Organ blood flow assessment with the ModulHeart cardiorenal support device.

BACKGROUND: ModulHeart (Puzzle Medical Devices Inc) is a novel percutaneous flow entrainment pump anchored in the descending aorta. The current study evaluates the hemodynamic effect of ModulHeart support and its impact on cerebral, myocardial, and renal blood flow. METHODS: ModulHeart was implanted in the descending aorta of four healthy calves. A ramp protocol (2000 RPM increments) was performed with the pump operating at five different speeds from 14 000 to 22 000 RPM. For each speed, pressures proximal and distal to the pump, and right heart catheterization measurements were recorded. Stable-isotope labeled microspheres were injected in the left ventricle to evaluate organ perfusion. RESULTS: Thermodilution cardiac output increased by 23% at 22 000 RPM. Greater pump speeds resulted in greater pump gradients, up to 10 mm Hg in mean arterial pressure at 22 000 RPM, without significant reduction of proximal perfusion pressures. Arterial pulse pressure remained stable at all speeds. ModulHeart was not associated with a reduction in cerebral or myocardial blood flow at any speed. Renal cortical and medullary blood flow increased by up to 50% and 40%, respectively. CONCLUSION: The ModulHeart device implanted in the descending aorta of healthy calves resulted in significant arterial pressure gradients and preserved pulse pressure. Greater pump speeds translated into greater increases in renal blood flow, with no decrease in cerebral or myocardial perfusion.

Parental Travel Behaviors and Children's Independent Mobility: A MultiSite Study.

PURPOSE: Children who are allowed greater independent mobility (IM) are more physically active. This study investigated associations between parents' current travel mode to work, their own IM and school travel mode as a child, and their child's IM. METHODS: Children in grades 4 to 6 (n = 1699) were recruited from urban, suburban, and rural schools in Vancouver, Ottawa, and Trois-Rivières. Parents reported their current travel mode to work, IM, and school travel mode as a child. Children self-reported their IM using Hillman's 6 mobility licenses. Multiple imputation was performed to replace missing data. Gender-stratified generalized linear mixed models were adjusted for child age, parent gender, urbanization, and socioeconomic status. RESULTS: The older a parent was allowed to travel alone as a child, the less IM their child had (boys: ß = -0.09, 95% confidence interval [CI], -0.13 to -0.04; girls: ß = -0.09, 95% CI, -0.13 to -0.06). Girls whose parents biked to work (ß = 0.45, 95% CI, 0.06-0.83) or lived in Trois-Rivières versus other sites (ß = 0.82, 95% CI, -0.43 to 1.21) had higher IM. IM increased with each year of age (boys: ß = 0.46, CI, 0.34-0.58; girls: ß = 0.38, 95% CI, 0.28-0.48). CONCLUSION: Parents who experienced IM later may be more restrictive of their child's IM. This may help explain the intergenerational decline in children's IM.

Cardiorespiratory Fitness of Police Recruits: Normative Reference Values and Temporal Trend.

ABSTRACT: Poirier, S, Houle, J, Lajoie, C, and Trudeau, F. Cardiorespiratory fitness of police recruits: normative reference values and temporal trend. J Strength Cond Res 37(1): 207-212, 2023-Several studies have highlighted the increased risk of cardiovascular diseases (CVDs) among police officers. Given the longitudinal association between cardiorespiratory fitness (CRF) in early adulthood and later appearance of CVD, the identification of police recruits exhibiting lower CRF could allow the implementation of targeted CVD prevention strategies. Unfortunately, norm-referenced values for the CRF of Canadian police recruits are not yet available. Thus, this research aimed to provide norm-referenced values for the CRF of police recruits in the province of Quebec (Canada) and to evaluate the temporal trend in the CRF of police recruits over a 14-year period. First, a model was developed to estimate maximal oxygen consumption (V̇O2max) based on the results of the physical ability test (PAT) used for the recruitment of police officers in Quebec. Based on the previously developed model, the CRF of police recruits who completed the PAT from 2004 to 2017 was retrospectively assessed using administrative records. The analysis of 7,234 PAT results including 2,150 females (29.7%) and 5,084 males (70.3%) suggests that police recruits generally present high levels of CRF with an average estimated V̇O2max of 53.3 ml·min-1·kg-1 for males and 43.8 ml·min-1·kg-1 for females. Furthermore, our analyses showed significant but small positive correlations between estimated V̇O2max and time periods of PAT performance for male (rs = 0.105, p < 0.001) and female recruits (rs = 0.125, p < 0.001). Overall, our results suggest that the CRF of police recruits in Quebec is considerably higher than that of their North American peers.

Relationships Among Children's Independent Mobility, Active Transportation, and Physical Activity: A Multisite Cross-Sectional Study.

PURPOSE: Children's independent mobility (IM) may facilitate both active transportation (AT) and physical activity (PA), but previous studies examining these associations were conducted in single regions that provided limited geographical variability. METHOD: We recruited 1699 children (55.0% girls) in 37 schools stratified by level of urbanization and socioeconomic status in 3 regions of Canada: Ottawa, Trois-Rivières, and Vancouver. Participants wore a SC-StepRx pedometer for 7 days and completed a validated questionnaire from which we derived a 6-point IM index, the number of AT trips over a week, and the volume of AT to/from school (in kilometer per week). We investigated relationships among measures of IM, AT, and PA employing linear mixed models or generalized linear mixed models adjusted for site, urbanization, and socioeconomic status. RESULTS: Each unit increase in IM was associated with 9% more AT trips, 19% higher AT volume, and 147 more steps per day, with consistent results across genders. Both measures of AT were associated with marginally higher PA when pooling boys' and girls' data. Children in Vancouver engaged in more AT. PA did not vary across site, urbanization, or socioeconomic status. CONCLUSION: IM was associated with more AT and PA regardless of where children lived, underscoring a need for IM interventions.

Relationships between area-level socioeconomic status and urbanization with active transportation, independent mobility, outdoor time, and physical activity among Canadian children.

BACKGROUND: Active transportation (AT), independent mobility (IM), and outdoor time are promising ways to increase children's physical activity. However, in order to create interventions to increase those forms of physical activity, it is important to understand the relationships between area-level socioeconomic status (SES) and type of urbanization with AT, IM, outdoor time, and physical activity, and this was the aim of the study. METHODS: One thousand six hundred ninety-nine children in grades 4 to 6 (mean age: 10.2 ± 1.0 years) from three Canadian regions participated. AT, IM, and outdoor time were assessed using questionnaires and physical activity was measured using the SC-StepRX pedometer. Area-level SES was assessed using the median household income of the census tract in which the school was located and type of urbanization was determined for each school using standardized procedures. Generalized linear and general linear mixed models were used to examine the relationships. RESULTS: Area-level SES and the type of urbanization were generally not related to AT, IM, or physical activity for either gender. However, we observed that both boys and girls living in lower SES areas had decreased odds of spending > 2 h outdoors on weekend days compared to their peers from higher SES areas. Girls living in suburban or rural areas were more likely to spend > 2 h outdoors on weekdays compared to their urban counterparts. CONCLUSIONS: AT, IM, and physical activity are generally not associated with area-level SES or the type of urbanization in this sample of Canadian children. The finding regarding outdoor time showing that both boys and girls of lower SES areas had decreased odds of spending > 2 h outdoors on weekends compared to their peers from higher SES areas suggest that additional efforts should be implemented to offer outdoor play opportunities in lower SES areas.

[Training session on healthy environments: evaluation of an intervention for local stakeholders]. / Sensibiliser aux environnements favorables aux saines habitudes de vie : évaluation d’une intervention auprès des personnes-relais.

BACKGROUND: Around the world, various interventions have been developed to encourage the adoption of healthy lifestyles, particularly nutrition and physical activity. Physical, political, economic and socio-cultural environments have a major influence on individual attitudes in relation to healthy lifestyle. However, stakeholders with the greatest impact on improving these environments are not always well informed about the theory and their roles on the creation of environments favourable to healthy lifestyles. Various stakeholders from the province of Quebec were therefore invited to attend training sessions in order to prepare them to act on these four environments. OBJECTIVES: 1) To describe the perceptions of the stakeholders who attended these sessions concerning the content and teaching methods and 2) to identify stakeholders' changes of perceptions and practices following the training session. METHODS: Twelve (12) focus groups and 52 individual interviews were conducted across Quebec with stakeholders who attended a training session. RESULTS: Our results indicate increased awareness of stakeholders on the importance of their role but also the need to more precisely target those aspects requiring increased awareness. A content better suited to the level of expertise is therefore proposed to maximize the benefits of these training sessions. CONCLUSION: Training sessions must be addressed to influential stakeholders with a limited knowledge on the subject, which is often the case for municipal decision-makers known to play a major role in promoting environments favourable to healthy eating and physical activity.

A prospective study of health-related lifestyle changes among police cadets.

The objectives of this prospective study were to explore the health-related lifestyle of police cadets and assess changes in their health behaviors following entry into the police force. To do so, 190 police cadets completed an online questionnaire assessing their physical activity level, sedentary behaviors, diet quality, sleep hygiene, alcohol consumption, cigarette smoking, and stress level. One year following their graduation from the police training program, participants were invited to, once again, complete the questionnaire. Our results suggest that police cadets generally display healthy lifestyles, with very few cadets being physically inactive, smokers, reporting insufficient sleep duration, and displaying obesity. Nevertheless, paired-sample comparisons highlighted significant decreases in physical activity, fruit and vegetable intake, sleep duration, and sleep quality at the follow-up. Likewise, significant increases in fast-food consumption and BMI were observed.

Developing an interprofessional decision support tool for diabetic foot ulcers management in primary care within the family medicine group model: a Delphi study in Canada.

BACKGROUND: Primary care professionals encounter difficulties coordinating the continuum of care between primary care providers and second-line specialists and adhere to practice guidelines pertaining to diabetic foot ulcers management. Family medicine groups are providing primary care services aimed to improve access, interdisciplinary care, coordination and quality of health services, and reduce emergency department visits. Most professionals working in family medicine groups are primary care physicians and registered nurses. The aim of this study was to develop and validate an interprofessional decision support tool to guide the management of diabetic foot ulcers for primary care professionals working within the family medicine group model. METHODS: A one-page decision tool developed by the research team was validated by an expert panel using a three-round Delphi protocol held between December 2019 and August 2021. The tool includes 43 individual actions and a care pathway from initial presentation to secondary prevention. Data collection was realized with both paper and electronic questionnaires, and answers were compiled in an electronic spreadsheet. Data was analyzed with use of descriptive statistics, and consensus for each item was defined as ≥ 80% agreement. RESULTS: Experts from 12 pre-identified professions of the diabetic foot ulcer interdisciplinary care team were included, 39 participants out of the 59 invited to first round (66.1%), 34 out of 39 for second (87.2%) and 22 out of 34 for third (64.7%) rounds. All items included in the final version of the decision support tool reached consensus and were deemed clear, relevant and feasible. One or more professionals were identified to be responsible for every action to be taken. CONCLUSIONS: This study provided a comprehensive decision support tool to guide primary care professionals in the management of diabetic foot ulcers. Implementation and evaluation in the clinical setting will need to be undertaken in the future.

Preservation of von Willebrand Factor Activity With the ModulHeart Device.

von Willebrand Factor (VWF) destruction is common with current heart pumps. This study evaluates VWF activity with ModulHeart, a novel device using 3 micropumps in parallel. In model 1, ModulHeart was compared with Impella devices in vitro. In model 2, 3 healthy swine received ModulHeart. Model 3 includes VWF data from patients who underwent protected percutaneous coronary intervention with ModulHeart. In models 1, 2, and 3, ModulHeart resulted in preservation of VWF, whereas there was a 27% and 19% reduction in VWF activity with the Impella CP and 5.0, respectively. ModulHeart features a unique design and demonstrated preservation of VWF activity.

Factors related to firefighters' food behaviors at the fire station: a quantitative study.

OBJECTIVE: Using a cross-sectional correlational study, the purpose was to quantitatively investigate factors associated to firefighters' food behaviors while on duty at the fire station. METHODS: Two hundred and fifty-two (252) firefighters (males: 96%; age: 39 ± 11 years) completed an online questionnaire assessing diet and exploring factors that could be associated to firefighters' food behaviors at the fire station. RESULTS: First regression analysis showed that level of education, years of experience, self-perceived nutrition knowledge, autonomous motivation and accessibility to unhealthy foods were the best predictors of healthy food score. Second regression analysis revealed that body mass index (BMI), autonomous motivation and meals interrupted by emergency calls were the best predictors of fast-food score. CONCLUSIONS: This study highlights the various factors associated with firefighters' food behaviors at the fire station.

Correlates of Physical Activity in Children from Families Speaking Non-official Languages at Home: a Multi-site Canadian Study.

BACKGROUND: Children from families speaking a non-official language at home may be particularly at risk for low physical activity (PA), underscoring a need to investigate correlates of PA in this subpopulation. METHODS: We recruited 478 children in 37 schools stratified by area-level socioeconomic status (SES) and type of urbanization within three regions of Canada. Steps/day were measured using SC-StepRx pedometers. We assessed potential social-ecological correlates with child and parent surveys. We used gender-stratified linear mixed models to examine the correlates of steps/day. RESULTS: Outdoor time was the strongest correlate of boys' and girls' PA. Lower area-level SES was associated with less PA among boys, but outdoor time attenuated this difference. The strength of association between outdoor time and PA decreased with age in boys and increased with age in girls. DISCUSSION: Outdoor time was the most consistent correlate of PA. Future interventions should promote outdoor time and address socioeconomic disparities.

The Relative Age Effect in Ice Hockey: Analysis of Its Presence, Its Fading and of a Reversal Effect among Junior and Professional Leagues.

This study analyzes the relative age effect (RAE) among the world's best junior hockey leagues and in the NHL. Despite the prevalence of RAE in ice hockey, past research suggests its fading-reversal over time, which may occur at later stages of athletic development. The hypothesis of the RAE reversal was tested with two sources of raw data files from the 2021-2022 season: 15 of the best international junior and minor professional leagues (N = 7 399) and the NHL (N = 812). Birth quartile distributions were analyzed to verify the prevalence of RAE and quantile regression was used to test the reversal of RAE hypotheses. Advanced hockey metrics were aggregated from multiple data sources and used to compare early born with late born players using birth quartiles. Prevalence of the RAE was verified with crosstabs analyses and quantile regression was used to test the reversal effect. Results indicated that the RAE still prevailed in ice hockey, with higher magnitude in Canadian leagues. Regression analyses showed that late-born junior and minor pro players, despite getting less exposure in terms of games played, attained levels of offensive production similar to those of early born players. Late-born players able to emerge in the NHL performed similarly and sometimes displayed better performance (in some markers). Results suggest that stakeholders should find ways to pay special attention to late born players in talent identification processes and offer them opportunities to develop at the highest levels.

Physical Activity, Occupational Stress, and Cardiovascular Risk Factors in Law Enforcement Officers: A Cross-sectional Study.

OBJECTIVE: This cross-sectional study aimed to assess the interrelationship between leisure-time physical activity (LTPA), occupational stress, and cardiovascular disease (CVD) risk factors in law enforcement officers (LEOs). METHODS: A total of 229 LEOs completed a survey assessing their LTPA level, occupational stress, and CVD risk factors. RESULTS: After adjusting for age and sex, physically inactive LEOs are more likely to have one or more CVD risk factors. While high occupational stress was associated with greater odds of CVD risk factors in physically inactive LEOs, stress was not significantly associated with the prevalence of CVD risk factors in active LEOs. CONCLUSIONS: Our results suggest that occupational stress is associated with the prevalence of CVD risk factors in LEOs. Nevertheless, LTPA might have the potential to mitigate the impact of occupational stress on CVD risk factors.

The science and art of testing in ice hockey: a systematic review of twenty years of research.

Introduction: Ice hockey is a complex sport requiring multiple athletic and technical attributes. Considering the variety of tests developed, on-ice testing protocols have been created to measure the physiological and mechanical attributes associated with performance. To our knowledge, a lack of technical resources exists to help stakeholders opt for on-ice protocols from among those developed. It becomes crucial for researchers and practitioners to select relevant and context-specific procedures. This systematic review of the literature outlines an inventory of the on-ice tests that have been used in the domain of ice hockey research over the last twenty years, and summarize protocols mostly used in major athletic components. Methods: A search was performed on three databases (PubMed, SPORTDiscus and Scopus) by following the PRISMA guidelines. Specific keywords were selected to find publications using on-ice testing protocols in the methodology. Four aspects of athletic attributes were used to categorize the protocols: aerobic capacity, acceleration-speed, agility-change of direction and ability to repeat skating sprints. Analyses were conducted regarding four categories of observations: population under study, on-ice reported test(s), outcomes measures and main findings. Results: A total of 107 articles were included, resulting in 55 on-ice tests related to the on-ice assessments of four major athletic components: aerobic capacity (n = 7), acceleration-speed (n = 6), agility and change of direction (n = 23) and repeated skating sprint ability (n = 19). Testing in male and older cohorts (≥16 years old) predominates, with a primary focus on the competitive amateur level. The selected tests were mainly designed for assessing on-ice physiological responses and fitness (n = 38), talent identification-team selection (n = 19), efficiency of interventions (n = 17) and validation purposes (n = 16). Conclusion: A prevalence of on-ice skating tests to assess the ability to repeat intense efforts, agility, acceleration and speed components exists, which are relevant and linked to match requirement. The wealth of on-ice tests used in the literature reflects the need to adapt the on-ice evaluation process to the population, constraints, and goals. This review is a valid toolbox and can benefit for researchers and practitioners interested in testing hockey players from different levels, with a variety of aims and needs, by helping them to select the relevant procedures to their environment and practice context.

Needs and interests regarding the lifestyle habits of students in a Canadian university.

OBJECTIVE: In this study, we investigate university students to learn about their barriers to improving and/or maintaining a healthy lifestyle and their needs and interests regarding the development of a tailored intervention to promote physical activity and a healthy diet. PARTICIPANTS: The qualitative research included three focus groups consisting of 22 university students.Methods: The interview grid was developed around the variables of the ecological Conceptual Framework of the Quebec Ministry of Health and Social Services. Data were analyzed using NVivo software.Results: Time constraints due to a heavy workload, high costs and low motivation were the reasons students failed to participate in physical activity and/or adopt a healthy diet. Furthermore, they perceived that on-campus food and physical activity are more expensive and the quality of food is poorer.Conclusions: Students are nevertheless interested in the development of a tailored intervention to promote physical activity and a healthy diet.

Health, Safety, and Wellness Concerns Among Law Enforcement Officers: An Inductive Approach.

Background: Although studies have assessed the impact of occupational risk factors on the health of law enforcement officers (LEO's), few have involved (LEO's) as informants in ways that allow their points of view to be heard directly. Thus, the objective of this study is to explore the occupational health, safety, and wellness (OHSW) concerns of (LEO's). Methods: (LEO's) working in Quebec, Canada were invited to answer an open-ended question regarding their OHSW concerns. Using a multi-stage content analysis, the collected answers were analyzed and coded by two members of the research team to identify the most recurrent concerns of (LEO's). Findings: Five themes relating to the OHSW concerns of (LEO's) were identified, namely, the work schedule, occupational stress, work equipment, workplace health promotion, and operational risks. Furthermore, our analyses highlighted differences in the concerns of (LEO's) based on their level of experience and sex. Conclusions/Application to Practice: This study addresses a gap in the literature on the OHSW concerns from the perspective of (LEO's). Overall, our results support that the work schedule and occupational stress associated with law enforcement are the two most recurrent concerns of (LEO's). Thus, the results of this study further stress the need for police organizations to implement strategies and policies, which could mitigate the deleterious effects of these hazards on the overall wellness of (LEO's).

Change in heart rate variability during two firefighting work cycles.

This study aimed to determine whether the change in heart rate variability from pre to post firefighting is modulated by different work cycles. Thirteen male firefighters underwent two firefighting simulations that comprised two identical 25-min work bouts intercalated by a passive recovery period of either 20 min (T20) or 5 min (T5). The square root of the mean squared differences of successive R-R intervals (RMSSD) and aural temperature were measured at rest before (PRE) and after (POST) firefighting simulations. The decrease in RMSSD was different between firefighting simulations (T20: -10 ± 21.2 ms, T5: -19.9 ± 20.9 ms, interaction, p = 0.02). Post-firefighting aural temperature was greater (p = 0.05) in T5 (37.18 ± 0.53 °C) than in T20 (36.88 ± 0.49 °C). In conclusion, a shorter recovery period of 5 min between firefighting work bouts decreases post-firefighting heart rate variability, possibly attributed to a lower parasympathetic reactivation and a higher absolute value of body temperature.

[Improve cardiovascular health by physical activity: take the good measure]. / Améliorer la santé cardiovasculaire par l'activité physique: prendre la bonne mesure.

Adherence to physical activity is low among persons with cardiac disease. To influence this behaviour positively, it is suggested clinicians adapt the recommendations to each patient. Besides estimating needs and the values and the preferences of the person, professionals need to measure the physical activity. This measure also allows clinicians to follow the evolution of the behaviour further to the interventions. Subjective methods (questionnaire, logbook) and objective methods (pedometer, accelerometer, and heart rate monitor) can be used. There are advantages and inconveniences to each of these methods. This clinical column provides a review of these various methods to choose the one that is the most suited to the clinical context.

Physical Activity Participation in People With an Active Diabetic Foot Ulceration: A Scoping Review.

BACKGROUND: Being physically active on a regular basis has a favourable impact on diabetes-related complications. With the exception of evidence advising individuals with an active diabetic foot ulceration (DFU) to avoid weight-bearing activity, no physical activity (PA) recommendations are currently provided for this population. OBJECTIVE: The aim of this scoping review was to examine and map the existing research evidence of PA participation for individuals with an active DFU. DESIGN: A scoping review using the Arksey and O'Malley framework was conducted in electronic databases and grey literature from inception to June 2020 to identify publications that investigated individuals with type 1 or type 2 diabetes and an active DFU at enrolment in relation to a PA intervention. Reported outcomes had to inform on effects of PA on any health or wound parameters. RESULTS: Nineteen articles from 17 distinct studies met inclusion criteria. Fourteen of the included studies were published in the last 10 years. Types of exercises and materials used, duration of studies, offloading considerations and provision of wound care varied greatly between studies. Included studies are heterogenous in methodological designs and aims, and reporting was often lacking important components of wound care and PA interventions. A discussion based on descriptive statistics and narrative analysis is provided. CONCLUSIONS: It is not possible from this scoping review to determine what would be the ideal components of a PA program for this specific population. Conclusions are limited by the quality and design of the included studies. No articles evaluated quality of life, mortality or cardiorespiratory capacity, nor were adverse effects routinely reported.

Normative values of resting heart rate variability in young male contact sport athletes: Reference values for the assessment and treatment of concussion.

Objective: The objective of this study was to identify the main determinants of heart rate variability (HRV) in male athletes aged 14 to 21 years who practice competitive contact sports and to integrate these determinants with the aim of defining normative values of short-term HRV in the time and frequency domains. Methods: Participants (n = 369) were aged 14 to 21 years and included 221 football players and 148 ice hockey players. HRV was measured for 5 min at rest, and standard HRV parameters in the time and frequency domains were calculated. Heart rate (HR), age, body mass index (BMI), number of sports weekly practices (WSP) and concussion history (mTBI) were considered determinants potentially able to influence HRV. Results: Multiple regression analysis revealed that HR was the primary determinant of standard HRV parameters. The models accounted for 13% to 55% of the total variance of HRV and the contribution of HR to this model was the strongest (ß ranged from -0.34 to -0.75). HR was the only determinant that significantly contributes to all HRV parameters. To counteract this dependence, we calculated HRV corrected by the mean RR interval (RRm). Such corrections do not remove any physiological differences in HRV; they simply remove the mathematical bias. HRV parameters were therefore normalized, and their normative limits were developed relative to the mean heart rate. After correction, the correlation coefficients between HR and all corrected HRV parameters were not statistically significant and ranged from -0.001 to 0.045 (p > 0.40 for all). The automatically corrected HRV calculator, which recalculates standard HRV parameters and converts them into corrected parameters in addition to determining whether a given value is within normal limits, facilitates clinical interpretation. Conclusion: This study provides for the first time corrected normative values of short-term and resting state HRV parameters in competitive contact sport athletes aged 14 to 21 years. These values were developed independently of the major determinants of HRV. The baseline values for HRV parameters given here could be used in clinical practice when assessing and monitoring cerebral concussions. They may assist in decision making for a safe return to play.