Sympathetic Baroreflex Sensitivity is Enhanced in Postmenopausal Women.

The sympathetic nervous system is critical for regulating blood pressure (BP) via the arterial baroreflex as well as sympathetic transduction in the peripheral vasculature. These mechanisms interact and both may be altered with aging and impacted by menopause. Although age-related decreases in sympathetic transduction have been demonstrated in women, it remains unclear whether sympathetic baroreflex sensitivity (BRS) is impaired in postmenopausal women (POST). We tested the hypothesis that sympathetic BRS would be enhanced in POST compared to premenopausal women (PRE). We examined beat-by-beat BP and muscle sympathetic nerve activity (MSNA) in 19 PRE (22±2 yr, 22±3 kg/m2) and 12 POST (57±5 yr, 24±2 kg/m2) during 10 minutes of rest. Spontaneous sympathetic BRS was quantified as the slope of a linear regression between MSNA burst incidence and diastolic BP. Sympathetic transduction to mean arterial pressure (MAP) for the 10-cardiac cycles following spontaneous MSNA bursts was assessed via signal averaging method. Resting MAP was similar (PRE: 82±8 vs. POST: 85±8 mm Hg, P=0.43), whereas resting MSNA was elevated in POST (PRE: 10±6 vs. POST: 45±16 bursts/100 heartbeats, P<0.0001). Spontaneous sympathetic BRS was enhanced in POST (PRE: -2.0±1.2 vs. POST: -5.2±1.9 bursts/beat/mm Hg, P<0.0005). Sympathetic transduction to MAP was attenuated in POST (Time: P<0.001, Group: P<0.001, Interaction: P<0.01). These data suggest that sympathetic BRS may be enhanced in POST. Consistent with recent hypotheses, enhanced sensitivity of the arterial baroreflex's neural arc may signify a compensatory response to reduced efficiency of the peripheral arterial baroreflex arc (i.e., sympathetic transduction) to preserve BP buffering capacity.

Determinants of physical activity promotion in primary care from the patient perspective of people at risk of or living with chronic disease: a COM-B analysis.

BACKGROUND: Chronic disease (CD) accounts for more than half of the overall global disease burden and physical activity (PA) is an established evidence-based strategy for the prevention and management of CD. Global policy emphasises the value of embedding PA into primary healthcare, highlighting the positive effects on PA behaviour. However, there is limited implementation of PA protocols in primary care, and research is needed to guide its integration into routine practice. The voice of the patient is underrepresented in the literature, resulting in the absence of critical insights into determinants of PA promotion in primary care. The purpose of the research was to identify the perspectives of people at risk of or living with CD on the determinants of PA promotion in primary care and to map these determinants across the six COM-B constructs. METHODS: Semi-structured interviews (n = 22), guided by the COM-B model were conducted with people aged 35-60 years, at risk of or living with CD and not meeting the PA guidelines. A hybrid analytic approach of thematic inductive and deductive analysis was applied to the participant transcripts guided by a COM-B informed coding framework. RESULTS: In total, 37 determinants across constructs related to capability, opportunity and motivation were prominent, examples include; physical capability constraints, the conflation of exercise with weight management, credibility of the health services in PA advice, communication styles in PA promotion, expectations of tailored support for PA, social support, accessibility, and integration of PA into routine habits. CONCLUSION: Exploring the determinants of PA promotion through the lens of the COM-B model facilitated a systematic approach to understanding the primary care user perspective of the healthcare professional (HCP) broaching the topic of PA. Findings emphasise the value of HCPs being supported to broach the issue of PA in a therapeutic and patient-centred manner using diverse and flexible approaches, while highlighting the importance of tailored, accessible PA opportunities that build self-efficacy and foster social support. The research provides valuable learnings to support PA promotion and the development of strategies in primary care through encompassing the perspective of those living with or at risk of CD.

Co-designing a Physical Activity Service for Refugees and Asylum Seekers Using an Experience-Based Co-design Framework.

People from refugee and asylum seeker backgrounds resettling in Australia often experience intersecting risks for poor mental and physical health. Physical activity can promote better health outcomes, however there are limited programs tailored for this population. Therefore, understanding how to support refugees and asylum seekers to engage in physical activity is crucial. This paper aims to describe how the experience-based co-design (EBCD) process was used to identify priorities for a new physical activity service for refugees and asylum seekers. Using an EBCD framework we conducted qualitative interviews and co-design workshops with service users (refugees and asylum seekers living in the community) and service providers at a community Centre in Sydney, Australia. Sixteen participants, including eight service users and eight service providers engaged in the EBCD process over 12-months. The interviews revealed common themes or 'touchpoints' including barriers and enablers to physical activity participation such as access, safety and competing stressors. Subsequent co-design focus groups resulted in the establishment of five fundamental priorities and actionable strategies; ensuring cultural and psychological safety, promoting accessibility, facilitating support to access basic needs, enhancing physical activity literacy and fostering social connection. Using EBCD methodology, this study used the insights and lived experiences of both service users and providers to co-design a physical activity service for refugees and asylum seekers which is safe, supportive, social and accessible. The results of the implementation and evaluation of the program are ongoing.

Inverse Association between Exercising Blood Pressure Response and Left Ventricular Chamber Size and Mass in Women Who Habitually Resistance Train.

Exercise is a major modifiable lifestyle factor that leads to temporarily increased systolic blood pressure (SBP), which is thought to influence left ventricular mass normalized to body surface area (LVM/BSA). This relationship has never been studied in women who habitually perform resistance exercise. PURPOSE: To determine if a direct correlation exists between the SBP response to resistance exercise (change from rest; eSBP) and LVM/BSA in young healthy women who habitually resistance train. METHODS: Leg extension resistance exercise was performed while continuously monitoring blood pressure using finger plethysmography. LVM was estimated using echocardiography. Data are shown as mean ± SD. RESULTS: Thirty-one women participated (age 23 ± 3 years, height 164 ± 7 cm, body mass 63.7 ± 10.3 kg). Resting SBP (110 ± 8 mmHg, r = 0.355, p = 0.049) was shown to be directly correlated to LVM/BSA (72.0 ± 28.4 g/m2). Conversely, eSBP (30.8 ± 14.6 ∆mmHg, r = -0.437, p = 0.014) was inversely related to LVM/BSA. eSBP was not correlated to interventricular septum width (0.88 ± 0.12 cm, r = -0.137, p = 0.463) or posterior wall thickness (0.91 ± 0.15 cm, r = -0.084, p = 0.654). eSBP was inversely related to left ventricle internal diameter during diastole (LVIDd) (4.25 ± 0.33 cm, r = -0.411, p = 0.021). CONCLUSION: Counter to the hypothesis, these data suggest an inverse association between eSBP during resistance exercise and LVM/BSA in healthy young women who resistance train. This relationship is due to a smaller LVIDd with greater eSBP.

Impact of a family history of hypertension and physical activity on left ventricular mass.

BACKGROUND: A positive family history of hypertension (FHH) (+FHH) is associated with elevated left ventricular mass (LVM). Regular physical activity (PA) may eliminate differences in LVM between +FHH and negative family history of hypertension (-FHH) adults. The aim of this study was to determine if a +FHH is associated with a greater LVM compared to a -FHH group within a sample of young, mostly active healthy adults with and without statistically controlling for PA. METHODS: Healthy young (18-32 y) participants self-reported FHH status and habitual moderate and vigorous PA frequency. Participants then underwent an echocardiogram. RESULTS: Of the 61 participants, 32 (M=11, W=21; non-active=8) reported -FHH and the remaining 29 (M=13, W=16; non-active=2) reported a +FHH. Mann-Whitney tests found the +FHH group had greater LVM (-FHH 129.5±41.8, +FHH 155.2±42.6 g, P=0.015) and LVM/body surface area (BSA) (-FHH 73.5±17.4, +FHH 88.4±17.3 g/m2, P=0.004). Separate ANCOVA models accounting for moderate and vigorous PA found that FHH status independently predicted LVM/BSA and PA frequencies were significant modifiers (ANCOVA controlling moderate PA: FHH status P=0.004, partial η2=0.133; moderate PA P=0.020, partial η2=0.089), (ANCOVA controlling vigorous PA: FHH status P=0.004, partial η2=0.132; vigorous PA P=0.007, partial η2=0.117). CONCLUSIONS: This analysis suggests that physically active young adults with a +FHH have elevated LVM compared to their -FHH counterparts. This finding is independent of their habitual moderate and vigorous physical activity frequencies.

Validation of the Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) questionnaire for adults.

BACKGROUND: The Collaborative Outcome study on Health and Functioning during Infection Times (COH-FIT; www.coh-fit.com) is an anonymous and global online survey measuring health and functioning during the COVID-19 pandemic. The aim of this study was to test concurrently the validity of COH-FIT items and the internal validity of the co-primary outcome, a composite psychopathology "P-score". METHODS: The COH-FIT survey has been translated into 30 languages (two blind forward-translations, consensus, one independent English back-translation, final harmonization). To measure mental health, 1-4 items ("COH-FIT items") were extracted from validated questionnaires (e.g. Patient Health Questionnaire 9). COH-FIT items measured anxiety, depressive, post-traumatic, obsessive-compulsive, bipolar and psychotic symptoms, as well as stress, sleep and concentration. COH-FIT Items which correlated r ≥ 0.5 with validated companion questionnaires, were initially retained. A P-score factor structure was then identified from these items using exploratory factor analysis (EFA) and confirmatory factor analyses (CFA) on data split into training and validation sets. Consistency of results across languages, gender and age was assessed. RESULTS: From >150,000 adult responses by May 6th, 2022, a subset of 22,456 completed both COH-FIT items and validated questionnaires. Concurrent validity was consistently demonstrated across different languages for COH-FIT items. CFA confirmed EFA results of five first-order factors (anxiety, depression, post-traumatic, psychotic, psychophysiologic symptoms) and revealed a single second-order factor P-score, with high internal reliability (ω = 0.95). Factor structure was consistent across age and sex. CONCLUSIONS: COH-FIT is a valid instrument to globally measure mental health during infection times. The P-score is a valid measure of multidimensional mental health.

A qualitative evaluation of an exercise practitioner in an outpatient child and adolescent mental health service.

BACKGROUND: Physical activity interventions can confer a range of physical and mental health benefits among young people with mental disorders. In some contexts, such as Ireland, integrated physical activity is not easily available within child and adolescent mental health services. Therefore, an interagency pilot intervention was established in a child and adolescent mental health service in Ireland with the integration of a novel exercise practitioner into the multidisciplinary mental health team. OBJECTIVE: A qualitative evaluation was conducted to understand the impact of the pilot intervention and to understand issues of implementation that arose throughout. METHODS: In-depth qualitative interviews with service users' parents/guardians (N = 3) and a single focus group with existing service providers (N = 3), framed by the RE-AIM framework were conducted to evaluate the pilot intervention. Data were analysed using thematic analysis to explore themes. RESULTS: Three overarching themes were identified. These were as follows: (i) Making changes toward healthier physical activity behaviours; (ii) An intervention of therapeutic holism; and (iii) The integrated service delivery. CONCLUSIONS: This research provides insight on the value of a novel integrated exercise practitioner in outpatient young persons' mental health services in Ireland, indicating an enhanced and complimentary therapeutic service. These findings will be helpful for integrating Exercise Practitioners in this setting going forward.

Oxygen Consumption and Blood Pressure Are Not Influenced by Use of a Backpack Hip Strap.

INTRODUCTION: Several studies have explored the effect of backpack carriage on physiologic responses while walking, but few have focused specifically on the influence of the use of a hip strap on these responses. The aim of this study was to investigate the effect of a backpack hip strap on physiologic responses when walking at a moderate intensity while carrying a backpack with a standardized relative load of 30% of the wearer's body mass. METHODS: Twenty-three healthy, active participants carrying backpacks walked on a treadmill at a speed and grade that elicited 40-50% of their heart rate reserve. Participants completed 2 counterbalanced 30-min trials, one with the hip strap in the strapped condition and one with the hip strap unfastened. Metabolic, heart rate, blood pressure, and muscle oxygen saturation (SmO2) responses were recorded during both trials. For each variable, 5-min intervals were averaged at baseline, 5, 10, 15, 20, 25, and 30 min. A repeated measures ANOVA test was used to evaluate the differences between the conditions at each time point. Data reported are the values from the final 5-min interval (30 min) and are reported as mean±SD. RESULTS: No differences were found between strapped and unstrapped trials for oxygen consumption (strapped 21.9±4.2 mL·kg-1·min-1; unstrapped 22.0±4.4 mL·kg-1·min-1, P=0.842), Δmean arterial pressure (strapped +5±17 Δmm Hg; unstrapped +12±14 Δmm Hg, P=0.128) or muscle oxygen saturation of the quadriceps (strapped 86±15%; unstrapped 90±12%, P=0.359) and calf (strapped 73±19%; unstrapped 81±12%, P=0.888). CONCLUSIONS: These results suggest that wearing a hip strap does not influence physiologic responses up to 30 min of moderate intensity walking while carrying 30% of the wearer's mass.

The effects of a respiratory training mask on steady-state oxygen consumption at rest and during exercise.

No studies have directly measured ventilatory and metabolic responses while wearing a respiratory training mask (RTM) at rest and during exercise. Eleven aerobically fit adults (age: 21 ± 1 years) completed a randomized cross-over study while wearing an RTM or control mask during cycling at 50% Wmax. An RTM was retrofitted with a gas collection tube and set to the manufacturer's "altitude resistance" setting of 6,000 ft (1,800 m). Metabolic gas analysis, ratings of perceived exertion, and oxygen saturation (SpO2) were measured during rest and cycling exercise. The RTM did not affect metabolic, ventilation, and SpO2 at rest compared to the control mask (all, effect of condition: P > 0.05). During exercise, the RTM blunted respiratory rate and minute ventilation (effect of condition: P < 0.05) compared to control. Similar increases in VO2 and VCO2 were observed in both conditions (both, effect of condition: P > 0.05). However, the RTM led to decreased fractional expired O2 and increased fractional expired CO2 (effect of condition: P < 0.05) compared to the control mask. In addition, the RTM decreased SpO2 and increased RPE (both, effect of condition: P < 0.05) during exercise. Despite limited influence on ventilation and metabolism at rest, the RTM reduces ventilation and disrupts gas concentrations during exercise leading to modest hypoxemia.

Naltrexone alters cardiovascular function following acute forced swimming in mice.

Purpose: Naltrexone (NTX) is an opioid antagonist that can reverse the physiological effects of opioid receptors when bound. Opioid receptors have been found to play a role in cardiovascular (CV) function, and thus, binding of NTX may alter CV activity at rest and in response to acute and chronic exercise (EX). We hypothesized that opioid receptor blockade will alter the typical CV responses following acute EX. Methods: We assessed the effects of opioid receptor blockade on CV function via echocardiography in mice following an acute bout of forced swimming (FSw), a model of rodent EX. We administered opioid receptor antagonist, NTX, or saline in mice before FSw and in the absence of an FSw perturbation. Furthermore, we assessed how NTX can influence maximal EX capacity on a rodent treadmill. Results: Our data shows that NTX administration does not decrease maximal EX capacity in mice (P > 0.05). However, NTX attenuated cardiac output following FSw (FSw = 52.5 ± 2.5 ml/min vs. FSw + NTX = 32.7 ± 5.2 ml/min; P < 0.05) when compared with saline control (33.5 ± 3.8 ml/min). Further, the administration of NTX in the non-EX condition significantly (P < 0.05) reduced ejection fraction. Conclusion: These data suggest that normal opioid receptor activation is necessary for typical CV function following FSw.

Athero-occlusive Disease Appears to be Associated with Slower Abdominal Aortic Aneurysm Growth: An Exploratory Analysis of the TEDY Trial.

OBJECTIVE: The role of atherosclerosis in abdominal aortic aneurysm (AAA) pathogenesis is controversial. The aim of this study was to compare AAA growth in patients who did and did not have concurrent athero-occlusive disease (AOD). METHODS: Patients with an AAA measuring 35 - 49 mm in maximum diameter were recruited as part of the TElmisartan in the management of abdominal aortic aneurysm (TEDY) trial. TEDY participants who had infrarenal aortic volume and orthogonal diameter assessed by computed tomography at entry and at least one other time point during the trial (12 and/or 24 months) were included. AOD was defined by prior diagnoses of coronary heart disease, stroke, or peripheral arterial disease or an ankle brachial pressure index < 0.90. The increase in AAA volume and diameter from entry for participants who did and did not have AOD was assessed using linear mixed effects models; 131 of the 210 participants recruited to TEDY were included. RESULTS: In an unadjusted analysis, the mean (95% confidence interval) annual increases in AAA volume and diameter for participants with AOD were 3.26 (0.82 - 5.70) cm3 and 0.70 (0.19 - 1.22) mm slower than those without AOD, p = .008 and .007 respectively. The association between AOD and significantly slower AAA growth was maintained after adjusting for risk factors and medications, significantly unequally distributed between participants with and without an AOD diagnosis. CONCLUSION: In an exploratory analysis of a selective cohort from the TEDY trial, AOD was associated with slower AAA growth. Validation of these findings in other cohorts is needed.

Physical and mental health impact of COVID-19 on children, adolescents, and their families: The Collaborative Outcomes study on Health and Functioning during Infection Times - Children and Adolescents (COH-FIT-C&A).

BACKGROUND: The COVID-19 pandemic has altered daily routines and family functioning, led to closing schools, and dramatically limited social interactions worldwide. Measuring its impact on mental health of vulnerable children and adolescents is crucial. METHODS: The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT - www.coh-fit.com) is an on-line anonymous survey, available in 30 languages, involving >230 investigators from 49 countries supported by national/international professional associations. COH-FIT has thee waves (until the pandemic is declared over by the WHO, and 6-18 months plus 24-36 months after its end). In addition to adults, COH-FIT also includes adolescents (age 14-17 years), and children (age 6-13 years), recruited via non-probability/snowball and representative sampling and assessed via self-rating and parental rating. Non-modifiable/modifiable risk factors/treatment targets to inform prevention/intervention programs to promote health and prevent mental and physical illness in children and adolescents will be generated by COH-FIT. Co-primary outcomes are changes in well-being (WHO-5) and a composite psychopathology P-Score. Multiple behavioral, family, coping strategy and service utilization factors are also assessed, including functioning and quality of life. RESULTS: Up to June 2021, over 13,000 children and adolescents from 59 countries have participated in the COH-FIT project, with representative samples from eleven countries. LIMITATIONS: Cross-sectional and anonymous design. CONCLUSIONS: Evidence generated by COH-FIT will provide an international estimate of the COVID-19 effect on children's, adolescents' and families', mental and physical health, well-being, functioning and quality of life, informing the formulation of present and future evidence-based interventions and policies to minimize adverse effects of the present and future pandemics on youth.

Influence of Age and Estradiol on Sympathetic Nerve Activity Responses to Exercise in Women.

INTRODUCTION: Postmenopausal women (PMW) display exaggerated increases in blood pressure (BP) during exercise, yet the mechanism(s) involved remain unclear. Moreover, research on the impact of menopausal changes in estradiol on cardiovascular control during exercise are limited. Herein, we tested the hypothesis that sympathetic responses during exercise are augmented in PMWcompared with young women (YW), and estradiol administration attenuates these responses. METHODS: Muscle sympathetic nerve activity (MSNA) and mean arterial pressure (MAP) were measured in 13 PMW (58 ± 1 yr) and 17 YW (22 ± 1 yr) during 2 min of isometric handgrip. Separately, MSNA and BP responses were measured during isometric handgrip in six PMW (53 ± 1 yr) before and after 1 month of transdermal estradiol (100 µg·d-1). A period of postexercise ischemia (PEI) to isolate muscle metaboreflex activation followed all handgrip bouts. RESULTS: Resting MAP was similar between PMW and YW, whereas MSNA was greater in PMW (23 ± 3 vs 8 ± 1 bursts per minute; P < 0.05). During handgrip, the increases in MSNA (PMW Δ16 ± 2 vs YW Δ6 ± 1 bursts per minute; P < 0.05) and MAP (PMW Δ18 ± 2 vs YW Δ12 ± 2 mm Hg; P < 0.05) were greater in PMW and remained augmented during PEI. Estradiol administration decreased resting MAP but not MSNA in PMW. Moreover, MSNA (PMW (-E2) Δ27 ± 8 bursts per minute versus PMW (+E2) Δ12 ± 5 bursts per minute; P < 0.05) and MAP (Δ31 ± 8 mm Hg vs Δ20 ± 6 mm Hg; P < 0.05) responses during handgrip were attenuated in PMW after estradiol administration. Likewise, MAP responses during PEI were lower after estradiol. CONCLUSIONS: These data suggest that PMW exhibit an exaggerated MSNA and BP response to isometric exercise, due in part to heightened metaboreflex activation. Furthermore, estradiol administration attenuated BP and MSNA responses to exercise in PMW.

The collaborative outcomes study on health and functioning during infection times in adults (COH-FIT-Adults): Design and methods of an international online survey targeting physical and mental health effects of the COVID-19 pandemic.

BACKGROUND: . High-quality comprehensive data on short-/long-term physical/mental health effects of the COVID-19 pandemic are needed. METHODS: . The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) is an international, multi-language (n=30) project involving >230 investigators from 49 countries/territories/regions, endorsed by national/international professional associations. COH-FIT is a multi-wave, on-line anonymous, cross-sectional survey [wave 1: 04/2020 until the end of the pandemic, 12 months waves 2/3 starting 6/24 months threreafter] for adults, adolescents (14-17), and children (6-13), utilizing non-probability/snowball and representative sampling. COH-FIT aims to identify non-modifiable/modifiable risk factors/treatment targets to inform prevention/intervention programs to improve social/health outcomes in the general population/vulnerable subgrous during/after COVID-19. In adults, co-primary outcomes are change from pre-COVID-19 to intra-COVID-19 in well-being (WHO-5) and a composite psychopathology P-Score. Key secondary outcomes are a P-extended score, global mental and physical health. Secondary outcomes include health-service utilization/functioning, treatment adherence, functioning, symptoms/behaviors/emotions, substance use, violence, among others. RESULTS: . Starting 04/26/2020, up to 14/07/2021 >151,000 people from 155 countries/territories/regions and six continents have participated. Representative samples of ≥1,000 adults have been collected in 15 countries. Overall, 43.0% had prior physical disorders, 16.3% had prior mental disorders, 26.5% were health care workers, 8.2% were aged ≥65 years, 19.3% were exposed to someone infected with COVID-19, 76.1% had been in quarantine, and 2.1% had been COVID 19-positive. LIMITATIONS: . Cross-sectional survey, preponderance of non-representative participants. CONCLUSIONS: . Results from COH-FIT will comprehensively quantify the impact of COVID-19, seeking to identify high-risk groups in need for acute and long-term intervention, and inform evidence-based health policies/strategies during this/future pandemics.

The reproducibility of measuring maximum abdominal aortic aneurysm diameter from ultrasound images.

BACKGROUND: Accurate repeat assessment of the diameter of an abdominal aortic aneurysm (AAA) is important. This study investigated the reproducibility of different methods of measuring AAA diameter from ultrasound images. METHODS: Fifty AAA patients were assessed by ultrasound. Maximum AAA diameter was measured independently by three trained observers on two separate occasions using a standardised protocol. Five diameters were measured from each scan, three in the anterior-posterior (AP) and two in the transverse (TV) plane, including inner-to-inner (ITI), outer-to-outer (OTO) and leading edge-to-leading edge (LETLE). Intra- and inter-observer reproducibility were reported as reproducibility coefficients. Statistical comparison of methods was performed using linear mixed effects models. RESULTS: Intra-observer reproducibility coefficients (AP LETLE 2.2 mm; AP ITI 2.4 mm; AP OTO 2.6 mm) were smaller than inter-observer reproducibility coefficients (AP LETLE 4.6 mm: AP ITI 4.5; and AP OTO 4.8 mm). There was no statistically significant difference in intra-observer reproducibility of three types of measurements performed in the AP plane. Measurements obtained in the TV plane had statistically significant worse intra-observer reproducibility than those performed in the AP plane. CONCLUSIONS: This study suggests that the comparison of maximum AAA diameter between repeat images is most reproducibly performed by a single trained observer measuring diameters in the AP plane.

Otopathogen interactions in the nasopharynx of children, and the predictive value of nasopharyngeal aspirate culture for the aetiology of upper respiratory infections.

AIM: To evaluate nasopharyngeal aspirate cultures for screening otopathogen carriage in the adenoid in children 2-7 years of age. METHODS: Thirty-seven children, 2-7 years of age, scheduled for adenoidectomy were enrolled into this prospective study at Rockhampton, Australia. Adenoid biopsy and nasopharyngeal aspirate bacteriology were assessed by conventional culture. Demographic and environmental data were collected by questionnaire. Statistical analyses for descriptive, comparison and logistic regression tests between microbial, demographic, environmental and clinical groups were applied. RESULTS: Streptococcus pneumoniae, Staphylococcus aureus, non-typeable Haemophilus influenzae and Moraxella catarrhalis were detected in 38, 38, 35 and 24% of cases, respectively. Streptococcus pneumoniae was an independent determinant for non-typeable H. influenzae and S. aureus colonisation, and S. aureus was an independent determinant for S. pneumoniae colonisation. The nasopharyngeal aspirate otopathogen cultures were strong predictors for otopathogens in the adenoid, with moderate-high test accuracy for all otopathogens (receiver operator characteristics area under the curve ranging from 71 to 97% for the otopathogens tested). Children with positive non-typeable H. influenzae, M. catarrhalis, S. pneumoniae and S. aureus nasopharyngeal aspirate cultures were more likely to have the equivalent species in adenoid cultures (positive likelihood ratios = undefined, 15.0, 9.09 and 5.85, respectively). CONCLUSIONS: This study provides evidence that nasopharyngeal aspirate cultures are an indicator of otopathogens in the adenoid. Nasopharyngeal aspirate cultures may provide clinicians with information that informs clinical management. Strategies for improved management to reduce otopathogen carriage could reduce the prevalence of chronic upper respiratory infections that contribute to adenoidectomy.

Young healthy adults with a family history of hypertension have increased microvascular reactivity but decreased macrovascular function.

OBJECTIVE: To determine whether, like hypertensives, normotensive adults with a family history of hypertension (+FHH) display lower microvascular reactivity and conduit artery function than normotensive adults without a family history of hypertension (-FHH). METHODS: A forearm vascular occlusion test was performed on healthy normotensive adults while resting in the supine position. A near-infrared spectroscopy sensor placed on the forearm measured skeletal muscle oxygen saturation kinetics to determine microvascular reactivity. Simultaneously, an ultrasound probe placed on the brachial artery above the occlusion cuff was used to assess flow-mediated dilation; a test of macrovascular function. RESULTS: Twenty-two participants were included in this investigation (-FHH n = 13, +FHH n = 9). Following cuff release, the resaturation slope (1st 10 s median ± SD, -FHH 2.76 ± 2.10, +FHH 5.59 ± 2.47%/s; p = .036) was greater in +FHH when accounting for the magnitude and rate of the decrease in skeletal muscle oxygen saturation during occlusion. Conversely, flow-mediated dilation (median ± SD, -FHH 5.96 ± 5.22, +FHH 4.10 ± 3.17%∆; p = .031) was lower in +FHH when accounting for baseline artery diameter and shear rate. CONCLUSIONS: Young +FHH adults have altered microvascular and macrovascular reactivity compared with young -FHH adults.

Exploring the Experiences of Physical Activity among Key Stakeholders in Rehabilitation and Recovery Mental Health Services.

Physical activity has therapeutic benefits for mental health service users. To date, there is limited evidence that has brought together the experiences of physical activity for service users and key multi-disciplinary service providers that support activity in outpatient settings, particularly in contexts where activity is not well integrated into policy and care structures. Previous research has relied on homogenous samples of either service users or service providers of a specific discipline, and key stakeholders like peer-support workers are under-represented. This research explored and thematically analysed multi-stakeholder (service users, n = 6; and service providers, n = 8) experiences of physical activity in outpatient mental health service in Ireland using phenomenologically influenced qualitative interviews. Two salient themes were identified; 'The challenges of being physically active in recovery' and 'Physical activity is a tool for recovery'. This research presents an account of the experiences of some of these poorly represented stakeholders such as carers, peer-support workers, doctors and nurse management, in addition to other well represented stakeholders.

Mild dehydration following voluntary water intake reduction does not affect anaerobic power performance.

BACKGROUND: Dehydration is common among athletes. The negative impact of dehydration on aerobic performance is well characterized. However, little is known about the effect of dehydration on anaerobic performance particularly when dehydration results from insufficient water intake, not water loss due to body temperature regulation. The purpose of this study was to examine the effect of dehydration on anaerobic performance following voluntary water intake reduction. METHODS: Fifteen healthy adults completed two exercise sessions, euhydrated (EUD) and dehydrated (DEH). Sessions consisted of baseline anthropometric and blood lactate measurement followed by a 30-second Wingate test and three vertical jump trials to measure anaerobic performance. Additional blood lactate measurements were taken immediately and at 5, 10, and 15 minutes after taking the Wingate test. RESULTS: The dehydration protocol resulted in a reduction in body mass (EUD 69.1±17.2 kg, DEH 68.1±16.6 kg, P=0.039). The 30-s Wingate peak power (EUD 971±302 W, DEH 960±316 W, P=0.578) was not different between conditions, nor was the vertical jump height (EUH 26.4±4.5 cm, DEH 26.6±3.6 cm, P=0.778). Blood lactate (P<0.001) was elevated immediately following the 30-s Wingate test which remained throughout the trial. There were no differences in blood lactate between conditions. CONCLUSIONS: Acute anaerobic power and exercise performance is not negatively affected by voluntary dehydration.