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Development Genes and Evolution Mar 2020
Topics: Animals; Biodiversity; Biological Evolution; Ecology; Female; Male; Sex Characteristics; Spiders
PubMed: 32124013
DOI: 10.1007/s00427-020-00658-5 -
Global Health Action Jan 2021: The term 'last mile' has been used across disciplines to refer to populations who are farthest away, most difficult to reach, or last to benefit from a program or...
: The term 'last mile' has been used across disciplines to refer to populations who are farthest away, most difficult to reach, or last to benefit from a program or service. However, last mile research lacks a shared understanding around its conceptualization.: This project used a concept mapping process to answer the questions: what is last mile research in global health and, how can it be used to make positive change for health equity in the last mile?: Between July and December 2019, a five-stage concept mapping exercise was undertaken using online concept mapping software and an in-person consensus meeting. The stages were: establishment of an expert group and focus prompt; idea generation; sorting and rating; initial analysis and final consensus meeting.: A group of 15 health researchers with experience working with populations in last mile contexts and who were based at the Matariki Network institutions of Queen's University, CAN and Dartmouth College, USA took part. The resulting concept map had 64 unique idea statements and the process resulted in a map with five clusters. These included: (1) Last mile populations; (2) Research methods and approaches; (3) Structural and systemic factors; (4) Health system factors, and (5) Broader environmental factors. Central to the map were the ideas of equity, human rights, health systems, and contextual sensitivity.: This is the first time 'last mile research' has been the focus of a formal concept mapping exercise. The resulting map showed consensus about last mile populations are, research should be undertaken in the last mile and last mile health disparities exist. The map can be used to inform research training programs, however, repeating this process with researchers and members from different last mile populations would also add further insight.
Topics: Consensus; Exercise; Health Equity; Humans; Research Design; Research Personnel
PubMed: 33736574
DOI: 10.1080/16549716.2021.1893026 -
Journal of the International Society of... Jan 2020The ergogenic effects of supplemental carbohydrate on aerobic exercise performance at high altitude (HA) may be modulated by acclimatization status. Longitudinal... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The ergogenic effects of supplemental carbohydrate on aerobic exercise performance at high altitude (HA) may be modulated by acclimatization status. Longitudinal evaluation of potential performance benefits of carbohydrate supplementation in the same volunteers before and after acclimatization to HA have not been reported.
PURPOSE
This study examined how consuming carbohydrate affected 2-mile time trial performance in lowlanders at HA (4300 m) before and after acclimatization.
METHODS
Fourteen unacclimatized men performed 80 min of metabolically-matched (~ 1.7 L/min) treadmill walking at sea level (SL), after ~ 5 h of acute HA exposure, and after 22 days of HA acclimatization and concomitant 40% energy deficit (chronic HA). Before, and every 20 min during walking, participants consumed either carbohydrate (CHO, n = 8; 65.25 g fructose + 79.75 g glucose, 1.8 g carbohydrate/min) or flavor-matched placebo (PLA, n = 6) beverages. A self-paced 2-mile treadmill time trial was performed immediately after completing the 80-min walk.
RESULTS
There were no differences (P > 0.05) in time trial duration between CHO and PLA at SL, acute HA, or chronic HA. Time trial duration was longer (P < 0.05) at acute HA (mean ± SD; 27.3 ± 6.3 min) compared to chronic HA (23.6 ± 4.5 min) and SL (17.6 ± 3.6 min); however, time trial duration at chronic HA was still longer than SL (P < 0.05).
CONCLUSION
These data suggest that carbohydrate supplementation does not enhance aerobic exercise performance in lowlanders acutely exposed or acclimatized to HA.
TRIAL REGISTRATION
NCT, NCT02731066, Registered March 292,016.
Topics: Acclimatization; Altitude; Carbohydrates; Dietary Supplements; Exercise; Heart Rate; Humans; Longitudinal Studies; Male; Oxygen Consumption; Physical Exertion
PubMed: 31918720
DOI: 10.1186/s12970-020-0335-2 -
Respirology (Carlton, Vic.) Nov 2020
Topics: Exercise Tolerance; Humans; Hypertension, Pulmonary; Idiopathic Pulmonary Fibrosis; Oxygen
PubMed: 32573005
DOI: 10.1111/resp.13890 -
Scientific Reports May 2021Elite middle distance runners present as a unique population in which to explore biomechanical phenomena in relation to running speed, as their training and racing spans...
Elite middle distance runners present as a unique population in which to explore biomechanical phenomena in relation to running speed, as their training and racing spans a broad spectrum of paces. However, there have been no comprehensive investigations of running mechanics across speeds within this population. Here, we used the spring-mass model of running to explore global mechanical behavior across speeds in these runners. Ten elite-level 1500 m and mile runners (mean 1500 m best: 3:37.3 ± 3.6 s; mile: 3:54.6 ± 3.9 s) and ten highly trained 1500 m and mile runners (mean 1500 m best: 4:07.6 ± 3.7 s; mile: 4:27.4 ± 4.1 s) ran on a treadmill at 10 speeds where temporal measures were recorded. Spatiotemporal and spring-mass characteristics and their corresponding variation were calculated within and across speeds. All spatiotemporal measures changed with speed in both groups, but the changes were less substantial in the elites. The elite runners ran with greater approximated vertical forces (+ 0.16 BW) and steeper impact angles (+ 3.1°) across speeds. Moreover, the elites ran with greater leg and vertical stiffnesses (+ 2.1 kN/m and + 3.6 kN/m) across speeds. Neither group changed leg stiffness with increasing speeds, but both groups increased vertical stiffness (1.6 kN/m per km/h), and the elite runners more so (further + 0.4 kN/m per km/h). The elite runners also demonstrated lower variability in their spatiotemporal behavior across speeds. Together, these findings suggested that elite middle distance runners may have distinct global mechanical patterns across running speeds, where they behave as stiffer, less variable spring-mass systems compared to highly trained, but sub-elite counterparts.
Topics: Biomechanical Phenomena; Humans; Male; Running
PubMed: 34006954
DOI: 10.1038/s41598-021-89858-1 -
Scandinavian Journal of Public Health May 2022At the intersection of the Sustainable Development Goals, humanitarian assistance and health, the umbrella term 'health in the last mile' has gained traction. In August...
BACKGROUND
At the intersection of the Sustainable Development Goals, humanitarian assistance and health, the umbrella term 'health in the last mile' has gained traction. In August 2019, the Norwegian Red Cross commissioned a global report to conceptualise and assess what 'health in the last mile' refers to, in terms of access, needs and structural and geographical barriers and vulnerabilities, and describe how these vulnerabilities overlap in different humanitarian settings and regions.
AIMS
The purpose of this commentary article is to highlight the report's most important findings for an academic audience, from the perspective of the Norwegian Red Cross.
DISCUSSION
The aim of the report was to propose a definition and create a methodology to help identify people and populations living in the last mile of healthcare; acknowledging that these go far beyond those affected by armed conflicts and sudden onset disasters. As the report reveals, last-mile populations are not adequately reached by current universal health coverage strategies. The report highlights the key role played by local humanitarian actors in reducing barriers to access to healthcare. Local stakeholders have first-hand knowledge of the needs of populations in the last mile and on how they navigate the barriers to healthcare access. The report also addresses questions such as: Who are the people with least access to healthcare? What are their health needs and what barriers do they face? Not least, when many live without access to healthcare services, how do we determine where the last mile begins? The report proposes a definition of 'the last mile' involving converging factors that exacerbate barriers to healthcare and identifies 18 groups that are considered potential last-mile populations. Global epidemics, such as the latest COVID-19, have shown that the concept of vulnerability is continually changing. These situations can bring new vulnerable populations to the edge of the last mile which were already vulnerable and ignored before the outset of the outbreak.
CONCLUSIONS
Topics: COVID-19; Disasters; Emergencies; Health Facilities; Health Services Accessibility; Humans
PubMed: 33624552
DOI: 10.1177/1403494821993693 -
Sexual and Reproductive Health Matters Dec 2022Globally, significant progress has been made in the realm of adolescent sexual and reproductive health. We conceptualised "last mile" adolescents as having two or more... (Review)
Review
Globally, significant progress has been made in the realm of adolescent sexual and reproductive health. We conceptualised "last mile" adolescents as having two or more of the following factors of identity: refugee, Indigenous, 2SLGBTQIA+, out of school, rurally or remotely located, slum dwelling, incarcerated or previously incarcerated, HIV/AIDS infected, and living with a disability. We conducted a scoping review with an aim to synthesise evidence and identify research gaps in the literature pertaining to the sexual and reproductive health and rights (SRHR) of last mile adolescents. We conducted searches in three databases (Embase, Global Health, and Medline). Fifty-four publications met our inclusion criteria. Our results revealed that the state of evidence on the SRHR of last mile adolescents is poor. Very few studies used qualitative and mixed-method inquiry. The number of studies carried out in North America, Europe, and Oceania were limited. We found insufficient disaggregated data with respect to SRHR-related knowledge, behaviour, and access to services. Adopting an intersectional lens is critical to uncover the multiplicative effects of last mile adolescents' factors of identity on their SRHR. National data systems should be strengthened to enable the collection of quality disaggregated data which can play a vital role in identifying SRHR inequities affecting last mile adolescents. Research priorities should be realigned to generate data globally on the SRHR of last mile adolescents whose lives are marked by intersecting vulnerabilities.
Topics: Adolescent; Humans; Reproductive Health; Reproductive Health Services; Reproductive Rights; Sexual Behavior; Sexual Health
PubMed: 35666196
DOI: 10.1080/26410397.2022.2077283 -
American Journal of Preventive Medicine Aug 2022Traffic fatalities remain a major public health challenge despite progress made during recent decades. This study develops exposure-based estimates of fatalities per...
INTRODUCTION
Traffic fatalities remain a major public health challenge despite progress made during recent decades. This study develops exposure-based estimates of fatalities per mile traveled for pedestrians, cyclists, and light-duty vehicle occupants and describes disparities by race/ethnicity, including a subanalysis of fatality rates during darkness and in urban areas.
METHODS
Estimates of person-miles traveled by mode and race/ethnicity group were derived from the 2017 National Household Travel Survey using replicate weights. Three-year average (2016‒2018) traffic fatalities were measured by mode and race/ethnicity group with the U.S. Fatality Analysis Reporting System. Fatality rates per mile traveled and CIs were calculated for each subgroup as well as separately for trips occurring during darkness and in urban areas. Analysis was conducted in 2021‒2022.
RESULTS
Exposure to traffic fatality differs by race/ethnicity group and by mode, indicating that adjustment for differential exposure is needed when estimating disparities. The authors find that fatality rates per 100 million miles traveled are systematically higher for Black and Hispanic Americans for all modes and notably higher for vulnerable modes (e.g., Black Americans died at more than 4 times the rate for White Americans while cycling, 33.71 [95% CI: 21.84, 73.83] compared with 7.53 [95% CI: 6.64, 8.69], and more than 2 times the rate while walking, 40.92 [95% CI: 36.58, 46.44] compared with 18.77 [95% CI: 17.30, 20.51]). Previous estimates that do not adjust for differential exposure may underestimate disparities by race/ethnicity. Observed disparities remained when considering only urban areas and appear to be exacerbated during darkness.
CONCLUSIONS
Traffic fatalities are a substantial and preventable public health challenge in America. Black and Hispanic Americans have higher traffic fatality rates per mile traveled than White Americans across the transportation system, requiring urgent attention.
Topics: Accidents, Traffic; Bicycling; Ethnicity; Humans; Pedestrians; Transportation; United States
PubMed: 35868815
DOI: 10.1016/j.amepre.2022.03.012 -
World Journal of Surgical Oncology Feb 2022The aim of this study was to determine the long-term overall and disease-free survival and factors associated with overall survival in patients with esophageal cancer... (Review)
Review
OBJECTIVES
The aim of this study was to determine the long-term overall and disease-free survival and factors associated with overall survival in patients with esophageal cancer undergoing a totally minimally invasive Ivor Lewis esophagectomy (MILE) at a safety-net hospital.
METHODS
This was a single-center retrospective review of consecutive patients who underwent MILE from September 2013 to November 2017. Overall and disease-free survival were analyzed by Kaplan-Meier estimates, and hazard ratios (HR) were derived from multivariable Cox regression models.
RESULTS
Ninety-six patients underwent MILE during the study period. Overall survival at 1, 3, and 5 years was 83.2%, 61.9%, and 55.9%, respectively. Disease-free survival at 1, 3, and 5 years was 83.2%, 60.6%, and 47.5%, respectively. Overall survival (p < 0.001) and disease-free survival (p < 0.001) differed across pathological stages. By multivariable analysis, increasing age (HR, 1.06; p = 0.02), decreasing Karnofsky performance status score (HR, 0.94; p = 0.002), presence of stage IV disease (HR, 5.62; p = 0.002), locoregional recurrence (HR, 2.94; p = 0.03), and distant recurrence (HR, 4.78; p < 0.001) were negatively associated with overall survival. Overall survival significantly declined within 2 years and was independently associated with stage IV disease (HR, 3.29; p = 0.04) and distant recurrence (HR, 5.78; p < 0.001).
CONCLUSION
MILE offers favorable long-term overall and disease-free survival outcomes. Age, Karnofsky performance status score, stage IV, and disease recurrence are shown to be prognostic factors of overall survival. Prospective studies comparing long-term outcomes after different MIE approaches are warranted to validate survival outcomes after MILE.
Topics: Esophageal Neoplasms; Esophagectomy; Humans; Minimally Invasive Surgical Procedures; Neoplasm Recurrence, Local; Postoperative Complications; Prospective Studies; Retrospective Studies; Treatment Outcome
PubMed: 35209914
DOI: 10.1186/s12957-022-02518-0