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International Journal of Environmental... Nov 2019The population of older people is increasing at a rapid rate, with those 80 years and older set to triple by 2050. This systematic review aimed to examine older people's...
The population of older people is increasing at a rapid rate, with those 80 years and older set to triple by 2050. This systematic review aimed to examine older people's perceptions and behaviours against existing heatwaves prevention measures and systematically categorize and analyse those measures using the Ottawa charter for health promotion framework. Peer-reviewed published literature between 22nd September 2006 and 24th April 2018 was retrieved, according to the PRISMA guidelines, from five different databases. Eighteen articles were finally included. There is a lack of published studies from developing countries. Results were categorized and analysed using the Ottawa charter five action areas. Mitigation strategies from current heat action plans are discussed and gaps are highlighted. A lack of systematic evaluation of heat action plans efficacy was identified. Older people are not demonstrating all recommended preventative measures during heatwaves. Support personnel and health professionals are not being pro-active enough in facilitating prevention of adverse effects from heatwaves. Governments are beginning to implement policy changes, but other recommended support measures outlined in the Ottawa charter are still lacking, and hence require further action. Linkage between specific components of heat action plans and outcomes cannot be ascertained; therefore, more systematic evaluation is needed.
Topics: Acclimatization; Aged; Aged, 80 and over; Developing Countries; Health Promotion; Hot Temperature; Humans
PubMed: 31717424
DOI: 10.3390/ijerph16224370 -
Sports Medicine (Auckland, N.Z.) May 2021The acute effects of resistance training (RT) set structure alteration are well established; however, less is known about their effects on chronic training adaptations. (Meta-Analysis)
Meta-Analysis
BACKGROUND
The acute effects of resistance training (RT) set structure alteration are well established; however, less is known about their effects on chronic training adaptations.
OBJECTIVE
The aim of this systematic review and meta-analysis was to synthesise the available evidence on the effectiveness of traditional (TS), cluster (CS) and rest redistribution (RR) set structures in promoting chronic RT adaptations, and provide an overview of the factors which might differentially influence the magnitude of specific training adaptations between set structure types.
METHODS
This review was performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines encompassing the literature search of five databases. Studies in English that compared muscular strength, endurance, and/or hypertrophy adaptations, as well as vertical jump performance, velocity and power at submaximal loads and shifts in the slopes of force-velocity profiles between TS and CS or RR set structures (i.e., alternative set structures) were included. Risk of bias assessment was performed using a modified Cochrane Collaboration's tool for assessing risk of bias in randomised trials. Random-effects meta-analyses and meta-regressions were performed where possible.
RESULTS
17 studies met the inclusion criteria, none had more than one risk of bias item assessed as high risk. Pooled results revealed that none of the set structures were more effective at inducing strength (standardised mean difference (SMD) = - 0.06) or hypertrophy (SMD = - 0.03). TS were more effective at improving muscular endurance compared to alternative set structures (SMD = - 0.38), whereas alternative set structures tended to be more effective for vertical jump performance gains (SMD = 0.13), but this effect was not statistically significant (p = 0.190). Greater velocity and power outputs at submaximal loads (SMD = 0.18) were observed when using alternative set structures compared to TS. In addition, alternative set structures promoted greater shifts of the slope of force-velocity profiles towards more velocity dominant profiles compared to TS (SMD = 0.28). Sub-group analyses controlling for each alternative set structure independently showed mixed results likely caused by the relatively small number of studies available for some outcomes.
CONCLUSION
Modifying TS to an alternative set structure (CS or RR) has a negligible impact on strength and hypertrophy. Using CS and RR can lead to greater vertical jump performance, velocity and power at submaximal loads and shifts to more velocity dominant force-velocity profiles compared to training using TS. However, TS may provide more favourable effects on muscle endurance when compared to CS and RR. These findings demonstrate that altering TS to alternative set structures may influence the magnitude of specific muscular adaptations indicating set structure manipulation is an important consideration for RT program design.
PROTOCOL REGISTRATION
The original protocol was prospectively registered (CRD42019138954) with the PROSPERO (International Prospective Register of Systematic Reviews).
Topics: Acclimatization; Adaptation, Physiological; Humans; Muscle Strength; Resistance Training; Rest
PubMed: 33417154
DOI: 10.1007/s40279-020-01423-4 -
Sports Medicine (Auckland, N.Z.) Mar 2023Isotonic exercise is the most common mode of strength training. Isotonic strength is often measured in the movement that was exercised, but isometric and isokinetic... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Isotonic exercise is the most common mode of strength training. Isotonic strength is often measured in the movement that was exercised, but isometric and isokinetic movements are also commonly used to quantify changes in muscular strength. Previous research suggests that increasing strength in one movement may not lead to an increase in strength in a different movement. Quantifying the increase in strength in a movement not trained may be important for understanding strength training adaptations and making recommendations for resistance exercise and rehabilitation programs.
OBJECTIVE
To quantify changes in non-specific strength relative to a control.
DESIGN
A systematic review and random effects meta-analysis was conducted investigating the effects of isotonic strength training on isotonic and isokinetic/isometric strength.
SEARCH AND INCLUSION
This systematic review was conducted in Google scholar, PubMed, Academic Search Premier, and MENDELEY. To be included in this review paper the article needed to meet the following criteria: (1) report sufficient data for our variables of interest (i.e., changes in isotonic strength and changes in isokinetic or isometric strength); (2) include a time-matched non-exercise control; (3) be written in English; (4) include healthy human participants over the age of 18 years; (5) the participants had to train and test isotonically; (6) the participants had to be tested isokinetically or isometrically on a device different from that they trained on; (7) the non-specific strength task had to test a muscle involved in the training (i.e., could not have trained chest press and test handgrip strength); and (8) the control group and the experimental group had to perform the same number of strength tests.
RESULTS
We completed two separate searches. In the original search a total of 880 papers were screened and nine papers met the inclusion criteria. In the secondary search a total of 2594 papers were screened and three additional papers were added (total of 12 studies). The overall effect of resistance training on changes in strength within a movement that was not directly trained was 0.8 (Cohen's d) with a standard error of 0.286. This overall effect was significant (t = 2.821, p = 0.01) and the 95% confidence interval (CI) is 0.22-1.4. The overall effect of resistance training on strength changes within a movement that was directly trained was 1.84 (Cohen's d) with a standard error of 0.296. This overall effect was significant (t = 6.221, p < 0.001) and the 95% CI is 1.23-2.4.
CONCLUSION
The results of our meta-analysis suggest that strength increases in both the specific and non-specific strength tests. However, the smaller effect size associated with non-specific strength suggests that it will be difficult for a single study to meaningfully investigate the transfer of strength training adaptions.
Topics: Humans; Adult; Middle Aged; Hand Strength; Muscle, Skeletal; Muscle Strength; Adaptation, Physiological; Acclimatization; Resistance Training
PubMed: 36396899
DOI: 10.1007/s40279-022-01790-0 -
International Journal of Environmental... Sep 2022The Himalayan region is a fragile high mountain landscape where the population experiences acute vulnerability within a complex coupled human-natural system due to... (Review)
Review
The Himalayan region is a fragile high mountain landscape where the population experiences acute vulnerability within a complex coupled human-natural system due to environmental, social, and economic linkages. The lack of significant regional and spatial knowledge of multi-faceted vulnerabilities hinders any potential recommendations to address these vulnerabilities. We systematically reviewed the literature to recommend mitigation interventions based on the region's socio-economic and ecological vulnerability research to date. We applied the PRISMA (Preferred Reporting of Items for Systematic Review and Meta-Analysis) criteria to search for results from four comprehensive databases. For our assessment, we compiled a final sample ( = 59) of vulnerability research papers to examine the vulnerability types, spatial variation, assessment methodology, and significant drivers of change. Our study represented all Himalayan countries, namely, India, Nepal, Pakistan, China, and Bhutan. More than half of the vulnerability studies were conducted in the central Himalayan region, a quarter in the western Himalayas, and a few in the eastern Himalayas. Our review revealed that the primary drivers of change were climate change, land use/land cover, and glacial lake formation. The vulnerability assessments in the Himalayan region primarily used social science methods as compared to natural science methods. While the vulnerability studies seldom assessed mitigation interventions, our analysis identified fourteen recommendations. The recommended interventions mainly included policy interventions, livelihood improvement, and adaptation measures. This study emphasized that sustainable development requires cross-sectoral interventions to manage existing resources and mitigate the confronting vulnerabilities of the region.
Topics: Acclimatization; Climate Change; Humans; India; Lakes; Nepal
PubMed: 36231508
DOI: 10.3390/ijerph191912177 -
Medical Teacher Feb 2006Review period January 1992-December 2001. Final analysis July 2004-January 2005. BACKGROUND AND REVIEW CONTEXT: There has been no rigorous systematic review of the... (Review)
Review
REVIEW DATE
Review period January 1992-December 2001. Final analysis July 2004-January 2005. BACKGROUND AND REVIEW CONTEXT: There has been no rigorous systematic review of the outcomes of early exposure to clinical and community settings in medical education. OBJECTIVES OF REVIEW: Identify published empirical evidence of the effects of early experience in medical education, analyse it, and synthesize conclusions from it. Identify the strengths and limitations of the research effort to date, and identify objectives for future research.
SEARCH STRATEGY
Ovid search of: BEI, ERIC, Medline, CINAHL and EMBASE Additional electronic searches of: Psychinfo, Timelit, EBM reviews, SIGLE, and the Cochrane databases. Hand-searches of:Medical Education, Medical Teacher, Academic Medicine, Teaching and Learning in Medicine, Advances in Health Sciences Education, Journal of Educational Psychology.
EXPERIENCE
Authentic (real as opposed to simulated) human contact in a social or clinical context that enhances learning of health, illness and/or disease, and the role of the health professional. Early: What would traditionally have been regarded as the preclinical phase, usually the first 2 years. Inclusions: All empirical studies (verifiable, observational data) of early experience in the basic education of health professionals, whatever their design or methodology, including papers not in English. Evidence from other health care professions that could be applied to medicine was included.
EXCLUSIONS
Not empirical; not early; post-basic; simulated rather than 'authentic' experience.
DATA COLLECTION
Careful validation of selection processes. Coding by two reviewers onto an extensively modified version of the standard BEME coding sheet. Accumulation into an Access database. Secondary coding and synthesis of an interpretation.
HEADLINE RESULTS
A total of 73 studies met the selection criteria and yielded 277 educational outcomes; 116 of those outcomes (from 38 studies) were rated strong and important enough to include in a narrative synthesis of results; 76% of those outcomes were from descriptive studies and 24% from comparative studies. Early experience motivated and satisfied students of the health professions and helped them acclimatize to clinical environments, develop professionally, interact with patients with more confidence and less stress, develop self-reflection and appraisal skill, and develop a professional identity. It strengthened their learning and made it more real and relevant to clinical practice. It helped students learn about the structure and function of the healthcare system, and about preventive care and the role of health professionals. It supported the learning of both biomedical and behavioural/social sciences and helped students acquire communication and basic clinical skills. There were outcomes for beneficiaries other than students, including teachers, patients, populations, organizations and specialties. Early experience increased recruitment to primary care/rural medical practice, though mainly in US studies which introduced it for that specific purpose as part of a complex intervention.
CONCLUSIONS
Early experience helps medical students socialize to their chosen profession. It helps them acquire a range of subject matter and makes their learning more real and relevant. It has potential benefits for other stakeholders, notably teachers and patients. It can influence career choices.
Topics: Attitude of Health Personnel; Clinical Clerkship; Clinical Competence; Curriculum; Empathy; Family Practice; Forecasting; Health Knowledge, Attitudes, Practice; Health Services Research; Physician-Patient Relations; Primary Health Care; Socialization; United Kingdom
PubMed: 16627313
DOI: 10.1080/01421590500410971 -
Journal of Thermal Biology Feb 2024Cross-adaptation (CA) refers to the successful induction of physiological adaptation under one environmental stressor (e.g., heat), to enable subsequent benefit in... (Meta-Analysis)
Meta-Analysis
Cross-adaptation (CA) refers to the successful induction of physiological adaptation under one environmental stressor (e.g., heat), to enable subsequent benefit in another (e.g., hypoxia). This systematic review and exploratory meta-analysis investigated the effect of heat acclimation (HA) on physiological, perceptual and physical performance outcome measures during rest, and submaximal and maximal intensity exercise in hypoxia. Database searches in Scopus and MEDLINE were performed. Studies were included when they met the Population, Intervention, Comparison, and Outcome criteria, were of English-language, peer-reviewed, full-text original articles, using human participants. Risk of bias and study quality were assessed using the COnsensus based Standards for the selection of health status Measurement INstruments checklist. Nine studies were included, totalling 79 participants (100 % recreationally trained males). The most common method of HA included fixed-intensity exercise comprising 9 ± 3 sessions, 89 ± 24-min in duration and occurred within 39 ± 2 °C and 32 ± 13 % relative humidity. CA induced a moderate, beneficial effect on physiological measures at rest (oxygen saturation: g = 0.60) and during submaximal exercise (heart rate: g = -0.65, core temperature: g = -0.68 and skin temperature: g = -0.72). A small effect was found for ventilation (g = 0.24) and performance measures (peak power: g = 0.32 and time trial time: g = -0.43) during maximal intensity exercise. No effect was observed for perceptual outcome measures. CA may be appropriate for individuals, such as occupational or military workers, whose access to altitude exposure prior to undertaking submaximal activity in hypoxic conditions is restricted. Methodological variances exist within the current literature, and females and well-trained individuals have yet to be investigated. Future research should focus on these cohorts and explore the mechanistic underpinnings of CA.
Topics: Male; Humans; Acclimatization; Adaptation, Physiological; Heat-Shock Response; Exercise; Hypoxia; Heat Stress Disorders
PubMed: 38471285
DOI: 10.1016/j.jtherbio.2024.103793 -
Journal of Thermal Biology May 2021Thermal conditioning has been introduced as a cost-effective way to improve performance and thermotolerance in broilers. However, since all the trials were performed... (Meta-Analysis)
Meta-Analysis
Thermal conditioning has been introduced as a cost-effective way to improve performance and thermotolerance in broilers. However, since all the trials were performed under various experimental conditions, it appears difficult to draw general conclusions. Therefore, the objective of this study was to quantify the response of broilers to thermal conditioning through a meta-analysis approach. A literature search was conducted on Scopus, PubMed, Scielo, Web of Science, and Google scholar in December 2020. A restricted maximum likelihood random effect model was used to pool the effect sizes from the body weight gain (BWG), feed intake (FI), feed conversion ratio (FCR), and body temperature (Tb). BWG, FI, and Tb were computed using the standardized mean difference (SMD) while FCR was computed using mean differences (MD) with a 95% confidence interval (IC). Growth performances were evaluated during the thermoneutral conditions while Tb was evaluated after either acute or chronic heat stress after early age thermal conditioning. A total of 17 studies were included in the dataset. Thermal conditioning significantly increased BWG (SMD = 0.139, IC = 0.0372-0.2407, P = 0.0074) and FI (SMD = 0.292, IC = 0.108-0.476, P = 0.0019) compared with the control. Additionally, subgroup analysis revealed that overall Tb was significantly reduced under acute heat stress (SMD = -0.455, IC = -0.718 to -0.192, P < 0.001) but not affected during chronic heat stress (SMD = -0.115, IC = -0.651 to -0.420, P = 0.6729). In conclusion, thermal conditioning significantly increased the broiler's BWG and FI under thermoneutral conditions and can help in reducing Tb under acute heat stress.
Topics: Animals; Chickens; Heat-Shock Response; Thermotolerance
PubMed: 34016343
DOI: 10.1016/j.jtherbio.2021.102916 -
BMC Public Health Jun 2024Global warming has led to an increase in the number and intensity of extreme heat events, posing a significant threat to the health and safety of workers, especially...
PURPOSE
Global warming has led to an increase in the number and intensity of extreme heat events, posing a significant threat to the health and safety of workers, especially those working outdoors, as they often have limited access to cooling strategies. The present systematic literature review (a) summarizes the current knowledge on the impacts of climate change on outdoor workers, (b) provides historical background on this issue, (c) explores factors that reduce and increase thermal stress resilience, (d) discusses the heat mitigation strategies, and (e) provides an overview of existing policy and legal frameworks on occupational heat exposure among outdoor workers.
MATERIALS AND METHODS
In this systematic review, we searched scientific databases including Scopus (N = 855), Web of Science (N = 828), and PubMed (N = 202). Additionally, we identified relevant studies on climate change and heat-stress control measures through Google Scholar (N = 116) using specific search terms. In total, we monitored 2001 articles pertaining to worker populations (men = 2921; women = 627) in various outdoor climate conditions across 14 countries. After full-text assessment, 55 studies were selected for inclusion, and finally, 29 eligible papers were included for data extraction.
RESULTS
Failure to implement effective control strategies for outdoor workers will result in decreased resilience to thermal stress. The findings underscore a lack of awareness regarding certain adaptation strategies and interventions aimed at preventing and enhancing resilience to the impact of climate change on heat stress prevalence among workers in outdoor tropical and subtropical environments. However, attractive alternative solutions from the aspects of economic and ecological sustainability in the overall assessment of heat stress resilience can be referred to acclimatization, shading, optimized clothing properties and planned breaks.
CONCLUSION
The integration of climate change adaptation strategies into occupational health programs can enhance occupational heat resilience among outdoor workers. Conducting cost-benefit evaluations of health and safety measures for thermal stress adaptation strategies among outdoor workers is crucial for professionals and policymakers in low- and middle-income tropical and subtropical countries. In this respect, complementary measures targeting hydration, work-rest regimes, ventilated garments, self-pacing, and mechanization can be adopted to protect outdoor workers. Risk management strategies, adaptive measures, heat risk awareness, practical interventions, training programs, and protective policies should be implemented in hot-dry and hot-humid climates to boost the tolerance and resilience of outdoor workers.
Topics: Humans; Climate Change; Heat Stress Disorders; Occupational Exposure; Hot Temperature; Female; Male
PubMed: 38926816
DOI: 10.1186/s12889-024-19212-3 -
Journal of Sports Science & Medicine Jun 2019The aim of this meta-analysis was to evaluate the effectiveness of heat acclimatization (HA) on time trial (TT) performance, maximum oxygen uptake (VO), exercise heart... (Meta-Analysis)
Meta-Analysis
The aim of this meta-analysis was to evaluate the effectiveness of heat acclimatization (HA) on time trial (TT) performance, maximum oxygen uptake (VO), exercise heart rate (HR), time trials heart rate (HR), maximal heart rate (HR), core temperature (T), mean skin temperature (T), thermal comfort (T), plasma volume (PV), blood lactate concentration and rate of perceived exertion (RPE). Cochrane-CENTRAL, EMBASE, CINAHL and PubMed databases and reference lists of included studies were searched for randomized controlled trials that investigated the efficacy of HA in athletes. Data were then extracted from the entered studies for analyses. A total of 11 randomised controlled trials (215 participants; mean age, 26.09 years; 91% men) were included after screening of 508 titles and abstracts and 19 full-text articles. The pooled standard mean difference (SMD) between the HA and non-HA groups were 0.50 (95% CI: 0.03 to 0.97, p = 0.04) for TT performance and 1 (95% CI: 1 to 2, p = 0.007) for HR. The pooled mean difference (MD) between the HA and non-HA groups were -7 (95% CI: -13 to -1, p = 0.03) for HR. The changes in T and RPE were too small to be meaningful. There were no significant differences between the HA and non-HA groups for VO, HR, T, T, PV and blood lactate concentration (all p > 0.05). This meta-analysis implies that HA may improve tolerance to discomfort during heat exposure, but may not necessarily improve the associated physiological markers of improved performance.
Topics: Acclimatization; Athletic Performance; Body Temperature; Heart Rate; Hot Temperature; Humans; Lactic Acid; Oxygen Consumption; Plasma Volume; Randomized Controlled Trials as Topic; Skin Temperature
PubMed: 31191102
DOI: No ID Found -
Journal of Thermal Biology Feb 2022Rheumatic Diseases (RD) are a class of disorders of the musculoskeletal system, including different conditions, and are considered a major cause of disability among the...
Rheumatic Diseases (RD) are a class of disorders of the musculoskeletal system, including different conditions, and are considered a major cause of disability among the population. RD do not have an objective and quick diagnosis and are sometimes challenging. In this way, Infrared Thermography (IT) could represent a fast and effective tool to detect essential information for diagnosing RD. Thus, the aim of this systematic review was to summarize and describe the clinical applicability of IT in RD. This innovative systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in the International Prospective Registry of Systematic Reviews (PROSPERO) (CRD42020214601). The risk of bias assessment was performed using the Cochrane tool. The PubMed, EMBASE, Science Direct, Web of Science, CINAHL, and SciELO databases were searched from their inception to June 2021. In total, 476 studies were identified and 12 studies met the inclusion criteria. The main RD analyzed were Raynaud's Phenomenon (RP), Scleroderma, Osteoarthritis (OA), Rheumatoid arthritis (RA), and localized juvenile scleroderma. The assessment protocols were similar in terms of acclimatization time, distance between the camera and the individual, temperature, and ambient humidity. Evidence demonstrates that infrared thermography is an effective tool to assess the health status of individuals with rheumatic diseases, producing clinical information relevant to diagnosis and treatment.
Topics: Humans; Infrared Rays; Rheumatic Diseases; Thermography
PubMed: 35180959
DOI: 10.1016/j.jtherbio.2021.103172