Nadir blood pressure responses to longer consecutive cardiac cycle sequences absent of sympathetic bursts are associated with popliteal endothelial-dependent dilation.

PURPOSE: The nadir pressure responses to cardiac cycles absent of muscle sympathetic nerve activity (MSNA) bursts (or non-bursts) are typically reported in studies quantifying sympathetic transduction, but the information gained by studying non-bursts is unclear. We tested the hypothesis that longer sequences of non-bursts (≥8 cardiac cycles) would be associated with a greater nadir diastolic blood pressure (DBP) and that better popliteal artery function would be associated with an augmented reduction in DBP. METHODS: Resting beat-by-beat DBP (via finger photoplethysmography) and common peroneal nerve MSNA (via microneurography) were recorded in 39 healthy, adults (age 23.4 ± 5.3 years; 19 females). For each cardiac cycle absent of MSNA bursts, the mean nadir DBP (ΔDBP) during the 12 cardiac cycles following were determined, and separate analyses were conducted for ≥8 or < 8 cardiac cycle sequences. Popliteal artery endothelial-dependent (via flow-mediated dilation; FMD) and endothelial-independent vasodilation (via nitroglycerin-mediated dilation; NMD) were determined. RESULTS: The nadir DBP responses to sequences ≥8 cardiac cycles were larger (-1.40 ± 1.27 mmHg) than sequences <8 (-0.38 ± 0.46 mmHg; p < 0.001). In adjusting for sex and burst frequency (14 ± 8 bursts/min), larger absolute or relative FMD (p < 0.01), but not NMD (p > 0.53) was associated with an augmented nadir DBP. This overall DBP-FMD relationship was similar in sequences ≥8 (p = 0.04-0.05), but not <8 (p > 0.72). CONCLUSION: The DBP responses to non-bursts, particularly longer sequences, were inversely associated with popliteal endothelial function, but not vascular smooth muscle sensitivity. This study provides insight into the information gained by quantifying the DBP responses to cardiac cycles absent of MSNA.

Moderate intensity intermittent lifestyle physical activity is associated with better executive function in older adults.

Executive functions are among the first cognitive abilities to decline with age and age-related executive function slowing predisposes older adults to cognitive disorders and disease. Intermittent Lifestyle Physical Activity (ILPA) reflects brief, unplanned activity that occurs during routine daily activities and is operationalized as activity bouts <60s. Our understanding of short bouts of habitual physical activity and executive functions is limited. We tested the hypothesis that greater amounts of ILPA in moderate and vigorous intensity domains would be associated with better executive function in older adults. Forty older adults (26 females, 68 ± 6, >55 years; body mass index: 26.6 ± 4.3 kg/m2) completed a Trail-Making-Task and wore an activPAL 24-hr/day for 6.2 ± 1.8-days. For each intensity, total time and time spent in bouts <60 s were determined. Trail A (processing speed) and Trail B (cognitive flexibility) were completed in 25.8 ± 8.2 s and 63.2 ± 26.2 s, respectively. Non-parametric Spearman's rank correlations report that moderate ILPA (3.2 ± 3.2 min/day) and total-moderate physical activity (20.1 ± 16.0 min/day) were associated with faster Trail A (total-moderate physical activity: ρ=-0.48; moderate-ILPA: ρ = -0.50; both, p < 0.003) and Trail B time (total-moderate physical activity: ρ = 0.36; moderate-ILPA: ρ = -0.46; both, p < 0.020). However, the results show no evidence of an association with either vigorous physical activity or light physical activity (total time or ILPA bouts: all, p > 0.180). Moderate physical activity accumulated in longer bouts (>60 s) was not associated with Trail B time (p = 0.201). Therefore, more total moderate physical activity and shorter bouts (<60 s) may result in better executive functions in older adults.

Effectiveness of contrast-enhanced duplex ultrasound for detecting renal artery stenosis: A systematic review.

PURPOSE: Contrast-enhanced duplex ultrasound (CEUS) might be a useful tool to diagnosing renal artery stenosis (RAS). We amalgamated and reviewed the evidence assessing the diagnostic accuracy of CEUS on detecting RAS compared to angiography. METHODS: This preregistered systematic review included studies that compared the presence of RAS via CEUS with angiography. Sources were searched in November 2022 and included Scopus, EMBASE, MEDLINE, CINAHL, and Academic Search Premier (n = 1717). The Quality Assessment of Diagnostic Studies 2 tool assessed study quality. Results are presented narratively. RESULTS: The studies included (n = 11) had a total of 447 unique participants (193 females) and average age of 56 ± 9 years. Five of eleven studies investigated CEUS using SonoVue contrast agent and reported an average accuracy (91% ± 2%), sensitivity (91% ± 3%), specificity (90% ± 5%), negative predictive value (86% ± 6%), and positive predictive value (94% ± 1%) with all values >80%. The accuracy of CEUS using other types of contrast agent (n = 6), including Levovsit (n = 3/6), Definity (n = 1/6), perfienapent emulsion (n = 1/6), and perfluorocarbon-exposed sonicated dextrose albumin (n = 1/6) was mixed. These studies detected an average accuracy of 91 ± 11% (n = 2/3% > 80%), sensitivity of 98% ± 4%, (n = 3/3% > 80%), and specificity of 86% ± 10% (n = 2/3% > 80%). Included studies had generally low risk of bias and applicability concerns except for unclear flow and timing (n = 7/11) and applicability of patient selection (n = 4/11). CONCLUSION: Despite being limited by the heterogeneity of included studies, our review indicates a high overall diagnostic accuracy for CEUS to detect RAS compared to angiography, with the largest evidence-base for SonoVue contrast. Radiologists and hospital decision makers should consider CEUS as an acceptable alternative to angiography.

Sitting knee-flexion angle does not influence endothelial-dependent vasodilation in laboratory or free-living conditions.

INTRODUCTION: Single bouts of prolonged bent-legged sitting attenuate popliteal endothelial-dependent vasodilation (as assessed via flow-mediated dilation [FMD]), which is partially attributed to arterial 'kinking'. However, the impact of knee-flexion angle on sitting-induced popliteal FMD is unknown. The objective of this study was to perform separate laboratory and free-living studies to test the hypotheses that: (1) popliteal FMD impairments would be graded between knee flexions at 90° (bent-legged sitting) > 45° > 0° (straight-legged sitting) following a 3-hour bout of sitting; and (2) more habitual time spent bent-legged sitting (< 45°) would be associated with lower FMD. METHODS: The laboratory study included eight young, healthy adults (24 ± 2 years; four women) who underwent two sitting bouts over 2 days with one leg positioned at a knee-flexion angle of 0° or 90° and the opposite leg at 45° knee flexion. Popliteal FMD was assessed at pre- and postsitting timepoints. RESULTS: Sitting-induced reductions in FMD were similar between all knee-flexion angles (all, p > 0.674). The free-living study included 35 young, healthy adults (23 ± 3 years; 16 women) who wore three activPAL monitors (torso, thigh, shin) to determine detailed sedentary postures. Time spent sedentary (624 ± 127 min/day), straight-legged sitting (112 ± 98 min/day), and bent-legged sitting (442 ± 106 min/day) were not related to relative FMD (5.3 ± 1.8%; all, p > 0.240). CONCLUSION: These findings suggest that knee-flexion angle-mediated arterial 'kinking' during sitting is not a major contributor toward sitting-induced popliteal endothelial-dependent vasodilatory dysfunction.

Faster stepping cadence partially explains the higher metabolic cost of walking among females versus males.

The metabolic cost of walking (MCOW), or oxygen uptake normalized to distance, provides information on the energy expended during movement. There are conflicting reports as to whether sex differences in MCOW exist, with scarce evidence investigating factors that explain potential sex differences. This study 1) tested the hypothesis that females exhibit a higher MCOW than males, 2) determined whether normalizing to stepping cadence ameliorates the hypothesized sex difference, and 3) explored whether more habitual step counts and time in intensity-related physical activity, and less sedentary time were associated with a decreased MCOW. Seventy-six participants (42 females, 24 ± 5 yr) completed a five-stage, graded treadmill protocol with speeds increasing from 0.89 to 1.79 m/s (6-min walking stage followed by 4-min passive rest). Steady-state oxygen uptake (via indirect calorimetry) and stepping cadence (via manual counts) were determined. Gross and net MCOW, normalized to distance traveled (km) and step-cadence (1,000 steps) were calculated for each stage. Thirty-nine participants (23 females) wore an activPAL on their thigh for 6.9 ± 0.4 days. Normalized to distance, females had greater gross MCOW (J/kg/km) at all speeds (P < 0.014). Normalized to stepping frequency, females exhibited greater gross and net MCOW at 1.12 and 1.79 m/s (J/kg/1,000 steps; P < 0.01) but not at any other speeds (P < 0.075). Stature was negatively associated with free-living cadence (r = -0.347, P = 0.030). Females expend more energy/kilometer traveled than males, but normalizing to stepping cadence attenuated these differences. Such observations provide an explanation for prior work documenting higher MCOW among females and highlight the importance of stepping cadence when assessing the MCOW.NEW & NOTEWORTHY Whether there are sex differences in the metabolic cost of walking (MCOW) and the factors that may contribute to these are unclear. We demonstrate that females exhibit a larger net MCOW than males. These differences were largely attenuated when normalized to stepping cadence. Free-living activity was not associated with MCOW. We demonstrate that stepping cadence, but not free-living activity, partially explains the higher MCOW in females than males.

Mechanistic, participant, and movement-related factors that contribute to low-flow-mediated constriction.

Endothelial function is commonly determined via the ultrasound-based flow-mediated dilation (FMD) technique which assesses arterial dilation in response to a hyperemia response following distal cuff occlusion. However, the low-flow-mediated constriction (L-FMC) response during cuff-induced ischemia is often overlooked. L-FMC provides unique information regarding endothelial function, but vascular researchers may be unclear on what this metric adds. Therefore, the objective of this review was to examine the mechanistic determinants and participant-level factors of L-FMC. Existing mechanistic studies have demonstrated that vasoreactivity to low flow may be mediated via non-nitric oxide vasodilators (i.e., endothelial hyperpolarizing factors and/or prostaglandins), inflammatory markers, and enhancement of vasoconstriction via endothelin-1. In general, participant-level factors such as aging and presence of cardiovascular conditions generally are associated with attenuated L-FMC responses. However, the influence of sex on L-FMC is unclear with divergent results between L-FMC in upper versus lower limb vessels. The ability of aerobic exercise to augment L-FMC (i.e., make more negative) is well supported, but there is a major gap in the literature concerning the mechanistic underpinnings of this observation. This review summarizes that while larger L-FMC responses are generally healthy, the impact of interventions to augment/attenuate L-FMC has not included mechanistic measures that would provide insight into non-nitric oxide-based endothelial function. Clarifications to terminology and areas of further inquiry as it relates to the specific pharmacological, individual-level factors, and lifestyle behaviors that impact L-FMC are highlighted. A greater integration of mechanistic work alongside applied lifestyle interventions is required to better understand endothelial cell function to reductions in local blood flow.

Impact of exercise training on pulse wave velocity in healthy and clinical populations: a systematic review of systematic reviews.

Elevated pulse wave velocity (PWV) determined arterial stiffness is a prominent marker of cardiovascular disease (CVD) risk. Exercise training delays the progression of CVD, but existing reviews on the impact of training on PWV are conflicting. We synthesized the evidence on the effects of exercise training interventions on PWV. We searched Scopus, EMBASE, PubMed, CINAHL, and Academic Search Premier databases for systematic reviews including PWV, and examined the effects of exercise training on PWV. We screened 842 citations that resulted in 44 systematic reviews, including 22 meta-analyses [unique participants, n = 6,719 (3,390 females)]. Studies were conducted in general adults with/without disease(s) (n = 19, 8 meta-analyses), kidney disease (n = 9, 6 meta-analyses), increased CVD risk or CVD (n = 7, 5 meta-analyses), type 2 diabetes mellitus (n = 3, 2 meta-analyses), and other conditions (n = 6, 2 meta-analyses). In general adults, PWV was reduced by aerobic exercise (ß, -0.75 to -0.52 m/s) and low-to-moderate intensity resistance exercise training (ß, -0.34 m/s). Exercise training was beneficial for patients with kidney disease (ß, -1.13 to -0.56 m/s). Aerobic exercise improved PWV in adults with CVD or high CVD risk (ß, -0.70 to -0.42 m/s). Combined aerobic and resistance exercise training decreased carotid-femoral (CF) PWV in patients with CVD (ß, -1.15 m/s) and decreased brachial-ankle (BA) PWV in postmenopausal females (ß, -1.18 m/s). Neither aerobic nor combined training improved PWV in individuals with type 2 diabetes. The potential physiological mechanisms involved are discussed. Overall, the included systematic reviews and meta-analyses documented that exercise training was an effective strategy to improve PWV, but the optimal type of training varied between populations.

Impact of unilateral dual-brachial arteries on endothelial-dependent and endothelial-independent vasodilation: a case study.

TAKE HOME MESSAGE: Our case study indicated that a bifurcated brachial artery exhibited worse vasodilatory responses relative to an intact contralateral artery.

Higher habitual lying time is inversely associated with vagal-related heart rate variability outcomes in younger adults.

Heart rate variability (HRV) is a well-established noninvasive marker of autonomic cardiac control. We test whether time spent sitting (negatively) versus lying (positively) influences vagal HRV outcomes. HRV (10 min supine electrocardiogram) and free-living postures (dual-accelerometer configuration, 7 days) were measured in 31 young healthy adults (15♀, age: 23 ± 3 years). Habitual lying (66 ± 61 min/day), but not sitting time (558 ± 109 min/day), total sedentary time (623 ± 132 min/day), nor step counts (10 752 ± 3200 steps/day; all, p > 0.090), was associated with root mean square of successive cardiac interval differences (ρ = -0.409, p = 0.022) and normalized high-frequency HRV (ρ = -0.361, p = 0.046). These findings document a paradoxical negative impact of waking lying time on cardioautonomic function. Take home message Using a multi-accelerometer configuration, we demonstrated that more habitual waking time lying, but not sitting or total sedentary time, was associated with worse vagally mediated cardiac control.

Physical function in children and adolescents pre- and 1-year post-liver transplant.

BACKGROUND: Several studies describe poorer motor developmental motor outcomes post-liver transplant (LT) in younger children. Limited studies examine physical function in older children and adolescents pre- and post-LT. METHODS: Retrospective review of standard of care physical function outcome measures pre- and 1-year post-LT in children ≥6 years at LT. Measures include: 6-minute walk test (6MWT), grip strength, Bruininks-Oseretsky Test of Motor Proficiency-2 (BOT-2) components, Physical Activity Questionnaire (PAQ), and Paediatric Quality of Life Multidimensional Fatigue Scale. Association of medical variables with outcomes was explored. RESULTS: The study cohort included 23 (8 male, median (interquartile range) age 11.67 (8.25, 13.92) years at LT) participants. Top two primary diagnoses included biliary atresia (30.4%) and fulminant hepatic failure (21.7%). At 1-year post-LT, over one-third (36%) were overweight or obese. Compared with healthy norms, children had significantly lower pre-LT PAQ scores (p = .002), pre- and post-6MWT scores (p < .001) and post-LT BOT-2 strength and agility scores (p < .001). Pre-LT, lower balance scores were associated with abdominal distention/ascites (p = .009) and splenomegaly (p = .017). Lower pre-LT platelet count correlated with poorer balance (r = .532, p = .017) and lower strength and agility scores (r = .446, p = .043). Significant moderate inverse correlations were found between weight/body mass index z-scores and BOT-2 components. Post-LT children continue to demonstrate decreased levels of motor proficiency and functional capacity but report less fatigue and increased physical activity. CONCLUSIONS: Older children and adolescents undergoing LT are at risk of decreased physical function, highlighting the need for pre- and post-LT rehabilitation to optimize long term outcomes.

Validity of ActivPAL CREA software detection of sitting and lying during free-living conditions.

Objective. Approaches to differentiate sitting and lying are available within the default activPAL software from a single thigh-worn monitor. Dual-monitor methods use multiple monitors positioned on the thigh and torso to characterize sitting versus lying. We evaluated the validity between these two methods to measure waking, sitting, and lying time in free-living conditions. We also examined if the degree-threshold distinguishing sitting/lying for the dual-monitor (<30° and <45°) impacted results.Approach. Thirty-five young adults (24 ± 3 years, 16 females) wore an activPAL 24 h per day on their thigh and torso during free-living conditions (average: 6.8 ± 1.0 d, 239 total). Data were processed using the default activPAL software (thigh-only) or a custom MATLAB program (dual-monitor).Main results. The single-monitor recorded less lying time (59 ± 99 min d-1) and more sitting time (514 ± 203 min d-1) than the dual-monitor method regardless of 30° (lying: 85 ± 94 min d-1; sitting: 488 ± 166 min d-1) or 45° lying threshold (lying: 170 ± 142, sitting: 403 ± 164 min d-1; all,p< 0.001). The single monitor lying time was weakly correlated to the dual-monitor (30°:ρ= 0.25, 45°:ρ= 0.21; both,p< 0.001), whereas sitting was moderate-strong (30°:ρ= 0.76, 45°:ρ= 0.58; both,p< 0.001). However, the mean absolute error was 81 min d-1(30°) and 132 min d-1(45°) for both lying and sitting.Significance. The method of differentiating sitting/lying from a single thigh-worn activPAL records more sitting time and less lying time compared to a dual-monitor configuration (regardless of degree-threshold) that considered the position of the torso. A further refinement of algorithms or implementation of multiple-monitor methods may be needed for researchers to derive detailed sedentary positions.

Exercise training augments brain function and reduces pain perception in adults with chronic pain: A systematic review of intervention studies.

Introduction: Chronic pain (CP) is a leading cause of disability worldwide. Pain may be measured using subjective questionnaires, but understanding the underlying physiology, such as brain function, could improve prognosis. Further, there has been a shift towards cost-effective lifestyle modification for the management of CP. Methods: We conducted a systematic review (Registration: #CRD42022331870) using articles retrieved from four databases (Pubmed, EMBASE, AMED, and CINAHL) to assess the effect of exercise on brain function and pain perception/quality of life in adults with CP. Results: Our search yielded 1879 articles; after exclusion, ten were included in the final review. Study participants were diagnosed with either osteoarthritis or fibromyalgia. However, two studies included "fibromyalgia and low back pain" or "fibromyalgia, back, and complex regional pain." Exercise interventions that were 12 weeks or longer (n = 8/10) altered brain function and improved pain and/or quality of life outcomes. The cortico-limbic pathway, default-mode network, and dorsolateral prefrontal cortex were key regions that experienced alterations post-intervention. All studies that reported an improvement in brain function also demonstrated an improvement in pain perception and/or quality of life. Discussion: Our review suggests that alterations in brain function, notably the cortico-limbic, default-mode and dorsolateral prefrontal cortex, may be responsible for the downstream improvements in the subjective experience of CP. Through appropriate programming (i.e., length of intervention), exercise may represent a viable option to manage CP via its positive influence on brain health.

More moderate-intensity physical activity and less prolonged sedentary time are associated with better very short-term systolic blood pressure variability in healthy adults.

Whole-day movement guidelines for improving health, recommend that adults engage in at least 150 min week-1 of moderate-to-vigorous aerobic physical activity and limit their sedentary time. In young adults, higher systolic blood pressure variability (BPV) is a precursor for the development of hypertension. The impact of habitual activity that comprises (inter)national guidelines on BPV is unclear. We tested the hypothesis that less habitual physical activity and greater sedentary time would be associated with larger BPV. Ninety-two normotensive participants [age: 19-38 years, body mass index (BMI): 23.6 ± 3.3 kg/m2, 44♀] wore an activPAL monitor on their thigh for 7.0 ± 0.3 days. Ten minutes of supine systolic arterial pressure was measured via finger photoplethysmography (115 ± 11 mmHg). Beat-by-beat systolic BPV was measured using the average real variability index (1.1 ± 0.6 mmHg). Relationships between habitual activity outcomes and BPV were assessed via multiple regressions adjusted for age, sex, and BMI. Moderate-intensity physical activity (average: 36 ± 19 min day-1; ß = -0.010, p = 0.02) and time spent in sedentary bouts >1-h (245 ± 134 min day-1; ß = 0.002, p < 0.001), but not light-intensity activity, vigorous-intensity activity, standing time, sedentary breaks, or time spent in sedentary bouts <1-h (all, p > 0.10) were predictors of systolic BPV. Higher moderate physical activity and lower prolonged sedentary time were associated with attenuated systolic BPV responses in young adults. These findings highlight the cardiovascular benefits of habitual activity among younger adults and suggest that simple strategies such as reducing long periods of uninterrupted sitting and increasing moderate-intensity physical activity may be efficacious for reducing the risk of developing or delaying the onset of hypertension.

Impact of Exercise Training Interventions on Flow-Mediated Dilation in Adults: An Umbrella Review.

BACKGROUND: Dysfunction of the endothelium is a key precursor of cardiovascular disease. Endothelial function, as assessed via the flow-mediated dilation test, is attenuated with chronic disease (e.g., type 2 diabetes mellitus, hypertension). Exercise training may mitigate this dysfunction and promote better vascular health. OBJECTIVE: The main objective of this umbrella review was to determine the impact of exercise training on flow-mediated dilation in healthy adults and those with chronic disease. METHODS: Studies were included if they conducted a systematic review and/or meta-analysis on flow-mediated dilation responses to exercise interventions in adults. Sources were searched in January 2022 and included Scopus, EMBASE, MEDLINE, CINAHL, and Academic Search Premier. National Institutes of Health quality assessment tools were used. The results were presented narratively. RESULTS: Twenty-seven systematic reviews, including 19 meta-analyses, (total: 5464 unique participants, 2181 reported unique female individuals) met the inclusion criteria. The average overall quality of included reviews was 8.8/11. The quality of studies within each included review varied from low to moderate using a variety of quality assessment scales. Reviews were conducted in healthy adults (n = 9, meta-analyses = 6), as well as those with type 2 diabetes (n = 5, meta-analyses = 4), cardiovascular conditions [i.e., conditions that impact the cardiovascular system, but excluding samples of only type 2 diabetes] (n = 11, meta-analyses = 7), and other chronic conditions (n = 2, meta-analyses = 2). Overall, the included reviews provided evidence that the type of training to optimally improve FMD may vary based on disease condition. Specifically, the evidence suggests that healthy adults benefitted most from higher intensity aerobic training and/or more frequent low-to-moderate resistance training. In addition, adults with type 2 diabetes benefitted most from low-intensity resistance or aerobic exercise training, whereas those with cardiovascular conditions should consider engaging in high-intensity aerobic training to improve endothelial function. CONCLUSIONS: This information may help guide the design of specific exercise programs or recommendations for adults with chronic conditions.

Characterization of Detailed Sedentary Postures Using a Tri-Monitor ActivPAL Configuration in Free-Living Conditions.

Objective monitors such as the activPAL characterize time when the thigh is horizontal as sedentary time. However, there are physiological differences between lying, bent-legged sitting, and straight-legged sitting. We introduce a three-monitor configuration to assess detailed sedentary postures and demonstrate its use in characterizing such positions in free-living conditions. We explored time spent in each sedentary posture between prolonged (>1 h) versus non-prolonged (<1 h) sedentary bouts. In total, 35 healthy adults (16♀, 24 ± 3 years; 24 h/day for 6.8 ± 1.0 days) wore an activPAL accelerometer on their thigh, torso, and shin. Hip and knee joint flexion angle estimates were determined during sedentary bouts using the dot-product method between the torso−thigh and thigh−shin, respectively. Compared to lying (69 ± 60 min/day) or straight-legged sitting (113 ± 100 min/day), most time was spent in bent-legged sitting (439 ± 101 min/day, p < 0.001). Most of the bent-legged sitting time was accumulated in non-prolonged bouts (328 ± 83 vs. 112 ± 63 min/day, p < 0.001). In contrast, similar time was spent in straight-legged sitting and lying between prolonged/non-prolonged bouts (both, p > 0.26). We document that a considerable amount of waking time is accumulated in lying or straight-legged sitting. This methodological approach equips researchers with a means of characterizing detailed sedentary postures in uncontrolled conditions and may help answer novel research questions on sedentariness.

30 Year Trends of Reduced Physical Fitness in Undergraduate Students Studying Human Movement.

The physical fitness of Canadian adults has decreased over the past 30 years, while sedentary time has increased. However, it is unknown if university students studying human movement exhibit similar population declines. Physical fitness (i.e., anthropometrics, musculoskeletal fitness, and aerobic fitness) and habitual activity (e.g., physical activity, stationary time, etc.) was measured in a cohort of kinesiology students (Post30; 2010-2016; n = 129 males, 224 females) using standardized fitness testing and accelerometry, respectively. Physical fitness was compared to data collected on a cohort of students from the same institution and program, 30 years prior (i.e., Pre, 1984-1987, n = 103 males, 73 females). Post30 had greater waist circumference (males: 83.6 ± 9.1 cm vs. 77.8 ± 8.3 cm, females: 77.1 ± 9.7 cm vs. 70.3 ± 5.2 cm, both p < 0.001) and lower estimated maximal aerobic fitness (males: 55 ± 11 vs. 63 ± 7, females: 45 ± 10 vs. 50 ± 7 mLO2/kg/min, both, p < 0.001). Compared to Pre, male Post30 vertical jump (53.6 ± 10.2 vs. 57.0 ± 8.4 cm, p = 0.04) and female Post30 broad jump (178.7 ± 22.1 vs. 186.0 ± 15.5 cm, p < 0.001) were lower. A subsample (n = 65) of Post30 whose habitual activity was assessed, met the aerobic portion of Canadian physical activity guidelines (~400 min/week), but spent excessive amounts of time stationary (10.7 h/day). Current kinesiology students may not be immune to population decreases in physical fitness. Relative to previous group of students interested in movement, fitness was lower in our sample, potentially attributed to excessive stationary time. Regular assessment of physical fitness in kinesiology curriculums may be valuable to understand these declining trends in undergraduate students that mimic population declines in fitness.

Understanding the Use of Patient Rooms to Inform Family Zone Implementation: A Qualitative Study.

A family zone (FZ) is a portion of the patient room that visitors use to visit their loved one. The purpose of this study was to explore the experiences of patients, family and hospital staff to inform potential FZ implementation. Two focus groups (N = 17) were conducted using semi-structured interviews. Participants reported that family members assisted with patient care and engaged in positive social interactions while in the patient room, but physical design elements and organizational policies may act as barriers. Understanding the current use of and barriers to FZs can guide future implementation to maximize benefits for patient care.

Impact of habitual sedentary patterns on popliteal artery endothelial-dependent vasodilation in healthy adults.

INTRODUCTION: Acute, laboratory-based bouts of prolonged sitting attenuate lower-limb arterial endothelial-dependent vasodilation. However, the impact of habitual sedentary patterns on popliteal artery endothelial health is unclear. We tested the hypothesis that greater habitual total sedentary time, more time spent in prolonged sedentary bouts, and fewer sedentary breaks would be associated with worse popliteal flow-mediated dilation (FMD) responses. METHODS: This cross-sectional study used 98 healthy participants (19-77 years, 53 females) that wore an activPAL monitor on the thigh for 6.4 ± 0.8 days to objectively measure sedentary activity and completed a popliteal ultrasound assessment to determine FMD. Both relative (%baseline diameter) and absolute (mm) FMD were calculated. Using bivariate correlation and multiple regression analyses, we examined if there were relationships between sedentary outcomes and FMD while statistically controlling for any potential confounders. RESULTS: In the multiple regression model, age (p = 0.006, ß = -0.030, 95% CI = -0.051, -0.009) and total time in sedentary bouts > 1 hour (p = 0.031, ß = -0.005, 95% CI = -0.009, -0.001) were independent predictors of relative FMD. Age (ß = -0.002, 95% CI = -0.003, -0.001), mean blood flow (ß = 0.013, 95% CI = 0.002, 0.024), moderate-intensity physical activity (ß = 155.9E-5, 95% CI = 22.4E-5, 289.4E-5), sedentary breaks (ß = 0.036, 95% CI = 0.007, 0.066), and total time spent in sedentary bouts > 1 hour (ß = -25.02E-5, 95% CI = -47.67E-5, -2.378E-5) were predictors of absolute FMD (all, p < 0.047). All independent outcomes remained significant after partially controlling for all other predictor variables (all, p < 0.031). CONCLUSIONS: Habitual prolonged sedentary bouts and sedentary breaks, but not total sedentary time, were predictors of popliteal endothelial-dependent vasodilatory function. The patterns by which sedentary time is accumulated may be more important than the total sedentary time on lower-limb arterial health.