A Preliminary Investigation into the Frequency Dose Effects of High-Intensity Functional Training on Cardiometabolic Health.

The objective of this study was to explore the effects of three weekly frequency doses of high-intensity functional training (HIFT) on an array of cardiometabolic markers in adults with metabolic syndrome (MetS). Twenty-one men and women, randomized into one (HIFT1), two (HIFT2), or three (HIFT3) days per week of HIFT, completed 3-weeks of familiarization plus a 12-week progressive training program. Pre- and post-intervention, several cardiometabolic, body composition, oxygen consumption, metabolic syndrome severity, and perceptions of fitness measurements were assessed. Additionally, an exercise enjoyment survey was administered post-intervention. A Cohen's d was used to demonstrate within-group change effect size. Although this study was not fully powered, a one-way and two-way ANOVA were used to compare the dose groups to provide provisional insights. No differences were found when frequency dose groups were compared. Many cardiometabolic, body composition, and fitness improvements were seen within each group, with clinically meaningful improvements in the metabolic syndrome severity score (MSSS) (HIFT1: -0.105, d = 0.28; HIFT2: -0.382, d = 1.20; HIFT3: -0.467, d = 1.07), waist circumference (HIFT1: -4.1cm, d = 3.33; HIFT2: -5.4cm, d = 0.89; HIFT3: -0.7cm, d = 0.20), and blood glucose (HIFT1: -9.5mg/dL, d = 0.98; HIFT2: -4.9mg/dL, d = 1.00; HIFT3: -1.7mg/dL, d = 0.23). All three groups similarly reported high exercise enjoyment and likeliness to continue after the intervention. In conclusion, HIFT performed once, twice, or thrice a week elicits improvements in MetS and is considered enjoyable. HIFT, even at a low weekly dose, therefore represents a potential strategy to reduce the global MetS burden.

Promoting physical activity in rural Australian adults using an online intervention.

OBJECTIVES: Rural Australian adults are consistently identified as insufficiently active, likely due to challenges implementing community-based physical activity programs in rural settings. On-line strategies to promote physical activity may be particularly effective in rural settings where isolation and scarcity of qualified support are potential barriers. The Rural Environments and Community Health (REACH) study evaluated the effectiveness of an online-delivered walking intervention among South Australian rural adults. DESIGN: Randomised controlled study design. METHODS: A twelve-week intervention, with six- and twelve-month follow-up, was conducted. Participants (n=171; 50.6±12.5years), recruited through flyers, local newspapers and radio, were randomised to comparison or intervention groups and received a pedometer. The intervention group received access to the REACH website and personalised step goals based on ratings of perceived exertion and daily affect. The comparison group received a paper diary and generic step goals. Outcome measures were accelerometry-assessed sedentary, light (LPA) and moderate-to-vigorous (MVPA) physical activity. Linear mixed models assessed changes over the intervention and follow-ups. RESULTS: Sedentary time decreased, and LPA and MVPA increased in both groups across the intervention (p<0.05). The intervention group demonstrated a larger increase in LPA at six-month follow-up relative to comparison (p<0.05). Both groups decreased sedentary time, overall and in bouts ≥30min, between baseline and twelve-month follow-up (p<0.05). From baseline to twelve-month follow-up, MVPA (total min and bouts ≥10min) declined more in the comparison group than the intervention group (p<0.05). CONCLUSION: While increased physical activity and decreased sedentary time were observed in both groups during the intervention period, maintenance was only observed for LPA at six-month follow-up in the intervention group. By twelve-month follow-up, post-intervention improvements had largely disappeared, suggesting that additional research is needed to identify ways to improve long-term adherence.

Adherence, Compliance, and Health Risk Factor Changes following Short-Term Physical Activity Interventions.

BACKGROUND: Low physical activity (PA) levels are associated with poor health risk factor profiles. Intervention strategies to increase PA and quantify the rate and magnitude of change in risk factors are important. METHODS: Interventions were conducted over 40 days to increase PA in 736 insufficiently active (<150 min/wk PA) participants using either a pedometer or instructor-led group protocol. There were a further 135 active participants as controls. Major cardiovascular and metabolic risk factors, including fitness parameters, were measured before and after intervention. RESULTS: Adherence to the interventions was higher for the group versus pedometer participants (87.1% versus 79.8%) and compliance rates for achieving sufficient levels of PA (≥150 min/wk) were also higher for the group participants (95.8% versus 77.6%). Total weekly PA patterns increased by 300 and 435 minutes, for the pedometer and group participants, respectively. Improvements were found for waist girth, total cholesterol, aerobic fitness, and flexibility relative to controls. The change in vigorous PA, but not moderate PA, was a significant predictor of the change in eight of 11 risk factor variables measured. CONCLUSIONS: Rapid and dramatic increases in PA among previously insufficiently active adults can result in important health benefits.

Rural Environments and Community Health (REACH): a randomised controlled trial protocol for an online walking intervention in rural adults.

BACKGROUND: Rural Australian adults are continually shown to be insufficiently active with higher prevalence of lifestyle-related diseases associated with physical inactivity compared to urban adults. This may, partly, be attributable to the challenges associated with implementing community-based physical activity programs in rural communities. There is a need for broadly accessible physical activity programs specifically tailored to the unique attributes of rural communities. The aim of the Rural Environments And Community Health (REACH) study is to evaluate the effectiveness of an online-delivered physical activity intervention for increasing regular walking among adults living in rural areas of South Australia. METHODS/DESIGN: This is a randomised controlled trial. The intervention is 12-weeks with a 12-month follow-up. Participants will be insufficiently active, aged 18 to 70 years and randomly assigned to either Control or Intervention group. Participants receive a pedometer, but only the Intervention group will receive access to the purpose built REACH website where they will report steps taken, affect and ratings of perceived exertion during daily walking. These variables will be used to establish individualised step goals for increasing walking. Control participants will receive a paper diary to record their variables and generic incremental step goals.The primary outcome measures are time spent in sedentary, light and moderate-to-vigorous intensity physical activity, measured by accelerometry. Secondary outcomes include 1) health measures (anthropometric and physiological), 2) psychological well-being, 3) diet quality, and 4) correlates of physical activity (exercise self-efficacy and physical activity environments). Measures will be collected at baseline, post-intervention, 6-month and 12-month follow-up. DISCUSSION: This protocol describes the implementation of a trial testing the effectiveness of an online resource designed to assist rural Australians to become more physically active. The outcomes of this study will guide the efforts of health promotion professionals by providing evidence for a relatively inexpensive, widely accessible and effective method for increasing physical activity that can be utilized by anyone with access to the internet. Findings may indicate future directions for the implementation of physical activity and other health related interventions in rural communities. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTR12614000927628 (registered 28 August 2014).

Tuning the adhesion of layer-by-layer films to the physicochemical properties of inner limiting membranes using nanoparticles.

Retinal trauma is a serious concern for patients undergoing inner limiting membrane (ILM) peeling to correct for various vitreoretinal interface conditions. This mechanical trauma can be prevented by modifying the surface of surgical instruments to increase adhesion to the ILM. To this effect, we have studied the effects of roughness and surface charge on the adhesive properties of ILMs by utilizing layer-by-layer (LbL) films with embedded gold nanoparticles (LbL-AuNP films). LbL films were assembled on atomic force microscopy (AFM) tipless cantilevers. Topographical analysis of these films, with and without nanoparticles, showed that LbL films with nanoparticles had a higher rms roughness compared to films alone or unmodified cantilevers. Nanoparticle-modified LbL films significantly increased the adhesion forces at the cantilever-ILM interface, compared to LbL films without particles. Surprisingly, adsorption of gold nanoparticles onto the AFM cantilevers caused increases in adhesion forces greater than those measured with LbL-AuNP films. These results have important implications for the design of surface modifications for vitreoretinal surgical instruments.

The impact of socioeconomic position on sport participation among South Australian youth.

Organised sport among youth makes a substantial contribution to daily energy expenditure. This study investigated socioeconomic gradients in sport participation and predictors of participation. A representative sample of young South Australians (10-15 y; n=1737) was surveyed on organised sport participation in the previous 12 months, and predictors derived from the Children's Physical Activity Correlates scale and a parent survey. Four constructs were derived: 'is it worth it?' (perceived outcomes); 'am I able?' (perceived competency); 'reinforcing' (parental support); and 'enabling' (perceived barriers, from the parent survey). Socioeconomic position (SEP) was operationalized by an area-level indicator, the Socioeconomic Indicator for Advantage (SEIFA), split into tertiles. Sport participation was higher among high (highest SEIFA tertile) compared with low (lowest SEIFA tertile) SEP children. All predictors except 'am I able?' were positively associated with sport participation among boys and girls. Of these predictors, the 'enabling' construct varied by SEP among both boys and girls, with high SEP children reporting fewer barriers to participation. High SEP girls reported higher scores on 'reinforcing' and 'is it worth it?' than their low SEP counterparts. Low SEP girls reported lower levels of both instrumental and affective support from parents to play sport. There are distinct SEP gradients in sport participation, as well as its psychosocial and environmental predictors among South Australian youth. Low SEP girls are the most disadvantaged in terms of parental support to participate in sport. Interventions targeting this vulnerable group are urgently required.

Interactions of socioeconomic position with psychosocial and environmental correlates of children's physical activity: an observational study of South Australian families.

BACKGROUND: Evidence for psychosocial and environmental correlates on children's physical activity is scattered and somewhat unconvincing. Further, the moderating influences of socioeconomic position (SEP) on these influences are largely unexplored. The aim of this study was to examine the interactions of SEP, operationalised by mother education, and predictors of children's physical activity based on the Youth Physical Activity Promotion Model. METHODS: In 2005, a sample of South Australians (10-15 y) was surveyed on psychosocial and environmental correlates of physical activity using the Children's Physical Activity Correlates Questionnaire (n = 3300) and a parent survey (n = 1720). The following constructs were derived: 'is it worth it?' (perceived outcomes); 'am I able?' (perceived competency); 'reinforcing' (parental support); and 'enabling' (parent-perceived barriers). Self-reported physical activity was represented by a global score derived from the Physical Activity Questionnaire for Adolescents. Associations among physical activity and hypothesised correlates were tested among children with mothers of high (university educated) and low (left school at or before 15 y) SEP. RESULTS: Among high SEP children, 'is it worth it?' emerged as a significant predictor of physical activity for boys and girls. Among low SEP children, 'is it worth it?' predicted boys' physical activity, while among girls, 'reinforcing' was the only significant predictor, explaining ~35% of the total explained variance in physical activity. CONCLUSION: While perceived outcomes emerged as a consistent predictor of physical activity in this sample, parental support was a powerful limiting factor among low SEP girls. Interventions among this high risk group should focus on supporting parents to provide both emotional and instrumental support for their daughters to engage in physical activity.

Failure of recombinant factor VIIa to correct the coagulopathy in a case of severe postpartum hemorrhage.

BACKGROUND: Postpartum hemorrhage (PPH)remains an important cause of maternal morbidity and mortality. Several published reports suggest that recombinant factor VIIa (rFVIIa) is effective in controlling bleeding in PPH. This study reports a case of severe PPH complicated by disseminated intravascular coagulation(DIC), in which early rFVIIa (44 mg/kg) administration not only failed to control the bleeding in vivo but also, surprisingly, failed to correct the patient's international normalized ratio (INR) in vitro. It was hypothesized that the failure of rFVIIa to correct the INR indicated a deficiency in a downstream coagulation factor(s). To investigate this, coagulation factor levels were measured in blood samples that had been drawn periodically during resuscitation in the operating room. STUDY DESIGN AND METHODS: Clinical and laboratory data were extracted from the medical record.Plasma samples that had been obtained during resuscitation were frozen, and activity levels of the following factors were subsequently measured: fibrinogen, FII, FV, FVII, F IX, and FX. RESULTS: After rFVIIa administration, the patient's INR remained elevated at 1.9, and bleeding continued. It was determined that at the time rFVIIa was administered, the patient's fibrinogen level was very low(60 mg/dL). INR normalization and control of bleeding was achieved only after the patient's fibrinogen level was restored to normal. FII, F IX, and FX remained at hemostatic levels throughout resuscitation. CONCLUSIONS: In this case of severe PPH complicated by DIC, fibrinogen appears to have been limiting at the time rFVIIa was administered. It is suggested that fibrinogen levels should be corrected during PPH resuscitation before rFVIIa use is considered.

Active transport to school as part of a broader habit of walking and cycling among South Australian youth.

This study examined whether active commuting to and from school was associated with more frequent walking and cycling to other neighborhood destinations. Parents reported on free-time physical activity and frequency of active commuting among 1,643 South Australians (9-15 years), as well as their perceptions of risk associated with active commuting in the neighborhood. Groups were formed on the basis of active and motorized transport to and from school and compared on the frequency of walking and cycling to other neighborhood destinations. Those who actively commuted between home and school were approximately 30% more likely to actively commute to other neighborhood destinations, independent of age, free-time physical activity, and neighborhood risk. Active commuting to and from school is part of a broader habit of walking and cycling in the neighborhood among school age South Australians. The advantages of promoting active transport between home and school might extend beyond the energy expenditure of that journey alone.