Individual Response to Standardized Exercise: Total and Abdominal Adipose Tissue.

PURPOSE: (1) Determine the effect of exercise amount and intensity on the proportion of individuals for whom the adipose tissue (AT) response is above the minimal clinically important difference (MCID); and (2) Examine whether clinically meaningful anthropometric changes reflect individual AT responses above the MCID. METHODS: Men (n = 41) and women (n = 62) (52.7 ± 7.6 yr) were randomized to control (n = 20); low amount low intensity (n = 24); high amount low intensity (n = 30); and high amount high intensity (n = 29) treadmill exercise for 24 wk. The AT changes were measured by MRI. 90% confidence intervals for each individual's observed response were calculated as the observed score ±1.64 × TE (technical error of measurement). RESULTS: For visceral AT, HAHI and HALI had a greater proportion of individuals whose AT change and 90% confidence interval were beyond the MCID compared to controls (P < 0.006). For all other AT depots, all exercise groups had significantly more individuals whose changes were beyond the MCID compared with controls. Of those who achieved a waist circumference or body weight reduction ≥ the MCID, 76% to 93% achieved abdominal, abdominal subcutaneous, and visceral AT changes ≥ the MCID. CONCLUSIONS: Increasing exercise amount and/or intensity may increase the proportion of individuals who achieve clinically meaningful visceral AT reductions. Waist circumference or body weight changes beyond a clinically meaningful threshold are predictive of clinically meaningful abdominal adiposity changes.

Individual Response to Standardized Exercise: Total and Abdominal Adipose Tissue.

PURPOSE: (1) Determine the effect of exercise amount and intensity on the proportion of adipose tissue (AT) responses likely, very likely, and unlikely above the minimal clinically important difference (MCID); and (2) Examine whether clinically meaningful anthropometric changes reflect individual AT responses above the MCID. METHODS: Men (n=41) and women (n=62) (52.7 ± 7.6 years) were randomized to control (N=20); low amount low intensity (LALI, N=24); high amount low intensity (HALI, N=30); and high amount high intensity (HAHI, N=29) exercise for 24 weeks. AT changes were measured by MRI. The probability that individual responses were > MCID after adjusting for technical error of measurement were calculated for each individual and categorized as: 'Unlikely' = < 25%, 'Possibly' = 25-74%, 'Likely' = 75-94%, 'Very Likely' = 95-100% chance. RESULTS: The HALI (total AT) and HAHI (total AT, visceral AT) groups had a greater proportion of individuals whose response was "very likely" ≥ MCID vs controls (p<0.006). Across the abdominal AT depots, for individuals who reduced WC or body weight ≥ 2 cm or 2 kg, respectively, 51-69% of responses were "likely" or "very likely" beyond the MCID. CONCLUSION: Increasing exercise amount and/or intensity may increase the proportion of individuals deemed 'very likely' to achieve clinically meaningful AT reductions. The use of anthropometric change to identify individual response for adiposity reduction remains a challenge.

Mosquitoes and tourism in Grenada - Poster abstract

The global public health importance of mosquitoes cannot be over-emphasised. The tourist industry relies heavily on customer satisfaction and this study examined the importance of mosquitoes as a cause of dissatisfaction amongst tourists visiting Grenada. Tourists who had spent three days or more at four popular hotels were included in the study. This study also examined the species and breeding site distribution of mosquitoes in the hotels selected. Three cross sectional surveys were carried out in both the dry and wet seasons at various time intervals and ovitraps were placed in various parts of each hotel for up to a week. Eggs collected from these traps were identified. Aedes sp were more numerous than Culex sp eggs and were more numerous in the rainy season. Of the tourists interviewed by questionaire, 87 percent had been bitten by mosquitoes during their stay; 74 percent had been bitten twice, 18 percent twenty times and 8 percent more than 20 times. Seventy-seven percent (77 percent) of tourists perceived mosquitoes as a severe biting nuisance whilst 16 percent and 7 percent perceived them as moderate or mild, respectively. Biting nuisance was most severe in the wet season and the dining room was reported as the most important site where biting took place for all hotels studied. Potential breeding sites were identified and appropriate mosquito control measures have been suggested to the hotels.(AU)

Knowledge and fears of anaesthesia in Jamaican patients

One hundred Jamaican patients between the ages of 12 and 80 years were interviewed pre-operatively to determine their knowledge and fears of anaesthesia/surgery. Only 15 percent knew what role the anaesthetist would play in their care. Sixty-two per cent thought that he/she worked under the direction of the surgeon. Eighty-three per cent expressed no fear of going to sleep for surgery and 60 percent actually expressed a specific fear of anaesthesia. The patients utilised doctors and nurses as their main sources of information to gain knowledge pre-operatively of the operative experience. The importance of simple, comprehensive explanations given to patients by this group of personnel, particularly by the anaesthetist at a pre-operative visit, is emphasised. Other methods to explain the role of anaesthesia to patients are described, and their suitability for use in developing countries is discussed (AU)