive function, independent of the duration of illness. For individuals with < 15 years of illness, there was a significant association between weekly MVPA and working memory performance. CONCLUSION: PA appears to be associated with executive function in some, but not all, individuals with schizophrenia.

Possible Cognitive Benefits of Acute Physical Exercise in Children With ADHD.

OBJECTIVE: Studies have suggested that even a single session of physical exercise enhances executive functions. ADHD is among the most common developmental disorders in childhood, but little is known about alternative treatments for this disorder. Therefore, we performed a systematic review of the literature to analyze articles that evaluated the executive functions of children with ADHD after an acute exercise session. METHOD: We reviewed articles indexed in the PubMed, American Psychiatric Association (APA) psychNET, Scopus, and Web of Knowledge databases between 1980 and 2013. RESULTS: Of 231 articles selected, only three met the inclusion criteria. CONCLUSION: Based on these 3 articles, we concluded that 30 min of physical exercise reportedly improved the executive functions of children with ADHD. Due to the small number of articles selected, further studies are needed to confirm these benefits.

The effect of an acute bout of exercise on executive function among individuals with schizophrenia.

Cognitive impairment represents a significant source of disability among individuals with schizophrenia. Therefore, the aim of this study was to investigate, at a proof-of-concept level, whether one single bout of exercise can improve executive function among these individuals. In this within-participant, counterbalanced experiment, participants with schizophrenia (n=36) completed two sessions (cycling at moderate-intensity and passively sitting) for 20min, with a one-week washout period between the two sessions. Participants completed the Wisconsin Card Sorting Test (WCST) before and after each session to measure changes in executive function. The inclusion of both sessions completed by each participant in the analyses revealed a significant carryover effect. Consequently, only the WCST scores from the first session completed by each participant was analyzed. There was a significant time by session interaction effect for non-perseverative errors. Post-hoc Tukey's HSD contrasts revealed a significant reduction in non-perseverative errors in the exercise group that was of moderate-to-large effect. Furthermore, there was also a moderate between-group difference at post-testing. Therefore, an acute bout of exercise can improve performance on an executive function task in individuals with schizophrenia. Specifically, the reduction in non-perseverative errors on the WCST may reflect improved attention, inhibition and overall working memory.

Exercise and non-exercise aerobic power prediction models using six-minute walk test / Equações de predição da potência aeróbica usando o teste de caminhada de seis minutos

BACKGROUND AND OBJECTIVE: A simple, low-cost approach commonly used to objectively analyze the cardiorespiratory fitness of individuals with different health conditions is the six-minute walk test (6-MWT). Our objective was to develop peak aerobic power prediction using the six-minute walk test in healthy older men. METHODS: We measured body composition (body mass [BM], body mass index [BMI], fat percentage [FAT]) and peak aerobic power breath-by-breath during cardiopulmonary exercise testing (CPET [velocity, heart rate [HR] and VO2 at the anaerobic threshold and peak]) and a 6-MWT (distance [D], weight by distance [WxD], HR and oxygen consumption [VO2] at peak) in 76 healthy older men aged 65 to 80 years (69.1 ± 0.3 yrs-old). RESULTS: We observed significant correlations for VO2peak during the 6-MWT as a function of WxD (R = 0.75, P < 0.0005), BM (R = 0.56, P < 0.0005), D (R = 0.43, P = 0.0004) and maximum HR (R = 0.37, P = 0.001). Distance correlated significantly with FAT (R = -0.43, P = 0.005), BMI (R = -0.36, P = 0.021) and age (R = -0.31, P < 0.045), whereas WxD correlated with BM (R = 0.86, P<0.005).The inclusion of WxD increased the R2 from 0.65 to 0.74 and decreased the estimative error while yielding the following equation (R = 0.86, standard error of the estimate (SEE) = 182.1 mL•min-1, P < 0.0005) to predict VO2peak: VO2peak = 962.2 + (0.037 x WxD) + (8.565 x maximum HR). A non-exercise model was obtained by univariate regressions but not multiple regressions. The FAT (R = 0.43, SEE = 702.2 m, P < 0.005) yielded the best model for predicting distance, i.e., distance = 702.2 - (3.067 x FAT). CONCLUSION: Our prediction model seems to accurately estimate VO2peak in healthy older men primarily when WxD is considered.

OBJETIVO: O teste de caminhada de seis minutos (TC6M) é uma estrategia simples e de baixo custo operacional que objetivamente mede a aptidão cardiorrespiratória de indivíduos com diferentes condições de saúde. Nosso objetivo foi desenvolver equações de predição da potência aeróbica em homens idosos saudáveis usando o TC6M. MÉTODOS: Foram medidos a composição corporal (massa corporal [MC], índice de massa corporal [BMI], porcentagem de gordura [%G]) e potência aeróbica de pico através de teste cardiopulmonar de exercício máximo (velocidade, frequência cardíaca [FC] e consumo de oxigênio [VO2] no limiar anaeróbico e no pico]) e através do TC6M (distancia [D], produto massa corporal x distância, FC e VO2de pico) em 76 idosos saudáveis com idade entre 65 e 80 anos (69.1 ± 0.3 anos). RESULTADOS: Foram observadas correlações significativas para VO2pico no TC6M em função do produto MCxD (R = 0,75, P < 0,0005), MC (R = 0,56, P < 0,0005), D (R = 0,43, P = 0,0004) e FC máxima (R = 0,37, P = 0,001). A correlacionou-se significativamente com %G (R = -0,43, P = 0,005), IMC (R = -0,36, P = 0,021) e idade (R = -0,31, P < 0,045), enquanto que a MCxD correlacionou-se com MC (R = 0,86, P < 0,005). A inclusão da MCxD aumentou o R 2 de 0,65 para 0,74 e diminuiu o erro padrão da estimativa (EPE) gerando a equação (R = 0,86, EPE = 182,1 mL·min-1, P < 0,0005) para a predição do VO2peak: VO2peak = 962,2 + (0,037 x MCxD) + (8,565 x FC máxima). Foi também gerado um modelo preditivo não dependente de exercício através de regressão univariada, mas não múltipla. A %G (R=0,43, EPE = 702,2 m, P < 0,005) gerou o melhor modelo para a predição da distancia, i.e., distancia = 702,2 - (3,067 x %G). CONCLUSÃO: Nossas modelos de predição parecem estimar precisamente o VO2pico de idosos saudáveis, especialmente quando a MCxD é considerada.

Predictors of muscle strength in older individuals / Preditores de força muscular em idosos

PURPOSE: To analyze possible relationships between load, body mass and lean body mass in an effort to provide norm-referenced standards for the one repetition maximum test and to predict whole body muscle strength (WBMS) in older individuals. METHODS: We measured body mass, lean body mass and the one repetition maximum (1RM) test in different exercises in 189 older men and women aged 61 to 82 years. Whole body muscle strength (WBMS) was calculated as the sum of loads of the different exercises. RESULTS: For women, the inclusion of body mass or lean body mass increased the R2 from 0.41 to 0.82, and yielded the following equation: WBMS = 75.788 + (2.288 × load in kg of latissimus pull down) + (0.799 × lean body mass in kg). For men, the inclusion of either body mass (WBMS = 290.33 - [3.140 × age in years] + [1.236 × body mass in kg] + [1.549 × load in kg of leg press]) or, in particular, lean body mass (WBMS = 343.25 - [3.298 × age in years] + [.415 × lean body mass in kg] + [1.737 × load in kg of leg press]) decreased the standard error of the estimate. CONCLUSION: Our data support the idea that load correlates with body mass and lean body mass and that the load used for a specific exercise is significantly associated with WBMS, thereby permitting the development of a predictive model of WBMS with increased accuracy.

OBJETIVO: Analisar as relações entre carga, massa corporal e massa magra na tentativa de fornecer normas padrão de referencia para o teste de uma repetição máxima e predizer a forca muscular corporal em idosos. MÉTODOS: A massa corporal, a massa magra e o teste de uma repetição máxima (1RM) foram medidos em 189 idosos com idade entre 61 e 82 anos. A forca muscular corporal (FMC) foi calculada como a somatória das cargas dos diferentes exercícios. RESULTADOS: Para mulheres, a inclusão da massa corporal ou da massa magra aumentou o R2 de 0.41 para 0.82, e resultou na equação: FMC = 75.788 + (2.288 × carga em kg para o puxador) + (0.799 × massa magra em kg). Para homens, a inclusão da massa corporal (FMC = 290.33 - [3.140 × idade em anos] + [1.236 × massa corporal em kg] + [1.549 × carga em kg para o leg press]) ou da massa magra (FMC = 343.25 - [3.298 × idade em anos] + [.415 × massa magra em kg] + [1.737 × carga em kg para o leg press]) diminuiu o erro padrão da estimativa. CONCLUSÃO: Nossos resultados suportam a ideia de que a carga correlaciona-se com a massa corporal e massa magra, e que a carga empregada em determinado exercício está significativamente associada com a forca muscular corporal. Portanto, isso permite o desenvolvimento de um modelo preditivo de forca muscular corporal com substancial acurácia.

Effects of low doses of polyunsaturated Fatty acids on the attention deficit/hyperactivity disorder of children: a systematic review.

UNLABELLED: Since attention deficit/hyperactivity disorder (ADHD) presents high prevalence among children, science has been researching alternative forms of treatment that do not involve medication. OBJECTIVE: To evaluate the effects of polyunsaturated fatty acids (PUFAs) on attention deficit/hyperactivity disorder. METHODS: We reviewed the articles published between 1980 and 2012 indexed in the databases PubMed, APA psychNET, Scopus and Web of Knowledge. RESULTS: Initially 231 articles were selected, out of which 12 met the inclusion criteria. The articles selected reported a modest cognitive and behavioral improvement of the patients after treatment with low doses of PUFAs. Those results might be associated with the evaluation methodology, the doses of PUFAs administered or the duration of treatment.

The effects of a session of resistance training on sleep patterns in the elderly.

The purpose of this study was to evaluate the influence of a session of resistance training on the sleep patterns of elderly people. Forty men aged 65-80 years who were sedentary and clinically healthy were divided into two groups: the control group (n = 18) and the resistance group (n = 22). Both groups underwent two polysomnography tests, one at baseline and another after either a resistance training session (the resistance group) or no physical exercise (the control group). The resistance training session was based on 60% of one repetition maximum (a test that assesses the maximum force). We observed that the frequency with which the control group awoke (arousal index) increased from 16.29 ± 6.06 events/h to 20.09 ± 6.9 events/h, and in the resistance group, it decreased from 22.27 ± 11 events/h to 20.41 ± 8.57 events/h (t = 2.10 and p = 0.04). For stage-1 sleep, there was an increase from 4.96% at baseline to 5.40% in the control group, and there was a decrease in the resistance group from 8.32 to 6.21% after the exercise session (t = 2.12 and p = 0.04). A session of resistance training at 60% of one repetition maximum was able to modify the sleep pattern in men aged 65-80 years, suggesting that physical exercise has a modest influence on sleep consolidation.

Exercise training improves sleep pattern and metabolic profile in elderly people in a time-dependent manner.

Aging and physical inactivity are two factors that favors the development of cardiovascular disease, metabolic syndrome, obesity, diabetes, and sleep dysfunction. In contrast, the adoption a habitual of moderate exercise may present a non-pharmacological treatment alternative for sleep and metabolic disorders. We aimed to assess the effects of moderate exercise training on sleep quality and on the metabolic profile of elderly people with a sedentary lifestyle. Fourteen male sedentary, healthy, elderly volunteers performed moderate training for 60 minutes/day, 3 days/week for 24 wk at a work rate equivalent to the ventilatory aerobic threshold. The environment was kept at a temperature of 23 ± 2 °C, with an air humidity 60 ± 5%. Blood and polysomnographs analysis were collected 3 times: at baseline (1 week before training began), 3 and 6 months (after 3 and 6 months of training). Training promoted increasing aerobic capacity (relative VO2, time and velocity to VO2max; p < 0.05), and reduced serum NEFA, and insulin concentrations as well as improved HOMA index (p < 0.05), and increased adiponectin levels (p < 0.05), after 3 months of training when compared with baseline data. The sleep parameters, awake time and REM sleep latency were decreased after 6 months exercise training (p < 0.05) in relation baseline values. Our results demonstrate that the moderate exercise training protocol improves the sleep profile in older people, but the metabolism adaptation does not persist. Suggesting that this population requires training strategy modifications as to ensure consistent alterations regarding metabolism.

The impact of resistance exercise on the cognitive function of the elderly.

PURPOSE: The purpose of this study was to assess the impact of 24 wk of resistance training at two different intensities on cognitive functions in the elderly. METHODS: Sixty-two elderly individuals were randomly assigned to three groups: CONTROL (N = 23), experimental moderate (EMODERATE; N = 19), and experimental high (EHIGH; N = 20). The volunteers were assessed on physical, hemodynamic, cognitive, and mood parameters before and after the program. RESULTS: On the 1 RM test (P < 0.001), the two experimental groups performed better than the CONTROL group, but they did not show differences between themselves. The EHIGH group gained more lean mass (P = 0.05) than the CONTROL group and performed better on the following tests: digit span forward (P < 0.001), Corsi's block-tapping task backward (P = 0.001), similarities (P = 0.03), Rey-Osterrieth complex figure immediate recall (P = 0.02), Toulouse-Pieron concentration test errors (P = 0.01), SF-36 (general health) (P = 0.04), POMS (tension-anxiety, P = 0.04; depression-dejection, P = 0.03; and total mood disorder, P = 0.03). The EMODERATE group scored higher means than the CONTROL group on digit span forward (P < 0.001), Corsi's block-tapping task backward (P = 0.01), similarities (P = 0.02), Rey-Osterrieth complex figure immediate recall (P = 0.02), SF-36 (general health, P = 0.005; vitality, P = 0.006), POMS (tension-anxiety, P = 0.001; depression-dejection, P = 0.006; anger-hostility, P = 0.006; fatigue-inertia, P = 0.02; confusion-bewilderment, P = 0.02; and total mood disorder, P = 0.001). We also found that IGF-1 serum levels were higher in the experimental groups (EMODERATE, P = 0.02; EHIGH, P < 0.001). CONCLUSIONS: Moderate- and high-intensity resistance exercise programs had equally beneficial effects on cognitive functioning.