Consecutive days of cold water immersion: effects on cycling performance and heart rate variability.

We investigated performance and heart rate (HR) variability (HRV) over consecutive days of cycling with post-exercise cold water immersion (CWI) or passive recovery (PAS). In a crossover design, 11 cyclists completed two separate 3-day training blocks (120 min cycling per day, 66 maximal sprints, 9 min time trialling [TT]), followed by 2 days of recovery-based training. The cyclists recovered from each training session by standing in cold water (10 °C) or at room temperature (27 °C) for 5 min. Mean power for sprints, total TT work and HR were assessed during each session. Resting vagal-HRV (natural logarithm of square-root of mean squared differences of successive R-R intervals; ln rMSSD) was assessed after exercise, after the recovery intervention, during sleep and upon waking. CWI allowed better maintenance of mean sprint power (between-trial difference [90 % confidence limits] +12.4 % [5.9; 18.9]), cadence (+2.0 % [0.6; 3.5]), and mean HR during exercise (+1.6 % [0.0; 3.2]) compared with PAS. ln rMSSD immediately following CWI was higher (+144 % [92; 211]) compared with PAS. There was no difference between the trials in TT performance (-0.2 % [-3.5; 3.0]) or waking ln rMSSD (-1.2 % [-5.9; 3.4]). CWI helps to maintain sprint performance during consecutive days of training, whereas its effects on vagal-HRV vary over time and depend on prior exercise intensity.

The effect of post-exercise hydrotherapy on subsequent exercise performance and heart rate variability

We investigated the effect of hydrotherapy on time-trial performance and cardiac parasympathetic reactivation during recovery from intense training. On three occasions, 18 well-trained cyclists completed 60 min high-intensity cycling, followed 20 min later by one of three 10-min recovery interventions: passive rest (PAS), cold water immersion (CWI), or contrast water immersion (CWT). The cyclists then rested quietly for 160 min with R-R intervals and perceptions of recovery recorded every 30 min. Cardiac parasympathetic activity was evaluated using the natural logarithm of the square root of mean squared differences of successive R-R intervals (ln rMSSD). Finally, the cyclists completed a work-based cycling time trial. Effects were examined using magnitude-based inferences. Differences in time-trial performance between the three trials were trivial. Compared with PAS, general fatigue was very likely lower for CWI (difference [90% confidence limits; -12% (-18; -5)]) and CWT [-11% (-19; -2)]. Leg soreness was almost certainly lower following CWI [-22% (-30; -14)] and CWT [-27% (-37; -15)]. The change in mean ln rMSSD following the recovery interventions (ln rMSSD(Post-interv)) was almost certainly higher following CWI [16.0% (10.4; 23.2)] and very likely higher following CWT [12.5% (5.5; 20.0)] compared with PAS, and possibly higher following CWI [3.7% (-0.9; 8.4)] compared with CWT. The correlations between performance, ln rMSSD(Post-interv) and perceptions of recovery were unclear. A moderate correlation was observed between ln rMSSD(Post-interv) and leg soreness [r = -0.50 (-0.66; -0.29)]. Although the effects of CWI and CWT on performance were trivial, the beneficial effects on perceptions of recovery support the use of these recovery strategies.

Environmental rights or a right to the environment? Exploring the nexus between human rights and environmental protection.

The importance of the environment to the fulfilment of human rights is widely accepted at international law. What is less well-accepted is the proposition that we, as humans, possess rights to the environment beyond what is necessary to support our basic human needs. The suggestion that a human right to a healthy environment may be emerging at international law raises a number of theoretical and practical challenges for human rights law, with such challenges coming from both within and outside the human rights discourse. It is argued that human rights law can make a positive contribution to environmental protection, but the precise nature of the connection between the environment and human rights warrants more critical analysis. This short paper considers the different ways that the environment is conceptualised in international human rights law and analyses the proposition that a right to a healthy environment is emerging. It identifies some of the challenges which would need to be overcome before such a right could be recognised, including those which draw on the disciplines of deep ecology and earth jurisprudence.

Battling in a virtual world: a proposal for increased copyright protection of multimedia products in Australia

This article discusses the adequacy of copyright protection afforded to multimedia products pursuant to the Copyright Act 1968 (Cth) and in response to international obligations. The paper critically evaluates the effect that the most recent amendments to the Copyright Act have had on the protection of copyright in multimedia products. An outline of some practical measures of protection available to copyright owners as alternatives or complements to the current statutory regime is provided, ultimately concluding that the current legislative protection is ineffective. The paper closes by considering possible future reform by way of statutory amendments to the Copyright Act aimed at increasing protection of copyright in multimedia products.

Striving to achieve best practice in heart failure disease management

Based on a national audit of chronic heart failure (CHF) management programmes (CHF-MPs) conducted in 2006, Driscoll et al identified a disproportionate distribution ranging from 0 to 4.2 programmes/million population in the various states of Australia with many programmes not following best practice.1 We welcome their proposal to develop national benchmarks for CHF management and acknowledge the contributions of the Heart Foundation and health professionals in finalising these recommendations.2 We would like to share the Queensland experience in striving towards best practice with the number of CHF-MPs increasing from four (at the time of the 2006 survey) to 23, equating to 5.0 programmes/million population. Queensland now has a state-wide heart failure service steering committee with a focus on the development of CHF-MPs supported by a central coordinator...

The effect of exercise on sleep quality in heart failure

Purpose The primary objective of this study was to examine the effect of exercise on subjective sleep quality in heart failure patients. Methods This study used a randomised, controlled trial design with blinded end-point analysis. Participants were randomly assigned to a 12-week programme of education and self-management support (control) or to the same programme with the addition of a tailored physical activity programme designed and supervised by an exercise specialist (intervention). The intervention consisted of 1 hour of aerobic and resistance exercise twice a week. Participants included 108 patients referred to three hospital heart failure services in Queensland, Australia. Results Patients who participated in supervised exercise classes showed significant improvement in subjective sleep quality, sleep latency, sleep disturbance and global sleep quality scores after 12 weeks of supervised hospital based exercise. Secondary analysis showed that improvements in sleep quality were correlated with improvements in geriatric depression score (p=0.00) and exercise performance (p=0.03). General linear models were used to examine whether the changes in sleep quality following intervention occurred independently of changes in depression, exercise performance and weight. Separate models adjusting for each covariate were performed. Results suggest that exercise significantly improved sleep quality independent of changes in depression, exercise performance and weight. Conclusion This study supports the hypothesis that a 12 week program of aerobic and resistance exercise improves subjective sleep quality in patients with heart failure. This is the first randomised controlled trial to examine the role of exercise in the improvement of sleep quality for patients with this disease. While this study establishes exercise as a therapy for poor sleep quality, further research is needed to investigate exercise as a treatment for other parameters of sleep in this population. Study investigators plan to undertake a more in-depth examination within the next 12 months

Personalised electronic messages to improve sun protection in young adults

The incidence of all skin cancers, including melanoma, continues to rise. It is well known that ultraviolet (UV) radiation is the main environmental risk factor for skin cancer, and excessive exposure at a young age increases the risk of developing skin cancer. The aim of this study was to determine the acceptability and feasibility of delivering sun protection messages via electronic media such as short message services (SMS) to people 18-40 years, and explore factors associated with their acceptability. Overall, 80% of participants agreed that they would like to receive some form of sun protection advice; of these, 20% prefer to receive it via SMS and 42% via email. Willingness to receive electronic messages about the UV index was associated with being unsure about whether a suntanned person would look healthy and greater use of sun protection in the past. Careful attention to message framing and timing of message delivery and focus on short-term effects of sun exposure such as sunburn and skin ageing should increase the acceptability of such messages to young people. We conclude that sun protection messages delivered to young adults via electronic media appear feasible and acceptable.

Creating Queensland, creative communities partnership - major Brisbane festival & Australia Council for the Arts

In March 2010, Brisbane Festival commissioned a Research Team, led by Dr Bree Hadley and Dr Sandra Gattenhof, Creative Industries Faculty, Queensland University of Technology, to conduct an evaluation of the Creating Queensland program, a new Creative Communities partnership between Brisbane Festival and the Australia Council for the Arts. This Final Report reviews and reports on the effectiveness of the program gathered during three phases throughout 2010: Phase 1, in which the research team analysed Brisbane Festival’s pre-existing data on the Creating Queensland events in 2009; Phase 2, in which the research team designed a new suite of instruments to gather data from producers, producing partners, artists and attendees involved in the Creating Queensland events in 2010; and Phase 3, in which the research team used content analysis of the narratives emerging in the data to establish how Brisbane Festival has adopted processes, activities or engagement protocols to operate as catalysts that produce experiences with specific impacts on individuals and communities. The Final Report finds that the Creating Queensland events concentrate on developing specific experiences for those involved – usually associated with storytelling, showcasing, and the valorisation or re-valorisation of neglected or forgotten cultural forms – in order to give communities a voice. It finds that the events prioritise accessibility – usually associated with allowing specific local communities or local artists to present material that is meaningful to them – and inclusivity – usually associated with using connections with producing partners (such as the Multicultural Development Association) to bring more and more people into the program. It finds that the events have a capacity-building effect, which allows local communities to increase their capacity to launch their own ideas, initiatives or events, allows individuals to increase their employability, or allows communities and individuals to increase their visibility within mainstream cultural practices and infrastructure. The Final Report further finds that Brisbane Festival has, throughout its years of commitment to community programming, developed specific techniques to enable events in the Creating Queensland program to have these effects, that these can be tracked, and, as a result, deployed or redeployed both by Brisbane Festival and other community arts organisations in the development of effective community arts programs. The data demonstrates that Creating Queensland is, by and large, having the desired effect on communities – people are actually participating, presenting work, and increasing their personal, professional and social skills in various ways, and this is valued by all stakeholders. The data also demonstrates that, as would be expected with any community arts program – particularly programs of this size and complexity – there are areas in which Creating Queensland is functioning exceptionally well and areas in which continuous improvement processes should be continued. Areas of excellence relate to Brisbane Festival’s longstanding commitment to community arts, and active community participation in the arts, as well as its ability to create well-known and loved programs that use effective techniques to have a positive impact on communities. Areas for improvement relate to Brisbane Festival’s potential to benefit from the following: clarifying relationships between community participants and professionals; increasing mentoring relationships between these groups; consolidating the discourses it uses to describe event aims across strategic, production, and publicity documents across the years; and re-considering the number of small events inside the larger Creating Queensland program.

Drugs for hypertension, angina and heart failure

12.1 Drugs for hypertension 12.1.1 Epidemiology and pathophysiology 12.1.2 Diuretics for hypertension 12.2.3 Vasodilators for hypertension 12.4.4 β-Adrenoceptor blockers for hypertension 12.2. Drugs for angina 12.2.1 Typical angina 12.2.2 Drugs to treat an attack of typical angina 12,2.3 Drugs to prevent an attack of typical angina 12.2.4 Atypical angina 12.3 Drugs for heart failure 12.3.1 The heart failure epidemic 12.3.2 Compensatory changes in heart failure 12.3.3 Diuretics for heart failure 12.3.4 ACE inhibitors and AT1-receptor antagonists 12.3.5 β-adrenoceptor antagonists 12.3.6 Digoxin

Telephone support to rural and remote patients with heart failure : the Chronic Heart failure Assessment by Telephone (CHAT) study

Background Heart failure (HF) remains a condition with high morbidity and mortality. We tested a telephone support strategy to reduce major events in rural and remote Australians with HF, who have limited healthcare access. Telephone support comprised an interactive telecommunication software tool (TeleWatch) with follow-up by trained cardiac nurses. Methods Patients with a general practice (GP) diagnosis of HF were randomised to usual care (UC) or UC and telephone support intervention (UC+I) using a cluster design involving 143 GPs throughout Australia. Patients were followed for 12 months. The primary end-point was the Packer clinical composite score. Secondary end-points included hospitalisation for any cause, death or hospitalisation, as well as HF hospitalisation. Results Four hundred and five patients were randomised into CHAT. Patients were well matched at baseline for key demographic variables. The primary end-point of the Packer Score was not different between the two groups (P=0.98), although more patients improved with UC+I. There were fewer patients hospitalised for any cause (74 versus 114, adjusted HR 0.67 [95% CI 0.50-0.89], p=0.006) and who died or were hospitalised (89 versus 124, adjusted HR 0.70 [95% CI 0.53 – 0.92], p=0.011), in the UC+I vs UC group. HF hospitalisations were reduced with UC+I (23 versus 35, adjusted HR 0.81 [95% CI 0.44 – 1.38]), although this was not significant (p=0.43). There were 16 deaths in the UC group and 17 in the UC+I group (p=0.43). Conclusions Although no difference was observed in the primary end-point of CHAT (Packer composite score), UC+I significantly reduced the number of HF patients hospitalised amongst a rural and remote cohort. These data suggest that telephone support may be an efficacious approach to improve clinical outcomes in rural and remote HF patients.

Heart beats and economic decisions : Observing mental stress in the ultimatum bargaining game

One aim of experimental economics is to try to better understand human economic decision making. Early research of the ultimatum bargaining game (Gueth et al., 1982) revealed that other motives than pure monetary reward play a role. Neuroeconomic research has introduced the recording of physiological observations as signals of emotional responses. In this study, we apply heart rate variability (HRV) measuring technology to explore the behaviour and physiological reactions of proposers and responders in the ultimatum bargaining game. Since this technology is small and non-intrusive, we are able to run the experiment in a standard experimental economic setup. We show that low o�ers by a proposer cause signs of mental stress in both the proposer and the responder, as both exhibit high ratios of low to high frequency activity in the HRV spectrum.

Confronting the shortage of skilled and professional workers : A large scale industry-school partnership initiative

In most of the advanced economies, students are losing interest in careers especially in engineering and related industries. Hence, western economies are confronting a critical skilled labour shortage in areas of technology, science and engineering. The aim of this paper is to document how the organisational and institutional elements of one industry-school partnerships initiative – The Gateway Schools Program - contribute to productive knowledge sharing and networking. In particular this paper focuses on an initiative of an Australian State government in response to a perceived crisis around the skills shortage in an economy transitioning from a localised to a global knowledge production economy. The Gateway Schools initiative signals the first sustained attempt in Australia to incorporate schools into production networks through strategic partnerships linking them to partner organisations at the industry level. We provide case examples of how four schools operationalise the partnerships with the mining and energy industries and how these partnerships as knowledge assets impact the delivery of curriculum and capacity building among teachers. A program theory approach to analysis, informed by theoretical perspectives of Bailey (1994), Bagnall (2007) and Walsh (2004) was adopted. Each of these theorists provides a related but different perspective on the establishment, purpose, and effectiveness respectively of partnerships. Our ultimate goal is to define those characteristics of successful partnerships that do contribute to enhanced interest and engagement by students in those careers that are currently experiencing critical shortages.