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1.
Cancer ; 129(2): 296-306, 2023 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-36367438

RESUMO

BACKGROUND: This study examined associations of device-measured physical activity and sedentary time with quality of life (QOL) and fatigue in newly diagnosed breast cancer patients in the Alberta Moving Beyond Breast Cancer (AMBER) cohort study. METHODS: After diagnosis, 1409 participants completed the SF-36 version 2 and the Fatigue Scale, wore an ActiGraph device on their right hip to measure physical activity, and an activPAL device on their thigh to measure sedentary time (sitting/lying) and steps. ActiGraph data was analyzed using a hybrid machine learning method (R Sojourn package, Soj3x) and activPAL data were analyzed using activPAL algorithms (PAL Software version 8). Quantile regression was used to examine cross-sectional associations of QOL and fatigue with steps, physical activity, and sedentary hours at the 25th, 50th, and 75th percentiles of the QOL and fatigue distributions. RESULTS: Total daily moderate and vigorous physical activity (MVPA) hours was positively associated with better physical QOL at the 25th (ß = 2.14, p = <.001), 50th (ß = 1.98, p = <.001), and 75th percentiles (ß = 1.25, p = .003); better mental QOL at the 25th (ß = 1.73, p = .05) and 50th percentiles (ß = 1.07, p = .03); and less fatigue at the 25th (ß = 4.44, p < .001), 50th (ß = 3.08, p = <.001), and 75th percentiles (ß = 1.51, p = <.001). Similar patterns of associations were observed for daily steps. Total sedentary hours was associated with worse fatigue at the 25th (ß = -0.58, p = .05), 50th (ß = -0.39, p = .06), and 75th percentiles (ß = -0.24, p = .02). Sedentary hours were not associated with physical or mental QOL. CONCLUSIONS: MVPA and steps were associated with better physical and mental QOL and less fatigue in newly diagnosed breast cancer patients. Higher sedentary time was associated with greater fatigue symptoms.


Assuntos
Neoplasias da Mama , Qualidade de Vida , Humanos , Feminino , Estudos de Coortes , Comportamento Sedentário , Neoplasias da Mama/complicações , Neoplasias da Mama/epidemiologia , Estudos Transversais , Exercício Físico , Fadiga/epidemiologia , Fadiga/etiologia
2.
Breast Cancer Res Treat ; 199(3): 533-544, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37055681

RESUMO

PURPOSE: Newly diagnosed breast cancer patients face substantial stress and uncertainty that may undermine their quality of life (QoL). The purpose of the present study was to examine the associations between health-related fitness (HRF) and QoL in newly diagnosed breast cancer patients from the Alberta Moving Beyond Breast Cancer Study. METHODS: Newly diagnosed breast cancer patients with early-stage disease (n = 1458) were recruited between 2012 and 2019 in Edmonton and Calgary, Canada to complete baseline HRF and QoL assessments within 90 days of diagnosis. HRF assessments included cardiorespiratory fitness (VO2peak treadmill test), muscular fitness (upper and lower body strength and endurance tests), and body composition (dual x-ray absorptiometry). QoL was assessed by the Medical Outcomes Study Short Form 36 (SF-36) version 2. We used logistic regression analyses to examine the associations between quartiles of HRF and poor/fair QoL (bottom 20%) after adjusting for key covariates. RESULTS: In multivariable analysis, the least fit groups compared to the most fit groups for relative upper body strength (OR = 3.19; 95% CI = 1.98-5.14), lean mass percentage (OR = 2.31; 95% CI = 1.37-3.89), and relative VO2peak (OR = 2.08; 95% CI = 1.21-3.57) were independently at a significantly higher risk of poor/fair physical QoL. No meaningful associations were found for mental QoL. CONCLUSIONS: The three main components of HRF (muscular fitness, cardiorespiratory fitness, and body composition) were independently associated with physical QoL in newly diagnosed breast cancer patients. Exercise interventions designed to improve these components of HRF may optimize physical QoL and help newly diagnosed breast cancer patients better prepare for treatments and recovery.


Assuntos
Neoplasias da Mama , Aptidão Cardiorrespiratória , Humanos , Feminino , Neoplasias da Mama/terapia , Qualidade de Vida , Aptidão Física , Exercício Físico
3.
BMC Cancer ; 23(1): 500, 2023 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-37268901

RESUMO

BACKGROUND: Decisions to participate in cancer trials are associated with uncertainty, distress, wanting to help find a cure, the hope for benefit, and altruism. There is a gap in the literature regarding research examining participation in prospective cohort studies. The aim of this study was to examine the experiences of newly diagnosed women with breast cancer participating in the AMBER Study to identify potential strategies to support patients' recruitment, retention, and motivation. METHODS: Newly diagnosed breast cancer patients were recruited from the Alberta Moving Beyond Breast Cancer (AMBER) cohort study. Data were collected using semi-structured conversational interviews with 21 participants from February to May 2020. Transcripts were imported into NVivo software for management, organization, and coding. Inductive content analysis was undertaken. RESULTS: Five main concepts associated with recruitment, retention, and motivation to participate were identified. These main concepts included: (1) personal interest in exercise and nutrition; (2) investment in individual results; (3) personal and professional interest in research; (4) burden of assessments; (5) importance of research staff. CONCLUSIONS: Breast cancer survivors participating in this prospective cohort study had numerous reasons for participating and these reasons could be considered in future studies to enhance participant recruitment and retention. Improving recruitment and retention in prospective cancer cohort studies could result in more valid and generalizable study findings that could improve the care of cancer survivors.


Assuntos
Neoplasias da Mama , Humanos , Feminino , Alberta , Estudos de Coortes , Estudos Prospectivos , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/terapia , Pesquisa Qualitativa
4.
Psychooncology ; 32(8): 1268-1278, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37395625

RESUMO

BACKGROUND: Few studies have examined depression after a cancer diagnosis and before initiating adjuvant or neoadjuvant systemic treatments. In this study, we present baseline data on device-measured physical activity, sedentary behaviour, depression, happiness, and satisfaction with life in newly diagnosed breast cancer survivors. PURPOSE: To examine associations of accelerometer-assessed physical activity and sedentary time with depression symptoms and prevalence, happiness, and satisfaction with life. METHODS: Shortly after diagnosis, 1425 participants completed depression, happiness, and satisfaction with life measures and wore an ActiGraph® device on their hip to measure physical activity and the activPALTM inclinometer on their thigh for 7 days to measure sedentary time (sitting/lying) and steps (1384 completed both device measures). ActiGraph® data were analysed using a hybrid machine learning method (R Sojourn package, Soj3x), and activPALTM data using activPALTM algorithms (PAL Software version 8). We used linear and logistic regression to examine associations of physical activity and sedentary time with depression symptom severity (0-27) and depression prevalence, happiness (0-100), and satisfaction with life (0-35). For the logistic regression analysis, we compared participants with none-minimal depression (n = 895) to participants with some depression (that is, mild, moderate, moderately-severe, or severe depression [n = 530]). RESULTS: Participants reported a mean depression symptom severity score of 4.3 (SD = 4.1), a satisfaction with life score of 25.7 (SD = 7.2), and a happiness score of 70 (SD = 21.8). Higher moderate-to-vigorous physical activity (MVPA) was associated with reduced depression symptom severity scores (ß = -0.51, 95% CI: -0.87 to -0.14, p = 0.007). A 1 hour increase in MVPA was associated with a reduced odds of at least mild or worse depression by 24% (Odds Ratio [OR] = 0.76, 95% CI: 0.62-0.94, p = 0.012). Higher daily step counts were associated with lower depression symptom severity scores (ß = -0.16, 95% CI: -0.24 to -0.10, p < 0.001). Perceptions of happiness was associated with higher MVPA (ß = 2.17, 95% CI: 0.17-4.17, p = 0.033). Sedentary time was not associated with depression severity, but higher sedentary time was associated with lower perceptions of happiness (ß = -0.80, 95% CI: -1.48 to -0.11, p = 0.023). CONCLUSIONS: Higher physical activity was associated with fewer depression symptom severity scores and reduced odds of mild or worse depression in women newly diagnosed with breast cancer. Higher physical activity and daily step counts were also associated with stronger perceptions of happiness and satisfaction with life, respectively. Sedentary time was not associated with depression symptom severity or odds of having depression, but was associated with stronger perceptions of happiness.


Assuntos
Neoplasias da Mama , Depressão , Humanos , Feminino , Depressão/epidemiologia , Comportamento Sedentário , Felicidade , Exercício Físico , Satisfação Pessoal , Acelerometria
5.
Support Care Cancer ; 31(9): 537, 2023 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-37624525

RESUMO

PURPOSE: Identifying correlates of physical activity and sedentary behaviour allows for the identification of factors that may be targeted in future behaviour change interventions. This study sought to determine the social-cognitive, demographic, clinical, and health-related correlates of physical activity and sedentary behaviour in individuals recently diagnosed with breast cancer. METHODS: Data were collected from 1381 participants within 90 days of diagnosis in the Alberta Moving Beyond Breast Cancer (AMBER) Cohort Study. Physical activity and sedentary behaviour were measured with ActiGraph GT3X+® and activPALTM devices, respectively, for seven consecutive days. Correlates were collected via a self-reported questionnaire, medical record extraction, or measured by staff. RESULTS: Multivariable models were fitted for sedentary behaviour, light physical activity, and moderate-to-vigorous physical activity. Greater sedentary behaviour was associated with higher body fat percentage (BF%) (ß=0.044; p<0.001) and being single (ß=0.542; p<0.002). Lower light physical activity was associated with higher BF% (ß=-0.044; p<0.001), higher body mass index (ß=-0.039; p<0.001), greater disease barrier influence (ß=-0.006; p<0.001), a HER2-positive diagnosis (ß=-0.278; p=0.001), and being single (ß=-0.385; p= 0.001). Lower moderate-to-vigorous physical activity was associated with higher BF% (ß =-0.011; p=0.001), greater disease barrier influence (ß=-0.002; p<0.001), and being of Asian (ß=-0.189; p=0.002) or Indian/South American (ß=-0.189; p=0.002) descent. Greater moderate-to-vigorous physical activity was associated with having greater intentions (ß=0.049; p=0.033) and planning (ß=0.026; p=0.015) towards physical activity. CONCLUSION: Tailoring interventions to increase physical activity for individuals recently diagnosed with breast cancer may improve long-term outcomes across the breast cancer continuum.


Assuntos
Neoplasias da Mama , Comportamento Sedentário , Humanos , Feminino , Estudos de Coortes , Exercício Físico , Demografia , Cognição
6.
Cancer Causes Control ; 33(3): 441-453, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35064432

RESUMO

PURPOSE: The Alberta Moving Beyond Breast Cancer (AMBER) Study is an ongoing prospective cohort study investigating how direct measures of physical activity (PA), sedentary behavior (SB), and health-related fitness (HRF) are associated with survival after breast cancer. METHODS: Women in Alberta with newly diagnosed stage I (≥ T1c) to IIIc breast cancer were recruited between 2012 and 2019. Baseline assessments were completed within 90 days of surgery. Measurements included accelerometers to measure PA and SB; a graded treadmill test with gas exchange analysis to measure cardiorespiratory fitness (VO2peak); upper and lower body muscular strength and endurance; dual-X-ray absorptiometry to measure body composition; and questionnaires to measure self-reported PA and SB. RESULTS: At baseline, the 1528 participants' mean age was 56 ± 11 years, 59% were post-menopausal, 62% had overweight/obesity, and 55% were diagnosed with stage II or III disease. Based on device measurements, study participants spent 8.9 ± 1.7 h/day sedentary, 4.4 ± 1.2 h/day in light-intensity activity, 0.9 ± 0.5 h/day in moderate-intensity activity, and 0.2 ± 0.2 h/day in vigorous-intensity activity. For those participants who reached VO2peak, the average aerobic fitness level was 26.6 ± 6 ml/kg/min. Average body fat was 43 ± 7.1%. CONCLUSION: We have established a unique cohort of breast cancer survivors with a wealth of data on PA, SB, and HRF obtained through both direct and self-reported measurements. Study participants are being followed for at least ten years to assess all outcomes after breast cancer. These data will inform clinical and public health guidelines on PA, SB, and HRF for improving breast cancer outcomes.


Assuntos
Neoplasias da Mama , Idoso , Alberta/epidemiologia , Neoplasias da Mama/epidemiologia , Estudos de Coortes , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Comportamento Sedentário
7.
Am J Physiol Endocrinol Metab ; 314(6): E605-E619, 2018 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-28655718

RESUMO

In striated muscle, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have differential effects on the metabolism of glucose and differential effects on the metabolism of protein. We have shown that, despite similar incorporation, treatment of C2C12 myotubes (CM) with EPA but not DHA improves glucose uptake and protein accretion. We hypothesized that these differential effects of EPA and DHA may be due to divergent shifts in lipidomic profiles leading to altered proteomic profiles. We therefore carried out an assessment of the impact of treating CM with EPA and DHA on lipidomic and proteomic profiles. Fatty acid methyl esters (FAME) analysis revealed that both EPA and DHA led to similar but substantials changes in fatty acid profiles with the exception of arachidonic acid, which was decreased only by DHA, and docosapentanoic acid (DPA), which was increased only by EPA treatment. Global lipidomic analysis showed that EPA and DHA induced large alterations in the cellular lipid profiles and in particular, the phospholipid classes. Subsequent targeted analysis confirmed that the most differentially regulated species were phosphatidylcholines and phosphatidylethanolamines containing long-chain fatty acids with five (EPA treatment) or six (DHA treatment) double bonds. As these are typically membrane-associated lipid species we hypothesized that these treatments differentially altered the membrane-associated proteome. Stable isotope labeling by amino acids in cell culture (SILAC)-based proteomics of the membrane fraction revealed significant divergence in the effects of EPA and DHA on the membrane-associated proteome. We conclude that the EPA-specific increase in polyunsaturated long-chain fatty acids in the phospholipid fraction is associated with an altered membrane-associated proteome and these may be critical events in the metabolic remodeling induced by EPA treatment.


Assuntos
Ácidos Docosa-Hexaenoicos/farmacologia , Ácido Eicosapentaenoico/farmacologia , Glucose/metabolismo , Metabolismo dos Lipídeos/efeitos dos fármacos , Proteínas de Membrana/efeitos dos fármacos , Músculo Esquelético/efeitos dos fármacos , Proteoma/efeitos dos fármacos , Animais , Metabolismo dos Carboidratos/efeitos dos fármacos , Membrana Celular/efeitos dos fármacos , Membrana Celular/metabolismo , Células Cultivadas , Ácido Eicosapentaenoico/análogos & derivados , Ácidos Graxos/metabolismo , Proteínas de Membrana/metabolismo , Camundongos , Músculo Esquelético/metabolismo , Proteoma/metabolismo , Triglicerídeos/metabolismo
8.
Langmuir ; 34(11): 3395-3404, 2018 03 20.
Artigo em Inglês | MEDLINE | ID: mdl-29444568

RESUMO

The interaction of nonionic surfactant hexaethylene glycol monododecyl ether (C12E6) with a reconstituted cuticular wheat wax film has been investigated by spectroscopic ellipsometry and neutron reflection (NR) to help understand the role of the leaf wax barrier during pesticide uptake, focusing on the mimicry of the actions adjuvants impose on the physical integrity and transport of the cuticular wax films against surfactant concentration. As the C12E6 concentration was increased up to the critical micelle concentration (CMC = 0.067 mM), an increasing amount of surfactant mass was deposited onto the wax film. Alongside surface adsorption, C12E6 was also observed to penetrate the wax film, which is evident from the NR measurements using fully protonated and chain-deuterated surfactants. Furthermore, surfactant action upon the model wax film was found to be physically reversible below the CMC, as water rinsing could readily remove the adsorbed surfactant, leaving the wax film in its original state. Above the CMC, the detergency action of the surfactant became dominant, and a significant proportion of the wax film was removed, causing structural damage. The results thus reveal that both water and C12E6 could easily penetrate the wax film throughout the concentration range measured, indicating a clear pathway for the transport of active ingredients while the removal of the wax components above the CMC must have enhanced the transport process. As the partial removal of the wax film could also expose the underlying cutaneous substrate to the environment and undermine the plant's health, this study has a broad implication to the roles of surfactants in crop care.

9.
Int J Sport Nutr Exerc Metab ; 27(4): 305-313, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28387540

RESUMO

Omega-3 fatty acid (n-3 FA) supplementation could promote adaptation to soccer-specific training. We examined the impact of a 4-week period of n-3 FA supplementation during training on adaptations in 1RM knee extensor strength, 20-m sprint speed, vertical jump power, and anaerobic endurance capacity (Yo-Yo test) in competitive soccer players. Twenty six soccer players were randomly assigned to one of two groups: n-3 FA supplementation (n-3 FA; n = 13) or placebo (n = 13). Both groups performed two experimental trial days. Assessments of physical function and respiratory function were conducted pre (PRE) and post (POST) supplementation. Training session intensity, competitive games and nutritional intake were monitored during the 4-week period. No differences were observed in respiratory measurements (FEV1, FVC) between groups. No main effect of treatment was observed for 1RM knee extensor strength, explosive leg power, or 20 m sprint performance, but strength improved as a result of the training period in both groups (p < .05). Yo-Yo test distance improved with training in the n-3 FA group only (p < .01). The mean difference (95% CI) in Yo-Yo test distance completed from PRE to POST was 203 (66-340) m for n-3 FA, and 62 (-94-217) m for placebo, with a moderate effect size (Cohen's d of 0.52). We conclude that 4 weeks of n-3 FA supplementation does not improve strength, power or speed assessments in competitive soccer players. However, the increase in anaerobic endurance capacity evident only in the n-3 FA treatment group suggests an interaction that requires further study.


Assuntos
Desempenho Atlético , Ácidos Graxos Ômega-3/administração & dosagem , Resistência Física , Futebol/fisiologia , Fenômenos Fisiológicos da Nutrição Esportiva , Adaptação Fisiológica , Adolescente , Adulto , Ácidos Graxos/sangue , Feminino , Volume Expiratório Forçado , Humanos , Masculino , Pico do Fluxo Expiratório , Adulto Jovem
10.
BMC Cancer ; 16: 481, 2016 07 14.
Artigo em Inglês | MEDLINE | ID: mdl-27416835

RESUMO

BACKGROUND: To our knowledge, the Alberta Moving Beyond Breast Cancer (AMBER) Study is the first and only prospective cohort study of breast cancer survivors that includes objectively-measured physical activity (PA), sedentary behavior, health-related fitness (HRF), and biologic mechanisms focused on understanding breast cancer outcomes. The purpose of the present study was to report on the feasibility of recruitment, baseline measurement completion, and the representativeness of the first 500 participants. METHODS: AMBER is enrolling newly diagnosed stage I (≥T1c) to IIIc breast cancer survivors in Alberta, Canada. Baseline assessments are completed soon after diagnosis and include cardiorespiratory fitness, musculoskeletal fitness, body composition, objective and self-reported PA and sedentary behavior, lymphedema, and blood collection. RESULTS: Between July 2012 and November 2014, AMBER recruited its first 500 participants from a pool of 1,447 (35 %) eligible breast cancer survivors. Baseline HRF assessments were completed on ≥85 % of participants with the exception of upper body strength. Collection of ≥4 days/week of monitoring for the Actigraph GT3X® and ActivPAL® were obtained from 90 % of participants. Completion rates were also high for blood (99 %), lymphedema (98 %), and questionnaires (95 %) including patient-reported outcomes and correlates of exercise. The first 500 participants in AMBER are an average age of 56 years, 60 % are overweight or obese, and 58 % have disease stage II or III. CONCLUSION: Despite the modest recruitment rate and younger age, AMBER has demonstrated that many newly diagnosed breast cancer survivors are willing and able to complete a wide array of sophisticated and physically demanding HRF and PA assessments soon after diagnosis. AMBER is a unique breast cancer survivor cohort that may inform future randomized controlled trials on lifestyle and breast cancer outcomes as well as PA behavior change in breast cancer survivors. Moreover, AMBER may also inform guidelines on PA, sedentary behavior, and HRF for improving breast cancer outcomes and survivorship.


Assuntos
Neoplasias da Mama/terapia , Idoso , Alberta , Neoplasias da Mama/psicologia , Exercício Físico , Feminino , Nível de Saúde , Humanos , Pessoa de Meia-Idade , Seleção de Pacientes , Aptidão Física , Estudos Prospectivos , Comportamento Sedentário , Sobreviventes
11.
Philos Trans A Math Phys Eng Sci ; 374(2072)2016 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-27298439

RESUMO

A model has been designed to predict the phase which forms in water for a non-ionic surfactant, at a given concentration and temperature. The full phase diagram is generated by selecting enough data points to cover the region of interest. The model estimates the probability for each one of 10 possible phases and selects the one with the highest likelihood. The probabilities are based on the recursive partitioning of a dataset of 10 000 known observations. The model covers alkyl chain length and branching, ethoxylate head length and number, and end capping of one or more of the ethoxylate chains. The relationship between chemical structure, shape and phase behaviour is discussed.This article is part of the themed issue 'Soft interfacial materials: from fundamentals to formulation'.

12.
J Microsc ; 258(2): 119-26, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25611705

RESUMO

Leaf surfaces are highly complex functional systems with well defined chemistry and structure dictating the barrier and transport properties of the leaf cuticle. It is a significant imaging challenge to analyse the very thin and often complex wax-like leaf cuticle morphology in their natural state. Scanning electron microscopy (SEM) and to a lesser extent Atomic force microscopy are techniques that have been used to study the leaf surface but their remains information that is difficult to obtain via these approaches. SEM is able to produce highly detailed and high-resolution images needed to study leaf structures at the submicron level. It typically operates in a vacuum or low pressure environment and as a consequence is generally unable to deal with the in situ analysis of dynamic surface events at submicron scales. Atomic force microscopy also possess the high-resolution imaging required and can follow dynamic events in ambient and liquid environments, but can over exaggerate small features and cannot image most leaf surfaces due to their inherent roughness at the micron scale. Scanning ion conductance microscopy (SICM), which operates in a liquid environment, provides a potential complementary analytical approach able to address these issues and which is yet to be explored for studying leaf surfaces. Here we illustrate the potential of SICM on various leaf surfaces and compare the data to SEM and atomic force microscopy images on the same samples. In achieving successful imaging we also show that SICM can be used to study the wetting of hydrophobic surfaces in situ. This has potentially wider implications than the study of leaves alone as surface wetting phenomena are important in a range of fundamental and applied studies.


Assuntos
Microscopia de Força Atômica/métodos , Microscopia Eletrônica de Varredura/métodos , Microscopia/métodos , Folhas de Planta/ultraestrutura , Microscopia/instrumentação , Microscopia de Força Atômica/instrumentação , Microscopia Eletrônica de Varredura/instrumentação
13.
Jt Comm J Qual Patient Saf ; 41(11): 483-91, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26484679

RESUMO

BACKGROUND: Sepsis is a leading cause of death, but evidence suggests that early recognition and prompt intervention can save lives. In 2005 Houston Methodist Hospital prioritized sepsis detection and management in its ICU. In late 2007, because of marginal effects on sepsis death rates, the focus shifted to designing a program that would be readily used by nurses and ensure early recognition of patients showing signs suspicious for sepsis, as well as the institution of prompt, evidence-based interventions to diagnose and treat it. METHODS: The intervention had four components: organizational commitment and data-based leadership; development and integration of an early sepsis screening tool into the electronic health record; creation of screening and response protocols; and education and training of nurses. Twice-daily screening of patients on targeted units was conducted by bedside nurses; nurse practitioners initiated definitive treatment as indicated. Evaluation focused on extent of implementation, trends in inpatient mortality, and, for Medicare beneficiaries, a before-after (2008-2011) comparison of outcomes and costs. A federal grant in 2012 enabled expansion of the program. RESULTS: By year 3 (2011) 33% of inpatients were screened (56,190 screens in 9,718 unique patients), up from 10% in year 1 (2009). Inpatient sepsis-associated death rates decreased from 29.7% in the preimplementation period (2006-2008) to 21.1% after implementation (2009-2014). Death rates and hospital costs for Medicare beneficiaries decreased from preimplementation levels without a compensatory increase in discharges to postacute care. CONCLUSION: This program has been associated with lower inpatient death rates and costs. Further testing of the robustness and exportability of the program is under way.


Assuntos
Custos de Cuidados de Saúde , Unidades de Terapia Intensiva , Avaliação em Enfermagem , Sepse/economia , Sepse/mortalidade , Sepse/enfermagem , Redução de Custos , Registros Eletrônicos de Saúde , Mortalidade Hospitalar , Humanos , Inovação Organizacional , Objetivos Organizacionais , Segurança do Paciente , Garantia da Qualidade dos Cuidados de Saúde , Melhoria de Qualidade , Texas/epidemiologia
14.
Can J Diet Pract Res ; 76(2): 76-80, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26067416

RESUMO

The aim of this cross-sectional study was to survey exercise specialists about nutrition counselling practices, their own dietary practices, and to identify potential relationships. An electronic survey was used to examine characteristics and strategies used for assessing and promoting healthy eating to clients. Exercise specialists (n = 94) were recruited through a public registry and through targeted advertising on 2 professional websites in Alberta, Canada. Eighty-five percent of respondents promoted healthy eating to clients. Confidence in assessing and promoting healthy eating was moderate to low. Those with more than 6 years of professional experience reported higher confidence compared with those with less than 1 year of experience in assessing healthy eating (P < 0.05) and promoting healthy eating (P < 0.01). Confidence was higher among those with more professional experience but who did not meet Canada's Food Guide recommendations (P < 0.05). Professional experience, personal dietary practices, and confidence are important characteristics when considering the assessment and promotion of healthy eating by exercise specialists. Promoting collaborative relationships between registered dietitians and exercise specialists would likely benefit exercise specialists when they are assessing and promoting healthy eating among their clients.


Assuntos
Dieta Saudável , Exercício Físico , Comportamento Alimentar , Promoção da Saúde , Adulto , Alberta , Estudos Transversais , Dieta , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Inquéritos e Questionários
15.
J Sports Sci ; 32(3): 239-47, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24168428

RESUMO

The aim of this study was to determine the physical demands of women's rugby union match play using time-motion analysis and heart rate (HR) response. Thirty-eight premier club level female rugby players, ages 18-34 years were videotaped and HRs monitored for a full match. Performances were coded into 12 different movement categories: 5 speeds of locomotion (standing, walking, jogging, striding, sprinting), 4 forms of intensive non-running exertion (ruck/maul/tackle, pack down, scrum, lift) and 3 discrete activities (kick, jump, open field tackle). The main results revealed that backs spend significantly more time sprinting and walking whereas forwards spend more time in intensive non-running exertion and jogging. Forwards also had a significantly higher total work frequency compared to the backs, but a higher total rest frequency compared to the backs. In terms of HR responses, forwards displayed higher mean HRs throughout the match and more time above 80% of their maximum HR than backs. In summary, women's rugby union is characterised by intermittent bursts of high-intensity activity, where forwards and backs have similar anaerobic energy demands, but different specific match demands.


Assuntos
Desempenho Atlético/fisiologia , Exercício Físico/fisiologia , Futebol Americano/fisiologia , Frequência Cardíaca , Movimento , Esforço Físico/fisiologia , Estudos de Tempo e Movimento , Adulto , Feminino , Humanos , Descanso/fisiologia , Corrida/fisiologia , Caminhada/fisiologia , Adulto Jovem
16.
Int J Sport Nutr Exerc Metab ; 24(2): 236-44, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24225560

RESUMO

Acute resistance exercise and L-arginine have both been shown to independently elevate plasma growth hormone (GH) concentrations; however, their combined effect is controversial. The purpose was to investigate the combined effects of resistance exercise and L-arginine supplementation on plasma L-arginine, GH, GH secretagogues, and IGF-1 in strength trained participants. Fourteen strength trained males (age: 25 ± 4 y; body mass: 81.4 ± 9.0 kg; height: 179.4 ± 6.9 cm; and training experience: 6.3 ± 3.4 y) participated in a randomized double-blind crossover design (separated by ~7 days). Subjects reported to the laboratory at 08:00 in a fasted state, consumed L-arginine (ARG; 0.075 g·kg-1 body mass) or a placebo (PLA) before performing an acute bout of resistance exercise (3 sets of 8 exercises, 10 repetitions at ~75% 1RM). Blood samples were collected at rest, before exercise, and at 0, 15, 30, and 60 min of rest-recovery. The ARG condition significantly increased plasma L-arginine concentrations (~120%) while no change was detected in the PLA condition. There were no differences between conditions for GH, GH-releasing hormone, ghrelin, or IGF-1 at any time point. GH-inhibiting hormone was significantly lower in the ARG condition. However, integrated area under the curve for GH was blunted in the ARG condition (L-arginine = 288.4 ± 368.7 vs. placebo = 487.9± 482.0 min·ng·mL1, p < .05). L-arginine ingested before resistance exercise significantly elevated plasma L-arginine concentration but attenuated plasma GH in strength trained individuals despite a lower GHIH. Furthermore our data shows that the GH suppression was not due to a GH or IGF-1 induced autonegative feedback loop.


Assuntos
Arginina/farmacologia , Hormônio do Crescimento Humano/sangue , Força Muscular , Treinamento Resistido , Administração Oral , Adulto , Área Sob a Curva , Arginina/administração & dosagem , Arginina/sangue , Estudos Cross-Over , Método Duplo-Cego , Humanos , Fator de Crescimento Insulin-Like I/metabolismo , Masculino , Aptidão Física/fisiologia , Descanso/fisiologia , Somatostatina/sangue , Adulto Jovem
17.
Int J Sport Nutr Exerc Metab ; 24(2): 188-95, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24225595

RESUMO

The purpose was to investigate the effects of a controlled typical 1-day diet supplemented with two different doses of whey protein isolate on blood amino acid profiles and hormonal concentrations following the final meal. Nine males (age: 29.6 ± 6.3 yrs) completed four conditions in random order: a control (C) condition of a typical mixed diet containing ~10% protein (0.8 g·kg1), 65% carbohydrate, and 25% fat; a placebo (P) condition calorically matched with carbohydrate to the whey protein conditions; a low-dose condition of 0.8 grams of whey protein isolate per kilogram body mass per day (g·kg1·d1; W1) in addition to the typical mixed diet; or a high-dose condition of 1.6 g·kg1·d1 (W2) of supplemental whey protein in addition to the typical mixed diet. Following the final meal, significant (p < .05) increases in total amino acids, essential amino acids (EAA), branch-chained amino acids (BCAA), and leucine were observed in plasma with whey protein supplementation while no changes were observed in the control and placebo conditions. There was no significant group difference for glucose, insulin, testosterone, cortisol, or growth hormone. In conclusion, supplementing a typical daily food intake consisting of 0.8 g of protein·kg1·d1 with a whey protein isolate (an additional 0.8 or 1.6 g·kg1·d1) significantly elevated total amino acids, EAA, BCAA, and leucine but had no effect on glucose, insulin, testosterone, cortisol, or growth hormone following the final meal. Future acute and chronic supplementation research examining the physiological and health outcomes associated with elevated amino acid profiles is warranted.


Assuntos
Aminoácidos/sangue , Suplementos Nutricionais , Hormônios/sangue , Proteínas do Leite/farmacologia , Adulto , Aminoácidos de Cadeia Ramificada/sangue , Glicemia/metabolismo , Dieta , Relação Dose-Resposta a Droga , Hormônio do Crescimento Humano/sangue , Humanos , Hidrocortisona/sangue , Insulina/sangue , Leucina/sangue , Masculino , Refeições , Proteínas do Leite/administração & dosagem , Testosterona/sangue , Proteínas do Soro do Leite , Adulto Jovem
18.
J Sport Health Sci ; 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38697290

RESUMO

BACKGROUND: Newly diagnosed breast cancer patients experience symptoms that may affect their quality of life, treatment outcomes, and survival. Preventing and managing breast cancer-related symptoms soon after diagnosis is essential. The purpose of this study was to investigate the associations between health-related fitness (HRF) and patient-reported symptoms in newly diagnosed breast cancer patients. METHODS: This study utilized baseline data from the Alberta Moving Beyond Breast Cancer Cohort Study that were collected within 90 days of diagnosis. HRF measures included peak cardiopulmonary fitness (peak volume of oxygen consumption (VO2peak)), maximal muscular strength and endurance, flexibility, and body composition. Symptom measures included depression, sleep quality, and fatigue. Adjusted multivariable logistic regression was performed for analyses. RESULTS: Of 1458 participants, 51.5% reported poor sleep quality, 26.5% reported significant fatigue, and 10.4% reported moderate depression. In multivariable-adjusted models, lower relative VO2peak was independently associated with a greater likelihood of all symptom measures, including moderate depression (p < 0.001), poor sleep quality (p = 0.009), significant fatigue (p = 0.008), any symptom (p < 0.001), and multiple symptoms (p < 0.001). VO2peak demonstrated threshold associations with all symptom measures such that all 3 lower quartiles exhibited similar elevated risk compared to the highest quartile. The strength of the threshold associations varied by the symptom measure with odds ratios ranging from ∼1.5 for poor sleep quality to ∼3.0 for moderate depression and multiple symptoms. Moreover, lower relative upper body muscular endurance was also independently associated with fatigue in a dose-response manner (p = 0.001), and higher body weight was independently associated with poor sleep quality in an inverted U pattern (p = 0.021). CONCLUSION: Relative VO2peak appears to be a critical HRF component associated with multiple patient-reported symptoms in newly diagnosed breast cancer patients. Other HRF parameters may also be important for specific symptoms. Exercise interventions targeting different HRF components may help newly diagnosed breast cancer patients manage specific symptoms and improve outcomes.

19.
Int J Sport Nutr Exerc Metab ; 23(4): 369-77, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23319437

RESUMO

L-arginine may enhance endurance performance mediated by two primary mechanisms including enhanced secretion of endogenous growth hormone (GH) and as a precursor of nitric oxide (NO); however, research in trained participants has been equivocal. The purpose was to investigate the effect of acute L-arginine ingestion on the hormonal and metabolic response during submaximal exercise in trained cyclists. Fifteen aerobically trained men (age: 28 ± 5 y; body mass: 77.4 ± 9.5 kg; height: 180.9 ± 7.9 cm; VO2max: 59.6 ± 5.9 ml·kg- 1·min-1) participated in a randomized, double-blind, crossover study. Subjects consumed L-arginine (ARG; 0. 075 g·kg-1 body mass) or a placebo (PLA) before performing an acute bout of submaximal exercise (60 min at 80% of power output achieved at ventilatory threshold). The ARG condition significantly increased plasma L-arginine concentrations (~146%), while no change was detected in the PLA condition. There were no differences between conditions for GH, nonesterified fatty acids (NEFA), lactate, glucose, VO2, VCO2, RER, CHO oxidation, and NOx. There was reduced fat oxidation at the start of exercise (ARG: 0.36 ± 0.25 vs. PLA: 0.42 ± 0.23 g·min-1, p < .05) and an elevated plasma glycerol concentrations at the 45-min time point (ARG: 340.3 vs. PLA: 288.5 µmol·L-1, p < .05) after L-arginine consumption. In conclusion, the acute ingestion of L-arginine did not alter any hormonal, metabolic, or cardio-respiratory responses during submaximal exercise except for a small but significant increase in glycerol at the 45-min time point and a reduction in fat oxidation at the start of exercise.


Assuntos
Arginina/administração & dosagem , Arginina/sangue , Suplementos Nutricionais , Exercício Físico/fisiologia , Resistência Física/efeitos dos fármacos , Adulto , Atletas , Desempenho Atlético , Ciclismo , Glicemia/metabolismo , Estudos Cross-Over , Método Duplo-Cego , Ácidos Graxos não Esterificados/sangue , Hormônio do Crescimento/sangue , Frequência Cardíaca/efeitos dos fármacos , Humanos , Ácido Láctico/sangue , Masculino , Consumo de Oxigênio , Fenômenos Fisiológicos da Nutrição Esportiva , Adulto Jovem
20.
J Strength Cond Res ; 27(10): 2816-22, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23287835

RESUMO

To evaluate the time international canoe polo players spend performing various game activities, measure heart rate (HR) responses during games, and describe the physiological profile of elite players. Eight national canoe polo players were videotaped and wore HR monitors during 3 games at a World Championship and underwent fitness testing. The mean age, height, and weight were 25 ± 1 years, 1.82 ± 0.04 m, and 81.9 ± 10.9 kg, respectively. Time-motion analysis of 3 games indicated that the players spent 29 ± 3% of the game slow and moderate forward paddling, 28 ± 5% contesting, 27 ± 5% resting and gliding, 7 ± 1% turning, 5 ± 1% backward paddling, 2 ± 1% sprinting, and 2 ± 1% dribbling. Sixty-nine (±20)% of the game time was played at an HR intensity above the HR that corresponded to the ventilatory threshold (VT) that was determined during the peak V[Combining Dot Above]O2 test. Peak oxygen uptake and VT were 3.3 ± 0.3 and 2.2 ± 0.3 L·min, respectively, on a modified Monark arm crank ergometer. Arm crank peak 5-second anaerobic power was 379 W. The majority of the time spent during international canoe polo games involved slow-to-moderate forward paddling, contesting for the ball, and resting and gliding. Canoe polo games are played at a high intensity indicated by the HR responses, and the physiological characteristics suggest that these athletes had high levels of upper body aerobic and anaerobic fitness levels.


Assuntos
Desempenho Atlético/fisiologia , Frequência Cardíaca/fisiologia , Esportes/fisiologia , Estudos de Tempo e Movimento , Adulto , Antropometria , Humanos , Masculino , Monitorização Ambulatorial , Consumo de Oxigênio/fisiologia , Aptidão Física/fisiologia , Reprodutibilidade dos Testes , Navios , Gravação de Videoteipe
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