المؤلفون: Jemma L. Smith, Kevin Deighton, Aidan Q. Innes, Marc Holl, Laura Mould, Zhining Liao, Patrick Doherty, Greg Whyte, James A. King, Davina Deniszczyc, Benjamin M. Kelly

المصدر: Frontiers in Medicine, Vol 10 (2023)

مصطلحات موضوعية: coronavirus, SARS-CoV-2, exercise, emotional wellbeing, digital health, fatigue, Medicine (General), R5-920

الوصف: IntroductionTwo million people in the UK are experiencing long COVID (LC), which necessitates effective and scalable interventions to manage this condition. This study provides the first results from a scalable rehabilitation programme for participants presenting with LC.Methods601 adult participants with symptoms of LC completed the Nuffield Health COVID-19 Rehabilitation Programme between February 2021 and March 2022 and provided written informed consent for the inclusion of outcomes data in external publications. The 12-week programme included three exercise sessions per week consisting of aerobic and strength-based exercises, and stability and mobility activities. The first 6 weeks of the programme were conducted remotely, whereas the second 6 weeks incorporated face-to-face rehabilitation sessions in a community setting. A weekly telephone call with a rehabilitation specialist was also provided to support queries and advise on exercise selection, symptom management and emotional wellbeing.ResultsThe 12-week rehabilitation programme significantly improved Dyspnea-12 (D-12), Duke Activity Status Index (DASI), World Health Orginaisation-5 (WHO-5) and EQ-5D-5L utility scores (all p < 0.001), with the 95% confidence intervals (CI) for the improvement in each of these outcomes exceeding the minimum clinically important difference (MCID) for each measure (mean change [CI]: D-12: −3.4 [−3.9, −2.9]; DASI: 9.2 [8.2, 10.1]; WHO-5: 20.3 [18.6, 22.0]; EQ-5D-5L utility: 0.11 [0.10, 0.13]). Significant improvements exceeding the MCID were also observed for sit-to-stand test results (4.1 [3.5, 4.6]). On completion of the rehabilitation programme, participants also reported significantly fewer GP consultations (p < 0.001), sick days (p = 0.003) and outpatient visits (p = 0.007) during the previous 3 months compared with baseline.DiscussionThe blended and community design of this rehabilitation model makes it scalable and meets the urgent need for an effective intervention to support patients experiencing LC. This rehabilitation model is well placed to support the NHS (and other healthcare systems worldwide) in its aim of controlling the impacts of COVID-19 and delivering on its long-term plan.Clinical trial registrationhttps://www.isrctn.com/ISRCTN14707226, identifier 14707226.

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fmed.2023.1149922/fullTest; https://doaj.org/toc/2296-858XTest

الوصول الحر: https://doaj.org/article/5d6208a58e40485e8770a4a77b3419cfTest

المؤلفون: Jemma L. Smith, Aidan Q. Innes, Danielle S. Burns, Davina Deniszczyc, James Selfe, Stephen MacConville, Kevin Deighton, Benjamin M. Kelly

المصدر: Frontiers in Rehabilitation Sciences, Vol 4 (2023)

مصطلحات موضوعية: osteoarthritis, exercise, wellbeing, joint, knee, hip, Other systems of medicine, RZ201-999, Medical technology, R855-855.5

الوصف: IntroductionOsteoarthritis is a chronic musculoskeletal condition that impacts more than 300 million people worldwide, with 43 million people experiencing moderate to severe disability due to the disease. This service evaluation provides the results from a tailored blended model of care on joint health, physical function, and personal wellbeing.Methods1,593 adult participants with osteoarthritis completed the Nuffield Health Joint Pain Programme between February 2019 and May 2022. The 12-week programme included two 40-min exercise sessions per week. All exercise sessions were conducted face-to-face and were followed by 20 min of education to provide information and advice on managing osteoarthritis.ResultsThe 12-week joint pain programme significantly improved Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) global scores (Week 0: 37.5 [17.2]; Week 12: 24.0 [16.6]; p

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fresc.2023.1147938/fullTest; https://doaj.org/toc/2673-6861Test

الوصول الحر: https://doaj.org/article/31a797b604ec471ab0c9c5836d6df20dTest

المؤلفون: Zhuoxiu Jin, Alice E. Thackray, James A. King, Kevin Deighton, Melanie J. Davies, David J. Stensel

المصدر: Sensors, Vol 23, Iss 17, p 7417 (2023)

مصطلحات موضوعية: continuous glucose monitoring, blood glucose, agreement, glycaemic dynamics, Chemical technology, TP1-1185

الوصف: Continuous glucose monitoring (CGM) is used clinically and for research purposes to capture glycaemic profiles. The accuracy of CGM among healthy populations has not been widely assessed. This study assessed agreement between glucose concentrations obtained from venous plasma and from CGM (FreeStyle Libre2TM, Abbott Diabetes Care, Witney, UK) in healthy women. Glucose concentrations were assessed after fasting and every 15 min after a standardized breakfast over a 4-h lab period. Accuracy of CGM was determined by Bland–Altman plot, 15/15% sensor agreement analysis, Clarke error grid analysis (EGA) and mean absolute relative difference (MARD). In all, 429 valid CGM readings with paired venous plasma glucose (VPG) values were obtained from 29 healthy women. Mean CGM readings were 1.14 mmol/L (95% CI: 0.97 to 1.30 mmol/L, p < 0.001) higher than VPG concentrations. Ratio 95% limits of agreement were from 0.68 to 2.20, and a proportional bias (slope: 0.22) was reported. Additionally, 45% of the CGM readings were within ±0.83 mmol/L (±15 mg/dL) or ±15% of VPG, while 85.3% were within EGA Zones A + B (clinically acceptable). MARD was 27.5% (95% CI: 20.8, 34.2%), with higher MARD values in the hypoglycaemia range and when VPG concentrations were falling. The FreeStyle Libre2TM CGM system tends to overestimate glucose concentrations compared to venous plasma samples in healthy women, especially during hypoglycaemia and during glycaemic swings.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/1424-8220/23/17/7417Test; https://doaj.org/toc/1424-8220Test

الوصول الحر: https://doaj.org/article/aae9e97e33f04e1588dec226c2b0709aTest

المؤلفون: Paola Ghione, M Lia Palomba, Hervé Ghesquieres, Sabela Bobillo, Anik R Patel, Myrna Nahas, Steve Kanters, Kevin Deighton, Anthony Hatswell, Long Ma, Eve H. Limbrick-Oldfield, Julia Thornton Snider, Sally W. Wade, Maria Teresa Riberio, John Radford, Sara Beygi, John Gribben

المصدر: Haematologica, Vol 108, Iss 3 (2022)

مصطلحات موضوعية: Diseases of the blood and blood-forming organs, RC633-647.5

الوصف: The SCHOLAR-5 study examines treatment patterns and outcomes of real-world follicular lymphoma (FL) patients on 3rd line of treatment (LoT) or higher, for whom existing data are limited. SCHOLAR-5 is a retrospective cohort study using data from adults (≥ 18 years) with grade 1-3a FL, initiating ≥3rd LoT after June 2014 at major lymphoma centers in the US and Europe. Objective response rate (ORR), complete response (CR), progression-free survival (PFS) and overall survival (OS) were analyzed by LoT. Time-to-event outcomes were assessed using Kaplan-Meier methods. Of 128 patients, 87 initiated 3rd LoT, 63 initiated 4th LoT, and 47 initiated 5th LoT. At 1st eligible LoT, 31% progressed within 24-months of 1st LoT anti-CD20 combination therapy, 28% had prior autologous stem cell transplantation, and 31% were refractory to the previous LoT. The most common regimen in each LoT was chemoimmunotherapy; however, experimental drugs were increasingly used at later LoT. In the US, anti-CD20 monotherapy was more common at ≥3rd LoT compared to Europe, where stem cell transplants were more common. ORR at 3rd LoT was 68% (CR 44%), but decreased after each LoT to 37% (CR 22%) in ≥5 LoT. Median OS and PFS at 3rd LoT were 68 and 11 months, respectively, and reduced to 43 and 4 months at ≥5 LoT. Treatments were heterogenous at each LoT in both the US and Europe. Few FL patients achieved CR in later LoT, and duration of response and survival diminished with each subsequent line.

وصف الملف: electronic resource

العلاقة: https://haematologica.org/article/view/10839Test; https://doaj.org/toc/0390-6078Test; https://doaj.org/toc/1592-8721Test

الوصول الحر: https://doaj.org/article/604a1f99ccae4ab1b8ca2279a5620a97Test

المؤلفون: Alex Griffiths, Oliver Shannon, Jamie Matu, Roderick King, Kevin Deighton, John P. O’Hara

المصدر: Journal of the International Society of Sports Nutrition, Vol 16, Iss 1 (2019)

مصطلحات موضوعية: altitude, carbohydrate, fat, oxidation, relative, absolute, rer, Nutrition. Foods and food supply, TX341-641, Sports medicine, RC1200-1245

الوصف: Background A recent commentary has been published on our meta-analysis, which investigated substrate oxidation during exercise matched for relative intensities in hypoxia compared with normoxia. Within this commentary, the authors proposed that exercise matched for absolute intensities in hypoxia compared with normoxia, should have been included within the analysis, as this model provides a more suitable experimental design when considering nutritional interventions in hypoxia. Main body Within this response, we provide a rationale for the use of exercise matched for relative intensities in hypoxia compared with normoxia. Specifically, we argue that this model provides a physiological stimulus replicable of real world situations, by reducing the absolute workload undertaken in hypoxia. Further, the use of exercise matched for relative intensities isolates the metabolic response to hypoxia, rather than the increased relative exercise intensity experienced in hypoxia when utilising exercise matched for absolute intensities. In addition, we also report previously unpublished data analysed at the time of the original meta-analysis, assessing substrate oxidation during exercise matched for absolute intensities in hypoxia compared with normoxia. Conclusion An increased reliance on carbohydrate oxidation was observed during exercise matched for absolute intensities in hypoxia compared with normoxia. These data now provide a comparable dataset for the use of researchers and practitioners alike in the design of nutritional interventions for relevant populations.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1550-2783Test

الوصول الحر: https://doaj.org/article/a3af86b034c541d2b70d78423103b1fbTest

المؤلفون: Lauren L. O’Mahoney, Jamie Matu, Oliver J. Price, Karen M. Birch, Ramzi A. Ajjan, Diane Farrar, Robyn Tapp, Daniel J. West, Kevin Deighton, Matthew D. Campbell

المصدر: Cardiovascular Diabetology, Vol 17, Iss 1, Pp 1-13 (2018)

مصطلحات موضوعية: Type 2 diabetes, Omega-3 polyunsaturated fatty acids, Eicosapentaenoic acid, Docosahexaenoic acid, Cardiovascular disease, Meta-analysis, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Abstract Background Randomized controlled trials (RCTs) suggest that supplementation with omega-3 polyunsaturated fatty acids (n-3PUFAs) may favourably modify cardiometabolic biomarkers in type 2 diabetes (T2DM). Previous meta-analyses are limited by insufficient sample sizes and omission of meta-regression techniques, and a large number of RCTs have subsequently been published since the last comprehensive meta-analysis. Updated information regarding the impact of dosage, duration or an interaction between these two factors is therefore warranted. The objective was to comprehensively assess the effect of n-3PUFAs supplementation on cardiometabolic biomarkers including lipid profiles, inflammatory parameters, blood pressure, and indices of glycaemic control, in people with T2DM, and identify whether treatment dosage, duration or an interaction thereof modify these effects. Methods Databases including PubMed and MEDLINE were searched until 13th July 2017 for RCTs investigating the effect of n-3PUFAs supplementation on lipid profiles, inflammatory parameters, blood pressure, and indices of glycaemic control. Data were pooled using random-effects meta-analysis and presented as standardised mean difference (Hedges g) with 95% confidence intervals (95% CI). Meta-regression analysis was performed to investigate the effects of duration of supplementation and total dosage of n-3PUFAs as moderator variables where appropriate. Results A total of 45 RCTs were identified, involving 2674 people with T2DM. n-3PUFAs supplementation was associated with significant reductions in LDL [ES: − 0.10, (95% CI − 0.17, − 0.03); p = 0.007], VLDL (ES: − 0.26 (− 0.51, − 0.01); p = 0.044], triglycerides (ES: − 0.39 (− 0.55, − 0.24; p ≤ 0.001] and HbA1c (ES: − 0.27 (− 0.48, − 0.06); p = 0.010]. Moreover, n-3PUFAs supplementation was associated with reduction in plasma levels of TNF-α [ES: − 0.59 (− 1.17, − 0.01); p = 0.045] and IL-6 (ES: − 1.67 (− 3.14, − 0.20); p = 0.026]. All other lipid markers, indices of glycaemic control, inflammatory parameters, and blood pressure remained unchanged (p > 0.05). Conclusions n-3PUFAs supplementation produces favourable hypolipidemic effects, a reduction in pro-inflammatory cytokine levels and improvement in glycaemia. Neither duration nor dosage appear to explain the observed heterogeneity in response to n-3PUFAs. Trial registration This trial was registered at http://www.crd.york.ac.ukTest as CRD42016050802

وصف الملف: electronic resource

العلاقة: http://link.springer.com/article/10.1186/s12933-018-0740-xTest; https://doaj.org/toc/1475-2840Test

الوصول الحر: https://doaj.org/article/ce9f8a918f4d4c4f84eb4211cfafc460Test

المؤلفون: Theocharis Ispoglou, Kevin Deighton, Roderick FGJ King, Helen White, Matthew Lees

المصدر: Nutrition Journal, Vol 16, Iss 1, Pp 1-10 (2017)

مصطلحات موضوعية: L-leucine, Energy, Protein, Sarcopenia, Appetite, Hormones, Nutrition. Foods and food supply, TX341-641, Nutritional diseases. Deficiency diseases, RC620-627

الوصف: Abstract Background Inadequate protein intake (PI), containing a sub-optimal source of essential amino acids (EAAs), and reduced appetite are contributing factors to age-related sarcopenia. The satiating effects of dietary protein per se may negatively affect energy intake (EI), thus there is a need to explore alternative strategies to facilitate PI without compromising appetite and subsequent EI. Methods Older women completed two experiments (EXP1 and EXP2) where they consumed either a Bar (565 kJ), a Gel (477 kJ), both rich in EAAs (7.5 g, 40% L-leucine), or nothing (Control). In EXP1, participants (n = 10, 68 ± 5 years, mean ± SD) consumed Bar, Gel or Control with appetite sensations and appetite-related hormonal responses monitored for one hour, followed by consumption of an ad libitum breakfast (ALB). In EXP2, participants (n = 11, 69 ± 5 years) ingested Bar, Gel or Control alongside an ALB. Results In EXP1, EI at ALB was not different (P = 0.674) between conditions (1179 ± 566, 1254 ± 511, 1206 ± 550 kJ for the Control, Bar, and Gel respectively). However, total EI was significantly higher in the Bar and Gel compared to the Control after accounting for the energy content of the supplements (P

وصف الملف: electronic resource

العلاقة: http://link.springer.com/article/10.1186/s12937-017-0298-6Test; https://doaj.org/toc/1475-2891Test

الوصول الحر: https://doaj.org/article/afcb8e61a4d24ca28371c2ca1b7b1fc3Test

المؤلفون: Alex Griffiths, Oliver M. Shannon, Jamie Matu, Roderick King, Kevin Deighton, John P. O’Hara

المصدر: Journal of the International Society of Sports Nutrition, Vol 16, Iss 1 (2019)

مصطلحات موضوعية: altitude, exercise, substrate, carbohydrate, fat, oxidation, systematic review, Nutrition. Foods and food supply, TX341-641, Sports medicine, RC1200-1245

الوصف: Background A better understanding of hypoxia-induced changes in substrate utilisation can facilitate the development of nutritional strategies for mountaineers, military personnel and athletes during exposure to altitude. However, reported metabolic responses are currently divergent. As such, this systematic review and meta-analysis aims to determine the changes in substrate utilisation during exercise in hypoxia compared with normoxia and identify study characteristics responsible for the heterogeneity in findings. Methods A total of six databases (PubMed, the Cochrane Library, MEDLINE, SPORTDiscus, PsychINFO, and CINAHL via EBSCOhost) were searched for published original studies, conference proceedings, abstracts, dissertations and theses. Studies were included if they evaluated respiratory exchange ratio (RER) and/or carbohydrate or fat oxidation during steady state exercise matched for relative intensities in normoxia and hypoxia (normobaric or hypobaric). A random-effects meta-analysis was performed on outcome variables. Meta-regression analysis was performed to investigate potential sources of heterogeneity. Results In total, 18 studies were included in the meta-analysis. There was no significant change in RER during exercise matched for relative exercise intensities in hypoxia, compared with normoxia (mean difference: 0.01, 95% CI: -0.02 to 0.05; n = 31, p = 0.45). Meta-regression analysis suggests that consumption of a pre-exercise meal (p

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1550-2783Test

الوصول الحر: https://doaj.org/article/08403cca45d44521ba0739b33d7df28eTest

المؤلفون: Sarah B Clarke, Kevin Deighton, Caroline Newman, Gareth Nicholson, Liam Gallagher, Christopher J Boos, Adrian Mellor, David R Woods, John P O'Hara

المصدر: PLoS ONE, Vol 13, Iss 1, p e0190919 (2018)

مصطلحات موضوعية: Medicine, Science

الوصف: Postural control and joint position sense are essential for safely undertaking leisure and professional activities, particularly at high altitude. We tested whether exposure to a 12-day trek with a gradual ascent to high altitude impairs postural control and joint position sense. This was a repeated measures observational study of 12 military service personnel (28±4 years). Postural control (sway velocity measured by a portable force platform) during standing balance, a Sharpened Romberg Test and knee joint position sense were measured, in England (113m elevation) and at 3 research camps (3619m, 4600m and 5140m) on a 12-day high altitude trek in the Dhaulagiri region of Nepal. Pulse oximetry, and Lake Louise scores were also recorded on the morning and evening of each trek day. Data were compared between altitudes and relationships between pulse oximetry, Lake Louise score, and sway velocity were explored. Total sway velocity during standing balance with eyes open (p = 0.003, d = 1.9) and during Sharpened Romberg test with eyes open (p = 0.007, d = 1.6) was significantly greater at altitudes of 3619m and 5140m when compared with sea level. Anterior-posterior sway velocity during standing balance with eyes open was also significantly greater at altitudes of 3619m and 5140m when compared with sea level (p = 0.001, d = 1.9). Knee joint position sense was not altered at higher altitudes. There were no significant correlations between Lake Louise scores, pulse oximetry and postural sway. Despite a gradual ascent profile, exposure to 3619 m was associated with impairments in postural control without impairment in knee joint position sense. Importantly, these impairments did not worsen at higher altitudes of 4600 m or 5140 m. The present findings should be considered during future trekking expeditions when developing training strategies targeted to manage impairments in postural control that occur with increasing altitude.

وصف الملف: electronic resource

العلاقة: http://europepmc.org/articles/PMC5771604?pdf=renderTest; https://doaj.org/toc/1932-6203Test

الوصول الحر: https://doaj.org/article/26bcd6588ef1472188396405b5efe60fTest

المؤلفون: Nessan Costello, Jim McKenna, Kevin Deighton, Ben Jones

المصدر: Frontiers in Nutrition, Vol 4 (2017)

مصطلحات موضوعية: behavior change, behavior change wheel, dietary assessment, elite athletes, validity and reliability, Nutrition. Foods and food supply, TX341-641

وصف الملف: electronic resource

العلاقة: http://journal.frontiersin.org/article/10.3389/fnut.2017.00047/fullTest; https://doaj.org/toc/2296-861XTest

الوصول الحر: https://doaj.org/article/0d6d964aa81642e38aa0c7dc52a4c8eaTest