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1.
Artigo em Inglês | MEDLINE | ID: mdl-34769776

RESUMO

BACKGROUND: Muscle soreness after a competition or a training session has been a concern of runners due to its harmful effect on performance. It is not known if stronger individuals present a lower level of muscle soreness after a strenuous physical effort. The aim of this study was to investigate whether the pre-race muscle strength or the V˙O2max level can predict muscle soreness 24, 48 and 72 h after a full marathon in men. METHODS: Thirty-one marathon runners participated in this study (age, 40.8 ± 8.8 years old; weight, 74.3 ± 10.4 kg; height, 174.2 ± 7.6 cm; maximum oxygen uptake, V˙O2max, 57.7 ± 6.8 mL/kg/min). The isokinetic strength test for thigh muscles and the V˙O2max level was performed 15-30 days before the marathon and the participants were evaluated for the subjective feeling of soreness before, 24, 48 and 72 h after the marathon. RESULTS: The participants presented more pain 24 h after the race (median = 3, IQR = 1) than before it (median = 0, IQR = 0) (p < 0.001), and the strength values for the knee extensor muscles were significantly associated with muscle soreness assessed 24 h after the race (p = 0.028), but not 48 (p = 0.990) or 72 h (p = 0.416) after the race. The V˙O2max level was not associated with the muscle pain level at any moment after the marathon. CONCLUSIONS: Marathon runners who presented higher muscular strength for the knee extensor muscles presented lower muscle soreness 24 h after the race, but not after 48 h or 72 h after the race. Therefore, the muscle soreness level 3 days after a marathon race does not depend on muscle strength.


Assuntos
Mialgia , Corrida , Adulto , Humanos , Masculino , Corrida de Maratona , Pessoa de Meia-Idade , Força Muscular , Mialgia/etiologia , Oxigênio , Consumo de Oxigênio
2.
Artigo em Inglês | MEDLINE | ID: mdl-34769884

RESUMO

In elite pool swimmers competing at world class level, mainly athletes from the United States of America and Australia are dominating. Little is known, however, for the nationality of dominating swimmers in elite open-water long-distance swimming races such as the official FINA races over 5 km, 10 km and 25 km-held since 2000. The aim of this study was to investigate the participation and performance trends by nationality of these elite open-water swimmers. Race results from all female and male swimmers competing in 5 km, 10 km and 25 km FINA races between 2000 and 2020 were analyzed. A total of 9819 swimmers competed between 2000 and 2020 in these races. The five countries that figure most times among the top ten in 5 km, 10 km and 25 km races over the years were Italy, Germany, Russia, Brazil and the Netherlands. In 10 km races, considering the all the athletes from each country, male athletes from Germany, Italy, and France presented faster race times than the other countries. In 10 km, female athletes presented no significant difference among the countries. In 5 and 25 km races, there were no differences between countries, for male and female athletes. Moreover, comparing only the 10 best results (top 10) from each country, there were no differences between countries in 5 km, 10 km and 25 km, for male and female athletes. Men were faster than women for all three distances. In summary, male swimmers from Europe (i.e., Germany, Italy, France) are dominating the 10 km FINA races. In the 5 km and 25 km FINA races, there is no dominating nationality, but among the top five countries in the top 10 over the years, three are European countries.


Assuntos
Desempenho Atlético , Água , Atletas , Feminino , Alemanha , Humanos , Masculino , Natação
3.
Front Med (Lausanne) ; 8: 664510, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34765612

RESUMO

Background: The effect of financial incentives on the quality of primary care is of high interest, and so is its sustainability after financial incentives are withdrawn. Objective: To assess both long-term effects and sustainability of financial incentives for general practitioners (GPs) in the treatment of patients with diabetes mellitus based on quality indicators (QIs) calculated from routine data from electronic medical records. Design/Participants: Randomized controlled trial using routine data from electronic medical records of patients with diabetes mellitus of Swiss GPs. Intervention: During the study period of 24 months, all GPs received bimonthly feedback reports with information on their actual treatment as reflected in QIs. In the intervention group, the reports were combined with financial incentives for quality improvement. The incentive was stopped after 12 months. Measurements: Proportion of patients meeting the process QI of annual HbA1c measurements and the clinical QI of blood pressure levels below 140/85 mmHg. Results: A total of 71 GPs from 43 different practices were included along with 3,854 of their patients with diabetes mellitus. Throughout the study, the proportion of patients with annual HbA1c measurements was stable in the intervention group (78.8-78.9%) and decreased slightly in the control group (81.5-80.2%) [odds ratio (OR): 1.21; 95% CI: 1.04-1.42, p < 0.05]. The proportion of patients achieving blood pressure levels below 140/85 mmHg decreased in the control group (51.2-47.2%) and increased in the intervention group (49.7-51.9%) (OR: 1.18; 95% CI: 1.04-1.35, p < 0.05) where it peaked at 54.9% after 18 months and decreased steadily over the last 6 months. Conclusion: After the withdrawal of financial incentives for the GPs after 12 months, some QIs still improved, indicating that 1 year might be too short to observe the full effect of such interventions. The decrease in QI achievement rates after 18 months suggests that the positive effects of time-limited financial incentives eventually wane.

4.
J Pain Res ; 14: 3109-3120, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34675640

RESUMO

Purpose: Low back pain (LBP) is one of the most frequent reasons for medical consultations. Literature suggests a large evidence-performance gap, especially regarding pain management. Therefore, the monitoring of treatment patterns is important to ensure high quality of treatment. This study aimed to describe treatment patterns specific to patients with diagnostic imaging of the spine for LBP. Patients and Methods: The study was retrospective observational and based on health claims data from 2015 to 2019 provided by a Swiss health insurance company covering around 12% of the population. Patients, ≥18 years of age, with diagnostic imaging of the spine were included and observed 12 months before and after imaging. Patients with back surgery or comorbidities associated with the use of pain medications were excluded. Results: In total, 60,822 patients (mean age: 53.5 y, 56.1% female) were included and 85% received at least one pain medication. Of these, non-steroidal anti-inflammatory drugs, paracetamol, or opioids were prescribed in 88.6%, 70.7%, and 40.3% of patients, respectively. Strong opioids were used in 17% of patients given opioids. Patients with combinations of diagnostic imaging methods had the highest odds of receiving pain medication prescriptions (1.81, 95% CI: 1.66, 1.96, P < 0.001). Prescribed defined daily doses corresponded to short-term therapies. Conclusion: Although the majority of patients received non-opioid short-term therapies, we found a substantial use of opioids, and in particular, a relative high usage of strong opioids. Our results highlighted the importance of both patient and healthcare provider awareness regarding the prudent treatment of LBP.

5.
Nutrients ; 13(10)2021 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-34684522

RESUMO

As a key modulator of training adaptations and racing performance, nutrition plays a critical role in endurance runners' success, and the training/racing behaviors of runners are potentially affected by their diet types. The present study aimed to investigate whether distance runners with a vegan diet (i.e., devoid of foods or ingredients from animal sources), vegetarian diet (i.e., devoid of meat and flesh foods), and omnivorous diet (i.e., a mixed diet with no restriction on food sources) have different training and racing patterns in general and based on race distance subgroups. A total of 3835 recreational runners completed an online survey. Runners were assigned to dietary (omnivorous, vegetarian, and vegan) and race distance (<21 km, half-marathon, and marathon/ultra-marathon) groups. In addition to sociodemographic information, a complete profile of data sets focusing on running and racing behaviors/patterns was evaluated using a questionnaire-based epidemiological approach. There were 1272 omnivores (47% females), 598 vegetarians (64% females), and 994 vegans (65% females). Compared to vegans and vegetarians, omnivorous runners prepared for a longer time period for running events, had a higher number of half-marathons and marathons completed with a better finish time, and had more reliance on training under supervision (p < 0.05). The present findings indicate an important association of diet types with patterns of training and racing amongst endurance runners that may be related to different motives of omnivorous, vegetarian, and vegan runners for participating in events.


Assuntos
Atletas/estatística & dados numéricos , Dieta Vegana/estatística & dados numéricos , Dieta Vegetariana/estatística & dados numéricos , Dieta/estatística & dados numéricos , Corrida/estatística & dados numéricos , Adulto , Estudos Transversais , Dieta/métodos , Comportamento Alimentar/fisiologia , Feminino , Humanos , Masculino , Carne , Resistência Física/fisiologia , Inquéritos e Questionários
6.
Eur J Health Econ ; 2021 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-34718899

RESUMO

Low back pain (LBP) is one of the most common musculoskeletal disorders worldwide and a frequent cause for health care utilization with a high economic burden. A large proportion of diagnostic imaging in patients with LBP is inappropriate and can cause more harm than good, which in turn can lead to higher health care costs. The aim of this study was to determine characteristics and health care costs for patients with a diagnostic imaging for LBP in Switzerland. Groupe Mutuel, one of the biggest health care insurance companies in Switzerland and covering approximately 12% of the population, provided data for this analysis. Patients were identified by diagnostic imaging for the lumbar spine in 2016 or 2017. The study period was 2015-2019, that is one year before and two years after the year of imaging. Regression analysis models were used to identify patient variables associated with higher health care costs. A total of 75,296 patients (57% female, mean age: 54.5 years) were included into the study. Magnetic resonance imaging was the most commonly used diagnostic method (44.3%). Patients generated annual mean health care costs of 518,488,470 CHF (466,639,621 Euro) in the whole observation period; 640 million CHF (576 million Euro) in the index year. Overall, costs for LBP patients were 72% higher compared with the costs of no LBP patients. Our findings confirm the economic burden of LBP and highlight the importance of ongoing efforts to improve prevention, diagnostics and patient care in patients with LBP.

7.
JAMA Netw Open ; 4(9): e2121418, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34505889

RESUMO

Importance: In observational studies, patients' treatment outcome expectations have been associated with better outcomes (ie, a placebo response), whereas concerns about adverse side effects have been associated with an in increase in the negative effects of treatments (ie, a nocebo response). Some randomized trials have suggested that communication from clinicians could affect the treatment outcomes by changing patients' expectations. Objective: To investigate whether treatment outcome expectations and reported adverse side effects could be affected by different briefing contents before a minimal acupuncture treatment in patients with chronic low back pain (CLBP). Design, Setting, and Participants: This randomized single-blinded clinical trial was conducted among patients with CLBP at 1 outpatient clinic in Switzerland who had a pain intensity of at least 4 on a numeric rating scale from 0 to 10. Different recruitment channels were used to enroll patients. Data were collected from May 2016 to December 2017 and were analyzed from June to November 2018. Interventions: Patients were randomized to receive either a regular expectation briefing or a high expectation briefing (effectiveness) and either a regular adverse side effect briefing or an intense adverse side effect briefing (adverse side effect) in a 2 × 2 factorial design. The intervention (briefing sessions and written materials) was standardized and delivered before the acupuncture treatment, with additional booster informative emails provided during the 4-week, 8-session acupuncture course. Main Outcomes and Measures: The primary end point was the patients' expectations regarding the effectiveness of the acupuncture treatment (Expectation for Treatment Scale [ETS]) after the briefing and the subsequent pain intensity (numeric rating scale). The primary end point for the adverse side effect briefing was the adverse side effect score at the end of the acupuncture treatment, derived from session-by-session assessments of adverse side effects. Results: A total of 152 patients with CLBP (mean [SD] age, 39.54 [12.52] years; 100 [65.8%] women) were included. The estimated group difference (regular vs high) for the ETS was -0.16 (95% CI -0.81 to 0.50, P = .64), indicating no evidence for a difference between intervention groups. There was also no evidence for a difference in pain intensity at the end of the acupuncture treatment between the groups with different expectation briefings. The adverse side effects score in the group with the intense adverse side effect briefing were estimated to be 1.31 times higher (95% CI, 0.94 to 1.82; P = .11) than after a regular adverse side effect briefing, but the finding was not statistically significant. Conclusions and Relevance: In this study, suggestions regarding treatment benefits (placebo) and adverse side effects (nocebo) did not affect treatment expectations or adverse side effects. Information regarding adverse side effects might require more research to understand nocebo responses. Trial Registration: German Clinical Trials Register Identifier: DRKS00010191.

8.
Children (Basel) ; 8(9)2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34572225

RESUMO

In soccer, accurate kicking skills are important determinants of successful performance. A successful kick must meet several criteria, including speed, accuracy, and timing. In fact, players who are able to kick the ball more accurately under various difficulties, such as time pressure, space constraints, the opponent's pressure, and the distance between the kicking point and the goal, have a clear advantage during soccer games. The aim of the present study was to investigate the effect of exercise difficulty and time-of-day on perceived task difficulty and kicking performance. Accordingly, 32 boys (age: 11 ± 0.7 years; height: 1.45 ± 0.07 m; body-mass: 38.9 ± 7.8 kg) performed shooting accuracy tests under two difficulty levels (distance (long-distance (LD) vs. short-distance (SD)) and time pressure (Without-time-pressure (WTP) vs. With-time-pressure (TP)) at 08:00 h and 17:00 h. Absolute-error, variable-error, and constant-error were evaluated during the kicking tasks, in addition to ball velocity and shooting quality. Moreover, rating-of-perceived-exertion score (RPE), feeling-scale (FS), and perceived difficulty were completed immediately at the end of each test. The results showed that shooting quality was not affected by the time-of-day, but it was better in WTP vs. TP (p < 0.05), and in SD vs. LD (p < 0.05), respectively. Higher values for FS and lower values for RPE were observed in the morning compared to the afternoon (p < 0.05) and in WTP vs. TP (p < 0.05). In conclusion, specific soccer skills of boys were not time-of-day dependent, but they may be associated with time pressure and task difficulty.

9.
Medicina (Kaunas) ; 57(9)2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34577846

RESUMO

Background and objective: Existing research shows that the sex differences in distance-limited ultra-cycling races decreased with both increasing race distance and increasing age. It is unknown, however, whether the sex differences in time-limited ultra-cycling races will equally decrease with increasing race distance and age. This study aimed to examine the sex differences regarding performance for time-limited ultra-cycling races (6, 12, and 24 h). Methods: Data were obtained from the online database of the Ultra-Cycling Marathon Association (UMCA) of time-limited ultra-cycling races (6, 12, and 24 h) from the years 1983-2019. A total of 18,241 race results were analyzed to compare cycling speed between men and women by calendar year, age group (<29; 30-39; 40-49; 50-59; 60-69; >70 years), and race duration. Results: The participation of both men (85.1%) and women (14.9%) increased between 1983 and 2019. The age of peak performance was between 40 and 59 years for men and between 30 and 59 years for women. Between 2000 and 2019, more men (63.1% of male participants and 52.2% of female participants) competed in 24 h races. In the 24 h races, the sex difference decreased significantly in all age groups. Men cycled 9.6% faster than women in the 12 h races and 4% faster in the 24 h races. Both women and men improved their performance significantly across the decades. Between 2000 and 2019, the improvement in the 24 h races were 15.6% for men and 21.9% for women. Conclusion: The sex differences in cycling speed decreased between men and women with increasing duration of ultra-cycling races and with increasing age. Women showed a greater performance improvement than men in the last 20 years. The average cycling speed of men and women started to converge in the 24 h races.


Assuntos
Desempenho Atlético , Caracteres Sexuais , Adulto , Idoso , Ciclismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resistência Física , Fatores Sexuais
10.
PLoS One ; 16(9): e0255952, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34555041

RESUMO

BACKGROUND: The effect of vegan diets on metabolic processes in the body is still controversial in ultra endurance athletes. The study aims to determine gut microbiome adaptation to extreme exercise according to vegan or omnivore diet consumed in ultra-marathoners. We also seek to evaluate long-term vegan diets' effects on redox homeostasis, and muscle fatigue, and assess energy availability. METHODS: Seventy participants will be assigned to the study, including 35 vegan ultra-marathoners and 35 omnivores competing in the Sri-Chinmoy ultra marathon race. Research data will be collected from the participants at four steps (three visits to the research laboratory and the race day) throughout the study. At the first visit (seven days before the race), fecal samples, and anthropometric measurements will be collected. Body composition will be measured using DXA. Participants will be informed about keeping detailed food records and will be asked to record their diet data and activity logs during the entire study period. At second visit, maximum oxygen consumption will be measured on treadmill. On race day, blood samples will be collected immediately before, and 0. min, 2 hours, and 24 hours after the race. Body weight will be measured before and after the race. The blood and fecal samples will be stored at -80 C until analysis. Plasma malondialdehyde, reactive oxygen metabolites, total antioxidant capacity, Heatshockprotein-70, and serum Orosomucoid-1 will be analyzed in blood samples. Fecal samples will be analyzed with shotgun metagenomic analysis and interpreted using bioinformatics pipeline (HumanN2). Statistical tests will be analyzed using SPSS version 23.0 and R Software. DISCUSSION: Study findings will determine the effects of the vegan diet on sports performance, revealing the multiple interactions between host and gut microbiome at the whole metagenomic level. Additionally, results will show the possible adaptation throughout the race by analyzing blood and fecal samples. Furthermore, by assessing energy availability and determining host-metabolite crosstalk for ultra-endurance athletes, possible nutritional deficiencies can be identified. Thus, advanced nutritional strategies can be developed based on metabolic needs. TRIAL REGISTRATION: Current controlled trials, ISRCTN registry 69541705. Registered on 8 December 2019.


Assuntos
Desempenho Atlético/fisiologia , Dieta , Microbioma Gastrointestinal , Corrida de Maratona , Redes e Vias Metabólicas , Metagenoma , Veganos/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto Jovem
11.
Acta Neuropsychiatr ; : 1-6, 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34521487

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic and the necessary social isolation and distancing measures - that were adopted to prevent spreading the virus, including the suspension of university classes - negatively impacted the mental health of young adults. The aim of the current study was to investigate whether returning to online classes, even not presential, during the social isolation of the COVID-19 pandemic, affected the mental health of university students. METHODS: Forty students (10 men and 30 women) (age, 22.3 ± 3.8 years; body mass, 62.5 ± 17.8 kg; height, 165.6 ± 8.7 cm) from undergraduate health courses participated in the study. The students answered a self-administered questionnaire designed to gather personal and quarantine information as well as information about the frequency of depression (PHQ-9) and anxiety (GAD-7) symptoms. The questionnaire was answered before and after the return to online classes. RESULTS: There was a significantly lower frequency of depression symptoms after the return to online classes (Z = -2.27; p = 0.02). However, there was no difference in anxiety symptoms before and after returning to online classes (Z = -0.51; p = 0.61). CONCLUSIONS: Return to online classes positively impacted the mental health (decrease of frequency of depression symptoms) of university students. Future studies are needed to observe whether the changes observed after returning to school are maintained over time.

12.
Bone ; 154: 116217, 2021 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-34583063

RESUMO

BACKGROUND: Osteoporosis is a systemic disease affecting half of women over the age of 50 years. Considering that almost 90% of peak of bone mass is achieved until the second decade of life, ensuring a maximal bone mineral content acquisition may compensate for age-associated bone loss. Among several other factors, physical activity has been recommended to improve bone mass acquisition. However, it is unknown whether athletes involved with sports with different impact loading characteristics differ in regards to bone mass measurements. AIM: To compare the bone mass content, bone mass density and lean mass of young female soccer players (odd-impact loading exercise), handball players (high-impact loading exercises) and non-athletes. METHODS: A total of 115 female handball players (15.5 ± 1.3 years, 165.2 ± 5.6 cm and 61.9 ± 9.3 kg) and 142 soccer players (15.5 ± 1.5 years, 163.7 ± 6.6 cm and 56.5 ± 7.7 kg) were evaluated for body composition using a dual-emission X-ray absorptiometry system, and 136 female non-athletes (data from NHANES) (15.1 ± 1.32 years, 163.5 ± 5.8 cm and 67.2 ± 19.4 kg) were considered as the control. RESULTS: Handball players presented higher bone mass content values than soccer players for upper limbs (294.8 ± 40.2 g and 270.7 ± 45.7 g, p < 0.001), lower limbs (1011.6 ± 145.5 g and 967.7 ± 144.3 g, p = 0.035), trunk (911.1 ± 182.5 g and 841.6 ± 163.7 g, p = 0.001), ribs (312.4 ± 69.9 g and 272.9 ± 58.0 g, p < 0.001), spine (245.1 ± 46.8 g and 222.0 ± 45.1 g, p < 0.001) and total bone mass (2708.7 ± 384.1 g and 2534.8 ± 386.0 g, p < 0.001). Moreover, non-athletes presented lower bone mass content for lower limbs (740.6 ± 132.3 g, p < 0.001), trunk (539.7 ± 98.6 g, p < 0.001), ribs (138.2 ± 29.9 g, p < 0.001), pelvis (238.9 ± 54.6 g, p < 0.001), spine (152.8 ± 26.4 g, p < 0.001) and total bone mass (1987.5 ± 311.3 g, p < 0.001) than both handball and soccer players. Handball players also presented higher bone mass density values than soccer players for trunk, ribs and spine (p < 0.05) and handball and soccer players presented higher bone mass density than non-athletes for all measurements (p < 0.005). Finally, the non-athletes' lower limb lean mass was lower than soccer and handball players values (p < 0.05). CONCLUSION: Adolescent females engaged in handball training for at least one year present higher bone mass contents than those who are engaged in soccer training, which, in turn, present higher bone mass contents than non-athletes. These results might be used by physicians and healthcare providers to justify the choice of a particular sport to enhance bone mass gain in female adolescents.

13.
Nutrients ; 13(8)2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34444935

RESUMO

It has been well-documented that female and male athletes differ in many physiological and psychological characteristics related to endurance performance. This sex-based difference appears to be associated with their nutritional demands including the patterns of supplement intake. However, there is a paucity of research addressing the sex differences in supplement intake amongst distance runners. The present study aimed to investigate and compare supplement intake between female and male distance runners (10 km, half-marathon, (ultra-)marathon) and the potential associations with diet type and race distance. A total of 317 runners participated in an online survey, and 220 distance runners (127 females and 93 males) made up the final sample after a multi-stage data clearance. Participants were also assigned to dietary (omnivorous, vegetarian, vegan) and race distance (10-km, half-marathon, marathon/ultra-marathon) subgroups. Sociodemographic characteristics and the patterns of supplement intake including type, frequency, dosage, and brands were collected using a questionnaire. One-way ANOVA and logistic regression were used for data analysis. A total of 54.3% of female runners and 47.3% male runners reported consuming supplements regularly. The frequency of supplement intake was similar between females and males (generally or across dietary and distance subgroups). There was no significant relationship for sex alone or sex interactions with diet type and race distance on supplement intake (p < 0.05). However, a non-significant higher intake of vitamin and mineral (but not CHO/protein) supplements was reported by vegan and vegetarian (but not by omnivorous) females compared to their male counterparts. In summary, despite the reported findings, sex could not be considered as a strong modulator of supplement intake among different groups of endurance runners.


Assuntos
Suplementos Nutricionais , Comportamento Alimentar , Resistência Física , Corrida , Adulto , Atletas , Estudos Transversais , Dieta/métodos , Dieta Vegana , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Caracteres Sexuais , Fatores Sexuais , Inquéritos e Questionários , Veganos , Vegetarianos , Vitaminas/administração & dosagem
14.
Nutrients ; 13(8)2021 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-34444901

RESUMO

Nutrient deficiency is a common cause of underperformance in endurance athletes, and supplement intake is frequently considered compensatory for vegan and vegetarian athletes specifically. This study aimed to investigate the patterns of supplement intake among vegan, vegetarian, and omnivorous distance (>10 km) runners and its association with age, sex, and race distance. From a total of 317 runners who participated in an online survey, 220 distance runners (mean age: 38.5 years; mean BMI: 21.75 kg/m2) were selected for the final sample after data clearance and assigned to 100 omnivores, 40 vegetarians, or 80 vegans. Sociodemographic information, racing experience, and patterns of supplement intake, including type, frequency, dosage, etc., were collected using a questionnaire. Macronutrient intake was assessed using a food frequency questionnaire. ANOVA and logistic regression were used for data analysis. The prevalence of supplement intake was 51% for total runners and 72% among vegan runners. Age, sex, and race distance had no significant effect on the type of supplement intake (p > 0.05). Compared to omnivores and vegetarians, vegan runners reported consuming more vitamin (but not carbohydrate/protein or mineral) supplements (p < 0.05). Vitamin B12, magnesium, and multivitamin had the most prevalent use amongst micronutrient supplements. This study points to a central role for supplementary nutritional strategies in different groups of distance runners. The present findings may help future investigations by design to identify specific requirements of endurance runners when adhering to specific kinds of diet particularly plant-based diets.


Assuntos
Atletas/estatística & dados numéricos , Suplementos Nutricionais/estatística & dados numéricos , Corrida/estatística & dados numéricos , Veganos/estatística & dados numéricos , Vegetarianos/estatística & dados numéricos , Adulto , Análise de Variância , Estudos Transversais , Dieta/métodos , Inquéritos sobre Dietas , Ingestão de Alimentos , Feminino , Humanos , Modelos Logísticos , Masculino , Substâncias para Melhoria do Desempenho/uso terapêutico , Resistência Física , Inquéritos e Questionários
16.
Nutrients ; 13(8)2021 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-34444770

RESUMO

Testing and prescribing vitamin B12 (also known as cobalamin) is increasing in Switzerland but substantial variation among general practitioners (GPs) with respect to testing has been noted. In this study, we aimed at exploring GPs' mindsets regarding vitamin B12 testing and prescribing. A cross-sectional study was conducted using an online survey distributed by e-mail to Swiss GPs. The questionnaire explored mindsets related to testing and prescribing vitamin B12 in specific clinical situations, as well as testing and prescribing strategies. The questionnaire was sent to 876 GPs and 390 GPs responded (44.5%). The most controversial domains for testing and prescribing vitamin B12 were idiopathic fatigue (57.4% and 43.4% of GPs agreed, respectively) and depressive symptoms (53.0% and 35.4% of GPs agreed, respectively). There was substantial variation among GPs with regard to testing strategies (89.5% of GPS used a serum cobalamin test, 71.3% of GPS used holotranscobalamin, and 27.6% of GPs used homocysteine or methylmalonic acid). Intramuscular injection was the predominantly prescribed route of application (median of 87.5% of the prescriptions). In this study, we focus on discordant mindsets that can be specifically targeted by using educational interventions, and research questions that still need answering specifically about the effectiveness of vitamin B12 for idiopathic fatigue.


Assuntos
Medicina Geral , Clínicos Gerais , Médicos/psicologia , Vitamina B 12/administração & dosagem , Adolescente , Adulto , Anemia/diagnóstico , Anemia/tratamento farmacológico , Atitude do Pessoal de Saúde , Técnicas de Laboratório Clínico , Estudos Transversais , Depressão/diagnóstico , Depressão/tratamento farmacológico , Fadiga/diagnóstico , Fadiga/tratamento farmacológico , Feminino , Humanos , Masculino , Polineuropatias , Padrões de Prática Médica , Inquéritos e Questionários , Suíça , Vitamina B 12/sangue , Deficiência de Vitamina B 12/diagnóstico , Deficiência de Vitamina B 12/tratamento farmacológico , Adulto Jovem
17.
Health Policy ; 125(10): 1305-1310, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34392960

RESUMO

AIMS: In some healthcare systems, physicians are allowed to dispense drugs; in others, drug-dispensing is restricted to pharmacists. Whether physician-dispensing affects patient health is unknown. Thus, we aimed to investigate associations between physician-dispensing and clinical and process measurements in patients with selected long-term conditions indicating increased cardiovascular risk. METHODS: Retrospective cross-sectional study in 2018 based on data from electronic medical records of 22405 patients (73.6% physician-dispensing) in Switzerland with medications for diabetes mellitus, arterial hypertension, or lipid-related disorders. We used multilevel regression models to determine the associations between physician-dispensing and clinical measurements (glycated hemoglobin [HbA1c], systolic blood pressure [sBP], low-density lipoprotein cholesterol [LDL-C]) or process measurements (number of annual clinical measurements, consultations, and drug prescriptions). RESULTS: Median (interquartile range) HbA1c value was 6.8% (6.3-7.5) both for the physician-dispensing and pharmacist-dispensing group, sBP was 137 (126-150) and 136 mmHg (126-149), and LDL-C was 2.3 (1.8-3.0) and 2.5 mmol/L (1.9-3.2). After adjustments, the physician-dispensing group had 4% lower LDL-C levels (p = 0.041), 12% more frequent HbA1c measurements (p = 0001), 16% higher annual consultation rates (p < 0.05 for all conditions), and equal number of different drugs, compared to the pharmacist-dispensing group. CONCLUSIONS: We found no relevant differences in selected clinical measurements between physician- and pharmacist-dispensing, and mixed results in process measurements. Our results do not indicate that one drug-dispensing channel is superior to the other.

18.
Life (Basel) ; 11(7)2021 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-34357079

RESUMO

Although skinfold-derived equations seem to be practical for field application in estimating body fat percentage (BF%) and minimum body mass in Olympic wrestlers, prediction equations applied first need to be cross-validated in Olympic wrestlers to define the best prediction equation. This study aimed to evaluate the most accurate field method to predict BF% in Olympic wrestlers compared to BF% estimated by air displacement plethysmography (ADP). Sixty-one male (body mass 72.4 ± 13.5 kg; height 170.3 ± 7.0 cm; body mass index (BMI) 24.9 ± 3.5 kg.m-2; BF% 8.5 ± 4.9%) and twenty-five female wrestlers (body mass 60.3 ± 9.9 kg; height 161.3 ± 7.1 cm; BMI 23.1 ± 2.5 kg.m-2; BF% 18.7 ± 4.7%) undertook body composition assessments including ADP and nine-site skinfold measurements. Correlations, bias, limits of agreement, and standardized differences between alterations in BF% measured by ADP and other prediction equations were evaluated to validate measures, and multiple regression analyses to develop an Olympic wrestlers-specific prediction formula. The Stewart and Hannan equation for male wrestlers and the Durnin and Womersley equation for female wrestlers provided the most accurate BF% compared to the measured BF% by ADP, with the lowest bias and presented no significant differences between the measured and predicted BF%. A new prediction equation was developed using only abdominal skinfold and sex as variables, predicting 83.2% of the variance. The findings suggest the use of the new wrestler-specific prediction equation proposed in the study as a valid and accurate alternative to ADP to quantify BF% among Olympic wrestlers.

19.
Sao Paulo Med J ; 139(5): 464-475, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34378735

RESUMO

BACKGROUND: Postpoliomyelitis syndrome is a clinical condition that can affect poliomyelitis survivors. OBJECTIVE: Our aim was to evaluate knowledge of poliomyelitis and postpoliomyelitis syndrome among Brazilian healthcare professionals. DESIGN AND SETTING: Cross-sectional study conducted at a Brazilian public higher education institution located in the state of Goiás. METHODS: The participants (n = 578) were Brazilian physicians, physical therapists, nurses, nutritionists and psychologists. A self-administered questionnaire (30 questions) was designed to probe knowledge about poliomyelitis and postpoliomyelitis syndrome. From the questionnaire, we created a structured test to objectively evaluate the knowledge of these professionals. The test was composed of 20 questions and was scored over a range from 0 (totally ill-informed) to 20 (totally well-informed). RESULTS: In general, the physicians, physical therapists and nurses demonstrated better understanding of poliomyelitis and postpoliomyelitis syndrome. The healthcare professionals who had received previous information about poliomyelitis and postpoliomyelitis syndrome had significantly higher scores than those who had never received information (P < 0.001). On average, this difference was approximately 28.6%. CONCLUSIONS: The findings from the present study indicate that there is a critical need for improvement of knowledge about postpoliomyelitis syndrome among Brazilian healthcare professionals. The services provided by these professionals may therefore become compromised. Furthermore, public healthcare initiatives should be implemented to improve knowledge among healthcare professionals.


Assuntos
Pessoal de Saúde , Poliomielite , Brasil , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Humanos
20.
Front Physiol ; 12: 649898, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34305629

RESUMO

The influence of environmental conditions has been investigated for different marathon races, but not for the Berlin Marathon, the fastest marathon race course in the world. The aim of this study was to investigate the potential influence of environmental conditions such as temperature, precipitation, sunshine, and atmospheric pressure on marathon race times in the Berlin Marathon since its first event in 1974-2019. A total of n = 882,540 valid finisher records were available for analysis, of which 724,135 correspond to male and 158,405 to female runners. We performed analyses regarding performance levels considering all finishers, the top 3, the top 10, and the top 100 women and men. Within the 46 years of Berlin marathons under study, there was some level of precipitation for 18 years, and 28 years without any rain. Sunshine was predominant in 25 of the events, whilst in the other 21, cloud cover was predominant. There was no significant trend with time in any of the weather variables (e.g., no increase in temperature across the years). Overall runners became slower with increasing temperature and sunshine duration, however, elite runners (i.e., top 3 and top 10) seemed to run faster and improved their race times when the temperature increased (with women improving more than men). Top 10 women seemed to benefit more from increasing temperatures than top 10 males, and male top 100 runners seemed to benefit more from increasing temperatures than female top 100 runners. In the top three sub-group, no differences were observed between male and female correlations. In summary, in marathoners competing in the Berlin Marathon between 1974 and 2019, increasing temperatures and sunshine duration showed a different effect on different performance levels where overall runners (i.e., the general mass of runners) became slower with increasing temperature and sunshine duration, but elite runners (i.e., top 3, top 10) became faster with increasing temperatures where sex differences exist.

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