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1.
Curr Sports Med Rep ; 21(2): 45-52, 2022 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-35120050

RESUMEN

ABSTRACT: The use of compression garments (CG) has been associated with improved recovery following exercise-induced muscle damage. The mechanisms responsible are not well established, and no consensus exists regarding the effects of compression pressure (i.e., the "dose"), which until recently was seldom reported. With the increasing prevalence of studies reporting directly measured pressures, the present review aims to consolidate current evidence on optimal pressures for recovery from exercise-induced muscle damage. In addition, recent findings suggesting that custom-fitted garments provide greater precision and experimental control are discussed. Finally, biochemical data from human trials are presented to support a theoretical mechanism by which CG enhance recovery, with recommendations for future research. The effects of compression on adaptation remain unexplored. More studies are required to investigate the relationship between compression pressure and the recovery of performance and physiological outcomes. Furthermore, improved mechanistic understanding may help elucidate the optimal conditions by which CG enhance recovery.


Asunto(s)
Vestuario , Músculo Esquelético , Humanos
2.
J Strength Cond Res ; 36(1): 212-219, 2022 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-32091467

RESUMEN

ABSTRACT: Brown, F, Jeffries, O, Gissane, C, Howatson, G, van Someren, K, Pedlar, C, Myers, T, and Hill, JA. Custom-fitted compression garments enhance recovery from muscle damage in rugby players. J Strength Cond Res 36(1): 212-219, 2022-to evaluate the effects of custom-fitted compression garments (CG) on recovery from muscle damage in rugby players. Forty-five players were tested for lower-body strength, power, and indices of muscle damage before completing a damaging protocol (20 × 20-m sprints with 5-m deceleration, 100 drop jumps). Players were randomly assigned to wear either custom-fitted (CF, n = 13), or standard-sized CG (SSG, n = 16), or to receive sham ultrasound therapy (CON, n = 16) immediately after exercise. Players were retested immediately, then after 24 and 48 hours. Strength recovery was significantly different between groups (F = 2.7, p = 0.02), with only CF recovering to baseline values by 48 hours (p = 0.973). Time × condition effects were also apparent for creatine kinase activity (χ2 = 30.4, p < 0.001) and midthigh girth (F = 3.7, p = 0.005), with faster recovery apparent in CF compared with both CON and SSG (p < 0.05). Custom-fitted CG improved strength recovery and indices of muscle damage in rugby players, compared with controls and standard-sized garments. Athletes and coaches would be advised to use appropriately fitted CG to enhance strength recovery after damaging exercise.


Asunto(s)
Traumatismos de la Rodilla/prevención & control , Músculo Esquelético , Rugby , Medias de Compresión , Atletas , Vestuario , Fútbol Americano , Humanos , Fuerza Muscular , Músculo Esquelético/fisiología
3.
Eur J Sport Sci ; 22(4): 521-529, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33583335

RESUMEN

This study investigated the effects of custom-fitted compression garments (CG) worn during recovery over a multi-day training camp in elite judo players (judoka). A single blind, placebo-controlled study was carried out in 11 elite judoka, using a two-way crossover design. Two three-day training camps were completed in CG and placebo conditions in a random order. Changes in performance and physiological markers were compared between conditions. Judoka were assessed before training for (maximal) isometric knee extension and grip strength, countermovement jump performance and bench-press velocity, alongside soreness, limb circumferences, plasma creatine kinase activity (CK) and perceived bruising. Measurements were repeated after 12, 36 and 43 h of training, whereupon judoka rated the effectiveness of each intervention. Knee extension and bench-press performance demonstrated significant familiarization (p < 0.001), and were excluded from subsequent analysis. Jump performance was unaffected by training (p > 0.05). Grip strength declined throughout training (p < 0.001), with peak decrements of -9.7% indicating mild muscle damage. Increases in bruising, CK and soreness demonstrated highly variable, if significant (p < 0.001) responses. Although CG were perceived as significantly more effective than placebo for recovery (p = 0.046), no effects were observed for any other outcome (p > 0.05). Compression conferred no statistically significant impact upon recovery markers in elite judoka throughout training. Muscle damage responses were inconsistent in this population. Individual athletes would be advised to monitor habitually-used performance measures while using CG to ascertain whether perceptual benefits translate into enhanced recovery.HighlightsCompression garments were perceived as more effective for recovery than placebo by elite judoka.However, no measures of performance or muscle damage were enhanced by CG.Randori was associated with inconsistent muscle damage responses in elite judoka, while lower-body performance was not impaired.Individual athletes would be advised to monitor habitually-used performance measures while using CG to ascertain whether perceptual benefits translate into enhanced recovery.


Asunto(s)
Artes Marciales , Atletas , Vestuario , Fuerza de la Mano , Humanos , Artes Marciales/fisiología , Fuerza Muscular/fisiología , Método Simple Ciego
4.
Int J Sports Physiol Perform ; 15(3): 368-374, 2020 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-31614329

RESUMEN

PURPOSE: To investigate the effects of supplementation with tart cherry juice (TCJ) on markers of recovery after intermittent exercise under habitual dietary conditions. METHODS: Using a randomized, single-blind, placebo (PLA)-controlled, independent-groups design, 20 team-sport players (8 male and 12 female; age 26 [4] y, height 175.4 [9.6] cm, body mass 70.2 [12.6] kg) were divided equally into 2 groups and consumed either TCJ or PLA twice per day for 8 consecutive days while following their normal dietary habits. Participants completed an adapted version of the Loughborough Intermittent Shuttle Test (LIST) on day 6 of supplementation. Countermovement jump, 20-m sprint, maximal voluntary isometric contraction, and delayed onset muscle soreness were assessed at baseline and 1, 24, and 48 hours post-LIST. Blood markers of muscle damage (creatine kinase) and inflammation (C-reactive protein) were taken presupplementation, immediately pre-LIST, and 1, 24, and 48 hours post-LIST. Data were analyzed using a repeated-measures analysis of variance. RESULTS: Countermovement jump, 20-m sprint, and maximal voluntary isometric contraction showed significantly faster recovery with TCJ (P < .05) at 24 and 48 hours post-LIST. A significant interaction effect (P < .05) was observed for muscle soreness; however, Bonferroni post hoc analysis could not identify when the significant differences between TCJ and PLA occurred. There were no significant differences throughout recovery between TCJ and PLA for C-reactive protein and creatine kinase (P < .05). CONCLUSION: The results suggest that TCJ, in addition to habitual diet, can accelerate recovery after intermittent exercise and therefore extend the efficacy of TCJ in accelerating recovery in team sports.

5.
J Glob Oncol ; 4: 1-9, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-30241137

RESUMEN

INTRODUCTION: Breast cancer ranks among the most common adult cancers in Kenya. Individuals with a family history of the disease are at increased risk. Mutations most commonly associated with breast cancer affect BRCA1 and BRCA2; mutations in several other genes may also confer breast cancer risk. Genetic testing and counseling can help patients understand their risk and assist clinicians in choosing therapies. We aimed to uncover what patients know, experience, and think with regard to breast cancer genetics in Kenya. METHODS: Participants included breast cancer survivors age > 18 years. Participants completed a demographic questionnaire before participating in focus group discussions to uncover knowledge of, experiences with, and attitudes toward the genetics of breast cancer. Data were analyzed by inductive thematic analysis. RESULTS: Four focus groups were conducted. Participants had rudimentary knowledge about genetics and cancer development, and although they understood breast cancer could be familial, many suspected environmental factors causing spontaneous disease. They reported limited experience with counseling about genetic risk, perceiving that their physicians were too busy to provide comprehensive information. Many indicated they promoted cancer screening among family to promote early diagnosis. Participants expressed a need for more comprehensive counseling and access to genetic testing, recognizing the added clarity it would bring to their families' risk of cancer. CONCLUSION: Improved communication from health care teams could clarify the risk of cancer for affected families. The introduction of affordable genetic testing and counseling for breast cancer in Kenya is welcomed by survivors.


Asunto(s)
Neoplasias de la Mama/psicología , Adulto , Estudios Transversales , Femenino , Humanos , Kenia , Persona de Mediana Edad , Investigación Cualitativa
6.
Eur J Hum Genet ; 26(4): 505-517, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29379195

RESUMEN

Clinical genetic services are increasingly providing a more nuanced understanding of genetic disease diagnostics and future risk for patients. Effectively conveying genetic information is essential for patients to make informed decisions. This is especially important for survivors of heritable cancers such as retinoblastoma (childhood eye cancer), where survivors who carry a germline mutation in the RB1 gene are at increased risk of second cancers in adulthood, and of passing on the disease risk to future offspring. We conducted focus groups with adult survivors of retinoblastoma and parents of children with retinoblastoma, to uncover their knowledge of, experiences with and attitudes about retinoblastoma genetics and related impacts of the cancer. Results revealed that participants understood that retinoblastoma was a genetic disease, but often misunderstood the implications of genetics on cancer phenotype and risk. Experiences with genetic testing and counseling were generally positive, however, participants reported challenges in accessing genetic information and psychosocial support. Participants suggested more educational resources, peer-to-peer counseling, and psychosocial support would enhance uptake of important genetic information. The results of the study will inform patient-oriented approaches to deliver comprehensive genetic healthcare.


Asunto(s)
Asesoramiento Genético/psicología , Predisposición Genética a la Enfermedad/psicología , Conocimientos, Actitudes y Práctica en Salud , Neoplasias de la Retina/psicología , Retinoblastoma/psicología , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Padres/psicología , Pacientes/psicología , Neoplasias de la Retina/genética , Retinoblastoma/genética
7.
Dev Dyn ; 247(2): 289-303, 2018 02.
Artículo en Inglés | MEDLINE | ID: mdl-29024245

RESUMEN

BACKGROUND: In this study, we reveal a previously undescribed role of the HACE1 (HECT domain and Ankyrin repeat Containing E3 ubiquitin-protein ligase 1) tumor suppressor protein in normal vertebrate heart development using the zebrafish (Danio rerio) model. We examined the link between the cardiac phenotypes associated with hace1 loss of function to the expression of the Rho small family GTPase, rac1, which is a known target of HACE1 and promotes ROS production via its interaction with NADPH oxidase holoenzymes. RESULTS: We demonstrate that loss of hace1 in zebrafish via morpholino knockdown results in cardiac deformities, specifically a looping defect, where the heart is either tubular or "inverted". Whole-mount in situ hybridization of cardiac markers shows distinct abnormalities in ventricular morphology and atrioventricular valve formation in the hearts of these morphants, as well as increased expression of rac1. Importantly, this phenotype appears to be directly related to Nox enzyme-dependent ROS production, as both genetic inhibition by nox1 and nox2 morpholinos or pharmacologic rescue using ROS scavenging agents restores normal cardiac structure. CONCLUSIONS: Our study demonstrates that HACE1 is critical in the normal development and proper function of the vertebrate heart via a ROS-dependent mechanism. Developmental Dynamics 247:289-303, 2018. © 2017 Wiley Periodicals, Inc.


Asunto(s)
Corazón/crecimiento & desarrollo , Especies Reactivas de Oxígeno/metabolismo , Ubiquitina-Proteína Ligasas/fisiología , Pez Cebra/embriología , Animales , Embrión no Mamífero , Cardiopatías Congénitas/etiología , NADPH Oxidasas , Proteínas Supresoras de Tumor , Proteína de Unión al GTP rac1
8.
J Genet Couns ; 27(3): 574-588, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29170903

RESUMEN

Genetic testing and counseling have become integral to the timely control of heritable cancers, like the childhood eye cancer retinoblastoma. This study aimed to determine attitudes, knowledge and experiences related to retinoblastoma genetics, among survivors and parents of children with retinoblastoma in Kenya. This qualitative study used focus groups as the primary data collection method, coupled with a brief demographic questionnaire. Study settings were Kenyatta National Hospital and Presbyterian Church of East Africa Kikuyu Hospital. Thematic analysis was used to identify key themes. Thirty-one individuals participated in five focus groups. Two main concepts emerged: (1) the origins of retinoblastoma are unclear, and (2) retinoblastoma is associated with significant challenges. The lack of clarity surrounding the origins of retinoblastoma was linked to limited knowledge of retinoblastoma genetics, and limited genetic counseling delivery and uptake. The challenges associated with retinoblastoma were discussed in terms of the impact of the diagnosis on individuals and families, and unmet healthcare needs related to the diagnosis. Next steps will incorporate these findings to develop evidence-informed and accessible cancer genetic services in Kenya.


Asunto(s)
Supervivientes de Cáncer/psicología , Asesoramiento Genético/métodos , Neoplasias de la Retina/psicología , Retinoblastoma/psicología , Niño , Preescolar , Femenino , Grupos Focales , Pruebas Genéticas/métodos , Humanos , Kenia , Masculino , Padres/psicología , Investigación Cualitativa , Neoplasias de la Retina/genética , Retinoblastoma/genética
9.
J Strength Cond Res ; 31(11): 2977-2982, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28859013

RESUMEN

Upton, CM, Brown, FC, and Hill, JA. Efficacy of compression garments on recovery from a simulated rugby protocol. J Strength Cond Res 31(11): 2977-2982, 2017-The aim of this study was to examine the efficacy of lower limb compression garments on recovery in club-level rugby players. Nineteen participants (age, 20.3 ± 1.7 years, height, 184.2 ± 7.5 cm, and body mass, 89.5 ± 9.9 kg) completed a rugby-specific, muscle-damaging protocol before being assigned to a compression garment group (n = 10) or a SHAM ("recovery" drink) treatment (n = 9). The compression group wore the garments for 48 hours after exercise, whereas SHAM consumed a sweetened, low energy drink within an hour of protocol completion. Perceived muscle soreness (PMS), creatine kinase (CK), maximal voluntary isometric contraction (MVIC), and countermovement jump (CMJ) height were measured at baseline, post, 24, and 48 hours after exercise. Perceived muscle soreness was significantly lower in the compression group compared with the SHAM group at both 24 and 48 hours after exercise (p ≤ 0.05). The compression group was also subject to lower CK values than SHAM, as demonstrated by a significant time by group effect (p ≤ 0.05). There was no significant group effect for MVIC or CMJ (p > 0.05). Wearing compression garments after a rugby-specific, muscle-damaging protocol seems to reduce PMS and circulating concentrations of CK, suggesting improved recovery from muscle-damaging exercise.


Asunto(s)
Vestuario , Vendajes de Compresión , Fútbol Americano/fisiología , Músculo Esquelético/fisiología , Mialgia/terapia , Creatina Quinasa/biosíntesis , Humanos , Contracción Isométrica/fisiología , Extremidad Inferior , Masculino , Percepción , Medicina Deportiva , Adulto Joven
10.
J Occup Environ Med ; 59(4): e20-e23, 2017 04.
Artículo en Inglés | MEDLINE | ID: mdl-28628053

RESUMEN

OBJECTIVE: To compare the effects of personal protective equipment (PPE) weight on blood pressure (BP) and heart rate (HR), between volunteer firefighters (FF) and athletes. METHODS: Athletes and FF were matched by body size and came to the lab twice for two treadmill tests. The "Regular" test was completed in normal fitness clothing, and PPE test was completed in full structural PPE with monitoring of HR assessment every minute and BP each stage. RESULTS: In the FF cohort, all submaximal HR and BP levels were different. HRmax and VO2max were also different (all P < 0.05). In athletes, HRmax was higher in Regular test than PPE. CONCLUSIONS: Future research should examine the effect of different PPE weights on HR and BP responses.


Asunto(s)
Bomberos , Equipo de Protección Personal , Esfuerzo Físico/fisiología , Soporte de Peso/fisiología , Presión Sanguínea , Prueba de Esfuerzo , Fútbol Americano/fisiología , Frecuencia Cardíaca , Humanos , Masculino , Consumo de Oxígeno , Deportes de Raqueta/fisiología , Carga de Trabajo , Adulto Joven
11.
Int J Exerc Sci ; 9(3): 482-490, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27766134

RESUMEN

Previous studies have investigated carotid artery intima-media thickness (IMT) and blood pressure and found a direct correlation between the two. It is known that adult females have better cardiovascular health than males until a certain stage of life, yet limited research has examined gender differences in vascular function. Thus, the purpose of this study was to investigate vascular structure and function, blood pressure, and blood glucose/cholesterol levels in relation to gender differences in young healthy adults. On three separate days, 44 adults (26.30 ± 11.9yrs; 24M, 20F) completed a carotid IMT ultrasound, a flow-mediated dilation (FMD), a fasted glucose and cholesterol test, a 24hr ambulatory blood pressure monitoring, a VO2max test, and a body composition measurement. Females had lower systolic blood pressure, lower diastolic blood pressure, lower LDL/HDL ratios, lower body mass index, a higher HDL count, and lower plasma glucose levels than males (p < 0.05 for all), all of which suggest better cardiovascular health. However, we found no gender differences in vascular health measures, IMT and FMD. Our results suggest that while young adult females have better cardiovascular health than males, endothelial function may not yet be affected in the young adult years.

12.
Global Health ; 12(1): 23, 2016 05 26.
Artículo en Inglés | MEDLINE | ID: mdl-27229322

RESUMEN

BACKGROUND: Strategic, interdisciplinary partnerships are essential to addressing the complex drivers of health inequities that result in survival disparities worldwide. Take for example the aggressive early childhood eye cancer retinoblastoma, where survival reaches 97 % in resource-rich countries, but is as low 30 % in some resource-limited nations, where 92 % of the burden lies. This suggests a need for a multifaceted approach to achieve a tangible and sustainable increase in survival. METHODS: We assembled the history the Kenyan National Retinoblastoma Strategy (KNRbS), using information documented in NGO reports, grant applications, news articles, meeting agendas and summaries. We evaluated the KNRbS using the principles found in the guide for transboundary research partnerships developed by the Swiss Commission for Research Partnerships with Developing Countries. RESULTS: A nationally co-ordinated approach drawing input and expertise from multiple disciplines and sectors presented opportunities to optimise cure of children with retinoblastoma. Annual meetings were key to achieving the over 40 major outputs of the group's efforts, related to Awareness, Medical Care, Family Support and Resource Mobilization. Three features were found to be critical to the KNRbS success: multidisciplinarity, consistency and flexibility. CONCLUSION: The KNRbS has achieved a number of key outputs with limited financial investment. As a partnership, the KNRbS meets most of the criteria identified for success. Challenges remain in securing the long-term sustainability of its achievements. Elements of the Kenyan National Retinoblastoma Strategy may be useful to other developing countries struggling with limited survival of retinoblastoma and other cancers or rare diseases.


Asunto(s)
Atención a la Salud/normas , Planificación en Salud/métodos , Política de Salud/tendencias , Relaciones Interprofesionales , Retinoblastoma/terapia , África Oriental , Atención a la Salud/métodos , Atención a la Salud/tendencias , Humanos
13.
Int J Vasc Med ; 2016: 6851256, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26904291

RESUMEN

Studies report that football players have high blood pressure (BP) and increased cardiovascular risk. There are over 70,000 NCAA football players and 450 Division III schools sponsor football programs, yet limited research exists on vascular health of athletes. This study aimed to compare vascular and cardiovascular health measures between football players and nonathlete controls. Twenty-three athletes and 19 nonathletes participated. Vascular health measures included flow-mediated dilation (FMD) and carotid artery intima-media thickness (IMT). Cardiovascular measures included clinic and 24 hr BP levels, body composition, VO2 max, and fasting glucose/cholesterol levels. Compared to controls, football players had a worse vascular and cardiovascular profile. Football players had thicker carotid artery IMT (0.49 ± 0.06 mm versus 0.46 ± 0.07 mm) and larger brachial artery diameter during FMD (4.3 ± 0.5 mm versus 3.7 ± 0.6 mm), but no difference in percent FMD. Systolic BP was significantly higher in football players at all measurements: resting (128.2 ± 6.4 mmHg versus 122.4 ± 6.8 mmHg), submaximal exercise (150.4 ± 18.8 mmHg versus 137.3 ± 9.5 mmHg), maximal exercise (211.3 ± 25.9 mmHg versus 191.4 ± 19.2 mmHg), and 24-hour BP (124.9 ± 6.3 mmHg versus 109.8 ± 3.7 mmHg). Football players also had higher fasting glucose (91.6 ± 6.5 mg/dL versus 86.6 ± 5.8 mg/dL), lower HDL (36.5 ± 11.2 mg/dL versus 47.1 ± 14.8 mg/dL), and higher body fat percentage (29.2 ± 7.9% versus 23.2 ± 7.0%). Division III collegiate football players remain an understudied population and may be at increased cardiovascular risk.

14.
Future Microbiol ; 10(11): 1719-26, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26597425

RESUMEN

Drug combination therapy is a promising strategy to extend the lifespan of our antimicrobials. Drug combinations used in treatment must be carefully selected to minimize the evolution of resistance, either by carefully determining drug pairs that hinder the acquisition of resistance mechanisms, or by screening for combinations that inhibit growth and show reduced vulnerability to resistance. Modeling of interactions between drugs has provided intriguing insights into strategies for combination therapy deployment. Ultimately, more rigorous clinical trials need to be performed to evaluate the laboratory and modeling results and advance treatment options.


Asunto(s)
Antiinfecciosos/farmacología , Antiinfecciosos/uso terapéutico , Enfermedades Transmisibles/tratamiento farmacológico , Resistencia a Medicamentos , Quimioterapia Combinada/métodos , Humanos
15.
Health Educ Behav ; 42(4): 436-48, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-26245932

RESUMEN

BACKGROUND: Intimate partner violence (IPV) has been recognized as a public health problem since the late 20th century. To spur IPV prevention efforts nationwide, the DELTA PREP Project selected 19 state domestic violence coalitions to build organizational prevention capacity and catalyze IPV primary prevention strategies within their states. OBJECTIVE: DELTA PREP's summative evaluation addressed four major questions: (1) Did coalitions improve their prevention capacity during the project period? (2) Did coalitions serve as catalysts for prevention activities within their states during the project period? (3) Was initial prevention capacity associated with the number of prevention activity types initiated by coalitions by the end of the project? (4) Did coalitions sustain their prevention activities 6 months after the end of the project period? RESULTS: DELTA PREP achieved its capacity-building goal, with all 19 participant coalitions integrating prevention within their organizations and serving as catalysts for prevention activities in their states. At 6 months follow up, coalitions had sustained almost all prevention activities they initiated during the project. Baseline prevention capacity (Beginner vs. Intermediate) was not associated with the number of prevention activity types coalitions implemented by the end of the project. CONCLUSION: Service and treatment organizations are increasingly asked to integrate a full spectrum of prevention strategies. Selecting organizations that have high levels of general capacity and readiness for an innovation like integrating a public health approach to IPV prevention will likely increase success in building an innovation-specific capacity, and in turn implementing an innovation.


Asunto(s)
Violencia de Pareja/prevención & control , Creación de Capacidad/organización & administración , Humanos , Relaciones Interinstitucionales , Violencia de Pareja/estadística & datos numéricos , Objetivos Organizacionales , Prevención Primaria/métodos , Prevención Primaria/organización & administración , Desarrollo de Programa , Evaluación de Programas y Proyectos de Salud , Administración en Salud Pública/métodos , Gobierno Estatal , Estados Unidos/epidemiología
16.
Health Educ Behav ; 42(4): 471-9, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-26245935

RESUMEN

Although health education programs may benefit from quality improvement methods, scant resources exist to help practitioners apply these methods for program improvement. The purpose of this article is to describe the Data-to-Action framework, a process that guides practitioners through rapid-feedback cycles in order to generate actionable data to improve implementation of ongoing programs. The framework was designed while implementing DELTA PREP, a 3-year project aimed at building the primary prevention capacities of statewide domestic violence coalitions. The authors describe the framework's main steps and provide a case example of a rapid-feedback cycle and several examples of rapid-feedback memos produced during the project period. The authors also discuss implications for health education evaluation and practice.


Asunto(s)
Violencia de Pareja/prevención & control , Mejoramiento de la Calidad/organización & administración , Retroalimentación , Humanos , Innovación Organizacional , Objetivos Organizacionales , Desarrollo de Programa , Evaluación de Programas y Proyectos de Salud , Administración en Salud Pública/métodos , Estados Unidos
17.
PLoS One ; 10(6): e0129852, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26035834

RESUMEN

BACKGROUND: Clinical genetic testing is becoming an integral part of medical care for inherited disorders. While genetic testing and counseling are readily available in high-income countries, in low- and middle-income countries like Kenya genetic testing is limited and genetic counseling is virtually non-existent. Genetic testing is likely to become widespread in Kenya within the next decade, yet there has not been a concomitant increase in genetic counseling resources. To address this gap, we designed an interactive workshop for clinicians in Kenya focused on the genetics of the childhood eye cancer retinoblastoma. The objectives were to increase retinoblastoma genetics knowledge, build genetic counseling skills and increase confidence in those skills. METHODS: The workshop was conducted at the 2013 Kenyan National Retinoblastoma Strategy meeting. It included a retinoblastoma genetics presentation, small group discussion of case studies and genetic counseling role-play. Knowledge was assessed by standardized test, and genetic counseling skills and confidence by questionnaire. RESULTS: Knowledge increased significantly post-workshop, driven by increased knowledge of retinoblastoma causative genetics. One-year post-workshop, participant knowledge had returned to baseline, indicating that knowledge retention requires more frequent reinforcement. Participants reported feeling more confident discussing genetics with patients, and had integrated more genetic counseling into patient interactions. CONCLUSION: A comprehensive retinoblastoma genetics workshop can increase the knowledge and skills necessary for effective retinoblastoma genetic counseling.


Asunto(s)
Educación Médica Continua/métodos , Neoplasias del Ojo/diagnóstico , Asesoramiento Genético , Servicios Genéticos/normas , Conocimientos, Actitudes y Práctica en Salud , Retinoblastoma/diagnóstico , Competencia Clínica , Atención a la Salud , Neoplasias del Ojo/genética , Pruebas Genéticas , Humanos , Kenia , Médicos , Retinoblastoma/genética
18.
J Int Soc Sports Nutr ; 12: 22, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25983669

RESUMEN

BACKGROUND: Prolonged exercise, such as marathon running, has been associated with an increase in respiratory mucosal inflammation. The aim of this pilot study was to examine the effects of Montmorency cherry juice on markers of stress, immunity and inflammation following a Marathon. METHODS: Twenty recreational Marathon runners consumed either cherry juice (CJ) or placebo (PL) before and after a Marathon race. Markers of mucosal immunity secretory immunoglobulin A (sIgA), immunoglobulin G (IgG), salivary cortisol, inflammation (CRP) and self-reported incidence and severity of upper respiratory tract symptoms (URTS) were measured before and following the race. RESULTS: All variables except secretory IgA and IgG concentrations in saliva showed a significant time effect (P <0.01). Serum CRP showed a significant interaction and treatment effect (P < 0.01). The CRP increase at 24 and 48 h post-Marathon was lower (P < 0.01) in the CJ group compared to PL group. Mucosal immunity and salivary cortisol showed no interaction effect or treatment effect. The incidence and severity of URTS was significantly greater than baseline at 24 h and 48 h following the race in the PL group and was also greater than the CJ group (P < 0.05). No URTS were reported in the CJ group whereas 50 % of runners in the PL group reported URTS at 24 h and 48 h post-Marathon. CONCLUSIONS: This is the first study that provides encouraging evidence of the potential role of Montmorency cherries in reducing the development of URTS post-Marathon possibly caused by exercise-induced hyperventilation trauma, and/or other infectious and non-infectious factors.


Asunto(s)
Jugos de Frutas y Vegetales , Prunus avium , Enfermedades Respiratorias/dietoterapia , Enfermedades Respiratorias/epidemiología , Carrera , Estrés Fisiológico , Adulto , Índice de Masa Corporal , Proteína C-Reactiva/metabolismo , Femenino , Humanos , Hidrocortisona/metabolismo , Inmunoglobulina A/metabolismo , Inmunoglobulina G/metabolismo , Incidencia , Inflamación/dietoterapia , Masculino , Persona de Mediana Edad , Resistencia Física , Proyectos Piloto , Adulto Joven
19.
Cell Rep ; 10(5): 809-819, 2015 Feb 10.
Artículo en Inglés | MEDLINE | ID: mdl-25660029

RESUMEN

The evolution of drug resistance threatens human health worldwide. An emerging strategy to mitigate drug resistance is combination therapy. The fate of multidrug-resistant pathogens depends on their fitness relative to susceptible counterparts, yet the fitness consequences of multidrug resistance remain enigmatic. Here, we dissect fitness consequences of the evolution of resistance to antifungal drug combinations in the leading human fungal pathogen, Candida albicans. We focus on the most widely deployed antifungals, the azoles, and inhibitors of the molecular chaperone Hsp90 and protein phosphatase calcineurin, which regulate cellular stress responses required for azole resistance. We find tradeoffs such that adaptation to drug combinations is associated with reduced fitness in distinct environments, including those relevant to the human host. We identify mutations associated with fitness tradeoffs in clinical isolates and that influence morphogenesis, a key virulence trait. Thus, we delineate evolutionary constraints that may minimize the evolution of resistance to antifungal combinations.

20.
J Strength Cond Res ; 28(8): 2228-35, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24714530

RESUMEN

Strenuous physical activity can result in exercise-induced muscle damage. The purpose of this study was to investigate the efficacy of a lower limb compression garment in accelerating recovery from a marathon run. Twenty four subjects (female, n = 7; male, n = 17) completed a marathon run before being assigned to a treatment group or a sham treatment group. The treatment group wore lower limb compression tights for 72 hours after the marathon run, the sham treatment group received a single treatment of 15 minutes of sham ultrasound after the marathon run. Perceived muscle soreness, maximal voluntary isometric contraction (MVIC), and serum markers of creatine kinase (CK) and C-reactive protein (C-RP) were assessed before, immediately after, and 24, 48, and 72 hours after the marathon run. Perceived muscle soreness was significantly lower (p ≤ 0.05) in the compression group at 24 hours after marathon when compared with the sham group. There were no significant group effects for MVIC, CK, and C-RP (p > 0.05). The use of a lower limb compression garment improved subjective perceptions of recovery; however, there was neither a significant improvement in muscular strength nor a significant attenuation in markers of exercise-induced muscle damage and inflammation.


Asunto(s)
Vestuario , Músculo Esquelético/fisiopatología , Presión , Recuperación de la Función , Carrera/fisiología , Adulto , Proteína C-Reactiva/metabolismo , Creatina Quinasa/sangre , Femenino , Humanos , Contracción Isométrica , Masculino , Persona de Mediana Edad , Fuerza Muscular , Músculo Esquelético/patología , Mialgia/sangre , Mialgia/etiología , Mialgia/fisiopatología , Percepción
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