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The Effect of Vitamin D Supplementation in Elite Adolescent Dancers on Muscle Function and Injury Incidence: A Randomised Double-Blind Study.(International Journal of Sports Physiology and Performance, 2018-06-12)A number of studies have noted low levels of Vitamin D in dancers and this has been associated with increased risk of injuries and decreased muscular strength indices. The aim of the present study was to examine whether vitamin D supplementation over a 4-month period can improve muscle function and injury incidence. Eighty-four participants volunteered, exclusion criteria and drop out (19%) reduced cohort to 67 (f=29, m=38; 17-19yrs). Participants were randomly assigned to either an intervention or placebo group (2:1 ratio). All provided a venous blood sample pre and post the 4-month study period. The intervention group received 120,000IU vitamin D to be taken over a 1-week period and the placebo group received the same number of inert pills. Participants completed a series of muscle function tests pre and post the monitoring period. Injury incidence was recorded by the independent health team at the school. Pre-intervention 6% of the cohort were vitamin D deficient, 81% were insufficient and 13% had sufficient levels; post-intervention 53% were insufficient and 47% were sufficient. The intervention group reported a significant increase in serum 25(OH)D3 (57%; p<0.00) and isometric strength (7.8%; p=0.022) but not muscular power. There was a significant association between traumatic injury occurrence for the intervention and control groups (10.9% vs. 31.8%; p < .02). Vitamin D supplementation decreased the numbers of deficient and insufficient participants within this cohort. The intervention group reported a small significant increase in muscle strength that was negatively associated with traumatic injury occurrence.
10 Marked differences in the pharmacokinetic and pharmacodynamic profiles of ticagrelor in patients undergoing treatment for ST elevation and non ST elevation myocardial infarction (stemi and nstemi)(BMJ Publishing Group, 2018-06-01)Introduction Ticagrelor, an orally administered, direct acting, reversible P2Y12 receptor inhibitor, provides faster onset and greater levels of platelet inhibition when compared to clopidogrel. Current data indicates a reduced antiplatelet effect in STEMI. We sought to determine the early pharmacokinetic (PK) and pharmacodynamic (PD) effect of ticagrelor loading doses administered to patients undergoing PCI for STEMI and NSTEMI. Methods This is a single centre non-randomised study. P2Y12 naive patients presenting with STEMI or NSTEMI were considered for inclusion. All patients gave informed consent. Enrolled patients were administered a loading dose of aspirin 300 mg and ticagrelor 180 mg prior to PCI. Blood was sampled at 20 min, coronary balloon time, 1 hour and 4 hours after loading. PD results are expressed as P2Y12 reaction units (PRU) and were assessed using VerifyNow. A PRU>208 indicates a sub-optimal antiplatelet response. PK properties were assessed by measuring plasma concentration of ticagrelor parent compound (T-PC) and active metabolite (T-AM) using liquid chromatography in tandem with mass spectrometry. The lower limits of quantification of T-PC and its active metabolite, AR-C124910XX (T-AM) are 1 ng/ml and 2.5 ng/ml respectively. PRU and plasma concentrations over time were tested between the two groups using 2-way ANOVA. p<0.05 was considered significant. Results 30 patients (15 STEMI/15 NSTEMI) were recruited. Baseline characteristics are described in Table 1.
Psychosocial determinants of depression in the community of the elderly with cardiovascular disease.(Elsevier, 2018-03-17)The co-morbidity of cardiovascular disease (CVD) and depression is quite frequent in old people, and some potential biological and behavioural mechanisms linking them have been reported. Yet the impact of psychosocial factors on depression in the elderly with CVD remains unclear. This study aimed to analyze the psychosocial determinants of depression in the elderly with CVD. Using the Geriatric Mental Status-Automated Geriatric Examination for Computer Assisted Taxonomy, a community-based household survey was performed in 2,199 elderly people from the Anhui cohort third-wave survey from 2007 to 2009 and an extended study in Hubei from 2010 to 2011. Multiple logistic regression analyses were employed to assess the influence of psychosocial factors on depression. Among them, the prevalence of depression was 4.77%. Three factors were associated with depression in elderly in the community: self-assessed physical health status, anything else severely upsetting and unpleasantness with relatives, friends, or neighbors. In particular, associations of psychosocial factors with depression were more evident in individuals with CVD. This study confirms several psychosocial determinants of depression and the impact of CVD on the associations among the elderly, which provides some clues for interventional strategies of late-life depression.
Childhood maltreatment and psychotic experiences: exploring the specificity of early maladaptive schemas(Wiley, 2018-07-13)Objective: One potential mechanism that has received limited attention within psychosis research, is early maladaptive schemas (EMS). Our aim was to examine if EMS acts as a potential mediating pathway between early trauma and psychotic symptomology. Methods: A quantitative survey was hosted online. N= 302 participants took part. The analysis employed a multiple mediation framework. Results: Analysis demonstrated significant specificity effects. Different forms of child maltreatment were significantly associated with psychosis experiences through specific dimensions of maladaptive schemas. Conclusions: Results indicated specificity effects in that specific types of maltreatment are associated with specific maladaptive schemas. From a practitioner’s perspective, these findings offer credence to cognitive theories of psychopathology, and support the validity of EMS identification and modification among clients with psychotic symptomology; both as a fundamental component of traditional CBT and within specialised schema focused therapy.