Randomized Pilot Study of an Advanced Smart-Pill Bottle as an Adherence Intervention in Patients With HIV on Antiretroviral Treatment.

BACKGROUND: Adherence is critical to achieve the benefits of antiretroviral therapy. A smart-pill bottle service that transmits real-time adherence data via cellular networks to a central service and prompts nonadherent patients with phone or text messages may improve adherence. METHODS: Adults with HIV taking a tenofovir-containing regimen with suboptimal adherence were randomized to adherence counseling ± a smart-pill bottle service for 12 weeks. Tenofovir diphosphate (TFV-DP) levels by dried blood spot, HIV RNA levels, CD4 cell counts, and self-reported adherence were collected. RESULTS: Sixty-three participants (22% women; 48% black, 25% Latino) were randomized: 30 to the smart-pill bottle (2 of whom were lost to follow-up before the baseline visit), and 33 to control arms. At baseline, 49% of participants had HIV RNA ≤20 copies/mL and 61% reported 100% adherence with ART over 4 days. From baseline to week 12, median TFV-DP levels were +252 and -41 fmol/punch in the bottle and control arms, respectively (P = 0.10). Exploratory exclusion of 3 participants with known or suspected drug-drug interactions found median TFV-DP levels of +278 and -38 fmol/punch, respectively (P = 0.04). There were no differences in study discontinuations, HIV RNA suppression, CD4 cell counts, or self-reported adherence at week 12. CONCLUSIONS: In a diverse group of participants with suboptimal adherence to ART, the smart-pill bottle service was associated with higher TFV-DP levels.

Physical qualities and activity profiles of sub-elite and recreational Australian football players.

OBJECTIVES: To investigate the relationship between physical qualities and match activity profiles of recreational Australian football players. DESIGN: Prospective cohort study. METHODS: Forty players from three recreational Australian football teams (Division One, Two and Three) underwent a battery of fitness tests (vertical jump, 10 and 40 m sprint, 6 m × 30 m repeated sprint test, Yo-Yo intermittent recovery level Two and 2-km time trial). The activity profiles of competitive match-play were quantified using 10-Hz Global Positioning System units. RESULTS: Division One players possessed greater maximum velocity, Yo-Yo level Two and 2-km time trial performances than Division Two and Three players. In addition, Division One players covered greater relative distance, and relative distances at moderate- and high-intensities during match-play than Division Two and Three players. Division Two players had better 2-km time trial performances than Division Three players. Positive associations (P < 0.05) were found between 10 m acceleration, maximum velocity, Yo-Yo level Two and 2-km time trial performances and relative distance, and relative distances covered at moderate- and high-intensities during match-play. Moderate relationships were found between vertical jump and relative distance and high-intensity running. CONCLUSIONS: Sub-elite Australian football players competing at a higher level exhibit greater physical qualities and match-play activity profiles than lesser-skilled recreational players. Acceleration and maximum velocity, 2-km time trial and Yo-Yo level Two performances discriminate between players of different playing levels, and are related to physical match performance in recreational Australian football. The development of these qualities is likely to contribute to improved match performance in recreational Australian football players.

Relationship between tests of physical qualities and physical match performance in elite rugby league players.

Previous investigators have reported significant relationships between tests of physical qualities and physical match performance in high-intensity, intermittent team sport (e.g., soccer) players. Although rugby league requires competitors to perform high-intensity running, unlike most other high-intensity intermittent team sports, the physical demands are significantly increased through the large amounts of tackling, wrestling, and grappling that players are required to perform during match play. This study investigated the relationship between tests of physical qualities and match performance in professional rugby league players and determined whether running capacities were associated with the collision and repeated high-intensity effort demands of match play. Thirty-eight elite rugby league players (mean ± SD, age, 23.1 ± 2.7 years) performed tests of repeated sprint ability (12 × 20-m sprints on a 20-second cycle), prolonged high-intensity intermittent running ability (8 × 12-second shuttle sprints on a 48-second cycle), and estimated maximal aerobic power (VO2max) (multistage fitness test). Global positioning system data were collected during 16 professional rugby league matches. Players with better, prolonged, high-intensity intermittent running ability covered greater total distance and greater distance in high-speed running during match play. However, inconsistent relationships were found between tests of running abilities and other match performance variables, with prolonged high-intensity running ability (negative), VO2max (positive), and repeated-sprint ability (no relationship) differentially associated with the total number of collisions and repeated high-intensity effort bouts performed in competition. These findings demonstrate the importance of prolonged high-intensity running ability to the match running performance of elite rugby league players but also highlight the need for game-specific conditioning to prepare players for the high-intensity collision and repeated-effort demands of the game.