Heinicke, K; Heinicke, I; Schmidt, W; Wolfarth, B
It is well known that altitude training stimulates erythropoiesis, but only few data are available concerning the direct altitude effect on red blood cell volume (RCV) in world class endurance athletes during exposure to continued hypoxia. The purpose of this study was to evaluate the impact of three weeks of traditional altitude training at 2050 m on total hemoglobin mass (tHb), RCV and erythropoietic activity in highly-trained endurance athletes. Total hemoglobin mass, RCV, plasma volume (PV), and blood volume (BV) from 6 males and 4 females, all members of a world class biathlon team, were determined on days 1 and 20 during their stay at altitude as well as 16 days after returning to sea-level conditions (800 m, only males) by using the CO-rebreathing method. In males tHb (14.0 +/- 0.2 to 15.3 +/- 1.0 g/kg, p altitude and returned to near sea-level values 16 days after descent. Similarly in females, tHb (13.0 +/- 1.0 to 14.2 +/- 1.3 g/kg, p altitude training period, whereas PV was not altered. In male athletes, plasma erythropoietin concentration increased up to day 4 at altitude (11.8 +/- 5.0 to 20.8 +/- 6.0 mU/ml, p altitude training period, both parameters indicating enhanced erythropoietic activity. In conclusion, we show for the first time that a three-week traditional altitude training increases erythropoietic activity even in world class endurance athletes leading to elevated tHb and RCV. Considering the relatively fast return of tHb and RCV to sea-level values after hypoxic exposure, our data suggest to precisely schedule training at altitude and competition at sea level.
For more than 40 years, the effects of classical altitude training on sea-level performance have been the subject of many scientific investigations in individual endurance sports. To our knowledge, no studies have been performed in team sports like football. Two well-controlled studies showed that living and training at an altitude of >or=1800-2700 m for 3-4 weeks is superior to equivalent training at sea level in well-trained athletes. Most of the controlled studies with elite athletes did not reveal such an effect. However, the results of some uncontrolled studies indicate that sea-level performance might be enhanced after altitude training also in elite athletes. Whether hypoxia provides an additional stimulus for muscular adaptation, when training is performed with equal intensity compared with sea-level training is not known. There is some evidence for an augmentation of total hemoglobin mass after classical altitude training with duration >or=3 weeks at an altitude >or=2000 m due to altitude acclimatization. Considerable individual variation is observed in the erythropoietic response to hypoxia and in the hypoxia-induced reduction of aerobic performance capacity during training at altitude, both of which are thought to contribute to inter-individual variation in the improvement of sea-level performance after altitude training.
Rusko, Heikki K; Tikkanen, Heikki O; Peltonen, Juha E
The benefits of living and training at altitude (HiHi) for an improved altitude performance of athletes are clear, but controlled studies for an improved sea-level performance are controversial. The reasons for not having a positive effect of HiHi include: (1) the acclimatization effect may have been insufficient for elite athletes to stimulate an increase in red cell mass/haemoglobin mass because of too low an altitude (altitude training period (training effect at altitude may have been compromised due to insufficient training stimuli for enhancing the function of the neuromuscular and cardiovascular systems; and (3) enhanced stress with possible overtraining symptoms and an increased frequency of infections. Moreover, the effects of hypoxia in the brain may influence both training intensity and physiological responses during training at altitude. Thus, interrupting hypoxic exposure by training in normoxia may be a key factor in avoiding or minimizing the noxious effects that are known to occur in chronic hypoxia. When comparing HiHi and HiLo (living high and training low), it is obvious that both can induce a positive acclimatization effect and increase the oxygen transport capacity of blood, at least in 'responders', if certain prerequisites are met. The minimum dose to attain a haematological acclimatization effect is > 12 h a day for at least 3 weeks at an altitude or simulated altitude of 2100-2500 m. Exposure to hypoxia appears to have some positive transfer effects on subsequent training in normoxia during and after HiLo. The increased oxygen transport capacity of blood allows training at higher intensity during and after HiLo in subsequent normoxia, thereby increasing the potential to improve some neuromuscular and cardiovascular determinants of endurance performance. The effects of hypoxic training and intermittent short-term severe hypoxia at rest are not yet clear and they require further study.
Saunders, Philo U; Pyne, David B; Gore, Christopher J
Since the 1968 Olympic Games when the effects of altitude on endurance performance became evident, moderate altitude training ( approximately 2000 to 3000 m) has become popular to improve competition performance both at altitude and sea level. When endurance athletes are exposed acutely to moderate altitude, a number of physiological responses occur that can comprise performance at altitude; these include increased ventilation, increased heart rate, decreased stroke volume, reduced plasma volume, and lower maximal aerobic power ((.)Vo(2max)) by approximately 15% to 20%. Over a period of several weeks, one primary acclimatization response is an increase in the volume of red blood cells and consequently of (.)Vo(2max). Altitudes > approximately 2000 m for >3 weeks and adequate iron stores are required to elicit these responses. However, the primacy of more red blood cells for superior sea-level performance is not clear-cut since the best endurance athletes in the world, from Ethiopia (approximately 2000 to 3000 m), have only marginally elevated hemoglobin concentrations. The substantial reduction in (.)Vo(2max) of athletes at moderate altitude implies that their training should include adequate short-duration (approximately 1 to 2 min), high-intensity efforts with long recoveries to avoid a reduction in race-specific fitness. At the elite level, athlete performance is not dependent solely on (.)Vo(2max), and the "smallest worthwhile change" in performance for improving race results is as little as 0.5%. Consequently, contemporary statistical approaches that utilize the concept of the smallest worthwhile change are likely to be more appropriate than conventional statistical methods when attempting to understand the potential benefits and mechanisms of altitude training.
Dick, F W
There can be little doubt that training at altitude is fundamental to preparing an athlete for competition at altitude. However the value of training at altitude for competition at sea level appears on the one hand to lack total acceptance amongst sports scientists; and on the other to hold some cloak of mystery for coaches who have yet to enjoy first hand experience. The fact is that very few endurance athletes will ignore the critical edge which altitude training affords. Each fraction of a percentage of performance advantage gained through methods which are within the rules of fair play in sport, may shift the balance between failure and achievement. Moreover, there is growing support for application of training at altitude for speed-related disciplines. This paper aims to demystify the subject by dealing with practical aspects of training at altitude. Such aspects include a checklist of what should and should not be done at altitude, when to use altitude relative to target competitions, and specific training examples.
Wilber, Randall L
Altitude/hypoxic training has traditionally been an intriguing and controversial area of research and sport performance. This controversial aspect was evident recently in the form of scholarly debates in highly regarded professional journals, as well as the World Anti-Doping Agency's (WADA) consideration of placing "artificially-induced hypoxic conditions" on the 2007 Prohibited List of Substances/Methods. In light of the ongoing controversy surrounding altitude/hypoxic training, this symposium was organized with the following objectives in mind: 1) to examine the primary physiological responses and underlying mechanisms associated with altitude/hypoxic training, including the influence of genetic predisposition; 2) to present evidence supporting the effect of altitude/hypoxic acclimatization on both hematological and nonhematological markers, including erythrocyte volume, skeletal muscle-buffering capacity, hypoxic ventilatory response, and physiological efficiency/economy; 3) to evaluate the efficacy of several contemporary simulated altitude modalities and training strategies, including hypoxic tents, nitrogen apartments, and intermittent hypoxic exposure (IHE) or training, and to address the legal and ethical issues associated with the use of simulated altitude; and 4) to describe different altitude/hypoxic training strategies used by elite-level athletes, including Olympians and military special forces. In addressing these objectives, papers will be presented on the topics of: 1) effect of hypoxic "dose" on physiological responses and sea-level performance (Drs. Benjamin Levine and James Stray-Gundersen), 2) nonhematological mechanisms of improved performance after hypoxic exposure (Dr. Christopher Gore), 3) application of altitude/hypoxic training by elite athletes (Dr. Randall Wilber), and 4) military applications of hypoxic training (Dr. Stephen Muza).
Chen, Shu-Man; Lin, Hsueh-Yi; Kuo, Chia-Hua
Under altitude hypoxia condition, energy reliance on anaerobic glycolysis increases to compensate the shortfall caused by reduced fatty acid oxidation. Short-term moderate altitude exposure plus endurance physical activity has been found to improve glucose tolerance (not fasting glucose) in humans, which is associated with the improvement in the whole-body insulin sensitivity. However, most of people cannot accommodate high altitude exposure above 4500 M due to acute mountain sickness and insulin resistance. There is a wide variation among individuals in response to the altitude challenge. In particular, the improvement in glucose tolerance and insulin sensitivity by prolonged altitude hiking activity was not apparent in those individuals with low baseline dehydroepiandrosterone sulfate (DHEA-S) concentration. In rats, exercise training recovery under prolonged hypoxia exposure (14-15% oxygen, 8 h per day for 6 weeks) can also improve insulin sensitivity, secondary to an effective suppression of adiposity. After prolonged hypoxia training, obese abnormality in upregulated baseline levels of AMP-activated protein kinase (AMPK) and AS160 phosphorylation in skeletal muscle can be reversed. In humans, moderate hypoxia increases postprandial blood distribution towards skeletal muscle during a training recovery. This physiological response plays a role in the redistribution of fuel storage among important energy storage sites and may explain its potent effect on the favorable change in body composition. Altitude training can exert strong impact on our metabolic system, and has the potential to be designed as a non-pharmacological or recreational intervention regimen for correcting metabolic syndromes.
Ranković Goran; Radovanović Dragan
Altitude training in various forms is widely practiced by athletes and coaches in an attempt to improve sea level endurance. Training at high altitude may improve performance at sea level through altitude acclimatization, which improves oxygen transport and/or utilization, or through hypoxia, which intensifies the training stimulus. This basic physiological aspect allows three training modalities: live high and train high (classic high-altitude training), live low and train high (training thr...
Michalczyk, Małgorzata; Czuba, Miłosz; Zydek, Grzegorz; Zając, Adam; Langfort, Józef
The concept of altitude or hypoxic training is a common practice in cycling. However, several strategies for training regimens have been proposed, like "live high, train high" (LH-TH), "live high, train low" (LH-TL) or "intermittent hypoxic training" (IHT). Each of them combines the effect of acclimatization and different training protocols that require specific nutrition. An appropriate nutrition strategy and adequate hydration can help athletes achieve their fitness and performance goals in this unfriendly environment. In this review, the physiological stress of altitude exposure and training will be discussed, with specific nutrition recommendations for athletes training under such conditions. However, there is little research about the nutrition demands of athletes who train at moderate altitude. Our review considers energetic demands and body mass or body composition changes due to altitude training, including respiratory and urinary water loss under these conditions. Carbohydrate intake recommendations and hydration status are discussed in detail, while iron storage and metabolism is also considered. Last, but not least the risk of increased oxidative stress under hypoxic conditions and antioxidant supplementation suggestions are presented.
Michalczyk, Małgorzata; Czuba, Miłosz; Zydek, Grzegorz; Zając, Adam; Langfort, Józef
The concept of altitude or hypoxic training is a common practice in cycling. However, several strategies for training regimens have been proposed, like “live high, train high” (LH-TH), “live high, train low” (LH-TL) or “intermittent hypoxic training” (IHT). Each of them combines the effect of acclimatization and different training protocols that require specific nutrition. An appropriate nutrition strategy and adequate hydration can help athletes achieve their fitness and performance goals in this unfriendly environment. In this review, the physiological stress of altitude exposure and training will be discussed, with specific nutrition recommendations for athletes training under such conditions. However, there is little research about the nutrition demands of athletes who train at moderate altitude. Our review considers energetic demands and body mass or body composition changes due to altitude training, including respiratory and urinary water loss under these conditions. Carbohydrate intake recommendations and hydration status are discussed in detail, while iron storage and metabolism is also considered. Last, but not least the risk of increased oxidative stress under hypoxic conditions and antioxidant supplementation suggestions are presented. PMID:27322318
Full Text Available The concept of altitude or hypoxic training is a common practice in cycling. However, several strategies for training regimens have been proposed, like “live high, train high” (LH-TH, “live high, train low” (LH-TL or “intermittent hypoxic training” (IHT. Each of them combines the effect of acclimatization and different training protocols that require specific nutrition. An appropriate nutrition strategy and adequate hydration can help athletes achieve their fitness and performance goals in this unfriendly environment. In this review, the physiological stress of altitude exposure and training will be discussed, with specific nutrition recommendations for athletes training under such conditions. However, there is little research about the nutrition demands of athletes who train at moderate altitude. Our review considers energetic demands and body mass or body composition changes due to altitude training, including respiratory and urinary water loss under these conditions. Carbohydrate intake recommendations and hydration status are discussed in detail, while iron storage and metabolism is also considered. Last, but not least the risk of increased oxidative stress under hypoxic conditions and antioxidant supplementation suggestions are presented.
Altitud y deportes de equipo: métodos tradicionales desafiados por un entrenamiento innovador y específico en hipoxia. [Altitude and team sports: traditional methods challenged by innovative sport-specific training in hypoxia].
Full Text Available Entre los diferentes métodos de entrenamiento en altitud, el "entrenamiento hipóxico intermitente" (IHT – método en el cual los atletas viven al nivel del mar pero se entrenan en condiciones de hipoxia – ha ganado una popularidad sin precedentes. Un análisis exhaustivo de los estudios que incluyen IHT muestra los beneficios sorprendentemente pobres para la mejora del rendimiento al nivel del mar, en comparación con el mismo entrenamiento realizado en normoxia. A pesar de las adaptaciones moleculares positivas observadas después de varias modalidades IHT, las características de estímulo del entrenamiento óptimo en hipoxia son todavía confusas y su traducción funcional en una mejora de rendimiento general es mínima. Para superar algunas limitaciones inherentes al IHT (carga de trabajo inferior debido a la hipoxia, estudios recientes han investigado un nuevo método, llamado RSH, de entrenamiento basado en la repetición de sprints con recuperaciones incompletas en hipoxia. Además, el creciente interés científico acerca de la aplicación práctica del entrenamiento hipóxico legitima el desarrollo de tecnologías innovadoras que sirven a los atletas de un deporte específico. Los objetivos de esta revisión son triples. Primero, analizar los resultados de los estudios que implican ejercicios de alta intensidad realizados en hipoxia para mejorar el rendimiento al nivel del mar diferenciando IHT y RSH. Segundo, discutir los posibles mecanismos que sustentan su eficacia y sus limitaciones inherentes. Tercero, presentar los beneficios potenciales del uso de innovaciones tecnológicas que indudablemente contribuirán a mejorar la comprensión de las adaptaciones fisiológicas inducidas por hipoxia mediante la realización de investigaciones pertinentes con un ajuste "ecológico" específico. Abstract Among the different altitude training methods, intermittent hypoxic training (IHT; i.e., a method where athletes live at or near sea
Yanagida, Ryo; Ogawa, Yojiro; Mizuochi, Fumio; Suzuki, Tsukasa; Takahashi, Masanori; Iwasaki, Kenichi
Altitude training is frequently used for athletes requiring competitive endurance in an attempt to improve their sea-level performance. However, there has been no study in which the mechanisms by which spontaneous arterial-cardiac baroreflex function changes was examined in responders or nonresponders of altitude training. The purpose of this study was to clarify the different effects of altitude training on baroreflex function between responders and nonresponders. Twelve university student cross-country skiers (6 men, 6 women; age, 19±1 years) participated in the altitude training in a camp for 3 weeks, which was carried out in accordance with the method of Living High-Training Low. Baroreflex function was estimated by transfer function analysis before and after the training. The responders of the training were 3 men and 2 women, and the nonresponders were 3 men and 4 women. In the responders, the transfer function gain in the high-frequency range significantly increased after the training (28.9→46.5 ms/mmHg p=0.021). On the other hand, no significant change in this index was observed in the nonresponders (25.9→21.2 ms/mmHg p=0.405). As indicated by the results of transfer function gain in the high-frequency range, the baroreflex function in the responders increased significantly after the altitude training, whereas no significant change was observed in the nonresponders.
Ranković, Goran; Radovanović, Dragan
Altitude training in various forms is widely practiced by athletes and coaches in an attempt to improve sea level endurance. Training at high altitude may improve performance at sea level through altitude acclimatisation, which improves oxygen transport and/or utilisation, or through hypoxia, which intensifies the training stimulus. This basic physiological aspect allows three training modalities: live high and train high (classic high-altitude training), live low and train high (training through hypoxia), and live high and train low (the new trend). In an effort to reduce the financial and logistical challenges of travelling to high-altitude training sites, scientists and manufactures have developed artificial high-altitude environments, which simulate the hypoxic conditions of moderate altitude (2000-3000 meters). Endurance athletes from many sports have recently started using nitrogen environments, or hypoxic rooms and tents as part of their altitude training programmes. The results of controlled studies on these modalities of high-altitude training, their practical approach, and ethics are summarised.
Full Text Available Altitude training in various forms is widely practiced by athletes and coaches in an attempt to improve sea level endurance. Training at high altitude may improve performance at sea level through altitude acclimatization, which improves oxygen transport and/or utilization, or through hypoxia, which intensifies the training stimulus. This basic physiological aspect allows three training modalities: live high and train high (classic high-altitude training, live low and train high (training through hypoxia, and live high and train low (the new trend. In an effort to reduce the financial and logistical challenges of traveling to high-altitude training sites, scientists and manufactures have developed artificial high-altitude environments, which simulate the hypoxic conditions of moderate altitude (2000-3000 meters. Endurance athletes from many sports have recently started using nitrogen environments, or hypoxic rooms and tents as part of their altitude training programmes. The results of controlled studies on these modalities of high-altitude training, their practical approach, and ethics are summarized.
Lundby, Carsten; Robach, Paul
What is the topic of this review? The aim is to evaluate the effectiveness of various altitude training strategies as investigated within the last few years. What advances does it highlight? Based on the available literature, the foundation to recommend altitude training to athletes is weak. Athletes may use one of the various altitude training strategies to improve exercise performance. The scientific support for such strategies is, however, not as sound as one would perhaps imagine. The question addressed in this review is whether altitude training should be recommended to elite athletes or not. © 2016 The Authors. Experimental Physiology © 2016 The Physiological Society.
Lorenzo Pugliese, Fabio R. Serpiello, Grégoire P. Millet, Antonio La Torre
Full Text Available Traditionally, Live High-Train High (LHTH interventions were adopted when athletes trained and lived at altitude to try maximising the benefits offered by hypoxic exposure and improving sea level performance. Nevertheless, scientific research has proposed that the possible benefits of hypoxia would be offset by the inability to maintain high training intensity at altitude. However, elite athletes have been rarely recruited as an experimental sample, and training intensity has almost never been monitored during altitude research. This case study is an attempt to provide a practical example of successful LHTH interventions in two Olympic gold medal athletes. Training diaries were collected and total training volumes, volumes at different intensities, and sea level performance recorded before, during and after a 3-week LHTH camp. Both athletes successfully completed the LHTH camp (2090 m maintaining similar absolute training intensity and training volume at high-intensity (> 91% of race pace compared to sea level. After the LHTH intervention both athletes obtained enhancements in performance and they won an Olympic gold medal. In our opinion, LHTH interventions can be used as a simple, yet effective, method to maintain absolute, and improve relative training intensity in elite endurance athletes.
Pugliese, Lorenzo; Serpiello, Fabio R; Millet, Grégoire P; La Torre, Antonio
Traditionally, Live High-Train High (LHTH) interventions were adopted when athletes trained and lived at altitude to try maximising the benefits offered by hypoxic exposure and improving sea level performance. Nevertheless, scientific research has proposed that the possible benefits of hypoxia would be offset by the inability to maintain high training intensity at altitude. However, elite athletes have been rarely recruited as an experimental sample, and training intensity has almost never been monitored during altitude research. This case study is an attempt to provide a practical example of successful LHTH interventions in two Olympic gold medal athletes. Training diaries were collected and total training volumes, volumes at different intensities, and sea level performance recorded before, during and after a 3-week LHTH camp. Both athletes successfully completed the LHTH camp (2090 m) maintaining similar absolute training intensity and training volume at high-intensity (> 91% of race pace) compared to sea level. After the LHTH intervention both athletes obtained enhancements in performance and they won an Olympic gold medal. In our opinion, LHTH interventions can be used as a simple, yet effective, method to maintain absolute, and improve relative training intensity in elite endurance athletes. Key PointsElite endurance athletes, with extensive altitude training experience, can maintain similar absolute intensity during LHTH compared to sea level.LHTH may be considered as an effective method to increase relative training intensity while maintaining the same running/walking pace, with possible beneficial effects on sea level performance.Training intensity could be the key factor for successful high-level LHTH camp.
Olga Cecilia Vargas Pinilla
Full Text Available An increase in altitude leads to a proportional fall in the barometric pressure, and a decrease in atmospheric oxygen pressure, producing hypobaric hypoxia that affects, in different degrees, all body organs, systems and functions. The chronically reduced partial pressure of oxygen causes that individuals adapt and adjust to physiological stress. These adaptations are modulated by many factors, including the degree of hypoxia related to altitude, time of exposure, exercise intensity and individual conditions. It has been established that exposure to high altitude is an environmental stressor that elicits a response that contributes to many adjustments and adaptations that influence exercise capacity and endurance performance. These adaptations include in crease in hemoglobin concentration, ventilation, capillary density and tissue myoglobin concentration. However, a negative effect in strength and power is related to a decrease in muscle fiber size and body mass due to the decrease in the training intensity. Many researches aim at establishing how training or living at high altitudes affects performance in athletes. Training methods, such as living in high altitudes training low, and training high-living in low altitudes have been used to research the changes in the physical condition in athletes and how the physiological adaptations to hypoxia can enhanceperformance at sea level. This review analyzes the literature related to altitude training focused on how physiological adaptations to hypoxic environments influence performance, and which protocols are most frequently used to train in high altitudes.
Wilber, Randall L
At the Olympic level, differences in performance are typically less than 0.5%. This helps explain why many contemporary elite endurance athletes in summer and winter sport incorporate some form of altitude/hypoxic training within their year-round training plan, believing that it will provide the "competitive edge" to succeed at the Olympic level. The purpose of this paper is to describe the practical application of altitude/hypoxic training as used by elite athletes. Within the general framework of the paper, both anecdotal and scientific evidence will be presented relative to the efficacy of several contemporary altitude/hypoxic training models and devices currently used by Olympic-level athletes for the purpose of legally enhancing performance. These include the three primary altitude/hypoxic training models: 1) live high+train high (LH+TH), 2) live high+train low (LH+TL), and 3) live low+train high (LL+TH). The LH+TL model will be examined in detail and will include its various modifications: natural/terrestrial altitude, simulated altitude via nitrogen dilution or oxygen filtration, and hypobaric normoxia via supplemental oxygen. A somewhat opposite approach to LH+TL is the altitude/hypoxic training strategy of LL+TH, and data regarding its efficacy will be presented. Recently, several of these altitude/hypoxic training strategies and devices underwent critical review by the World Anti-Doping Agency (WADA) for the purpose of potentially banning them as illegal performance-enhancing substances/methods. This paper will conclude with an update on the most recent statement from WADA regarding the use of simulated altitude devices.
Billaut, François; Gore, Christopher J; Aughey, Robert J
Field-based team sport matches are composed of short, high-intensity efforts, interspersed with intervals of rest or submaximal exercise, repeated over a period of 60-120 minutes. Matches may also be played at moderate altitude where the lower oxygen partial pressure exerts a detrimental effect on performance. To enhance run-based performance, team-sport athletes use varied training strategies focusing on different aspects of team-sport physiology, including aerobic, sprint, repeated-sprint and resistance training. Interestingly, 'altitude' training (i.e. living and/or training in O(2)-reduced environments) has only been empirically employed by athletes and coaches to improve the basic characteristics of speed and endurance necessary to excel in team sports. Hypoxia, as an additional stimulus to training, is typically used by endurance athletes to enhance performance at sea level and to prepare for competition at altitude. Several approaches have evolved in the last few decades, which are known to enhance aerobic power and, thus, endurance performance. Altitude training can also promote an increased anaerobic fitness, and may enhance sprint capacity. Therefore, altitude training may confer potentially-beneficial adaptations to team-sport athletes, which have been overlooked in contemporary sport physiology research. Here, we review the current knowledge on the established benefits of altitude training on physiological systems relevant to team-sport performance, and conclude that current evidence supports implementation of altitude training modalities to enhance match physical performances at both sea level and altitude. We hope that this will guide the practice of many athletes and stimulate future research to better refine training programmes.
Helfer, Samuel; Quackenbush, Joseph; Fletcher, Michael; Pendergast, David R
Climbing and trekking at altitude are common recreational and military activities. Physiological effects of altitude are hypoxia and hyperventilation. The hyperventilatory response to altitude may cause respiratory muscle fatigue and reduce sustained submaximal exercise. Voluntary isocapnic hyperpnea respiratory muscle training (VIHT) improves exercise endurance at sea level and at depth. The purpose of this study was to test the hypothesis that VIHT would improve exercise time at altitude [3600 m (11,811 ft)] compared to control and placebo groups. Subjects pedaled an ergometer until exhaustion at simulated altitude in a hypobaric chamber while noninvasive arterial saturation (Sao2), ventilation (VE), and oxygen consumption (Vo2) were measured. As expected, Sao2 decreased to 88 ± 4% saturation at rest and to 81 ± 2% during exercise, and was not affected by VIHT. VIHT resulted in a 40% increase in maximal training VE compared to pre-VIHT. Exercise endurance significantly increased 44% after VIHT (P = altitude post-VIHT increased more (49%) for longer (21 min) and decreased less (11% at 25.4 ± 6.7 min). VIHT improved exercise time at altitude and sustained VE. This suggests that VIHT reduced respiratory muscle fatigue and would be useful to trekkers and military personnel working at altitude. Helfer S, Quackenbush J, Fletcher M, Pendergast DR. Respiratory muscle training and exercise endurance at altitutde. Aerosp Med Hum Perform. 2016; 87(8):704-711.
Reactions from 1,161 trainees out of 12,759 trainees subjected to the FAA altitude chamber training flights from 1965-1989 are annotated in this survey. Although there were some mild and expected reactions, these training profiles appear to provide a...
Fudge, Barry W; Pringle, Jamie S M; Maxwell, Neil S; Turner, Gareth; Ingham, Stephen A; Jones, Andrew M
Altitude training is commonly used by endurance athletes and coaches in pursuit of enhancement of performance on return to sea level. The purpose of the current review article was to update and evaluate recent literature relevant to the practical application of altitude training for endurance athletes. Consequently, the literature can be considered in either of two categories: performance-led investigations or mechanistic advancements/insights. Each section discusses the relevant literature and proposes future directions where appropriate.
Levine, Benjamin D; Stray-Gundersen, James
Altitude training continues to be a key adjunctive aid for the training of competitive athletes throughout the world. Over the past decade, evidence has accumulated from many groups of investigators that the "living high--training low" approach to altitude training provides the most robust and reliable performance enhancements. The success of this strategy depends on two key features: 1) living high enough, for enough hours per day, for a long enough period of time, to initiate and sustain an erythropoietic effect of high altitude; and 2) training low enough to allow maximal quality of high intensity workouts, requiring high rates of sustained oxidative flux. Because of the relatively limited access to environments where such a strategy can be practically applied, numerous devices have been developed to "bring the mountain to the athlete," which has raised the key issue of the appropriate "dose" of altitude required to stimulate an acclimatization response and performance enhancement. These include devices using molecular sieve technology to provide a normobaric hypoxic living or sleeping environment, approaches using very high altitudes (5,500m) for shorter periods of time during the day, and "intermittent hypoxic training" involving breathing very hypoxic gas mixtures for alternating 5 minutes periods over the course of 60-90 minutes. Unfortunately, objective testing of the strategies employing short term (less than 4 hours) normobaric or hypobaric hypoxia has failed to demonstrate an advantage of these techniques. Moreover individual variability of the response to even the best of living high--training low strategies has been great, and the mechanisms behind this variability remain obscure. Future research efforts will need to focus on defining the optimal dosing strategy for these devices, and determining the underlying mechanisms of the individual variability so as to enable the individualized "prescription" of altitude exposure to optimize the performance of
Carr, Amelia J; Saunders, Philo U; Vallance, Brent S; Garvican-Lewis, Laura A; Gore, Christopher J
This study examined effects of low altitude training and a live-high: train-low protocol (combining both natural and simulated modalities) on haemoglobin mass (Hbmass), maximum oxygen consumption (VO2max), time to exhaustion, and submaximal exercise measures. Eighteen elite-level race-walkers were assigned to one of two experimental groups; lowHH (low Hypobaric Hypoxia: continuous exposure to 1380 m for 21 consecutive days; n = 10) or a combined low altitude training and nightly Normobaric Hypoxia (lowHH+NHnight: living and training at 1380 m, plus 9 h.night(-1) at a simulated altitude of 3000 m using hypoxic tents; n = 8). A control group (CON; n = 10) lived and trained at 600 m. Measurement of Hbmass, time to exhaustion and VO2max was performed before and after the training intervention. Paired samples t-tests were used to assess absolute and percentage change pre and post-test differences within groups, and differences between groups were assessed using a one-way ANOVA with least significant difference post-hoc testing. Statistical significance was tested at p altitude (1380 m) combined with sleeping in altitude tents (3000 m) as one effective alternative to traditional altitude training methods, which can improve Hbmass. Key pointsIn some countries, it may not be possible to perform classical altitude training effectively, due to the low elevation at altitude training venues. An additional hypoxic stimulus can be provided by simulating higher altitudes overnight, using altitude tents.Three weeks of combined (living and training at 1380 m) and simulated altitude exposure (at 3000 m) can improve haemoglobin mass by over 3% in comparison to control values, and can also improve time to exhaustion by ~9% in comparison to baseline.We recommend that, in the context of an altitude training camp at low altitudes (~1400 m) the addition of a relatively short exposure to simulated altitudes of 3000 m can elicit physiological and performance benefits, without compromise to
Full Text Available High altitude retinopathy(HARrefers to the body which can't adapt to the hypobaric hypoxia environment at high altitude leading to retinal diseases, which typically manifested as retinal hemorrhages, optic disc edema and cotton wool spots. With the development of high altitude medicine, HAR become a hot topic of eye research in recent years. New researches show a significantly higher incidence of HAR, and HAR has a close contact with acute mountain sickness, high altitude cerebral edema and high altitude pulmonary edema. A further study in pathogenesis and prevention measures of HAR will promote the prevention of altitude sickness. Traditional Chinese Medicine has achieved good effects in the prevention of altitude sickness, but the effect and mechanism of herbs on HAR has not been reported. Through read and summarize the relevant literatures and reports, the author will give an overview of the research advances on HAR's pathogenesis and application of Traditional Chinese Medicine.
A survey was conducted to determine if training in high-altitude physiology should : be required for civilian pilots; what the current status of such training was; and, : if required, what should be included in an ideal curriculum. The survey include...
Quackenbush, Joseph; Duquin, Aubrey; Helfer, Samuel; Pendergast, David R
Hiking and trekking often occur at altitudes up to 12,000 ft altitude. The hypoxia-induced hyperventilation at altitude paradoxically reduces arterial CO2 (Paco2). A reduction in Paco2 results in vasoconstriction of the blood vessels of the brain and thus in local hypoxia. The local hypoxia likely affects cognitive function, which may result in reduced performance and altitude accidents. Recent publications have demonstrated that voluntary isocapnic hyperventilatory training of the respiratory muscles (VIHT) can markedly enhance exercise endurance as it is associated with reduced ventilation and its energy cost. VIHT may be useful in blunting the altitude-induced hyperventilation leading to higher Paco2 and improved cognitive function. This study examined the effects of VIHT, compared to control (C) and placebo (PVIHT) groups, on selected measures of executive functioning, including working memory and processing speed (i.e., Stroop Test, Symbol Digit Modalities Test, and Digit Span Forward) at simulated altitude up to 12,000 ft. Associated physiological parameters were also measured. The Digit Span Forward Test did not show improvements after VIHT in any group. The VIHT group, but not C or PVIHT groups, improved significantly (17-30%) on the Stroop Test. Similarly the VIHT group, but not the C and PVIHT groups, improved correct responses (26%) and number of attempts (24%) on the Symbol Digit Modalities Test. In addition, reaction time was also improved (16%). VIHT improved processing speed and working memory during exercise at altitude.
Chapman, Robert F; Stickford, Jonathon L; Levine, Benjamin D
level, the 'live high-train low' model of altitude training can help athletes in endurance events to maximize performance.
Li, Peng; Zhang, Gang; You, Hai-Yan; Zheng, Ran; Gao, Yu-Qi
Ascent to high altitude is associated with decreases in cognitive function and work performance as a result of hypoxia. Some workers with special jobs typically undergo intensive mental training because they are expected to be agile, stable and error-free in their job performance. The purpose of this study was to determine the risk to cognitive function acquired from training following hypoxic exposure. The results of WHO neurobehavioral core tests battery (WHO-NCTB) and Raven's standard progressive matrices (RSPM) tests of a group of 54 highly trained military operators were compared with those of 51 non-trained ordinary people and were investigated at sea level and on the fifth day after arrival at high altitudes (3900m). Meanwhile, the plasma levels of brain-derived neurotrophic factor (BDNF), interleukin 1β (IL-1β) and vascular endothelial growth factor (VEGF) were examined. The result showed that at sea level, the trained group exhibited significantly better performance on neurobehavioral and RSPM tests. At high altitude, both groups had decreased accuracy in most cognitive tests and took longer to finish them. More importantly, the highly trained subjects showed more substantial declines than the non-trained subjects in visual reaction accuracy, auditory reaction speed, digit symbol scores, ability to report correct dots in a pursuit aiming test and total RSPM scores. This means that the training-dependent cognitive advantages in these areas were suppressed at high altitudes. The above phenomenon maybe associated with decreased BDNF and elevated inflammatory factor during hypoxia, and other mechanisms could not be excluded. Copyright © 2012 Elsevier Inc. All rights reserved.
Rodríguez, Ferran A; Iglesias, Xavier; Feriche, Belén; Calderón-Soto, Carmen; Chaverri, Diego; Wachsmuth, Nadine B; Schmidt, Walter; Levine, Benjamin D
This controlled, nonrandomized, parallel-groups trial investigated the effects on performance, V˙O2 and hemoglobin mass (tHbmass) of four preparatory in-season training interventions: living and training at moderate altitude for 3 and 4 wk (Hi-Hi3, Hi-Hi), living high and training high and low (Hi-HiLo, 4 wk), and living and training at sea level (SL) (Lo-Lo, 4 wk). From 61 elite swimmers, 54 met all inclusion criteria and completed time trials over 50- and 400-m crawl (TT50, TT400), and 100 (sprinters) or 200 m (nonsprinters) at best stroke (TT100/TT200). Maximal oxygen uptake (V˙O2max) and HR were measured with an incremental 4 × 200 m test. Training load was estimated using cumulative training impulse method and session RPE. Initial measures (PRE) were repeated immediately (POST) and once weekly on return to SL (PostW1 to PostW4). tHbmass was measured in duplicate at PRE and once weekly during the camp with CO rebreathing. Effects were analyzed using mixed linear modeling. TT100 or TT200 was worse or unchanged immediately at POST, but improved by approximately 3.5% regardless of living or training at SL or altitude after at least 1 wk of SL recovery. Hi-HiLo achieved greater improvement 2 (5.3%) and 4 wk (6.3%) after the camp. Hi-HiLo also improved more in TT400 and TT50 2 (4.2% and 5.2%, respectively) and 4 wk (4.7% and 5.5%) from return. This performance improvement was not linked linearly to changes in V˙O2max or tHbmass. A well-implemented 3- or 4-wk training camp may impair performance immediately but clearly improves performance even in elite swimmers after a period of SL recovery. Hi-HiLo for 4 wk improves performance in swimming above and beyond altitude and SL controls through complex mechanisms involving altitude living and SL training effects.
Strzała, Marek; Ostrowski, Andrzej; Szyguła, Zbigniew
It is possible to plan an altitude training (AT) period in such a way that the enhanced physical endurance obtained as a result of adaptation to hypoxia will appear and can be used to improve performance in competition. Yet finding rationales for usage of AT in highly trained swimmers is problematic. In practice AT, in its various forms, is still controversial, and an objective review of research concentrating on the advantages and disadvantages of AT has been presented in several scientific publications, including in no small part the observations of swimmers. The aim of this article is to review the various methods and present both the advantageous and unfavourable physiological changes that occur in athletes as a result of AT. Moreover, AT results in the sport of swimming have been collected. They include an approach towards primary models of altitude/hypoxic training: live high + train high, live high + train low, live low + train high, as well as subsequent methods: Intermittent Hypoxic Exposure (IHE) and Intermittent Hypoxic Training (IHT). Apnoea training, which is descended from freediving, is also mentioned, and which can be used with, or as a substitute for, the well-known IHE or IHT methods. In conclusion, swimmers who train using hypoxia may be among the best-trained athletes, and that even a slight improvement in physical endurance might result in the shortening of a swimming time in a given competition, and the achievement of a personal best, which is hard to obtain by normal training methods, when the personal results of the swimmer have reached a plateau. PMID:23486564
Fuller, R.J. [School of Architecture and Building, Deakin University, Geelong, Vic. 3217 (Australia); Zahnd, A.; Thakuri, S. [Department of Mechanical Engineering, Kathmandu University and RIDS-Nepal (Nepal)
Humla Province is a remote mountainous region of northwest Nepal. The climate is harsh and the local people are extremely poor. Most people endure a subsistence culture, living in traditional housing. Energy for cooking and heating comes from fuelwood, supplies of which are diminishing. In order to improve the indoor environment and reduce fuelwood use, smokeless stoves are being introduced to replace the open fire in Humli homes. There is some concern, however, that comfort levels may not be as acceptable with these stoves. The aim of this research was therefore to investigate ways in which the comfort levels in traditional Humli housing might be improved using simple and low cost strategies. Temperature data was recorded in four rooms of a traditional Humli home over a 12-day period and used with fuelwood data to validate a TRNSYS simulation model of the house. This model was then used to evaluate the impact on comfort levels in the house of various energy conservation strategies using PMV and PPD indicators. As a single strategy, it was found that reducing infiltration of outside air was likely to be more effective than increasing the insulation level in the ceilings. The most successful strategy, however, was the creation of sunspaces at the entrances to the living rooms. This strategy increased average internal temperatures by 1.7 and 2.3 C. In combination with increased insulation levels, the sunspaces reduced comfort dissatisfaction levels by over 50%. (author)
Stickford, Abigail S L; Wilhite, Daniel P; Chapman, Robert F
Investigations into ventilatory, metabolic, and hematological changes with altitude training have been completed; however, there is a lack of research exploring potential gait-kinematic changes after altitude training, despite a common complaint of athletes being a lack of leg "turnover" on return from altitude training. To determine if select kinematic variables changed in a group of elite distance runners after 4 wk of altitude training. Six elite male distance runners completed a 28-d altitude-training intervention in Flagstaff, AZ (2150 m), following a modified "live high-train low" model, wherein higherintensity runs were performed at lower altitudes (945-1150 m) and low-intensity sessions were completed at higher altitudes (1950-2850 m). Gait parameters were measured 2-9 d before departure to altitude and 1 to 2 d after returning to sea level at running speeds of 300-360 m/min. No differences were found in ground-contact time, swing time, or stride length or frequency after altitude training (P > .05). Running mechanics are not affected by chronic altitude training in elite distance runners. The data suggest that either chronic training at altitude truly has no effect on running mechanics or completing the live high-train low model of altitude training, where higher-velocity workouts are completed at lower elevations, mitigates any negative mechanical adaptations that may be associated with chronic training at slower speeds.
This article overviews current comprehension of altitude training, which is quite contradictory: many sources declare that altitude training provides no benefits to sea level performances compared to appropriate conventional training while others consider altitude training to be an efficacious and proven tool to enhance high-performance preparation. This contradiction can be partly explained by the variety of individual training responses, i.e., individual predispositions among some athletes ...
Full Text Available Objective: Opinions on the suitability of sports training at altitudes of 1800-2200 m above sea level (ASL for increasing performance in youth are not unanimous. The objective of this study was to test the influence of a ten day altitude training camp on performance in well-trained adolescent cross-country skiers. Methods: A running test of 3 × 2 km (aerobic, anaerobic and critical intensity was used with a rest interval of 10 minutes. The test was performed 4 times - an initial test at a lowland (900 m ASL prior to departure for altitude, two tests at altitude (1850 m ASL, a final test ten days after returning to lower altitudes. The aerobic, anaerobic and critical load intensities were set by graded a load test. For all individual tests, the participants maintained the same heart rate individually defined for the various segments using a heart rate monitor. Changes in speed between the tests were compared. The body's internal response was also monitored by the concentration of lactate (2 and 8 minutes after each exertion. Participants: Well-trained adolescent cross-country skiers (N = 11, age: 14.4 ± 1.2 years, weight: 54.4 ± 8.6 kg, height: 170 ± 7 cm, fat: 13 ± 2.6%. Results: The average times attained in the first altitude test for aerobic and anaerobic load were higher (p < .05 than in the entry test at low altitude. In the second altitude test the average times for all intensities were significantly (p < .05 higher than in the first altitude test. In the tests after returning to the lower altitudes the times attained for all intensities were on average higher than at altitude. The average lactate concentration levels following the various intensities were similar (p > .05. The dynamics of the cool-down monitored via the lactate value at the eighth minute after completing the relevant segment showed that at altitude the adolescents cooled down significantly (p < .05 slower rate following the aerobic and anaerobic intensity than at
Mizuno, M; Juel, C; Bro-Rasmussen, Thomas
Morphological and biochemical characteristics of biopsies obtained from gastrocnemius (GAS) and triceps brachii muscle (TRI), as well as maximal O2 uptake (VO2 max) and O2 deficit, were determined in 10 well-trained cross-country skiers before and after a 2-wk stay (2,100 m above sea level......) and training (2,700 m above sea level) at altitude. On return to sea level, VO2 max was the same as the prealtitude value, whereas an increase in O2 deficit (29%) and in short-term running performance (17%) was observed (P less than 0.05). GAS showed maintained capillary supply but a 10% decrease...... increase in buffer capacity of GAS and short-term running time (P less than 0.05). Thus the present study indicates no effect of 2 wk of altitude training on VO2 max but provides evidence to suggest an improvement in short-term exercise performance, which may be the result of an increase in muscle buffer...
Chapman, Robert F
Performance in athletic activities that include a significant aerobic component at mild or moderate altitudes shows a large individual variation. Physiologically, a large portion of the negative effect of altitude on exercise performance can be traced to limitations of oxygen diffusion, either at the level of the alveoli or the muscle microvasculature. In the lung, the ability to maintain arterial oxyhaemoglobin saturation (SaO₂) appears to be a primary factor, ultimately influencing oxygen delivery to the periphery. SaO₂ in hypoxia can be defended by increasing ventilatory drive; however, during heavy exercise, many athletes demonstrate limitations to expiratory flow and are unable to increase ventilation in hypoxia. Additionally, increasing ventilatory work in hypoxia may actually be negative for performance, if dyspnoea increases or muscle blood flow is reduced secondary to an increased sympathetic outflow (eg, the muscle metaboreflex response). Taken together, some athletes are clearly more negatively affected during exercise in hypoxia than other athletes. With careful screening, it may be possible to develop a protocol for determining which athletes may be the most negatively affected during competition and/or training at altitude.
Full Text Available Competitive athletes frequently use altitude training (AT to improve sea-level performance. ATbecame interesting for sport scientists and athletes since Olympic Games in Mexico City in 1968. Exercise ataltitude may increase the training stimulus and enlarge the effects of endurance training. The first notedadaptation induced by staying at altitude is an increase in red blood cell mass that improves aerobic power andsea-level performance. Currently, there are several types of AT modalities: traditional ‘live high-train high’,contemporary ‘live high-train low’, intermittent hypoxic exposure during rest, live low-train high andintermittent hypoxic exposure during continuous session. Despite several substantial differences between thesemethods of hypoxic all of them have the same goal: to stimulate an improvement in athletic performance at sealevel. A proper distinction must be made between altitude acclimatization during preparation for competitions ataltitude and AT and acclimatization for improvement of the sea-level performances. Former scientific researchesidentified two longer phases of enhanced work capacity after AT. First phase of enhanced work capacityoccurring between days 3-7 and 12-13, while the best results are achieved during 18 and 20 days after AT.Second phase of enhanced work capacity is reported between days 36 and 48 after AT. The further developmentof practical knowledge in area of AT should predominantly include recommendations about application ofdifferent AT methods in training periodization in different sports. Improvement of the work capacity andduration of enhanced work capacity at the sea level after AT stimuli are the main questions opened for futurescientific researches.
Full Text Available High altitude training is one of the effective strategies for improving aerobic exercise performance at sea level via altitude acclimatization, thereby improving oxygen transport and/or utilization. But its underlying molecular mechanisms on physiological functions and exercise performance of athletes are still vague. More recent evidence suggests that the recycling of cellular components by autophagy is an important process of the body involved in the adaptive responses to exercise. Whether high altitude training can activate autophagy or whether high altitude training can improve exercise performance through exercise-induced autophagy is still unclear. In this narrative review article, we will summarize current research advances in the improvement of exercise performance through high altitude training and its reasonable molecular mechanisms associated with autophagy, which will provide a new field to explore the molecular mechanisms of adaptive response to high altitude training.
Frese, F; Friedmann-Bette, B
Classical altitude training can cause an increase in total hemoglobin mass (THM) if a minimum "dose of hypoxia" is reached (altitude >or=2,000 m, >or=3 weeks). We wanted to find out if repetitive exposure to mild hypoxia during living and training at low altitude (training camps at low altitude interspersed by 3 weeks of sea-level training and at the same time points in a control group (CG) of 5 well-trained runners. EPO, sTfR and ferritin were also repeatedly measured during the altitude training camps. Repeated measures ANOVA revealed significant increases in EPO- and sTfR-levels during both training camps and a significant decrease in ferritin indicating enhanced erythropoietic stimulation during living and training at low altitude. Furthermore, significant augmentation of THM by 5.1% occurred in the course of the 2 altitude training camps. In conclusion, repetitive living and training at low altitude leads to a hypoxia-induced increase in erythropoietic stimulation in elite 400 m and 800 m runners and, apparently, might also cause a consecutive augmentation of THM.
Gough, Clare E; Saunders, Philo U; Fowlie, John; Savage, Bernard; Pyne, David B; Anson, Judith M; Wachsmuth, Nadine; Prommer, Nicole; Gore, Christopher J
We compared changes in performance and total haemoglobin mass (tHb) of elite swimmers in the weeks following either Classic or Live High:Train Low (LHTL) altitude training. Twenty-six elite swimmers (15 male, 11 female, 21.4 ± 2.7 years; mean ± SD) were divided into two groups for 3 weeks of either Classic or LHTL altitude training. Swimming performances over 100 or 200 m were assessed before altitude, then 1, 7, 14 and 28 days after returning to sea-level. Total haemoglobin mass was measured twice before altitude, then 1 and 14 days after return to sea-level. Changes in swimming performance in the first week after Classic and LHTL were compared against those of Race Control (n = 11), a group of elite swimmers who did not complete altitude training. In addition, a season-long comparison of swimming performance between altitude and non-altitude groups was undertaken to compare the progression of performances over the course of a competitive season. Regardless of altitude training modality, swimming performances were substantially slower 1 day (Classic 1.4 ± 1.3% and LHTL 1.6 ± 1.6%; mean ± 90% confidence limits) and 7 days (0.9 ± 1.0% and 1.9 ± 1.1%) after altitude compared to Race Control. In both groups, performances 14 and 28 days after altitude were not different from pre-altitude. The season-long comparison indicated that no clear advantage was obtained by swimmers who completed altitude training. Both Classic and LHTL elicited ~4% increases in tHb. Although altitude training induced erythropoeisis, this physiological adaptation did not transfer directly into improved competitive performance in elite swimmers.
Alagha, Babak; AhmadBeygi, Shervin; Ahmadbeigy, Shervin; Moosavi, Seyed Ali Javad; Jalali, Seyed Mahmood
Susceptibility to hypoxia is influenced by a multitude of factors, including fatigue, physical activity, illnesses, ambient temperature, rate of ascent, destination altitude, medications, and alcohol. Anecdotally, several reports have been made regarding changes in the form of hypoxia presentation in Iranian fighter pilots in the absence of these factors. This study focused specifically on the effect of pilot age on susceptibility to hypoxia and its initial presentation. We assumed that a pilot's age may increase his susceptibility to hypoxia and consequently reduce the amount of time it takes for hypoxia to present. Because our literature review did not reveal any previous study addressing the possible relationship between age and susceptibility to hypoxia, the purpose of this study is to address and clarify this relationship. In this retrospective study, we collected information from Iranian fighter pilots (n = 30) through an anonymous questionnaire in 2000. The form of hypoxia presentation of each subject was evaluated during five altitude chamber training (ACT) sessions that were conducted routinely from 1972 to 1984. To enhance the accuracy of the study's results, confounding factors such as prior hypoxia experience in an ACT session have been taken into consideration. The results revealed a statistically significant relationship between age and a change in the form of hypoxia presentation in our subjects. Increased age reduced the amount of time before the first individual hypoxia symptom appeared (P < .000002). Although having previous hypoxia experience may help pilots to recognize their symptoms earlier, its effect was not statistically significant (P < .18). A few changes in the nature of individual symptoms were observed; however, we did not find a meaningful statistical correlation between pilot age and change in the nature of symptoms. Susceptibility ot hypoxia increases with pilot age. Copyright © 2012 Air Medical Journal Associates. Published by
Son, Hee Jeong; Kim, Hyo Jeong; Kim, Jin Hae; Ohno, Hideki; Kim, Chang Keun
Rapid growth during adolescence caused by metabolic changes and their metabolic response to anaerobic and aerobic exercise differs considerably from that in adults and this is especially true in the responses to stresses, such as altitude exposure. However, there is little information on the suitability of exercise training at altitude for young athletes. Six male Korean adolescent alpine skiers (13-17 yr), with a skiing career of 3-5 yr, participated in the study. All subjects were exposed to an altitude of 2700 m (8858 ft) for 5 wk and altitude exposure consisted of 6 d/wk of training (4-5 h/d), with living quarters at 2100 m (-6890 ft) (Tignes, France). The 5 wk of ski training at altitude were maintained at the same level (the same number of slalom and giant slalom skiing trials) as at sea level. There was a significant increase in oxygen transport capacity, despite decreased erythropoietin (EPO) production (-31%) after altitude training. Red blood cell (RBC), hemoglobin (Hb), hematocrit (Hct), and 2,3 DPG concentrations increased significantly during altitude exposure and after return to sea level. Results indicate that applying altitude training in adolescent skiers may improve their endurance performance. However, EPO production during altitude training needs to be evaluated in larger future studies.
Full Text Available This study evaluated the influence of an altitude training (AT camp on swimming start time and loaded squat jump performance. To accomplish this goal, 13 international swimmers (8 women, 5 men were allocated to both the control (Sea Level Training, SLT and experimental conditions (AT, 2320 m above sea level that were separated by a one year period. All tests (15 m freestyle swimming start and loaded squat jumps with additional loads of 25%, 50%, 75%, and 100% of swimmers' body weight were performed before and after a concurrent 3-week strength and endurance training program prescribed by the national coach. Following the SLT camp, significant impairments in swimming start times to 10 (+3.1% and 15 m (+4.0% were observed (P 0.05. Trivial changes in peak velocity were obtained during the loaded squat jump after both training periods (effect sizes: < 0.20. Based on these results we can conclude that a traditional training high-living high strategy concurrent training of 3 weeks does not adversely affect swimming start time and loaded squat jump performance in high level swimmers, but further studies are necessary to assess the effectiveness of power-oriented resistance training in the development of explosive actions.
Chapman, Robert F; Karlsen, Trine; Resaland, Geir K; Ge, R-L; Harber, Matthew P; Witkowski, Sarah; Stray-Gundersen, James; Levine, Benjamin D
Chronic living at altitudes of ∼2,500 m causes consistent hematological acclimatization in most, but not all, groups of athletes; however, responses of erythropoietin (EPO) and red cell mass to a given altitude show substantial individual variability. We hypothesized that athletes living at higher altitudes would experience greater improvements in sea level performance, secondary to greater hematological acclimatization, compared with athletes living at lower altitudes. After 4 wk of group sea level training and testing, 48 collegiate distance runners (32 men, 16 women) were randomly assigned to one of four living altitudes (1,780, 2,085, 2,454, or 2,800 m). All athletes trained together daily at a common altitude from 1,250-3,000 m following a modified live high-train low model. Subjects completed hematological, metabolic, and performance measures at sea level, before and after altitude training; EPO was assessed at various time points while at altitude. On return from altitude, 3,000-m time trial performance was significantly improved in groups living at the middle two altitudes (2,085 and 2,454 m), but not in groups living at 1,780 and 2,800 m. EPO was significantly higher in all groups at 24 and 48 h, but returned to sea level baseline after 72 h in the 1,780-m group. Erythrocyte volume was significantly higher within all groups after return from altitude and was not different between groups. These data suggest that, when completing a 4-wk altitude camp following the live high-train low model, there is a target altitude between 2,000 and 2,500 m that produces an optimal acclimatization response for sea level performance.
Tirabassi, Jill N; Olewinski, Lucianne; Khodaee, Morteza
Significant elevations of traditional biomarkers of liver injury can occur as a result of running an ultramarathon. Traditional serum biomarker levels of liver injury will significantly increase as the result of participating in this 161-km race at altitude. Prospective cross-sectional study. Level 3. A total of 64 (before) and 83 (after) volunteer runners participated in a prospective observational field-based study at the Leadville 100 ultramarathon race. Changes in serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), creatine kinase (CK), and bilirubin levels were measured. Of 669 athletes who started the race, 352 successfully completed the race within the 30-hour cutoff (53%). Of 36 runners who had pre- and postrace blood samples taken, the mean ALT, AST, and bilirubin levels were increased from 23 ± 10 U/L, 23 ± 5 U/L, and 0.60 ± 0.29 mg/dL to 117 ± 106 U/L, 485 ± 500 U/L, and 1.60 ± 0.61 mg/dL, respectively (all P athletes' age, sex, body mass index, or finishing time. Significant positive linear correlations between AST, ALT, and LDH with CK were seen. Athletes in this study did not seek medical attention after the race based on an electronic survey (92% response rate). Significant elevations of traditional biomarkers of liver injury occurred as a result of running an ultramarathon at altitude. These correlated with CK, a marker of muscle injury. When reviewing laboratory studies of traditional biomarkers of liver injury in athletes after an ultramarathon, significant elevations may be seen from baseline but are likely to be of no clinical consequence.
Constantini, Keren; Wilhite, Daniel P; Chapman, Robert F
Constantini, Keren, Daniel P. Wilhite, and Robert F. Chapman. A clinician guide to altitude training for optimal endurance exercise performance at sea level. High Alt Med Biol. 18:93-101, 2017.-For well over 50 years, endurance athletes have been utilizing altitude training in an effort to enhance performance in sea level competition. This brief review will offer the clinician a series of evidence-based best-practice guidelines on prealtitude and altitude training considerations, which can ultimately maximize performance improvement outcomes.
Jensen, Kurt; Höög, Martina; Willis, Sarah
INTRODUCTION: The Olympic cross country skiing competitions in 2014 will be held in Sochi, Russia at an altitude of approximately 1500m. Although moderate, this altitude is known to reduce performance in highly trained endurance athletes. It is also known that individuals react differently during...... altitude exposure. The purpose of this study was to evaluate performance changes during and after three weeks of training in moderate altitude in elite skiers. METHOD: Four male and three female skiers were tested on a roller skiing treadmill using the classic technique at sea level (NORM1), after 3 and 20...... and the WVO2max decreased 8.9% and 9.1%, respectively (P0.05). In contrast, the average power output (322±87W) during the “all out” test increased 3.4±2.7% 10 days after the altitude training (P
Flaherty, Gerard; O'Connor, Rory; Johnston, Niall
High altitude training is regarded as an integral component of modern athletic preparation, especially for endurance sports such as middle and long distance running. It has rapidly achieved popularity among elite endurance athletes and their coaches. Increased hypoxic stress at altitude facilitates key physiological adaptations within the athlete, which in turn may lead to improvements in sea-level athletic performance. Despite much research in this area to date, the exact mechanisms which underlie such improvements remain to be fully elucidated. This review describes the current understanding of physiological adaptation to high altitude training and its implications for athletic performance. It also discusses the rationale and main effects of different training models currently employed to maximise performance. Athletes who travel to altitude for training purposes are at risk of suffering the detrimental effects of altitude. Altitude illness, weight loss, immune suppression and sleep disturbance may serve to limit athletic performance. This review provides an overview of potential problems which an athlete may experience at altitude, and offers specific training recommendations so that these detrimental effects are minimised. Copyright © 2016 Elsevier Ltd. All rights reserved.
Bor-Kucukatay, Melek; Colak, Ridvan; Erken, Gülten; Kilic-Toprak, Emine; Kucukatay, Vural
Altitude training is frequently used by athletes to improve sea-level performance. However, the objective benefits of altitude training are controversial. This study aimed to investigate the possible alterations in hemorheological parameters in response to altitude training. Sprague Dawley rats, were divided into 6 groups: live low-train low (LLTL), live high-train high (LHTH), live high-train low (LHTL) and their controls live high and low (LHALC), live high (LHC), live low (LLC). LHC and LHTH groups were exposed to hypoxia (15% O2, altitudes of 3000 m), 4 weeks. LHALC and LHTL were exposed to 12 hours hypoxia/normoxia per day, 4 weeks. Hypoxia was maintained by a hypoxic tent. The training protocol corresponded to 60-70% of maximal exercise capacity. Rats of training groups ran on treadmill for 20-30 min/day, 4 days/week, 4 weeks. Erythrocyte deformability of LHC group was increased compared to LHALC and LLC. Deformability of LHTH group was higher than LHALC and LLTL groups. No statistically significant alteration in erythrocyte aggregation parameters was observed. There were no significant relationships between RBC deformability and exercise performance. The results of this study show that, living (LHC) and training at altitude (LHTH) seems more advantageous in hemorheological point of view.
Pottgiesser, Torben; Ahlgrim, Christoph; Ruthardt, Sebastian; Dickhuth, Hans-Hermann; Schumacher, Yorck Olaf
The underlying mechanisms of altitude training are still a matter of controversial discussion but erythropoietic adaptations with an increase of total haemoglobin mass (tHb) have been shown in several studies, partly depending on an adequate hypoxic dose. The aim of this retrospective study was to investigate if a 3 weeks sojourn at moderate altitude (1816 m) with conventional training sessions (live and train at moderate altitude), especially under real and uncontrolled conditions, results in an increased tHb. tHb was measured in seven male cyclists competing at elite level (German national cycling team, U23 category) prior to the ascent to altitude and immediately after descent to sea-level. The athletes completed a 21 days altitude training camp living at 1816 m and training at 1800-2400 m during the competitive season. No significant difference was found in tHb after the altitude sojourn (prior 927+/-109g vs. 951+/-113g post, 95% CI -13-61g). Additionally, the analysis of red cell volume, plasma volume and blood volume or haemoglobin concentration [Hb] as well as haematocrit (Hct) did not reveal any significant changes. The data supports the theory that an adequate hypoxic dose is required for adaptations of the erythropoietic system with an increase of tHb and a threshold of approximately 2100-2500 m has to be exceeded.
Heinicke, Ilmar; Boehler, Annette; Rechsteiner, Thomas; Bogdanova, Anna; Jelkmann, Wolfgang; Hofer, Markus; Rawlings, Pablo; Araneda, Oscar F; Behn, Claus; Gassmann, Max; Heinicke, Katja
Oxidative stress occurs at altitude, and physical exertion might enhance this stress. In the present study, we investigated the combined effects of exercise and moderate altitude on redox balance in ten endurance exercising biathletes, and five sedentary volunteers during a 6-week-stay at 2,800 m. As a marker for oxidative stress, hydrogen peroxide (H(2)O(2)) was analyzed by the biosensor measuring system Ecocheck, and 8-iso prostaglandin F2alpha (8-iso PGF2alpha) was determined by enzyme immunoassay in exhaled breath condensate (EBC). To determine the whole blood antioxidative capacity, we measured reduced glutathione (GSH) enzymatically using Ellman's reagent. Exercising athletes and sedentary volunteers showed increased levels of oxidative markers at moderate altitude, contrary to our expectations; there was no difference between both groups. Therefore, all subjects' data were pooled to examine the oxidative stress response exclusively due to altitude exposure. H(2)O(2) levels increased at altitude and remained elevated for 3 days after returning to sea level (p altitude, but declined immediately after returning to sea level (p altitude resulted in elevated GSH levels (p altitude (p altitude for up to 6 weeks increases markers of oxidative stress in EBC independent of additional endurance training. Notably, this oxidative stress is still detectable 3 days upon return to sea level.
Amelia J. Carr, Philo U. Saunders, Brent S. Vallance, Laura A. Garvican-Lewis, Christopher J. Gore
Full Text Available This study examined effects of low altitude training and a live-high: train-low protocol (combining both natural and simulated modalities on haemoglobin mass (Hbmass, maximum oxygen consumption (VO2max, time to exhaustion, and submaximal exercise measures. Eighteen elite-level race-walkers were assigned to one of two experimental groups; lowHH (low Hypobaric Hypoxia: continuous exposure to 1380 m for 21 consecutive days; n = 10 or a combined low altitude training and nightly Normobaric Hypoxia (lowHH+NHnight: living and training at 1380 m, plus 9 h.night-1 at a simulated altitude of 3000 m using hypoxic tents; n = 8. A control group (CON; n = 10 lived and trained at 600 m. Measurement of Hbmass, time to exhaustion and VO2max was performed before and after the training intervention. Paired samples t-tests were used to assess absolute and percentage change pre and post-test differences within groups, and differences between groups were assessed using a one-way ANOVA with least significant difference post-hoc testing. Statistical significance was tested at p < 0.05. There was a 3.7% increase in Hbmass in lowHH+NHnight compared with CON (p = 0.02. In comparison to baseline, Hbmass increased by 1.2% (±1.4% in the lowHH group, 2.6% (±1.8% in lowHH+NHnight, and there was a decrease of 0.9% (±4.9% in CON. VO2max increased by ~4% within both experimental conditions but was not significantly greater than the 1% increase in CON. There was a ~9% difference in pre and post-intervention values in time to exhaustion after lowHH+NH-night (p = 0.03 and a ~8% pre to post-intervention difference (p = 0.006 after lowHH only. We recommend low altitude (1380 m combined with sleeping in altitude tents (3000 m as one effective alternative to traditional altitude training methods, which can improve Hbmass.
Garvican, L; Martin, D; Quod, M; Stephens, B; Sassi, A; Gore, C
To determine the time course of hemoglobin mass (Hb(mass)) to natural altitude training, Hb(mass), erythropoietin [EPO], reticulocytes, ferritin and soluble transferrin receptor (sTfR) were measured in 13 elite cyclists during, and 10 days after, 3 weeks of sea level (n=5) or altitude (n=8, 2760 m) training. Mean Hb(mass), with a typical error of ∼2%, increased during the first 11 days at altitude (mean ± standard deviation 2.9 ± 2.0%) and was 3.5 ± 2.5% higher than baseline after 19 days. [EPO] increased 64.2 ± 18.8% after 2 nights at altitude but was not different from baseline after 12 nights. Hb(mass) and [EPO] did not increase in sea level. Reticulocytes (%) were slightly elevated in altitude at Days 5 and 12 (18.9 ± 17.7% and 20.4 ± 25.3%), sTfR was elevated at Day 12 (18.9 ± 15.0%), but both returned to baseline by Day 20. Hb(mass) and [EPO] decreased on descent to sea level while ferritin increased. The mean increase in Hb(mass) observed after 11 days (∼300 h) of altitude training was beyond the measurement error and consitent with the mean increase after 300 h of simulated live high:train low altitude. Our results suggest that in elite cyclists, Hb(mass) increases progressively with 3 weeks of natural altitude exposure, with greater increases expected as exposure persists. © 2010 John Wiley & Sons A/S.
Wachsmuth, N B; Völzke, C; Prommer, N; Schmidt-Trucksäss, A; Frese, F; Spahl, O; Eastwood, A; Stray-Gundersen, J; Schmidt, W
Aim of the study was to determine the influence of classic altitude training on hemoglobin mass (Hb-mass) in elite swimmers under the following aspects: (1) normal oscillation of Hb-mass at sea level; (2) time course of adaptation and de-adaptation; (3) sex influences; (4) influences of illness and injury; (5) interaction of Hb-mass and competition performance. Hb-mass of 45 top swimmers (male 24; female 21) was repeatedly measured (~6 times) over the course of 2 years using the optimized CO-rebreathing method. Twenty-five athletes trained between one and three times for 3-4 weeks at altitude training camps (ATCs) at 2,320 m (3 ATCs) and 1,360 m (1 ATC). Performance was determined by analyzing 726 competitions according to the German point system. The variation of Hb-mass without hypoxic influence was 3.0 % (m) and 2.7 % (f). At altitude, Hb-mass increased by 7.2 ± 3.3 % (p altitude. In conclusion, the altitude (2,320 m) effect on Hb-mass is still present 3 weeks after return, it decisively depends on the health status, but is not influenced by sex. In healthy subjects it exceeds by far the oscillation occurring at sea level. After return from altitude performance increases after a delay of 3 weeks.
Woods, Amy L; Sharma, Avish P; Garvican-Lewis, Laura A; Saunders, Philo U; Rice, Anthony J; Thompson, Kevin G
High altitude exposure can increase resting metabolic rate (RMR) and induce weight loss in obese populations, but there is a lack of research regarding RMR in athletes at moderate elevations common to endurance training camps. The present study aimed to determine whether 4 weeks of classical altitude training affects RMR in middle-distance runners. Ten highly trained athletes were recruited for 4 weeks of endurance training undertaking identical programs at either 2200m in Flagstaff, Arizona (ALT, n = 5) or 600m in Canberra, Australia (CON, n = 5). RMR, anthropometry, energy intake, and hemoglobin mass (Hb mass ) were assessed pre- and posttraining. Weekly run distance during the training block was: ALT 96.8 ± 18.3km; CON 103.1 ± 5.6km. A significant interaction for Time*Group was observed for absolute (kJ.day -1 ) (F-statistic, p-value: F (1,8) =13.890, p = .01) and relative RMR (F (1,8) =653.453, p = .003) POST-training. No significant changes in anthropometry were observed in either group. Energy intake was unchanged (mean ± SD of difference, ALT: 195 ± 3921kJ, p = .25; CON: 836 ± 7535kJ, p = .75). A significant main effect for time was demonstrated for total Hb mass (g) (F (1,8) =13.380, p = .01), but no significant interactions were observed for either variable [Total Hb mass (g): F (1,8) =1.706, p = .23; Relative Hb mass (g.kg -1 ): F (1,8) =0.609, p = .46]. These novel findings have important practical application to endurance athletes routinely training at moderate altitude, and those seeking to optimize energy management without compromising training adaptation. Altitude exposure may increase RMR and enhance training adaptation,. During training camps at moderate altitude, an increased energy intake is likely required to support an increased RMR and provide sufficient energy for training and performance.
Nation, Daniel A; Bondi, Mark W; Gayles, Ellis; Delis, Dean C
Cognitive dysfunction from high altitude exposure is a major cause of civilian and military air disasters. Pilot training improves recognition of the early symptoms of altitude exposure so that countermeasures may be taken before loss of consciousness. Little is known regarding the nature of cognitive impairments manifesting within this critical window when life-saving measures may still be taken. Prior studies evaluating cognition during high altitude simulation have predominantly focused on measures of reaction time and other basic attention or motor processes. Memory encoding, retention, and retrieval represent critical cognitive functions that may be vulnerable to acute hypoxic/ischemic events and could play a major role in survival of air emergencies, yet these processes have not been studied in the context of high altitude simulation training. In a series of experiments, military aircrew underwent neuropsychological testing before, during, and after brief (15 min) exposure to high altitude simulation (20,000 ft) in a pressure-controlled chamber. Acute exposure to high altitude simulation caused rapid impairment in learning and memory with relative preservation of basic visual and auditory attention. Memory dysfunction was predominantly characterized by deficiencies in memory encoding, as memory for information learned during high altitude exposure did not improve after washout at sea level. Retrieval and retention of memories learned shortly before altitude exposure were also impaired, suggesting further impairment in memory retention. Deficits in memory encoding and retention are rapidly induced upon exposure to high altitude, an effect that could impact life-saving situational awareness and response. (JINS, 2017, 23, 1-10).
Bonne, Thomas Christian; Lundby, Carsten; Lundby, Anne Kristine; Sander, Mikael; Bejder, Jacob; Nordsborg, Nikolai Baastrup
The impact of altitude training on haematological parameters and the Athlete Biological Passport (ABP) was evaluated in international-level elite athletes. One group of swimmers lived high and trained high (LHTH, n = 10) for three to four weeks at 2130 m or higher whereas a control group (n = 10) completed a three-week training camp at sea-level. Haematological parameters were determined weekly three times before and four times after the training camps. ABP thresholds for haemoglobin concentration ([Hb]), reticulocyte percentage (RET%), OFF score and the abnormal blood profile score (ABPS) were calculated using the Bayesian model. After altitude training, six swimmers exceeded the 99% ABP thresholds: two swimmers exceeded the OFF score thresholds at day +7; one swimmer exceeded the OFF score threshold at day +28; one swimmer exceeded the threshold for RET% at day +14; and one swimmer surpassed the ABPS threshold at day +14. In the control group, no values exceeded the individual ABP reference range. In conclusion, LHTH induces haematological changes in Olympic-level elite athletes which can exceed the individually generated references in the ABP. Training at altitude should be considered a confounding factor for ABP interpretation for up to four weeks after altitude exposure but does not consistently cause abnormal values in the ABP. Copyright © 2014 John Wiley & Sons, Ltd.
Bonne, Thomas Christian; Lundby, Carsten; Lundby, Anne Kristine
The impact of altitude training on haematological parameters and the Athlete Biological Passport (ABP) was evaluated in international-level elite athletes. One group of swimmers lived high and trained high (LHTH, n = 10) for three to four weeks at 2130 m or higher whereas a control group (n = 10......) completed a three-week training camp at sea-level. Haematological parameters were determined weekly three times before and four times after the training camps. ABP thresholds for haemoglobin concentration ([Hb]), reticulocyte percentage (RET%), OFF score and the abnormal blood profile score (ABPS) were...... calculated using the Bayesian model. After altitude training, six swimmers exceeded the 99% ABP thresholds: two swimmers exceeded the OFF score thresholds at day +7; one swimmer exceeded the OFF score threshold at day +28; one swimmer exceeded the threshold for RET% at day +14; and one swimmer surpassed...
Klarod, Kultida; Philippe, Marc; Gatterer, Hannes; Burtscher, Martin
This pilot study aimed (a) to evaluate the effects of eccentric exercise training at low and moderate altitudes on physical fitness in pre-diabetic men and (b) to establish whether or not oxidative stress levels and antioxidant status were associated with performance improvements. In this crossover trial, five pre-diabetic men conducted nine downhill walking sessions (3 days/week, 3 consecutive weeks) at low altitude (from 1360 to 850 m) and one year later at moderate altitude (from 2447 to 2000 m). Exercise testing and the determination of parameters of oxidative stress and antioxidant capacity were performed pre- and post-training. The biological antioxidant activity of plasma (BAP) increased after eccentric training at moderate altitude ( p training at moderate-altitude training ( p = 0.009). Maximum power output improved after training at low altitude and the changes were significantly related to baseline BAP/dROMs ratio ( r = 0.90). No decrease was seen for fasting plasma glucose. Eccentric exercise training in pre-diabetic men improved performance only when performed at low altitude and this improvement was positively related to the baseline BAP/dROMs ratio. In contrast, 3 weeks of eccentric exercise training increased BAP levels and the BAP/dROMs ratio only at moderate altitude without improving the performance. Thus, one might speculate that the BAP/dROMs ratio has to increase before performance improvements occur at moderate altitude.
Sperlich, Billy; Achtzehn, Silvia; de Marées, Markus; von Papen, Henning; Mester, Joachim
There is a debate on the optimal way of monitoring training loads in elite endurance athletes especially during altitude training camps. In this case report, including nine members of the German national middle distance running team, we describe a practical approach to monitor the psychobiological stress markers during 21 days of altitude training (~2100 m above sea-level) to estimate the training load and to control muscle damage, fatigue, and/or chronic overreaching. Daily examination included: oxygen saturation of hemoglobin, resting heart rate, body mass, body and sleep perception, capillary blood concentration of creatine kinase. Every other day, venous serum concentration of blood urea nitrogen, venous blood concentration of hemoglobin, hematocrit, red and white blood cell were measured. If two or more of the above-mentioned stress markers were beyond or beneath the athlete's normal individual range, the training load of the subsequent training session was reduced. Running speed at 3 mmol L(-1) blood lactate (V3) improved and no athlete showed any signs of underperformance, chronic muscle damage, decrease body and sleep perception as well as activated inflammatory process during the 21 days. The dense screening of biomarkers in the present case study may stimulate further research to identify candidate markers for load monitoring in elite middle- and long-distance runners during a training camp at altitude. © 2016 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.
Płoszczyca, Kamila; Langfort, Józef; Czuba, Miłosz
Background: One of the goals of altitude training is to increase blood oxygen-carrying capacity in order to improve sea-level endurance performance in athletes. The elevated erythropoietin (EPO) production in hypoxia is a key factor in the achievement of enhanced hematological variables. The level of the EPO increase and acceleration of erythropoiesis depend on the duration of exposure and degree of hypoxia. Furthermore, many other factors may affect the hematological response to altitude training. Aim: The purpose of this narrative review was to: (1) analyze the kinetics of EPO and hematological variables during and after altitude training; (2) summarize the current state of knowledge about the possible causes of individual or cohort differences in EPO and hematological response to altitude training; (3) formulate practical guidelines for athletes to improve the efficiency of altitude training. Methods: A narrative review was performed following an electronic search of the databases PubMed/MEDLINE and SPORTDiscus via EBSCO for all English-language articles published between 1997 and 2017. Results: Complete unification of results from studies on EPO kinetics was difficult due to different time and frequency of blood sampling by different researchers during and after altitude training, but the data presented in the reviewed literature allowed us to detect certain trends. The results of the reviewed studies were divergent and indicated either increase or no change of hematological variables following altitude training. Factors that may affect the hematological response to altitude training include hypoxic dose, training content, training background of athletes, and/or individual variability of EPO production. Conclusions: Despite the potential benefits arising from altitude training, its effectiveness in improving hematological variables is still debatable. Further research and better understanding of factors influencing the response to altitude, as well as factors
Płoszczyca, Kamila; Langfort, Józef; Czuba, Miłosz
Background: One of the goals of altitude training is to increase blood oxygen-carrying capacity in order to improve sea-level endurance performance in athletes. The elevated erythropoietin (EPO) production in hypoxia is a key factor in the achievement of enhanced hematological variables. The level of the EPO increase and acceleration of erythropoiesis depend on the duration of exposure and degree of hypoxia. Furthermore, many other factors may affect the hematological response to altitude training. Aim: The purpose of this narrative review was to: (1) analyze the kinetics of EPO and hematological variables during and after altitude training; (2) summarize the current state of knowledge about the possible causes of individual or cohort differences in EPO and hematological response to altitude training; (3) formulate practical guidelines for athletes to improve the efficiency of altitude training. Methods: A narrative review was performed following an electronic search of the databases PubMed/MEDLINE and SPORTDiscus via EBSCO for all English-language articles published between 1997 and 2017. Results: Complete unification of results from studies on EPO kinetics was difficult due to different time and frequency of blood sampling by different researchers during and after altitude training, but the data presented in the reviewed literature allowed us to detect certain trends. The results of the reviewed studies were divergent and indicated either increase or no change of hematological variables following altitude training. Factors that may affect the hematological response to altitude training include hypoxic dose, training content, training background of athletes, and/or individual variability of EPO production. Conclusions: Despite the potential benefits arising from altitude training, its effectiveness in improving hematological variables is still debatable. Further research and better understanding of factors influencing the response to altitude, as well as factors
Full Text Available Background: One of the goals of altitude training is to increase blood oxygen-carrying capacity in order to improve sea-level endurance performance in athletes. The elevated erythropoietin (EPO production in hypoxia is a key factor in the achievement of enhanced hematological variables. The level of the EPO increase and acceleration of erythropoiesis depend on the duration of exposure and degree of hypoxia. Furthermore, many other factors may affect the hematological response to altitude training.Aim: The purpose of this narrative review was to: (1 analyze the kinetics of EPO and hematological variables during and after altitude training; (2 summarize the current state of knowledge about the possible causes of individual or cohort differences in EPO and hematological response to altitude training; (3 formulate practical guidelines for athletes to improve the efficiency of altitude training.Methods: A narrative review was performed following an electronic search of the databases PubMed/MEDLINE and SPORTDiscus via EBSCO for all English-language articles published between 1997 and 2017.Results: Complete unification of results from studies on EPO kinetics was difficult due to different time and frequency of blood sampling by different researchers during and after altitude training, but the data presented in the reviewed literature allowed us to detect certain trends. The results of the reviewed studies were divergent and indicated either increase or no change of hematological variables following altitude training. Factors that may affect the hematological response to altitude training include hypoxic dose, training content, training background of athletes, and/or individual variability of EPO production.Conclusions: Despite the potential benefits arising from altitude training, its effectiveness in improving hematological variables is still debatable. Further research and better understanding of factors influencing the response to altitude, as well
Chia, Michael; Liao, Chin-An; Huang, Chih-Yang; Lee, Wen-Chih; Hou, Chien-Wen; Yu, Szu-Hsien; Harris, M Brennan; Hsu, Tung-Shiung; Lee, Shin-Da; Kuo, Chia-Hua
Swimmers tend to have greater body fat than athletes from other sports. The purpose of the study was to examine changes in body composition after altitude hypoxia exposure and the role of blood distribution to the skeletal muscle in swimmers. With a constant training volume of 12.3 km/day, young male swimmers (N = 10, 14.8 ± 0.5 years) moved from sea-level to a higher altitude of 2,300 meters. Body composition was measured before and after translocation to altitude using dual-energy X-ray absorptiometry (DXA) along with 8 control male subjects who resided at sea level for the same period of time. To determine the effects of hypoxia on muscle blood perfusion, total hemoglobin concentration (THC) was traced by near-infrared spectroscopy (NIRS) in the triceps and quadriceps muscles under glucose-ingested and insulin-secreted conditions during hypoxia exposure (16% O2) after training. While no change in body composition was found in the control group, subjects who trained at altitude had unequivocally decreased fat mass (-1.7 ± 0.3 kg, -11.4%) with increased lean mass (+0.8 ± 0.2 kg, +1.5%). Arterial oxygen saturation significantly decreased with increased plasma lactate during hypoxia recovery mimicking 2,300 meters at altitude (~93% versus ~97%). Intriguingly, hypoxia resulted in elevated muscle THC, and sympathetic nervous activities occurred in parallel with greater-percent oxygen saturation in both muscle groups. In conclusion, the present study provides evidence that increased blood distribution to the skeletal muscle under postprandial condition may contribute to the reciprocally increased muscle mass and decreased body mass after a 3-week altitude exposure in swimmers.
Wilhite, Daniel P; Mickleborough, Timothy D; Laymon, Abigail S; Chapman, Robert F
The purpose of this study was to estimate the percentage of the increase in whole body maximal oxygen consumption (.VO(2max)) that is accounted for by increased respiratory muscle oxygen uptake after altitude training. Six elite male distance runners (.VO(2max) = 70.6 ± 4.5 ml kg(-1) min(-1)) and one elite female distance runner (.VO(2max)) = 64.7 ml kg(-1) min(-1)) completed a 28-day "live high-train low" training intervention (living elevation, 2,150 m). Before and after altitude training, subjects ran at three submaximal speeds, and during a separate session, performed a graded exercise test to exhaustion. A regression equation derived from published data was used to estimate respiratory muscle .VO(2) (.VO(2RM)) using our ventilation (.VE) values. .VO(2RM) was also estimated retrospectively from a larger group of distance runners (n = 22). .VO(2max) significantly (p altitude (196 ± 59 ml min(-1)), while (.VE) at .VO(2max) also significantly (p altitude (201 ± 36 ml min(-1)), along with a 10.8 ± 2.1 l min(-1) increase in (.VE), thus requiring an estimated 27 % of Δ .VO(2max) Our data suggest that a substantial portion of the improvement in .VO(2max) with chronic altitude training goes to fuel the respiratory muscles as opposed to the musculature which directly contributes to locomotion. Consequently, the time-course of decay in ventilatory acclimatization following return to sea-level may have an impact on competitive performance.
Marlow, Nicholas; Altree, Meryl; Babidge, Wendy; Field, John; Hewett, Peter; Maddern, Guy J
Training in basic laparoscopic skills can be undertaken using traditional methods, where trainees are educated by experienced surgeons through a process of graduated responsibility or by simulation-based training. This study aimed to assess whether simulation trained individuals reach the same level of proficiency in basic laparoscopic skills as traditional trained participants when assessed in a simulated environment. A prospective study was undertaken. Participants were allocated to one of two cohorts according to surgical experience. Participants from the inexperienced cohort were randomized to receive training in basic laparoscopic skills on either a box trainer or a virtual reality simulator. They were then assessed on the simulator on which they did not receive training. Participants from the experienced cohort, considered to have received traditional training in basic laparoscopic skills, did not receive simulation training and were randomized to either the box trainer or virtual reality simulator for skills assessment. The assessment scores from different cohorts on either simulator were then compared. A total of 138 participants completed the assessment session, 101 in the inexperienced simulation-trained cohort and 37 on the experienced traditionally trained cohort. There was no statistically significant difference between the training outcomes of simulation and traditionally trained participants, irrespective of the simulator type used. The results demonstrated that participants trained on either a box trainer or virtual reality simulator achieved a level of basic laparoscopic skills assessed in a simulated environment that was not significantly different from participants who had been traditionally trained in basic laparoscopic skills. © 2013 Royal Australasian College of Surgeons.
García-Ramos, Amador; Padial, Paulino; de la Fuente, Blanca; Argüelles-Cienfuegos, Javier; Bonitch-Góngora, Juan; Feriche, Belén
This study aimed (a) to analyze the development in the squat jump height and swimming start performance after an altitude training camp, (b) to correlate the jump height and swimming start performance before and after the altitude training period, and (c) to correlate the percent change in the squat jump height with the percent change in swimming start performance. Fifteen elite male swimmers from the Spanish Junior National Team (17.1 ± 0.8 years) were tested before and after a 17-day training camp at moderate altitude. The height reached in the squat jump exercise with additional loads of 0, 25, 50, 75, and 100% of swimmers' pretest body weight and swimming start performance (time to 5, 10, and 15 m) were the dependent variables analyzed. Significant increases in the jump height (p ≤ 0.05; effect size [ES]: 0.35-0.48) and swimming start performance (p jump height before training (r = -0.56 to -0.77) and after training (r = -0.50 to -0.71). The change in the squat jump height was inversely correlated with the change in the start time at 5 m (r = -0.47), 10 m (r = -0.73), and 15 m (r = -0.62). These results suggest that altitude training can be suitable to enhance explosive performance. The correlations obtained between the squat jump height and start time in the raw and change scores confirm the relevance of having high levels of lower-body muscular power to optimize swimming start performance.
Bishop, David J; Girard, Olivier
Team sports are increasingly popular, with millions of participants worldwide. Athletes engaged in these sports are required to repeatedly produce skilful actions and maximal or near-maximal efforts (eg, accelerations, changes in pace and direction, sprints, jumps and kicks), interspersed with brief recovery intervals (consisting of rest or low-intensity to moderate-intensity activity), over an extended period of time (1-2 h). While performance in most team sports is dominated by technical and tactical proficiencies, successful team-sport athletes must also have highly-developed, specific, physical capacities. Much effort goes into designing training programmes to improve these physical capacities, with expected benefits for team-sport performance. Recently, some team sports have introduced altitude training in the belief that it can further enhance team-sport physical performance. Until now, however, there is little published evidence showing improved team-sport performance following altitude training, despite the often considerable expense involved. In the absence of such studies, this review will identify important determinants of team-sport physical performance that may be improved by altitude training, with potential benefits for team-sport performance. These determinants can be broadly described as factors that enhance either sprint performance or the ability to recover from maximal or near-maximal efforts. There is some evidence that some of these physical capacities may be enhanced by altitude training, but further research is required to verify that these adaptations occur, that they are greater than what could be achieved by appropriate sea-level training and that they translate to improved team-sport performance.
Bishop, David J; Girard, Olivier
Team sports are increasingly popular, with millions of participants worldwide. Athletes engaged in these sports are required to repeatedly produce skilful actions and maximal or near-maximal efforts (eg, accelerations, changes in pace and direction, sprints, jumps and kicks), interspersed with brief recovery intervals (consisting of rest or low-intensity to moderate-intensity activity), over an extended period of time (1–2 h). While performance in most team sports is dominated by technical and tactical proficiencies, successful team-sport athletes must also have highly-developed, specific, physical capacities. Much effort goes into designing training programmes to improve these physical capacities, with expected benefits for team-sport performance. Recently, some team sports have introduced altitude training in the belief that it can further enhance team-sport physical performance. Until now, however, there is little published evidence showing improved team-sport performance following altitude training, despite the often considerable expense involved. In the absence of such studies, this review will identify important determinants of team-sport physical performance that may be improved by altitude training, with potential benefits for team-sport performance. These determinants can be broadly described as factors that enhance either sprint performance or the ability to recover from maximal or near-maximal efforts. There is some evidence that some of these physical capacities may be enhanced by altitude training, but further research is required to verify that these adaptations occur, that they are greater than what could be achieved by appropriate sea-level training and that they translate to improved team-sport performance. PMID:24282200
Videodisc skills training programs developed by Industrial Training Corporation are being used and evaluated by major industrial facilities. In one such study, interactive videodisc training programs were compared to videotape and instructor-based training to determine the effectiveness of videodisc in terms of performance, training time and trainee attitudes. Results showed that when initial training was done using the interactive videodisc system, trainee performance was superior to the performance of trainees using videotape, and approximately equal to the performance of those trained by an instructor. When each method was used in follow-up training, interactive videodisc was definitely the most effective. Results also indicate that training time can be reduced using interactive videodisc. Attitudes of both trainees and instructors toward the interactive videodisc training were positive
Cazorla, O; Aït Mou, Y; Goret, L; Vassort, G; Dauzat, M; Lacampagne, A; Tanguy, S; Obert, P
Previous studies have questioned whether there is an improved cardiac function after high-altitude training. Accordingly, the present study was designed specifically to test whether this apparent blunted response of the whole heart to training can be accounted for by altered mechanical properties at the cellular level. Adult rats were trained for 5 weeks under normoxic (N, NT for sedentary and trained animals, respectively) or hypobaric hypoxic (H, HT) conditions. Cardiac morphology and function were evaluated by echocardiography. Calcium Ca2+ sensitivity of the contractile machinery was estimated in skinned cardiomyocytes isolated from the left ventricular (LV) sub-epicardium (Epi) and sub-endocardium (Endo) at short and long sarcomere lengths (SL). Cardiac remodelling was harmonious (increase in wall thickness with chamber dilatation) in NT rats and disharmonious (hypertrophy without chamber dilatation) in HT rats. Contrary to NT rats, HT rats did not exhibit enhancement in global cardiac performance evaluated by echocardiography. Stretch- dependent Ca2+ sensitization of the myofilaments (cellular index of the Frank-Starling mechanism) increased from Epi to Endo in N rats. Training in normoxic conditions further increased this stretch-dependent Ca2+ sensitization. Chronic hypoxia did not significantly affect myofibrilar Ca2+ sensitivity. In contrast, high-altitude training decreased Ca2+ sensitivity of the myofilaments at both SL, mostly in Endo cells, resulting in a loss of the transmural gradient of the stretch-dependent Ca2+ sensitization. Expression of myosin heavy chain isoforms was affected both by training and chronic hypoxia but did not correlate with mechanical data. Training at sea level increased the transmural gradient of stretch-dependent Ca2+ sensitization of the myofilaments, accounting for an improved Frank-Starling mechanism. High-altitude training depressed myofilament response to Ca2+, especially in the Endo layer. This led to a reduction in
Heil, K M; Keenan, A C M
In recent years, small scale counter-insurgency and expeditionary operations have frequently taken place in mountainous, high-altitude areas. Preparation of soldiers for these environments has typically focussed on extended stays at altitude to ensure physiological acclimatisation. However, with the likelihood that future UK deployments may be unpredictable and thus with little time for preparation, is there a means by which the same acclimatisation may be achieved? The field of athletics has been researching such adaptations since the rise of the elite North African long-distance runners in the 1960s. These athletes all lived high above sea level and had become accustomed to performing in the relatively hypoxic environment found at high altitudes. The research has focussed on eliciting physiological acclimatisation in as short a time as possible, while maintaining the ability to train at the correct intensity. In the following review of altitude training we highlight areas for future investigation and assess whether protocols developed for athletes can be applied to military personnel.
Chen, Chung-Yu; Hou, Chien-Wen; Bernard, Jeffrey R; Chen, Chiu-Chou; Hung, Ta-Cheng; Cheng, Lu-Ling; Liao, Yi-Hung; Kuo, Chia-Hua
High altitude training is a widely used strategy for improving aerobic exercise performance. Both Rhodiola crenulata (R) and Cordyceps sinensis (C) supplements have been reported to improve exercise performance. However, it is not clear whether the provision of R and C during high altitude training could further enhance aerobic endurance capacity. In this study, we examined the effect of R and C based supplementation on aerobic exercise capacity following 2-week high altitude training. Alterations to autonomic nervous system activity, circulatory hormonal, and hematological profiles were investigated. Eighteen male subjects were divided into two groups: Placebo (n=9) and R/C supplementation (RC, n=9). Both groups received either RC (R: 1400 mg+C: 600 mg per day) or the placebo during a 2-week training period at an altitude of 2200 m. After 2 weeks of altitude training, compared with Placebo group, the exhaustive run time was markedly longer (Placebo: +2.2% vs. RC: +5.7%; paltitude training (paltitude training provides greater training benefits in improving aerobic performance. This beneficial effect of RC treatment may result from better maintenance of PNS activity and accelerated physiological adaptations during high altitude training.
Gore, Christopher J; Sharpe, Ken; Garvican-Lewis, Laura A; Saunders, Philo U; Humberstone, Clare E; Robertson, Eileen Y; Wachsmuth, Nadine B; Clark, Sally A; McLean, Blake D; Friedmann-Bette, Birgit; Neya, Mitsuo; Pottgiesser, Torben; Schumacher, Yorck O; Schmidt, Walter F
To characterise the time course of changes in haemoglobin mass (Hbmass) in response to altitude exposure. This meta-analysis uses raw data from 17 studies that used carbon monoxide rebreathing to determine Hbmass prealtitude, during altitude and postaltitude. Seven studies were classic altitude training, eight were live high train low (LHTL) and two mixed classic and LHTL. Separate linear-mixed models were fitted to the data from the 17 studies and the resultant estimates of the effects of altitude used in a random effects meta-analysis to obtain an overall estimate of the effect of altitude, with separate analyses during altitude and postaltitude. In addition, within-subject differences from the prealtitude phase for altitude participant and all the data on control participants were used to estimate the analytical SD. The 'true' between-subject response to altitude was estimated from the within-subject differences on altitude participants, between the prealtitude and during-altitude phases, together with the estimated analytical SD. During-altitude Hbmass was estimated to increase by ∼1.1%/100 h for LHTL and classic altitude. Postaltitude Hbmass was estimated to be 3.3% higher than prealtitude values for up to 20 days. The within-subject SD was constant at ∼2% for up to 7 days between observations, indicative of analytical error. A 95% prediction interval for the 'true' response of an athlete exposed to 300 h of altitude was estimated to be 1.1-6%. Camps as short as 2 weeks of classic and LHTL altitude will quite likely increase Hbmass and most athletes can expect benefit.
Chapman, Robert F; Laymon Stickford, Abigail S; Lundby, Carsten; Levine, Benjamin D
While a number of published studies exist to guide endurance athletes with the best practices regarding implementation of altitude training, a key unanswered question concerns the proper timing of return to sea level prior to major competitions. Evidence reviewed here suggests that, altogether, the deacclimatization responses of hematological, ventilatory, and biomechanical factors with return to sea level likely interact to determine the best timing for competitive performance.
Gentry, James; Rango, Juan; Zhang, Jianzhong; Biedermann, Shane
Decompression sickness (DCS) is a potential danger and risk for both divers and aircrew alike. DCS is also a potential side effect of altitude (hypobaric) chamber training as well and can present long after training occurs. Literature review shows that altitude chamber induced DCS has approximately a 0.25% incidence. A 32-yr-old, active duty military member developed symptoms of DCS 3 h after his hypobaric chamber training. Unfortunately, he did not seek treatment for DCS until 48 h after the exposure. His initial treatment included ground level oxygen therapy for 30 min at 12 L of oxygen per minute using a nonrebreathing mask. He achieved complete symptom resolution and was returned to duty. However, 12 d after his initial Flight Medicine evaluation, the patient returned complaining of a right temporal headache, multijoint pains, and fatigue. He was treated in the hyperbaric chamber and had complete resolution of symptoms. He was returned to flying status and 5 mo later denied any return of symptoms. Hypobaric chamber familiarity training is a requirement for all military aircrew personnel to allow them assess their ability to identify symptoms of hypoxia. This training method is not only costly to maintain, but it also places aircrew and chamber technicians at risk for potential long-term side effects from failed recompression treatment of DCS. We are presenting a case of recurrent DCS symptoms 12 d after initial ground level oxygen therapy.Gentry J, Rango J, Zhang J, Biedermann S. Latent presentation of decompression sickness after altitude chamber training in an active duty flier. Aerosp Med Hum Perform. 2017; 88(4):427-430.
León-López, Josefa; Calderón-Soto, Carmen; Pérez-Sánchez, Matías; Feriche, Belén; Iglesias, Xavier; Chaverri, Diego; Rodréguez, Ferran A
Using a controlled parallel group longitudinal trial design, we investigated the effects of different training interventions on the prooxidant/antioxidant status of elite athletes: living and training at moderate altitude for 3 (Hi-Hi3) and 4 weeks (Hi-Hi), and for 4 weeks too, living high and training high and low (Hi-HiLo) and living and training at sea level (Lo-Lo). From 61 swimmers, 54 completed the study. Nitrites, carbonyls, and lipid peroxidation (LPO) levels were assessed in plasma. Enzymatic antioxidants glutathione peroxidase (GPx) and glutathione reductase (GRd), and non-enzymatic antioxidants total glutathione (GST), reduced glutathione (GSH) and oxidized glutathione (GSSG) were analysed in the erythrocyte fraction. At the end of the intervention, nitrites levels were similar in all altitude groups but higher than in the Lo-Lo controls (P = .02). Hi-HiLo had greater GPx activity than Hi-Hi and Hi-Hi3 during most of the intervention (P ≤ .001). GRd activity was higher in Lo-Lo than in Hi-Hi at the end of the training camp (P ≤ .001). All groups showed increased levels of LPO, except Lo-Lo, and carbonyls at the end of the study (P ≤ .001). Training at altitude for 3 or 4 weeks drives oxidative stress leading to cellular damage mainly by worsening the antioxidant capacities. The GSSG/GSH ratio appears to be related to perceived exertion and fatigue. The stronger antioxidant defence showed by the Hi-HiLo group suggests an inverse relationship between redox alterations and performance. Further studies are required to investigate the role of oxidative stress in acclimatization, performance, and health.
Diebel, Sebastian R; Newhouse, Ian; Thompson, David S; Johnson, Vineet B K
Running economy (RE) and VO 2 max are important predictors of endurance performance for elite and semi-elite endurance athletes, with RE being an appropriate predictor in a homogenous running population. Altitude training has been observed to change RE (mL.kg -1 .min -1 ), and VO 2 max due to alterations resulting from acclimatization. This study tracked changes in RE and VO 2 max before and after a 10-day altitude training camp at 1828 meters. VO 2 max, RE expressed calorically, and respiratory exchange ratio (RER), were measured below anaerobic threshold (AT) to observe differences between pre-and post-altitude training. Eight varsity cross-country runners between the ages of 18 and 22 years performed an incremental treadmill test, pre- and post-10-day altitude training. Paired samples t-tests were used to statistically analyze the data. Average RE (VO 2 mL.kg -1 .min -1 ) improved following altitude intervention ( M = 56.44 ± 4.28) compared to pre-altitude training (61.30 ± 7.56). These differences were statistically significant t ( 7 )= 2.71, p =.014. RE expressed as kcals.kg -1 .km -1 improved following altitude training (16.73 ± 2.96) compared to (18.44 ± 4.04) pre-altitude training and was statistically significant t( 7 ) =3.08, p = .008. RER taken during the last minute of steady-state was higher (0.97, ± .019) post-altitude training, compared to (0.90 ± .043) pre-altitude. These differences were statistically significant t ( 7 ) -3.62, p =.008. VO 2 max (mL.kg -1 .min -1 ) was lower in 6 out of 8 participants (63.91, ± 8.65) post-altitude compared to (69.90, ± 10.80) pre-altitude and was statistically significant t( 7 ) = 2.33, p =.026. The observed improvements in RE may be beneficial for endurance athletes competing and/or training at moderate altitudes near 1828 meters.
Focuses on the comparative use of training from human performance technology (HPT) and traditional training perspectives, based on taxonomy. Concludes that the primary difference is a holistic systems performance improvement approach by eliminating barriers with HPT versus reaction or response to a set of business objectives in traditional…
Impact of Training traditional birth attendants on maternal mortality and ... with focus on reducing the high rate of maternal and new-born mortality in rural settings in ... What is needed is to identify TBAs, map their distribution and train them on ...
de Paula, Paula; Niebauer, Josef
High altitude training has become a mainstay in endurance sports, with live high-train low as the current protocol of choice. Athletes either live or sleep in artificial or natural hypoxic conditions with the aim to increase serum erythropoietin concentrations, which are thought to improve maximum oxygen uptake and thus exercise performance. Changes, however, are not very striking and only apparent in so-called responders, who are not a well-defined group and may be as little as 50% of the trained study population. Whereas some studies show minor improvement, others report no change or even worsening. Furthermore, the mechanisms behind the proposed beneficial changes remain obscure and are far from being proven. There is an evident lack of sufficiently powered randomized, double-blinded studies, with training protocols that are identical for all groups and groups that are indeed comparable. Several studies discriminate between responders and non-responders, without clearly assessing the characteristics of the so-called responders. Until this has been done, it remains unclear if such a group really exists and how these subjects are characterized. This, however, would be of immense value, so protocols could be tailored to athletes' needs. Taken together, the current literature on natural or artificial hypoxia somewhat documents improved performance at high but not low altitude.
Yanagisawa, Kae; Ito, Osamu; Nagai, Satsuki; Onishi, Shohei
To prevent water loss in the early stage of high altitude training, we focused on the effect of electrolyte-carbohydrate beverage (EC). Subjects were 16 male university students who belonged to a ski club. They had ski training at an altitude of 1,800 m. The water (WT) group drank only water, and the EC group drank only an electrolyte-carbohydrate beverage. They arrived at the training site in the late afternoon. The study started at 7 pm on the day of arrival and continued until noon of the 4(th) day. In the first 12 hours, 1 L of beverages were given. On the second and third days, 2.5 L of beverages were given. All subjects ate the same meals. Each morning while in fasting condition, subjects were weighed and blood was withdrawn for various parameters (hemoglobin, hematocrit, sodium, potassium and aldosterone). Urine was collected at 12 hour intervals for a total 60 hours (5 times). The urine volume, gravity, sodium and potassium concentrations were measured. Peripheral oxygen saturation and heart rate were measured during sleep with a pulse oximeter. Liquid intakes in both groups were similar, hence the electrolytes intake was higher in the EC group than in the WT group. The total urine volume was lower in the EC group than in the WT group, respectively (paltitude training may be effective in decreasing urinary output and preventing loss of blood plasma volume.
McLean, Blake D; Buttifant, David; Gore, Christopher J; White, Kevin; Kemp, Justin
To quantify the year-to-year variability of altitude-induced changes in haemoglobin mass (Hb(mass)) in elite team-sport athletes. 12 Australian-Footballers completed a 19-day (ALT1) and 18-day (ALT2) moderate altitude (∼2100 m), training camp separated by 12 months. An additional 20 participants completed only one of the two training camps (ALT1 additional n=9, ALT2 additional n=11). Total Hb(mass) was assessed using carbon monoxide rebreathing before (PRE), after (POST₁) and 4 weeks after each camp. The typical error of Hb(mass) for the pooled data of all 32 participants was 2.6%. A contemporary statistics analysis was used with the smallest worthwhile change set to 2% for Hb(mass). POST₁ Hb(mass) was very likely increased in ALT1 (3.6 ± 1.6%, n=19; mean ± ∼90 CL) as well as ALT2 (4.4 ± 1.3%, n=23) with an individual responsiveness of 1.3% and 2.2%, respectively. There was a small correlation between ALT1 and ALT2 (R=0.21, p=0.59) for a change in Hb(mass), but a moderately inverse relationship between the change in Hb(mass) and initial relative Hb(mass) (g/kg (R=-0.51, p=0.04)). Two preseason moderate altitude camps 1 year apart yielded a similar (4%) mean increase in Hb(mass) of elite footballers, with an individual responsiveness of approximately half the group mean effect, indicating that most players gained benefit. Nevertheless, the same individuals generally did not change their Hb(mass) consistently from year to year. Thus, a 'responder' or 'non-responder' to altitude for Hb(mass) does not appear to be a fixed trait.
García-Ramos, Amador; Štirn, Igor; Padial, Paulino; Argüelles-Cienfuegos, Javier; De la Fuente, Blanca; Calderón, Carmen; Bonitch-Góngora, Juan; Tomazin, Katja; Strumbelj, Boro; Strojnik, Vojko; Feriche, Belén
This study evaluated the influence of an altitude training (AT) camp on swimming start time and loaded squat jump performance. To accomplish this goal, 13 international swimmers (8 women, 5 men) were allocated to both the control (Sea Level Training, SLT) and experimental conditions (AT, 2320 m above sea level) that were separated by a one year period. All tests (15 m freestyle swimming start and loaded squat jumps with additional loads of 25%, 50%, 75%, and 100% of swimmers' body weight) were performed before and after a concurrent 3-week strength and endurance training program prescribed by the national coach. Following the SLT camp, significant impairments in swimming start times to 10 (+3.1%) and 15 m (+4.0%) were observed (P 0.05). Trivial changes in peak velocity were obtained during the loaded squat jump after both training periods (effect sizes: training high-living high strategy concurrent training of 3 weeks does not adversely affect swimming start time and loaded squat jump performance in high level swimmers, but further studies are necessary to assess the effectiveness of power-oriented resistance training in the development of explosive actions.
Girard, Olivier; Amann, Markus; Aughey, Robert; Billaut, François; Bishop, David J; Bourdon, Pitre; Buchheit, Martin; Chapman, Robert; D'Hooghe, Michel; Garvican-Lewis, Laura A; Gore, Christopher J; Millet, Grégoire P; Roach, Gregory D; Sargent, Charli; Saunders, Philo U; Schmidt, Walter; Schumacher, Yorck O
Despite the limited research on the effects of altitude (or hypoxic) training interventions on team-sport performance, players from all around the world engaged in these sports are now using altitude training more than ever before. In March 2013, an Altitude Training and Team Sports conference was held in Doha, Qatar, to establish a forum of research and practical insights into this rapidly growing field. A round-table meeting in which the panellists engaged in focused discussions concluded this conference. This has resulted in the present position statement, designed to highlight some key issues raised during the debates and to integrate the ideas into a shared conceptual framework. The present signposting document has been developed for use by support teams (coaches, performance scientists, physicians, strength and conditioning staff) and other professionals who have an interest in the practical application of altitude training for team sports. After more than four decades of research, there is still no consensus on the optimal strategies to elicit the best results from altitude training in a team-sport population. However, there are some recommended strategies discussed in this position statement to adopt for improving the acclimatisation process when training/competing at altitude and for potentially enhancing sea-level performance. It is our hope that this information will be intriguing, balanced and, more importantly, stimulating to the point that it promotes constructive discussion and serves as a guide for future research aimed at advancing the bourgeoning body of knowledge in the area of altitude training for team sports.
Girard, Olivier; Amann, Markus; Aughey, Robert; Billaut, François; Bishop, David J; Bourdon, Pitre; Buchheit, Martin; Chapman, Robert; D'Hooghe, Michel; Garvican-Lewis, Laura A; Gore, Christopher J; Millet, Grégoire P; Roach, Gregory D; Sargent, Charli; Saunders, Philo U; Schmidt, Walter; Schumacher, Yorck O
Despite the limited research on the effects of altitude (or hypoxic) training interventions on team-sport performance, players from all around the world engaged in these sports are now using altitude training more than ever before. In March 2013, an Altitude Training and Team Sports conference was held in Doha, Qatar, to establish a forum of research and practical insights into this rapidly growing field. A round-table meeting in which the panellists engaged in focused discussions concluded this conference. This has resulted in the present position statement, designed to highlight some key issues raised during the debates and to integrate the ideas into a shared conceptual framework. The present signposting document has been developed for use by support teams (coaches, performance scientists, physicians, strength and conditioning staff) and other professionals who have an interest in the practical application of altitude training for team sports. After more than four decades of research, there is still no consensus on the optimal strategies to elicit the best results from altitude training in a team-sport population. However, there are some recommended strategies discussed in this position statement to adopt for improving the acclimatisation process when training/competing at altitude and for potentially enhancing sea-level performance. It is our hope that this information will be intriguing, balanced and, more importantly, stimulating to the point that it promotes constructive discussion and serves as a guide for future research aimed at advancing the bourgeoning body of knowledge in the area of altitude training for team sports. PMID:24282213
Eminov, Farid; Golitsyna, Irina
The paper presents issues of modern IT-specialists training. Formation of information-educational environment of IT-professionals is discussed. Studying of enterprise infocommunication infrastructure and its management features within a framework of the traditional educational process is considered. [For the complete proceedings, see ED579395.
Diebel, Sebastian R; Newhouse, Ian; Thompson, David S; Johnson, Vineet B K
Altitude training has been shown to alter blood lactate (BL) levels due to alterations resulting from acclimatization. This study aims to estimate the impact of altitude training on BL changes immediately following an incremental treadmill test and during recovery before and after 10-day altitude training at approximately 1828 meters. Eight varsity cross-country runners performed an incremental treadmill test (ITT), pre and post-altitude training. Resting and post-warm-up BL values were recorded. During ITT, heart rate (HR), oxygen saturation (SpO2), and time to exhaustion were monitored. BL was also measured post-ITT at 0, 2, 4, 6, and 8 minutes. The average of all BL values was higher following altitude intervention (8.8 ± 4.6 mmol/L) compared to pre-intervention (7.4 ± 3.3 mmol/L). These differences were statistically significant ( t (6) = -2.40, p = .026). BL immediately (0 minutes) after the ITT was higher following the altitude intervention (13.6 ± 3.6 mmol/L) compared to pre-intervention (9.7 ± 3.8 mmol/L) and was statistically significant ( t (7) = -3.30, p = .006). Average HR during the ITT was lower following the altitude intervention (176.9 ± 11.1 bpm) compared to pre (187 ± 9.5 bpm), these differences were statistically significant ( t (28)= 18.07, p= altitude intervention at 1828 meters may benefit varsity cross-country runners. The higher post-exercise BL may be attributed to more anaerobic contributions. Lower HR may suggest a larger stroke volume and/or more efficient O2 carrying capacity.
McLean, Blake D; Buttifant, David; Gore, Christopher J; White, Kevin; Liess, Carsten; Kemp, Justin
Little research has been done on the physiological and performance effects of altitude training on team-sport athletes. Therefore, this study examined changes in 2000-m time-trial running performance (TT), hemoglobin mass (Hbmass), and intramuscular carnosine content of elite Australian Football (AF) players after a preseason altitude camp. Thirty elite AF players completed 19 days of living and training at either moderate altitude (~2130 m; ALT, n = 21) or sea level (CON, n = 9). TT performance and Hbmass were assessed preintervention (PRE) and postintervention (POST1) in both groups and at 4 wk after returning to sea level (POST2) in ALT only. Improvement in TT performance after altitude was likely 1.5% (± 4.8-90%CL) greater in ALT than in CON, with an individual responsiveness of 0.8%. Improvements in TT were maintained at POST2 in ALT. Hbmass after altitude was very likely increased in ALT compared with CON (2.8% ± 3.5%), with an individual responsiveness of 1.3%. Hbmass returned to baseline at POST2. Intramuscular carnosine did not change in either gastrocnemius or soleus from PRE to POST1. A preseason altitude camp improved TT performance and Hbmass in elite AF players to a magnitude similar to that demonstrated by elite endurance athletes undertaking altitude training. The individual responsiveness of both TT and Hbmass was approximately half the group mean effect, indicating that most players gained benefit. The maintenance of running performance for 4 wk, despite Hbmass returning to baseline, suggests that altitude training is a valuable preparation for AF players leading into the competitive season.
Bejder, Jacob; Nordsborg, Nikolai Baastrup
The novel hypothesis that "Live High-Train Low" (LHTL) does not improve sport-specific exercise performance (e.g., time trial) is discussed. Indeed, many studies demonstrate improved performance after LHTL but unfortunately control groups are often lacking, leaving open the possibility of training...
Aughey, Robert J; Buchheit, Martin; Garvican-Lewis, Laura A; Roach, Gregory D; Sargent, Charli; Billaut, François; Varley, Matthew C; Bourdon, Pitre C; Gore, Christopher J
The question of whether altitude training can enhance subsequent sea-level performance has been well investigated over many decades. However, research on this topic has focused on athletes from individual or endurance sports, with scant number of studies on team-sport athletes. Questions that need to be answered include whether this type of training may enhance team-sport athlete performance, when success in team-sport is often more based on technical and tactical ability rather than physical capacity per se. This review will contrast and compare athletes from two sports representative of endurance (cycling) and team-sports (soccer). Specifically, we draw on the respective competition schedules, physiological capacities, activity profiles and energetics of each sport to compare the similarities between athletes from these sports and discuss the relative merits of altitude training for these athletes. The application of conventional live-high, train-high; live-high, train-low; and intermittent hypoxic training for team-sport athletes in the context of the above will be presented. When the above points are considered, we will conclude that dependent on resources and training objectives, altitude training can be seen as an attractive proposition to enhance the physical performance of team-sport athletes without the need for an obvious increase in training load.
Aughey, Robert J; Buchheit, Martin; Garvican-Lewis, Laura A; Roach, Gregory D; Sargent, Charli; Billaut, François; Varley, Matthew C; Bourdon, Pitre C; Gore, Christopher J
The question of whether altitude training can enhance subsequent sea-level performance has been well investigated over many decades. However, research on this topic has focused on athletes from individual or endurance sports, with scant number of studies on team-sport athletes. Questions that need to be answered include whether this type of training may enhance team-sport athlete performance, when success in team-sport is often more based on technical and tactical ability rather than physical capacity per se. This review will contrast and compare athletes from two sports representative of endurance (cycling) and team-sports (soccer). Specifically, we draw on the respective competition schedules, physiological capacities, activity profiles and energetics of each sport to compare the similarities between athletes from these sports and discuss the relative merits of altitude training for these athletes. The application of conventional live-high, train-high; live-high, train-low; and intermittent hypoxic training for team-sport athletes in the context of the above will be presented. When the above points are considered, we will conclude that dependent on resources and training objectives, altitude training can be seen as an attractive proposition to enhance the physical performance of team-sport athletes without the need for an obvious increase in training load. PMID:24255910
Alice Ciolino, a midwife from London spent eight months in Ethiopia with Doctors of the World. Her mission was to train Traditional Birth Attendants (TBAs). Based in the Somali region of Ethiopia, access to healthcare facilities was limited; indeed Kebri Dehar had the only hospital in the region. Here Alice shares her experience of what it is like to live and work in a remote part of the world, far from the medical facilities we take for granted in the West.
Full Text Available Objective To investigate the effects of plateau hypoxia environment on the physiology and biochemistry indicators of troops executing different combat mission. Methods Troops included the soldiers in camp (station altitude 4030m and 4600m and those soldiers in field training (altitude 4300m for one month. Blood samples were collected and the physiology and biochemistry indicators were detected including heart rate (HR, blood pressure (BP, oxygen saturation (SpO2 and the concentrations of hemoglobin (Hb, serum total protein (TP, albumin (ALB and globulin (GLB, the ratio of albumin and globulin (A/G, concentrations of total cholesterol (TC, triglycerides (TG, high-density lipoprotein cholesterol (HDL-C and low density lipoprotein cholesterol (LDL-C, creatine kinase (CK, lactic dehydrogenase (LDH, aspartate aminotransferase (AST, alanine aminotransferase (ALT and AST/ALT. Results The HR was significantly higher in soldiers of field training (82.25±14.10 beats/min than in soldiers stationed in camp (74.18±9.02 beats/min, P0.05. The concentration of Hb and the prevalence of plateau polycythemia were significantly higher in soldiers of field training (211.6±17.4g/L and 55.6% than in soldiers stationed in camp (199.3±22.7g/L and 25.7%, P0.05. The concentration of serum LDH was significantly higher and the abnormality rate of LDH was also higher in soldiers of field training (273.70±136.74U/L and 72.7% than in soldiers stationed in camp (205.19±77.94 U/L and 51.1%, P<0.01 and P<0.05. Conclusions The protein nutrition in plateau soldiers is sufficient, but the prevalence of plateau polycythemia, dyslipidemia and the abnormality rate of LDH were higher in soldiers of field training than in soldiers stationed in camp. Regular physical examination should be taken into consideration, early prevention and treatment is also important. DOI: 10.11855/j.issn.0577-7402.2017.10.13
Thomas W. Kaminski
Full Text Available Protocols for strengthening muscle are important for fitness, rehabilitation, and the prevention of myotendinous injuries. In trained individuals, the optimal method of increasing strength remains unclear. The purpose of this study was to compare the effects of a traditional method of strengthening with a method that allowed for enhanced-eccentric training, on changes in elbow flexor strength in trained subjects. Thirty-nine (8 male, 31 female trained subjects with normal elbow function participated in this study. Subjects were rank-ordered according to isometric force production and randomly assigned to one of three training groups: control (CONT, traditional concentric/eccentric (TRAD, and concentric/enhanced-eccentric (NEG. The training groups completed 24 training sessions. An evaluator blinded to training group performed all testing. Mixed model ANOVA techniques were used to determine if differences existed in concentric one repetition maximum strength, and isometric force production among groups. Changes in peak and average isokinetic force production were also compared. Type 1 error was maintained at 5%. While both groups improved concentric one repetition maximum (NEG = 15.5%, TRAD = 13.8% neither training group statistically differed from changes demonstrated by the CONT group. Nor did either training group show significant improvements in isometric or isokinetic force production over the CONT group. These results do not support the superiority of enhanced-eccentric training for increasing force production in trained subjects.
Nadarajan, V S; Ooi, C H; Sthaneshwar, P; Thompson, M W
Altitude training is sometimes employed by elite endurance athletes to improve their sea level performance. This improvement results from the increased red cell mass consequent upon the boost in erythropoietin (EPO) level that occurs as a response to the relatively hypoxic environment at high altitudes. We measured serum EPO levels together with various red cell and reticulocyte parameters including immature reticulocyte fraction (IRF) in eight national track-endurance cyclists, resident at sea-level, prior to and upon return from an altitude of approximately 1905 m. Reticulocytes and soluble transferrin receptor (sTfR) were significantly increased with reduction in ferritin levels immediately on return from high altitude indicating increased erythropoietic activity. IRF in particular showed a significant peak immediately on return but decline to sub-baseline levels by day 9, and recovery to baseline by day 16. Our results indicate that IRF is a sensitive marker of erythropoietic status in athletes undergoing altitude training and subsequent loss of EPO stimuli on return to sea level.
Full Text Available In this research, it was aimed to compare the physiological performances of athletes at sea level, at high altitude and 8 days after returning back to sea level on the basis of certain blood parameters, pulse and blood pressure. 12 male athletes between the ages of 19 and 23 voluntarily participated in the research. The subjects were exposed to endurance training at high altitude and at sea level between 09.00 and 11.00 in the morning. The subjects’ erythrocyte (RBC, leucocyte (WBC, haemoglobin (Hb, haematocrit (HCT, systolic blood pressure at rest (SBPR and diastolic blood pressure at rest (DBPR, heart rate at rest (HRR, aerobic (20m shuttle run test and anaerobic capacity (vertical jump levels were tested at sea level, on the 15th day at high altitude (3120m and 8 days after returning back to sea level. Statistical analysis comprised of t-test and the significance level of the results was accepted at (P<0.05. As a result of the research the following were determined: It can be said that high altitude trainings for fifteen days included in the annual training program of athletes can improve their performance.
Norris, Jacob N; Viirre, Erik; Aralis, Hilary; Sracic, Michael K; Thomas, Darren; Gertsch, Jeffery H
Few studies have evaluated high altitude headache (HAH) and acute mountain sickness (AMS) in military populations training at moderate (1,500-2,500 m) to high altitudes (>2,500 m). In the current study, researchers interviewed active duty personnel training at Marine Corps Mountain Warfare Training Center. Participants were asked about HAH and AMS symptoms, potential risk factors, and medications used. In a sample of 192 U.S. Navy and Marine Corps personnel, 14.6% reported AMS (Lake Louise Criteria > or = 3) and 28.6% reported HAH. Dehydration and recent arrival at altitude (defined as data collected on days 2-3) were significantly associated with AMS; decreased sleep allowance was significantly associated with HAH. Although ibuprofen/Motrin users were more likely to screen positive for AMS, among AMS-positive participants, ibuprofen/Motrin users had decreased likelihood of reporting robust AMS relative to non-ibuprofen/Motrin users (p altitude. Further, ibuprofen/Motrin may be a reasonable treatment for the symptoms of AMS and HAH, although further study is warranted.
Clare E. Humberstone-Gough
Full Text Available Live High:Train Low (LHTL altitude training is a popular ergogenic aid amongst athletes. An alternative hypoxia protocol, acute (60-90 min daily Intermittent Hypoxic Exposure (IHE, has shown potential for improving athletic performance. The aim of this study was to compare directly the effects of LHTL and IHE on the running and blood characteristics of elite triathletes. Changes in total haemoglobin mass (Hbmass, maximal oxygen consumption (VO2max, velocity at VO2max (vVO2max, time to exhaustion (TTE, running economy, maximal blood lactate concentration ([La] and 3 mM [La] running speed were compared following 17 days of LHTL (240 h of hypoxia, IHE (10.2 h of hypoxia or Placebo treatment in 24 Australian National Team triathletes (7 female, 17 male. There was a clear 3.2 ± 4.8% (mean ± 90% confidence limits increase in Hbmass following LHTL compared with Placebo, whereas the corresponding change of -1.4 ± 4.5% in IHE was unclear. Following LHTL, running economy was 2.8 ± 4.4% improved compared to IHE and 3mM [La] running speed was 4.4 ± 4.5% improved compared to Placebo. After IHE, there were no beneficial changes in running economy or 3mM [La] running speed compared to Placebo. There were no clear changes in VO2max, vVO2max and TTE following either method of hypoxia. The clear difference in Hbmass response between LHTL and IHE indicated that the dose of hypoxia in IHE was insufficient to induce accelerated erythropoiesis. Improved running economy and 3mM [La] running speed following LHTL suggested that this method of hypoxic exposure may enhance performance at submaximal running speeds. Overall, there was no evidence to support the use of IHE in elite triathletes
Hydren, Jay R; Kraemer, William J; Volek, Jeff S; Dunn-Lewis, Courtenay; Comstock, Brett A; Szivak, Tunde K; Hooper, David R; Denegar, Craig R; Maresh, Carl M
Thousands of youth athletes travel to high altitude to participate in lift-access alpine sports. The purpose of this study was to examine the impact of acute high-altitude exposure on balance, choice reaction time, power, quickness, flexibility, strength endurance, and V[Combining Dot Above]O2max in youth lowlander athletes during a weeklong preseason training camp in Summit County, CO, USA. Eleven youth ski racers (4 boys and 7 girls; age, 13.7 ± 0.5 years; height, 157.2 ± 12.6 cm; weight, 52.4 ± 6.8 kg) with 7.7 ± 2.2 skiing years of experience participated in baseline testing at 160 m one week before the camp and a set of daily tests in the morning and afternoon at 2,828 m and skied between 3,328 and 3,802 m during a 6-day camp. Balance and choice reaction time tests were stagnant or improved slightly during the first 3 days and then improved on days 4 and 6. Vertical jump, flexibility, T-agility test, and push-ups in 1 minute improved on day 6. The number of sit-ups in 1 minute did not improve, and scores on the multistage fitness test decreased 20.34%. There was no effect of Lake Louise acute mountain sickness (AMS) questionnaire scores on performance variables measured. Athletes sojourning to high altitude for ski camps can train on immediate ascent but should slowly increase training volume over the first 3 days. Athletes should expect improvements in balance and reaction time 3-6 days into acclimatization. Coaches and athletes should expect about 20% of youth lowlander athletes to have signs and symptoms of AMS during the first 3 days of altitude exposure for alpine lift access sports at altitudes of up to 3,800 m.
Patricia E. Bailey
Full Text Available Objective. To assess the effect that a training intervention for traditional birth attendants (TBAs in Guatemala had on the detection of obstetric complications, the referral of patients with complications to the formal health care system, and, ultimately, those patients' utilization of essential obstetric care services. Methods. Using a quasi-experimental design, a surveillance system of births was implemented to collect population-based information from 3 518 women between 1990 and 1993. All women were interviewed postpartum by physicians. There were three key independent variables in our study: 1 geographical area (intervention community and non-intervention community, 2 time in relation to the training intervention (before or after, and 3 presence or absence of a TBA at the time of the complication. The key dependent variables for women interviewed were 1 development of an obstetric complication, 2 detection of the problem by the TBA, 3 referral to a health facility, 4 compliance with referral, and 5 use of services. Results. The incidence of postpartum complications decreased after the intervention, controlling for intervention community. On the other hand, after the intervention TBAs were less likely to recognize most maternal complications, and referral rates did not increase significantly. The likelihood of using health care services increased six-fold among women who were not attended by TBAs, and no increase was observed among those who were attended by TBAs. Conclusion. Training TBAs may have had a positive effect on the rate, detection, and referral of postpartum complications. However, the evidence is less convincing for overall increases in the detection of complications, in referral to the formal health care system, and in the utilization of essential obstetric services among women attended by TBAs.
Khodaee, Morteza; Grothe, Heather L; Seyfert, Jonathan H; VanBaak, Karin
Athletes at different skill levels perform strenuous physical activity at high altitude for a variety of reasons. Multiple team and endurance events are held at high altitude and may place athletes at increased risk for developing acute high altitude illness (AHAI). Training at high altitude has been a routine part of preparation for some of the high level athletes for a long time. There is a general belief that altitude training improves athletic performance for competitive and recreational athletes. A review of relevant publications between 1980 and 2015 was completed using PubMed and Google Scholar. Clinical review. Level 3. AHAI is a relatively uncommon and potentially serious condition among travelers to altitudes above 2500 m. The broad term AHAI includes several syndromes such as acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE). Athletes may be at higher risk for developing AHAI due to faster ascent and more vigorous exertion compared with nonathletes. Evidence regarding the effects of altitude training on athletic performance is weak. The natural live high, train low altitude training strategy may provide the best protocol for enhancing endurance performance in elite and subelite athletes. High altitude sports are generally safe for recreational athletes, but they should be aware of their individual risks. Individualized and appropriate acclimatization is an essential component of injury and illness prevention.
Lobigs, Louisa M; Garvican-Lewis, Laura A; Vuong, Victor L; Tee, Nicolin; Gore, Christopher J; Peeling, Peter; Dawson, Brian; Schumacher, Yorck O
Altitude is a confounding factor within the Athlete Biological Passport (ABP) due, in part, to the plasma volume (PV) response to hypoxia. Here, a newly developed PV blood test is applied to assess the possible efficacy of reducing the influence of PV on the volumetric ABP markers; haemoglobin concentration ([Hb]) and the OFF-score. Endurance athletes (n=34) completed a 21-night simulated live-high train-low (LHTL) protocol (14 h.d -1 at 3000 m). Bloods were collected twice pre-altitude; at days 3, 8, and 15 at altitude; and 1, 7, 21, and 42 days post-altitude. A full blood count was performed on the whole blood sample. Serum was analysed for transferrin, albumin, calcium, creatinine, total protein, and low-density lipoprotein. The PV blood test (consisting of the serum markers, [Hb] and platelets) was applied to the ABP adaptive model and new reference predictions were calculated for [Hb] and the OFF-score, thereby reducing the PV variance component. The PV correction refined the ABP reference predictions. The number of atypical passport findings (ATPFs) for [Hb] was reduced from 7 of 5 subjects to 6 of 3 subjects. The OFF-score ATPFs increased with the PV correction (from 9 to 13, 99% specificity); most likely the result of more specific reference limit predictions combined with the altitude-induced increase in red cell production. Importantly, all abnormal biomarker values were identified by a low confidence value. Although the multifaceted, individual physiological response to altitude confounded some results, the PV model appears capable of reducing the impact of PV fluctuations on [Hb]. Copyright © 2018 John Wiley & Sons, Ltd.
Causer, Joe; Harvey, Adrian; Snelgrove, Ryan; Arsenault, Gina; Vickers, Joan N
We examined the effectiveness of technical training (TT) and quiet eye training (QE) on the performance of one-handed square knot tying in surgical residents. Twenty surgical residents were randomly assigned to the 2 groups and completed pretest, training, retention, and transfer tests. Participants wore a mobile eye tracker that simultaneously recorded their gaze and hand movements. Dependent variables were knot tying performance (%), QE duration (%), number of fixations, total movement time (s), and hand movement phase time (s). The QE training group had significantly higher performance scores, a longer QE duration, fewer fixations, faster total knot tying times, and faster movement phase times compared with the TT group. The QE group maintained performance in the transfer test, whereas the TT group significantly decreased performance from retention to transfer. QE training significantly improved learning, retention, and transfer of surgical knot tying compared with a traditional technical approach. Both performance effectiveness (performance outcome) and movement efficiency (hand movement times) were improved using QE modeling, instruction, and feedback. Copyright © 2014 Elsevier Inc. All rights reserved.
Sharma, Avish P; Saunders, Philo U; Garvican-Lewis, Laura A; Clark, Brad; Stanley, Jamie; Robertson, Eileen Y; Thompson, Kevin G
To determine the effect of training at 2100-m natural altitude on running speed (RS) during training sessions over a range of intensities relevant to middle-distance running performance. In an observational study, 19 elite middle-distance runners (mean ± SD age 25 ± 5 y, VO 2 max, 71 ± 5 mL · kg -1 · min -1 ) completed either 4-6 wk of sea-level training (CON, n = 7) or a 4- to 5-wk natural altitude-training camp living at 2100 m and training at 1400-2700 m (ALT, n = 12) after a period of sea-level training. Each training session was recorded on a GPS watch, and athletes also provided a score for session rating of perceived exertion (sRPE). Training sessions were grouped according to duration and intensity. RS (km/h) and sRPE from matched training sessions completed at sea level and 2100 m were compared within ALT, with sessions completed at sea level in CON describing normal variation. In ALT, RS was reduced at altitude compared with sea level, with the greatest decrements observed during threshold- and VO 2 max-intensity sessions (5.8% and 3.6%, respectively). Velocity of low-intensity and race-pace sessions completed at a lower altitude (1400 m) and/or with additional recovery was maintained in ALT, though at a significantly greater sRPE (P = .04 and .05, respectively). There was no change in velocity or sRPE at any intensity in CON. RS in elite middle-distance athletes is adversely affected at 2100-m natural altitude, with levels of impairment dependent on the intensity of training. Maintenance of RS at certain intensities while training at altitude can result in a higher perceived exertion.
Medicine, Enugu State University of Science and Technology, 5Department of Obstetrics and ... Aim: The aim was to audit childbirth emergency referrals by trained TBAs to a ..... training of TBAs has been documented by previous African.
Full Text Available Purpose: to determine the effect of hypoxic training on the attention indicators at different altitudes when crossing the Mount Elbrus. Material & Methods: the study of various attention indicators with the participation of control (n=16 and experimental (n=12 groups with the use of interval hypoxic training (IHT in the 15–15 mode with breathing through the system into a confined space in the experimental group and using the methods of mathematical statistics are carried out. Result: studies have made it possible to determine that the use of the regime of discontinuous hypoxia 15–15 in the training process of the pre-competitive period contribute to an increase in attention rates that affect adaptation to the load under hypoxia conditions. Conclusion: results of the conducted studies indicate that the use of IHT in the 15–15 mode in the period before the ascent to Mount Elbrus allows to significantly increase the attention rates of qualified climbers at different altitude levels.
Saunders, Philo U; Ahlgrim, Christoph; Vallance, Brent; Green, Daniel J; Robertson, Eileen Y; Clark, Sally A; Schumacher, Yorck O; Gore, Christopher J
To quantify physiological and performance effects of hypoxic exposure, a training camp, the placebo effect, and a combination of these factors. Elite Australian and International race walkers (n = 17) were recruited, including men and women. Three groups were assigned: 1) Live High:Train Low (LHTL, n = 6) of 14 h/d at 3000 m simulated altitude; 2) Placebo (n = 6) of 14 h/d of normoxic exposure (600 m); and 3) Nocebo (n = 5) living in normoxia. All groups undertook similar training during the intervention. Physiological and performance measures included 10-min maximal treadmill distance, peak oxygen uptake (VO2peak), walking economy, and hemoglobin mass (Hbmass). Blinding failed, so the Placebo group was a second control group aware of the treatment. All three groups improved treadmill performance by approx. 4%. Compared with Placebo, LHTL increased Hbmass by 8.6% (90% CI: 3.5 to 14.0%; P = .01, very likely), VO2peak by 2.7% (-2.2 to 7.9%; P = .34, possibly), but had no additional improvement in treadmill distance (-0.8%, -4.6 to 3.8%; P = .75, unlikely) or economy (-8.2%, -24.1 to 5.7%; P = .31, unlikely). Compared with Nocebo, LHTL increased Hbmass by 5.5% (2.5 to 8.7%; P = .01, very likely), VO2peak by 5.8% (2.3 to 9.4%; P = .02, very likely), but had no additional improvement in treadmill distance (0.3%, -1.9 to 2.5%; P = .75, possibly) and had a decrease in walking economy (-16.5%, -30.5 to 3.9%; P = .04, very likely). Overall, 3-wk LHTL simulated altitude training for 14 h/d increased Hbmass and VO2peak, but the improvement in treadmill performance was not greater than the training camp effect.
Andersen, Steven Arild Wuyts; Mikkelsen, Peter Trier; Konge, Lars; Cayé-Thomasen, Per; Sørensen, Mads Sølvsten
The cognitive load (CL) theoretical framework suggests that working memory is limited, which has implications for learning and skills acquisition. Complex learning situations such as surgical skills training can potentially induce a cognitive overload, inhibiting learning. This study aims to compare CL in traditional cadaveric dissection training and virtual reality (VR) simulation training of mastoidectomy. A prospective, crossover study. Participants performed cadaveric dissection before VR simulation of the procedure or vice versa. CL was estimated by secondary-task reaction time testing at baseline and during the procedure in both training modalities. The national Danish temporal bone course. A total of 40 novice otorhinolaryngology residents. Reaction time was increased by 20% in VR simulation training and 55% in cadaveric dissection training of mastoidectomy compared with baseline measurements. Traditional dissection training increased CL significantly more than VR simulation training (p < 0.001). VR simulation training imposed a lower CL than traditional cadaveric dissection training of mastoidectomy. Learning complex surgical skills can be a challenge for the novice and mastoidectomy skills training could potentially be optimized by employing VR simulation training first because of the lower CL. Traditional dissection training could then be used to supplement skills training after basic competencies have been acquired in the VR simulation. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Buchheit, Martin; Hammond, Kristal; Bourdon, Pitre C; Simpson, Ben M; Garvican-Lewis, Laura A; Schmidt, Walter F; Gore, Christopher J; Aughey, Robert J
To compare relative match intensities of sea-level versus high-altitude native soccer players during a 2-week camp at 3600 m, data from 7 sea-level (Australian U17 National team, AUS) and 6 high-altitude (a Bolivian U18 team, BOL) native soccer players were analysed. Two matches were played at sea-level and three at 3600 m on Days 1, 6 and 13. The Yo-Yo Intermittent recovery test (vYo-YoIR1) was performed at sea-level, and on Days 3 and 10. Match activity profiles were measured via 10-Hz GPS. Distance covered >14.4 km.h(-1) (D>14.4 km·h(-1)) and >80% of vYo-YoIR1 (D>80%vYo-YoIR1) were examined. Upon arrival at altitude, there was a greater decrement in vYo-YoIR1 (Cohen's d +1.0, 90%CL ± 0.8) and D>14.4 km·h(-1) (+0.5 ± 0.8) in AUS. D>14.4 km.h(-1) was similarly reduced relative to vYo-YoIR1 in both groups, so that D>80%vYo-YoIR1 remained similarly unchanged (-0.1 ± 0.8). Throughout the altitude sojourn, vYo-YoIR1 and D>14.4 km·h(-1) increased in parallel in AUS, so that D>80%vYo-YoIR1 remained stable in AUS (+6.0%/match, 90%CL ± 6.7); conversely D>80%vYo-YoIR1 decreased largely in BOL (-12.2%/match ± 6.2). In sea-level natives competing at high-altitude, changes in match running performance likely follow those in high-intensity running performance. Bolivian data confirm that increases in 'fitness' do not necessarily translate into greater match running performance, but rather in reduced relative exercise intensity. Key pointsWhen playing at high-altitude, players may alter their activities during matches in relation to their transient maximal physical capacities, possibly to maintain a 'tolerable' relative exercise intensity.While there is no doubt that running performance per se in not the main determinant of match outcomes (Carling, 2013), fitness levels influence relative match intensity (Buchheit et al., 2012, Mendez-Villanueva et al., 2013), which in-turn may impact on decision making and skill performance (Rampinini et al., 2008).In the context of
Saravanan, Sheela; Turrell, Gavin; Johnson, Helen; Fraser, Jenny; Patterson, Carla
Training birth attendants (TBAs) to provide essential maternal and infant health care services during delivery and ongoing community care in developing countries. Despite inadequate evidence of relevance and effectiveness of TBA training programmes, there has been a policy shift since the 1990s in that many donor agencies funding TBA training…
Tam, E; Bruseghini, P; Calabria, E; Dal Sacco, L; Doria, C; Grassi, B; Pietrangelo, T; Pogliaghi, S; Reggiani, C; Salvadego, D; Schena, F; Toniolo, L; Verratti, V; Vernillo, G; Capelli, Carlo
We investigated the effects of moderate-intensity training at low and high altitude on VO2 and QaO2 kinetics and on myosin heavy-chain expression (MyHC) in seven women (36.3 yy ± 7.1; 65.8 kg ± 11.7; 165 cm ± 8) who participated in two 12- to 14-day trekking expeditions at low (598 m) and high altitude (4132 m) separated by 4 months of recovery. Breath-by-breath VO2 and beat-by-beat QaO2 at the onset of moderate-intensity cycling exercise and energy cost of walking (Cw) were assessed before and after trekking. MyHC expression of vastus lateralis was evaluated before and after low-altitude and after high-altitude trekking; muscle fiber high-resolution respirography was performed at the beginning of the study and after high-altitude trekking. Mean response time of VO2 kinetics was faster (P = 0.002 and P = 0.001) and oxygen deficit was smaller (P = 0.001 and P = 0.0004) after low- and high-altitude trekking, whereas ˙ QaO2 kinetics and Cw did not change. Percentages of slow and fast isoforms of MyHC and mitochondrial mass were not affected by low- and high-altitude training. After training altitude, muscle fiber ADP-stimulated mitochondrial respiration was decreased as compared with the control condition (P = 0.016), whereas leak respiration was increased (P = 0.031), leading to a significant increase in the respiratory control ratio (P = 0.016). Although training did not significantly modify muscle phenotype, it induced beneficial adaptations of the oxygen transport-utilization systems witnessed by faster VO2 kinetics at exercise onset.
Park, Hun-Young; Hwang, Hyejung; Park, Jonghoon; Lee, Seongno; Lim, Kiwon
This study was designed as a meta-analysis of randomized controlled trials comparing effectiveness of altitude/hypoxic training (experimental) versus sea-level training (control) on oxygen delivery capacity of the blood and aerobic exercise capacity of elite athletes in Korea. Databases (Research Information Service System, Korean studies Information Service System, National Assembly Library) were for randomized controlled trials comparing altitude/hypoxic training versus sea-level training in elite athletes. Studies published in Korea up to December 2015 were eligible for inclusion. Oxygen delivery capacity of the blood was quantified by red blood cell (RBC), hemoglobin (Hb), hematocrit (Hct), erythropoietin (EPO); and aerobic exercise capacity was quantified by maximal oxygen consumption (VO2max). RBC, Hb, Hct, VO2max represented heterogeneity and compared post-intervention between altitude/hypoxic training and sea-level training in elite athletes by a random effect model meta-analysis. EPO represented homogeneity and meta-analysis performed by a fixed effect model. Eight independent studies with 156 elite athletes (experimental: n = 82, control: n = 74) were included in the metaanalysis. RBC (4.499×10(5) cell/ul, 95 % CI: 2.469 to 6.529), Hb (5.447 g/dl, 95 % CI: 3.028 to 7.866), Hct (3.639 %, 95 % CI: 1.687 to 5.591), EPO (0.711 mU/mL, 95% CI: 0.282 to 1.140), VO2max (1.637 ml/kg/min, 95% CI: 0.599 to 1.400) showed significantly greater increase following altitude/hypoxic training, as compared with sea-level training. For elite athletes in Korea, altitude/ hypoxic training appears more effective than sea-level training for improvement of oxygen delivery capacity of the blood and aerobic exercise capacity.
Park, Hun-young; Hwang, Hyejung; Park, Jonghoon; Lee, Seongno; Lim, Kiwon
[Purpose] This study was designed as a meta-analysis of randomized controlled trials comparing effectiveness of altitude/hypoxic training (experimental) versus sea-level training (control) on oxygen delivery capacity of the blood and aerobic exercise capacity of elite athletes in Korea. [Methods] Databases (Research Information Service System, Korean studies Information Service System, National Assembly Library) were for randomized controlled trials comparing altitude/hypoxic training versus sea-level training in elite athletes. Studies published in Korea up to December 2015 were eligible for inclusion. Oxygen delivery capacity of the blood was quantified by red blood cell (RBC), hemoglobin (Hb), hematocrit (Hct), erythropoietin (EPO); and aerobic exercise capacity was quantified by maximal oxygen consumption (VO2max). RBC, Hb, Hct, VO2max represented heterogeneity and compared post-intervention between altitude/hypoxic training and sea-level training in elite athletes by a random effect model meta-analysis. EPO represented homogeneity and meta-analysis performed by a fixed effect model. Eight independent studies with 156 elite athletes (experimental: n = 82, control: n = 74) were included in the metaanalysis. [Results] RBC (4.499×105 cell/ul, 95 % CI: 2.469 to 6.529), Hb (5.447 g/dl, 95 % CI: 3.028 to 7.866), Hct (3.639 %, 95 % CI: 1.687 to 5.591), EPO (0.711 mU/mL, 95% CI: 0.282 to 1.140), VO2max (1.637 ml/kg/min, 95% CI: 0.599 to 1.400) showed significantly greater increase following altitude/hypoxic training, as compared with sea-level training. [Conclusion] For elite athletes in Korea, altitude/ hypoxic training appears more effective than sea-level training for improvement of oxygen delivery capacity of the blood and aerobic exercise capacity. PMID:27298808
and children. My wife’s patience, understanding, and sacrifice permitted me to focus on the academic material and writing , neither of which came...for a training strategy that leverages the RPA weapon system’s unique modularity to produce well-trained RPA pilots more quickly. vii...momentum. He states, “The social constructivists have a key to understanding the behavior of young systems; technical
Full Text Available Changes of Selected Hematological Parameters and Morning Rest Rate during Ten Days High Altitude Stay and Training This article describes the influence of a ten day stay and training in a high altitude area (1850 m ASL on selected blood count parameters and morning resting heart rate. Three tests were performed on a group of young cross country skiers (n = 10, age: 18.7 ± 4.8: two days before, two days after and ten days after the altitude training camp. Two day after the return, significant (p 0.05. The study in a group of young cross country skiers has shown positive effects of a tenday training camp in high altitude on blood count parameters and morning resting heart rate monitored in lowland two and ten days after the return from high altitude. Změny vybraných hematologických parametrů a ranní klidové srdeční frekvence v průběhu desetidenního tréninku a pobytu ve vyšší nadmořské výšce Článek popisuje vliv desetidenního tréninku a pobytu ve vyšší nadmořské výšce (1850 m n. m. na vybrané parametry krevního obrazu a ranní klidové srdeční frekvence. U skupiny mladých běžců na lyžích (n = 10, věk: 18,7 ± 4,8 byly realizovány celkem tři odběry krve: dva dny před soustředěním ve výšce, dva dny a deset dnů po návratu do nížiny. Dva dny po návratu byly signifikantně (p 0,05. Průměrné hodnoty ranní klidové srdeční frekvence byly během soustředění ve výšce vyšší než před odjezdem v nížině (p 0,05. Námi realizovaný výzkum u skupiny mladých běžců na lyžích prokázal pozitivní efekt desetidenního pobytu a tréninku ve vyšší nadmořské výšce (1850 m n. m. na sledované krevní parametry a ranní klidovou srdeční frekvenci v nížině po návratu.
Dankbaar, Mary E W; Storm, Diana J; Teeuwen, Irene C; Schuit, Stephanie C E
Introduction There is a demand for more attractive and efficient training programmes in postgraduate health care training. This retrospective study aims to show the effectiveness of a blended versus traditional face-to-face training design. For nurses in postgraduate Acute and Intensive Care training, the effectiveness of a blended course design was compared with a traditional design. Methods In a first pilot study 57 students took a traditional course (2-h lecture and 2-h workshop) and 46 students took a blended course (2-h lecture and 2-h online self-study material). Test results were compared for both groups. After positive results in the pilot study, the design was replicated for the complete programme in Acute and Intensive Care. Now 16 students followed the traditional programme (11 days face-to-face education) and 31 students did the blended programme (7 days face-to-face and 40 h online self-study). An evaluation was done after the pilot and course costs were calculated. Results Results show that the traditional and blended groups were similar regarding the main characteristics and did not differ in learning results for both the pilot and the complete programme. Student evaluations of both designs were positive; however, the blended group were more confident that they had achieved the learning objectives. Training costs were reduced substantially. Conclusion The blended training design offers an effective and attractive training solution, leading to a significant reduction in costs.
Chen, Yu-Ching; Lee, Shin-Da; Kuo, Cha-Hua; Ho, Low-Tone
The skeletal muscle AMP-activated protein kinase (AMPK)-related glucose transport pathway is involved in glucose homeostasis. In this study, we examined whether obese control Zucker rats had abnormal expression of proteins in the LKB1-AMPK-AS160-GLUT4 pathway in red gastrocnemius muscle compared to that in lean (normal) control Zucker rats. We also compared the chronic training effects of exercise, hypoxia, and altitude training on this pathway in lean and obese rats. At sea level, lean and obese rats were divided into 4 groups for 6 weeks training as follows: 1) control; 2) exercise (progressive daily swimming-exercise training with comparable exercise signals between the two groups); 3) hypoxia (8 hours of daily 14% O2 exposure); and 4) exercise plus hypoxia (also called altitude training). Seven animals were used for each group. The obese rats in the control group had higher body weights, elevated fasting insulin and glucose levels, and higher baseline levels of muscle AMPK and AS160 phosphorylation compared with those of lean control rats. For obese Zucker rats in the exercise or hypoxia groups, the muscle AMPK phosphorylation level was significantly decreased compared with that of the control group. For obese Zucker rats in the altitude training group, the levels of AMPK, AS160 phosphorylation, fasting insulin, and fasting glucose were decreased concomitant with an approximate 50% increase in the muscle GLUT4 protein level compared with those of the control group. In lean rats, the altitude training efficiently lowered fasting glucose and insulin levels and increased muscle AMPK and AS160 phosphorylation as well as GLUT4 protein levels. Our results provide evidence that long-term altitude training may be a potentially effective nonpharmacological strategy for treating and preventing insulin resistance based on its effects on the skeletal muscle AMPK-AS160-GLUT4 pathway.
Høyer, Ellen; Jahnsen, Reidun; Stanghelle, Johan Kvalvik; Strand, Liv Inger
Treadmill training with body weight support (TTBWS) for relearning walking ability after brain damage is an approach under current investigation. Efficiency of this method beyond traditional training is lacking evidence, especially in patients needing walking assistance after stroke. The objective of this study was to investigate change in walking and transfer abilities, comparing TTBWS with traditional walking training. A single-blinded, randomized controlled trial was conducted. Sixty patients referred for multi-disciplinary primary rehabilitation were assigned into one of two intervention groups, one received 30 sessions of TTBWS plus traditional training, the other traditional training alone. Daily training was 1 hr. Outcome measures were Functional Ambulation Categories (FAC), Walking, Functional Independence Measure (FIM); shorter transfer and stairs, 10 m and 6-min walk tests. Substantial improvements in walking and transfer were shown within both groups after 5 and 11 weeks of intervention. Overall no statistical significant differences were found between the groups, but 12 of 17 physical measures tended to show improvements in favour of the treadmill approach. Both training strategies provided significant improvements in the tested activities, suggesting that similar outcomes can be obtained in the two modalities by systematic, intensive and goal directed training.
Dodd, Caleb D.; Burris, Scott; Fraze, Steve; Doerfert, David; McCulloch, Abigail
The incorporation of hot and cold food bars into grocery stores in an effort to capture a portion of the home meal replacement industry is presenting new challenges for retail food establishments. To ensure retail success and customer safety, employees need to be educated in food safety practices. Traditional methods of training are not meeting…
Conclusions: Although both plyometric training methods improved lower body maximal-intensity exercise performance, the traditional sets methods resulted in greater adaptations in sprint performance, while the cluster sets method resulted in greater jump and agility adaptations.
Yanuar T. Sastranegara
Full Text Available Barotitis media (BM frequently occurr in High Altitude High Opening (HAHO training simulation as a result from rapid change of pressure. The aim of this study was to investigate septal deviation and other risk factors that increase the risk of BM. This experimental study was conducted at the Indonesian Center for Aviation Medicine and Health (Lakespra Saryanto during May – July 2007 involving Indonesian Armed Forces (TNI HAHO training. Medical examinations were performed before and after training. An otolaryngologist confirm the diagnosis of BM. Cox regression analysis using STATA 9.0 program was performed to identify dominant risk factors for BM. A number of 177 subjects participated in this study. We found 56.5% had BM after training. Septal deviation was found in 28.8% of the subjects and it moderately increased the risk of BM by 23% than normal septum [adjusted relative risk (RRα = 1.23; 95% confidence interval (CI = 0.95 – 1.60; p=0.123]. Those who have been smoking for 1-3 years had 70% increase risk for BM than non-smoking subjects (RRα= 1.68; 95% CI = 1.17 – 2.42. Those who have been in the force for 5 years or longer were 50% more at risk for BM than those who have been in the force less than 5 years. In addition, trainees had 40% higher risk than subjects with special qualifications for HAHO (RRα = 1.40; 95% CI = 0.99 – 1.97; p = 0.051. Special caution need to be applied for those who had septal deviation, longer working period, habit of smoking for 1-3 years, and trainees to minimize the risk of BM. (Med J Indones 2008; 17: 37-42Keywords: barotitis media, septal deviation, HAHO training simulation
There are several different methods of learning motor skills, like traditional (linear) and differential (nonlinear) learning training. The traditional motor learning approach proposes that learners improve a skill just by repeating it. According to the teaching principles, exercises are selected along continua from easy to hard and from simple to…
Chaouachi, Anis; Hammami, Raouf; Kaabi, Sofiene; Chamari, Karim; Drinkwater, Eric J; Behm, David G
A number of organizations recommend that advanced resistance training (RT) techniques can be implemented with children. The objective of this study was to evaluate the effectiveness of Olympic-style weightlifting (OWL), plyometrics, and traditional RT programs with children. Sixty-three children (10-12 years) were randomly allocated to a 12-week control OWL, plyometric, or traditional RT program. Pre- and post-training tests included body mass index (BMI), sum of skinfolds, countermovement jump (CMJ), horizontal jump, balance, 5- and 20-m sprint times, isokinetic force and power at 60 and 300° · s(-1). Magnitude-based inferences were used to analyze the likelihood of an effect having a standardized (Cohen's) effect size exceeding 0.20. All interventions were generally superior to the control group. Olympic weightlifting was >80% likely to provide substantially better improvements than plyometric training for CMJ, horizontal jump, and 5- and 20-m sprint times, whereas >75% likely to substantially exceed traditional RT for balance and isokinetic power at 300° · s(-1). Plyometric training was >78% likely to elicit substantially better training adaptations than traditional RT for balance, isokinetic force at 60 and 300° · s(-1), isokinetic power at 300° · s(-1), and 5- and 20-m sprints. Traditional RT only exceeded plyometric training for BMI and isokinetic power at 60° · s(-1). Hence, OWL and plyometrics can provide similar or greater performance adaptations for children. It is recommended that any of the 3 training modalities can be implemented under professional supervision with proper training progressions to enhance training adaptations in children.
Paddock, Michael T; Bailitz, John; Horowitz, Russ; Khishfe, Basem; Cosby, Karen; Sergel, Michelle J
Pre-hospital focused assessment with sonography in trauma (FAST) has been effectively used to improve patient care in multiple mass casualty events throughout the world. Although requisite FAST knowledge may now be learned remotely by disaster response team members, traditional live instructor and model hands-on FAST skills training remains logistically challenging. The objective of this pilot study was to compare the effectiveness of a novel portable ultrasound (US) simulator with traditional FAST skills training for a deployed mixed provider disaster response team. We randomized participants into one of three training groups stratified by provider role: Group A. Traditional Skills Training, Group B. US Simulator Skills Training, and Group C. Traditional Skills Training Plus US Simulator Skills Training. After skills training, we measured participants' FAST image acquisition and interpretation skills using a standardized direct observation tool (SDOT) with healthy models and review of FAST patient images. Pre- and post-course US and FAST knowledge were also assessed using a previously validated multiple-choice evaluation. We used the ANOVA procedure to determine the statistical significance of differences between the means of each group's skills scores. Paired sample t-tests were used to determine the statistical significance of pre- and post-course mean knowledge scores within groups. We enrolled 36 participants, 12 randomized to each training group. Randomization resulted in similar distribution of participants between training groups with respect to provider role, age, sex, and prior US training. For the FAST SDOT image acquisition and interpretation mean skills scores, there was no statistically significant difference between training groups. For US and FAST mean knowledge scores, there was a statistically significant improvement between pre- and post-course scores within each group, but again there was not a statistically significant difference between
Henri J.M. Claessen
Full Text Available In this article some methods and types of education in traditional Polynesia will be presented. The emphasis will fall on the second half of the eighteenth century. This period has been selected for on the one hand it covers the final years of the Polynesian culture before it was deeply influenced by good intended efforts of missionaries and administrators who tried to erase heathen customs and introduce dresses, and introducing reading and writing and the negative forces of traders, whalers and colonizers, who came to the islands to relax after arduous travels, and to buy cheap goods and food. On the other hand many voyagers, missionaries, administrators and traders left us in their logs and journals detailed descriptions of the islanders and their cultures as they had seen them and tried to understand them. These publications will be considered here as ‘sources’.
Serwetnyk, Tara M; Filmore, Kristi; VonBacho, Stephanie; Cole, Robert; Miterko, Cindy; Smith, Caitlin; Smith, Charlene M
Basic Life Support certification for nursing staff is achieved through various training methods. This study compared three American Heart Association training methods for nurses seeking Basic Life Support renewal: a traditional classroom approach and two online options. Findings indicate that online methods for Basic Life Support renewal deliver cost and time savings, while maintaining positive learning outcomes, satisfaction, and confidence level of participants.
: beliefs, practices, institutions, and also things. In this sense, the meaning of the term in social research is very close to its usage in common language and is not always theoretically well developed (see Shils, 1971: 123). But the concept of tradition has also been central to major theoretical debates...... on the nature of social change, especially in connection with the notion of modernity. Here tradition is linked to various forms of agency as a factor of both stability and intentional change....
Seiler, Hilde Lohne; Torstveit, Monica Klungland; Anderssen, Sigmund A.
Published versiom of an article in the journal:Journal of Aging and Physical Activity. Also available from Human Kinetics: http://http://journals.humankinetics.com/japa-back-issues/japa-volume-21-issue-1-january/traditional-versus-functional-strength-training-effects-on-muscle-strength-and-power-in-the-elderly The aim was to determine whether strength training with machines vs. functional strength training at 80% of one-repetition maximum improves muscle strength and power among the elderl...
Girard, Olivier; Brocherie, Franck; Millet, Grégoire P
With the evolving boundaries of sports science and greater understanding of the driving factors in the human performance physiology, one of the limiting factors has now become the technology. The growing scientific interest on the practical application of hypoxic training for intermittent activities such as team and racket sports legitimises the development of innovative technologies serving athletes in a sport-specific setting. Description of a new mobile inflatable simulated hypoxic equipment. The system comprises two inflatable units-that is, a tunnel and a rectangular design, each with a 215 m(3) volume and a hypoxic trailer generating over 3000 Lpm of hypoxic air with FiO₂ between 0.21 and 0.10 (a simulated altitude up to 5100 m). The inflatable units offer a 45 m running lane (width=1.8 m and height=2.5 m) as well as a 8 m × 10 m dome tent. FiO₂ is stable within a range of 0.1% in normal conditions inside the tunnel. The air supplied is very dry-typically 10-15% relative humidity. This mobile inflatable simulated hypoxic equipment is a promising technological advance within sport sciences. It offers an opportunity for team-sport players to train under hypoxic conditions, both for repeating sprints (tunnel configuration) or small-side games (rectangular configuration).
Rivière, Maxence; Louit, Loic; Strokosch, Alasdair; Seitz, Laurent B
Rivière, M, Louit, L, Strokosch, A, and Seitz, LB. Variable resistance training promotes greater strength and power adaptations than traditional resistance training in elite youth rugby league players. J Strength Cond Res 31(4): 947-955, 2017-The purpose of this study was to examine the strength, velocity, and power adaptations in youth rugby league players in response to a variable resistance training (VRT) or traditional free-weight resistance training (TRAD) intervention. Sixteen elite youth players were assigned to a VRT or TRAD group and completed 2 weekly upper- and lower-body strength and power sessions for 6 weeks. Training programs were identical except that the VRT group trained the bench press exercise with 20% of the prescribed load coming from elastic bands. Bench press 1 repetition maximum (1RM) and bench press mean velocity and power at 35, 45, 65, 75, and 85% of 1RM were measured before and after the training intervention, and the magnitude of the changes was determined using effect sizes (ESs). The VRT group experienced larger increases in both absolute (ES = 0.46 vs. 0.20) and relative (ES = 0.41 vs. 0.19) bench press 1RM. Similar results were observed for mean velocity as well as both absolute and relative mean power at 35, 45, 65, 75, and 85% of 1RM. Furthermore, both groups experienced large gains in both velocity and power in the heavier loads but small improvements in the lighter loads. The improvements in both velocity and power against the heavier loads were larger for the VRT group, whereas smaller differences existed between the 2 groups in the lighter loads. Variable resistance training using elastic bands may offer a greater training stimulus than traditional free-weight resistance training to improve upper-body strength, velocity, and power in elite youth rugby league players.
Campos, Francisco; Frese, Michael; Goldstein, Markus; Iacovone, Leonardo; Johnson, Hillary C; McKenzie, David; Mensmann, Mona
Standard business training programs aim to boost the incomes of the millions of self-employed business owners in developing countries by teaching basic financial and marketing practices, yet the impacts of such programs are mixed. We tested whether a psychology-based personal initiative training approach, which teaches a proactive mindset and focuses on entrepreneurial behaviors, could have more success. A randomized controlled trial in Togo assigned microenterprise owners to a control group ( n = 500), a leading business training program ( n = 500), or a personal initiative training program ( n = 500). Four follow-up surveys tracked outcomes for firms over 2 years and showed that personal initiative training increased firm profits by 30%, compared with a statistically insignificant 11% for traditional training. The training is cost-effective, paying for itself within 1 year. Copyright © 2017 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.
Walker, Simon; Blazevich, Anthony J.; Haff, G. Gregory; Tufano, James J.; Newton, Robert U.; Häkkinen, Keijo
As training experience increases it becomes more challenging to induce further neuromuscular adaptation. Consequently, strength trainers seek alternative training methods in order to further increase strength and muscle mass. One method is to utilize accentuated eccentric loading, which applies a greater external load during the eccentric phase of the lift as compared to the concentric phase. Based upon this practice, the purpose of this study was to determine the effects of 10 weeks of accentuated eccentric loading vs. traditional isoinertial resistance training in strength-trained men. Young (22 ± 3 years, 177 ± 6 cm, 76 ± 10 kg, n = 28) strength-trained men (2.6 ± 2.2 years experience) were allocated to concentric-eccentric resistance training in the form of accentuated eccentric load (eccentric load = concentric load + 40%) or traditional resistance training, while the control group continued their normal unsupervised training program. Both intervention groups performed three sets of 6-RM (session 1) and three sets of 10-RM (session 2) bilateral leg press and unilateral knee extension exercises per week. Maximum force production was measured by unilateral isometric (110° knee angle) and isokinetic (concentric and eccentric 30°.s−1) knee extension tests, and work capacity was measured by a knee extension repetition-to-failure test. Muscle mass was assessed using panoramic ultrasonography and dual-energy x-ray absorptiometry. Surface electromyogram amplitude normalized to maximum M-wave and the twitch interpolation technique were used to examine maximal muscle activation. After training, maximum isometric torque increased significantly more in the accentuated eccentric load group than control (18 ± 10 vs. 1 ± 5%, p < 0.01), which was accompanied by an increase in voluntary activation (3.5 ± 5%, p < 0.05). Isokinetic eccentric torque increased significantly after accentuated eccentric load training only (10 ± 9%, p < 0.05), whereas concentric torque
Satishchandra, D M; Naik, V A; Wantamutte, A S; Mallapur, M D
To study the impact of training of Traditional Birth Attendants (TBAs) on the Newborn care in resource poor setting in rural area. A community based study in the Primary Health Center (PHC) area was conducted over one year period between March 2006 to February 2007. The study participants were 50 Traditional Birth Attendants (TBAs)who conduct home deliveries in the PHC area. Training was conducted for two days which included topics on techniques of conducting safe delivery and newborn care practices. Pre-test evaluation regarding knowledge and practices about newborn care was done. Post-test evaluation was done at first month (early) and at fifth month (late) after the training. Analysis was done by using Mc. Nemer's test, Chi- square test with Yates's correction and Fischer's exact test. Pre-test evaluation showed that, knowledge and practices about newborn care services provided by the previously trained TBAs and untrained TBAs were poor. Early and late post-test evaluation showed that, there was a progressive improvement in the newborn care provided by both the groups. Preintervention period (one year prior to the training) and postintervention period (one year after the training) showed that, there was a statistically significant (p<0.05) reduction in the perinatal deaths (11 to 3) and neonatal deaths (10 to 2) among the deliveries conducted by TBAs after the training. Training programme for TBAs with regular reinforcements in the resource poor setting will not only improve the quality of newborn care but also reduces perinatal deaths.
Garvican-Lewis, Laura A; Clark, Sally A; Polglaze, Ted; McFadden, Greg; Gore, Christopher J
Water polo requires high aerobic power to meet the demands of match play. Live high:train low (LHTL) may enhance aerobic capacity at sea level. Before the Olympics, the Australian women's water polo team utilised LHTL in an attempt to enhance aerobic fitness. Over 6 months, 11 players completed three normobaric LHTL exposures (block 1:11 days at 3000 m; block 2+3:9 days at 2500 m, 11 days normoxia, 10 days at 2800 m). Haemoglobin mass (Hbmass) was measured through carbon monoxide-rebreathing. Before each block, the relationship between Hbmass and water polo-specific aerobic fitness was investigated using the Multistage Shuttle Swim Test (MSST). Effect size statistics were adopted with likely, highly likely and almost certainly results being >75%, >95%, >99%, respectively. A Pearson product moment correlation was used to characterise the association between pooled data of Hbmass and MSST. Hbmass (mean ± SD, pre 721 ± 66 g) likely increased after block 1 and almost certainly after block 2+3 (% change; 90% confidence limits: block 1: 3.7%; 1.3-6.2%, block 2+3: 4.5%; 3.8-5.1%) and the net effect was almost certainly higher after block 2+3 than before block 1 (pre) by 8.5%; 7.3-9.7%. There was a very large correlation between Hbmass (g/kg) and MSST score (r=0.73). LHTL exposures of <2 weeks induced approximately 4% increase in Hbmass of water polo players. Extra Hbmass may increase aerobic power, but since match performance is nuanced by many factors it is impossible to ascertain whether the increased Hbmass contributed to Australia's Bronze medal.
Buchheit, M; Racinais, S; Bilsborough, J; Hocking, J; Mendez-Villanueva, A; Bourdon, P C; Voss, S; Livingston, S; Christian, R; Périard, J; Cordy, J; Coutts, A J
Objectives To examine with a parallel group study design the performance and physiological responses to a 14-day off-season ‘live high-train low in the heat’ training camp in elite football players. Methods Seventeen professional Australian Rules Football players participated in outdoor football-specific skills (32±1°C, 11.5 h) and indoor strength (23±1°C, 9.3 h) sessions and slept (12 nights) and cycled indoors (4.3 h) in either normal air (NORM, n=8) or normobaric hypoxia (14±1 h/day, FiO2 15.2–14.3%, corresponding to a simulated altitude of 2500–3000 m, hypoxic (HYP), n=9). They completed the Yo-Yo Intermittent Recovery level 2 (Yo-YoIR2) in temperate conditions (23±1°C, normal air) precamp (Pre) and postcamp (Post). Plasma volume (PV) and haemoglobin mass (Hbmass) were measured at similar times and 4 weeks postcamp (4WPost). Sweat sodium concentration ((Na+)sweat) was measured Pre and Post during a heat-response test (44°C). Results Both groups showed very large improvements in Yo-YoIR2 at Post (+44%; 90% CL 38, 50), with no between-group differences in the changes (−1%; −9, 9). Postcamp, large changes in PV (+5.6%; −1.8, 5.6) and (Na+)sweat (−29%; −37, −19) were observed in both groups, while Hbmass only moderately increased in HYP (+2.6%; 0.5, 4.5). At 4WPost, there was a likely slightly greater increase in Hbmass (+4.6%; 0.0, 9.3) and PV (+6%; −5, 18, unclear) in HYP than in NORM. Conclusions The combination of heat and hypoxic exposure during sleep/training might offer a promising ‘conditioning cocktail’ in team sports. PMID:24282209
Sissine, Mysha; Segan, Robert; Taylor, Mathew; Jefferson, Bobby; Borrelli, Alice; Koehler, Mohandas; Chelvayohan, Meena
Another one million community healthcare workers are needed to address the growing global population and increasing demand of health care services. This paper describes a cost comparison between two training approaches to better understand costs implications of training community health workers (CHWs) in Sub-Saharan Africa. Our team created a prospective model to forecast and compare the costs of two training methods as described in the Dalburge Report - (1) a traditional didactic training approach ("baseline") and (2) a blended eLearning training approach ("blended"). After running the model for training 100,000 CHWs, we compared the results and scaled up those results to one million CHWs. A substantial difference exists in total costs between the baseline and blended training programs. RESULTS indicate that using a blended eLearning approach for training community health care workers could provide a total cost savings of 42%. Scaling the model to one million CHWs, the blended eLearning training approach reduces total costs by 25%. The blended eLearning savings are a result of decreased classroom time, thereby reducing the costs associated with travel, trainers and classroom costs; and using a tablet with WiFi plus a feature phone rather than a smartphone with data plan. The results of this cost analysis indicate significant savings through using a blended eLearning approach in comparison to a traditional didactic method for CHW training by as much as 67%. These results correspond to the Dalberg publication which indicates that using a blended eLearning approach is an opportunity for closing the gap in training community health care workers.
Colquhoun, Ryan J; Gai, Christopher M; Walters, Jeoffrey; Brannon, Andrew R; Kilpatrick, Marcus W; DʼAgostino, Dominic P; Campbell, Bill I
Colquhoun, RJ, Gai, CM, Walters, J, Brannon, AR, Kilpatrick, MW, D'Agostino, DP, and Campbell, WI. Comparison of powerlifting performance in trained men using traditional and flexible daily undulating periodization. J Strength Cond Res 31(2): 283-291, 2017-Daily undulating periodization (DUP) is a growing trend, both in practice and in the scientific literature. A new form of DUP, flexible daily undulating periodization (FDUP), allows for athletes to have some autonomy by choosing the order of their training. The purpose of this study was to compare an FDUP model to a traditional model of DUP on powerlifting performance in resistance-trained men. Twenty-five resistance-trained men were randomly assigned to one of 2 groups: FDUP (N = 14) or DUP (N = 11). All participants possessed a minimum of 6 months of resistance training experience and were required to squat, bench press, and deadlift 125, 100, and 150% of their body mass, respectively. Dependent variables assessed at baseline and after the 9-week training program included bench press 1 repetition maximum (1RM), squat 1RM, deadlift 1RM, powerlifting total, Wilks Coefficient, fat mass, and fat-free mass (FFM). Dependent variables assessed during each individual training session were motivation to train, Session Rating of Perceived Exertion (Session RPE), and satisfaction with training session. After the 9-week training program, no significant differences in intensity or volume were found between groups. Both groups significantly improved bench press 1RM (FDUP: +6.5 kg; DUP: +8.8 kg), squat 1RM (FDUP: +15.6 kg; DUP: +18.0 kg), deadlift 1RM (FDUP: +14.8 kg; DUP: +13.6 kg), powerlifting total (FDUP: +36.8 kg; DUP: +40.4 kg), and Wilks Coefficient (FDUP: +24.8; DUP: +26.0) over the course of study (p = <0.001 for each variable). There was also a significant increase in FFM (FDUP: +0.8 kg; DUP: +0.8 kg) for both groups (p = 0.003). There were no differences in motivation to train, session RPE, or satisfaction with
Maté-Muñoz, José Luis; Monroy, Antonio J Antón; Jodra Jiménez, Pablo; Garnacho-Castaño, Manuel V
The purpose of this study was compare the effects of a traditional and an instability resistance circuit training program on upper and lower limb strength, power, movement velocity and jumping ability. Thirty-six healthy untrained men were assigned to two experimental groups and a control group. Subjects in the experimental groups performed a resistance circuit training program consisting of traditional exercises (TRT, n = 10) or exercises executed in conditions of instability (using BOSU® and TRX®) (IRT, n = 12). Both programs involved three days per week of training for a total of seven weeks. The following variables were determined before and after training: maximal strength (1RM), average (AV) and peak velocity (PV), average (AP) and peak power (PP), all during bench press (BP) and back squat (BS) exercises, along with squat jump (SJ) height and counter movement jump (CMJ) height. All variables were found to significantly improve (p velocity and jumping ability. Key PointsSimilar adaptations in terms of gains in strength, power, movement velocity and jumping ability were produced in response to both training programs.Both the stability and instability approaches seem suitable for healthy, physically-active individuals with or with limited experience in resistance training.RPE emerged as a useful tool to monitor exercise intensity during instability strength training.
Deegan, Donna; Wims, Padraig; Pettit, Tony
Purpose: In this article the use of blended learning multimedia materials as an education tool was compared with the traditional approach for skills training. Design/Methodology/Approach: This study was conducted in Ireland using a pre-test, post-test experimental design. All students were instructed on how to complete two skills using either a…
J M Sarabia
Full Text Available It has been suggested that strength training effects (i.e. neural or structural vary, depending on the total repetitions performed and velocity loss in each training set.The aim of this study is to compare the effects of two training programmes (i.e. one with loads that maximise power output and individualised repetitions, and the other following traditional power training.Twenty-five males were divided into three groups (optimum power [OP = 10], traditional training [TT = 9] and control group [CG = 6]. The training load used for OP was individualised using loads that maximised power output (41.7% ± 5.8 of one repetition maximum [1RM] and repetitions at maximum power (4 to 9 repetitions, or 'reps'. Volume (sets x repetitions was the same for both experimental groups, while intensity for TT was that needed to perform only 50% of the maximum number of possible repetitions (i.e. 61.1%-66.6% of 1RM. The training programme ran over 11 weeks (2 sessions per week; 4-5 sets per session; 3-minute rests between sets, with pre-, intermediate and post-tests which included: anthropometry, 1RM, peak power output (PPO with 30%, 40% and 50% of 1RM in the bench press throw, and salivary testosterone (ST and cortisol (SC concentrations. Rate of perceived exertion (RPE and power output were recorded in all sessions.Following the intermediate test, PPO was increased in the OP group for each load (10.9%-13.2%. Following the post-test, both experimental groups had increased 1RM (11.8%-13.8% and PPO for each load (14.1%-19.6%. Significant decreases in PPO were found for the TT group during all sets (4.9%-15.4%, along with significantly higher RPE (37%.OP appears to be a more efficient method of training, with less neuromuscular fatigue and lower RPE.
Full Text Available The features of construction of the traditional system of preparation of young sportsmen are certain on the stage of the preliminary base training. In researches 200 players took part in age 12-15 years. The indexes of frequency of cardiac rhythm, expenses of energy, competition activity of young sportsmen are presented. Indexes are fixed during implementation of the different typical trainings programs, participating in bilateral and official games. The typical rations of feed are analysed. The results of deep medical inspection are rotined.
Terriff, Colleen M; McKeirnan, Kimberly
This study compared traditional training (TT) and just-in-time training (JITT) of P3 student pharmacists regarding interest, confidence, and comfort pre- and post-training (primary objective); and assessment and administration competency (secondary objective) during a simulated influenza vaccination clinic. Student pharmacists were randomized 1:1 to receive either TT or JITT, completed pre- and post-training surveys assessing interest, confidence and comfort; and evaluated on performance during a simulated emergency infant vaccination. An infant manikin simulated a child <1 year of age, and an actor role-played the mother. All students received a briefing about the simulated mass vaccination prior to their performance assessment. Survey differences between groups were analyzed by ANOVA. The competency assessment was analyzed by a Chi-square or Fisher's exact test for individual steps and Student t-test for mean scores. Pre-training interest was high and maintained post-training. Pre-training confidence and comfort levels were low and improved in both groups. Mean competency scores were comparable between the TT and JITT groups. Comparing groups, TT students more commonly missed proper injection site selection and care; while JITT missed distracting the infant and administration documentation. JITT for student pharmacists to learn skills required to immunize infants elicits similar outcomes (interest, confidence, comfort, and administration competency) as TT for emergency pediatric influenza vaccination. Copyright © 2017 Elsevier Inc. All rights reserved.
Federal Laboratory Consortium — The Altitude Lab evaluates the performance of complete oxygen systems operated in individually controlled hypobaric chambers, which duplicate pressures that would be...
Full Text Available Objective To observe the changes in oxygen metabolism and sonic hedgehog (SHH signaling pathway in soldiers returning to plains after being stationed and trained for 6 months in a plateau. Methods Eighty male officers and soldiers, aged 20-30 (22.3±2.9 years, after being stationed and trained on plateau (altitude 3960m for 6 months and returned to plain region (altitude 200m, were selected as subjects. Before their returning to plateau, 6 months after their station and training in plateau, and 2 days after their returning to plain, fasting venous blood samples were collected, the serum levels of superoxide dismutase (SOD, malondialdehyde (MDA and Sonic Hedgehog (SHH were determined by ELISA, the transcription of SHH mRNA was assayed by RT-PCR, and the expressions of SMO and nucleoprotein GLI2 were detected by Western blotting. All the data mentioned above were collected for statistical analysis. Results As the subjects entered and garrisoned in plateau for 6 months, the activity of SOD decreased and the content of MDA increased significantly (P < 0.05. Both the protein expression and mRNA transcription of SHH were significantly higher after staying in plateau than in plain. When they returned to plain, both parameters decreased significantly, but were still higher than that when they lived in plain (P < 0.01. The expressions of SMO and nucleoprotein GLI2 showed a same tendency of changes. Conclusion High altitude environment may have a great influence on oxygen metabolism of organism and SHH signal pathway, and the hypoxic environment of high altitude region is one of the conditions in activating the SHH signal pathway.
Heikura, Ida A; Burke, Louise M; Bergland, Dan; Uusitalo, Arja L T; Mero, Antti A; Stellingwerff, Trent
We investigated the effects of sex, energy availability (EA), and health status on the change in hemoglobin mass (ΔHbmass) in elite endurance athletes over ~3 to 4 weeks of Live-High/Train-High altitude training (Flagstaff, AZ, 2135m; n=27 females; n=21 males; 27% 2016 Olympians). Pre- and post-camp Hbmass (optimized CO re-breathing method) and iron status were measured, EA was estimated via food and training logs and Low Energy Availability in Females Questionnaire (LEAF-Q) and a general injury/illness questionnaire was completed. Hypoxic exposure (hours) was calculated with low (600h) groupings. Absolute and relative percentage ΔHbmass (%ΔHbmass) was significantly greater in females (6.2±4.0%, paltitude training, while emphasizing the importance of athlete health and indices of EA on an optimal baseline Hbmass and hematological response to hypoxia.
Tomas K. Tong
Full Text Available This field study investigated the influences of exposure to natural low altitude on endurance training-induced alterations of redox homeostasis in professional adolescent runners undergoing 12-week off-season conditioning program at an altitude of 1700 m (Alt, by comparison with that of their counterparts completing the program at sea-level (SL. For age-, gender-, and Tanner-stage-matched comparison, 26 runners (n=13 in each group were selected and studied. Following the conditioning program, unaltered serum levels of thiobarbituric acid reactive substances (TBARS, total antioxidant capacity (T-AOC, and superoxide dismutase accompanied with an increase in oxidized glutathione (GSSG and decreases of xanthine oxidase, reduced glutathione (GSH, and GSH/GSSG ratio were observed in both Alt and SL groups. Serum glutathione peroxidase and catalase did not change in SL, whereas these enzymes, respectively, decreased and increased in Alt. Uric acid (UA decreased in SL and increased in Alt. Moreover, the decreases in GSH and GSH/GSSG ratio in Alt were relatively lower compared to those in SL. Further, significant interindividual correlations were found between changes in catalase and TBARS, as well as between UA and T-AOC. These findings suggest that long-term training at natural low altitude is unlikely to cause retained oxidative stress in professional adolescent runners.
Tong, Tomas K; Kong, Zhaowei; Lin, Hua; He, Yeheng; Lippi, Giuseppe; Shi, Qingde; Zhang, Haifeng; Nie, Jinlei
This field study investigated the influences of exposure to natural low altitude on endurance training-induced alterations of redox homeostasis in professional adolescent runners undergoing 12-week off-season conditioning program at an altitude of 1700 m (Alt), by comparison with that of their counterparts completing the program at sea-level (SL). For age-, gender-, and Tanner-stage-matched comparison, 26 runners (n = 13 in each group) were selected and studied. Following the conditioning program, unaltered serum levels of thiobarbituric acid reactive substances (TBARS), total antioxidant capacity (T-AOC), and superoxide dismutase accompanied with an increase in oxidized glutathione (GSSG) and decreases of xanthine oxidase, reduced glutathione (GSH), and GSH/GSSG ratio were observed in both Alt and SL groups. Serum glutathione peroxidase and catalase did not change in SL, whereas these enzymes, respectively, decreased and increased in Alt. Uric acid (UA) decreased in SL and increased in Alt. Moreover, the decreases in GSH and GSH/GSSG ratio in Alt were relatively lower compared to those in SL. Further, significant interindividual correlations were found between changes in catalase and TBARS, as well as between UA and T-AOC. These findings suggest that long-term training at natural low altitude is unlikely to cause retained oxidative stress in professional adolescent runners.
Satishchandra, D M; Naik, V A; Wantamutte, A S; Mallapur, M D; Sangolli, H N
To study the impact of Training of Traditional Birth Attendants (TBAs) on maternal health care in a rural area. An interventional study in the Primary Health Center area was conducted over 1-year period between March 2006 and February 2007, which included all the 50 Traditional Birth Attendants (30 previously trained and 20 untrained), as study participants. Pretest evaluation regarding knowledge, attitude, and practices about maternal care was done. Post-test evaluation was done at the first month (early) and at the fifth month (late) after the training. Analysis was done by using Mc. Nemer's test, Chi-square test with Yates's correction and Fischer's exact test. Early and late post-test evaluation showed that there was a progressive improvement in the maternal health care provided by both the groups. Significant reduction in the maternal and perinatal deaths among the deliveries conducted by TBAs after the training was noted. Training programme for TBAs with regular follow-ups in the resource-poor setting will not only improve the quality of maternal care but also reduce perinatal deaths.
José Luis Maté-Muñoz
Full Text Available The purpose of this study was compare the effects of a traditional and an instability resistance circuit training program on upper and lower limb strength, power, movement velocity and jumping ability. Thirty-six healthy untrained men were assigned to two experimental groups and a control group. Subjects in the experimental groups performed a resistance circuit training program consisting of traditional exercises (TRT, n = 10 or exercises executed in conditions of instability (using BOSU® and TRX® (IRT, n = 12. Both programs involved three days per week of training for a total of seven weeks. The following variables were determined before and after training: maximal strength (1RM, average (AV and peak velocity (PV, average (AP and peak power (PP, all during bench press (BP and back squat (BS exercises, along with squat jump (SJ height and counter movement jump (CMJ height. All variables were found to significantly improve (p <0.05 in response to both training programs. Major improvements were observed in SJ height (IRT = 22.1%, TRT = 20.1%, CMJ height (IRT = 17.7%, TRT = 15.2%, 1RM in BS (IRT = 13.03%, TRT = 12.6%, 1RM in BP (IRT = 4.7%, TRT = 4.4%, AP in BS (IRT = 10.5%, TRT = 9.3%, AP in BP (IRT = 2.4%, TRT = 8.1%, PP in BS (IRT=19.42%, TRT = 22.3%, PP in BP (IRT = 7.6%, TRT = 11.5%, AV in BS (IRT = 10.5%, TRT = 9.4%, and PV in BS (IRT = 8.6%, TRT = 4.5%. Despite such improvements no significant differences were detected in the posttraining variables recorded for the two experimental groups. These data indicate that a circuit training program using two instability training devices is as effective in untrained men as a program executed under stable conditions for improving strength (1RM, power, movement velocity and jumping ability.
Gill, Christopher J; Phiri-Mazala, Grace; Guerina, Nicholas G; Kasimba, Joshua; Mulenga, Charity; MacLeod, William B; Waitolo, Nelson; Knapp, Anna B; Mirochnick, Mark; Mazimba, Arthur; Fox, Matthew P; Sabin, Lora; Seidenberg, Philip; Simon, Jonathon L; Hamer, Davidson H
Objective To determine whether training traditional birth attendants to manage several common perinatal conditions could reduce neonatal mortality in the setting of a resource poor country with limited access to healthcare. Design Prospective, cluster randomised and controlled effectiveness study. Setting Lufwanyama, an agrarian, poorly developed district located in the Copperbelt province, Zambia. All births carried out by study birth attendants occurred at mothers’ homes, in rural village s...
Schembri, Laura; Fenech, Pauline; Sacco, Mark
This randomised controlled trial (RCT) employed a pre-test/post-test design to compare the effects of core training (Pilates method) and traditional back exercises on a population with low back pain (LBP). Therapeutic intervention related to the Pilates method has recently become popular, but there is little evidence to prove it works. In this study, 120 individuals with LBP were allocated to three different groups. Group A was the control group, Group B was given modifie...
Engum, Scott A; Jeffries, Pamela; Fisher, Lisa
Virtual reality simulators allow trainees to practice techniques without consequences, reduce potential risk associated with training, minimize animal use, and help to develop standards and optimize procedures. Current intravenous (IV) catheter placement training methods utilize plastic arms, however, the lack of variability can diminish the educational stimulus for the student. This study compares the effectiveness of an interactive, multimedia, virtual reality computer IV catheter simulator with a traditional laboratory experience of teaching IV venipuncture skills to both nursing and medical students. A randomized, pretest-posttest experimental design was employed. A total of 163 participants, 70 baccalaureate nursing students and 93 third-year medical students beginning their fundamental skills training were recruited. The students ranged in age from 20 to 55 years (mean 25). Fifty-eight percent were female and 68% percent perceived themselves as having average computer skills (25% declaring excellence). The methods of IV catheter education compared included a traditional method of instruction involving a scripted self-study module which involved a 10-minute videotape, instructor demonstration, and hands-on-experience using plastic mannequin arms. The second method involved an interactive multimedia, commercially made computer catheter simulator program utilizing virtual reality (CathSim). The pretest scores were similar between the computer and the traditional laboratory group. There was a significant improvement in cognitive gains, student satisfaction, and documentation of the procedure with the traditional laboratory group compared with the computer catheter simulator group. Both groups were similar in their ability to demonstrate the skill correctly. CONCLUSIONS; This evaluation and assessment was an initial effort to assess new teaching methodologies related to intravenous catheter placement and their effects on student learning outcomes and behaviors
Domej, Wolfgang; Trapp, Michael; Miggitsch, Eva Maria; Krakher, Tiziana; Riedlbauer, Rita; Roher, Peter; Schwaberger, Günther
The behavior of blood pressure under hypoxic conditions depends on individual factors, altitude and duration of stay at altitude. While most humans are normotensive at higher altitudes, a few will react with moderate hypertension or hypotension. Excessive elevation of arterial blood pressure is not even to be expected below 4,000 m. Rather, several weeks' stay at higher altitude will decrease systolic and diastolic blood pressure at rest as well as during physical exertion. A high-altitude treatment for rehabilitation purposes at moderate altitude may be recommended for patients with cardio-circulatory disorders. Improvements can last several months even after returning to accustomed altitudes. Furthermore, endurance-trained hypertensive patients with pharmacologically controlled arterial blood pressure might be able to participate in mountain treks without additional health risk.
Asadi, Abbas; Ramírez-Campillo, Rodrigo
The aim of this study was to compare the effects of 6-week cluster versus traditional plyometric training sets on jumping ability, sprint and agility performance. Thirteen college students were assigned to a cluster sets group (N=6) or traditional sets group (N=7). Both training groups completed the same training program. The traditional group completed five sets of 20 repetitions with 2min of rest between sets each session, while the cluster group completed five sets of 20 [2×10] repetitions with 30/90-s rest each session. Subjects were evaluated for countermovement jump (CMJ), standing long jump (SLJ), t test, 20-m and 40-m sprint test performance before and after the intervention. Both groups had similar improvements (Psets methods resulted in greater adaptations in sprint performance, while the cluster sets method resulted in greater jump and agility adaptations. Copyright © 2016 The Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.
Moya-Ramón, M.; Hernández-Davó, J. L.; Fernandez-Fernandez, J.; Sabido, R.
Background It has been suggested that strength training effects (i.e. neural or structural) vary, depending on the total repetitions performed and velocity loss in each training set. Purpose The aim of this study is to compare the effects of two training programmes (i.e. one with loads that maximise power output and individualised repetitions, and the other following traditional power training). Methods Twenty-five males were divided into three groups (optimum power [OP = 10], traditional training [TT = 9] and control group [CG = 6]). The training load used for OP was individualised using loads that maximised power output (41.7% ± 5.8 of one repetition maximum [1RM]) and repetitions at maximum power (4 to 9 repetitions, or ‘reps’). Volume (sets x repetitions) was the same for both experimental groups, while intensity for TT was that needed to perform only 50% of the maximum number of possible repetitions (i.e. 61.1%–66.6% of 1RM). The training programme ran over 11 weeks (2 sessions per week; 4–5 sets per session; 3-minute rests between sets), with pre-, intermediate and post-tests which included: anthropometry, 1RM, peak power output (PPO) with 30%, 40% and 50% of 1RM in the bench press throw, and salivary testosterone (ST) and cortisol (SC) concentrations. Rate of perceived exertion (RPE) and power output were recorded in all sessions. Results Following the intermediate test, PPO was increased in the OP group for each load (10.9%–13.2%). Following the post-test, both experimental groups had increased 1RM (11.8%–13.8%) and PPO for each load (14.1%–19.6%). Significant decreases in PPO were found for the TT group during all sets (4.9%–15.4%), along with significantly higher RPE (37%). Conclusion OP appears to be a more efficient method of training, with less neuromuscular fatigue and lower RPE. PMID:29053725
Pouliot, Mariève; Pyakurel, Dipesh; Smith-Hall, Carsten
Ethnopharmacological relevance Ophiocordyceps sinensis (Berk.) G.H.Sung, J.M.Sung, Hywel-Jones & Spatafora, a high altitude Himalayan fungus-caterpillar product found in alpine meadows in China, Bhutan, Nepal, and India, has been used in the Traditional Chinese Medicine system for over 2000 years...
Pallavi Sahay, MPT; Santosh Kr. Prasad, MSc; Shahnawaz Anwer, MPT; P.K. Lenka, PhD; Ratnesh Kumar, MS
The objective of this randomized controlled trial was to evaluate the efficacy of proprioceptive neuromuscular facilitation (PNF) techniques in comparison to traditional prosthetic training (TPT) in improving ambulatory function in transtibial amputees. Thirty study participants (19 men and 11 women) with unilateral transtibial amputation participated in the study. They were randomly allocated to either the traditional training group (i.e., TPT) (n = 15) or the PNF training group (n = 15). Th...
Kayombo, Edmund J
This paper presents discussion on impact of training traditional birth attendants (TBAs) on overall improvement of reproductive health care with focus on reducing the high rate of maternal and new-born mortality in rural settings in sub-Saharan Africa. The importance of TBAs for years has been denied by professional western trained health practitioners and other scientists until during the late 1980s, when World Health Organization through Safe motherhood 1987 found TBAs have a significant role in reducing maternal and new-born mortality. Trained TBAs in sub-Sahara Africa can have positive impact on reducing maternal and new-born mortality if the programme is well implemented with systematic follow-up after training. This could be done through joint meeting between health workers and TBAs as feed and learning experience from problem encountered in process of providing child delivery services. TBAs can help to break socio-cultural barriers on intervention on reproductive health programmes. However projects targeting TBAs should not be of hit and run; but gradually familiarize with the target group, build trust, transparency, and tolerance, willing to learn and creating rappour with them. In this paper, some case studies are described on how trained TBAs can be fully utilized in reducing maternal and new-born mortality rate in rural areas. What is needed is to identify TBAs, map their distribution and train them on basic primary healthcare related to child deliveries and complications which need to be referred to conventional health facilities immediately.
Maté-Muñoz, José Luis; Monroy, Antonio J. Antón; Jodra Jiménez, Pablo; Garnacho-Castaño, Manuel V.
The purpose of this study was compare the effects of a traditional and an instability resistance circuit training program on upper and lower limb strength, power, movement velocity and jumping ability. Thirty-six healthy untrained men were assigned to two experimental groups and a control group. Subjects in the experimental groups performed a resistance circuit training program consisting of traditional exercises (TRT, n = 10) or exercises executed in conditions of instability (using BOSU® and TRX®) (IRT, n = 12). Both programs involved three days per week of training for a total of seven weeks. The following variables were determined before and after training: maximal strength (1RM), average (AV) and peak velocity (PV), average (AP) and peak power (PP), all during bench press (BP) and back squat (BS) exercises, along with squat jump (SJ) height and counter movement jump (CMJ) height. All variables were found to significantly improve (p <0.05) in response to both training programs. Major improvements were observed in SJ height (IRT = 22.1%, TRT = 20.1%), CMJ height (IRT = 17.7%, TRT = 15.2%), 1RM in BS (IRT = 13.03%, TRT = 12.6%), 1RM in BP (IRT = 4.7%, TRT = 4.4%), AP in BS (IRT = 10.5%, TRT = 9.3%), AP in BP (IRT = 2.4%, TRT = 8.1%), PP in BS (IRT=19.42%, TRT = 22.3%), PP in BP (IRT = 7.6%, TRT = 11.5%), AV in BS (IRT = 10.5%, TRT = 9.4%), and PV in BS (IRT = 8.6%, TRT = 4.5%). Despite such improvements no significant differences were detected in the posttraining variables recorded for the two experimental groups. These data indicate that a circuit training program using two instability training devices is as effective in untrained men as a program executed under stable conditions for improving strength (1RM), power, movement velocity and jumping ability. Key Points Similar adaptations in terms of gains in strength, power, movement velocity and jumping ability were produced in response to both training programs. Both the stability and instability approaches
Ravgiala, Rebekah Rae
Theories regarding the development of expertise hold implications for alternative and traditional certification programs and the teachers they train. The literature suggests that when compared to experts in the field of teaching, the behaviors of novices differ in ways that are directly attributed to their pedagogical content knowledge. However, few studies have examined how first and second year biology teachers entering the profession from traditional and alternative training differ in their demonstration of subject-specific pedagogical content knowledge. The research problem in this multicase, naturalistic inquiry investigated how subject-specific pedagogical content knowledge was manifested among first and second year biology teachers in the task of transforming subject matter into forms that are potentially meaningful to students when explicit formal training has been and has not been imparted to them as preservice teachers. Two first year and two second year biology teachers were the subjects of this investigation. Allen and Amber obtained their certification through an alternative summer training institute in consecutive years. Tiffany and Tricia obtained their certification through a traditional, graduate level training program in consecutive years. Both programs were offered at the same northeastern state university. Participants contributed to six data gathering techniques including an initial semi-structured interview, responses to the Conceptions of Teaching Science questionnaire (Hewson & Hewson, 1989), three videotaped biology lessons, evaluation of three corresponding lesson plans, and a final semi-structured interview conducted at the end of the investigation. An informal, end-of-study survey intended to offer participants an opportunity to disclose their thoughts and needs as first year teachers was also employed. Results indicate that while conceptions of teaching science may vary slightly among participants, there is no evidence to suggest that
Full Text Available The aim of the study was to estimate changes in blood morphology caused by participation of record-seeking swimmers in a high altitude training camp at 2,300 m above sea level and to assess their performance during major competitions before and after the camp. Eight swimmers (two females and six males - record-holders and medallists of the Polish National Championships, as well as finalists and medallists of the European and World Championships and the Olympic Games (including a two-time holder of the world record - were recruited. During the 2006/2007 season the athletes attended a training camp organized according to the principle “live high and train high”. The camp lasted 23 days and consisted of three micro-cycles of training, each of them with specific training objectives. Before and after participation in the training camp erythrocyte (red blood cells; RBC count, haemoglobin (Hb concentration and haematocrit (Hct were estimated at a hospital laboratory. Scores amassed by the examined athletes during major competitions were presented after their transformation into points based on the FINA (International Swimming Federation tables for years 2005-2008. The best results (time for a distance achieved during competitions organized before and after participation in the camp were regarded as reference points. Additionally, liquid balance of the body was monitored during 30 selected training units (15 in the morning and 15 in the evening. The response of the examined swimmers from the Polish Olympic Team to the high altitude training (at 2,300 m above sea level was represented by an almost three-fold increase in blood reticulocyte count during the first micro-cycle of training as well as by an elevated erythrocyte count (by 14.4% and haemoglobin (by 13.5% and haematocrit (by 14.8% levels estimated after completion of the training, as compared to the results obtained before the camp. Six out of eight subjects improved their performance in
Meerschman, Iris; Van Lierde, Kristiane; Van Puyvelde, Caro; Bostyn, Astrid; Claeys, Sofie; D'haeseleer, Evelien
Background: In contrast with most medical and pharmaceutical therapies, the optimal dosage for voice therapy or training is unknown. Aims: The aim of this study was to compare the effect of a short-term intensive voice training (IVT) with a longer-term traditional voice training (TVT) on the vocal quality and vocal capacities of vocally healthy…
Martinez-Bello, Vladimir Essau; Sanchis-Gomar, Fabian; Nascimento, Ana Lucia; Pallardo, Federico V; Ibañez-Sania, Sandra; Olaso-Gonzalez, Gloria; Calbet, Jose Antonio; Gomez-Cabrera, Mari Carmen; Viña, Jose
The regimen of aerobic training at sea level with recovery at high altitude has been used by athletes to improve performance. However, little is known about the effects of hypoxia when combined with sprint interval training on performance. The aim of the present study was to determine the effect of a "living high-sprint training low" strategy on hemoglobin, hematocrit and erythropoietin levels in rats. We also wanted to test whether the addition of a hypoxic stress to the program of daily treadmill running at high speeds induces expressional adaptations in skeletal muscle and affects performance. The protein content of peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α), cytochrome C, pyruvate dehydrogenase kinase (PDK1), heat shock protein 70 (HSP70), manganese superoxide dismutase (MnSOD) and citrate synthase activity were determined in different muscle fiber types in our animals (red and white gastrocnemius muscle). We also determined the maximal aerobic velocity (MAV) before and after the training period. A total of 24 male Wistar rats (3 month old) were randomly divided into four experimental groups: the normoxic control group (n = 6), the normoxic trained group (n = 6), the hypoxic control group (12 h pO(2) 12%/12 h pO(2) 21%) (n = 6) and the hypoxic trained group (12 h pO(2) 12%/12 h pO(2) 21%). Living in normobaric hypoxia condition for 21 days significantly increased hemoglobin, hematocrit and erythropoietin levels in both the rest and the trained groups. The trained animals (normoxia and hypoxia) significantly increased their maximal aerobic velocity. No changes were found in the skeletal muscle in PGC-1α, cytochrome C, PDK1, HSP70, MnSOD protein content and in the citrate synthase activity in any experimental group. Regardless of whether it is combined with sprint interval training or not, after 21 days of living at high altitude we found a significant increase in the hematological values determined in our study. However, contrary to
Gill, Christopher J; Guerina, Nicholas G; Mulenga, Charity; Knapp, Anna B; Mazala, Grace; Hamer, Davidson H
To provide relevant details on how interventions in the Lufwanyama Neonatal Survival Project (LUNESP) were developed and how Zambian traditional birth attendants (TBAs) were trained to perform them. The study tested 2 interventions: a simplified version of the American Academy of Pediatrics' neonatal resuscitation protocol (NRP); and antibiotics with facilitated referral (AFR). Key elements that enabled the positive study result were: focusing on common and correctible causes of mortality; selecting a study population with high unmet public health need; early community mobilization to build awareness and support; emphasizing simplicity in the intervention technology and algorithms; using a traditional training approach appropriate to students with low literacy rates; requiring TBAs to demonstrate their competence before completing each workshop; and minimizing attrition of skills by retraining and reassessing the TBAs regularly throughout the study. An effective NRP training model was created that is suitable for community-based neonatal interventions, in research or programmatic settings, and by practitioners with limited obstetric skills and low rates of literacy. Clinicaltrials.gov NCT00518856. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
García-Flores, Libia Alejandra; Medina, Sonia; Cejuela, Roberto; Martínez-Sanz, José Miguel; Oger, Camille; Galano, Jean-Marie; Durand, Thierry; Casas-Pina, Teresa; Martínez-Hernández, Pedro; Ferreres, Federico; Gil-Izquierdo, Ángel
This randomized and controlled trial investigated whether the increase in elite training at different altitudes altered the oxidative stress biomarkers of the nervous system. This is the first study to investigate four F4-neuroprostanes (F4-NeuroPs) and four F2-dihomo-isoprostanes (F2-dihomo-IsoPs) quantified in 24-h urine. The quantification was carried out by ultra high pressure liquid chromatography-triple quadrupole-tandem mass spectrometry (UHPLC-QqQ-MS/MS). Sixteen elite triathletes agreed to participate in the project. They were randomized in two groups, a group submitted to altitude training (AT, n = 8) and a group submitted to sea level training (SLT) (n = 8), with a control group (Cg) of non-athletes (n = 8). After the experimental period, the AT group triathletes gave significant data: 17-epi-17-F2t-dihomo-IsoP (from 5.2 ± 1.4 μg/mL 24 h(-1) to 6.6 ± 0.6 μg/mL 24 h(-1)), ent-7(RS)-7-F2t-dihomo-IsoP (from 6.6 ± 1.7 μg/mL 24 h(-1) to 8.6 ± 0.9 μg/mL 24 h(-1)), and ent-7-epi-7-F2t-dihomo-IsoP (from 8.4 ± 2.2 μg/mL 24 h(-1) to 11.3 ± 1.8 μg/mL 24 h(-1)) increased, while, of the neuronal degeneration-related compounds, only 10-epi-10-F4t-NeuroP (8.4 ± 1.7 μg/mL 24 h(-1)) and 10-F4t-NeuroP (5.2 ± 2.9 μg/mL 24 h(-1)) were detected in this group. For the Cg and SLT groups, no significant changes had occurred at the end of the two-week experimental period. Therefore, and as the main conclusion, the training at moderate altitude increased the F4-NeuroPs- and F2-dihomo-isoPs-related oxidative damage of the central nervous system compared to similar training at sea level.
Garcés, Ana; McClure, Elizabeth M; Hambidge, Michael; Krebs, Nancy F; Mazariegos, Manolo; Wright, Linda L; Moore, Janet; Carlo, Waldemar A
To evaluate the impact of birth attendant training using the World Health Organization Essential Newborn Care (ENC) course among traditional birth attendants, with a particular emphasis on the effect of acquisition of skills on perinatal outcomes. Population-based, prospective, interventional pre-post design study. 11 rural clusters in Chimaltenango, Guatemala. Health care providers. This study analyzed the effect of training and implementation of the ENC health care provider training course between September 2005 and December 2006. The primary outcome measure was the rate of death from all causes in the first seven days after birth in fetuses/infants ≥1500g. Secondary outcome measures were overall rate of stillbirth, rate of perinatal death, which included stillbirths plus neonatal deaths in the first seven days in fetuses/infants ≥1500g. Perinatal mortality decreased from 39.5/1000 pre-ENC to 26.4 post-ENC (RR 0.72; 95%CI 0.54-0.97). This reduction was attributable almost entirely to a decrease in the stillbirth rate of 21.4/1000 pre-Essential Newborn Care to 7.9/1000 post-ENC (RR 0.40; 95%CI 0.25-0.64). Seven-day neonatal mortality did not decrease (18.3/1000 to 18.6/1000; RR 1.05; 95%CI 0.70-1.57). Essential Newborn Care training reduced stillbirths in a population-based controlled study with deliveries conducted almost exclusively by traditional birth attendants. Scale-up of this intervention in other settings might help assess reproducibility and sustainability. © Published . This article is a U.S. Government work and is in the public domain in the USA. Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.
Hou, Yang; Shi, Jiangang; Lin, Yanping; Chen, Huajiang; Yuan, Wen
The cervical screw placement is one of the most difficult procedures in spine surgery, which often needs a long period of repeated practices and could cause screw placement-related complications. We performed this cadaver study to investigate the effectiveness of virtual surgical training system (VSTS) on cervical pedicle screw instrumentation for residents. A total of ten novice residents were randomly assigned to two groups: the simulation training (ST) group (n = 5) and control group (n = 5). The ST group received a surgical training of cervical pedicle screw placement on VSTS and the control group was given an introductory teaching session before cadaver test. Ten fresh adult spine specimens including 6 males and 4 females were collected, and were randomly allocated to the two groups. The bilateral C3-C6 pedicle screw instrumentation was performed in the specimens of the two groups, respectively. After instrumentation, screw positions of the two groups were evaluated by image examinations. There was significantly statistical difference in screw penetration rates between the ST (10%) and control group (62.5%, P VSTS as an advanced training tool exhibited promising effects on improving performance of novice residents in cervical pedicle screw placement compared with the traditional teaching methods.
Sibley, Lynn; Ann Sipe, Theresa
to summarise the available published and unpublished studies on traditional birth attendant (TBA) training effectiveness. a meta-analysis. sixty studies (n=60) spanning 1971-1999 from 24 countries and three regions. the effect size index, Cohen's h for each outcome; the variance-weighted mean effect size and 95% confidence interval for sub-group of outcomes; homogeneity tests on the distribution of the weighted mean effect sizes; and sensitivity analysis to detect the presence of publication bias. TBA training was associated with significant increases in attributes such as TBA 'knowledge' (90%), 'attitude' (74%), 'behaviour' (63%) and 'advice' (90%) over the untrained TBA baseline. Results for 'behaviour' and 'advice' in specific content areas related to peri-neonatal health outcome, however, reveal sources of variability and underscore the conflicting evidence on TBA training. TBA training was also associated with small but significant decreases in peri-neonatal mortality (8%) and birth asphyxia mortality (11%). Incomplete reporting limited the assessment of neonatal mortality due to tetanus and acute respiratory infection, maternal mortality, as well as assessment of the relationship between intervention characteristics and outcomes. The quality of studies included in the meta-analysis lack sufficient rigour to address the question of causality. Thus, while the data suggest that TBA training is effective in terms of the outcomes measured, we are unable to demonstrate that it is a cost-effective intervention. skilled attendance at birth is a distant reality in many developing countries and effective community-based strategies are needed to help reduce high levels of mortality. Given the magnitude of peri-neonatal mortality, the associations observed between TBA training peri-neonatal and birth asphyxia mortality, and TBA attributes in content relevant to peri-neonatal survival, we suggest that these strategies may usefully include TBA training in appropriate
Hamlin, Michael J; Lizamore, Catherine A; Hopkins, Will G
While adaptation to hypoxia at natural or simulated altitude has long been used with endurance athletes, it has only recently gained popularity for team-sport athletes. To analyse the effect of hypoxic interventions on high-intensity intermittent running performance in team-sport athletes. A systematic literature search of five journal databases was performed. Percent change in performance (distance covered) in the Yo-Yo intermittent recovery test (level 1 and level 2 were used without differentiation) in hypoxic (natural or simulated altitude) and control (sea level or normoxic placebo) groups was meta-analyzed with a mixed model. The modifying effects of study characteristics (type and dose of hypoxic exposure, training duration, post-altitude duration) were estimated with fixed effects, random effects allowed for repeated measurement within studies and residual real differences between studies, and the standard-error weighting factors were derived or imputed via standard deviations of change scores. Effects and their uncertainty were assessed with magnitude-based inference, with a smallest important improvement of 4% estimated via between-athlete standard deviations of performance at baseline. Ten studies qualified for inclusion, but two were excluded owing to small sample size and risk of publication bias. Hypoxic interventions occurred over a period of 7-28 days, and the range of total hypoxic exposure (in effective altitude-hours) was 4.5-33 km h in the intermittent-hypoxia studies and 180-710 km h in the live-high studies. There were 11 control and 15 experimental study-estimates in the final meta-analysis. Training effects were moderate and very likely beneficial in the control groups at 1 week (20 ± 14%, percent estimate, ± 90% confidence limits) and 4-week post-intervention (25 ± 23%). The intermittent and live-high hypoxic groups experienced additional likely beneficial gains at 1 week (13 ± 16%; 13 ± 15%) and 4-week post
de Hoyo Moisés
Full Text Available This study aimed to analyze the effects of power training using traditional vertical resistance exercises versus direction specific horizontal inertial flywheel training on performance in common sport-related tasks. Twenty-three healthy and physically active males (age: 22.29 ± 2.45 years volunteered to participate in this study. Participants were allocated into either the traditional training (TT group where the half squat exercise on a smith machine was applied or the horizontal flywheel training (HFT group performing the front step exercise with an inertial flywheel. Training volume and intensity were matched between groups by repetitions (5-8 sets with 8 repetitions and relative intensity (the load that maximized power (Pmax over the period of six weeks. Speed (10 m and 20 m, countermovement jump height (CMJH, 20 m change of direction ability (COD and strength during a maximal voluntary isometric contraction (MVIC were assessed before and after the training program. The differences between groups and by time were assessed using a two-way analysis of variance with repeated measures, followed by paired t-tests. A significant group by time interaction (p=0.004 was found in the TT group demonstrating a significantly higher CMJH. Within-group analysis revealed statistically significant improvements in a 10 m sprint (TT: −0.17 0.27 s vs. HFT: −0.11 0.10 s, CMJH (TT: 4.92 2.58 cm vs. HFT: 1.55 2.44 cm and MVIC (TT: 62.87 79.71 N vs. HFT: 106.56 121.63 N in both groups (p < 0.05. However, significant differences only occurred in the 20 m sprint time in the TT group (−0.04 0.12 s; p = 0.04. In conclusion, the results suggest that TT at the maximal peak power load is more effective than HFT for counter movement jump height while both TT and HFT elicited significant improvements in 10 m sprint performance while only TT significantly improved 20 m sprint performance.
Sibley, Lynn M; Sipe, Theresa Ann; Barry, Danika
Background Between the 1970s and 1990s, the World Health Organization promoted traditional birth attendant (TBA) training as one strategy to reduce maternal and neonatal mortality. To date, evidence in support of TBA training is limited but promising for some mortality outcomes. Objectives To assess the effects of TBA training on health behaviours and pregnancy outcomes. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (18 June 2012), citation alerts from our work and reference lists of studies identified in the search. Selection criteria Published and unpublished randomised controlled trials (RCT), comparing trained versus untrained TBAs, additionally trained versus trained TBAs, or women cared for/living in areas served by TBAs. Data collection and analysis Three authors independently assessed study quality and extracted data in the original and first update review. Three authors and one external reviewer independently assessed study quality and two extracted data in this second update. Main results Six studies involving over 1345 TBAs, more than 32,000 women and approximately 57,000 births that examined the effects of TBA training for trained versus untrained TBAs (one study) and additionally trained TBA training versus trained TBAs (five studies) are included in this review. These studies consist of individual randomised trials (two studies) and cluster-randomised trials (four studies). The primary outcomes across the sample of studies were perinatal deaths, stillbirths and neonatal deaths (early, late and overall). Trained TBAs versus untrained TBAs: one cluster-randomised trial found a significantly lower perinatal death rate in the trained versus untrained TBA clusters (adjusted odds ratio (OR) 0.70, 95% confidence interval (CI) 0.59 to 0.83), lower stillbirth rate (adjusted OR 0.69, 95% CI 0.57 to 0.83) and lower neonatal death rate (adjusted OR 0.71, 95% CI 0.61 to 0.82). This study also found the maternal death
Verderese, Maria de Lourdes; Turnbull, Lily M.
The publication provides guidelines for assisting developing countries in determining strategies for the utilization and training of traditional birth attendants (TBAs). TBA's are persons (usually women in rural areas) who assist the mother at childbirth and who initially acquired their skills through experience rather than formal training. After…
Schürer, S; Schellberg, D; Schmidt, J; Kallinowski, F; Mehrabi, A; Herfarth, Ch; Büchler, M W; Kadmon, M
The medical faculty of Heidelberg University implemented a new problem-based clinical curriculum (Heidelberg Curriculum Medicinale, or Heicumed) in 2001. The present study analyses the evaluation data of two student cohorts prior to the introduction of Heicumed. Its aim was to specify problems of the traditional training and to draw conclusions for implementation of a new curriculum. The evaluation instrument was the Heidelberg Inventory for the Evaluation of Teaching (HILVE-I). The data were analysed calculating differences in the means between defined groups, with the 13 primary scales of the HILVE I-instrument as dependent variables. Teaching method and subject had no systematic influence on evaluation results. Thus, didactic lecture in orthopedic surgery achieved better results than small group tutorials, while the data on vascular and general surgery showed opposite results. Major factors for success were continuity and didactic training of lecturers and tutors. This is convincingly reflected by the results of the lecture course "Differential diagnosis in general surgery". The good evaluation data on small group tutorials resulted largely from the "participation" and "discussion" scales, which represent interactivity in learning. The results of the present study suggest the importance of two major pedagogic ideas: continuity and didactic training of lecturers and tutors. These principles were widely implemented in Heicumed and have contributed to the success of the new curriculum.
Prata, Ndola; Quaiyum, Md Abdul; Passano, Paige; Bell, Suzanne; Bohl, Daniel D; Hossain, Shahed; Azmi, Ashrafi Jahan; Begum, Mohsina
A 50-fold disparity in maternal mortality exists between high- and low-income countries, and in most contexts, the single most common cause of maternal death is postpartum hemorrhage (PPH). In Bangladesh, as in many other low-income countries, the majority of deliveries are conducted at home by traditional birth attendants (TBAs) or family members. In the absence of skilled birth attendants, training TBAs in the use of misoprostol and an absorbent delivery mat to measure postpartum blood loss may strengthen the ability of TBAs to manage PPH. These complementary interventions were tested in operations research among 77,337 home births in rural Bangladesh. The purpose of this study was to evaluate TBAs' knowledge acquisition, knowledge retention, and changes in attitudes and practices related to PPH management in home births after undergoing training on the use of misoprostol and the blood collection delivery mat. We conclude that the training was highly effective and that the two interventions were safely and correctly used by TBAs at home births. Data on TBA practices indicate adherence to protocol, and 18 months after the interventions were implemented, TBA knowledge retention remained high. This program strengthens the case for community-based use of misoprostol and warrants consideration of this intervention as a potential model for scale-up in settings where complete coverage of skilled birth attendants (SBAs) remains a distant goal. Copyright © 2012 Elsevier Ltd. All rights reserved.
Gill, Christopher J; Phiri-Mazala, Grace; Guerina, Nicholas G; Kasimba, Joshua; Mulenga, Charity; MacLeod, William B; Waitolo, Nelson; Knapp, Anna B; Mirochnick, Mark; Mazimba, Arthur; Fox, Matthew P; Sabin, Lora; Seidenberg, Philip; Simon, Jonathon L; Hamer, Davidson H
To determine whether training traditional birth attendants to manage several common perinatal conditions could reduce neonatal mortality in the setting of a resource poor country with limited access to healthcare. Prospective, cluster randomised and controlled effectiveness study. Lufwanyama, an agrarian, poorly developed district located in the Copperbelt province, Zambia. All births carried out by study birth attendants occurred at mothers' homes, in rural village settings. 127 traditional birth attendants and mothers and their newborns (3559 infants delivered regardless of vital status) from Lufwanyama district. Using an unblinded design, birth attendants were cluster randomised to intervention or control groups. The intervention had two components: training in a modified version of the neonatal resuscitation protocol, and single dose amoxicillin coupled with facilitated referral of infants to a health centre. Control birth attendants continued their existing standard of care (basic obstetric skills and use of clean delivery kits). The primary outcome was the proportion of liveborn infants who died by day 28 after birth, with rate ratios statistically adjusted for clustering. Secondary outcomes were mortality at different time points; and comparison of causes of death based on verbal autopsy data. Among 3497 deliveries with reliable information, mortality at day 28 after birth was 45% lower among liveborn infants delivered by intervention birth attendants than control birth attendants (rate ratio 0.55, 95% confidence interval 0.33 to 0.90). The greatest reductions in mortality were in the first 24 hours after birth: 7.8 deaths per 1000 live births for infants delivered by intervention birth attendants compared with 19.9 per 1000 for infants delivered by control birth attendants (0.40, 0.19 to 0.83). Deaths due to birth asphyxia were reduced by 63% among infants delivered by intervention birth attendants (0.37, 0.17 to 0.81) and by 81% within the first two days
Phiri-Mazala, Grace; Guerina, Nicholas G; Kasimba, Joshua; Mulenga, Charity; MacLeod, William B; Waitolo, Nelson; Knapp, Anna B; Mirochnick, Mark; Mazimba, Arthur; Fox, Matthew P; Sabin, Lora; Seidenberg, Philip; Simon, Jonathon L; Hamer, Davidson H
Objective To determine whether training traditional birth attendants to manage several common perinatal conditions could reduce neonatal mortality in the setting of a resource poor country with limited access to healthcare. Design Prospective, cluster randomised and controlled effectiveness study. Setting Lufwanyama, an agrarian, poorly developed district located in the Copperbelt province, Zambia. All births carried out by study birth attendants occurred at mothers’ homes, in rural village settings. Participants 127 traditional birth attendants and mothers and their newborns (3559 infants delivered regardless of vital status) from Lufwanyama district. Interventions Using an unblinded design, birth attendants were cluster randomised to intervention or control groups. The intervention had two components: training in a modified version of the neonatal resuscitation protocol, and single dose amoxicillin coupled with facilitated referral of infants to a health centre. Control birth attendants continued their existing standard of care (basic obstetric skills and use of clean delivery kits). Main outcome measures The primary outcome was the proportion of liveborn infants who died by day 28 after birth, with rate ratios statistically adjusted for clustering. Secondary outcomes were mortality at different time points; and comparison of causes of death based on verbal autopsy data. Results Among 3497 deliveries with reliable information, mortality at day 28 after birth was 45% lower among liveborn infants delivered by intervention birth attendants than control birth attendants (rate ratio 0.55, 95% confidence interval 0.33 to 0.90). The greatest reductions in mortality were in the first 24 hours after birth: 7.8 deaths per 1000 live births for infants delivered by intervention birth attendants compared with 19.9 per 1000 for infants delivered by control birth attendants (0.40, 0.19 to 0.83). Deaths due to birth asphyxia were reduced by 63% among infants delivered by
MacDonald, Christopher J; Lamont, Hugh S; Garner, John C
Complex training (CT; alternating between heavy and lighter load resistance exercises with similar movement patterns within an exercise session) is a form of training that may potentially bring about a state of postactivation potentiation, resulting in increased dynamic power (Pmax) and rate of force development during the lighter load exercise. Such a method may be more effective than either modality, independently for developing strength. The purpose of this research was to compare the effects of resistance training (RT), plyometric training (PT), and CT on lower body strength and anthropometrics. Thirty recreationally trained college-aged men were trained using 1 of 3 methods: resistance, plyometric, or complex twice weekly for 6 weeks. The participants were tested pre, mid, and post to assess back squat strength, Romanian dead lift (RDL) strength, standing calf raise (SCR) strength, quadriceps girth, triceps surae girth, body mass, and body fat percentage. Diet was not controlled during this study. Statistical measures revealed a significant increase for squat strength (p = 0.000), RDL strength (p = 0.000), and SCR strength (p = 0.000) for all groups pre to post, with no differences between groups. There was also a main effect for time for girth measures of the quadriceps muscle group (p = 0.001), the triceps surae muscle group (p = 0.001), and body mass (p = 0.001; post hoc revealed no significant difference). There were main effects for time and group × time interactions for fat-free mass % (RT: p = 0.031; PT: p = 0.000). The results suggest that CT mirrors benefits seen with traditional RT or PT. Moreover, CT revealed no decrement in strength and anthropometric values and appears to be a viable training modality.
Shah, Ankit B; Coplan, Neil
Altitude plays an important role in cardiovascular performance and training for athletes. Whether it is mountaineers, skiers, or sea-level athletes trying to gain an edge by training or living at increased altitude, there are many potential benefits and harms of such endeavors. Echocardiographic studies done on athletes at increased altitude have shown evidence for right ventricular dysfunction and pulmonary hypertension, but no change in left ventricular ejection fraction. In addition, 10% of athletes are susceptible to pulmonary hypertension and high-altitude pulmonary edema. Some studies suggest that echocardiography may be able to identify athletes susceptible to high-altitude pulmonary edema prior to competing or training at increased altitudes. Further research is needed on the long-term effects of altitude training, as repeated, transient episodes of pulmonary hypertension and right ventricular dysfunction may have long-term implications. Current literature suggests that performance athletes are not at higher risk for ventricular arrhythmias when training or competing at increased altitudes. For sea-level athletes, the optimal strategy for attaining the benefits while minimizing the harms of altitude training still needs to be clarified, although-for now-the "live high, train low" approach appears to have the most rationale.
Geon Ha Kim
Full Text Available The purpose of this study was to investigate if multi-domain cognitive training, especially robot-assisted training, alters cortical thickness in the brains of elderly participants. A controlled trial was conducted with 85 volunteers without cognitive impairment who were 60 years old or older. Participants were first randomized into two groups. One group consisted of 48 participants who would receive cognitive training and 37 who would not receive training. The cognitive training group was randomly divided into two groups, 24 who received traditional cognitive training and 24 who received robot-assisted cognitive training. The training for both groups consisted of daily 90-min-session, five days a week for a total of 12 weeks. The primary outcome was the changes in cortical thickness. When compared to the control group, both groups who underwent cognitive training demonstrated attenuation of age related cortical thinning in the frontotemporal association cortices. When the robot and the traditional interventions were directly compared, the robot group showed less cortical thinning in the anterior cingulate cortices. Our results suggest that cognitive training can mitigate age-associated structural brain changes in the elderly.ClnicalTrials.gov NCT01596205.
Tiggemann, Carlos Leandro; Dias, Caroline Pieta; Radaelli, Regis; Massa, Jéssica Cassales; Bortoluzzi, Rafael; Schoenell, Maira Cristina Wolf; Noll, Matias; Alberton, Cristine Lima; Kruel, Luiz Fernando Martins
The present study compared the effects of 12 weeks of traditional resistance training and power training using rated perceived exertion (RPE) to determine training intensity on improvements in strength, muscle power, and ability to perform functional task in older women. Thirty healthy elderly women (60-75 years) were randomly assigned to traditional resistance training group (TRT; n = 15) or power training group (PT; n = 15). Participants trained twice a week for 12 weeks using six exercises. The training protocol was designed to ascertain that participants exercised at an RPE of 13-18 (on a 6-20 scale). Maximal dynamic strength, muscle power, and functional performance of lower limb muscles were assessed. Maximal dynamic strength muscle strength leg press (≈58 %) and knee extension (≈20 %) increased significantly (p training. Muscle power also increased with training (≈27 %; p functional performance after training period (≈13 %; p effective in improving maximal strength, muscle power, and functional performance of lower limbs in elderly women.
Clark, Anna D; Guilfoyle, Mathew R; Candy, Nicholas G; Budohoski, Karol P; Hofmann, Riikka; Barone, Damiano G; Santarius, Thomas; Kirollos, Ramez W; Trivedi, Rikin A
Stereoscopic three-dimensional (3D) imaging is increasingly used in the teaching of neuroanatomy and although this is mainly aimed at undergraduate medical students, it has enormous potential for enhancing the training of neurosurgeons. This study aims to assess whether 3D lecturing is an effective method of enhancing the knowledge and confidence of neurosurgeons and how it compares with traditional two-dimensional (2D) lecturing and cadaveric training. Three separate teaching sessions for neurosurgical trainees were organized: 1) 2D course (2D lecture + cadaveric session), 2) 3D lecture alone, and 3) 3D course (3D lecture + cadaveric session). Before and after each session, delegates were asked to complete questionnaires containing questions relating to surgical experience, anatomic knowledge, confidence in performing procedures, and perceived value of 3D, 2D, and cadaveric teaching. Although both 2D and 3D lectures and courses were similarly effective at improving self-rated knowledge and understanding, the 3D lecture and course were associated with significantly greater gains in confidence reported by the delegates for performing a subfrontal approach and sylvian fissure dissection. Stereoscopic 3D lectures provide neurosurgical trainees with greater confidence for performing standard operative approaches and enhances the benefit of subsequent practical experience in developing technical skills in cadaveric dissection. Copyright © 2017. Published by Elsevier Inc.
Okafor, I I; Arinze-Onyia, S U; Ohayi, Sar; Onyekpa, J I; Ugwu, E O
The essence of training traditional birth attendants (TBAs) is to attend to women in uncomplicated labor and to refer them immediately to hospitals when complications develop. The aim was to audit childbirth emergency referrals by trained TBAs to a specialist hospital in Enugu, Nigeria. A retrospective study of 205 childbirth emergencies referred to Semino Hospital and Maternity (SHM), Enugu by trained TBAs from August 1, 2011 to January 31, 2014. Data analysis was descriptive and inferential at 95% confidence level. Most of the patients (185/205, 90.2%) were married and (100/205, 48.8%) had earlier booked for antenatal care in formal health facilities. There were obstetric danger signs or previous bad obstetric histories (pregnancies with unfavorable outcome) in 110 (110/205, 53.7%) women on admission at SHM. One hundred and fifteen (115/205, 56.1%) women walked into the hospital by themselves while 50 (50/205, 24.39%) could not walk. The fetal heart sounds were normal in 94 (94/205, 45.6%), abnormal in 65 (65/205, 31.8%) and absent in 42 (42/205, 20.4%) of the women on admission. Five healthy babies were delivered by the TBAs before referring their mothers. Delays of more than 12 h had occurred in 155 (155/205, 76.6%) of the women before referrals. Prolonged labor (100/205, 48.8%), obstructed labor (40/205, 19.5%), attempted vaginal birth after previous cesarean delivery (40/205, 19.5%) and malpresentation (30/205, 14.6%) were the common indications for referrals. The maternal mortality and perinatal mortality ratios were 610/100,000 live births and 228/1000 total births respectively. Delays at TBA centers are common before referral and most patients are referred in poor clinical state. Further training and re-training of the TBAs with more emphasis on recognition of obstetric danger signs and bad obstetric histories may help in screening high-risk patients for prompt referral to hospitals before complications develop.
Mardegan, Karen J; Schofield, Margot J; Murphy, Gregory C
Basic Life Support (BLS) is a life-saving and fundamental skill in resuscitation. However, studies have reported limitations in BLS training outcomes for both health professional and lay populations, and noted the resource and time-intensive nature of traditional training approaches. This exploratory study evaluated the effectiveness of an interactive CD-based BLS training programme that included unsupervised manikin practice compared with a traditional instructor-led BLS training programme involving demonstration and supervised practice. A quasi-experimental post-test with follow-up design was used. The sample was comprised of two cohorts: Novice second-year undergraduate Nursing students (n=187) and Practising Nurses (n=107) in their first year of hospital employment. BLS skill outcomes were assessed at one week and again at eight weeks post training. No statistically significant differences were found between the CD and traditional instructor-led BLS training methods in BLS skills of Novice and Practising Nurses at one week and eight weeks post training. However, there was a decrement in skill between one week and eight weeks post-training across both groups and an overall low level of competence. The failure to find a difference between the CD-based BLS programme with unsupervised manikin practice and a resource-intensive traditional instructor-led BLS training programme may indicate equivalence of the programmes or, even study design limitations. It is concerning that competence displayed by trainees from both groups was less than optimal and suggests the need for renewed efforts to develop and evaluate BLS training programmes which can achieve high rates of competence with acceptable skill retention over time. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.
Furlanetto, Giulia; Badino, Federica; Brunetti, Michele; Champvillair, Elena; De Amicis, Mattia; Maggi, Valter; Pini, Roberta; Ravazzi, Cesare; Vallé, Francesca
Temperatures and precipitation are the main environmental factors influencing vegetation and pollen production. Knowing the modern climate optima and tolerances of those plants represented in fossil assemblages and assuming that the relationships between plants and climate in the past are not dissimilar from the modern ones, fossil pollen records offer many descriptors to reconstruct past climate variables. The aim of our work is to investigate the potential of high-altitude pollen records from an Alpine peat bog (TBValter, close to the Ruitor Glacier, Western Italian Alps) for quantitative paleoclimate estimates. The idea behind is that high-altitude ecosystems are more sensitive to climate changes, especially to changes in July temperatures that severely affect the timberline ecotone. Meantime, we met with difficulties when considering the factors involved in pollen dispersal over a complex altitudinal mountain pattern, such as the Alps. We used the EMPD-European Modern Pollen Database (Davis et al., 2013) as modern training set to be compared with our high-altitude fossil site. The EMPD dataset is valuable in that it provides a large geographic coverage of main ecological and climate gradients (at sub-continental scale) but lacks in sampling of altitudinal gradients and high-altitude sites in the Alps. We therefore designed an independent altitudinal training set for the alpine valley hosting our fossil site. 27 sampling plots were selected along a 1700m-elevational transect. In a first step, each plot was provided with (i) 3 moss polsters collected following the guidelines provided by Cañellas-Boltà et al. (2009) and analyzed separately to account for differences in pollen deposition at small scale, (ii) morphometrical parameters obtained through a high-resolution DEM, and (iii) temperature and precipitation were estimated by means of weighted linear regression of the meteorological variable versus elevation, locally evaluated for each site (Brunetti et al
Peltzer, Karl; Nqeketo, Ayanda; Petros, George; Kanta, Xola
Training designed to improve circumcision knowledge, attitude and practice was delivered over 5 days to 34 traditional surgeons and 49 traditional nurses in the Eastern Cape, South Africa. Training included the following topics: initiation rites; statutory regulation of traditional male circumcision and initiation into Manhood (TCIM); structure and function of the male sex organs; procedure of safe circumcision, infection control; sexually transmitted infections (STIs); HIV/AIDS; infection control measures; aftercare of the initiate including after care of the circumcision wound and initiate as a whole; detection and early management of common complications of circumcision; nutrition and fluid management; code of conduct and ethics; and sexual health education. The evaluation of the training consisted of a prospective assessment of knowledge and attitude immediately prior to and after training. Significant improvement in knowledge and/or attitudes was observed in legal aspects, STI, HIV and environmental aspects, attitudes in terms of improved collaboration with biomedical health care providers, normal and abnormal anatomy and physiology, sexually transmitted infections and including HIV, circumcision practice and aftercare of initiates. We concluded that safer circumcision training can be successfully delivered to traditional surgeons and nurses.
Elledge, Ross; Houlton, Samantha; Hackett, Stephanie; Evans, Martin J
While virtual learning environments (VLE) can be used in medical education as stand-alone educational interventions, they can also be used in preparation for traditional "face-to-face" training sessions as part of a "flipped classroom" model. We sought to evaluate the introduction of this model in a single module on maxillofacial radiology from a course on trauma skills. Course delegates were randomised into two groups: one was given access to an e-learning resource (test group) and the other attended a traditional didactic lecture (control group). Knowledge and confidence were assessed before and after the course with a 20-question single-best-answer paper and a 10-situation 100mm visual analogue scale (VAS) paper, respectively. All participants were then given free access to the VLE for 30days and were invited to take part in an e-survey. Neither group showed improvements in the single-best-answer scores, but both groups showed comparable improvements in VAS (control: median (range) values improved from 40.8 (17.7-82.5) mm to 62.8 (35.3-88.7) mm, p=0.001; test group: from 47.7 (10.9-58.1) mm to 60.5 (32.4-75.6) mm, p=0.005). Half of the respondents stated that they preferred the "flipped classroom" approach, and 22/22 stated that they would be "likely" or "very likely" to use an e-learning resource with expanded content. The "flipped classroom" approach was well received and there were comparable improvements in confidence. As maxillofacial radiology lends itself to online instruction with its reliance on the recognition of patterns, and problem-based approach to learning, a piloted e-learning resource could be developed in this area. Copyright © 2018 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Full Text Available Introduction: Although simulation-based training is increasingly used for medical education, its benefits in continuing medical education (CME are less established. This study seeks to evaluate the feasibility of incorporating simulation-based training into a CME conference and compare its effectiveness with the traditional workshop in improving knowledge and self-reported confidence. Methods: Participants (N=27 were group randomized to either a simulation-based workshop or a traditional case-based workshop. Results: Post-training, knowledge assessment score neither did increase significantly in the traditional group (d=0.13; p=0.76 nor did significantly decrease in the simulation group (d= − 0.44; p=0.19. Self-reported comfort in patient assessment parameters increased in both groups (p<0.05 in all. However, only the simulation group reported an increase in comfort in patient management (d=1.1, p=0.051 for the traditional group and d=1.3; p= 0.0003 for the simulation group. At 1 month, comfort measures in the traditional group increased consistently over time while these measures in the simulation group increased post-workshop but decreased by 1 month, suggesting that some of the effects of training with simulation may be short lived. Discussion: The use of simulation-based training was not associated with benefits in knowledge acquisition, knowledge retention, or comfort in patient assessment. It was associated with superior outcomes in comfort in patient management, but this benefit may be short-lived. Further studies are required to better define the conditions under which simulation-based training is beneficial.
Fisher, Nelli; Bernstein, Peter S; Satin, Andrew; Pardanani, Setul; Heo, Hye; Merkatz, Irwin R; Goffman, Dena
To compare eclampsia and magnesium toxicity management among residents randomly assigned to lecture or simulation-based education. Statified by year, residents (n = 38) were randomly assigned to 3 educational intervention groups: Simulation→Lecture, Simulation, and Lecture. Postintervention simulations were performed for all and scored using standardized lists. Maternal, fetal, eclampsia management, and magnesium toxcity scores were assigned. Mann-Whitney U, Wilcoxon rank sum and χ(2) tests were used for analysis. Postintervention maternal (16 and 15 vs 12; P < .05) and eclampsia (19 vs 16; P < .05) scores were significantly better in simulation based compared with lecture groups. Postintervention magnesium toxcitiy and fetal scores were not different among groups. Lecture added to simulation did not lead to incremental benefit when eclampsia scores were compared between Simulation→Lecture and Simulation (19 vs 19; P = nonsignificant). Simulation training is superior to traditional lecture alone for teaching crucial skills for the optimal management of both eclampsia and magnesium toxicity, 2 life-threatening obstetric emergencies. Published by Mosby, Inc.
Proske, Antje; Roscoe, Rod D.; McNamara, Danielle S.
Achieving sustained student engagement with practice in computer-based writing strategy training can be a challenge. One potential solution is to foster engagement by embedding practice in educational games; yet there is currently little research comparing the effectiveness of game-based practice versus more traditional forms of practice. In this…
Vansintejan, G A; Glaser, W A
During the 1980's in Karawa, Northwestern Zaire, a motion picture was produced which showed the interaction of the modern and traditional systems. The maternity center of the Karawa hospital was central to this effort. Traditional birth attendants (TBAs) became leading participants. Locally trained midwives were key trainers. The training and supervision programs had been ongoing for 2 years when Karawa was chosen as the movie site in 1986. The script was written by a midwife who had trained trainers of TBAs and TBAs themselves. All the steps in the selection, training, supervision, and supplying of TBAs in Karawa and its neighboring villages are included in the script. A Zairian team shot the script. The 5-member crew were employees of the Office Zairois de la Radio-Television (OZRT), the country's official television, radio, and film service. "Wibange" has separate sound tracks in French and English. Costs of the movie were met by contributions from both the US Agency for International Development and from Zaire. "Wibange--Traditional Birth Attendants: Their Training and Supervision" was developed in New York City. There are 2 final productions, a French and an English version. Running time is 23 minutes.
Kerr, Brendan; Hawkins, Trisha Lee-Ann; Herman, Robert; Barnes, Sue; Kaufmann, Stephanie; Fraser, Kristin; Ma, Irene W. Y.
Introduction Although simulation-based training is increasingly used for medical education, its benefits in continuing medical education (CME) are less established. This study seeks to evaluate the feasibility of incorporating simulation-based training into a CME conference and compare its effectiveness with the traditional workshop in improving knowledge and self-reported confidence. Methods Participants (N=27) were group randomized to either a simulation-based workshop or a traditional case-based workshop. Results Post-training, knowledge assessment score neither did increase significantly in the traditional group (d=0.13; p=0.76) nor did significantly decrease in the simulation group (d= − 0.44; p=0.19). Self-reported comfort in patient assessment parameters increased in both groups (psimulation-based training was not associated with benefits in knowledge acquisition, knowledge retention, or comfort in patient assessment. It was associated with superior outcomes in comfort in patient management, but this benefit may be short-lived. Further studies are required to better define the conditions under which simulation-based training is beneficial. PMID:23870304
Chen, Solomon Chih-Cheng; Wang, Jung-Der; Ward, Aimee Lou; Chan, Chang-Chuan; Chen, Pau-Chung; Chiang, Hung-Che; Kolola-Dzimadzi, Rose; Nyasulu, Yohane M Z; Yu, Joseph Kwong-Leung
to evaluate the effectiveness of continuing training for traditional birth attendants (TBAs) on their reproductive knowledge and performance. Mzuzu Central Hospital in the northern region of Malawi. PARTICIPANTS AND ANALYSIS: a total of 81 TBAs trained during 2004 and 2006 in Mzuzu, Malawi received continuing training courses. Their reproductive knowledge was assessed by a structured questionnaire during 2004 and 2007. A multivariate generalised estimating equation (GEE) model was constructed to determine the associations between their reproductive knowledge scores and age, years of education, time since the last training course, test frequency and number of babies delivered. from July 2004 to June 2007, a total of 1984 pregnant women visited these trained TBAs. A total of 79 (4.0%) mothers were referred to health facilities before the birth due to first-born or difficult pregnancies. No maternal deaths occurred among the remaining mothers. There were 26 deaths among 1905 newborn babies, giving a perinatal mortality rate of 13.6 per 1000 live births. The GEE model demonstrated that knowledge scores of TBAs were significantly higher for TBAs under the age of 45 years, TBAs with more than five years of education, TBAs who had taken a training course within one year, and TBAs with a higher test frequency. continuing training courses are effective to maintain the reproductive knowledge and performance of trained TBAs. It is recommended that continuing training should be offered regularly, at least annually. Copyright © 2010 Elsevier Ltd. All rights reserved.
Full Text Available Purpose : to identify the degree of efficiency traditionally used in Ukraine, the organization and conduct classes on football with students 6 to 10 years. Material : the study involved 57 students, ages 6-10 years. Investigations were carried out through the use of Polar Team System. Results : the indexes of the pulse energy and the cost of various options for training sessions, traditionally held in the sections with the children in groups of initial training. Marked reaction parameters organism beginners to competitive load. Substantiated quantitative characteristics of the diet of children. The data of the comparative analysis of energy cost of training sessions and daily food intake of children. Conclusions : It was found that classes with beginners accompanied by the use of heavy loads, often diet does not provide full recovery in children.
Gellman, Gregg W
This thesis proposes that it is possible to create an adjunct to traditional instructor-led training that will reduce training time and costs and at the same time improve performance using commercial off-the shelf (COTS) software...
Nybo, Lars; Sundstrup, Emil; Jakobsen, Markus D
The purpose of this study was to determine the effectiveness of brief intense interval training as exercise intervention for promoting health and to evaluate potential benefits about common interventions, that is, prolonged exercise and strength training....
Nybo, Lars; Sundstrup, Emil; Jakobsen, Markus D
The purpose of this study was to determine the effectiveness of brief intense interval training as exercise intervention for promoting health and to evaluate potential benefits about common interventions, that is, prolonged exercise and strength training.......The purpose of this study was to determine the effectiveness of brief intense interval training as exercise intervention for promoting health and to evaluate potential benefits about common interventions, that is, prolonged exercise and strength training....
This research investigated the limitations of Albert Bandura's theory of observational training (also known as observational learning) when applied to e-learning. The study focused on professional employees in different industries around the United States. These professionals engaged in continuous training either in the classroom or on in an…
Sloane, Stephanie; Liechty, Janet M.; Fiese, Barbara H.; Donovan, Sharon M.
Transdisciplinary (TD) approaches are increasingly used to address complex public health problems such as childhood obesity. Compared to traditional grant-funded scientific projects among established scientists, those designed around a TD, team-based approach yielded greater publication output after three to five years. However, little is known about how a TD focus throughout graduate school training may affect students’ publication-related productivity, impact, and collaboration. The objective of this study was to compare the publication patterns of students in traditional versus TD doctoral training programs. Productivity, impact, and collaboration of peer-reviewed publications were compared between traditional (n = 25) and TD (n = 11) students during the first five years of the TD program. Statistical differences were determined by t-test or chi square test at p students was 5.2 ± 10.1 (n = 56) compared to 3.6 ± 4.5 per traditional student (n = 82). Publication impact indicators were significantly higher for TD students vs. traditional students: 5.7 times more citations in Google Scholar, 6.1 times more citations in Scopus, 1.3 times higher journal impact factors, and a 1.4 times higher journal h-index. Collaboration indicators showed that publications by TD students had significantly more co-authors (1.3 times), and significantly more disciplines represented among co-authors (1.3 times), but not significantly more organizations represented per publication compared to traditional students. In conclusion, compared to doctoral students in traditional programs, TD students published works that were accepted into higher impact journals, were more frequently cited, and had more cross-disciplinary collaborations. PMID:29244832
Weakley, Jonathon J S; Till, Kevin; Read, Dale B; Roe, Gregory A B; Darrall-Jones, Joshua; Phibbs, Padraic J; Jones, Ben
Investigate the acute and short-term (i.e., 24 h) effects of traditional (TRAD), superset (SS), and tri-set (TRI) resistance training protocols on perceptions of intensity and physiological responses. Fourteen male participants completed a familiarisation session and three resistance training protocols (i.e., TRAD, SS, and TRI) in a randomised-crossover design. Rating of perceived exertion, lactate concentration ([Lac]), creatine kinase concentration ([CK]), countermovement jump (CMJ), testosterone, and cortisol concentrations was measured pre, immediately, and 24-h post the resistance training sessions with magnitude-based inferences assessing changes/differences within/between protocols. TRI reported possible to almost certainly greater efficiency and rate of perceived exertion, although session perceived load was very likely lower. SS and TRI had very likely to almost certainly greater lactate responses during the protocols, with changes in [CK] being very likely and likely increased at 24 h, respectively. At 24-h post-training, CMJ variables in the TRAD protocol had returned to baseline; however, SS and TRI were still possibly to likely reduced. Possible increases in testosterone immediately post SS and TRI protocols were reported, with SS showing possible increases at 24-h post-training. TRAD and SS showed almost certain and likely decreases in cortisol immediately post, respectively, with TRAD reporting likely decreases at 24-h post-training. SS and TRI can enhance training efficiency and reduce training time. However, acute and short-term physiological responses differ between protocols. Athletes can utilise SS and TRI resistance training, but may require additional recovery post-training to minimise effects of fatigue.
Full Text Available The purpose of this study was to compare the alternations of physical performance, some blood parameters, pulse and blood pressure of male student athletes from Kastamonu School of Physical Education and Sports. 15 student athletes volunteered for the study. The sampling group trained for two hours between 9.00-11.00 a.m. The sampling groups’ RBC, WBC, Hb, HCT, resting systolic blood pressure, resting diastolic blood pressure, resting heart rate and aerobic and anaerobic values on the fifteenth day at high altitude (3250 m and on the seventh day after returning sea level were measured. T- test was used as a statistical method and significance level was determined as (P0.05. The results suggest that athletes who trained at high altitude should be supplied by vitamin and minerals, they should sleep and rest regularly, they shouldn't make any exercise which can cause to lactic acid accumulation.
Colvard, Benjamin; Shames, Murray; Schanzer, Andres; Rectenwald, John; Chaer, Rabih; Lee, Jason T
The first 2 integrated vascular residents in the United States graduated in 2012, and in 2013, 11 more entered the job market. The purpose of this study was to compare the job search experiences of the first cohort of integrated 0 + 5 graduates to their counterparts completing traditional 5 + 2 fellowship programs. An anonymous, Web-based, 15-question survey was sent to all 11 graduating integrated residents in 2013 and to the 25 corresponding 5 + 2 graduating fellows within the same institution. Questions focused on the following domains: training experience, job search timelines and outcomes, and overall satisfaction with each training paradigm. Survey response was nearly 81% for the 0 + 5 graduates and 64% for the 5 + 2 graduates. Overall, there was no significant difference between residents and fellows in the operative experience obtained as measured by the number of open and endovascular cases logged. Dedicated research time during the entire training period was similar between residents and fellows. Nearly all graduates were extremely satisfied with their training and had positive experiences during their job searches with respect to starting salaries, numbers of offers, and desired practice type. More 0 + 5 residents chose academic and mixed practices over private practices compared with 5 + 2 fellowship graduates. Although longer term data are needed to understand the impact of the addition of 0 + 5 graduating residents to the vascular surgery work force, preliminary survey results suggest that both training paradigms (0 + 5 and 5 + 2) provide positive training experiences that result in excellent job search experiences. Based on the current and future need for vascular surgeons in the work force, the continued growth and expansion of integrated 0 + 5 vascular surgery residency positions as an alternative to traditional fellowship training is thus far justified. Copyright © 2015 Elsevier Inc. All rights reserved.
Catenazzi, Nadia; Sommaruga, Lorenzo; De Angelis, Kylene; Gabbianelli, Giulio
Within the C95-Challenge Erasmus+ project, mobile learning technologies are adopted and tested for bus and truck drivers training according to the EU 2003/59/EC Directive. Different kinds of training contents are developed in the form of interactive slides, hyper-videos, interactive quizzes and delivered on mobile devices. Existing apps and games…
Tamara J. Somers
Full Text Available Psychosocial pain management interventions are efficacious for cancer pain but are underutilized. Recent advances in mobile health (mHealth technologies provide new opportunities to decrease barriers to access psychosocial pain management interventions. The objective of this study was to gain information about the accessibility and efficacy of mobile pain coping skills training (mPCST intervention delivered to cancer patients with pain compared to traditional in-person pain coping skills training intervention. This study randomly assigned participants (N=30 to receive either mobile health pain coping skills training intervention delivered via Skype or traditional pain coping skills training delivered face-to-face (PCST-trad. This pilot trial suggests that mPCST is feasible, presents low burden to patients, may lead to high patient engagement, and appears to be acceptable to patients. Cancer patients with pain in the mPCST group reported decreases in pain severity and physical symptoms as well as increases in self-efficacy for pain management that were comparable to changes in the PCST-trad group (p’s < 0.05. These findings suggest that mPCST, which is a highly accessible intervention, may provide benefits similar to an in-person intervention and shows promise for being feasible, acceptable, and engaging to cancer patients with pain.
Ramirez-Campillo, Rodrigo; Sanchez-Sanchez, Javier; Gonzalo-Skok, Oliver; Rodríguez-Fernandez, Alejandro; Carretero, Manuel; Nakamura, Fabio Y
The aim of this study was to compare changes in young soccer player's fitness after traditional bilateral vs. unilateral combined plyometric and strength training. Male athletes were randomly divided in two groups; both received the same training, including strength training for knee extensors and flexors, in addition to horizontal plyometric training drills. The only difference between groups was the mode of drills technique: unilateral (UG; n = 9; age, 17.3 ± 1.1 years) vs. bilateral (TG; n = 9; age, 17.6 ± 0.5 years). One repetition maximum bilateral strength of knee muscle extensors (1RM_KE) and flexors (1RM_KF), change of direction ability (COD), horizontal and vertical jump ability with one (unilateral) and two (bilateral) legs, and limb symmetry index were measured before and after an 8-week in-season intervention period. Some regular soccer drills were replaced by combination of plyometric and strength training drills. Magnitude-based inference statistics were used for between-group and within-group comparisons. Beneficial effects ( p plyometric training should be complemented with unilateral drills, in order to maximize adaptations.
Edrich, Thomas; Stopfkuchen-Evans, Matthias; Scheiermann, Patrick; Heim, Markus; Chan, Wilma; Stone, Michael B; Dankl, Daniel; Aichner, Jonathan; Hinzmann, Dominik; Song, Pingping; Szabo, Ashley L; Frendl, Gyorgy; Vlassakov, Kamen; Varelmann, Dirk
Lung ultrasound (LUS) is a well-established method that can exclude pneumothorax by demonstration of pleural sliding and the associated ultrasound artifacts. The positive diagnosis of pneumothorax is more difficult to obtain and relies on detection of the edge of a pneumothorax, called the "lung point." Yet, anesthesiologists are not widely taught these techniques, even though their patients are susceptible to pneumothorax either through trauma or as a result of central line placement or regional anesthesia techniques performed near the thorax. In anticipation of an increased training demand for LUS, efficient and scalable teaching methods should be developed. In this study, we compared the improvement in LUS skills after either Web-based or classroom-based training. We hypothesized that Web-based training would not be inferior to "traditional" classroom-based training beyond a noninferiority limit of 10% and that both would be superior to no training. Furthermore, we hypothesized that this short training session would lead to LUS skills that are similar to those of ultrasound-trained emergency medicine (EM) physicians. After a pretest, anesthesiologists from 4 academic teaching hospitals were randomized to Web-based (group Web), classroom-based (group class), or no training (group control) and then completed a posttest. Groups Web and class returned for a retention test 4 weeks later. All 3 tests were similar, testing both practical and theoretical knowledge. EM physicians (group EM) performed the pretest only. Teaching for group class consisted of a standardized PowerPoint lecture conforming to the Consensus Conference on LUS followed by hands-on training. Group Web received a narrated video of the same PowerPoint presentation, followed by an online demonstration of LUS that also instructs the viewer to perform an LUS on himself using a clinically available ultrasound machine and submit smartphone snapshots of the resulting images as part of a portfolio system
Wilson, Amie; Gallos, Ioannis D; Plana, Nieves; Lissauer, David; Khan, Khalid S; Zamora, Javier; MacArthur, Christine; Coomarasamy, Arri
To assess the effectiveness of strategies incorporating training and support of traditional birth attendants on the outcomes of perinatal, neonatal, and maternal death in developing countries. Systematic review with meta-analysis. Medline, Embase, the Allied and Complementary Medicine database, British Nursing Index, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, BioMed Central, PsycINFO, Latin American and Caribbean Health Sciences Literature database, African Index Medicus, Web of Science, Reproductive Health Library, and Science Citation Index (from inception to April 2011), without language restrictions. Search terms were "birth attend*", "traditional midwife", "lay birth attendant", "dais", and "comadronas". Review methods We selected randomised and non-randomised controlled studies with outcomes of perinatal, neonatal, and maternal mortality. Two independent reviewers undertook data extraction. We pooled relative risks separately for the randomised and non-randomised controlled studies, using a random effects model. We identified six cluster randomised controlled trials (n=138 549) and seven non-randomised controlled studies (n=72 225) that investigated strategies incorporating training and support of traditional birth attendants. All six randomised controlled trials found a reduction in adverse perinatal outcomes; our meta-analysis showed significant reductions in perinatal death (relative risk 0.76, 95% confidence interval 0.64 to 0.88, Ptraditional birth attendants.
Rodrigo dos Santos Crepalde
Full Text Available ABSTRACT: The treatment given to traditional knowledge by school science tends to devalue it, subjecting it to naive, common sense, and even mythological vision. As a way of promoting dialogue and exchange between different cultures, which populate the classroom, interculturallity assumes that science education should be considered as the acquisition of yet another culture, without overcoming the validity of the others. This article presents a concrete case of teaching and learning of the physical sciences as an example of promoting the recognition of traditional knowledge about the Moon in a context of intercultural rural science teacher education. They are discussed representative excerpts of written productions of undergraduate rural education, major in natural sciences, conducted in the discipline of Introduction to Physics that aimed to argue about how scientific and traditional knowledge are related to the Moon and its implications for science teaching. It is noted that traditional knowledge is strongly intertwined with the social practices of communities of these graduates, pointing out the necessary inclusion of this knowledge in the intercultural rural science teacher education that stimulates the exchange and mutual enrichment.
Rogers, Kate; Gibson, Ann L.
We investigated responses of adult, novice practitioners (n = 9) to an 8-week traditional mat Pilates program (P) that met 1 hr/day three times/week. Classes consisted primarily of beginner and intermediate level exercises. Compared to an active control group (C; n = 13) that showed no improvements, those in P significantly (p less than 0.05)…
Today organizations have adopted a corporate university model to meet their training requirements, a model that adds value to the business in terms of revenue and profit, improvement in customer retention, improved employee productivity, cost reduction and retention of talented employees. This paper highlights the radical change and an evolution…
Barry, Helen; Milner, Brigid
A survey of 56 small/medium-sized Irish enterprises showed that 46% were highly proficient in electronic commerce, 42% were at the basic level. Media pressure significantly influenced adoption. In 40% of firms, owner-managers were the driving force. E-commerce was not yet business critical and relevant training was not yet a comprehensive…
Lloyd, Rhodri S; Radnor, John M; De Ste Croix, Mark B A; Cronin, John B; Oliver, Jon L
The purpose of this study was to compare the effectiveness of 6-week training interventions using different modes of resistance (traditional strength, plyometric, and combined training) on sprinting and jumping performances in boys before and after peak height velocity (PHV). Eighty school-aged boys were categorized into 2 maturity groups (pre- or post-PHV) and then randomly assigned to (a) plyometric training, (b) traditional strength training, (c) combined training, or (d) a control group. Experimental groups participated in twice-weekly training programs for 6 weeks. Acceleration, maximal running velocity, squat jump height, and reactive strength index data were collected pre- and postintervention. All training groups made significant gains in measures of sprinting and jumping irrespective of the mode of resistance training and maturity. Plyometric training elicited the greatest gains across all performance variables in pre-PHV children, whereas combined training was the most effective in eliciting change in all performance variables for the post-PHV cohort. Statistical analysis indicated that plyometric training produced greater changes in squat jump and acceleration performances in the pre-PHV group compared with the post-PHV cohort. All other training responses between pre- and post-PHV cohorts were not significant and not clinically meaningful. The study indicates that plyometric training might be more effective in eliciting short-term gains in jumping and sprinting in boys who are pre-PHV, whereas those who are post-PHV may benefit from the additive stimulus of combined training.
Mist, Scott; Ritenbaugh, Cheryl; Aickin, Mikel
To investigate whether a training process that focused on a questionnaire-based diagnosis in Traditional Chinese Medicine (TCM), and developing diagnostic consensus, would improve the agreement of TCM diagnoses among 10 TCM practitioners evaluating patients with temporomandibular joint disorder (TMJD). Evaluation of a diagnostic training program at the Department of Family and Community Medicine, University of Arizona, Tucson, Arizona, and the Oregon College of Oriental Medicine, Portland, Oregon. Screened participants for a study of TCM for TMJD. PRACTITIONERS: Ten (10) licensed acupuncturists with a minimum of 5 years licensure and education in Chinese herbs. A training session using a questionnaire-based diagnostic form was conducted, followed by waves of diagnostic sessions. Between sessions, practitioners discussed the results of the previous round of participants with a focus on reducing variability in primary diagnosis and severity rating of each diagnosis: 3 waves of 5 patients were assessed by 4 practitioner pairs for a total of 120 diagnoses. At 18 months, practitioners completed a recalibration exercise with a similar format with a total of 32 diagnoses. These diagnoses were then examined with respect to the rate of agreement among the 10 practitioners using inter-rater correlations and kappas. The inter-rater correlation with respect to the TCM diagnoses among the 10 practitioners increased from 0.112 to 0.618 with training. Statistically significant improvements were found between the baseline and 18 month exercises (p reliability of TCM diagnosis may be improved through a training process and a questionnaire-based diagnosis process. The improvements varied by diagnosis, with the greatest congruence among primary and more severe diagnoses. Future TCM studies should consider including calibration training to improve the validity of results.
Hohnecker, E. [Karlsruhe Univ. (T.H.) (Germany). Inst. fuer Strassenbau und Eisenbahnwesen
Profitability and capacity in public guided transport must be increased. One option is automatic, driverless train control. There are many questions surrounding the legal, technical and operational aspects of automated control which need to be answered. These intrinsic aspects of the system will be presented and discussed. The various options leading to automatic train control as well as the necessary technical measures will also be presented. (orig.) [German] Die Wirtschaftlichkeit und die Leistungsfaehigkeit im oeffentlichen spurgefuehrten Verkehr muessen erhoeht werden. Als Loesung bietet sich zukuenftig auch der automatische und fahrerlose Betrieb an. Das Fahren ohne Triebfahrzeugfuehrer wirft jedoch eine Vielzahl von Fragestellungen auf, die sowohl in juristischer, technischer und betrieblicher Hinsicht beantwortet werden muessen. Diese systemimmanenten Aspekte werden dargestellt und diskutiert. Anschliessend werden die Moeglichkeiten auf dem Weg zum Fahrautomaten aufgezeigt und die technischen Massnahmen zur Umsetzung des automatischen Fahrens erlaeutert. (orig.)
Soares, Enrico Gori; Brown, Lee E.; Gomes, Willy Andrade; Corrêa, Daniel Alves; Serpa, Érica Paes; da Silva, Josinaldo Jarbas; Junior, Guanis de Barros Vilela; Fioravanti, Gustavo zorzi; Aoki, Marcelo Saldanha; Lopes, Charles Ricardo; Marchetti, Paulo Henrique
The purpose of this study was to measure the acute effects of pre-exhaustion vs. traditional exercise order on neuromuscular performance and sEMG in trained men. Fourteen young, healthy, resistance trained men (age: 25.5 ± 4.0 years, height: 174.9 ± 4.1 cm, and total body mass: 80.0 ± 11.1 kg) took part of this study. All tests were randomized and counterbalanced for all subjects and experimental conditions. Volunteers attended one session in the laboratory. First, they performed ten repetition maximum (10RM) tests for each exercise (bench press and triceps pushdown) separately. Secondly, they performed all three conditions at 10RM: pre-test (bench press and triceps pushdown, separately), pre-exhaustion (triceps pushdown+bench press, PE) and traditional (bench press+triceps pushdown, TR), and rested 30 minutes between conditions. Results showed that pre-test was significantly greater than PE (p = 0.031) but not different than TR, for total volume load lifted. There was a significant difference between the pre-test and the time-course of lactate measures (p = 0.07). For bench press muscle activity of the pectoralis major, the last repetition was significantly greater than the first repetition (pre-test: p = 0.006, PE: p = 0.016, and TR: p = 0.005). Also, for muscle activity of the triceps brachii, the last repetition was significantly greater than the first repetition (pre-test: p = 0.001, PE: p = 0.005, and TR: p = 0.006). For triceps pushdown, muscle activity of the triceps brachii, the last repetition was significantly greater than the first repetition (pre-test: p = 0.006, PE: p = 0.016, and TR: p = 0.005). For RPE, there were no significant differences between PE and TR (p = 0.15). Our results suggest that exercise order decreases repetitions performed, however, neuromuscular fatigue, lactate, and RPE are not impacted. The lack of difference in total volume load lifted between PE and TR might explain, at least in part, the similar metabolic and perceptual
Jenna B Gillen
Full Text Available We investigated whether sprint interval training (SIT was a time-efficient exercise strategy to improve insulin sensitivity and other indices of cardiometabolic health to the same extent as traditional moderate-intensity continuous training (MICT. SIT involved 1 minute of intense exercise within a 10-minute time commitment, whereas MICT involved 50 minutes of continuous exercise per session.Sedentary men (27±8y; BMI = 26±6kg/m2 performed three weekly sessions of SIT (n = 9 or MICT (n = 10 for 12 weeks or served as non-training controls (n = 6. SIT involved 3x20-second 'all-out' cycle sprints (~500W interspersed with 2 minutes of cycling at 50W, whereas MICT involved 45 minutes of continuous cycling at ~70% maximal heart rate (~110W. Both protocols involved a 2-minute warm-up and 3-minute cool-down at 50W.Peak oxygen uptake increased after training by 19% in both groups (SIT: 32±7 to 38±8; MICT: 34±6 to 40±8ml/kg/min; p<0.001 for both. Insulin sensitivity index (CSI, determined by intravenous glucose tolerance tests performed before and 72 hours after training, increased similarly after SIT (4.9±2.5 to 7.5±4.7, p = 0.002 and MICT (5.0±3.3 to 6.7±5.0 x 10-4 min-1 [μU/mL]-1, p = 0.013 (p<0.05. Skeletal muscle mitochondrial content also increased similarly after SIT and MICT, as primarily reflected by the maximal activity of citrate synthase (CS; P<0.001. The corresponding changes in the control group were small for VO2peak (p = 0.99, CSI (p = 0.63 and CS (p = 0.97.Twelve weeks of brief intense interval exercise improved indices of cardiometabolic health to the same extent as traditional endurance training in sedentary men, despite a five-fold lower exercise volume and time commitment.
Full Text Available Background: For several years, educators have criticized the lecture-based approach to teaching and learning. Experts have rightly stressed on acquisition of a number of critical skills rather than focusing on lectures. Purpose. To compare students' pe1jormance after self-education with VCD and manikin, with thei performance after standard BLS training.Methods: In this randomized controlled study, twenty first-year nursing students were divided into two groups randomly, and were provided with basic life support (BLS instruction either in the traditional format of lecturing or with VCD and manikin without tutor. The students’ Performance was evaluated on a manikin with a checklist including all steps in BLS.Results: With traditional instruction, students' mean score was 42.2±3.91, while it was 46.3±3.86 with self-education, showing no significant difference.Conclusion: In nursing students with no previous BLS training, access to VCD and manikin facilitates immediate achievement of educational objectives similar to those of a standard BLS course. Self learning BLS with VCD should be enhanced with a short period of hands-on practice.Keywords: cardiopulmonary resuscitation (CPR, nursing students, cpr skills, education
M. Claire Horner-Devine
Full Text Available While the biological sciences have achieved gender parity in the undergraduate and graduate career stages, this is not the case at the faculty level. The WEBS (Women Evolving the Biological Sciences symposia go beyond traditional scientific training and professional development to address factors critical to women’s persistence in faculty careers: community and empowerment. Through a series of panel discussions, personal reflections and skills workshops, WEBS creates a community-based professional development experience and a space for participants to grapple with central issues affecting their scientific careers. Longitudinal qualitative survey data suggest that WEBS bolsters the participants’ confidence and empowerment, in addition to providing concrete skills for addressing a range of issues necessary to navigating scientific careers, leading to increased career satisfaction and career self-efficacy (i.e., the belief in one’s capacity to pursue their chosen career. These results highlight the importance and need for programs and opportunities for women in STEM that go beyond training in scientific skills and traditional professional development to include those that create a sense of community and empowerment.
The Effect of Laboratory Training Model of Teaching and Traditional Method on Knowledge, Comprehension, Application, Skills-Components of Achievement, Total Achievement and Retention Level in Chemistry
The present study aimed at finding the effectiveness of the Laboratory Training Model of Teaching (LTM) and comparing it with the traditional methods of teaching chemistry to seventh standard students. It strived to determine whether the (LTM) method in chemistry would be significantly more effective than the Traditional method in respect to the…
McCullum, A. J. K.; Schmidt, C.; Palacios, S. L.; Ly, V.
NASA's Indigenous Capacity Building Initiative is aimed to provide remote sensing training, mentoring, and research opportunities to the indigenous community. A key programmatic goal is the co-production of place-based trainings where participants have the opportunity to address specific natural resource research and management issues facing their tribal lands. Three primary strategies have been adopted to engage with our tribal partners, these include: (1) the use of existing tribal networks and conferences such as the National Tribal GIS Conference, (2) coordination with other federal agencies such as the Bureau of Indian Affairs (BIA) and tribal liaisons at regional Climate Science Centers, and (3) connecting with tribes directly. Regional partner visits with tribes, such as meetings with the Samish Indian Nation, are integral to cultivate trusting, collaborative, and sustained partnerships and an understanding of how Earth Observations can be applied to the unique set of challenges and goals each tribe faces. As the program continues to grow, we aim to increase our incorporation of Traditional Ecological Knowledge (TEK) into technical methods and to develop trainings tailored to thematic areas of interest to specific tribes. Engagement and feedback are encouraged to refine our approaches to increase capacity within the indigenous community to utilize NASA Earth Observations.
Puckette, J.O.; Suneson, N.H.
The summer field camp experience provides many students with their best opportunity to learn the scientific process by making observations and collecting, recording, evaluating, and interpreting geologic data. Field school projects enhance student professional development by requiring cooperation and interpersonal interaction, report writing to communicate interpretations, and the development of project management skills to achieve a common goal. The field school setting provides students with the opportunity to observe geologic features and their spatial distribution, size, and shape that will impact the student's future careers as geoscientists. The Les Huston Geology Field Camp (a.k.a. Oklahoma Geology Camp) near Ca??on City, Colorado, focuses on time-tested traditional methods of geological mapping and fieldwork to accomplish these goals. The curriculum consists of an introduction to field techniques (pacing, orienteering, measuring strike and dip, and using a Jacob's staff), sketching outcrops, section measuring (one illustrating facies changes), three mapping exercises (of increasing complexity), and a field geophysics project. Accurate rock and contact descriptions are emphasized, and attitudes and contacts are mapped in the field. Mapping is done on topographic maps at 1:12,000 and 1:6000 scales; air photos are provided. Global positioning system (GPS)-assisted mapping is allowed, but we insist that locations be recorded in the field and confirmed using visual observations. The course includes field trips to the Cripple Creek and Leadville mining districts, Floris-sant/Guffey volcano area, Pikes Peak batholith, and the Denver Basin. Each field trip is designed to emphasize aspects of geology that are not stressed in the field exercises. Students are strongly encouraged to accurately describe geologic features and gather evidence to support their interpretations of the geologic history. Concise reports are a part of each major exercise. Students are grouped
capacity even in normoxic conditions. For example, high dosages of dexamethasone are used in aerobic endurance sports to enhance physical performance. This...is why the World Anti- Doping Agency prohibits the administration of any glucosteroids during competitions . Fischler and colleagues [24...Medicine; 2004. Technical Note TN04-05. 4. Bärtsch P, Saltin B. General introduction to altitude adaptation and mountain sickness. Scand J Med Sci Sports
Huang, Po-Yu; Lin, Wen-Chen; Chiu, Bill Yuan-Chi; Chang, Hen-Hong; Lin, Kang-Ping
Pulse palpation was an important part of the traditional Chinese medicine (TCM) vascular examination. It is challenging for new physicians to learn to differentiate between palpations of various pulse types, due to limited comparative learning time with established masters, and so normally it takes many years to master the art. The purpose of this study was to introduce an offline TCM skill evaluation and comparison system that makes available learning of palpation without the master's presence. We record patient's radial artery pulse using an existing pressure-based pulse acquisition system, then annotate it with teachers' evaluation when palpating the same patient, assigned as likelihood of it being each pulse type, e.g. wiry, slippery, hesitant. These training data were separated into per-doctor and per-skill databases for evaluation and comparison purposes, using the following novel procedure: each database was used as training data to a panel of time-series data-mining algorithms, driven by two validation tests, with the created training models evaluated in mean-squared-error. Each validation of the panel and training data yielded an array of error terms, and we chose one to quantitatively evaluate palpation techniques, giving way to compute self consistency and mutual-similarity across different practitioners and techniques. Our experiment of two practitioners and 396 per-processing samples yielded the following: one of the physicians has much higher value of self-consistency for all tested pulse types. Also, the two physicians have high similarity in how they palpate the slipper pulse (P) type, but very dissimilar for hesitant (H) type. This system of skill comparisons may be more broadly applied in places where supervised learning algorithms can detect and use meaningful features in the data; we chose a panel of algorithms previously shown to be effective for many time-series types, but specialized algorithms may be added to improve feature-specific aspect
Full Text Available The aim of this study was to compare changes in young soccer player's fitness after traditional bilateral vs. unilateral combined plyometric and strength training. Male athletes were randomly divided in two groups; both received the same training, including strength training for knee extensors and flexors, in addition to horizontal plyometric training drills. The only difference between groups was the mode of drills technique: unilateral (UG; n = 9; age, 17.3 ± 1.1 years vs. bilateral (TG; n = 9; age, 17.6 ± 0.5 years. One repetition maximum bilateral strength of knee muscle extensors (1RM_KE and flexors (1RM_KF, change of direction ability (COD, horizontal and vertical jump ability with one (unilateral and two (bilateral legs, and limb symmetry index were measured before and after an 8-week in-season intervention period. Some regular soccer drills were replaced by combination of plyometric and strength training drills. Magnitude-based inference statistics were used for between-group and within-group comparisons. Beneficial effects (p < 0.05 in 1RM_KE, COD, and several test of jumping performance were found in both groups in comparison to pre-test values. The limb symmetry index was not affected in either group. The beneficial changes in 1RM_KE (8.1%; p = 0.074 and 1RM_KF (6.7%; p = 0.004, COD (3.1%; p = 0.149, and bilateral jump performance (from 2.7% [p = 0.535] to 10.5% [p = 0.002] were possible to most likely beneficial in the TG than in the UG. However, unilateral jump performance measures achieved likely to most likely beneficial changes in the UG compared to the TG (from 4.5% [p = 0.090] to 8.6% [p = 0.018]. The improvements in jumping ability were specific to the type of jump performed, with greater improvements in unilateral jump performance in the UG and bilateral jump performance in the TG. Therefore, bilateral strength and plyometric training should be complemented with unilateral drills, in order to maximize adaptations.
Laura A. Garvican-Lewis, Andrew D. Govus, Peter Peeling, Chris R. Abbiss, Christopher J. Gore
Full Text Available Altitude exposure increases the body’s need for iron (Gassmann and Muckenthaler, 2015, primarily to support accelerated erythropoiesis, yet clear supplementation guidelines do not exist. Athletes are typically recommended to ingest a daily oral iron supplement to facilitate altitude adaptations, and to help maintain iron balance. However, there is some debate as to whether athletes with otherwise healthy iron stores should be supplemented, due in part to concerns of iron overload. Excess iron in vital organs is associated with an increased risk of a number of conditions including cancer, liver disease and heart failure. Therefore clear guidelines are warranted and athletes should be discouraged from ‘self-prescribing” supplementation without medical advice. In the absence of prospective-controlled studies, decision tree analysis can be used to describe a data set, with the resultant regression tree serving as guide for clinical decision making. Here, we present a regression tree in the context of iron supplementation during altitude exposure, to examine the association between pre-altitude ferritin (Ferritin-Pre and the haemoglobin mass (Hbmass response, based on daily iron supplement dose. De-identified ferritin and Hbmass data from 178 athletes engaged in altitude training were extracted from the Australian Institute of Sport (AIS database. Altitude exposure was predominantly achieved via normobaric Live high: Train low (n = 147 at a simulated altitude of 3000 m for 2 to 4 weeks. The remaining athletes engaged in natural altitude training at venues ranging from 1350 to 2800 m for 3-4 weeks. Thus, the “hypoxic dose” ranged from ~890 km.h to ~1400 km.h. Ethical approval was granted by the AIS Human Ethics Committee, and athletes provided written informed consent. An in depth description and traditional analysis of the complete data set is presented elsewhere (Govus et al., 2015. Iron supplementation was prescribed by a sports physician
Nan, L.; Zhao, X.; Liu, L.; Wang, H.; Li, H.
The aim of this study was to compare the ecophysiology character of Ecolly grape (Vitis vinifera L.) with the new technology-single crawled cordon training (SCCT) and traditional method-independent long-stem pruning (ILSP). The connections among net photosynthesis rate (Pn), transpiration rate (Tr), instantaneous water utilization efficiency (WUEi), stomatal conductance (Cs) and intercellular CO/sub 2/ concentration (Ci) were always mutual and inextricable in the trial. The leaves in every stage had the highest Pn respectively when growing under the light irradiance of the different period. The ILSP showed a lower total photosynthetic capacity than the SCCT. There was the total semblable Tr for two pruning plants, but lower Tr in ILSP at the every position of the prior stage and riping stage (PS and RS) excluding the growing stage (GS). The WUEi declined because of the net CO/sub 2/ assimilation saturated and the transpiration constantly fleetly increased before the photosynthetic active radiation (PAR) increased to 600 meu mol m/sup -2/ s/sup -1/. The increased WUEis from the first to the second stage deduced that stomatal closure at high irradiance reduced more Tr than Pn, while the values decreased again in the last stage indicated that stomatal opening at low irradiance added more Tr than Pn. These results suggested that it may be possible technology to change trellises in order to obtain better ecophysiology character in this study. The growth variability of vine may be affected by a particular training style. (author)
Blakeman, Thomas; Britton, Tyler; Rodriquez, Dario; Branson, Richard
Aeromedical transport of critically ill patients requires continued, accurate performance of equipment at altitude. Changes in barometric pressure can affect the performance of mechanical ventilators calibrated for operation at sea level. Deploying ventilators that can maintain a consistent tidal volume (VT) delivery at various altitudes is imperative for lung protection when transporting wounded war fighters to each echelon of care. Three ventilators (Impact 731, Hamilton T1, and CareFusion Revel) were tested at pediatric (50 and 100 mL) and adult (250-750 mL) tidal VTs at 0 and 20 cm H₂O positive end expiratory pressure and at inspired oxygen of 0.21 and 1.0. Airway pressure, volume, and flow were measured at sea level as well as at 8,000, 16,000, and 22,000 ft (corresponding to barometric pressures of 760, 564, 412, and 321 mm Hg) using a calibrated pneumotachograph connected to a training test lung in an altitude chamber. Set VT and delivered VT as well as changes in VT at each altitude were compared by t test. The T1 delivered VT within 10% of set VT at 8,000 ft. The mean VT was less than set VT at sea level as a result of circuit compressible volume with the Revel and the 731. Changes in VT varied widely among the devices at sea level and at altitude. Increasing altitudes resulted in larger VT than set for the Revel and the T1. The 731 compensated for changes in altitude delivered VT within 10% at the adult settings at all altitudes. Altitude compensation is an active software algorithm. Only the 731 actively accounts for changes in barometric pressure to maintain the set VT at all tested altitudes.
Prieske, Olaf; Krüger, Tom; Aehle, Markus; Bauer, Erik; Granacher, Urs
Power training programs have proved to be effective in improving components of physical fitness such as speed. According to the concept of training specificity, it was postulated that exercises must attempt to closely mimic the demands of the respective activity. When transferring this idea to speed development, the purpose of the present study was to examine the effects of resisted sprint (RST) vs. traditional power training (TPT) on physical fitness in healthy young adults. Thirty-five healthy, physically active adults were randomly assigned to a RST ( n = 10, 23 ± 3 years), a TPT ( n = 9, 23 ± 3 years), or a passive control group ( n = 16, 23 ± 2 years). RST and TPT exercised for 6 weeks with three training sessions/week each lasting 45-60 min. RST comprised frontal and lateral sprint exercises using an expander system with increasing levels of resistance that was attached to a treadmill (h/p/cosmos). TPT included ballistic strength training at 40% of the one-repetition-maximum for the lower limbs (e.g., leg press, knee extensions). Before and after training, sprint (20-m sprint), change-of-direction speed (T-agility test), jump (drop, countermovement jump), and balance performances (Y balance test) were assessed. ANCOVA statistics revealed large main effects of group for 20-m sprint velocity and ground contact time (0.81 ≤ d ≤ 1.00). Post-hoc tests showed higher sprint velocity following RST and TPT (0.69 ≤ d ≤ 0.82) when compared to the control group, but no difference between RST and TPT. Pre-to-post changes amounted to 4.5% for RST [90%CI: (-1.1%;10.1%), d = 1.23] and 2.6% for TPT [90%CI: (0.4%;4.8%), d = 1.59]. Additionally, ground contact times during sprinting were shorter following RST and TPT (0.68 ≤ d ≤ 1.09) compared to the control group, but no difference between RST and TPT. Pre-to-post changes amounted to -6.3% for RST [90%CI: (-11.4%;-1.1%), d = 1.45) and -2.7% for TPT [90%CI: (-4.2%;-1.2%), d = 2.36]. Finally, effects for change
Whole-Body High-Intensity Interval Training Induce Similar Cardiorespiratory Adaptations Compared With Traditional High-Intensity Interval Training and Moderate-Intensity Continuous Training in Healthy Men.
Schaun, Gustavo Z; Pinto, Stephanie S; Silva, Mariana R; Dolinski, Davi B; Alberton, Cristine L
Schaun, GZ, Pinto, SS, Silva, MR, Dolinski, DB, and Alberton, CL. Sixteen weeks of whole-body high-intensity interval training induce similar cardiorespiratory responses compared with traditional high-intensity interval training and moderate-intensity continuous training in healthy men. J Strength Cond Res XX(X): 000-000, 2018-Low-volume high-intensity interval training (HIIT) protocols that use the body weight as resistance could be an interesting and inexpensive alternative to traditional ergometer-based high-intensity interval training (HIIT-T) and moderate-intensity continuous training (MICT). Therefore, our aim was to compare the effects of 16 weeks of whole-body HIIT (HIIT-WB), HIIT-T, and MICT on maximal oxygen uptake (V[Combining Dot Above]O2max), second ventilatory threshold (VT2), and running economy (RE) outcomes. Fifty-five healthy men (23.7 ± 0.7 years, 1.79 ± 0.01 m, 78.5 ± 1.7 kg) were randomized into 3 training groups (HIIT-T = 17; HIIT-WB = 19; MICT = 19) for 16 weeks (3× per week). The HIIT-T group performed eight 20-second bouts at 130% of the velocity associated to V[Combining Dot Above]O2max (vV[Combining Dot Above]O2max) interspersed by 10-second passive recovery on a treadmill, whereas HIIT-WB group performed the same protocol but used calisthenics exercises at an all-out intensity instead of treadmill running. Finally, MICT group exercised for 30 minutes at 90-95% of the heart rate (HR) associated to VT2. After the intervention, all groups improved V[Combining Dot Above]O2max, vV[Combining Dot Above]O2max, time to exhaustion (Tmax), VT2, velocity associated with VT2 (vVT2), and time to reach VT2 (tVT2) significantly (p HIIT-T compared with HIIT-WB (p HIIT-WB can be as effective as traditional HIIT while also being time-efficient compared with MICT to improve health-related outcomes after 16 weeks of training. However, HIIT-T and MICT seem preferable to enhance performance-related outcomes compared with HIIT-WB.
Full Text Available AbstrakHigh-altitude illness (HAI merupakan sekumpulan gejala paru dan otak yang terjadi pada orang yang baru pertama kali mendaki ke ketinggian. HAI terdiri dari acute mountain sickness (AMS, high-altitude cerebral edema (HACE dan high-altitude pulmonary edema (HAPE. Tujuan tinjauan pustaka ini adalah agar dokter dan wisatawan memahami risiko, tanda, gejala, dan pengobatan high-altitude illness. Perhatian banyak diberikan terhadap penyakit ini seiring dengan meningkatnya popularitas olahraga ekstrim (mendaki gunung tinggi, ski dan snowboarding dan adanya kemudahan serta ketersediaan perjalanan sehingga jutaan orang dapat terpapar bahaya HAI. Di Pherice, Nepal (ketinggian 4343 m, 43% pendaki mengalami gejala AMS. Pada studi yang dilakukan pada tempat wisata di resort ski Colorado, Honigman menggambarkan kejadian AMS 22% pada ketinggian 1850 m sampai 2750 m, sementara Dean menunjukkan 42% memiliki gejala pada ketinggian 3000 m. Aklimatisasi merupakan salah satu tindakan pencegahan yang dapat dilakukan sebelum pendakian, selain beberapa pengobatan seperti asetazolamid, dexamethasone, phosopodiestrase inhibitor, dan ginko biloba.Kata kunci: high-altitude illness, acute mountain sickness, edema cerebral, pulmonary edema AbstractHigh-altitude illness (HAI is symptoms of lung and brain that occurs in people who first climb to altitude. HAI includes acute mountain sickness (AMS, high-altitude cerebral edema (HACE and high altitude pulmonary edema (HAPE. The objective of this review was to understand the risks, signs, symptoms, and treatment of high-altitude illness. The attention was given to this disease due to the rising popularity of extreme sports (high mountain climbing, skiing and snowboarding and the ease and availability of the current travelling, almost each year, millions of people could be exposed to the danger of HAI. In Pherice, Nepal (altitude 4343 m, 43% of climbers have symptoms of AMS. Furthermore, in a study conducted at sites in
Vidal, Victoria L; Ohaeri, Beatrice M; John, Pamela; Helen, Delles
This quasi-experimental study, with a control group and experimental group, compares the effectiveness of virtual reality simulators on developing phlebotomy skills of nursing students with the effectiveness of traditional methods of teaching. Performance of actual phlebotomy on a live client was assessed after training, using a standardized form. Findings showed that students who were exposed to the virtual reality simulator performed better in the following performance metrics: pain factor, hematoma formation, and number of reinsertions. This study confirms that the use of the virtual reality-based system to supplement the traditional method may be the optimal program for training.
Korak, J Adam; Paquette, Max R; Brooks, Justin; Fuller, Dana K; Coons, John M
Rest-pause (4-s unloaded rest between repetitions) training effects on one repetition maximum (1 RM), lifting volume, and neural activation via electromyography (EMG) are currently vague in the literature and can benefit strength and conditioning professionals for resistance training programme design. Therefore, this study compared 1 RM, neural activation via (EMG), and volume differences between rest-pause vs. traditional resistance training. Trained males (N = 20) were randomly assigned to either a rest-pause or a traditional training group. Pre- and post-1 RM testing was recorded. Training sessions were completed twice a week for 4 weeks and consisted of four sets of bench press to volitional fatigue at 80% of pre-test 1 RM with a 2-min rest between sets. Total volume completed was recorded on each training day. Neural activation of the pectoralis major was measured on the first and last training days. A two-way repeated-measures ANOVA indicated both groups significantly increased their 1 RMs following the 4-week training protocol (p .05). An independent samples t test indicated that total volume lifted was significantly higher for the rest-pause group (56,778 vs. 38,315 lbs; p < .05) throughout the protocol and independently during weeks 2, 3, and 4. While strength and neural activation changes did not differ between groups, both increased 1 RMs and the rest-pause group achieved greater increases in volume than the traditional group. If volume is the focus of training, the rest-pause method should be utilized.
Silvia Erika Kober
Full Text Available Neurofeedback (NF is a Brain-Computer Interface (BCI application, in which the brain activity is fed back to the user in real-time enabling voluntary brain control. In this context, the significance of the feedback design is mainly unexplored. Highly immersive feedback scenarios using virtual reality (VR technique are available. However, their effects on subjective user experience as well as on objective outcome measures remain open. In the present article, we discuss the general pros and cons of using VR as feedback modality in BCI applications. Furthermore, we report on the results of an empirical study, in which the effects of traditional two-dimensional and three-dimensional VR based feedback scenarios on NF training performance and user experience in healthy older individuals and neurologic patients were compared. In conclusion, we suggest indications and contraindications of immersive VR feedback designs in BCI applications. Our results show that findings in healthy individuals are not always transferable to patient populations having an impact on serious game and feedback design.
Hartman-Ksycińska, Anna; Kluz-Zawadzka, Jolanta; Lewandowski, Bogumił
High-altitude illness is a result of prolonged high-altitude exposure of unacclimatized individuals. The illness is seen in the form of acute mountain sickness (AMS) which if not treated leads to potentially life-threatening high altitude pulmonary oedema and high-altitude cerebral oedema. Medical problems are caused by hypobaric hypoxia stimulating hypoxia-inducible factor (HIF) release. As a result, the central nervous system, circulation and respiratory system function impairment occurs. The most important factor in AMS treatment is acclimatization, withdrawing further ascent and rest or beginning to descent; oxygen supplementation, and pharmacological intervention, and, if available, a portable hyperbaric chamber. Because of the popularity of high-mountain sports and tourism better education of the population at risk is essential.
Gellman, Gregg W
.... The simulator, as part of a blended learning solution, was shown to be as effective as traditional instructor-based learning but was conceived at a fraction of the cost and with a significant reduction in total training time. Both of these factors are increasingly being valued in today's reality of increased operational tempo and reduced resources.
World Health Organization, Geneva (Switzerland).
Guidelines for the planning, implementation, and evaluation of nationwide programs for the training and utilization of traditional birth attendants (TBAs) are presented. The guide begins with a chart outlining the steps in the development and evaluation of TBA programs. The next section discusses the formulation of basic policies regarding the…
Suto, T. [Japan Society for the Promotion of Science, Tokyo (Japan); Ura, T. [The University of Tokyo, Tokyo (Japan). Institute of Industrial Science
A small autonomous robot with high software development efficiency was developed to investigate the control system of an autonomous cruising-type AUV in the actual environment. This robot has a minimum of functions required as a cruising type. One researcher can make an experiment on the robot because of its compactness and lightweight. The robot can also automatically cruise around in a small pool. It was confirmed that an adaptive constant altitude swimming controller utilizing a neural network verified by simulation can also be properly adjusted by an actual robot. The switching mechanism of neural networks was introduced to classify environmental patterns. The corresponding controller is adjusted automatically. In this study, a lightweight and compact cruising-type test-bed robot that has not existed until now was developed. This robot is easy to manufacture and construct in software. Therefore, it is to be desired that the researches and development of autonomous functions are promoted using such a robot. 9 refs., 13 figs., 1 tab.
Roppolo, Lynn P; Heymann, Rahm; Pepe, Paul; Wagner, James; Commons, Bradford; Miller, Ronna; Allen, Emilie; Horne, Leyla; Wainscott, Michael P; Idris, Ahamed H
The primary purpose of this study was to compare two, shorter, self-directed methods of cardiopulmonary resuscitation (CPR) education for healthcare professionals (HCP) to traditional training with a focus on the trainee's ability to perform two-person CPR. First-year medical students with either no prior CPR for HCP experience or prior training greater than 5 years were randomized to complete one of three courses: 1) HeartCode BLS System, 2) BLS Anytime, or 3) Traditional training. Only data from the adult CPR skills testing station was reviewed via video recording by certified CPR instructors and the Laerdal PC Skill Reporter software program (Laerdal Medical, Stavanger, Norway). There were 180 first-year medical students who met inclusion criteria: 68 were HeartCode BLS System, 53 BLS Anytime group, and 59 traditional group Regarding two-person CPR, 57 (84%) of Heartcode BLS students and 43 (81%) of BLS Anytime students were able to initiate the switch compared to 39 (66%) of traditional course students (p = 0.04). There were no significant differences in the quality of chest compressions or ventilations between the three groups. There was a trend for a much higher CPR skills testing pass rate for the traditional course students. However, failure to "clear to analyze or shock" while using the AED was the most common reason for failure in all groups. The self-directed learning groups not only had a high level of success in initiating the "switch" to two-person CPR, but were not significantly different from students who completed traditional training. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Gill, Christopher John; MacLeod, William B; Phiri-Mazala, Grace; Guerina, Nicholas G; Mirochnick, Mark; Knapp, Anna B; Hamer, Davidson H
Neonatal sepsis is a major cause of neonatal mortality. In populations with limited access to health care, early identification of bacterial infections and initiation of antibiotics by community health workers (CHWs) could be lifesaving. It is unknown whether this strategy would be feasible using traditional birth attendants (TBAs), a cadre of CHWs who typically have limited training and educational backgrounds. We analyzed data from the intervention arm of a cluster-randomized trial involving TBAs in Lufwanyama District, Zambia, from June 2006 to November 2008. TBAs followed neonates for signs of potential infection through 28 days of life. If any of 16 criteria were met, TBAs administered oral amoxicillin and facilitated referral to a rural health center. Our analysis included 1,889 neonates with final vital status by day 28. TBAs conducted a median of 2 (interquartile range 2-6) home visits (51.4% in week 1 and 48.2% in weeks 2-4) and referred 208 neonates (11%) for suspected sepsis. Of referred neonates, 176/208 (84.6%) completed their referral. Among neonates given amoxicillin, 171/183 (93.4%) were referred; among referred neonates, 171/208 (82.2%) received amoxicillin. Referral and/or initiation of antibiotics were strongly associated with neonatal death (for referral, relative risk [RR] = 7.93, 95% confidence interval [CI] = 4.4-14.3; for amoxicillin administration, RR = 4.7, 95% CI = 2.4-8.7). Neonates clinically judged to be "extremely sick" by the referring TBA were at greatest risk of death (RR = 8.61, 95% CI = 4.0-18.5). The strategy of administering a first dose of antibiotics and referring based solely on the clinical evaluation of a TBA is feasible and could be effective in reducing neonatal mortality in remote rural settings.
Qayumi, A K; Kurihara, Y; Imai, M; Pachev, G; Seo, H; Hoshino, Y; Cheifetz, R; Matsuura, K; Momoi, M; Saleem, M; Lara-Guerra, H; Miki, Y; Kariya, Y
This study aimed to compare the effects of computer-assisted, text-based and computer-and-text learning conditions on the performances of 3 groups of medical students in the pre-clinical years of their programme, taking into account their academic achievement to date. A fourth group of students served as a control (no-study) group. Participants were recruited from the pre-clinical years of the training programmes in 2 medical schools in Japan, Jichi Medical School near Tokyo and Kochi Medical School near Osaka. Participants were randomly assigned to 4 learning conditions and tested before and after the study on their knowledge of and skill in performing an abdominal examination, in a multiple-choice test and an objective structured clinical examination (OSCE), respectively. Information about performance in the programme was collected from school records and students were classified as average, good or excellent. Student and faculty evaluations of their experience in the study were explored by means of a short evaluation survey. Compared to the control group, all 3 study groups exhibited significant gains in performance on knowledge and performance measures. For the knowledge measure, the gains of the computer-assisted and computer-assisted plus text-based learning groups were significantly greater than the gains of the text-based learning group. The performances of the 3 groups did not differ on the OSCE measure. Analyses of gains by performance level revealed that high achieving students' learning was independent of study method. Lower achieving students performed better after using computer-based learning methods. The results suggest that computer-assisted learning methods will be of greater help to students who do not find the traditional methods effective. Explorations of the factors behind this are a matter for future research.
Apollo 16 commander John W. Young prepares to enter the lunar module in an altitude chamber in the Manned Spacecraft Operations Building at the spaceport prior to an altitude run. During the altitude run, in which Apollo 16 lunar module pilot Charles M. Duke also participated, the chamber was pumped down to simulate pressure at an altitude in excess of 200,000 feet. Young, Duke and command module pilot Thomas K. Mattingly II, are training at the Kennedy Space Center for the Apollo 16 mission. Launch is scheduled from Pad 39A, March 17, 1972.
Full Text Available Nowadays, situations associated with high altitude such as mountaineering, aviation increasingly draw the attention of people. Gas pressure decreases and hypoxia is encountered when climbing higher. Physiological and pathological responses of human body to different heights are different. Therefore, physiological and pathological changes that may occur together with height and to know the clinical outcomes of these are important . Acute mountain sickness caused by high altitude and high altitude cerebral edema are preventable diseases with appropriate precautions. Atmospheric oxygen decreasing with height, initiates many adaptive mechanisms. These adaptation mechanisms and acclimatization vary widely among individuals because of reasons such as environmental factors, exercise and cold. High altitude causes different changes in the cardiovascular system with various mechanisms. Although normal individuals easily adapt to these changes, this situation can lead to undesirable results in people with heart disease. For this reason, it should be known the effective evaluation of the people with known heart disease before traveling to high altitude and the complications due to the changes with height and the recommendations can be made to these patients. [TAF Prev Med Bull 2011; 10(2.000: 211-222
De Win, Gunter; Van Bruwaene, Siska; Aggarwal, Rajesh; Crea, Nicola; Zhang, Zhewen; De Ridder, Dirk; Miserez, Marc
To investigate whether preclinical laparoscopy training offers a benefit over standard apprenticeship training and apprenticeship training in combination with simulation training. This randomized controlled trial consisted of 3 groups of first-year surgical registrars receiving a different teaching method in laparoscopic surgery. The KU LEUVEN Faculty of Medicine is the largest medical faculty in Belgium. Thirty final-year medical students starting a general surgical career in the next academic year. Thirty final-year medical students were randomized into 3 groups, which differed in the way they were exposed to laparoscopic simulation training but were comparable in regard to ambidexterity, sex, age, and laparoscopic psychomotoric skills. The control group received only clinical training during surgical residentship, whereas the interval group received clinical training in combination with simulation training. The registrars were allowed to do deliberate practice. The Centre for Surgical Technologies Preclinical Training Programme (CST PTP) group received a preclinical simulation course during the final year as medical students, but was not exposed to any extra simulation training during surgical residentship. At the beginning of surgical residentship and 6 months later, all subjects performed a standardized suturing task and a laparoscopic cholecystectomy in a POP Trainer. All procedures were recorded together with time and motion tracking parameters. All videos were scored by a blinded observer using global rating scales. At baseline the 3 groups were comparable. At 6 months, for suturing, the CST PTP group was better than both the other groups with respect to time, checklist, and amount of movements. The interval group was better than the control group on only the time and checklist score. For the cholecystectomy evaluation, there was a statistical difference between the CST PTP study group and both other groups on all evaluation scales in favor of the CST PTP
Full Text Available Objective: The aim of this study was the comparison of traditional exercises & body weight supported training (BWST exercises on sensory-motor function, quality and quantity of walking in paraplegic spinal cord injured persons. Materials & Methods: 17 voluntary paraplegic spinal cord injured persons (Asia B,C, age 32.53±1.793 years, height 175.71±1.658 cm, weight 71.59±2.442 kg, and body mass index (BMI 23.18 ± 0.828 kg/m2 availability. The subjects were randomly assigned to BWSTT group (N=10 and Traditional exercises group (N=7 according to sensory and motor score. The subjects trained for 12 weeks, four times per week and 60 min per session. BWSTT include 15 min warm-up on fixed gear bike, 45 min BWSTT with 50% body weight and 10 min cold-down finally. 10% load was added each week. Traditional exercises included 15 min warm-up plus 45 min stretch exercise and resistance training. Results: The data showed that there were significant differences in changes of sensory function Pin score (P=0.002 and Light Score (P=0.002 sensory function, motor function (P=0.000, Walking index Spinal cord injury (WISCI (P=0.002, 6 min walking test (P=0.001 and 10 meter walking (P=0.001 between BWSTT and traditional exercise. Conclusion: BWSTT in comparison with traditional exercise can improve sensory-motor function and quality and quantity of walking in paraplegic spinal cord injured persons.
Selden, Sally; Sherrier, Tom; Wooters, Robert
The purpose of this study is to examine the effects of a new approach to performance appraisal training. Motivated by split-brain theory and existing studies of cognitive information processing and performance appraisals, this exploratory study examined the effects of a whole-brain approach to training managers for implementing performance…
Dong Ling; Si Xulan
Objective: To study the effect of chinese traditional medicine anti-fatigue prescription on the concentration of the serum testosterone (T) and cortisol (C) in male rats under the stress of maximum intensive training. Methods: Wistar male rat models of stress under maximum intensity training were established (n=40) and half of them were treated with Chinese traditional medicine anti-fatigue prescription twenty undisturbed rats served as controls. Testosterone and cortisol serum levels were determined with RIA at the end of the seven weeks' experiment. Results: Maximum intensive training would cause the level of the serum testosterone lowered, the concentration of the cortisol elevated and the ratio of T/C reduced. The serum T levels and T/C ratio were significantly lower and cortisol levels significantly higher in the untreated models than those in the treated models and controls (P<0.01). The levels of the two hormones were markedly corrected in the treated models with no significantly differences from those in the controls. However, the T/C ratio was still significantly lower than that in the controls (P <0.05) due to a relatively slightly greater degree of reduction of T levels. Conclusion: Anti-fatigue prescription can not only promote the recovery of fatigue after the maximum intensive training but also strengthen the anabolism of the rats. (authors)
Full Text Available In low- and middle-income countries (LMICs, where the rates of maternal mortality continue to be inappropriately high, there has been recognition of the importance of training traditional birth attendants (TBAs to help improve outcomes during pregnancy and childbirth. In Guatemala, there is no national comprehensive training program in place despite the fact that the majority of women rely on TBAs during pregnancy and childbirth. This community case study presents a unique education program led by TBAs for TBAs in rural Guatemala. Discussion of this training program focuses on programming implementation, curriculum development, sustainable methodology, and how an educational partnership with the current national health-care system can increase access to health care for women in LMICs. Recent modifications to this training model are also discussed including how a change in the clinical curriculum is further integrating TBAs into the national health infrastructure. The training program has demonstrated that Guatemalan TBAs are able to improve their basic obstetrical knowledge, are capable of identifying and referring early complications of pregnancy and labor, and can deliver basic prenatal care that would otherwise not be provided. This training model is helping transform the role of the TBA from a sole cultural practitioner to a validated health-care provider within the health-care infrastructure of Guatemala and has the potential to do the same in other LMICs.
Hernandez, Sasha; Oliveira, Jessica Bastos; Shirazian, Taraneh
In low- and middle-income countries (LMICs), where the rates of maternal mortality continue to be inappropriately high, there has been recognition of the importance of training traditional birth attendants (TBAs) to help improve outcomes during pregnancy and childbirth. In Guatemala, there is no national comprehensive training program in place despite the fact that the majority of women rely on TBAs during pregnancy and childbirth. This community case study presents a unique education program led by TBAs for TBAs in rural Guatemala. Discussion of this training program focuses on programming implementation, curriculum development, sustainable methodology, and how an educational partnership with the current national health-care system can increase access to health care for women in LMICs. Recent modifications to this training model are also discussed including how a change in the clinical curriculum is further integrating TBAs into the national health infrastructure. The training program has demonstrated that Guatemalan TBAs are able to improve their basic obstetrical knowledge, are capable of identifying and referring early complications of pregnancy and labor, and can deliver basic prenatal care that would otherwise not be provided. This training model is helping transform the role of the TBA from a sole cultural practitioner to a validated health-care provider within the health-care infrastructure of Guatemala and has the potential to do the same in other LMICs.
Vickery, Will; Dascombe, Ben; Duffield, Rob
This study compared physiological, physical and technical demands of Battlezone, traditional cricket training and one-day matches. Data were initially collected from 11 amateur, male cricket players (age: 22.2 ± 3.3 year, height: 1.82 ± 0.06 m body mass: 80.4 ± 9.8 kg) during four Battlezone and four traditional cricket training sessions encompassing different playing positions. Heart rate, blood lactate concentration, rating of perceived exertion and movement patterns of players were measured. Retrospective video analysis was performed to code for technical outcomes. Similar data were collected from 42 amateur, male cricket players (23.5 ± 4.7 year, 1.81 ± 0.07 m, 81.4 ± 11.4 kg) during one-day matches. Significant differences were found between Battlezone, traditional cricket training and one-day matches within each playing position. Specifically, Battlezone invoked the greatest physiological and physical demands from batsmen in comparison to traditional cricket training and one-day matches. However, the greatest technical demand for batsmen was observed during traditional cricket training. In regards to the other playing positions, a greater physiological, physical and technical demand was observed during Battlezone and traditional training than during one-day matches. These results suggest that the use of Battlezone and traditional cricket training provides players with a suitable training stimulus for replicating the physiological, physical and technical demands of one-day cricket.
Traditional African healing has been in existence for many centuries yet many people still seem not to understand how it relates to God and religion/spirituality. Some people seem to believe that traditional healers worship the ancestors and not God. It is therefore the aim of this paper to clarify this relationship by discussing a chain of communication between the worshipers and the Almighty God. Other aspects of traditional healing namely types of traditional healers, training of tradition...
Ruf, Joseph H.; Jones, Daniel
The dual-bell nozzle (fig. 1) is an altitude-compensating nozzle that has an inner contour consisting of two overlapped bells. At low altitudes, the dual-bell nozzle operates in mode 1, only utilizing the smaller, first bell of the nozzle. In mode 1, the nozzle flow separates from the wall at the inflection point between the two bell contours. As the vehicle reaches higher altitudes, the dual-bell nozzle flow transitions to mode 2, to flow full into the second, larger bell. This dual-mode operation allows near optimal expansion at two altitudes, enabling a higher mission average specific impulse (Isp) relative to that of a conventional, single-bell nozzle. Dual-bell nozzles have been studied analytically and subscale nozzle tests have been completed.1 This higher mission averaged Isp can provide up to a 5% increase2 in payload to orbit for existing launch vehicles. The next important step for the dual-bell nozzle is to confirm its potential in a relevant flight environment. Toward this end, NASA Marshall Space Flight Center (MSFC) and Armstrong Flight Research Center (AFRC) have been working to develop a subscale, hot-fire, dual-bell nozzle test article for flight testing on AFRC's F15-D flight test bed (figs. 2 and 3). Flight test data demonstrating a dual-bell ability to control the mode transition and result in a sufficient increase in a rocket's mission averaged Isp should help convince the launch service providers that the dual-bell nozzle would provide a return on the required investment to bring a dual-bell into flight operation. The Game Changing Department provided 0.2 FTE to ER42 for this effort in 2014.
Naida Macias Hernández
Full Text Available This article is a description of how to put into practice pedagogical actions in the school of Medicine “Rafael Ferro Macías” in Sandino where youngsters from more than 25 nations of the world study medicine, and whose traditions and customs are different, although there are some which are common. The plan of pedagogical actions was conceived considering the study about the common customs and traditions. The actions were centered in the collective participation of the students in tasks which were organized without considering the nationalities and allowing each nation to show its customs and traditions so that they could be known and gradually accepted by the others. In that way, cooperation, friendship, and respect have been achieved, and even couples from different nationalities were conformed as an expression of close friendship.
K. Tsimaras Vasileios
Full Text Available Traditional dance is gaining popularity as an intervention choice for improving poor balance ability of people with intellectual disability (ID. Balance improvement for individuals with ID through dance provides opportunities for participation in sport activities and promotes independent living. This short review provides in brief research evidence of dynamic balance improvement as measured by means of a balance deck in duration of 30, 45, and 60 sec intervals, highlighting the need to incorporate traditional dance programs in Physical Education (PE lessons applied on participants with ID. Overall, traditional dances provide emotional and cognitive interaction that has a direct positive effect on quality of life and successful motor performance of individuals with ID.
Vasileios K. Tsimaras
Full Text Available Traditional dance is gaining popularity as an intervention choice for improving poor balance ability of people with intellectual disability (ID. Balance improvement for individuals with ID through dance provides opportunities for participation in sport activities and promotes independent living. This short review provides in brief research evidence of dynamic balance improvement as measured by means of a balance deck in duration of 30, 45, and 60 sec intervals, highlighting the need to incorporate traditional dance programs in Physical Education (PE lessons applied on participants with ID. Overall, traditional dances provide emotional and cognitive interaction that has a direct positive effect on quality of life and successful motor performance of individuals with ID.
fitness flight gender growth helium hormone human hyperbaric hypobaric hypoxia incidence injury interface interruption intra in-vitro isobaric male...exposure in hypobaric chambers and, due to its omission of other training, was not adequate for any other use. The two items required prior to...were kept in the contractor lab. 3. Hypobaric exposure records (Research Chamber Flight Records, including AF Forms 361) were kept by Altitude and
De Lorenzo, Robert A; Abbott, Cynthia A
Until recently, the U.S. Army Combat Medic School used a traditional teaching model with heavy emphasis on large group lectures. Skills were taught separately with minimal links to didactics. To evaluate whether the adult learning model improves student learning in terms of cognitive performance and perception of proficiency in military medic training. The study population was two sequential groups of randomly selected junior, enlisted, active duty soldiers with no prior formal emergency medical training who were enrolled in an experimental model of a U.S. Army Combat Medic School. The control population was a similar group of students enrolled in the traditional curriculum. Instructors were drawn from the same pool, with experimental group instructors receiving two weeks of training in adult-learning strategies. The study population was enrolled in the experimental program that emphasized the principles of adult learning, including small-group interactive approach, self-directed study, multimedia didactics, and intensive integrated practice of psychomotor skills. Instructors and students were also surveyed at the end of the course as to their confidence in performing four critical skills. The survey instrument used a five-point scale ranging from "strongly disagree" through "undecided" to "strongly agree." Proficiency for this survey was defined as the sum of the top two ratings of "agree" or "strongly agree" to questions regarding the particular skill. Both experimental and control programs lasted ten weeks and covered the same academic content and nonacademic (e.g., physical fitness) requirements, and the two groups of students had similar duty days. Evaluations included performance on internal and National Registry of Emergency Medical Technicians (NREMT) written examinations and other measures of academic and nonacademic performance. One hundred fifty students (experimental n = 81, control n = 69) were enrolled in 1999-2000. The scores for internal course
The modern education institutes play an important role in fostering professional talents, reproducing knowledge and studies, and forming the identities of certain academic fields and vocational communities. It is a matter of common knowledge that the absence of an official Korean medicine medical school during the Japanese colonial era was a severely disadvantageous factor in the aspects of academic progress, fostering follow-up personnel, and establishment of social capability. Therefore, the then Korean medicine circle put emphasis on inadequate official education institutes as the main factor behind oppression. Furthermore, as the measure to promote the continuance of Korean medicine, the circle regarded establishing civilian Korean medicine training schools as their long-cherished wish and strived to accomplish the mission even after liberation. This study looked into how the Korean medicine circle during the Japanese colonial era utilized civilian training schools to conduct the Korean medicine education conforming to modern medical school and examined how the operation of these training schools influenced the changes in the traditional Korean medicine. After the introduction of the Western medical science, the Korean medicine circle aimed to improve the quality of Korean medicine doctors by establishing modern Korean medicine medical schools. However, after the annexation of Korea and Japan, official Korean medicine medical schools were not established since policies were organized centered on the Western medical science. In this light, the Korean medicine circle strived to nurture the younger generation of Korean medicine by establishing and operating the civilian Korean medicine training schools after the annexation between Korea and Japan. The schools were limited in terms of scale and status but possessed the forms conforming to the modern medical schools in terms of education system. In other words, the civilian training schools not only adhered to the
Bell, Suzanne; Passano, Paige; Bohl, Daniel D; Islam, Arshadul; Prata, Ndola
A consensus emerged in the late 1990s among leaders in global maternal health that traditional birth attendants (TBAs) should no longer be trained in delivery skills and should instead be trained as promoters of facility-based care. Many TBAs continue to be trained in places where home deliveries are the norm and the potential impacts of this training are important to understand. The primary objective of this study was to gain a more nuanced understanding of the full impact of training TBAs to use misoprostol and a blood measurement tool (mat) for the prevention of postpartum haemorrhage (PPH) at home deliveries through the perspective of those involved in the project. This qualitative study, conducted between July 2009 and July 2010 in Bangladesh, was nested within larger operations research, testing the feasibility and acceptability of scaling up community-based provision of misoprostol and a blood measurement tool for prevention of PPH. A total of 87 in-depth interviews (IDIs) were conducted with TBAs, community health workers (CHWs), managers, and government-employed family welfare visitors (FWVs) at three time points during the study. Computer-assisted thematic data analysis was conducted using ATLAS.ti (version 5.2). Four primary themes emerged during the data analysis, which all highlight changes that occurred following the training. The first theme describes the perceived direct changes linked to the two new interventions. The following three themes describe the indirect changes that interviewees perceived: strengthened linkages between TBAs and the formal healthcare system; strengthened linkages between TBAs and the communities they serve; and improved quality of services/service utilization. The data indicate that training TBAs and CHW supervisors resulted in perceived broader and more nuanced changes than simply improvements in TBAs' knowledge, attitudes, and practices. Acknowledgeing TBAs' important role in the community and in home deliveries and
Skinner, Natalie; Roche, Ann M.; Freeman, Toby; Mckinnon, Anna
Aim: This article presents a critical review of research on health professionals' attitudes towards alcohol and other drug (AOD)-related work relevant to both researchers and practitioners. It moves beyond education and training programs to examine the relevance of organizational culture in influencing attitudes. Method: A review of research…
Traditional dance is gaining popularity as an intervention choice for improving poor balance ability of people with intellectual disability (ID). Balance improvement for individuals with ID through dance provides opportunities for participation in sport activities and promotes independent living. This short review provides in brief research evidence of dynamic balance improvement as measured by means of a balance deck in duration of 30, 45, and 60 sec intervals, highlighting the need to incor...
Yeboah-Antwi, Kojo; Hamer, Davidson H; Semrau, Katherine; Waltensperger, Karen Z; Snetro-Plewman, Gail; Kambikambi, Chilobe; Sakala, Amon; Filumba, Stephen; Sichamba, Bias; Marsh, David R
Teaming is an accepted approach in health care settings but rarely practiced at the community level in developing countries. Save the Children trained and deployed teams of volunteer community health workers (CHWs) and trained traditional birth attendants (TBAs) to provide essential newborn and curative care for children aged 0-59 months in rural Zambia. This paper assessed whether CHWs and trained TBAs can work as teams to deliver interventions and ensure a continuum of care for all children under-five, including newborns. We trained CHW-TBA teams in teaming concepts and assessed their level of teaming prospectively every six months for two years. The overall score was a function of both teamwork and taskwork. We also assessed personal, community and service factors likely to influence the level of teaming. We created forty-seven teams of predominantly younger, male CHWs and older, female trained TBAs. After two years of deployment, twenty-one teams scored "high", twelve scored "low," and fourteen were inactive. Teamwork was high for mutual trust, team cohesion, comprehension of team goals and objectives, and communication, but not for decision making/planning. Taskwork was high for joint behavior change communication and outreach services with local health workers, but not for intra-team referral. Teams with members residing within one hour's walking distance were more likely to score high. It is feasible for a CHW and a trained TBA to work as a team. This may be an approach to provide a continuum of care for children under-five including newborns.
Scenic view at high altitude is a pleasure to the eyes, but it has some shortcoming effects as well. High altitude can be divided into different categories, i.e., high altitude (3000-5000 ft), very high altitude (5000-8000 ft), and extreme altitude (above 8000 ft). Much of the population resides at high altitude, and others go there for tourism. Military personnel are also posted there to defend boundaries. As we ascent to high altitude, partial pressure of oxygen reduces, whereas concentration remains the same; this reduces the availability of oxygen to different body parts. This pathophysiological condition is known as hypobaric hypoxia (HH) which leads to oxidative stress and further causes cognitive dysfunction in some cases. Hypoxia causes neurodegeneration in different brain regions; however, the hippocampus is found to be more prone in comparison to other brain regions. As the hippocampus is affected most, therefore, spatial memory is impaired most during such condition. This chapter will give a brief review of the damaging effect of high altitude on cognition and also throw light on possible herbal interventions at high altitude, which can improve cognitive performance as well as provide protection against the deteriorating effect of hypobaric hypoxia at high altitude.
Ingwersen, Kim Gordon; Jensen, Steen Lund; Sørensen, Lilli
outcome measure was change from baseline to 12 weeks in the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, assessed in the intention-to-treat population. RESULTS: A total of 100 patients were randomized to PHLE (n = 49) or LLE (n = 51). Mean changes in the DASH questionnaire were 7...... benefit from PHLE over traditional LLE among patients with rotator cuff tendinopathy. Further investigation of the possible interaction between exercise type and corticosteroid injection is needed to establish optimal and potentially synergistic combinations of these 2 factors. REGISTRATION: NCT01984203...
Full Text Available Background. The present study aimed to evaluate and compare the effect of two different types of Tai Chi programs on the Functional Movement Screening (FMS in older adults. Methods. Ninety older adults (65.5 ± 4.6 years old who met the eligibility criteria were randomized into three different groups based on a ratio of 1 : 1 : 1: a traditional Tai Chi exercise (TTC, a simplified Tai Chi exercise (TCRT, or a control group (routine activity. The FMS consisted of the deep squat, hurdle step, in-line lunge, shoulder mobility, active straight leg rise, trunk stability push-up, and rotatory stability, which was used to measure physical function before the present study and after six months of Tai Chi interventions. Results. Seventy-nine participants completed the present study (control = 27, TTC = 23, and TCRT = 29. Significant improvement on the FMS tests between the baseline and after the six-month intervention was observed in both Tai Chi programs, whereas no significant improvement was observed in the control group. In addition, participants in the TCRT group demonstrated greater improvement than those in the TTC group. Conclusions. The TCRT is more effective in improving the physical function in older adults when compared to the traditional Tai Chi modality, particularly for improving balance.
Wonnabussapawich, Preetiwat; Hamlin, Michael J; Lizamore, Catherine A; Manimmanakorn, Nuttaset; Leelayuwat, Naruemon; Tunkamnerdthai, Orathai; Thuwakum, Worrawut; Manimmanakorn, Apiwan
Wonnabussapawich, P, Hamlin, MJ, Lizamore, CA, Manimmanakorn, N, Leelayuwat, N, Tunkamnerdthai, O, Thuwakum, W, and Manimmanakorn, A. Living and training at 825 m for 8 weeks supplemented with intermittent hypoxic training at 3,000 m improves blood parameters and running performance. J Strength Cond Res 31(12): 3287-3294, 2017-We aimed to investigate the effect of an 8-week low-altitude training block supplemented with intermittent hypoxic training, on blood and performance parameters in soccer players. Forty university-level male soccer players were separated into altitude (n = 20, 825 m) or sea-level (n = 20, 125 m) groups. Before (1-2 days ago) and after (1 and 14 days later) training, players were asked to give a resting venous blood sample and complete a series of performance tests. Compared with sea level, the altitude group increased erythropoietin, red blood cell (RBC) count, and hematocrit 1 day after training (42.6 ± 24.0%, 1.8 ± 1.3%, 1.4 ± 1.1%, mean ± 95% confidence limits (CL), respectively). By 14 days after training, only RBC count and hemoglobin were substantially higher in the altitude compared with the sea-level group (3.2 ± 1.8%, 2.9 ± 2.1% respectively). Compared with sea level, the altitude group 1-2 days after training improved their 50-m (-2.9 ± 1.4%) and 2,800-m (-2.9 ± 4.4%) run times and demonstrated a higher maximal aerobic speed (4.7 ± 7.4%). These performance changes remained at 14 days after training with the addition of a likely higher estimated V[Combining Dot Above]O2max in the altitude compared with the sea-level group (3.2 ± 3.0%). Eight weeks of low-altitude training, supplemented with regular bouts of intermittent hypoxic training at higher altitude, produced beneficial performance improvements in team-sport athletes, which may increase the viability of such training to coaches and players that cannot access more traditional high altitude venues.
Mokgobi, M G
Traditional African healing has been in existence for many centuries yet many people still seem not to understand how it relates to God and religion/spirituality. Some people seem to believe that traditional healers worship the ancestors and not God. It is therefore the aim of this paper to clarify this relationship by discussing a chain of communication between the worshipers and the Almighty God. Other aspects of traditional healing namely types of traditional healers, training of traditional healers as well as the role of traditional healers in their communities are discussed. In conclusion, the services of traditional healers go far beyond the uses of herbs for physical illnesses. Traditional healers serve many roles which include but not limited to custodians of the traditional African religion and customs, educators about culture, counselors, social workers and psychologists.
G K Singh
Full Text Available Approximately, 140 million people worldwide live permanently at high altitudes (HAs and approximately another 40 million people travel to HA area (HAA every year for reasons of occupation, sports or recreation. In India, whole of Ladakh region, part of Northwest Kashmir, Northern part of Sikkim and Tenga valley of Arunachal are considered inhabited areas of HAA. The low quantity of oxygen, high exposure of ultraviolet (UV light, very low humidity, extreme subzero temperature in winter, high wind velocity, make this region difficult for lowlanders as well as for tourists. Acute mountain sickness, HA pulmonary edema, HA cerebral edema, and thromboembolic conditions are known to occur in HA. However, enough knowledge has not been shared on dermatoses peculiar to this region. Xerosis, UV-related skin disorders (tanning, photomelanosis, acute and chronic sunburn, polymorphic light eruption, chronic actinic dermatitis, actinic cheilitis, etc., cold injuries (frostbite, chilblains, acrocyanosis, erythrocyanosis, etc. nail changes (koilonychias, airborne contact dermatitis, insect bite reaction, and skin carcinoma (basal cell carcinomas, squamous cell carcinomas, and also rarely malignant melanoma are the dermatoses seen in HAAs. Early diagnosis and knowledge of HA dermatoses may prevent serious consequences of disease and improve the quality of life for the visitors as well as for native of the place.
Kaltsatou, A; Kouidi, E; Fountoulakis, K; Sipka, C; Theochari, V; Kandylis, D; Deligiannis, A
To examine the effects of an eight-month exercise training programme with Greek traditional dancing on functional capacity and quality of life in patients with schizophrenia. Randomized controlled trial. Sports Medicine Laboratory. A total of 31 patients, aged 59.9 ± 14.1 years. They were randomly assigned either to a Greek traditional dancing programme (Group A) or to a sedentary control group (Group B). A functional capacity assessment was performed at baseline and the end of the study. Global Assessment of Functioning Scale and Positive and Negative Syndrome Scale were also used. Quality of life was examined using the Quality of Life and Satisfaction questionnaire. After the eight months, Group A increased walking distance in the 6-minute walk test (328.4 ± 35.9 vs. 238.0 ± 47.6 m), sit-to-stand test (19.1 ± 1.8 vs. 25.1 ± 1.4 seconds), Berg Balance Scale score (53.1 ± 2.1 vs. 43.2 ± 6.7), lower limbs maximal isometric force (77.7 ± 25.7 vs. 51.0 ± 29.8 lb), Positive and Negative Syndrome Scale total score (77.0 ± 23.1 vs. 82.0 ± 24.4), Global Assessment of Functioning Scale total score (51.3 ± 15.5 vs. 47.7 ± 13.3) and Quality of Life total score (34.9 ± 5.2 vs. 28 ± 4.5), compared with Group B. Our results demonstrate that Greek traditional dances improve functional capacity and quality of life in patients with schizophrenia. © The Author(s) 2014.
Mobeen, N; Durocher, J; Zuberi, Nf; Jahan, N; Blum, J; Wasim, S; Walraven, G; Hatcher, J
to determine if misoprostol is safe and efficacious in preventing postpartum haemorrhage (PPH) when administered by trained traditional birth attendants (TBA) at home deliveries. a randomised, double-blind, placebo-controlled trial. Chitral, Khyber Pakhtunkhwa Province, Pakistan. a total of 1119 women giving birth at home. from June 2006 to June 2008, consenting women were randomised to receive 600 microg oral misoprostol (n = 534) or placebo (n = 585) after delivery to determine whether misoprostol reduced the incidence of PPH (≥ 500 ml). the primary outcomes were measured blood loss ≥ 500 ml after delivery and drop in haemoglobin >2 g/dl from before to after delivery. oral misoprostol was associated with a significant reduction in the rate of PPH (≥ 500 ml) (16.5 versus 21.9%; relative risk 0.76, 95% CI 0.59-0.97). There were no measurable differences between study groups for drop in haemoglobin >2 g/dl (relative risk 0.79, 95% CI 0.62-1.02); but significantly fewer women receiving misoprostol had a drop in haemoglobin >3 g/dl, compared with placebo (5.1 versus 9.6%; relative risk 0.53, 95% CI 0.34-0.83). Shivering and chills were significantly more common with misoprostol. There were no maternal deaths among participants. postpartum administration of 600 microg oral misoprostol by trained TBAs at home deliveries reduces the rate of PPH by 24%. Given its ease of use and low cost, misoprostol could reduce the burden of PPH in community settings where universal oxytocin prophylaxis is not feasible. Continual training and skill-building for TBAs, along with monitoring and evaluation of programme effectiveness, should accompany any widespread introduction of this drug.
Andrew M. Luks
Full Text Available At any point 1–5 days following ascent to altitudes ≥2500 m, individuals are at risk of developing one of three forms of acute altitude illness: acute mountain sickness, a syndrome of nonspecific symptoms including headache, lassitude, dizziness and nausea; high-altitude cerebral oedema, a potentially fatal illness characterised by ataxia, decreased consciousness and characteristic changes on magnetic resonance imaging; and high-altitude pulmonary oedema, a noncardiogenic form of pulmonary oedema resulting from excessive hypoxic pulmonary vasoconstriction which can be fatal if not recognised and treated promptly. This review provides detailed information about each of these important clinical entities. After reviewing the clinical features, epidemiology and current understanding of the pathophysiology of each disorder, we describe the current pharmacological and nonpharmacological approaches to the prevention and treatment of these diseases.
This study examined the effects of 3 wk of intermittent exposures (4 h/d, 5 d/wk) to 4,300 m altitude-equivalent, in combination with either passive sitting or exercise training, on the process of altitude acclimatization...
Noble, Bruce J.; Maresh, Carl M.
In general, basketball players with moderately high aerobic power who reside at an altitude of 1,000 m do not display the hypoxic response to an altitude of 2,200 m expected of sea level residents and aerobically trained athletes. (JD)
Bustamante Valles, Karla; Montes, Sandra; Madrigal, Maria de Jesus; Burciaga, Adan; Martínez, María Elena; Johnson, Michelle J
Stroke rehabilitation in low- and middle-income countries, such as Mexico, is often hampered by lack of clinical resources and funding. To provide a cost-effective solution for comprehensive post-stroke rehabilitation that can alleviate the need for one-on-one physical or occupational therapy, in lower and upper extremities, we proposed and implemented a technology-assisted rehabilitation gymnasium in Chihuahua, Mexico. The Gymnasium for Robotic Rehabilitation (Robot Gym) consisted of low- and high-tech systems for upper and lower limb rehabilitation. Our hypothesis is that the Robot Gym can provide a cost- and labor-efficient alternative for post-stroke rehabilitation, while being more or as effective as traditional physical and occupational therapy approaches. A typical group of stroke patients was randomly allocated to an intervention (n = 10) or a control group (n = 10). The intervention group received rehabilitation using the devices in the Robot Gym, whereas the control group (n = 10) received time-matched standard care. All of the study subjects were subjected to 24 two-hour therapy sessions over a period of 6 to 8 weeks. Several clinical assessments tests for upper and lower extremities were used to evaluate motor function pre- and post-intervention. A cost analysis was done to compare the cost effectiveness for both therapies. No significant differences were observed when comparing the results of the pre-intervention Mini-mental, Brunnstrom Test, and Geriatric Depression Scale Test, showing that both groups were functionally similar prior to the intervention. Although, both training groups were functionally equivalent, they had a significant age difference. The results of all of the upper extremity tests showed an improvement in function in both groups with no statistically significant differences between the groups. The Fugl-Meyer and the 10 Meters Walk lower extremity tests showed greater improvement in the intervention group compared to the
Sabin, Lora L; Knapp, Anna B; MacLeod, William B; Phiri-Mazala, Grace; Kasimba, Joshua; Hamer, Davidson H; Gill, Christopher J
The Lufwanyama Neonatal Survival Project ("LUNESP") was a cluster randomized, controlled trial that showed that training traditional birth attendants (TBAs) to perform interventions targeting birth asphyxia, hypothermia, and neonatal sepsis reduced all-cause neonatal mortality by 45%. This companion analysis was undertaken to analyze intervention costs and cost-effectiveness, and factors that might improve cost-effectiveness. We calculated LUNESP's financial and economic costs and the economic cost of implementation for a forecasted ten-year program (2011-2020). In each case, we calculated the incremental cost per death avoided and disability-adjusted life years (DALYs) averted in real 2011 US dollars. The forecasted 10-year program analysis included a base case as well as 'conservative' and 'optimistic' scenarios. Uncertainty was characterized using one-way sensitivity analyses and a multivariate probabilistic sensitivity analysis. The estimated financial and economic costs of LUNESP were $118,574 and $127,756, respectively, or $49,469 and $53,550 per year. Fixed costs accounted for nearly 90% of total costs. For the 10-year program, discounted total and annual program costs were $256,455 and $26,834 respectively; for the base case, optimistic, and conservative scenarios, the estimated cost per death avoided was $1,866, $591, and $3,024, and cost per DALY averted was $74, $24, and $120, respectively. Outcomes were robust to variations in local costs, but sensitive to variations in intervention effect size, number of births attended by TBAs, and the extent of foreign consultants' participation. Based on established guidelines, the strategy of using trained TBAs to reduce neonatal mortality was 'highly cost effective'. We strongly recommend consideration of this approach for other remote rural populations with limited access to health care.
Lora L Sabin
Full Text Available The Lufwanyama Neonatal Survival Project ("LUNESP" was a cluster randomized, controlled trial that showed that training traditional birth attendants (TBAs to perform interventions targeting birth asphyxia, hypothermia, and neonatal sepsis reduced all-cause neonatal mortality by 45%. This companion analysis was undertaken to analyze intervention costs and cost-effectiveness, and factors that might improve cost-effectiveness.We calculated LUNESP's financial and economic costs and the economic cost of implementation for a forecasted ten-year program (2011-2020. In each case, we calculated the incremental cost per death avoided and disability-adjusted life years (DALYs averted in real 2011 US dollars. The forecasted 10-year program analysis included a base case as well as 'conservative' and 'optimistic' scenarios. Uncertainty was characterized using one-way sensitivity analyses and a multivariate probabilistic sensitivity analysis. The estimated financial and economic costs of LUNESP were $118,574 and $127,756, respectively, or $49,469 and $53,550 per year. Fixed costs accounted for nearly 90% of total costs. For the 10-year program, discounted total and annual program costs were $256,455 and $26,834 respectively; for the base case, optimistic, and conservative scenarios, the estimated cost per death avoided was $1,866, $591, and $3,024, and cost per DALY averted was $74, $24, and $120, respectively. Outcomes were robust to variations in local costs, but sensitive to variations in intervention effect size, number of births attended by TBAs, and the extent of foreign consultants' participation.Based on established guidelines, the strategy of using trained TBAs to reduce neonatal mortality was 'highly cost effective'. We strongly recommend consideration of this approach for other remote rural populations with limited access to health care.
A pilot study to compare the views of traditionally trained and CAM-trained therapists using the clinical exemplar of the management of neck/upper limb pain to assess barriers to effective integration of approaches.
Denyer, Karen; Smith, Helen; Davies, Kevin; Horne, Rob; Hankins, Matthew; Walker-Bone, Karen
In the UK, patients frequently choose complementary (CAM) therapies, particularly for chronic painful musculoskeletal conditions. It is widely agreed that better integration of complementary and traditional healthcare is desirable. We piloted the Benefits and Risks of Treatment Questionnaire to compare the views of different healthcare practitioners about traditional and alternative approaches in one clinical scenario in order to assess barriers to effective integration. A cross-sectional survey of healthcare practitioners (primary care practitioners, physiotherapists, pharmacists, osteopaths, chiropractors and acupuncturists) in the UK. The views of all healthcare providers were compared using the exemplar of neck, shoulder and upper arm pain to explore the perceived risks and benefits of different types of therapeutic intervention using a mathematical cluster approach. 448/1254 (36%) useable replies were received representing all six professions. A mean of 14.9 years of experience was reported by participants. The cluster analyses revealed distinct clusters of opinion of benefit: primary care physicians, physiotherapists and pharmacists were significantly more likely to rate a cluster including: anti-inflammatory drugs, steroid injections, steroids, physiotherapy, paracetamol and antidepressants as beneficial for neck, shoulder and upper arm pain. In contrast, osteopaths and chiropractors, but not physiotherapists were significantly more likely to rate a cluster including chiropractic, osteopathy and physiotherapy as beneficial. The Beliefs about Risks and Benefits of Treatments Questionnaire can be applied using a postal approach and achieves similar response rates to other surveys amongst healthcare practitioners. Despite widespread agreement that increased integration of traditional and alternative approaches is desirable, the results of this study suggest that experienced practitioners show the strongest belief in the benefit of approaches closest to their
Campbell, Aaron D; McIntosh, Scott E; Nyberg, Andy; Powell, Amy P; Schoene, Robert B; Hackett, Peter
High-altitude athletes and adventurers face a number of environmental and medical risks. Clinicians often advise participants or guiding agencies before or during these experiences. Preparticipation evaluation (PPE) has the potential to reduce risk of high-altitude illnesses in athletes and adventurers. Specific conditions susceptible to high-altitude exacerbation also important to evaluate include cardiovascular and lung diseases. Recommendations by which to counsel individuals before participation in altitude sports and adventures are few and of limited focus. We reviewed the literature, collected expert opinion, and augmented principles of a traditional sport PPE to accommodate the high-altitude wilderness athlete/adventurer. We present our findings with specific recommendations on risk stratification during a PPE for the high-altitude athlete/adventurer. Copyright © 2015. Published by Elsevier Inc.
Full Text Available High-altitude pulmonary hypertension (HAPH is a specific disease affecting populations that live at high elevations. The prevalence of HAPH among those residing at high altitudes needs to be further defined. Whereas reduction in nitric oxide production may be one mechanism for the development of HAPH, the roles of endothelin-1 and prostaglandin I2 pathways in the pathogenesis of HAPH deserve further study. Although some studies have suggested that genetic factors contribute to the pathogenesis of HAPH, data published to date are insufficient for the identification of a significant number of gene polymorphims in HAPH. The clinical presentation of HAPH is nonspecific. Exertional dyspnoea is the most common symptom and signs related to right heart failure are common in late stages of HAPH. Echocardiography is the most useful screening tool and right heart catheterisation is the gold standard for the diagnosis of HAPH. The ideal management for HAPH is migration to lower altitudes. Phosphodiesterase 5 is an attractive drug target for the treatment of HAPH. In addition, acetazolamide is a promising therapeutic agent for high-altitude pulmonary hypertension. To date, no evidence has confirmed whether endothelin-receptor antagonists have efficacy in the treatment of high-altitude pulmonary hypertension.
Behm, David G.; Young, James D.; Whitten, Joseph H. D.; Reid, Jonathan C.; Quigley, Patrick J.; Low, Jonathan; Li, Yimeng; Lima, Camila D.; Hodgson, Daniel D.; Chaouachi, Anis; Prieske, Olaf; Granacher, Urs
Numerous national associations and multiple reviews have documented the safety and efficacy of strength training for children and adolescents. The literature highlights the significant training-induced increases in strength associated with youth strength training. However, the effectiveness of youth strength training programs to improve power measures is not as clear. This discrepancy may be related to training and testing specificity. Most prior youth strength training programs emphasized lower intensity resistance with relatively slow movements. Since power activities typically involve higher intensity, explosive-like contractions with higher angular velocities (e.g., plyometrics), there is a conflict between the training medium and testing measures. This meta-analysis compared strength (e.g., training with resistance or body mass) and power training programs (e.g., plyometric training) on proxies of muscle strength, power, and speed. A systematic literature search using a Boolean Search Strategy was conducted in the electronic databases PubMed, SPORT Discus, Web of Science, and Google Scholar and revealed 652 hits. After perusal of title, abstract, and full text, 107 studies were eligible for inclusion in this systematic review and meta-analysis. The meta-analysis showed small to moderate magnitude changes for training specificity with jump measures. In other words, power training was more effective than strength training for improving youth jump height. For sprint measures, strength training was more effective than power training with youth. Furthermore, strength training exhibited consistently large magnitude changes to lower body strength measures, which contrasted with the generally trivial, small and moderate magnitude training improvements of power training upon lower body strength, sprint and jump measures, respectively. Maturity related inadequacies in eccentric strength and balance might influence the lack of training specificity with the unilateral
David G. Behm
Full Text Available Numerous national associations and multiple reviews have documented the safety and efficacy of strength training for children and adolescents. The literature highlights the significant training-induced increases in strength associated with youth strength training. However, the effectiveness of youth strength training programs to improve power measures is not as clear. This discrepancy may be related to training and testing specificity. Most prior youth strength training programs emphasized lower intensity resistance with relatively slow movements. Since power activities typically involve higher intensity, explosive-like contractions with higher angular velocities (e.g., plyometrics, there is a conflict between the training medium and testing measures. This meta-analysis compared strength (e.g., training with resistance or body mass and power training programs (e.g., plyometric training on proxies of muscle strength, power, and speed. A systematic literature search using a Boolean Search Strategy was conducted in the electronic databases PubMed, SPORT Discus, Web of Science, and Google Scholar and revealed 652 hits. After perusal of title, abstract, and full text, 107 studies were eligible for inclusion in this systematic review and meta-analysis. The meta-analysis showed small to moderate magnitude changes for training specificity with jump measures. In other words, power training was more effective than strength training for improving youth jump height. For sprint measures, strength training was more effective than power training with youth. Furthermore, strength training exhibited consistently large magnitude changes to lower body strength measures, which contrasted with the generally trivial, small and moderate magnitude training improvements of power training upon lower body strength, sprint and jump measures, respectively. Maturity related inadequacies in eccentric strength and balance might influence the lack of training specificity with
Roach, Gregory D; Schmidt, Walter F; Aughey, Robert J; Bourdon, Pitre C; Soria, Rudy; Claros, Jesus C Jimenez; Garvican-Lewis, Laura A; Buchheit, Martin; Simpson, Ben M; Hammond, Kristal; Kley, Marlen; Wachsmuth, Nadine; Gore, Christopher J; Sargent, Charli
Background Altitude exposure causes acute sleep disruption in non-athletes, but little is known about its effects in elite athletes. The aim of this study was to examine the effects of altitude on two groups of elite athletes, that is, sea-level natives and high-altitude natives. Methods Sea-level natives were members of the Australian under-17 soccer team (n=14). High-altitude natives were members of a Bolivian under-20 club team (n=12). Teams participated in an 18-day (19 nights) training camp in Bolivia, with 6 nights at near sea level in Santa Cruz (430 m) and 13 nights at high altitude in La Paz (3600 m). Sleep was assessed on every day/night using activity monitors. Results The Australians’ sleep was shorter, and of poorer quality, on the first night at altitude compared with sea level. Sleep quality returned to normal by the end of the first week at altitude, but sleep quantity had still not stabilised at its normal level after 2 weeks. The quantity and quality of sleep obtained by the Bolivians was similar, or greater, on all nights at altitude compared with sea level. The Australians tended to obtain more sleep than the Bolivians at sea level and altitude, but the quality of the Bolivians’ sleep tended to be better than that of the Australians at altitude. Conclusions Exposure to high altitude causes acute and chronic disruption to the sleep of elite athletes who are sea-level natives, but it does not affect the sleep of elite athletes who are high-altitude natives. PMID:24282197
Roach, Gregory D; Schmidt, Walter F; Aughey, Robert J; Bourdon, Pitre C; Soria, Rudy; Claros, Jesus C Jimenez; Garvican-Lewis, Laura A; Buchheit, Martin; Simpson, Ben M; Hammond, Kristal; Kley, Marlen; Wachsmuth, Nadine; Gore, Christopher J; Sargent, Charli
Altitude exposure causes acute sleep disruption in non-athletes, but little is known about its effects in elite athletes. The aim of this study was to examine the effects of altitude on two groups of elite athletes, that is, sea-level natives and high-altitude natives. Sea-level natives were members of the Australian under-17 soccer team (n=14). High-altitude natives were members of a Bolivian under-20 club team (n=12). Teams participated in an 18-day (19 nights) training camp in Bolivia, with 6 nights at near sea level in Santa Cruz (430 m) and 13 nights at high altitude in La Paz (3600 m). Sleep was assessed on every day/night using activity monitors. The Australians' sleep was shorter, and of poorer quality, on the first night at altitude compared with sea level. Sleep quality returned to normal by the end of the first week at altitude, but sleep quantity had still not stabilised at its normal level after 2 weeks. The quantity and quality of sleep obtained by the Bolivians was similar, or greater, on all nights at altitude compared with sea level. The Australians tended to obtain more sleep than the Bolivians at sea level and altitude, but the quality of the Bolivians' sleep tended to be better than that of the Australians at altitude. Exposure to high altitude causes acute and chronic disruption to the sleep of elite athletes who are sea-level natives, but it does not affect the sleep of elite athletes who are high-altitude natives.
Luo, Yongjun; Luo, Rong; Li, Weiming; Huang, Jianjun; Zhou, Qiquan; Gao, Yuqi
China has the largest plateau in the world, which includes the whole of Tibet, part of Qinghai, Xinjiang, Yunnan, and Sichuan. The plateau area is about 257.2×10(4) km(2), which accounts for about 26.8% of the total area of China. According to data collected in 2006, approximately twelve million people were living at high altitudes, between 2200 to 5200 m high, on the Qinghai-Tibetan Plateau. Therefore, there is a need for medical workers who are trained to treat individuals living at high altitudes. To train undergraduates in high altitude medicine, the College of High Altitude Military Medicine was set up at the Third Military Medical University (TMMU) in Chongqing in 1999. This is the only school to teach high altitude medicine in China. Students at TMMU study natural and social sciences, basic medical sciences, clinical medical sciences, and high altitude medicine. In their 5(th) year, students work as interns at the General Hospital of Tibet Military Command in Lhasa for 3 months, where they receive on-site teaching. The method of on-site teaching is an innovative approach for training in high altitude medicine for undergraduates. Three improvements were implemented during the on-site teaching component of the training program: (1) standardization of the learning progress; (2) integration of formal knowledge with clinical experience; and (3) coaching students to develop habits of inquiry and to engage in ongoing self-improvement to set the stage for lifelong learning. Since the establishment of the innovative training methods in 2001, six classes of high altitude medicine undergraduates, who received on-site teaching, have graduated and achieved encouraging results. This evidence shows that on-site teaching needs to be used more widely in high altitude medicine education.
Maynard, Bryon T.; Raines, Nickey G.
The National Aeronautics and Space Administration entered a new age on January 14, 2004 with President Bush s announcement of the creation the Vision for Space Exploration that will take mankind back to the Moon and on beyond to Mars. In January, 2006, after two years of hard, dedicated labor, engineers within NASA and its contractor workforce decided that the J2X rocket, based on the heritage of the Apollo J2 engine, would be the new engine for the NASA Constellation Ares upper stage vehicle. This engine and vehicle combination would provide assured access to the International Space Station to replace that role played by the Space Shuttle and additionally, would serve as the Earth Departure Stage, to push the Crew Excursion Vehicle out of Earth Orbit and head it on a path for rendezvous with the Moon. Test as you fly, fly as you test was chosen to be the guiding philosophy and a pre-requisite for the engine design, development, test and evaluation program. An exhaustive survey of national test facility assets proved the required capability to test the J2X engine at high altitude for long durations did not exist so therefore, a high altitude/near space environment testing capability would have to be developed. After several agency concepts the A3 High Altitude Testing Facility proposal was selected by the J2X engine program on March 2, 2007 and later confirmed by a broad panel of NASA senior leadership in May 2007. This facility is to be built at NASA s John C. Stennis Space Center located near Gulfport, Mississippi. 30 plus years of Space Shuttle Main Engine development and flight certification testing makes Stennis uniquely suited to support the Vision For Space Exploration Return to the Moon. Propellant handling infrastructure, engine assembly facilities, a trained and dedicated workforce and a broad and varied technical support base will all ensure that the A3 facility will be built on time to support the schedule needs of the J2X engine and the ultimate flight
Portelli, Geoffrey; Serres, Julien R; Ruffier, Franck
Studies on insects' visual guidance systems have shed little light on how learning contributes to insects' altitude control system. In this study, honeybees were trained to fly along a double-roofed tunnel after entering it near either the ceiling or the floor of the tunnel. The honeybees trained to hug the ceiling therefore encountered a sudden change in the tunnel configuration midways: i.e. a "dorsal ditch". Thus, the trained honeybees met a sudden increase in the distance to the ceiling, corresponding to a sudden strong change in the visual cues available in their dorsal field of view. Honeybees reacted by rising quickly and hugging the new, higher ceiling, keeping a similar forward speed, distance to the ceiling and dorsal optic flow to those observed during the training step; whereas bees trained to follow the floor kept on following the floor regardless of the change in the ceiling height. When trained honeybees entered the tunnel via the other entry (the lower or upper entry) to that used during the training step, they quickly changed their altitude and hugged the surface they had previously learned to follow. These findings clearly show that trained honeybees control their altitude based on visual cues memorized during training. The memorized visual cues generated by the surfaces followed form a complex optic flow pattern: trained honeybees may attempt to match the visual cues they perceive with this memorized optic flow pattern by controlling their altitude.
Gusejnov, F.T.; Egorov, I.A.; Gladilin, K.L.; Farber, Yu.V.
Preliminary adaptation of rats of high altitude conditions (3200 m) and training in the altitude chamber at the same imitated altitude inhibit 3 H-thymidine labelling of thymus DNA both shortly (26 h) and later (20 and 30 days) after irradiation. Whether the thymidine incorporation is activated or delayed depends on conditions of pretreatment. The data obtained are discussed from the point of view of the raioprotective effect of preadaptation of animals to high-altitude hypoxia
Forest, Emmanuelle; Lenzen, Benoît; Öhman, Marie
The aim of this paper is to identify and discuss similarities and differences between the curricula for physical education (PE) in secondary schools in Sweden, France and the canton of Geneva (Switzerland) in the light of PE teaching traditions (PETTs). Teaching traditions concern ideas about the goals of school disciplines and therefore about the…
Billaut, François; Aughey, Robert J
The internationalism of field-based team sports (TS) such as football and rugby requires teams to compete in tournaments held at low to moderate altitude (∼1200-2500 m). In TS, acceleration, speed and aerobic endurance are physical characteristics associated with ball possession and, ultimately, scoring. While these qualities are affected by the development of neuromuscular fatigue at sea level, arterial hypoxaemia induced by exposure to altitude may further hinder the capacity to perform consecutive accelerations (CAC) or sprint endurance and thereby change the outcome of a match. The higher the altitude, the more severe the hypoxaemia, and thus, the larger the expected decline in aerobic endurance, CAC and match running performance. Therefore, it is critical for athletes and coaches to understand how arterial hypoxaemia affects aerobic endurance and CAC and the magnitude of decline they may face at altitude for optimal preparation and increased chances of success. This mini review summarises the effects of acute altitude/hypoxia exposure on aerobic endurance, CAC and activity profiles of TS athletes performing in the laboratory and during matches at natural altitude, and analyses the latest findings about the consequences of arterial hypoxaemia on the relationship between peripheral perturbations, neural adjustments and performance during repeated sprints or CAC. Finally, we briefly discuss how altitude training can potentially help athletes prepare for competition at altitude.
Hampson, Neil B; Kregenow, David A; Mahoney, Anne M; Kirtland, Steven H; Horan, Kathleen L; Holm, James R; Gerbino, Anthony J
Hypobaric hypoxia during commercial air travel has the potential to cause or worsen hypoxemia in individuals with pre-existing cardiopulmonary compromise. Knowledge of cabin altitude pressures aboard contemporary flights is essential to counseling patients accurately about flying safety. The objective of the study was to measure peak cabin altitudes during U.S. domestic commercial flights on a variety of aircraft. A handheld mountaineering altimeter was carried by the investigators in the plane cabin during commercial air travel and peak cabin altitude measured. The values were then compared between aircraft models, aircraft classes, and distances flown. The average peak cabin altitude on 207 flights aboard 17 different aircraft was 6341 +/- 1813 ft (1933 m +/- 553 m), significantly higher than when measured in a similar fashion in 1988. Peak cabin altitude was significantly higher for flights longer than 750 mi (7085 +/- 801 ft) compared to shorter flights (5160 +/- 2290 ft/1573 +/- 698 m). Cabin altitude increased linearly with flight distance for flights up to 750 mi in length, but was independent of flight distance for flights exceeding 750 mi. Peak cabin altitude was less than 5000 ft (1524 m) in 70% of flights shorter than 500 mi. Peak cabin altitudes greater than 8000 ft (2438 m) were measured on approximately 10% of the total flights. Peak cabin altitude on commercial aircraft flights has risen over time. Cabin altitude is lower with flights of shorter distance. Physicians should take these factors into account when determining an individual's need for supplemental oxygen during commercial air travel.
Kim, Soon Bae; Kim, Jong Sung; Kim, Sang Jun; Cho, Su Hee
Medical congresses often held in highlands. We reviewed several medical issues associated with altitude stress especially while physicians have participated medical congress held in high altitude. Altitude stress, also known as an acute mountain sickness (AMS), is caused by acute exposure to low oxygen level at high altitude which is defined as elevations at or above 1,200 m and AMS commonly occurs above 2,500 m. Altitude stress with various symptoms including insomnia can also be experienced in airplane. AMS and drunken state share many common features in symptoms, neurologic manifestations and even show multiple microbleeds in corpus callosum and white matter on MRI. Children are more susceptible to altitude stress than adults. Gradual ascent is the best method for the prevention of altitude stress. Adequate nutrition (mainly carbohydrates) and hydration are recommended. Consumption of alcohol can exacerbate the altitude-induced impairments in judgment and the visual senses and promote psychomotor dysfunction. For prevention or treatment of altitude stress, acetazolamide, phosphodiesterase inhibitors, dexamethasone and erythropoietin are helpful. Altitude stress can be experienced relatively often during participation of medical congress. It is necessary to remind the harmful effect of AMS because it can cause serious permanent organ damage even though the symptoms are negligible in most cases. PMID:27621942
Zenhong, C.; Buwalda, P.L.
Chinese dumplings such as Jiao Zi and Bao Zi are two of the popular traditional foods in Asia. They are usually made from wheat flour dough (rice flour or starch is sometimes used) that contains fillings. They can be steamed, boiled and fried and are consumed either as a main meal or dessert. As
Biondich, Amy Sue; Joslin, Jeremy D
The use of coca leaf for medicinal purposes is a centuries-old tradition of the native peoples of South America. Coca products are thought by many laypersons to provide risk-free benefits to users participating in strenuous activities at high altitude. Physiologic studies of coca have increased understanding of its possible mechanism of action as well as its potential impact on high altitude activities. This present work explores the role of coca throughout the history of the Andean peoples and explores whether this ancient remedy has a place in modern medicine. A focused summary of research articles with particular relevance to the field of wilderness medicine is also included to better provide the reader with lessons not only from history but also from another culture. Copyright © 2015 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.
Full Text Available Precise aerodynamics performance prediction plays key role for a flying vehicle to get its mission completed within desired accuracy. Aerodynamic coefficients for same Mach number can be different at different altitude due to difference in Reynolds number. Prediction of these aerodynamics coefficients can be made through experiments, analytical solution or Computational Fluid Dynamics (CFD. Advancements in computational power have generated the concept of using CFD as a virtual Wind Tunnel (WT, hence aerodynamic performance prediction in present study is based upon CFD (numerical test rig. Simulations at different altitudes for a range of Mach numbers with zero angle of attack are performed to predict axial force coefficient behavior with altitude (Reynolds number. Similar simulations for a fixed Mach number â3â and a range of angle of attacks are also carried out to envisage the variation in normal force and pitching moment coefficients with altitude (Reynolds number. Results clearly depict that the axial force coefficient is a function of altitude (Reynolds number and increase as altitude increases, especially for subsonic region. Variation in axial force coefficient with altitude (Reynolds number slightly increases for larger values of angle of attacks. Normal force and pitching moment coefficients do not depend on altitude (Reynolds number at smaller values of angle of attacks but show slight decrease as altitude increases. Present study suggests that variation of normal force and pitching moment coefficients with altitude can be neglected but the variation of axial force coefficient with altitude should be considered for vehicle fly in dense atmosphere. It is recommended to continue this study to more complex configurations for various Mach numbers with side slip and real gas effects. Keywords: Mach number, Reynolds number, Blunt body, Altitude effect, Angle of attacks
Souto-Otero, Manuel; Ure, Odd Bjorn
Coherence of national education and training systems is increasingly tabled in European policy debates. Leaning on literature about the emergence and consolidation of national education systems, this article explores the rationale for VET reforms in Norway and Spain by scrutinising attempts to strengthen the coherence of their VET systems.…
Shahid, Faiza; Hussain, Mukkarum; Baig, Mirza Mehmood; Haq, Ihtram ul
Precise aerodynamics performance prediction plays key role for a flying vehicle to get its mission completed within desired accuracy. Aerodynamic coefficients for same Mach number can be different at different altitude due to difference in Reynolds number. Prediction of these aerodynamics coefficients can be made through experiments, analytical solution or Computational Fluid Dynamics (CFD). Advancements in computational power have generated the concept of using CFD as a virtual Wind Tunnel (WT), hence aerodynamic performance prediction in present study is based upon CFD (numerical test rig). Simulations at different altitudes for a range of Mach numbers with zero angle of attack are performed to predict axial force coefficient behavior with altitude (Reynolds number). Similar simulations for a fixed Mach number '3' and a range of angle of attacks are also carried out to envisage the variation in normal force and pitching moment coefficients with altitude (Reynolds number). Results clearly depict that the axial force coefficient is a function of altitude (Reynolds number) and increase as altitude increases, especially for subsonic region. Variation in axial force coefficient with altitude (Reynolds number) slightly increases for larger values of angle of attacks. Normal force and pitching moment coefficients do not depend on altitude (Reynolds number) at smaller values of angle of attacks but show slight decrease as altitude increases. Present study suggests that variation of normal force and pitching moment coefficients with altitude can be neglected but the variation of axial force coefficient with altitude should be considered for vehicle fly in dense atmosphere. It is recommended to continue this study to more complex configurations for various Mach numbers with side slip and real gas effects.
Mastellos, Nikolaos; Tran, Tammy; Dharmayat, Kanika; Cecil, Elizabeth; Lee, Hsin-Yi; Wong, Cybele C Peng; Mkandawire, Winnie; Ngalande, Emmanuel; Wu, Joseph Tsung-Shu; Hardy, Victoria; Chirambo, Baxter Griphin; O'Donoghue, John Martin
Despite the increasing uptake of information and communication technologies (ICT) within healthcare services across developing countries, community healthcare workers (CHWs) have limited knowledge to fully utilise computerised clinical systems and mobile apps. The 'Introduction to Information and Communication Technology and eHealth' course was developed with the aim to provide CHWs in Malawi, Africa, with basic knowledge and computer skills to use digital solutions in healthcare delivery. The course was delivered using a traditional and a blended learning approach. Two questionnaires were developed and tested for face validity and reliability in a pilot course with 20 CHWs. Those were designed to measure CHWs' knowledge of and attitudes towards the use of ICT, before and after each course, as well as their satisfaction with each learning approach. Following validation, a randomised controlled trial was conducted to assess the effectiveness of the two learning approaches. A total of 40 CHWs were recruited, stratified by position, gender and computer experience, and allocated to the traditional or blended learning group using block randomisation. Participants completed the baseline and follow-up questionnaires before and after each course to assess the impact of each learning approach on their knowledge, attitudes, and satisfaction. Per-item, pre-post and between-group, mean differences for each approach were calculated using paired and unpaired t-tests, respectively. Per-item, between-group, satisfaction scores were compared using unpaired t-tests. Scores across all scales improved after attending the traditional and blended learning courses. Self-rated ICT knowledge was significantly improved in both groups with significant differences between groups in seven domains. However, actual ICT knowledge scores were similar across groups. There were no significant differences between groups in attitudinal gains. Satisfaction with the course was generally high in both
Zhang, Xuan; Zhang, Lihao; Li, Qingxuan; Chen, WanSong
With the variation of people and material during vehicle service, the gravity of vehicle could be unbalanced. As a result it might cause accident. In order to solve this problem, altitude valve is assembled on board. It can adjust the gravity of vehicle by the intake and outlet progress of the spring in the altitude valve to prevent the tilt of vehicles.
Weber, Roy E.
Vertebrates at high altitude are subjected to hypoxic conditions that challenge aerobic metabolism. O2 transport from the respiratory surfaces to tissues requires matching between the O2 loading and unloading tensions and theO2-affinity of blood, which is an integrated function of hemoglobin......, birds and ectothermic vertebrates at high altitude....
The commercialization of drugs started toward the end of Heian period (794-1192) when not only aristocrats and monks who were traditional patrons to drug makers, but also local clans and landlords who became powerful as a result of the disbanding of aristocratic manors accumulated enough wealth to spend money on medicine. Although traveling around the country was still a dangerous endeavor, merchants assembled groups to bring lucrative foreign drugs (mainly Chinese) to remote areas. The spread of commercial drugs to common people, however, did not happen until the early Edo period (1603-1867), when the so-called barrier system was installed nationwide to make domestic travel safe. Commercialization started in large cities and gradually spread to other areas. Many nostrums popular until recently appeared in the Genroku period (1688-1703) or later. Many such nostrums were all-cures, often consisting of such active ingredients as Saussureae radix, Agalloch, or Gambir. Even in the Edo period, many people living in agricultural or fishing villages, as well as those in the lower tier, were still poor. Much of the medication available to those people was therefore made of various plant or animal-derived substances that were traditionally used as folk medicines.
... procedures set forth in the certificate holder's approved low-altitude windshear flight training program and... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Recurrent training. 121.427 Section 121.427..., FLAG, AND SUPPLEMENTAL OPERATIONS Training Program § 121.427 Recurrent training. (a) Recurrent training...
High-altitude balloons typically fly between 25 and 50 km in altitude, which, while below the Karman line of 100 km, is yet far above the altitudes typically flown by aircraft. For example, the highest-flying commercial aircraft - the Concorde - had a maximum cruising altitude of only 18 km. zero2infinity, a Spanish company, is currently developing a pressurized pod named “bloon” which will be capable of lifting six people, including two pilot crew members and four paying passengers, to an altitude of 36 km through the use of high-altitude balloons. The boundary between Airspace and Outer Space has never been legally defined, mostly because of the lack of activities taking place between the altitude where airplanes fly and the lowest orbiting spacecraft. High-altitude balloons do fly at these in-between altitudes and the prospect of commercializing access to these parts of the stratosphere poses some questions in a new light. Given the relatively low altitude at which they fly, it may well be that these types of balloons would be considered to operate exclusively within air space. However, given the technology involved in crewed high altitude balloon flights, which is more similar to spacecraft engineering than to traditional hot-air or gas ballooning, it is necessary to evaluate the various legal regimes, codes, and regulations that would apply to such flights, especially regarding licenses and liabilities. For high altitude balloon flights commencing in Europe, the European Aviation Safety Agency (EASA) would very likely be the competent certification or licensing agency for these flights, although there would likely be input from various national aviation authorities as well. However, because the European Commission (EC) has not yet issued regulations regarding commercial spaceflight, particularly the use of high altitude balloons, new rules and regulations governing such flights may still need to be drafted and promulgated. With the development of
Full Text Available This article is about establishing a common transition altitude over all territory of Russian Federation. The main objective is to prove the necessity of a common transition altitude in Russian airspace and to define, which variant of tran- sition altitude (low, medium, high is the most suitable to be implemented in Russia. ICAO and IFALPA points of view, data and experience from different states and regions all over the world were examined in order to show all the advantages and disadvantages of different approaches towards common transition altitude. The research showed that the most appro- priate common transition altitude in Russia will be 10000 feet (3050 meters, it will cover almost all the international aero- dromes and regions in the country. Only several exceptions are needed in mountainous areas. This article can be used to further study of the possibility of implementation of common transition altitude, because it can’t take into consideration all the local features of all the FIRs (Flight Information Regions in Russia. The conclusion is establishing a common transi- tion altitude over such a big part of the world as Russian Federation will lead to improvement of the flight safety, harmoni- zation with ICAO and IFALPA policies and flexibility in airspace design.
Landis, Geoffrey A.; Denis, Vincent
Existing engineering materials allow the constuction of towers to heights of many kilometers. Orbital launch from a high altitude has significant advantages over sea-level launch due to the reduced atmospheric pressure, resulting in lower atmospheric drag on the vehicle and allowing higher rocket engine performance. High-altitude launch sites are particularly advantageous for single-stage to orbit (SSTO) vehicles, where the payload is typically 2% of the initial launch mass. An earlier paper enumerated some of the advantages of high altitude launch of SSTO vehicles. In this paper, we calculate launch trajectories for a candidate SSTO vehicle, and calculate the advantage of launch at launch altitudes 5 to 25 kilometer altitudes above sea level. The performance increase can be directly translated into increased payload capability to orbit, ranging from 5 to 20% increase in the mass to orbit. For a candidate vehicle with an initial payload fraction of 2% of gross lift-off weight, this corresponds to 31% increase in payload (for 5-km launch altitude) to 122% additional payload (for 25-km launch altitude).
Beasley, Gary S; Murphy, Anne M; Brenner, Joel I; Ravekes, William J
Johns Hopkins has been a leader in paediatric cardiology for over 85 years. In the 1940s, Dr Helen Taussig began training fellows in paediatric cardiology at Johns Hopkins at a time when the diagnosis and treatment of CHD were in the earliest stage. Under her leadership, the fellowship developed a strong foundation that has continued to evolve to meet the current needs of learners and educators. In the current era, the Johns Hopkins programme implements the current theories of adult education and actively engages our fellows in learning as well as teaching. The programme uses techniques such as flipped classroom, structured case-based small-group learning, observed and structured clinical examination, simulations, and innovative educational technology. These strategies combined with our faculty and rich history give our fellows a unique educational experience.
Full Text Available In the recent years there has been considerable interest in mountain sports, including mountaineering, owing to the general availability of climbing clothing and equipment as well trainings and professional literature. This raised a new question for the environmental and mountain medicine: Is mountaineering harmful to health? Potential hazards include the conditions existing in the alpine environment, i.e. lower atmospheric pressure leading to the development of hypobaric hypoxia, extreme physical effort, increased UV radiation, lack of access to fresh food, and mental stress. A reasonable measure of harmfulness of these factors is to determine the increase in the level of oxidative stress. Alpine environment can stimulate the antioxidant enzyme system but under specific circumstances it may exceed its capabilities with simultaneous consumption of low-molecular antioxidants resulting in increased generation of reactive oxygen species (ROS. This situation is referred to as oxidative stress. Rapid and uncontrolled proliferation of reactive oxygen species leads to a number of adverse changes, resulting in the above-average damage to the lipid structures of cell membranes (peroxidation, proteins (denaturation, and nucleic acids. Such situation within the human body cannot take place without resultant systemic consequences. This explains the malaise of people returning from high altitude and a marked decrease in their physical fitness. In addition, a theory is put forward that the increase in the level of oxidative stress is one of the factors responsible for the onset of acute mountain sickness (AMS. However, such statement requires further investigation because the currently available literature is inconclusive. This article presents the causes and effects of development of oxidative stress in the high mountains.
Full Text Available The purpose of our pilot study was to find out if total body water (TBW changes could objectively modify the course of adaptation during training for elite runners at different altitudes. The aim of this pilot study is to summarize the indication of the progress of acclimatization at high altitudes (1000–2700 meters above sea level during alpine conditioning. In three training camps at various altitudes the TBW of elite runners (F = 3, M = 1; n = 4; age 23 } 0.9 was monitored, in order to check the progress of acclimatization. We used BIA measurement methods (Bodystat 1500 at different high altitude running camps at the Czech Republic, Morocco and Ethiopia. Changes in TBW were used to check the progress of acclimatization. We discovered that the retention peaks of TBW corresponded with critical days (p ≤ 0.04; Cohen’s d. The highest measured increases of TBW at an altitude of 1000 m were for runner 1, 1.7 litres and for runner 2, 2.1 litres with retention peaks for both occurring on the 5th day. At an altitude of 1770 m runner 1 reached an increase of TBW of 6.3 litres, with a retention peak on the 11th day, and runner 3 had an increase of 5.1 litres with a peak on the 8th day. In the acclimatization phase we found two critical periods, from the 4th–6th day, and after the 10th–12th day. For runner 4 in altitude 2700m who completed the camp at a higher altitude, the situation is more complicated because there were fluctuations of the content of TBW in the range of 1.25 litres, with the highest depression on the 5th and then again an unsettled rise and reaching a maximum on the 12th, when she nearly returned to the initial value. Detected retention peaks reflected different levels of altitude (5th–12th days.We can conclude that the measuring of changes in TBW during camps at higher altitudes may be one of the biomarkers during acclimatization to altitude.
National Oceanic and Atmospheric Administration, Department of Commerce — The Air Force Flight Dynamics Laboratory conducted the High Altitude Clear Air Turbulence Project in the mid 1960s with the intention of better understanding air...
Conclusion: Besides low level of iodine intake, cassava consumption and living in high altitude were responsible for the observed variation and severity in goitre rates. IDD affects several dimensions of human life including school enrolment and marriage. Addressing IDD in-terms of salt iodization and training communities ...
West, John B
High-altitude physiology can be said to have begun in 1644 when Torricelli described the first mercury barometer and wrote the immortal words "We live submerged at the bottom of an ocean of the element air." Interestingly, the notion of atmospheric pressure had eluded his teacher, the great Galileo. Blaise Pascal was responsible for describing the fall in pressure with increasing altitude, and Otto von Guericke gave a dramatic demonstration of the enormous force that could be developed by atmospheric pressure. Robert Boyle learned of Guericke's experiment and, with Robert Hooke, constructed the first air pump that allowed small animals to be exposed to a low pressure. Hooke also constructed a small low-pressure chamber and exposed himself to a simulated altitude of about 2400 meters. With the advent of ballooning, humans were rapidly exposed to very low pressures, sometimes with tragic results. For example, the French balloon, Zénith, rose to over 8000 m, and two of the three aeronauts succumbed to the hypoxia. Paul Bert was the first person to clearly state that the deleterious effects of high altitude were caused by the low partial pressure of oxygen (PO2), and later research was accelerated by high-altitude stations and expeditions to high altitude. © 2015 New York Academy of Sciences.
Sargent, Charli; Schmidt, Walter F; Aughey, Robert J; Bourdon, Pitre C; Soria, Rudy; Claros, Jesus C Jimenez; Garvican-Lewis, Laura A; Buchheit, Martin; Simpson, Ben M; Hammond, Kristal; Kley, Marlen; Wachsmuth, Nadine; Gore, Christopher J; Roach, Gregory D
Background Altitude training is used by elite athletes to improve sports performance, but it may also disrupt sleep. The aim of this study was to examine the effects of 2 weeks at high altitude on the sleep of young elite athletes. Methods Participants (n=10) were members of the Australian under-17 soccer team on an 18-day (19-night) training camp in Bolivia, with six nights at near sea level in Santa Cruz (430 m) and 13 nights at high altitude in La Paz (3600 m). Sleep was monitored using polysomnography during a baseline night at 430 m and three nights at 3600 m (immediately after ascent, 1 week after ascent and 2 weeks after ascent). Data were analysed using effect size statistics. Results All results are reported as comparisons with baseline. Rapid eye movement (REM) sleep was likely lower immediately upon ascent to altitude, possibly lower after 1 week and similar after 2 weeks. On all three nights at altitude, hypopneas and desaturations were almost certainly higher; oxygen saturation was almost certainly lower; and central apnoeas, respiratory arousals and periodic breathing were very likely higher. The effects on REM sleep were common to all but one participant, but the effects on breathing were specific to only half the participants. Conclusions The immediate effects of terrestrial altitude of 3600 m are to reduce the amount of REM sleep obtained by young elite athletes, and to cause 50% of them to have impaired breathing during sleep. REM sleep returns to normal after 2 weeks at altitude, but impaired breathing does not improve. PMID:24282215
..., as appropriate, including low-altitude windshear training and training on operating during ground... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Recurrent training. 91.1107 Section 91.1107... Management § 91.1107 Recurrent training. (a) Each program manager must ensure that each crewmember receives...
... appropriate, including low-altitude windshear training and training on operating during ground icing... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Recurrent training. 135.351 Section 135.351... AND ON DEMAND OPERATIONS AND RULES GOVERNING PERSONS ON BOARD SUCH AIRCRAFT Training § 135.351...
Operational Medical Issues in Hypo-and Hyperbaric Conditions [les Questions medicales a caractere oprationel liees aux conditions hypobares ou... hyperbares ] To order the complete compilation report, use: ADA395680 The component part is provided here to allow users access to individually authored...Airforce was felt to meet this need and was recommended. Paper presented at the RTO HFM Symposium on "Operational Medical Issues in Hypo- and Hyperbaric
A substantial proportion of South Africa (SA)'s population lives at high altitude (>1 500 m), and many travel to very high altitudes (>3 500 m) for tourism, business, recreation or religious pilgrimages every year. Despite this, knowledge of acute altitude illnesses is poor among SA doctors. At altitude, the decreasing ambient ...
Valdir de Aquino Lemos
Full Text Available The number of persons who relocate to regions of high altitude for work, pleasure, sport, or residence increases every year. It is known that the reduced supply of oxygen (O2 induced by acute or chronic increases in altitude stimulates the body to adapt to new metabolic challenges imposed by hypoxia. Sleep can suffer partial fragmentation because of the exposure to high altitudes, and these changes have been described as one of the responsible factors for the many consequences at high altitudes. We conducted a review of the literature during the period from 1987 to 2012. This work explored the relationships among inflammation, hypoxia and sleep in the period of adaptation and examined a novel mechanism that might explain the harmful effects of altitude on sleep, involving increased Interleukin-1 beta (IL-1β, Interleukin-6 (IL-6, and tumor necrosis factor-alpha (TNF-α production from several tissues and cells, such as leukocytes and cells from skeletal muscle and brain.
de Aquino Lemos, Valdir; dos Santos, Ronaldo Vagner Thomatieli; Lira, Fabio Santos; Rodrigues, Bruno; Tufik, Sergio; de Mello, Marco Tulio
The number of persons who relocate to regions of high altitude for work, pleasure, sport, or residence increases every year. It is known that the reduced supply of oxygen (O2) induced by acute or chronic increases in altitude stimulates the body to adapt to new metabolic challenges imposed by hypoxia. Sleep can suffer partial fragmentation because of the exposure to high altitudes, and these changes have been described as one of the responsible factors for the many consequences at high altitudes. We conducted a review of the literature during the period from 1987 to 2012. This work explored the relationships among inflammation, hypoxia and sleep in the period of adaptation and examined a novel mechanism that might explain the harmful effects of altitude on sleep, involving increased Interleukin-1 beta (IL-1β), Interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) production from several tissues and cells, such as leukocytes and cells from skeletal muscle and brain. PMID:23690660
Moy, Leslie; Bhartia, Pawan K.; Jaross, Glen; Loughman, Robert; Kramarova, Natalya; Chen, Zhong; Taha, Ghassan; Chen, Grace; Xu, Philippe
One of the largest constraints to the retrieval of accurate ozone profiles from UV backscatter limb sounding sensors is altitude registration. Two methods, the Rayleigh scattering attitude sensing (RSAS) and absolute radiance residual method (ARRM), are able to determine altitude registration to the accuracy necessary for long-term ozone monitoring. The methods compare model calculations of radiances to measured radiances and are independent of onboard tracking devices. RSAS determines absolute altitude errors, but, because the method is susceptible to aerosol interference, it is limited to latitudes and time periods with minimal aerosol contamination. ARRM, a new technique introduced in this paper, can be applied across all seasons and altitudes. However, it is only appropriate for relative altitude error estimates. The application of RSAS to Limb Profiler (LP) measurements from the Ozone Mapping and Profiler Suite (OMPS) on board the Suomi NPP (SNPP) satellite indicates tangent height (TH) errors greater than 1 km with an absolute accuracy of +/-200 m. Results using ARRM indicate a approx. 300 to 400m intra-orbital TH change varying seasonally +/-100 m, likely due to either errors in the spacecraft pointing or in the geopotential height (GPH) data that we use in our analysis. ARRM shows a change of approx. 200m over 5 years with a relative accuracy (a long-term accuracy) of 100m outside the polar regions.
Jerde, E. A.; Thomas, E.
Although carbon dioxide represents a long-lived atmospheric component relevant to global climate change, it is also understood that many additional contributors influence the overall climate of Earth. Among these, short-lived components are more difficult to incorporate into models due to uncertainties in the abundances of these both spatially and temporally. Possibly the most significant of these short-lived components falls under the heading of “black carbon” (BC). There are numerous overlapping definitions of BC, but it is basically carbonaceous in nature and light absorbing. Due to its potential as a climate forcer, an understanding of the BC population in the atmosphere is critical for modeling of radiative forcing. Prior measurements of atmospheric BC generally consist of airplane- and ground-based sampling, typically below 5000 m and restricted in time and space. Given that BC has a residence time on the order of days, short-term variability is easily missed. Further, since the radiative forcing is a result of BC distributed through the entire atmospheric column, aircraft sampling is by definition incomplete. We are in the process of planning a more comprehensive sampling of the atmosphere for BC using high-altitude balloons. Balloon-borne sampling is a highly reliable means to sample air through the entire troposphere and into the lower stratosphere. Our system will incorporate a balloon and a flight train of two modules. One module will house an atmospheric sampler. This sampler will be single-stage (samples all particle sizes together), and will place particles directly on an SEM sample stub for analysis. The nozzle depositing the sample will be offset from the center of the stub, placing the aerosol particles toward the edge. At various altitudes, the stub will be rotated 45 degrees, providing 6-8 sample “cuts” of particle populations through the atmospheric column. The flights will reach approximately 27 km altitude, above which the balloons
Ashok Kumar Panda
Full Text Available Ancient medical systems are still prevalent in Sikkim, popularly nurtured by Buddhist groups using the traditional Tibetan pharmacopoeia overlapping with Ayurvedic medicine. Traditional medical practices and their associated cultural values are based round Sikkim′s three major communities, Lepcha, Bhutia and Nepalis. In this study, a semi-structured questionnaire was prepared for folk healers covering age and sex, educational qualification, source of knowledge, types of practices, experience and generation of practice, and transformation of knowledge. These were administered to forty-eight folk healers identified in different parts of Sikkim. 490 medicinal plants find their habitats in Sikkim because of its large variations in altitude and climate. For 31 commonly used by these folk healers, we present botanical name, family, local name, distribution, and parts used, together with their therapeutic uses, mostly Rheumatoid arthritis, Gout, Gonorrhea, Fever, Viral flu, asthma, Cough and Cold, indigestion, Jaundice etc. A case treated by a folk healer is also recounted. This study indicates that, in the studied area, Sikkim′s health traditions and folk practices are declining due to shifts in socio-economic patterns, and unwillingness of the younger generation to adopt folk healing as a profession.
Enomoto, R.; Chiba, J.; Ogawa, K.; Sumiyoshi, T.; Takasaki, F.; Kifune, T.; Matsubara, Y.; Nishimura, J.
We have developed a new detector to systematically measure the cosmic-ray electron flux at airplane altitudes. We loaded a lead-glass-based electron telescope onto a commercial cargo airplane. The first experiment was carried out using the air route between Narita (Japan) and Sydney (Australia); during this flight we measured the electron flux at various altitudes and latitudes. The thresholds of the electron energies were 1, 2, and 4 GeV. The results agree with a simple estimation using one-dimensional shower theory. A comparison with a Monte Carlo calculation was made
J. J. M. Smit
Full Text Available Traditional Birth Attendants (TBAs and traditional healers form an important link in the chain of health personnel providing primary health care in Malawi. In spite of the establishment of hospitals and health centres, it is to these traditional healers and TBAs that the majority of people turn in times of sickness and child-birth. Approximately 60 percent of all deliveries in Malawi occur in the villages. It is therefore important that due regard be paid to the activities of these traditional practitioners in order to ensure the achievement of the goal - "Health for all by the year 2000". The training of TBAs is seen as part of the Maternal and Child Health Services in the country.
J. J. M. Smit
Full Text Available Traditional Birth Attendants (TBAs and traditional healers form an important link in the chain of health personnel providing primary health care in Malawi. In spite of the establishment of hospitals and health centres, it is to these traditional healers and TBAs that the majority of people turn in times of sickness and child-birth. Approximately 60 percent of all deliveries in Malawi occur in the villages. It is therefore important that due regard be paid to the activities of these traditional practitioners in order to ensure the achievement of the goal - "Health for all by the year 2000". The training of TBAs is seen as part of the Maternal and Child Health Services in the country.
Weinbruch, Stephan; Nordby, Karl-Christian
Quantitative estimates for mortality in high altitude mountaineering are reviewed. Special emphasis is placed on the heterogeneity of the risk estimates and on confounding. Crude estimates for mortality are on the order of 1/1000 to 40/1000 persons above base camp, for both expedition members and high altitude porters. High altitude porters have mostly a lower risk than expedition members (risk ratio for all Nepalese peaks requiring an expedition permit: 0.73; 95 % confidence interval 0.59-0.89). The summit bid is generally the most dangerous part of an expedition for members, whereas most high altitude porters die during route preparation. On 8000 m peaks, the mortality during descent from summit varies between 4/1000 and 134/1000 summiteers (members plus porters). The risk estimates are confounded by human and environmental factors. Information on confounding by gender and age is contradictory and requires further work. There are indications for safety segregation of men and women, with women being more risk averse than men. Citizenship appears to be a significant confounder. Prior high altitude mountaineering experience in Nepal has no protective effect. Commercial expeditions in the Nepalese Himalayas have a lower mortality than traditional expeditions, though after controlling for confounding, the difference is not statistically significant. The overall mortality is increasing with increasing peak altitude for expedition members but not for high altitude porters. In the Nepalese Himalayas and in Alaska, a significant decrease of mortality with calendar year was observed. A few suggestions for further work are made at the end of the article.
Ntuen, Celestine A; Yoon, S
...: altitude control, heading control, airspeed control, and vertical airspeed control. Overall, results failed to demonstrate enhanced training effectiveness for an immersive VR training environment compared to a desktop (nonimmersive) environment...
Full Text Available In the study, the acute response of the 2000m maximal aerobic test on the biathletes living at different altitudes was analyzed. A total of 67 athletes (Mean age = 14,69 ± 1,22, Mean BMI = 19.60 ± 2.29 consisting of boys and girls represent the sample of the study who were tested during the qualification process of Turkey national team. The athletes divided into two groups. Thirty-two of the athletes living above the altitude of 1500m (considered as the altitude where physiological adaptation occurs coded as the high-altitude group, and thirty-five living below 1500m coded as the low altitude group. A shuttle-run test was applied to measure the aerobic power of the athletes. During the test, the heart rates were monitored continuously. The athletes living above 1500m showed higher VO2max and total lap score in the shuttle-run test compared to the athletes living below 1500m. But this difference was found to be statistically insignificant. The Living altitude – VO2max – Total Laps variables had positive moderate correlation each other (r = 0,363, r = 0,355. As the altitude increases, the endurance score increases. When each stage of the shuttle-run test examined, it was seen that those who live at low altitudes tend to give up the shuttle-run test earlier, although there was no difference in the mean heart rates between groups. Findings showed that the physiological response of the biathletes who had similar training history was influenced by the altitude they live on. In this respect, altitude adaptation in biathletes is thought to affect the score in competitions and national team selections.
Full Text Available The butterfly fauna of the high-altitude desert of Northern Chile, though depauperate, shows high endemism, is poorly known and is of considerable conservation concern. This study surveys butterflies along the Andean slope between 2400 and 500 m asl (prepuna, puna and Andean steppe habitats as well as in high and low altitude wetlands and in the neoriparian vegetation of agricultural sites. We also include historical sightings from museum records. We compare abundances between altitudes, between natural and impacted sites, as well as between two sampling years with different precipitation regimes. The results confirm high altitudinal turnover and show greatest similarity between wetland and slope faunas at similar altitudes. Results also underscore vulnerability to weather fluctuations, particularly in the more arid low-altitude sites, where abundances were much lower in the low precipitation sampling season and several species were not observed at all. Finally, we show that some species have shifted to the neoriparian vegetation of the agricultural landscape, whereas others were only observed in less impacted habitats dominated by native plants. These results suggest that acclimation to novel habitats depends on larval host plant use. The traditional agricultural environment can provide habitat for many, but not all, native butterfly species, but an estimation of the value of these habitats requires better understanding of butterfly life-history strategies and relationships with host plants.
Gnyawali, Subodh; Shrestha, Gauri Shankar; Khanal, Safal; Dennis, Talisa; Spencer, John C
High altitude, often characterized by settings over 2400m, can be detrimental to the human body and pose a significant risk to ocular health. Reports concerning various ocular morbidities occurring as a consequence of high altitude are limited in the current literature. This study was aimed at evaluating the ocular health of porters working at high altitudesof Himalayas in Nepal. A mobile eye clinic was set up in Ghat and patient data were collected from its out- patient unit by a team of seven optometrists which was run for five days. Ghat is a small village in north-eastern Nepal, located at 2860 m altitude. Travellers walking through the trekking route were invited to get their eyes checked at the clinic. Comprehensive ocular examinations were performed, including visual acuities, objective and subjective refraction, anterior and posterior segment evaluations, and intraocular pressure measurements; blood pressure and blood glucose levels were also measured as required. Ocular therapeutics, prescription glasses, sunglasses and ocular health referrals were provided free of cost as necessary. A total of 1890 people visited the eye clinic, among which 57.4% (n=1084) were porters. Almost half of the porters had an ocular morbidity. Correctable refractive error was most prevalent, with other ocular health-related complications, including dry eye disease, infectious disorders, glaucoma and cataract. Proper provision of regular and effective eye care services should be made more available for those residing at these high altitudes in Nepal. © NEPjOPH.
Full Text Available We introduce the altitudes of a triangle (the cevians perpendicular to the opposite sides. Using the generalized Ceva’s Theorem, we prove the existence and uniqueness of the orthocenter of a triangle . Finally, we formalize in Mizar  some formulas  to calculate distance using triangulation.
... action is needed because of changes occurring in the National Airspace System. These changes are designed... matters of flight safety and operational efficiency in the National Airspace System, are related to... RIVER, AK NDB BARTER ISLAND, AK NDB... 2000 From To MEA MAA Sec. 95.3000 Low Altitude RNAV Routes Sec...
Parvaiz A Koul
Full Text Available Background: Annual pilgrimage (Yatra to the cave shrine of Shri Amarnath Ji′ is a holy ritual among the Hindu devotees of Lord Shiva. Located in the Himalayan Mountain Range (altitude 13,000 ft in south Kashmir, the shrine is visited by thousands of devotees and altitude sickness is reportedly common. Materials and Methods: More than 600,000 pilgrims visited the cave shrine in 2011 and 2012 with 239 recorded deaths. Thirty one patients with suspected altitude sickness were referred from medical centers en-route the cave to Sher-i-Kashmir Institute of Medical Sciences, a tertiary-care center in capital Srinagar (5,000 ft. The clinical features and the response to treatment were recorded. Results: Thirty-one patients (all lowlanders, 19 male; age 18-60 years, median 41 had presented with acute onset breathlessness of 1-4 days (median 1.9 d starting within 12-24 h of a rapid ascent; accompanied by cough (68%, headache (8%, dizziness and nausea (65%. Sixteen patients had associated encephalopathy. Clinical features on admission included tachypnea ( n = 31, tachycardia ( n = 23, bilateral chest rales ( n = 29, cyanosis ( n = 22 and grade 2-4 encephalopathy. Hypoxemia was demonstrable in 24 cases and bilateral infiltrates on radiologic imaging in 29. Ten patients had evidence of high-altitude cerebral edema. All patients were managed with oxygen, steroids, nifedipine, sildenafil and other supportive measures including invasive ventilation ( n = 3. Three patients died due to multiorgan dysfunction. Conclusions: Altitude sickness is common among Amaranath Yatris from the plains and appropriate educational strategies should be invoked for prevention and prompt treatment.
Objective: To describe autopsy findings in fatal cases of high altitude pulmonary oedema. Study Design: Descriptive study. Place and Duration of Study: The study was carried out between 1999 and 2002 at an army field medical unit in Baltistan, Armed Forces Institute of Pathology, Rawalpindi and Army Medical College, Rawalpindi, Pakistan. Patients and Methods:Autopsies were performed in 17 fatal cases of High Altitude Pulmonary Edema (HAPE) occurring among soldiers serving in Siachen. Results:All cases were males with a mean age of 26.8 years (19-35). The mean altitude at which HAPE occurred was 5192 meters (2895-6492), and the mean duration of stay at these altitudes was 15.3 days (1-30). Eleven individuals had undergone proper acclimatization. The commonest clinical findings were cough (70%), dyspnoea (53%), nausea (47%), headache (41%), vomiting (35%), chest pain (35%) and tightness in chest (24%). Cyanosis and frothy secretions in the nostrils and mouth were present in all but one case. Mean combined weight of lungs was 1470 grams (1070-1810). There was marked congestion of outer and cut surfaces. Interstitial oedema was present in all cases. RBCs and leukocyte infiltrates were seen in 13 and alveolar hyaline membranes in 9 cases. Thrombi were seen in 2 cases. Cerebral oedema was present in 9 cases. Conclusion:HAPE can occur after more than two weeks of stay at high altitudes despite proper acclimatization. Concomitant cerebral oedema is frequently present. Our autopsy findings are consistent with what has been reported previously. (author)
This study focuses on the need for specialist training for mountain warfare. It analyzes the special characteristics of mountain and high altitude terrain which affect conduct of military operations...
Jacob A. Sinex
Full Text Available Endurance athletic performance is highly related to a number of factors that can be altered through altitude and hypoxic training including increases in erythrocyte volume, maximal aerobic exercise capacity, capillary density, and economy. Physiological adaptations in response to acute and chronic exposure to hypoxic environments are well documented and range from short-term detrimental effects to longer-term adaptations that can improve performance at altitude and in sea-level competitions. Many altitude and hypoxic training protocols have been developed, employing various combinations of living and training at sea-level, low, moderate, and high altitudes and utilizing natural and artificial altitudes, with varying degrees of effectiveness. Several factors have been identified that are associated with individual responses to hypoxic training, and techniques for identifying those athletes most likely to benefit from hypoxic training continue to be investigated. Exposure to sufficiently high altitude (2000–3000 m for more than 12 h/day, while training at lower altitudes, for a minimum of 21 days is recommended. Timing of altitude training related to competition remains under debate, although general recommendations can be considered.
... the certificate holder's approved low-altitude windshear flight training program and in appendix E to... holder's approved low-altitude windshear flight training program that are capable of being performed in... flight training. 121.424 Section 121.424 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION...
Bonne, Thomas Christian; Lundby, Carsten; Jørgensen, Susanne
PURPOSE: This study tested whether 3-4 weeks of classical "Live High-Train High" (LHTH) altitude training increases swim-specific VO2max through increased hemoglobin mass (Hbmass). METHODS: Ten swimmers lived and trained for more than 3 weeks between 2,130 and 3,094 m of altitude, and a control...
... procedures set forth in a certificate holder's approved low-altitude windshear flight training program when... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Training required. 121.433 Section 121.433..., FLAG, AND SUPPLEMENTAL OPERATIONS Crewmember Qualifications § 121.433 Training required. (a) Initial...
National Aeronautics and Space Administration — The CAMEX-4 ER-2 High Altitude Dropsonde dataset was collected by the ER-2 High Altitude Dropsonde System (EHAD), which used dropwinsondes fitted with Global...
Steigleman, Allan; Butler, Frank; Chhoeu, Austin; O'Malley, Timothy; Bower, Eric; Giebner, Stephen
This case report describes a 20-yr-old man who presented with retro-orbital pain and blurred vision in his left eye 3 wk after an altitude exposure in a hypobaric chamber. He was found to have significant deficits in color vision and visual fields consistent with an optic neuropathy in his left eye. The patient was diagnosed with decompression sickness and treated with hyperbaric oxygen with a U.S. Navy Treatment Table VI. All signs and symptoms resolved with a single hyperbaric oxygen treatment but recurred. A head MRI revealed a left frontoethmoid sinus opacity. A concomitant sinusitis was diagnosed. The patient had full resolution of symptoms after a total of four hyperbaric oxygen treatments and antibiotic therapy at 6-wk follow-up. Although a para-infectious etiology for this patient's optic neuropathy cannot be excluded, his history of altitude exposure and significant, rapid response to hyperbaric oxygen treatment strongly implies decompression sickness in this case.
(a) The continuous distribution of current density model reproduces the altitude distribution parameters of EEJ current density very well, (b) the altitude distribution parameters of EEJ current density in India and Peru are not significantly different and (c) The altitude distribution parameters of EEJ current density from rockets ...
Li Lei; Xu Ronglan
Considering the joint effects of diffusion, collision, oxidation and photoionization, the authors study the evolution of the barium cloud at different altitudes in the space plasma active experiment. The results present the variation of the loss rate, number density distribution and brightness of the barium cloud over the range from 120 to 260 km. This can be divided into oxidation, oxidation plus photoionization and photoionization regions
Full Text Available The approach and the objective of this experiment are consistent with the determination of changes of blood parameters after the stay of the students at an altitude of 1800-2300 meters, for a ten-day long ski course. In this paper are included a total of 64 students of the Faculty of Sport Sciences in Prishtina, of the age group of 19-25 (the average age is 21. All students previously have undergone a medical check for TA, arterial pulse and respiratory rate. In particular, the health situation is of subjects was examined, then, all students, at the same time, gave blood for analysis. In this experiment, three main hematologic parameters were taken in consideration: such as hemoglobin, hematocrit and red blood cells. The same analyses were carried out after the 10-day stay at a high altitude. The results of the experiment have shown significant changes after the ten-day stay at high altitude, despite the previous results that show changes only after the twenty-day stay in such elevations.
Nakamura, T.; Uwamino, Y.; Ohkubo, T.; Hara, A.
The altitude variation of the cosmic-ray neutron energy spectrum and the dose equivalent rate was measured at an average geomagnetic latitude of 24 degrees N by using the high-efficiency multi-sphere neutron spectrometer and neutron dose-equivalent counter developed by the authors. The data were obtained from a 2-h flight over Japan on 27 February 1985. The neutron energy spectra measured at sea level and at altitudes of 4880 m and at 11,280 m were compared with the calculated spectra of O'Brien and with other experimental spectra, and they are in moderately good agreement with them. The dose equivalent rate increases according to a quadratic curve up to about 6000 m and then increases linearly between 6000 m and 11,280 m. The dependence of dose equivalent rates at sea level and at an altitude of 12,500 m on geomagnetic latitude also is given by referring to other experimental results
The traditional operator job is changing, which among other things has generated a need for better job training. Surprisingly increased process automation has lead to increased operator qualifications, i.e. basic job training but also up-date and rehearsal training within certain fixed intervals. There are several, similar models for instructional system development available in the literature. One model which is of special interest integrates Operator Training development and Man-Machine Interfaces development. The extent to which Systematic Operator Training has been implemented varies with branches and companies. The nuclear power branch is given as an example in the report. This branch probably represents something better than the average among the process industries.(author)
Savely, Robert T.; Loftin, R. Bowen
Training is a major endeavor in all modern societies. Common training methods include training manuals, formal classes, procedural computer programs, simulations, and on-the-job training. NASA's training approach has focussed primarily on on-the-job training in a simulation environment for both crew and ground based personnel. NASA must explore new approaches to training for the 1990's and beyond. Specific autonomous training systems are described which are based on artificial intelligence technology for use by NASA astronauts, flight controllers, and ground based support personnel that show an alternative to current training systems. In addition to these specific systems, the evolution of a general architecture for autonomous intelligent training systems that integrates many of the features of traditional training programs with artificial intelligence techniques is presented. These Intelligent Computer Aided Training (ICAT) systems would provide much of the same experience that could be gained from the best on-the-job training.
Full Text Available Training at moderate altitude (~1800m is often used by athletes to stimulate muscle hypoxia. However, limited date is available on peripheral muscle oxidative metabolism at this altitude (1800AL. The purpose of this study was to determine whether acute exposure to 1800AL alters muscle oxygenation in the vastus lateralis muscle during resistance exercise. Twenty young active male subjects (aged 16 - 21 yr performed up to 50 repetitions of the parallel squat at 1800AL and near sea level (SL. They performed the exercise protocol within 3 h after arrival at 1800 AL. During the exercise, the changes in oxygenated hemoglobin (OxyHb in the vastus lateralis muscle, arterial oxygen saturation (SpO2, and heart rate were measured using near infrared continuous wave spectroscopy (NIRcws and pulse oximetry, respectively. Changes in OxyHb were expressed by Deff defined as the relative index of the maximum change ratio (% from the resting level. OxyHb in the vastus lateralis muscle decreased dramatically from the resting level immediately after the start of exercise at both altitudes. The Deff during exercise was significantly (p < 0.001 lower at 1800AL (60.4 ± 6.2 % than at near SL (74.4 ± 7.6 %. SpO2 during exercise was significantly (p < 0.001 lower at 1800AL (92.0 ± 1.7 % than at near SL (96.7 ± 1.2 %. Differences (SL - 1800AL in Deff during exercise correlated fairly strongly with differences in SpO2 during exercise (r = 0.660. These results suggested that acute exposure to moderate altitude caused a more dramatical decrease in peripheral muscle oxygenation during leg resistance exercise. It is salient to note, therefore , that peripheral muscle oxygenation status at moderate altitude could be evaluated using NIRcws and that moderate altitudes might be effectively used to apply hypoxic stress on peripheral muscles.
Küpper, Thomas E A H; Schöffl, Volker
Since hypoxic chambers are more and more available, they are used for preacclimatization to prepare for sojourns at high altitude. Since there are different protocols and the data differ, there is no general consensus about the standard how to perform preacclimatization by simulated altitude. The paper reviews the different types of exposure and focuses on the target groups which may benefit from preacclimatization. Since data about intermittent hypoxia for some hours per day to reduce the incidence of acute mountain sickness differ, it is suggested to perform preacclimatization by sleeping some nights at a simulated altitude which follows the altitude profile of the "gold standard" for high altitude acclimatization.
Andrew T. Taylor
Full Text Available High-altitude illnesses encompass the pulmonary and cerebral syndromes that occur in non-acclimatized individuals after rapid ascent to high altitude. The most common syndrome is acute mountain sickness (AMS which usually begins within a few hours of ascent and typically consists of headache variably accompanied by loss of appetite, nausea, vomiting, disturbed sleep, fatigue, and dizziness. With millions of travelers journeying to high altitudes every year and sleeping above 2,500 m, acute mountain sickness is a wide-spread clinical condition. Risk factors include home elevation, maximum altitude, sleeping altitude, rate of ascent, latitude, age, gender, physical condition, intensity of exercise, pre-acclimatization, genetic make-up, and pre-existing diseases. At higher altitudes, sleep disturbances may become more profound, mental performance is impaired, and weight loss may occur. If ascent is rapid, acetazolamide can reduce the risk of developing AMS, although a number of high-altitude travelers taking acetazolamide will still develop symptoms. Ibuprofen can be effective for headache. Symptoms can be rapidly relieved by descent, and descent is mandatory, if at all possible, for the management of the potentially fatal syndromes of high-altitude pulmonary and cerebral edema. The purpose of this review is to combine a discussion of specific risk factors, prevention, and treatment options with a summary of the basic physiologic responses to the hypoxia of altitude to provide a context for managing high-altitude illnesses and advising the non-acclimatized high-altitude traveler.
Hasim Rushiti; Florian Miftari; Besim Halilaj
The approach and the objective of this experiment are consistent with the determination of changes of blood parameters after the stay of the students at an altitude of 1800-2300 meters, for a ten-day long ski course. In this paper are included a total of 64 students of the Faculty of Sport Sciences in Prishtina, of the age group of 19-25 (the average age is 21). All students previously have undergone a medical check for TA, arterial pulse and respiratory rate. In particular, the health situat...
Introduction. One of the strategies Ministries of Health and their partners have adopted with the aim of promoting safe motherhood since the 1980's is training unskilled traditional birth attendants (TBAs). However, the assumption that training of traditional birth attendants (TBAs) would contribute greatly to reduce maternal ...
Sun, Peiyu; Yuan, Ke'e.; Yang, Jie; Hu, Shunxing
The aerosols near the ground are closely related to human health and climate change, the study on which has important significance. As we all know, the aerosol is inhomogeneous at different altitudes, of which the phase function is also different. In order to simplify the retrieval algorithm, it is usually assumed that the aerosol is uniform at different altitudes, which will bring measurement error. In this work, an experimental approach is demonstrated to measure the scattering phase function of atmospheric aerosol particles at different heights by CCD lidar system, which could solve the problem of the traditional CCD lidar system in assumption of phase function. The phase functions obtained by the new experimental approach are used to retrieve the aerosol extinction coefficient profiles. By comparison of the aerosol extinction coefficient retrieved by Mie-scattering aerosol lidar and CCD lidar at night, the reliability of new experimental approach is verified.
Pei, Xiaohui; He, Boshu; Ling, Ling; Wang, Lei [Beijing Jiaotong Univ., Beijing (China). Inst. of Mechanical, Electronic and Control Engineering
A drop-tube Furnace simulation model has been developed to investigate the pulverized coal combustion characteristics under different altitudes using the commercially available software Fluent. The altitude conditions of 0, 500, 1,000, 1,500 m have been discussed. The results included the fields of temperature, pressure, velocity, the coal burnout, CO burnout and NO emission in the tube furnace. The variation of these parameters with altitude has been analyzed. The coal combustion characteristics were affected by the altitude. The time and space for coal burnout should be increased with the rise of altitude. The valuable results could be referenced in the design of coal- fired furnaces for the high altitude areas.
A Lunar Landing Training Vehicle, piloted by Astronaut Neil Armstrong, goes through a checkout flight at Ellington Air Force Base on June 16, 1969. The total duration of the lunar simulation flight was five minutes and 59 seconds. Maximum altitude attained was about 300 feet.
Gonzales, Gustavo F.; Jefe de la Unidad de Reproducción, Instituto de Investigaciones de la Altura y Jefe del Laboratorio de Endocrinología y Reproducción, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia. Doctor en Medicina y Doctor en Ciencias. Especialista en Endocrinología.
The different types of response mechanisms that the organism uses when exposed to hypoxia include accommodation, acclimatization and adaptation. Accommodation is the initial response to acute exposure to high altitude hypoxia and is characterized by an increase in ventilation and heart rate. Acclimatization is observed in individuals temporarily exposed to high altitude, and to some extent, it enables them to tolerate the high altitudes. In this phase, erythropoiesis is increased, resulti...
Hüfner, Katharina; Brugger, Hermann; Kuster, Eva; Dünsser, Franziska; Stawinoga, Agnieszka E; Turner, Rachel; Tomazin, Iztok; Sperner-Unterweger, Barbara
Psychotic episodes during exposure to very high or extreme altitude have been frequently reported in mountain literature, but not systematically analysed and acknowledged as a distinct clinical entity. Episodes reported above 3500 m altitude with possible psychosis were collected from the lay literature and provide the basis for this observational study. Dimensional criteria of the Diagnostic and Statistical Manual of Mental Disorders were used for psychosis, and the Lake Louise Scoring criteria for acute mountain sickness and high-altitude cerebral oedema (HACE). Eighty-three of the episodes collected underwent a cluster analysis to identify similar groups. Ratings were done by two independent, trained researchers (κ values 0.6-1). Findings Cluster 1 included 51% (42/83) episodes without psychosis; cluster 2 22% (18/83) cases with psychosis, plus symptoms of HACE or mental status change from other origins; and cluster 3 28% (23/83) episodes with isolated psychosis. Possible risk factors of psychosis and associated somatic symptoms were analysed between the three clusters and revealed differences regarding the factors 'starvation' (χ2 test, p = 0.002), 'frostbite' (p = 0.024) and 'supplemental oxygen' (p = 0.046). Episodes with psychosis were reversible but associated with near accidents and accidents (p = 0.007, odds ratio 4.44). Episodes of psychosis during exposure to high altitude are frequently reported, but have not been specifically examined or assigned to medical diagnoses. In addition to the risk of suffering from somatic mountain illnesses, climbers and workers at high altitude should be aware of the potential occurrence of psychotic episodes, the associated risks and respective coping strategies.
National Aeronautics and Space Administration — Aurora Flight Sciences proposes to incorporate aspirated compressor technology into a high altitude, long endurance (HALE) concept engine. Aspiration has been proven...
Kamide, Y.; Brekke, A.
On the basis of updated EISCAT experiments, the first full derivation of the ionospheric current density of the auroral electrojets at six different altitudes are presented. It is found that current vectors at different altitudes are quite different, although the eastward and westward currents prevail in the evening and morning sectors, respectively, once the currents are integrated over altitude. The eastward electrojet becomes almost northward whilst the westward electrojet becomes almost southward, at the highest altitude, 125 km, in this study. The physical implications of these characteristics are discussed
Larsen, J J; Hansen, J M; Olsen, Niels Vidiendal
1. Exposure to altitude hypoxia elicits changes in glucose homeostasis with increases in glucose and insulin concentrations within the first few days at altitude. Both increased and unchanged hepatic glucose production (HGP) have previously been reported in response to acute altitude hypoxia...... (noradrenaline and adrenaline) and day 7 (adrenaline), but not at sea level. 4. In conclusion, insulin action decreases markedly in response to two days of altitude hypoxia, but improves with more prolonged exposure. HGP is always unchanged. The changes in insulin action may in part be explained by the changes...
The unique combination of thin air, freezing temperatures, and mountainous terrain that forms the high altitude environment has resisted advances in military technology for centuries, The emergence...
Nuclear power plant simulators have become the most important tool in training nuclear power plant operators. Yet, as these machines continue to become even more sophisticated, highly trained and experienced instructors with unique skills and insights are still essential in order to achieve effective and meaningful training. The making of a qualified simulator instructor involves training and techniques that exceed the traditional programs required of a Senior Reactor Operator (SRO). This paper discusses (i) the training necessary to produce a competent simulator instructor; and (ii) the continuing task of maintaining his or her proficiency. (author)
Hughes, Benjamin H; Brinton, John T; Ingram, David G; Halbower, Ann C
Sleep-disordered breathing (SDB) is prevalent among children and is associated with adverse health outcomes. Worldwide, approximately 250 million individuals reside at altitudes higher than 2000 meters above sea level (masl). The effect of chronic high-altitude exposure on children with SDB is unknown. This study aims to determine the impact of altitude on sleep study outcomes in children with SDB dwelling at high altitude. A single-center crossover study was performed to compare results of high-altitude home polysomnography (H-PSG) with lower altitude laboratory polysomnography (L-PSG) in school-age children dwelling at high altitude with symptoms consistent with SDB. The primary outcome was apnea-hypopnea index (AHI), with secondary outcomes including obstructive AHI; central AHI; and measures of oxygenation, sleep quality, and pulse rate. Twelve participants were enrolled, with 10 included in the final analysis. Median altitude was 1644 masl on L-PSG and 2531 masl on H-PSG. Median AHI was 2.40 on L-PSG and 10.95 on H-PSG. Both obstructive and central respiratory events accounted for the difference in AHI. Oxygenation and sleep fragmentation were worse and pulse rate higher on H-PSG compared to L-PSG. These findings reveal a clinically substantial impact of altitude on respiratory, sleep, and cardiovascular outcomes in children with SDB who dwell at high altitude. Within this population, L-PSG underestimates obstructive sleep apnea and central sleep apnea compared to H-PSG. Given the shortage of high-altitude pediatric sleep laboratories, these results suggest a role for home sleep apnea testing for children residing at high altitude. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail email@example.com.
Full Text Available Survival at high altitude is very challenging and in spite of adequate training and acclimatization, injuries are frequent. The fate of mountaineers and soldiers at such areas largely depends on the mercy of the climate. An avalanche causes physical trauma, cold injury and asphyxia to the victim. The patient in our report had diffuse cerebral edema, bilateral pulmonary consolidation and pneumothorax. In spite of the best efforts the victim succumbed to the injuries. There are many incidents of high altitude accidents in India. This case report is of a soldier deployed at the high altitude, is a lone ever reported survivor above 5000 meters, under 35 feet snow and below - 45°C for greater than 5 days of exposure to an avalanche
Des Jardins, A. C.
Three years ago we envisioned tapping into the strength of the National Space Grant Program to make the most of a rare astronomical event to engage the general public through education and to create meaningful long-lasting partnerships with other private and public entities. We believe strongly in giving student participants career-making opportunities through the use of the most cutting edge tools, resources, and communication. The NASA Space Grant network was in a unique position to engage the public in the eclipse in an awe-inspiring and educational way at a surprisingly small cost. In addition to public engagement, the multidisciplinary project presented an in-depth hands-on learning opportunity for the thousands of student participants. The project used a network of high altitude ballooning teams positioned along the path of totality from Oregon to South Carolina to conduct coordinated collaborative activities during the eclipse. These activities included 1) capturing and streaming live video of the eclipse from near space, 2) partnering with NASA Ames on a space biology experiment, and 3) conducting high-resolution atmospheric radiosonde measurements. This presentation will summarize the challenges, results, lessons learned, and professional evaluation from developing, training, and coordinating the collaboration. Details of the live streaming HD video and radiosonde activities are described in separate submissions to this session.
Full Text Available Tuberculosis infection, disease and mortality are all less common at high than low altitude and ascent to high altitude was historically recommended for treatment. The immunological and mycobacterial mechanisms underlying the association between altitude and tuberculosis are unclear. We studied the effects of altitude on mycobacteria and antimycobacterial immunity.Antimycobacterial immunity was assayed in 15 healthy adults residing at low altitude before and after they ascended to 3400 meters; and in 47 long-term high-altitude residents. Antimycobacterial immunity was assessed as the extent to which participants' whole blood supported or restricted growth of genetically modified luminescent Bacille Calmette-Guérin (BCG mycobacteria during 96 hours incubation. We developed a simplified whole blood assay that could be used by a technician in a low-technology setting. We used this to compare mycobacterial growth in participants' whole blood versus positive-control culture broth and versus negative-control plasma.Measurements of mycobacterial luminescence predicted the number of mycobacterial colonies cultured six weeks later. At low altitude, mycobacteria grew in blood at similar rates to positive-control culture broth whereas ascent to high altitude was associated with restriction (p ≤ 0.002 of mycobacterial growth to be 4-times less than in culture broth. At low altitude, mycobacteria grew in blood 25-times more than negative-control plasma whereas ascent to high altitude was associated with restriction (p ≤ 0.01 of mycobacterial growth to be only 6-times more than in plasma. There was no evidence of differences in antimycobacterial immunity at high altitude between people who had recently ascended to high altitude versus long-term high-altitude residents.An assay of luminescent mycobacterial growth in whole blood was adapted and found to be feasible in low-resource settings. This demonstrated that ascent to or residence at high altitude was
While developing a commercial training program to improve teamwork in control room crews, General Electric's Nuclear Training Services made an important discovery. Traditional training methods for developing teamwork and enhancing diagnostics capabilities are incomplete. Traditional methods generally help, but fail to fulfill the long-term needs of most teams. Teamwork has been treated as a short-term performance problem. Traditional diagnostic training suffers from a similar problem. Too often, it covers only the basic principles of decision-making, ignoring the development of expert diagnostic capabilities. In response to this discovery, they have developed comprehensive training in Team Building and Diagnostics
de Mol, Pieter; Krabbe, Hans G.; de Vries, Suzanna T.; Fokkert, Marion J.; Dikkeschei, Bert D.; Rienks, Rienk; Bilo, Karin M.; Bilo, Henk J. G.
Background: Due to increasing numbers of people with diabetes taking part in extreme sports (e. g., high-altitude trekking), reliable handheld blood glucose meters (BGMs) are necessary. Accurate blood glucose measurement under extreme conditions is paramount for safe recreation at altitude. Prior
Windsor, A Morgan, Jr.
The changing altitude of the Sun (either over the course of a day or longer periods) is a phenomenon that students do not normally appreciate. However, the altitude of the Sun affects many topics in disciplines as diverse as astronomy, meteorology, navigation, or horology, such as the basis for seasons, determination of latitude and longitude, or…
Gonzales, Gustavo F
The different types of response mechanisms that the organism uses when exposed to hypoxia include accommodation, acclimatization and adaptation. Accommodation is the initial response to acute exposure to high altitude hypoxia and is characterized by an increase in ventilation and heart rate. Acclimatization is observed in individuals temporarily exposed to high altitude, and to some extent, it enables them to tolerate the high altitudes. In this phase, erythropoiesis is increased, resulting in higher hemoglobin and hematocrit levels to improve oxygen delivery capacity. Adaptation is the process of natural acclimatization where genetical variations and acclimatization play a role in allowing subjects to live without any difficulties at high altitudes. Testosterone is a hormone that regulates erythropoiesis and ventilation and could be associated to the processes of acclimatization and adaptation to high altitude. Excessive erythrocytosis, which leads to chronic mountain sickness, is caused by low arterial oxygen saturation, ventilatory inefficiency and reduced ventilatory response to hypoxia. Testosterone increases during acute exposure to high altitude and also in natives at high altitude with excessive erythrocytosis. Results of current research allow us to conclude that increase in serum testosterone and hemoglobin is adequate for acclimatization, as they improve oxygen transport, but not for high altitude adaptation, since high serum testosterone levels are associated to excessive erythrocytosis.
Poessel, Sharon; Duerr, Adam E.; Hall, Jonathan C.; Braham, Melissa A.; Katzner, Todd
Altitude measurements from wildlife tracking devices, combined with elevation data, are commonly used to estimate the flight altitude of volant animals. However, these data often include measurement error. Understanding this error may improve estimation of flight altitude and benefit applied ecology.There are a number of different approaches that have been used to address this measurement error. These include filtering based on GPS data, filtering based on behaviour of the study species, and use of state-space models to correct measurement error. The effectiveness of these approaches is highly variable.Recent studies have based inference of flight altitude on misunderstandings about avian natural history and technical or analytical tools. In this Commentary, we discuss these misunderstandings and suggest alternative strategies both to resolve some of these issues and to improve estimation of flight altitude. These strategies also can be applied to other measures derived from telemetry data.Synthesis and applications. Our Commentary is intended to clarify and improve upon some of the assumptions made when estimating flight altitude and, more broadly, when using GPS telemetry data. We also suggest best practices for identifying flight behaviour, addressing GPS error, and using flight altitudes to estimate collision risk with anthropogenic structures. Addressing the issues we describe would help improve estimates of flight altitude and advance understanding of the treatment of error in wildlife telemetry studies.
Soleilhavoup, J.P.; Croute, F.; Tixador, R.; Blanquet, Y.; Planel, H.
Paramecia cultures placed at 3800 meter altitude show a proliferating activity acceleration compared to control cultures placed at low altitude under the same environment conditions. These results confirm the cosmic irradiation influence upon the activating effect produced by the natural ionizing radiations on living organisms [fr
Daanen, H.A.M.; Ruiten, H.J.A. van
A significant reduction in cold-induced vasodilation (CIVD) is observed at high altitudes. No agreement is found in the literature about acclimatization effects on CIVD. Two studies were performed to investigate the effect of altitude acclimatization on CIVD. In the first study 13 male subjects
Lassen, N A
but rather somewhat sharpened over five days at almost 4000 meters of altitude. This, along with other evidence, shows that CBF does not in itself adapt to chronic hypoxia. Nevertheless, a decrease in CBF is seen over days at constant altitude primarily due to increase in the hematocrit. The cerebral...
Schuler, B; Thomsen, JJ; Gassmann, M
This study tested the hypothesis that maximal oxygen uptake (VO2max) and performance increase upon altitude acclimatization at moderate altitude. Eight elite cyclists were studied at sea level, and after 1 (Day 1), 7 (Day 7), 14 (Day 14) and 21 (Day 21) days of exposure to 2340 m. Capillary blood...
Calbet, J.A.; Lundby, C.
, diffusion limitation explains most of the additional Pao2-Pao2. With altitude, acclimatization exercise (Pao2-Pao2) is reduced, but does not reach the low values observed in high altitude natives, who possess an exceptionally high DLo2. Convective O2 transport depends on arterial O2 content (Cao2), cardiac...
Gutwenger, Ivana; Hofer, Georg; Gutwenger, Anna K; Sandri, Marco; Wiedermann, Christian J
Hypoxic and hypobaric conditions may augment the beneficial influence of training on cardiovascular risk factors. This pilot study aimed to explore for effects of a two-week hiking vacation at moderate versus low altitude on adipokines and parameters of carbohydrate and lipid metabolism in patients with metabolic syndrome. Fourteen subjects (mean age: 55.8 years, range: 39 - 69) with metabolic syndrome participated in a 2-week structured training program (3 hours of guided daily hiking 4 times a week, training intensity at 55-65% of individual maximal heart rate; total training time, 24 hours). Participants were divided for residence and training into two groups, one at moderate altitude (1,900 m; n = 8), and the other at low altitude (300 m; n = 6). Anthropometric, cardiovascular and metabolic parameters were measured before and after the training period. In study participants, training overall reduced circulating levels of total cholesterol (p = 0.024), low-density lipoprotein cholesterol (p = 0.025) and adiponectin (p triglycerides (p = 0.025) and leptin (p = 0.015), whereas in the low altitude group (n = 6), none of the lipid parameters was significantly changed (each p > 0.05). Hiking-induced relative changes of triglyceride levels were positively associated with reductions in leptin levels (p = 0.006). As compared to 300 m altitude, training at 1,900 m showed borderline significant differences in the pre-post mean reduction rates of triglyceride (p = 0.050) and leptin levels (p = 0.093). Preliminary data on patients with metabolic syndrome suggest that a 2-week hiking vacation at moderate altitude may be more beneficial for adipokines and parameters of lipid metabolism than training at low altitude. In order to draw firm conclusions regarding better corrections of dyslipidemia and metabolic syndrome by physical exercise under mild hypobaric and hypoxic conditions, a sufficiently powered randomized clinical trial appears warranted. ClinicalTrials.gov ID NCT
Full Text Available Previous studies reported enhanced cerebrovascular CO2 reactivity upon ascent to high altitude using linear models. However, there is evidence that this response may be sigmoidal in nature. Moreover, it was speculated that these changes at high altitude are mediated by alterations in acid-base buffering. Accordingly, we reanalyzed previously published data to assess middle cerebral blood flow velocity (MCAv responses to modified rebreathing at sea level (SL, upon ascent (ALT1 and following 16 days of acclimatization (ALT16 to 5,260 m in 21 lowlanders. Using sigmoid curve fitting of the MCAv responses to CO2, we found the amplitude (95% vs. 129%, SL vs. ALT1, 95% confidence intervals (CI [77, 112], [111, 145], respectively, P=0.024 and the slope of the sigmoid response (4.5 vs. 7.5 %/mmHg, SL vs. ALT1, 95% CIs [3.1, 5.9], [6.0, 9.0], respectively, P=0.026 to be enhanced at ALT1, which persisted with acclimatization at ALT16 (amplitude: 177%, 95% CI [139, 215], P<0.001; slope: 10.3 %/mmHg, 95% CI [8.2, 12.5], P=0.003 compared to SL. Meanwhile, the sigmoidal response midpoint was unchanged at ALT1 (SL: 36.5 mmHg; ALT1: 35.4 mmHg, 95% CIs [34.0, 39.0], [33.1, 37.7], respectively, P=0.982, while it was reduced by ~7 mmHg at ALT16 (28.6 mmHg, 95% CI [26.4, 30.8], P=0.001 vs. SL, indicating leftward shift of the cerebrovascular CO2 response to a lower arterial partial pressure of CO2 (PaCO2 following acclimatization to altitude. Sigmoid fitting revealed a leftward shift in the midpoint of the cerebrovascular response curve which could not be observed with linear fitting. These findings demonstrate that there is resetting of the cerebrovascular CO2 reactivity operating point to a lower PaCO2 following acclimatization to high altitude. This cerebrovascular resetting is likely the result of an altered acid-base buffer status resulting from prolonged exposure to the severe hypocapnia associated with ventilatory acclimatization to high altitude.
Currently deployed unmanned rotorcraft rely on preplanned missions or teleoperation and do not actively incorporate information about obstacles, landing sites, wind, position uncertainty, and other aerial vehicles during online motion planning. Prior work has successfully addressed some tasks such as obstacle avoidance at slow speeds, or landing at known to be good locations. However, to enable autonomous missions in cluttered environments, the vehicle has to react quickly to previously unknown obstacles, respond to changing environmental conditions, and find unknown landing sites. We consider the problem of enabling autonomous operation at low-altitude with contributions to four problems. First we address the problem of fast obstacle avoidance for a small aerial vehicle and present results from over a 1000 rims at speeds up to 10 m/s. Fast response is achieved through a reactive algorithm whose response is learned based on observing a pilot. Second, we show an algorithm to update the obstacle cost expansion for path planning quickly and demonstrate it on a micro aerial vehicle, and an autonomous helicopter avoiding obstacles. Next, we examine the mission of finding a place to land near a ground goal. Good landing sites need to be detected and found and the final touch down goal is unknown. To detect the landing sites we convey a model based algorithm for landing sites that incorporates many helicopter relevant constraints such as landing sites, approach, abort, and ground paths in 3D range data. The landing site evaluation algorithm uses a patch-based coarse evaluation for slope and roughness, and a fine evaluation that fits a 3D model of the helicopter and landing gear to calculate a goodness measure. The data are evaluated in real-time to enable the helicopter to decide on a place to land. We show results from urban, vegetated, and desert environments, and demonstrate the first autonomous helicopter that selects its own landing sites. We present a generalized
ZHU, YP; WOERDENBAG, HJ
Herbal medicine, acupuncture and moxibustion, and massage and the three major constituent parts of traditional Chinese medicine. Although acupuncture is well known in many Western countries, Chinese herbal medicine, the mos important part of traditional Chinese medicine, is less well known in the
Jorissen, A.J.M.; Hamer, den J.; Leijten, A.J.M.; Salenikovich, A.
Due to new possibilities traditional timber framing has become increasingly popular since the beginning of the 21e century. Although traditional timber framing has been used for centuries, the expected mechanical behaviour is not dealt with in great detail in building codes, guidelines or text
Gaurav Sikri, AB Srinivasa
Full Text Available We read with profound interest the article titled ‘Increased hypoxic dose after training at low altitude with 9h per night at 3000m normobaric hypoxia’ by Carr et al. (2015. Authors have concluded that low altitude (1380 m combined with normobaric hypoxia of 3000 m improves total haemoglobin mass (Hbmass and is an effective alternate method for training. Like other studies on elite athletes, the authors of present work have brought out that a major limitation was non-availability of a control group consisting of subjects undertaking same supervised training at normoxia. The total number of ‘possible’ subjects for control group which were taken from a previous study (Saunders et al., 2010 was 11 i.e placebo group (n = 6; 3 male and 3 female and Nocebo group (n = 5; 3 female and 2 male. It seems likely that authors of the present study have chosen only 10 subjects out of those 11. The criteria for exclusion of one subject and selection of 10 out of 11 subjects from the previous study to form the control group of the present study may require further elaboration.
... Training Requirements The maneuvers and procedures required by § 121.424 of this part for pilot initial, transition, and upgrade flight training are set forth in the certificate holder's approved low-altitude... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Flight Training Requirements E Appendix E...
Tobiska, W. K.
The Automated Radiation Measurements for Aerospace Safety (ARMAS) project captures absorbed dose in Si with a fleet of 6 instruments on research aircraft. These dose rates are then converted to an effective dose rate. Over 325 flights since 2013 have captured global radiation at nearly all altitudes and latitudes. The radiation is predominantly caused by atmospheric neutrons and protons from galactic cosmic rays (GCRs). We have not yet obtained dose from solar energetic particle (SEP) events, which are rather rare. On 13 flights we have also measured dose rates that are up to twice the GCR background for approximately a half an hour per event while flying at higher magnetic latitudes near 60 degrees. The timing of the radiation appears to be coincident with periods of mild geomagnetic disturbances while flying above 10 km at L-shells of 3 to 6. The radiation source is best modeled as secondary gamma-ray photons caused by precipitating ultra-relativistic electrons from the outer Van Allen radiation belt originating as loss cone electrons scattered by electromagnetic ion cyclotron (EMIC) waves. We describe the observations and the lines of evidence for this intriguing new radiation source relevant to aviation crew and frequent flyers.
Human muscle operates along a continuum of power output, which is set through bioenergetic and anatomical principles. In turn, environmental and intrinsic factors during contractile work exert pronounced control over muscle performance by instructing muscle remodelling. This phenotypic control is specifically indicated with intense exercise at altitude, when extra strain is put on energy supply and the temperature-dependent mechanical efficiency of contraction. While it is classically thought that chronic exposure to hypoxia is maladaptive, repeated short episodes of reduced oxygenation alone or in combination with intense endurance work is now understood to preserve exercise performance when atmospheric oxygen levels are low. Endurance training at moderate altitude exploits the temperature-dependent malleability of energy supply that may maximize metabolic flux at altitude. The contribution of genomic mechanisms is important to the plasticity of metabolic pathways in exercised muscle. This is highlighted by the association of distinct gene polymorphisms in master governors of mitochondrial and vascular growth with exercise phenotypes. Feedforward control of human locomoter muscle by exercise involves the transient upregulation of transcript expression for metabolic processes. The response of the mitochondrial transcriptome to intense exercise is graded with respect to mitochondrial content and deoxygenation during muscle work and reflects exercise-induced mitochondrial biogenesis. This supports the notion that genome-mediated muscle malleability is under feedback control by design constraints of the pathway of oxygen. Thus, activity-dependent and genetic mechanisms contribute to the interindividual difference in the metabolic bottlenecks in athletes performing in exceptional environmental conditions.
Eduardo Borba Neves
Full Text Available The aim of this study was to investigate the Correlations between the Simulated Military Tasks Performance and Physical Fitness Tests at high altitude. This research is part of a project to modernize the physical fitness test of the Colombian Army. Data collection was performed at the 13th Battalion of Instruction and Training, located 30km south of Bogota D.C., with a temperature range from 1ºC to 23ºC during the study period, and at 3100m above sea level. The sample was composed by 60 volunteers from three different platoons. The volunteers start the data collection protocol after 2 weeks of acclimation at this altitude. The main results were the identification of a high positive correlation between the 3 Assault wall in succession and the Simulated Military Tasks performance (r = 0.764, p<0.001, and a moderate negative correlation between pull-ups and the Simulated Military Tasks performance (r = -0.535, p<0.001. It can be recommended the use of the 20-consecutive overtaking of the 3 Assault wall in succession as a good way to estimate the performance in operational tasks which involve: assault walls, network of wires, military Climbing Nets, Tarzan jump among others, at high altitude.
Voss, H. D.; Dailey, J. F.; Takehara, D.; Krueger, J. M.
Over a seven-year period Taylor University, an undergraduate liberal art school, has successfully launched and recovered over 200 sophisticated student payloads to altitudes between 20-33 km (100% success with rapid recovery) with flight times between 2 to 6 hrs. All of the payloads included two GPS tracking systems, cameras and monitors, a 110 kbit down link, an uplink command capability for educational experiments (K-12 and undergrad). Launches were conducted during the day and night, with multiple balloons, with up to 10 payloads for experiments, and under varying weather and upper atmospheric conditions. The many launches in a short period of time allowed the payload bus design to evolve toward increased performance, reliability, standardization, simplicity, and modularity for low-cost launch services. Through NSF and NASA grants, the program has expanded leading to over 50 universities trained at workshops to implement high altitude balloon launches in the classroom. A spin-off company (StraoStar Systems LLC) now sells the high-altitude balloon system and facilitates networking between schools. This high-altitude balloon program helps to advance knowledge and understanding across disciplines by giving students and faculty rapid and low-cost access to earth/ecology remote sensing from high altitude, insitu and limb atmospheric measurements, near-space stratosphere measurements, and IR/UV/cosmic ray access to the heavens. This new capability is possible by exposing students to recent advances in MEMS technology, nanotechnology, wireless telecommunication systems, GPS, DSPs and other microchip miniaturizations to build collaboration among science faculty, and provides quantitative assessment of the learning outcomes. Furthermore this program has generated many front page news reports along with significant TV coverage because of its connection to hands-on learning for students and adults of all ages, connection to understanding climate change and ways to mitigate
Full Text Available ′Omics′ developments in the form of genomics, proteomics and metabolomics have increased the impetus of traditional medicine research. Studies exploring the genomic, proteomic and metabolomic basis of human constitutional types based on Ayurveda and other systems of oriental medicine are becoming popular. Such studies remain important to developing better understanding of human variations and individual differences. Countries like India, Korea, China and Japan are investing in research on evidence-based traditional medicines and scientific validation of fundamental principles. This review provides an account of studies addressing relationships between traditional medicine and genomics.
Joshi, Kalpana; Ghodke, Yogita; Shintre, Pooja
'Omics' developments in the form of genomics, proteomics and metabolomics have increased the impetus of traditional medicine research. Studies exploring the genomic, proteomic and metabolomic basis of human constitutional types based on Ayurveda and other systems of oriental medicine are becoming popular. Such studies remain important to developing better understanding of human variations and individual differences. Countries like India, Korea, China and Japan are investing in research on evidence-based traditional medicines and scientific validation of fundamental principles. This review provides an account of studies addressing relationships between traditional medicine and genomics.
Sarah B Clarke
Full Text Available Postural control and joint position sense are essential for safely undertaking leisure and professional activities, particularly at high altitude. We tested whether exposure to a 12-day trek with a gradual ascent to high altitude impairs postural control and joint position sense. This was a repeated measures observational study of 12 military service personnel (28±4 years. Postural control (sway velocity measured by a portable force platform during standing balance, a Sharpened Romberg Test and knee joint position sense were measured, in England (113m elevation and at 3 research camps (3619m, 4600m and 5140m on a 12-day high altitude trek in the Dhaulagiri region of Nepal. Pulse oximetry, and Lake Louise scores were also recorded on the morning and evening of each trek day. Data were compared between altitudes and relationships between pulse oximetry, Lake Louise score, and sway velocity were explored. Total sway velocity during standing balance with eyes open (p = 0.003, d = 1.9 and during Sharpened Romberg test with eyes open (p = 0.007, d = 1.6 was significantly greater at altitudes of 3619m and 5140m when compared with sea level. Anterior-posterior sway velocity during standing balance with eyes open was also significantly greater at altitudes of 3619m and 5140m when compared with sea level (p = 0.001, d = 1.9. Knee joint position sense was not altered at higher altitudes. There were no significant correlations between Lake Louise scores, pulse oximetry and postural sway. Despite a gradual ascent profile, exposure to 3619 m was associated with impairments in postural control without impairment in knee joint position sense. Importantly, these impairments did not worsen at higher altitudes of 4600 m or 5140 m. The present findings should be considered during future trekking expeditions when developing training strategies targeted to manage impairments in postural control that occur with increasing altitude.
Clarke, Sarah B; Deighton, Kevin; Newman, Caroline; Nicholson, Gareth; Gallagher, Liam; Boos, Christopher J; Mellor, Adrian; Woods, David R; O'Hara, John P
Postural control and joint position sense are essential for safely undertaking leisure and professional activities, particularly at high altitude. We tested whether exposure to a 12-day trek with a gradual ascent to high altitude impairs postural control and joint position sense. This was a repeated measures observational study of 12 military service personnel (28±4 years). Postural control (sway velocity measured by a portable force platform) during standing balance, a Sharpened Romberg Test and knee joint position sense were measured, in England (113m elevation) and at 3 research camps (3619m, 4600m and 5140m) on a 12-day high altitude trek in the Dhaulagiri region of Nepal. Pulse oximetry, and Lake Louise scores were also recorded on the morning and evening of each trek day. Data were compared between altitudes and relationships between pulse oximetry, Lake Louise score, and sway velocity were explored. Total sway velocity during standing balance with eyes open (p = 0.003, d = 1.9) and during Sharpened Romberg test with eyes open (p = 0.007, d = 1.6) was significantly greater at altitudes of 3619m and 5140m when compared with sea level. Anterior-posterior sway velocity during standing balance with eyes open was also significantly greater at altitudes of 3619m and 5140m when compared with sea level (p = 0.001, d = 1.9). Knee joint position sense was not altered at higher altitudes. There were no significant correlations between Lake Louise scores, pulse oximetry and postural sway. Despite a gradual ascent profile, exposure to 3619 m was associated with impairments in postural control without impairment in knee joint position sense. Importantly, these impairments did not worsen at higher altitudes of 4600 m or 5140 m. The present findings should be considered during future trekking expeditions when developing training strategies targeted to manage impairments in postural control that occur with increasing altitude.
Wlach, S.; Schwarzbauch, M.; Laiacker, M.
The group Flying Robots at the DLR Institute of Robotics and Mechatronics in Oberpfaffenhofen conducts research on solar powered high altitude aircrafts. Due to the high altitude and the almost infinite mission duration, these platforms are also denoted as High Altitude Pseudo-Satellites (HAPS). This paper highlights some aspects of the design, building, integration and testing of a flying experimental platform for high altitudes. This unmanned aircraft, with a wingspan of 3 m and a mass of less than 10 kg, is meant to be launched as a glider from a high altitude balloon in 20 km altitude and shall investigate technologies for future large HAPS platforms. The aerodynamic requirements for high altitude flight included the development of a launch method allowing for a safe transition to horizontal flight from free-fall with low control authority. Due to the harsh environmental conditions in the stratosphere, the integration of electronic components in the airframe is a major effort. For regulatory reasons a reliable and situation dependent flight termination system had to be implemented. In May 2015 a flight campaign was conducted. The mission was a full success demonstrating that stratospheric research flights are feasible with rather small aircrafts.
Full Text Available In order to analyze the channel estimation performance of near space high altitude platform station (HAPS in wireless communication system, the structure and formation of HAPS are studied in this paper. The traditional Least Squares (LS channel estimation method and Singular Value Decomposition-Linear Minimum Mean-Squared (SVD-LMMS channel estimation method are compared and investigated. A novel channel estimation method and model are proposed. The channel estimation performance of HAPS is studied deeply. The simulation and theoretical analysis results show that the performance of the proposed method is better than the traditional methods. The lower Bit Error Rate (BER and higher Signal Noise Ratio (SNR can be obtained by the proposed method compared with the LS and SVD-LMMS methods.
The need for the training of mechanics is discussed, and the increased interest within the utility industry of placing a similar importance on this training as it has traditionally placed on operator training, is expressed. Effective approaches and techniques are described. Fundamental mechanical maintenance concepts and their practical application are discussed, including the use of supporting video programs. The importance of follow-up practical shop exercise which reinforces classroom instruction is stressed, drawing from practical utility experience. Utilizing success in training as a measure of eligibility for advancement is discussed as well as the interface between training and the company bargaining unit
Konge, Lars; Clementsen, Paul Frost; Ringsted, Charlotte
performance.A total of 16 respiratory physicians, without EBUS experience, were randomised to either virtual-reality simulator training or traditional apprenticeship training on patients, and then each physician performed EBUS-TBNA procedures on three patients. Three blinded, independent assessor assessed......-trained novices and apprenticeship-trained novices failing the test, respectively; pVirtual-reality simulator training was shown to be more...
PROF. OLIVER OSUAGWA
Dec 1, 2015 ... this technology and presented how to integrat VR with traditional instructional ... training has forced organizations to adopt new .... skills in a safe, controlled environment ... phone charger battery pack [B] connected to.
National Aeronautics and Space Administration — Altitude compensating nozzles continue to be of interest for use on future launch vehicle boosters and upper stages because of their higher mission average Isp and...
Gary, B. L. (Inventor)
A method and apparatus are provided for indicating the altitude at which an aircraft should fly so the W/d ratio (weight of the aircraft divided by the density of air) more closely approaches the optimum W/d for the aircraft. A passive microwave radiometer on the aircraft is directed at different angles with respect to the horizon to determine the air temperature, and therefore the density of the air, at different altitudes. The weight of the aircraft is known. The altitude of the aircraft is changed to fly the aircraft at an altitude at which is W/d ratio more closely approaches the optimum W/d ratio for that aircraft.
This paper considers the radiation environment in aircraft at high altitudes and spacecraft in low earth orbit and in deep space and the factors that influence the dose equivalents. Altitude, latitude and solar cycle are the major influences for flights below the radiation belts. In deep space, solar cycle and the occurrence of solar particle events are the factors of influence. The major radiation effects of concern are cancer and infertility in males. In high altitude aircraft the radiation consists mainly of protons and neutrons, with neutrons contributing about half the equivalent dose. The average dose rate at altitudes of transcontinental flights that approach the polar regions are greater by a factor of about 2.5 than on routes at low latitudes. Current estimates of does to air crews suggest they are well within the ICRP (1990) recommended dose limits for radiation workers
Yi, Xin; Liang, Yu; Huerta-Sanchez, Emilia
Residents of the Tibetan Plateau show heritable adaptations to extreme altitude. We sequenced 50 exomes of ethnic Tibetans, encompassing coding sequences of 92% of human genes, with an average coverage of 18x per individual. Genes showing population-specific allele frequency changes, which repres...... in genetic adaptation to high altitude.......Residents of the Tibetan Plateau show heritable adaptations to extreme altitude. We sequenced 50 exomes of ethnic Tibetans, encompassing coding sequences of 92% of human genes, with an average coverage of 18x per individual. Genes showing population-specific allele frequency changes, which...... represent strong candidates for altitude adaptation, were identified. The strongest signal of natural selection came from endothelial Per-Arnt-Sim (PAS) domain protein 1 (EPAS1), a transcription factor involved in response to hypoxia. One single-nucleotide polymorphism (SNP) at EPAS1 shows a 78% frequency...
Full Text Available The Ben Macdhui High Altitude Aerosol and Trace Gas Transport Experiment (BHATTEX) was started to characterize the nature and magnitude of atmospheric, aerosol and trace gas transport paths recirculation over and exiting from southern Africa...
I have the honor to transmit herewith the manuscript of a second edition of a Dictionary of Altitudes, the first edition having been published in 1884. The present work is considerably enlarged, mainly by the addition of determinations of altitudes by railroads. Besides the additions of matter, the principal change from the earlier edition consists in the substitution of a single alphabetic arrangement throughout the work for an alphabetic arrangement by States.
Yu Yongqing; Guo Jian; Yin Yu; Mao Yan; Li Guangfan; Fan Jianbin; Lu Jiayu; Su Zhiyi; Li Peng; Li Qingfeng; Liao Weiming; Zhou Jun
@@ The functional orientation of the Tibet High Altitude Test Base, subordinated to the State Grid Corporation of China (SGCC), is to serve power transmission projects in high altitude areas, especially to provide technical support for southwestern hydropower delivery projects by UHVDC transmission and Qinghai-Tibet grid interconnection project. This paper presents the matters concerned during siting and planning, functions,design scheme, the main performances and parameters of the test facilities, as well as the tests and research tasks already carried out.
Full Text Available Clothing is a unique dressing style of a community, a period or a profession. In clothing there is social status and difference principle rather than fashion. In this context, the society created a clothing style in line with its own customs, traditions and social structure. One of the features separating societies from each other and indicating their cultural and social classes is the clothing style. As it is known, traditional Turkish clothes reflecting the characteristics of Turkish society is our most beautiful heritage from past to present. From this heritage there are several examples of women's clothes c arried to present. When these examples are examined, it is possible to see the taste, the way of understanding art, joy and the lifestyle of the history. These garments are also the documents outlining the taste and grace of Turkish people. In the present study, traditional Kastamonu women's clothing, that has an important place in traditional cultural clothes of Anatolia, is investigated . The method of the present research is primarily defined as the examination of the written sources. The study is complet ed with the observations and examinations made in Kastamonu. According to the findings of the study, traditional Kastamonu women's clothing are examined and adapted to todays’ clothing.
Filho José Luiz Marcon
Full Text Available High-altitude regions of southern Brazil, located above 900 m above sea level, the cordon training with spur pruning is widely used because of easier application. In these regions, Chardonnay wine grape shows potential to produce quality wines, however, in commercial vineyards, the training system used has not provided productivities that makes economically viable the cultivation of this variety. Given this, the present study aimed to evaluate the effect of different cane-pruning systems on the vegetative, productive and enological potential of Chardonnay grapevines grown in the high-altitude region of Southern Brazil. The experiment was conducted in a commercial Chardonnay vineyard, located in São Joaquim – Santa Catarina State (28o17 ′39”S and 49∘ 55′56” W, to 1230 m a.s.l during 2015 and 2016 vintages. Chardonnay vines (grafted on 1103 Paulsen were planted in 2010, with a 3.0 m (row × 1.0 m (vine spacing. The treatments consisted of different cane-pruning systems: Cordon spur-pruning (control; Sylvoz; Cazenave; Capovolto; single Guyot and double Guyot. Pruning was performed in August of each year when the buds were in the green tip developmental stage. Data was analyzed by Scott Knott test (p < 0.05 following a randomized block design with four replicates, each consisting of 12 vines per plot. We observed higher yield in the Cazenave and double Guyot training system with three and two more tons of grapes than spur-pruning respectively. The bud fertility was higher in plants trained in double Guyot. Vines spur-pruned showed higher relation of leaf area: production, with values above 100 cm2 g−1 grape at 2016 vintage. Commercial maturity of grapes (soluble solids, acidity and polyphenols did not differ among training systems studied. The results suggest that cane-pruning systems could be an alternative to increase production efficiency of Chardonnay in high-altitude region of southern Brazil.
Noda, Atsushi; Homma, Masanori; Utashima, Masayoshi
This paper reports the result of a study for super low altitude satellite. The altitude of this satellite's orbit is lower than ever. The altitude of a conventional earth observing satellite is generally around from 600km to 900km. The lowest altitude of earth observing satellite launched in Japan was 350km; the Tropical Rainfall Measuring Mission (TRMM). By comparison, the satellite reported in this paper is much lower than that and it is planned to orbit below 200km. Furthermore, the duration of the flight planned is more than two years. Any satellite in the world has not achieved to keep such a low altitude that long term. The satellite in such a low orbit drops quickly because of the strong air drag. Our satellite will cancel the air drag effect by ion engine thrust. To realize this idea, a drag-free system will be applied. This usually leads a complicated and expensive satellite system. We, however, succeeded in finding a robust control law for a simple system even under the unpredictable change of air drag. When the altitude of the satellite is lowered successfully, the spatial resolution of an optical sensor can be highly improved. If a SAR is equipped with the satellite, it enables the drastic reduction of electric power consumption and the fabulous spatial resolution improvement at the same time.
Meena, Harsahay; Pandey, H K; Arya, M C; Ahmed, Zakwan
High altitude problems like hypoxia, acute mountain sickness, high altitude cerebral edema, pulmonary edema, insomnia, tiredness, lethargy, lack of appetite, body pain, dementia, and depression may occur when a person or a soldier residing in a lower altitude ascends to high-altitude areas. These problems arise due to low atmospheric pressure, severe cold, high intensity of solar radiation, high wind velocity, and very high fluctuation of day and night temperatures in these regions. These problems may escalate rapidly and may sometimes become life-threatening. Shilajit is a herbomineral drug which is pale-brown to blackish-brown, is composed of a gummy exudate that oozes from the rocks of the Himalayas in the summer months. It contains humus, organic plant materials, and fulvic acid as the main carrier molecules. It actively takes part in the transportation of nutrients into deep tissues and helps to overcome tiredness, lethargy, and chronic fatigue. Shilajit improves the ability to handle high altitudinal stresses and stimulates the immune system. Thus, Shilajit can be given as a supplement to people ascending to high-altitude areas so that it can act as a "health rejuvenator" and help to overcome high-altitude related problems.
Blakeman, Thomas; Rodriquez, Dario; Petro, Michael; Branson, Richard
Devices may forgo US military air worthiness and safety testing in an attempt to expedite the availability of critical assets such as mechanical ventilators with a waiver for one-time use in extenuating circumstances. We evaluated two Intensive Care Unit (ICU) level ventilators: Drager Evita XL and Puritan Bennett (PB) 840 in an altitude chamber at sea level and altitudes of 8,000 and 16,000 feet. Altitude affected delivered tidal volumes (VTs) in volume control mode (VCV) and Pressure Regulated Volume Controlled (PRVC) mode at altitude with the Evita XL but the differences were not considered clinically important with the PB 840. Sixty-seven percent of the V T s were outside the ASTM standard of ± 10% of set V T with the Evita XL at altitude. The PB 840 did not deliver V T s that were larger than the ASTM standard up to an altitude of 16,000 feet while the majority of the delivered V T s with the Därger XL were greater than the ASTM standard. This could present a patient safety issue. Caregivers must be aware of the capabilities and limitations of ICU ventilators when utilized in a hypobaric environment in order to provide safe care. Copyright © 2017 Air Medical Journal Associates. All rights reserved.
Luks, Andrew M; Grissom, Colin K; Jean, Dominique; Swenson, Erik R
To determine whether high altitude travel adversely affects mountain enthusiasts with Raynaud's phenomenon. Volunteers with Raynaud's phenomenon were recruited using announcements disseminated by organizations dedicated to climbing or wilderness travel and Internet discussion boards dedicated to mountain activities to complete an online, anonymous survey. Survey questions addressed demographic variables, aspects of their Raynaud's phenomenon, and features of their mountain activities. Respondents compared experiences with Raynaud's phenomenon between high (>2440 m; 8000 feet) and low elevations and rated agreement with statements concerning their disease and the effects of high altitude. One hundred forty-two people, 98% of whom had primary Raynaud's phenomenon, completed the questionnaire. Respondents spent 5 to 7 days per month at elevations above 2440 m and engaged in 5.4 +/- 2.0 different activities. Eighty-nine percent of respondents engaged in winter sports and only 22% reported changing their mountain activities because of Raynaud's phenomenon. Respondents reported a variety of tactics to prevent and treat Raynaud's attacks, but only 12% used prophylactic medications. Fifteen percent of respondents reported an episode of frostbite following a Raynaud's phenomenon attack at high altitude. There was considerable heterogeneity in participants' perceptions of the frequency, duration, and severity of attacks at high altitude compared to their home elevation. Motivated individuals with primary Raynaud's phenomenon, employing various prevention and treatment strategies, can engage in different activities, including winter sports, at altitudes above 2440 m. Frostbite may be common in this population at high altitude, and care must be taken to prevent its occurrence.
Full Text Available In the system of preparations for top-level sportsmen for grand competitions, impor tant place has training in the conditions of middle altitude mountains. In that condi tions it develops complex of adaptation reactions /fi rst of all the lack of oxygen/,that brings to improvement of functional possibilities of organism for competitions in lowland con ditions. In order to achieve high results, during the training in the mountains, it is important to fi nd the most effi cient way for use of environment conditions. It was deducted that adapta tion to the mountains conditions and development of the effi ciency of high quality wrest ling sportsmen it defers from less successful wrestlers. Repetition of staying in moun ted areas enables faster adaptation and offers possibility for use of high physical uti li zation.
Xu, Yan; Wang, Dong; Fan, Wen Lai; Mu, Xiao Qing; Chen, Jian
The earliest industrial biotechnology originated in ancient China and developed into a vibrant industry in traditional Chinese liquor, rice wine, soy sauce, and vinegar. It is now a significant component of the Chinese economy valued annually at about 150 billion RMB. Although the production methods had existed and remained basically unchanged for centuries, modern developments in biotechnology and related fields in the last decades have greatly impacted on these industries and led to numerous technological innovations. In this chapter, the main biochemical processes and related technological innovations in traditional Chinese biotechnology are illustrated with recent advances in functional microbiology, microbial ecology, solid-state fermentation, enzymology, chemistry of impact flavor compounds, and improvements made to relevant traditional industrial facilities. Recent biotechnological advances in making Chinese liquor, rice wine, soy sauce, and vinegar are reviewed.
Edward F. Millen
The study of traditional food and healthy eating habits has been one of the fast growing areas. All humans, both men and women, require food for their survival. However, both men and women indulge in food as if it were their sole purpose of existence. Hence, eating disorders are common among men and women. Then media has played an effective role not only in establishing faulty standards for traditional healthy food but also it has highlighted the importance of healthy eating. It has brought t...
Saunders, Philo U; Pyne, David B; Telford, Richard D; Hawley, John A
Running economy (RE) is typically defined as the energy demand for a given velocity of submaximal running, and is determined by measuring the steady-state consumption of oxygen (VO2) and the respiratory exchange ratio. Taking body mass (BM) into consideration, runners with good RE use less energy and therefore less oxygen than runners with poor RE at the same velocity. There is a strong association between RE and distance running performance, with RE being a better predictor of performance than maximal oxygen uptake (VO2max) in elite runners who have a similar VO2max). RE is traditionally measured by running on a treadmill in standard laboratory conditions, and, although this is not the same as overground running, it gives a good indication of how economical a runner is and how RE changes over time. In order to determine whether changes in RE are real or not, careful standardisation of footwear, time of test and nutritional status are required to limit typical error of measurement. Under controlled conditions, RE is a stable test capable of detecting relatively small changes elicited by training or other interventions. When tracking RE between or within groups it is important to account for BM. As VO2 during submaximal exercise does not, in general, increase linearly with BM, reporting RE with respect to the 0.75 power of BM has been recommended. A number of physiological and biomechanical factors appear to influence RE in highly trained or elite runners. These include metabolic adaptations within the muscle such as increased mitochondria and oxidative enzymes, the ability of the muscles to store and release elastic energy by increasing the stiffness of the muscles, and more efficient mechanics leading to less energy wasted on braking forces and excessive vertical oscillation. Interventions to improve RE are constantly sought after by athletes, coaches and sport scientists. Two interventions that have received recent widespread attention are strength training and
He, Binfeng; Wang, Jianchun; Qian, Guisheng; Hu, Mingdong; Qu, Xinming; Wei, Zhenghua; Li, Jin; Chen, Yan; Chen, Huaping; Zhou, Qiquan; Wang, Guansong
The syndrome of high-altitude de-acclimatization commonly takes place after long-term exposure to high altitudes upon return to low altitudes. The syndrome severely affects the returnee's quality of life. However, little attention has been paid to careful characterization of the syndrome and their underlying mechanisms. Male subjects from Chongqing (n = 67, 180 m) and Kunming (n = 70, 1800 m) visited a high-altitude area (3650 m) about 6 months and then returned to low-altitude. After they came back, all subjects were evaluated for high-altitude de-acclimatization syndrome on the 3(rd), 50(th), and 100(th). Symptom scores, routine blood and blood gas tests, and myocardial zymograms assay were used for observation their syndrome. The results showed that the incidence and severity of symptoms had decreased markedly on the 50(th) and 100(th) days, compared with the 3(rd) day. The symptom scores and incidence of different symptoms were lower among subjects returning to Kunming than among those returning to Chongqing. On the 3(rd) day, RBC, Hb, Hct, CK, CK-MB, and LDH values were significantly lower than values recorded at high altitudes, but they were higher than baseline values. On the 50(th) day, these values were not different from baseline values, but LDH levels did not return to baseline until the 100(th) day. These data show that, subjects who suffered high-altitude de-acclimatization syndrome, the recovery fully processes takes a long time (≥ 100(th) days). The appearance of the syndrome is found to be related to the changes in RBC, Hb, Hct, CK, CK-MB, and LDH levels, which should be caused by reoxygenation after hypoxia.
BACKGROUND: A significant proportion of births in Nigeria still occur at homes of traditional birth attendant. Traditional birth attendants are popular in developing and low resource countries. They lack no formal education or medical training and their clients end up with obstetric complications which lead to severe morbidity ...
Ma, X M; Kang, H L; Shi, C B; Li, Y; Wu, Y F; Liu, Z H; Wang, G; Lei, H Y
Objective: To investigate the relationship between occupational stress and working ability of workers in a petroleum processing enterprise in a high altitude area. Methods: A total of 728 workers in a petroleum processing enterprise at an altitude of 2850 m were subjected to a survey using Occupational Stress Inventory (OSI) , Work Ability Index (WAI) Scale, Occupational Role Questionnaire (ORQ) , Personal Strain Questionnaire (PSQ) , and Personal Resource Questionnaire (PRQ) from May 2014 to August 2016. Results: Of the 728 workers, 55 (7.6%) had a poor working ability, moderate in 262 (35.9%) , and good in 411 (56.5%). There were significant differences in WAI between the workers with different types of work, sexes, ages, and working years ( P occupational stress groups ( P Occupational stress is an influencing factor for the working ability of workers in the petroleum processing enterprise in the high altitude area. Hypoxia in high altitude area may further reduce the working ability. In order to reduce occupational stress and improve work ability, it should be considered to strengthen skills training, improve the working environment, and pay attention to mental health.
Vogt, Michael; Hoppeler, Hans
Altitude training has become very popular among athletes as a means to further increase exercise performance at sea level or to acclimatize to competition at altitude. Several approaches have evolved during the last few decades, with "live high-train low" and "live low-train high" being the most popular. This review focuses on functional, muscular, and practical aspects derived from extensive research on the "live low-train high" approach. According to this, subjects train in hypoxia but remain under normoxia for the rest of the time. It has been reasoned that exercising in hypoxia could increase the training stimulus. Hypoxia training studies published in the past have varied considerably in altitude (2300-5700 m) and training duration (10 days to 8 weeks) and the fitness of the subjects. The evidence from muscle structural, biochemical, and molecular findings point to a specific role of hypoxia in endurance training. However, based on the available performance capacity data such as maximal oxygen uptake (Vo(2)max) and (maximal) power output, hypoxia as a supplement to training is not consistently found to be advantageous for performance at sea level. Stronger evidence exists for benefits of hypoxic training on performance at altitude. "Live low-train high" may thus be considered when altitude acclimatization is not an option. In addition, the complex pattern of gene expression adaptations induced by supplemental training in hypoxia, but not normoxia, suggest that muscle tissue specifically responds to hypoxia. Whether and to what degree these gene expression changes translate into significant changes in protein concentrations that are ultimately responsible for observable structural or functional phenotypes remains open. It is conceivable that the global functional markers such as Vo(2)max and (maximal) power output are too coarse to detect more subtle changes that might still be functionally relevant, at least to high-level athletes.
Amry Daulat Gultom
Full Text Available High Altitude Platform (HAP merupakan solusi alternatif untuk mengatasi keterbatasan infrastruktur terestrial maupun satelit. HAP merupakan pesawat ataupun balon udara yang ditempatkan pada ketinggian 20-50 km di atas permukaan bumi. Kelebihan yang utama dari HAP adalah kemudahan dalam penempatan, fleksibilitas, biaya operasionalnya rendah, delay propagasi rendah, sudut elevasi lebar, cakupan yang luas. Penelitian ini dilakukan untuk mengetahui potensi HAP untuk komunikasi pita lebar dan perkembangannya di Indonesia. Analisis dilakukan secara deskriptif dengan mengolah data literatur yang didapat. Hasil penelitian menunjukkan bahwa di Indonesia terdapat potensi teknologi HAP untuk komunikasi pita lebar dengan lebar pita 2x300 MHz di band 27,9-28,2 GHz dan 31-31,3 GHz. Namun, belum ada peraturan yang mengatur alokasi frekuensi untuk HAP secara khusus di Indonesia.*****High Altitude Platform (HAP has been developed as an alternative solution in order to overcome limitation of terrestrial and satellite communication system. HAP is an aircraft or balloon situated on 20-50 km above the earth. Main advantages of HAP are flexibility in deployment, low propagation delay, wide elevation angle and broad coverage. The research is conducted to gather HAP potential for broadband communication and its development in Indonesia. Analysis is conducted by descriptive analysis from literature study gather. The research result shows that in Indonesia, there is potential of HAP technology for broadband communication with 2x300 MHz bandwidth within 27,9-28,2 GHz and 31-31,3 GHz. Yet, there are no specific regulations managing frequency allocation for HAP in Indonesia.
Full Text Available Chinese noodles originated in the Han dynasty, which has more than 4,000 years of history. There are many stories about the origin of noodles. To a certain extent, noodles also reflect the cultural traditions and customs of China, which essentially means “human nature” and “worldly common sense”. There are thousands of varieties of noodles in China, according to the classification of the shape of noodles, seasoning gravy, cooking craft, and so on. Many noodles have local characteristics. Noodles are accepted by people from all over the world. The industrial revolution and the development of the food industry realized the transition from a traditional handicraft industry to mass production using machinery. In addition, the invention of instant noodles and their mass production also greatly changed the noodle industry. In essence, noodles are a kind of cereal food, which is the main body of the traditional Chinese diet. It is the main source of energy for Chinese people and the most economical energy food. Adhering to the principle of “making cereal food the main food”, is to maintain our Chinese good diet tradition, which can avoid the disadvantages of a high energy, high fat, and low carbohydrate diet, and promote health. The importance of the status of noodles in the dietary structure of residents in our country and the health impact should not be ignored.
Hendrix, Janey B.
A collection for children and teachers of traditional Cherokee recipes emphasizes the art, rather than the science, of cooking. The hand-printed, illustrated format is designed to communicate the feeling of Cherokee history and culture and to encourage readers to collect and add family recipes. The cookbook could be used as a starting point for…
This article discusses traditional methods, such as the grammar-translation, and modern methods, the communicative approach, for teaching English-as-a-foreign-language in China. The relationship between linguistic accuracy and communicative competence, student-centered orientation, and the role of the teacher are highlighted. (Author/VWL)
This article presents a recipe for non-traditional wraps. In this article, the author describes how adults and children can help with the recipe and the skills involved with this recipe. The bigger role that children can play in the making of the item the more they are apt to try new things and appreciate the texture and taste.
In this podcast, a Latina nutrition educator shows how a community worked with local farmers to grow produce traditionally enjoyed by Hispanic/Latinos. Created: 11/1/2007 by National Diabetes Education Program (NDEP), a joint program of the Centers for Disease Control and Prevention and the National Institutes of Health. Date Released: 11/10/2007.
The appropriate use of forceps, vacuums or spatulas facilitates the rapid delivery of foetuses faced with life-threatening situations. It also makes possible the relief of certain cases of prolonged second-stage labor. In France, operative vaginal delivery (OVD) accounts for approximately 10% of all births. OVD training aims to optimize maternal, as well as neonatal safety. It should enable trainees to indicate or contraindicate an OVD safely, as well as to choose the appropriate instrument, use it correctly, and master quality control principles. Traditional OVD training is confronted with both spatial and time-related limitations. Spatial constraints involve both the teacher and trainee who only have limited visual access to the pelvic canal, and the head of the foetus; the time constraint occurs whenever the OVD occurs in an emergency setting. These limitations have been further aggravated by new constraints: decreasing time dedicated to training (European safety rules prohibit work the day after night duty), increasing litigation, and constraints imposed by society. Training by means of simulation removes such limitations making it possible to both avoid exposing pregnant women to the hazards of traditional training, and adapt the training to the skills of each trainee. OVD training should include forceps, vacuums and the use of spatulas. The OVD skills of obstetricians should be audited regularly on both a personal and a confidential level. Such audits could be based on a method using a simulator. Prospective studies comparing traditional and simulation-based training should be encouraged.
Supriya, K E
In Nigeria since 1987, the National Association of Nigeria Nurses and Midwives (NSNNM) has used traditional medial and traditional health care workers to curtail the practice of female circumcision. Other harmful traditions are being changed also, such as early marriage, taboos of pregnancy and childbirth, and scarification. 30,000 member of NANNM are involved in this effort to halt the harmful practices themselves and to change community opinion. The program involved national and state level workshops on harmful health consequences of traditional practices and instruction on how to conduct focus group discussions to assess women's beliefs and practices. The focus groups were found to be a particularly successful method of opening up discussion of taboo topics and expressing deep emotions. The response to the knowledge that circumcision was not necessary was rage and anger, which was channeled into advocacy roles or change in the practice. The result was the channeled into advocacy roles for change in the practice. The result was the development of books, leaflets and videos. One community group designed a dress with a decorative motif of tatoos and bodily cuts to symbolize circumcision and scarring. Plays and songs were written and performed. Artists provided models of female genitalia both before and after circumcision. The campaign has been successful in bringing this issue to the public attention in prominent ways, such a national television, health talk shows, and women;s magazines. One of the most important results of the effort has been the demonstration that culture and tradition can be changed from within, rather than from outside imposition of values and beliefs.
Pannell, Summer; Peltier-Glaze, Bernnell M.; Haynes, Ingrid; Davis, Delilah; Skelton, Carrie
This study sought to determine the effectiveness on increasing student achievement of principals trained in a traditional principal preparation program and those trained in an alternate route principal preparation program within the same Mississippi university. Sixty-six Mississippi principals and assistant principals participated in the study. Of…
Full Text Available Abstract Altitude travel results in acute variations of barometric pressure, which induce different degrees of hypoxia, changing the gas contents in body tissues and cavities. Non ventilated air containing cavities may induce barotraumas of the lung (pneumothorax, sinuses and middle ear, with pain, vertigo and hearing loss. Commercial air planes keep their cabin pressure at an equivalent altitude of about 2,500 m. This leads to an increased respiratory drive which may also result in symptoms of emotional hyperventilation. In patients with preexisting respiratory pathology due to lung, cardiovascular, pleural, thoracic neuromuscular or obesity-related diseases (i.e. obstructive sleep apnea an additional hypoxic stress may induce respiratory pump and/or heart failure. Clinical pre-altitude assessment must be disease-specific and it includes spirometry, pulsoximetry, ECG, pulmonary and systemic hypertension assessment. In patients with abnormal values we need, in addition, measurements of hemoglobin, pH, base excess, PaO2, and PaCO2 to evaluate whether O2- and CO2-transport is sufficient. Instead of the hypoxia altitude simulation test (HAST, which is not without danger for patients with respiratory insufficiency, we prefer primarily a hyperoxic challenge. The supplementation of normobaric O2 gives us information on the acute reversibility of the arterial hypoxemia and the reduction of ventilation and pulmonary hypertension, as well as about the efficiency of the additional O2-flow needed during altitude exposure. For difficult judgements the performance of the test in a hypobaric chamber with and without supplemental O2-breathing remains the gold standard. The increasing numbers of drugs to treat acute pulmonary hypertension due to altitude exposure (acetazolamide, dexamethasone, nifedipine, sildenafil or to other etiologies (anticoagulants, prostanoids, phosphodiesterase-5-inhibitors, endothelin receptor antagonists including mechanical aids to
Altitude travel results in acute variations of barometric pressure, which induce different degrees of hypoxia, changing the gas contents in body tissues and cavities. Non ventilated air containing cavities may induce barotraumas of the lung (pneumothorax), sinuses and middle ear, with pain, vertigo and hearing loss. Commercial air planes keep their cabin pressure at an equivalent altitude of about 2,500 m. This leads to an increased respiratory drive which may also result in symptoms of emotional hyperventilation. In patients with preexisting respiratory pathology due to lung, cardiovascular, pleural, thoracic neuromuscular or obesity-related diseases (i.e. obstructive sleep apnea) an additional hypoxic stress may induce respiratory pump and/or heart failure. Clinical pre-altitude assessment must be disease-specific and it includes spirometry, pulsoximetry, ECG, pulmonary and systemic hypertension assessment. In patients with abnormal values we need, in addition, measurements of hemoglobin, pH, base excess, PaO2, and PaCO2 to evaluate whether O2- and CO2-transport is sufficient.Instead of the hypoxia altitude simulation test (HAST), which is not without danger for patients with respiratory insufficiency, we prefer primarily a hyperoxic challenge. The supplementation of normobaric O2 gives us information on the acute reversibility of the arterial hypoxemia and the reduction of ventilation and pulmonary hypertension, as well as about the efficiency of the additional O2-flow needed during altitude exposure. For difficult judgements the performance of the test in a hypobaric chamber with and without supplemental O2-breathing remains the gold standard. The increasing numbers of drugs to treat acute pulmonary hypertension due to altitude exposure (acetazolamide, dexamethasone, nifedipine, sildenafil) or to other etiologies (anticoagulants, prostanoids, phosphodiesterase-5-inhibitors, endothelin receptor antagonists) including mechanical aids to reduce periodical or
The objective of this study was to investigate the effect of oxygen supplementation on broiler eggs in a hatchery at high altitude on the growth performance and ascites syndrome of broilers reared at low altitude. The treatment groups were low altitude with no oxygen supplemented in the hatchery (LA-NOX); high altitude with ...
McSharry, Patrick E
To assess the effect of altitude on match results and physiological performance of a large and diverse population of professional athletes. Statistical analysis of international football (soccer) scores and results. FIFA extensive database of 1460 football matches in 10 countries spanning over 100 years. Altitude had a significant (Pnegative impact on physiological performance as revealed through the overall underperformance of low altitude teams when playing against high altitude teams in South America. High altitude teams score more and concede fewer goals with increasing altitude difference. Each additional 1000 m of altitude difference increases the goal difference by about half of a goal. The probability of the home team winning for two teams from the same altitude is 0.537, whereas this rises to 0.825 for a home team with an altitude difference of 3695 m (such as Bolivia v Brazil) and falls to 0.213 when the altitude difference is -3695 m (such as Brazil v Bolivia). Altitude provides a significant advantage for high altitude teams when playing international football games at both low and high altitudes. Lowland teams are unable to acclimatise to high altitude, reducing physiological performance. As physiological performance does not protect against the effect of altitude, better predictors of individual susceptibility to altitude illness would facilitate team selection.
the cockpit. They might be used to train pilots in procedures to cope with NOE-altitude emergencies; howeve-r, a combination of cinematic simulation...airplanes. Although cockpit motion adds realism , thereby i-nproving pilot performanc, in the simulater Fedderqon, Vil; Guercio and Wall, i7?. Ince...operations. Light aircraft, part-task trainers, motion pictures and video tares, cinematic simulators, and digital teaching machines are among the
Gurovskiy, N. N.; Link, M. M.
The biomedical and preflight training of spacecraft crews is discussed based on a survey of scientific and technical literature in the U.S. and U.S.S.R. Experience gained from high velocity and high altitude aircraft flights, predictions of human reactions and theoretical models of human adaptation to the new environment of space, and actual spaceflight experience provided scientists and specialists with data from which the state of human health in space could be predicted and life support measures developed.
Full Text Available The traditional MUltiple SIgnal Classification (MUSIC algorithm requires significant computational effort and can not be employed for the Direction Of Arrival (DOA estimation of targets in a low-altitude multipath environment. As such, a novel MUSIC approach is proposed on the basis of the algorithm of Adaptive Step Glowworm Swarm Optimization (ASGSO. The virtual spatial smoothing of the matrix formed by each snapshot is used to realize the decorrelation of the multipath signal and the establishment of a fullorder correlation matrix. ASGSO optimizes the function and estimates the elevation of the target. The simulation results suggest that the proposed method can overcome the low altitude multipath effect and estimate the DOA of target readily and precisely without radar effective aperture loss.
Roszkowski, Paweł; Kowalczyk, Marcin
The article presents a low cost, fully - functional meter of altitude and pressure changes in a form of mobile application controlled by Android OS (operating system). The measurements are possible due to pressure sensor inserted in majority of latest modern mobile phones, which are known as smartphones. Using their computing capabilities and other equipment components like GPS receiver in connection with data from the sensor enabled authors to create a sophisticated handheld measuring platform with many unique features. One of them is a drawing altitude maps mode in which user can create maps of altitude changes just by moving around examined area. Another one is a convenient mode for altitude measurement. It is also extended with analysis tools which provide a possibility to compare measured values by displaying the data in a form of plots. The platform consists of external backup server, where the user can secure all gathered data. Moreover, the results of measurement's accuracy examination process which was executed after building the solution were shown. At the end, the realized meter of altitude was compared to other popular altimeters, which are available on the market currently.
Jain, S. C.; Singh, M. V.; Rawal, S. B.; Sharma, V. M.; Divekar, H. M.; Tyagi, A. K.; Panwar, M. R.; Swamy, Y. V.
In the present communication, effect of low doses of phosphate supplementation on short-term high altitude adaptation has been examined. Studies were carried out in 36 healthy, male, sea-level residents divided in a double blind fashion into drug and placebo treated groups. 3.2 mmol of phosphate were given orally to each subject of the drug treated group once a day for 4 days on arrival at an altitude of 3,500 m. Sequential studies were done in the subjects in both groups on the 3rd, 7th, 14th and 21st day of their altitude stay. Haemoglobin, haematocrit, erythrocyte and reticulocyte counts increased to the similar extent in both groups. Blood pH, pO2 and adenosine tri-phosphate (ATP) did not differ between the two groups. On 3rd day of the altitude stay, inorganic phosphate and 2,3-diphosphoglycerate (2,3 DPG) levels in the drug treated group increased significantly as compared to the placebo group. No significant difference in inorganic phosphate and 2,3 DPG was observed later on in the two groups. Psychological and clinical tests also indicated that the drug treated subjects felt better as compared to the placebo treated subjects. The present study suggests that low doses of phosphate increases circulating 2,3-DPG concentration which in turn brings about beneficial effect towards short term high altitude adaptation.
Bryan, N C; Stewart, M; Granger, D; Guzik, T G; Christner, B C
Owing to the challenges posed to microbial aerosol sampling at high altitudes, very little is known about the abundance, diversity, and extent of microbial taxa in the Earth-atmosphere system. To directly address this knowledge gap, we designed, constructed, and tested a system that passively samples aerosols during ascent through the atmosphere while tethered to a helium-filled latex sounding balloon. The sampling payload is ~ 2.7 kg and comprised of an electronics box and three sampling chambers (one serving as a procedural control). Each chamber is sealed with retractable doors that can be commanded to open and close at designated altitudes. The payload is deployed together with radio beacons that transmit GPS coordinates (latitude, longitude and altitude) in real time for tracking and recovery. A cut mechanism separates the payload string from the balloon at any desired altitude, returning all equipment safely to the ground on a parachute. When the chambers are opened, aerosol sampling is performed using the Rotorod® collection method (40 rods per chamber), with each rod passing through 0.035 m3 per km of altitude sampled. Based on quality control measurements, the collection of ~ 100 cells rod(-1) provided a 3-sigma confidence level of detection. The payload system described can be mated with any type of balloon platform and provides a tool for characterizing the vertical distribution of microorganisms in the troposphere and stratosphere. Copyright © 2014 Elsevier B.V. All rights reserved.
Full Text Available Extreme altitude can induce a range of cellular and systemic responses. Although it is known that hypoxia underlies the major changes and that the physiological responses include hemodynamic changes and erythropoiesis, the molecular mechanisms and signaling pathways mediating such changes are largely unknown. To obtain a more complete picture of the transcriptional regulatory landscape and networks involved in extreme altitude response, we followed four climbers on an expedition up Mount Xixiabangma (8,012 m, and collected blood samples at four stages during the climb for mRNA and miRNA expression assays. By analyzing dynamic changes of gene networks in response to extreme altitudes, we uncovered a highly modular network with 7 modules of various functions that changed in response to extreme altitudes. The erythrocyte differentiation module is the most prominently up-regulated, reflecting increased erythrocyte differentiation from hematopoietic stem cells, probably at the expense of differentiation into other cell lineages. These changes are accompanied by coordinated down-regulation of general translation. Network topology and flow analyses also uncovered regulators known to modulate hypoxia responses and erythrocyte development, as well as unknown regulators, such as the OCT4 gene, an important regulator in stem cells and assumed to only function in stem cells. We predicted computationally and validated experimentally that increased OCT4 expression at extreme altitude can directly elevate the expression of hemoglobin genes. Our approach established a new framework for analyzing the transcriptional regulatory network from a very limited number of samples.
Eldridge, Marlowe W; Braun, Ruedi K; Yoneda, Ken Y; Walby, William F
Strenuous exercise may be a significant contributing factor for development of high-altitude pulmonary edema, particularly at low or moderate altitudes. Thus we investigated the effects of heavy cycle ergometer exercise (90% maximal effort) under hypoxic conditions in which the combined effects of a marked increase in pulmonary blood flow and nonuniform hypoxic pulmonary vasoconstriction could add significantly to augment the mechanical stress on the pulmonary microcirculation. We postulated that intense exercise at altitude would result in an augmented permeability edema. We recruited eight endurance athletes and examined their bronchoalveolar lavage fluid (BALF) for red blood cells (RBCs), protein, inflammatory cells, and soluble mediators at 2 and 26 h after intense exercise under normoxic and hypoxic conditions. After heavy exercise, under all conditions, the athletes developed a permeability edema with high BALF RBC and protein concentrations in the absence of inflammation. We found that exercise at altitude (3,810 m) caused significantly greater leakage of RBCs [9.2 (SD 3.1)x10(4) cells/ml] into the alveolar space than that seen with normoxic exercise [5.4 (SD 1.2)x10(4) cells/ml]. At altitude, the 26-h postexercise BALF revealed significantly higher RBC and protein concentrations, suggesting an ongoing capillary leak. Interestingly, the BALF profiles following exercise at altitude are similar to that of early high-altitude pulmonary edema. These findings suggest that pulmonary capillary disruption occurs with intense exercise in healthy humans and that hypoxia augments the mechanical stresses on the pulmonary microcirculation.
Full Text Available Sadum is one of the traditional cloths of the Batak people in North Sumatra. It is woven on a back strap loom with supplementary weft technique. Sadum is a warp faced weaving made of cotton and beads woven into the cloth. Ritually it is used as a shoulder cloth, gifts exchanges, and in dances. It also bears the symbol of good tidings and blessings for the receiver. The cloth has change during times in technique, color, patterns, as well as in functions. But the use as a ritual cloth stays the same. The basic weaving techniques and equipments used to create it hasn’t change, but its material and added techniques has made this cloth become more rich in color, pattern, and texture. Most changes began when the Europeans came to Indonesia and introduced new material such as synthetic fibers and colors. In the 70s traditional cloth of Indonesia got its boost when the government declared batik as Indonesian national attire. This encourages other traditional weavings to develop into contemporary clothing. Later, new techniques and material were introduced to the Sadum weavings including embroidery, silk and golden threads which were never used before.
Verner, E.; Bruhweiler, F. C.; Abot, J.; Casarotto, V.; Dichoso, J.; Doody, E.; Esteves, F.; Morsch Filho, E.; Gonteski, D.; Lamos, M.; Leo, A.; Mulder, N.; Matubara, F.; Schramm, P.; Silva, R.; Quisberth, J.; Uritsky, G.; Kogut, A.; Lowe, L.; Mirel, P.; Lazear, J.
In this project a multi-disciplinary undergraduate team from CUA, comprising majors in Physics, Mechanical Engineering, Electrical Engineering, and Biology, design, build, test, fly, and analyze the data from a prototype attitude determination system (PADS). The goal of the experiment is to determine if an inexpensive attitude determination system could be built for high altitude research balloons using MEMS gyros. PADS is a NASA funded project, built by students with the cooperation of CUA faculty, Verner, Bruhweiler, and Abot, along with the contributed expertise of researchers and engineers at NASA/GSFC, Kogut, Lowe, Mirel, and Lazear. The project was initiated through a course taught in CUA's School of Engineering, which was followed by a devoted effort by students during the summer of 2014. The project is an experiment to use 18 MEMS gyros, similar to those used in many smartphones, to produce an averaged positional error signal that could be compared with the motion of the fixed optical system as recorded through a string of optical images of stellar fields to be stored on a hard drive flown with the experiment. The optical system, camera microprocessor, and hard drive are enclosed in a pressure vessel, which maintains approximately atmospheric pressure throughout the balloon flight. The experiment uses multiple microprocessors to control the camera exposures, record gyro data, and provide thermal control. CUA students also participated in NASA-led design reviews. Four students traveled to NASA's Columbia Scientific Balloon Facility in Palestine, Texas to integrate PADS into a large balloon gondola containing other experiments, before being shipped, then launched in mid-August at Ft. Sumner, New Mexico. The payload is to fly at a float altitude of 40-45,000 m, and the flight last approximately 15 hours. The payload is to return to earth by parachute and the retrieved data are to be analyzed by CUA undergraduates. A description of the instrument is presented
Bonne, Thomas Christian
= 0.051) and time to complete 3000 m tended (P = 0.09) to increase in LHTH but not after sea level training. In study III haematological parameters were determined weekly three times before and four times after classical altitude and sea level training and ABP thresholds for [Hb], %ret, OFF......-score and the abnormal blood profile score (ABPS) were generated using the official ABP software. After altitude training, six swimmers exceeded the 99% ABP thresholds: Two swimmers exceeded the OFF-score thresholds at day 7; One swimmer exceeded the OFF-score threshold at day 28; One swimmer exceeded the threshold...... for %ret at day 14; One swimmer surpassed the ABPS threshold at day 7 and one swimmer exceeded the ABPS threshold 28 days after altitude training. No values exceeded the individual thresholds in the control group. In conclusion, this thesis demonstrated that BV is a main determinant of the exercise induced...
Donovan Casas Patiño
Full Text Available Mexico has a great history and tradition in relation to the training of resident physicians, but what we find behind this process?, Power relations implied and not implied, unnoticed or ignored for convenience by the academic and health institutions, with the aggravation of forgetting its commitment to the training of men and women "professionals" and limited to meet another indicator of "human resources for health." The resident physician in academic and scientific training is immersed in this dehumanized maelstrom and ends up becoming a character for the domain of knowledge as power, forgetting that his act and its rationale lies in the principle of "primum non nocere" to that we would add: nor your person, nor your fellowman, much less whom you have the moral, ethical and civic responsibility to convey some of your knowledge and your experience, that is, part of your essence”.
Peck, L S; Chapelle, G
The trend towards large size in marine animals with latitude, and the existence of giant marine species in polar regions have long been recognized, but remained enigmatic until a recent study showed it to be an effect of increased oxygen availability in sea water of a low temperature. The effect was apparent in data from 12 sites worldwide because of variations in water oxygen content controlled by differences in temperature and salinity. Another major physical factor affecting oxygen content in aquatic environments is reduced pressure at high altitude. Suitable data from high-altitude sites are very scarce. However, an exceptionally rich crustacean collection, which remains largely undescribed, was obtained by the British 1937 expedition from Lake Titicaca on the border between Peru and Bolivia in the Andes at an altitude of 3809 m. We show that in Lake Titicaca the maximum length of amphipods is 2-4 times smaller than other low-salinity sites (Caspian Sea and Lake Baikal).
Gómez-Campos, Rossana; Arruda, Miguel; Almonacid-Fierro, Alejandro; Holbold, Edílson; Amaral-Camargo, Cristiane; Gamero, Diego; Cossio-Bolanos, Marco A
To determine the cardiorespiratory capacity of school children living at moderate altitude. 795 children (394 children and 401 girls) were selected from urban public schools in Arequipa, Peru at moderate altitude (2,320 m). Anthropometric variables (body mass, height, body fat percentage) and cardiorespiratory capacity were assessed using the Course Navette test, considering the following categories: deficient, poor, fair, good, very good and excellent. The results showed significant differences in all categories (poverweight (r=-0.20 to -0.22) and a moderate negative correlation with obesity (r=-0.39 to -0.42) were described for both genders. Low levels of cardiorespiratory capacity in boys and girls living at moderate altitude are observed, which is negatively correlated with excess body weight. The results suggest that 1 in 5 children are likely to suffer some type of cardiovascular event.
Jacobsen, Dean; Rostgaard, S.; Vásconez, J. J.
1. The solubility of oxygen in water increases with decreasing temperature. This has led to a general perception of cold, high mountain streams as more oxygen rich than warmer lowland streams, and that macroinvertebrates inhabiting high altitude streams have had no need to adapt to critical oxygen...... conditions. However, this fails to take into account that oxygen solubility declines with decreasing atmospheric pressure, which may be of importance at high altitudes. 2. Based on samples of macroinvertebrate benthos and in situ measurements of respiratory oxygen demand of macroinvertebrates in small...... the mean weight-specific respiratory rate of macroinvertebrates declined by only 50%, from 400 to 3800 m. We suggest that this disproportionately large gap between availability and demand of oxygen at high altitudes may imply a potential oxygen deficiency for the fauna, and we discuss how oxygen deficiency...
Collier, C.R. (Univ. of Southern California Medical Center, Los Angeles); Goldsmith, J.R.
The health risks to U.S. populations who are exposed to ambient carbon monoxide and live at altitudes (such as Denver, Salt Lake City, and Albuquerque) were evaluated using a set of mathematical models. The assumption that a given increase in carboxyhemoglobin would require a more stringent volumetric air quality standard was tested. The results using the model predict that the 8-h or 1-h standards adopted for sea level condition need not be altered to protect individuals against health risks at altitude, if the standards are in volumetric terms. They would need to be reduced if the standards are left in gravimetric terms. If the guideline is to be based on a given decrement of oxygen tension, many other variables must be specified, but expected differences in ambient carbon monoxide have a small impact compared to the effect of altitude itself.
Paul J. Anderson
Full Text Available Introduction Each year, the US Antarctic Program rapidly transports scientists and support personnel from sea level (SL to the South Pole (SP, 2835 m providing a unique natural laboratory to quantify the incidence of acute mountain sickness (AMS, patterns of altitude related symptoms and the field effectiveness of acetazolamide in a highly controlled setting. We hypothesized that the combination of rapid ascent (3 hr, accentuated hypobarism (relative to altitude, cold, and immediate exertion would increase altitude illness risk. Methods Medically screened adults (N = 246, age = 37 ± 11 yr, 30% female, BMI = 26 ± 4 kg/m 2 were recruited. All underwent SL and SP physiological evaluation, completed Lake Louise symptom questionnaires (LLSQ, to define AMS, and answered additional symptom related questions (eg, exertional dyspnea, mental status, cough, edema and general health, during the 1st week at altitude. Acetazolamide, while not mandatory, was used by 40% of participants. Results At SP, the barometric pressure resulted in physiological altitudes that approached 3400 m, while T ° C averaged -42, humidity 0.03%. Arterial oxygen saturation averaged 89% ± 3%. Overall, 52% developed LLSQ defined AMS. The most common symptoms reported were exertional dyspnea-(87%, sleeping difficulty-(74%, headache-(66%, fatigue-(65%, and dizziness/lightheadedness-(46%. Symptom severity peaked on days 1-2, yet in >20% exertional dyspnea, fatigue and sleep problems persisted through day 7. AMS incidence was similar between those using acetazolamide and those abstaining (51 vs. 52%, P = 0.87. Those who used acetazolamide tended to be older, have less altitude experience, worse symptoms on previous exposures, and less SP experience. Conclusion The incidence of AMS at SP tended to be higher than previously reports in other geographic locations at similar altitudes. Thus, the SP constitutes a more intense altitude exposure than might be expected considering physical
Full Text Available Neeraj M Shah,1 Sidra Hussain,2 Mark Cooke,3 John P O’Hara,3 Adrian Mellor3,4 1Division of Asthma, Allergy and Lung Biology, King’s College London, UK; 2School of Medicine, University College London, London, UK; 3Research Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Leeds, UK; 4Academic Department of Military Anaesthesia and Critical Care, Royal Centre for Defence Medicine, Birmingham, UK Abstract: Travel to high altitude is increasingly popular. With this comes an increased incidence of high-altitude illness and therefore an increased need to improve our strategies to prevent and accurately diagnose these. In this review, we provide a summary of recent advances of relevance to practitioners who may be advising travelers to altitude. Although the Lake Louise Score is now widely used as a diagnostic tool for acute mountain sickness (AMS, increasing evidence questions the validity of doing so, and of considering AMS as a single condition. Biomarkers, such as brain natriuretic peptide, are likely correlating with pulmonary artery systolic pressure, thus potential markers of the development of altitude illness. Established drug treatments include acetazolamide, nifedipine, and dexamethasone. Drugs with a potential to reduce the risk of developing AMS include nitrate supplements, propagators of nitric oxide, and supplemental iron. The role of exercise in the development of altitude illness remains hotly debated, and it appears that the intensity of exercise is more important than the exercise itself. Finally, despite copious studies demonstrating the value of preacclimatization in reducing the risk of altitude illness and improving performance, an optimal protocol to preacclimatize an individual remains elusive. Keywords: hypoxia, acute mountain sickness, acclimatization, biomarkers, preacclimatization
Full Text Available Global motion estimation (GME is a key technology in unmanned aerial vehicle remote sensing (UAVRS. However, when a UAV’s motion and behavior change significantly or the image information is not rich, traditional image-based methods for GME often perform poorly. Introducing bottom metadata can improve precision in a large-scale motion condition and reduce the dependence on unreliable image information. GME is divided into coarse and residual GME through coordinate transformation and based on the study hypotheses. In coarse GME, an auxiliary image is built to convert image matching from a wide baseline condition to a narrow baseline one. In residual GME, a novel information and contrast feature detection algorithm is proposed for big-block matching to maximize the use of reliable image information and ensure that the contents of interest are well estimated. Additionally, an image motion monitor is designed to select the appropriate processing strategy by monitoring the motion scales of translation, rotation, and zoom. A medium-altitude UAV is employed to collect three types of large-scale motion datasets. Peak signal to noise ratio (PSNR and motion scale are computed. This study’s result is encouraging and applicable to other medium- or high-altitude UAVs with a similar system structure.
Japan, which occupied Korea from 1910 through the end of World War II, transformed traditional medicine. Japanese colonialists propagandized the "benefits of modern civilization such as western medicine" and rejected the advantages of traditional medicine. This bias against Korean traditional medicine mirrored the government's rejection of its own traditional medicine. So, Korean traditional medicine was marginalized in the national health care system: traditional doctors were excluded from public institutions and references to traditional medicine were purged from school textbooks and newspapers. The wars that Japan waged between 1931 and 1944 effected a favorable change toward traditional medicines, however. The wars created a severe shortage of drugs and medical personnel. Thus the colonial government was eager for Koreans to cultivate and gather herbal drugs; it also built a large research institute for herbalism at the Keijo Imperial University in 1938. The colonial government made pharmacopoeia for traditional herbal drugs including plant and animal drugs from 1937 to 1942, independently from Japan. Under these conditions, the prestige of traditional medicine was greatly improved. Influential newspapers and magazines covered the traditional medicine and public lectures on traditional medicine drew large audiences. The wartime government abandoned its opposition to traditional medicine, and appointed a traditional practitioner to the staff of the public hospital in 1934. Moreover, the government allowed the association of the traditional medical doctors in Seoul to train three hundred more practitioners between 1937 and 1942. Japanese colonial policy toward traditional medicine reflected the contradiction between modernizing ideology and the reality of poor colonial medical care. Japanese propaganda promised that the colonial regime would provide more advanced medicine to Korea, but the promise was an empty one. In this situation, traditional medical doctors
Balestra, S; Fabbri, F; Giacomelli, G; Giacomelli, R; Giorgini, M; Kumar, A; Manzoor, S; McDonald, J; Margiotta, A; Medinaceli, E; Nogales, J; Patrizii, L; Popa, V; Quereshi, I; Saavedra, O; Sher, G; Shahzad, M; Spurio, M; Ticona, R; Togo, V; Velarde, A; Zanini, A
The search for rare particles in the cosmic radiation remains one of the main aims of non-accelerator particle astrophysics. Experiments at high altitude allow lower mass thresholds with respect to detectors at sea level or underground. The SLIM experiment is a large array of nuclear track detectors located at the Chacaltaya High Altitude Laboratory (5290 m a.s.l.). The preliminary results from the analysis of a part of the first 236 sq.m exposed for more than 3.6 y are here reported. The detector is sensitive to Intermediate Mass Magnetic Monopoles and to SQM nuggets and Q-balls, which are possible Dark Matter candidates.
Marco Quijano Rico
Nuestro proyecto se inició en 1982 en la Loma de Puntalarga, entre 2500 y2600 metros de altitud, a 5,78 ºN y 72,98 ºW, en la cordillera oriental de los Andes. Las variedades más utilizadas actualmente son Pinot noir, Riesling y cruzamientos de Riesling x Silvaner. Desde 1984 se realizan trabajos de investigación sobre temas pertinentes. La baja latitud, la elevada altitud, el volumen de precipitación relativamente modesto y la transparencia del cielo, determinan el flujo de radiación solar in...
Full Text Available The propose of this work is an equation for the module of the acceleration vector of the gravity, varying with the latitude and altitude. For this purpose, the following values of the gravity acceleration were used, at the sea level: in the equator, g0 = 9,7803 m/s2, and in the latitude of 450, gP = 9,8062 m/s2. The terrestrial profile were assumed as being a revolution ellipsoid, flattened in the poles, and the acceleration of the gravity varying with the altitude, at sea level, was considered dependent of the latitude too.
Eichhorn, G.; Coldwell, R.L.; Dunnam, F.E.; Rester, A.C.; Trombka, J.I.; Starr, R.; Lasche, G.P.
The Gamma Ray Advanced Detector(GRAD) consists of a n-type germanium detector inside an active bismuth-germanate Compton and charged particle shield with additional active plastic shielding across the aperture. It will be flown on a high altitude balloon at 36 km altitude at a latitude of 78 degree S over Antarctica for observations of gamma radiation emitted by the radioactive decay of 56 Co in the Supernova SN1987A, for assessment of the performance of bismuth-germanate scintillation material in the radiation environment of near space, for gathering information on the gamma-ray background over Antarctica, and for testing fault-tolerant software
Lyumugabe Loshima, François
Samples of traditional sorghum beer Ikigage was collected in the southern province of Rwanda and analyzed for microbiological and physico-chemical contents. Ikigage contained total aerobic mesophilic bacteria (33.55 x 106 cfu/ml), yeast (10.15 x 106 cfu/ml), lactic acid bacteria (35.35 x 104 cfu/ml), moulds (4.12 x 104 cfu/ml), E. coli (21.90 x 103 cfu/ml), fecal streptococci (22.50 x 103 cfu/ml), Staphylococcus aureus (16.02 x 103 cfu/ml), total coliform (32.30 x 103 cfu/ml), eth...
It was Paul Dirac who cast quantum mechanics into the form we now use, and many generations of theoreticians openly acknowledge his influence on their thinking. When Dirac died in 1984, St. John's College, Cambridge, his base for most of his lifetime, instituted an annual lecture in his memory at Cambridge. The first lecture, in 1986, attracted two heavyweights - Richard Feynman and Steven Weinberg. Far from using the lectures as a platform for their own work, in the Dirac tradition they presented stimulating material on deep underlying questions.
It was Paul Dirac who cast quantum mechanics into the form we now use, and many generations of theoreticians openly acknowledge his influence on their thinking. When Dirac died in 1984, St. John's College, Cambridge, his base for most of his lifetime, instituted an annual lecture in his memory at Cambridge. The first lecture, in 1986, attracted two heavyweights - Richard Feynman and Steven Weinberg. Far from using the lectures as a platform for their own work, in the Dirac tradition they presented stimulating material on deep underlying questions
Shelden, A; Wesselowski, S; Gordon, S G; Saunders, A B
A 6.5-year-old male Border Collie presented for transcatheter closure of an atrial septal defect due to exercise intolerance and cyanosis while working and training at altitude. A small, left-to-right shunting secundum atrial septal defect was confirmed with no evidence of significant right-sided volume overload. Pulmonary hypertension with subsequent right-to-left interatrial shunting occurring during exercise at high altitude was suspected and prompted the closure of the defect due to the dog's continued athletic requirements. The anatomy of the defect prompted use of a patent foramen ovale occluder rather than an atrial septal defect occluder, which was deployed using a combination of fluoroscopic and transesophageal echocardiographic guidance. The owner did not report continued exercise intolerance or cyanosis and the dog's lifestyle and residence at altitude was unchanged. Copyright © 2017 Elsevier B.V. All rights reserved.
Christoulas, K; Karamouzis, M; Mandroukas, K
To determine and compare the erythropoietic response and exercise performance of adolescent cross-country skiers, as a result of "living high-training high" (HH) and "living high-training low" (HL). Nine female and six male adolescent cross-country skiers volunteered to participate in separate trials. In the first trial (HH), the skiers lived and trained for 21 days at 1550-2050 m, while in the second trial (HL) they trained near sea level (450-500 m) but resided at 1550 m. All participants underwent maximal cycle ergometer tests for the determination of VO2max and cardiorespiratory parameters via an open circuit system at sea level before ascent to altitude, and 1-2 days after descent from altitude. Blood samples were drawn prior to and immediately after maximal cycle exercise testing, at sea level prior to ascent, on days 1 (D1) and 21 (D21) at altitude (1740 m), and 1-2 days post-altitude, for the determination of serum erythropoietin (EPO) concentration, haemoglobin (Hb), hematocrit (Ht), and red blood cell (RBC) volume. The results showed that both boys and girls cross-country skiers, significantly improved their sea level VO2max after 21 days of living at moderate altitude and training near sea level. The present study demonstrates that living at moderate altitude, 1550-2050 m and training low, near sea level (450-500 m) significantly increases VO2max and RBC mass for both boys and girls. Results indicate that applying the training concept "living high - training low" in adolescent athletes may improve their endurance performance.
Diano, Oscar F
The changing strategic environment has necessitated a shift in Army training from traditional maneuver warfare to full-spectrum operations to defeat irregular, catastrophic, and disruptive challenges more effectively...
Heinzer, Raphaël; Saugy, Jonas J; Rupp, Thomas; Tobback, Nadia; Faiss, Raphael; Bourdillon, Nicolas; Rubio, José Haba; Millet, Grégoire P
Hypoxia is known to generate sleep-disordered breathing but there is a debate about the pathophysiological responses to two different types of hypoxic exposure: normobaric hypoxia (NH) and hypobaric hypoxia (HH), which have never been directly compared. Our aim was to compare sleep disorders induced by these two types of altitude. Subjects were exposed to 26 h of simulated (NH) or real altitude (HH) corresponding to 3,450 m and a control condition (NN) in a randomized order. The sleep assessments were performed with nocturnal polysomnography (PSG) and questionnaires. Thirteen healthy trained males subjects volunteered for this study (mean ± SD; age 34 ± 9 y, body weight 76.2 ± 6.8 kg, height 179.7 ± 4.2 cm). Mean nocturnal oxygen saturation was further decreased during HH than in NH (81.2 ± 3.1 versus 83.6 ± 1.9%; P sleep time was longer in HH than in NH (351 ± 63 versus 317 ± 65 min, P sleep quality was similar between hypoxic conditions but lower than in NN. Our results suggest that HH has a greater effect on nocturnal breathing and sleep structure than NH. In HH, we observed more periodic breathing, which might arise from the lower saturation due to hypobaria, but needs to be confirmed. © 2016 Associated Professional Sleep Societies, LLC.
Tania dos Reis Mendonça
Full Text Available ABSTRACT The agronomical responses of Chardonnay, a variety indicated for sparkling wine production, is influenced by the vineyard management and the edaphoclimatic conditions of the region. The objective of this study was to evaluate the effects of two pruning types (Royat and double Guyot on vegetative and reproductive development of Chardonnay vine growing at high altitude in the Brazilian southeastern region. The experiment was carried out in a commercial vineyard located at 1,280 m of altitude in Divinolândia, São Paulo State, Brazil. The Chardonnay vines (clone 96, grafted onto 1103 Paulsen rootstock and trained in a vertical shoot positioning trellis system, were assessed. Vegetative vigor, bud fruitfulness, production and physicochemical composition of grapes were evaluated during 2014 and 2015 growing seasons. The Royat pruning induced higher vegetative vigor and increased the bud fruitfulness, the cluster number and the productivity of Chardonnay vine when compared to Guyot pruning. Even though the increase on yield was observed, there was no effect of pruning type on grape final quality. Therefore, the choice of pruning method in function of variety genetic characteristics and their interaction with environment can optimize the vineyard profitability. In the Brazilian southeast, the Royat system is the most suitable one to grow Chardonnay for sparkling wines production.
If you wish to participate in one of the following courses, please discuss with your supervisor and apply electronically directly from the course description pages that can be found on the Web at: http://www.cern.ch/Training/ or fill in an "application for training" form available from your Divisional Secretariat or from your DTO (Divisional Training Officer). Applications will be accepted in the order of their receipt. Language Training Françoise Benz tel. 73127 firstname.lastname@example.org General and Professional English Courses The next session will take place: from 1st March to 25 June 2004 (2 weeks break at Easter). These courses are open to all persons working on the Cern site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mr. Liptow: tel. 72957.
If you wish to participate in one of the following courses, please discuss with your supervisor and apply electronically directly from the course description pages that can be found on the Web at: http://www.cern.ch/Training/ or fill in an "application for training" form available from your Divisional Secretariat or from your DTO (Divisional Training Officer). Applications will be accepted in the order of their receipt. LANGUAGE TRAINING Françoise Benz tel. 73127 email@example.com General and Professional English Courses The next session will take place: from 1st March to 25 June 2004 (2 weeks break at Easter). These courses are open to all persons working on the Cern site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mr. Liptow: tel. 72957.
To validate the flight track dispersion algorithms currently in the ROUTEMAP and MR_NMAP noise models, measurements of the lateral distribution of flight operations were conducted on five low-altitude Military Training (MTRs...
elevation, sun location, temperature, humidity, ozone level, visibility, cloud coverage, and wind speed and direction. Survivability in the Low Altitude...JASP Summer PMSG 14–16 July 2009 Key West, FL AUG 45th AIAA/ASME/SAE/ASEE Joint Propulsion Conference and Exhibit 2–5 August 2009 Denver, CO
Bartsch, P.; Saltin, B.
ascent (average ascent rate 300 m/day above 2000 m a.s.l.), primarily in order to sleep and feel well, and minimize the risk of mountain sickness. A new classification of altitude levels based on the effects on performance and well-being is proposed and an overview given over the various modalities using...
The objective of this study was to evaluate the change of fatty acid composition in Delisava, Yomra, Sivri and Karayaglı Turkish hazelnut varieties with altitude. Fatty acid composition were determined by gas chromatography (GC) equiped with flame ionisation detector (FID) after obtained fatty acid methyl esters from crude ...
Full Text Available Reviewed: Climate Change Impacts on High-Altitude Ecosystems By Münir Öztürk, Khalid Rehman Hakeem, I. Faridah-Hanum and Efe. Recep, Cham, Switzerland: Springer International Publishing, 2015. xvii + 696 pp. US$ 239.00. ISBN 978-3-319-12858-0.
Reviewed: Climate Change Impacts on High-Altitude Ecosystems By Münir Öztürk, Khalid Rehman Hakeem, I. Faridah-Hanum and Efe. Recep, Cham, Switzerland: Springer International Publishing, 2015. xvii + 696 pp. US$ 239.00. ISBN 978-3-319-12858-0.
Bats alter their echolocation calls in response to changes in ecological and behavioral conditions, but little is known about how they adjust their call structure in response to changes in altitude. This study examines altitudinal variation in the echolocation calls of Brazilian free-tailed bats, T...
Limnological data of four high altitude lakes from the cold desert region of Himachal Pradesh, India, has been correlated with cyanobacterial diversity. Physico-chemical characteristics and nutrient contents of the studied lakes revealed that Sissu Lake is mesotrophic while Chandra Tal, Suraj Tal and Deepak Tal are ...
Detwiler, R. S.
This paper focuses on modeling the detection capabilities of NaI sensor systems at high altitudes for ground sources. The modeling was done with the Monte Carlo N-Transport (MCNP) code developed at Los Alamos National Laboratory. The specific systems modeled were the fixed wing and helicopter aircraft sensor systems, assets of the U. S. Department of Energy's National Nuclear Security Administration Nevada Operations Office (NNSA/NV) Aerial Measuring System (AMS). In previous (2001) modeling, Sodium Iodine (NaI) detector responses were simulated for both point and distributed surface sources as a function of gamma energy and altitude. For point sources, photo-peak efficiencies were calculated for a zero radial distance and an offset equal to the altitude. For distributed sources approximating an infinite plane, gross count efficiencies were calculated and normalized to a uniform surface deposition of 1 (micro)Ci/m 2 . To validate the calculations, benchmark measurements were made for simple source-detector configurations. The 2002 continuation of the modeling presented here includes checking models against available data, and modifications to allow more effective and accurate directional biasing of ground point and distributed sources. Fixed-wing data results will be shown for two point sources as a function of altitude
Jun 5, 2012 ... At low altitude, combined administration of vitamin E and ... inflammatory response within the muscles and other organs of .... temperature of 32°C. The depth of water in the tank was 30 cm. ..... protein and enhances the secretion of glucocorticoids .... convert more cholesterol towards bile acid synthesis and.
Chen, Fang; Zhang, Wei; Liang, Yu
Extreme altitude can induce a range of cellular and systemic responses. Although it is known that hypoxia underlies the major changes and that the physiological responses include hemodynamic changes and erythropoiesis, the molecular mechanisms and signaling pathways mediating such changes are lar...
DEMEER, K; HEYMANS, HSA; ZIJLSTRA, WG
Children permanently exposed to hypoxia at altitudes of > 3000 m above sea level show a phenotypical form of adaptation. Under these environmental conditions, oxygen uptake in the lungs is enhanced by increases in ventilation, lung compliance, and pulmonary diffusion. Lung and thorax volumes in
Kessel, Line; Kofoed, Peter Kristian; Zubieta-Calleja, Gustavo
in Denmark. RESULTS: No significant differences in lens fluorescence or transmittance were found between Bolivian and Danish volunteers. CONCLUSION: Age-corrected lens fluorescence and transmittance were comparable for healthy participants living at high altitude near the equator and healthy volunteers...
Sutton, J R; Lassen, N
We review the evidence that acute mountain sickness (AMS) and high altitude pulmonary oedema (HAPO) occur together more often than is realized. We hypothesize that AMS and HAPO have a common pathophysiological basis: both are due to increased pressure and flow in the microcirculation, causing...
Klausen, T; Poulsen, T D; Fogh-Andersen, N
in 2, 3 diphosphoglycerate. After 64 h at altitude, six of the nine subjects had down-regulated their serum-EPO concentrations so that median values were three times above those at sea level. These six subjects had significant diurnal variations of serum-EPO concentration at sea level; the nadir......This study tested the hypothesis that the diurnal variations of serum-erythropoietin concentration (serum-EPO) observed in normoxia also exist in hypoxia. The study also attempted to investigate the regulation of EPO production during sustained hypoxia. Nine subjects were investigated at sea level...... and during 4 days at an altitude of 4350 m. Median sea level serum-EPO concentration was 6 (range 6-13) U.l-1. Serum-EPO concentration increased after 18 and 42 h at altitude, [58 (range 39-240) and 54 (range 36-340) U.l-1, respectively], and then decreased after 64 and 88 h at altitude [34 (range 18...
... than 500 feet to any person, vessel, vehicle, or structure. (d) Helicopters. Helicopters may be... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Minimum safe altitudes: General. 91.119 Section 91.119 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION...
Podgaets, A.R.; Ockels, W.J.
Closed loop Laddermill flight control problem is considered in this paper. Laddermill is a high altitude kites system for energy production. The kites have been simulated as rigid bodies and the cable as a thin elastic line. Euler angles and cable speed are controls. Flight control is written as a
Mahoney, M.; Murphy, D. M.; Thomson, D. S.
Recent in situ measurements of the chemical composition of single aerosol particles at altitudes up to 19 km have revealed a number of surprising features about ambient particles. Upper tropospheric aerosols in the study region often contained more organic material than sulfate.
Klausen, T; Poulsen, T D; Fogh-Andersen, N
in 2, 3 diphosphoglycerate. After 64 h at altitude, six of the nine subjects had down-regulated their serum-EPO concentrations so that median values were three times above those at sea level. These six subjects had significant diurnal variations of serum-EPO concentration at sea level; the nadir...
Vuyk, J.; Bos, J. van den; Terhell, K.; Bos, R. de; Vletter, A.; Valk, P.; Beuzekom, M. van; Kleef, J. van; Dahan, A.
Acute mountain sickness is thought to be triggered by cerebral hypoxemia and be prevented by acetazolamide (Actz). The effect of Actz on cerebral oxygenation at altitude remains unknown. In 16 members of the 2005 Dutch Cho Oyu (8201 m, Tibet) expedition, the influence of Actz and exercise (750 mg PO
Stowhas, L.; Silva, C.; Moser, H.; Stichler, W.
Monthly precipitation and single storms have been collected during three years at 12 stations along a W-E profile in Chile, going from Juan Fernandez Islands to Valparaiso, Santiago and Infiernillo in the Andes, and analysed for their deuterium content. The deltaD values are correlated with the altitude of the station, the mean temperature - which also largely depends on the altitude - and the distance from the sea. The correlation parameters show however important variations from year to year and even more from month to month. For instance, in the stretch Santiago (520 m a.s.l.) - La Parva (2680 m) the mean isotopic gradient with altitude were: -1.84 deltaD per mil/100 m in 1970, -1.09 in 1971 and -2.0 in 1972. The low value observed in 1971 could be a consequence of the peculiar weather characteristics of this unusually dry year. In the stretch from the coast to Santiago the trend of the isotopic composition of precipitation is more complicated, because the so-called continental effect is superimposed to the altitude effect. The deuterium content variations have been also determined in snowpack profiles at La Parva station. The results show that snow melting occurs slowly at the bottom during the whole winter, at the expenses of the heat stored during summer in the soil. The melting of the surface snow layers only starts at the end of the winter and then proceeds very fast
Mast cell densities in the lung were measured in five native highlanders of La Paz (3600 m) and in one lowlander dying from high-altitude pulmonary oedema (HAPO) at 3440 m. Two of the highlanders were mestizos with normal pulmonary arteries and the others were Aymara Indians with muscular remodelling of their pulmonary vasculature. The aim of the investigation was to determine if accumulation of mast cells in the lung at high altitude (HA) is related to alveolar hypoxia alone, to a combination of hypoxia and muscularization of the pulmonary arterial tree, or to oedema of the lung. The lungs of four lowlanders were used as normoxic controls. The results showed that the mast cell density of the two Mestizos was in the normal range of lowlanders (0.6-8.8 cells/mm2). In the Aymara Indians the mast cell counts were raised (25.6-26.0 cells/mm2). In the lowlander dying from HAPO the mast cell count was greatly raised to 70.1 cells/mm2 lung tissue. The results show that in native highlanders an accumulation of mast cells in the lung is not related to hypoxia alone but to a combination of hypoxia and muscular remodelling of the pulmonary arteries. However, the most potent cause of increased mast cell density in the lung at high altitude appears to be high-altitude pulmonary oedema.
In the last few years, several non-traditional forms of inheritance have been recognized. These include mosaicism, cytoplasmic inheritance, uniparental disomy, imprinting, amplification/anticipation, and somatic recombination. Genomic imprinting (GI) is the dependence of the phenotype on the sex of the transmitting parent. GI in humans seems to involve growth, behaviour, and survival in utero. The detailed mechanism of genomic imprinting is not known, but it seems that some process is involved in turning a gene off; this probably involves two genes, one of which produces a product that turns a gene off, and the gene that is itself turned off. The process of imprinting (turning off) may be associated with methylation. Erasure of imprinting can occur, and seems to be associated with meiosis. 10 refs
San Miguel Simron, J.L.; Berger, J.; Spielvogel, H.; Tellez Castellon, W.; Lujan Medina, C.; Caceres, E.
The malnutrition is prevalent and is a major problem among Bolivian children. It is caused by several interacting factors: (1) inadequate protein energy intake due to low socio-economic status; (ii) exposure to acute, repeated and chronic bacterial infections; (iii) exposure to multiple and chronic parasitic infections; (iv) high altitude of the capital, La Paz, 3600 m, with a numerous populations compared to the rest of the country. The research objectives in the first phase are: (i) determination of protein utilization with a non-invasive method using stable isotope tracer among children living at high and low altitude; (ii) determination of protein metabolism among eutrophic children without parasitic or acute bacterial infections at both altitudes; (iii) determination of protein requirement among these children. Two groups of 10 pubertal children, matched for age and sex, of same socio-economic status, eutrophic, without malnutrition, infections or intestinal parasites will be studied; the different status being arrived by anthropometric, nutritional intake, biochemical and pediatrical evaluation. For the metabolic study, stable isotopes L-[1-13C] leucine labelled casein will be used and 13 CO 2 excreted will be measured. All the basic nutritional assessment and VCO 2 measurements will be performed in Bolivia, while the samples of expired gas will be stored in Vacutainers for further analysis by isotope radio mass spectrometer (IRMS), in Clermont-Ferrand, France. The plans for future work is based on the study of the effects of the different variables and their interactions. The following will be evaluated: (i) the socio-economic status; (ii) the bacterial infections: (iii) the parasitic infections; (iv) the altitude. As published by Obert, et al., the socio-economic variable is more connected with the nutritional status than with the altitude. 12 refs, 1 fig., 1 tab