Quality of reporting of randomized clinical trials in abstracts of the 2005 annual meeting of the American College of Rheumatology.

Objective: To determine the quality of abstracts reporting randomized clinical trials (RCT) at the 2005 Annual Scientific Meeting of the American College of Rheumatology.

Methods: All 2005 abstracts including late-breaking abstracts were assessed. An abstract was deemed to be reporting an RCT if it indicated that participants were randomized in the title or body of the abstract. RCT were excluded if they included only pharmacokinetic data. The CONSORT checklist was applied and relevant data extracted. We defined manufacturer support as acknowledgment of industry support or industry employee as co-author.

Results: Of 2146 abstracts, 143 (6.7%) reported RCT. Of these, 78.3% were drug trials, and 63.6% indicated manufacturer support. Only 30.8% of abstracts used "randomized" in the title, 44.1% did not explicitly state whether blinding was undertaken, and only 7.0% clearly stated who was blinded. Thirty percent of studies did not give an explicit definition of eligibility criteria of participants. While 84.6% explicitly described the experimental intervention, only 37.1% explicitly described the comparator intervention. Only 21% explicitly stated that an intention to treat analysis was performed. Baseline demographic and clinical characteristics were reported in 48.3%. While most abstracts reported summary results for each treatment group, only 35.7% reported effect size with its precision.

Conclusion: The quality of reporting is suboptimal in many RCT abstracts. Abstracts reporting RCT would benefit from a structured approach that ensures more detailed reporting of eligibility criteria, active and comparator interventions, flow of participants, and adequate summary and precision of results.

Age does not influence the bone response to treadmill exercise in female rats

Purpose: Because it is believed that bone may respond to exercise differently at different ages, we compared bone responses in immature and mature rats after 12 wk of treadmill running.

Methods: Twenty-two immature (5-wk-old) and 21 mature (17-wk-old) female Sprague Dawley rats were randomized into a running (trained, N = 10 immature, 9 mature) or a control group (controls, N = 12 immature, 12 mature) before sacrifice 12 wk later. Rats ran on a treadmill five times per week for 60-70 min at speeds up to 26 m[middle dot]min-1. Both at baseline and after intervention, we measured total body, lumbar spine, and proximal femoral bone mineral, as well as total body soft tissue composition using dual-energy x-ray absorptiometry (DXA) in vivo. After sacrificing the animals, we measured dynamic and static histomorphometry and three-point bending strength of the tibia.

Results: Running training was associated with greater differences in tibial subperiosteal area, cortical cross-sectional area, peak load, stiffness, and moment of inertia in immature and mature rats (P < 0.05). The trained rats had greater periosteal bone formation rates (P < 0.01) than controls, but there was no difference in tibial trabecular bone histomorphometry. Similar running-related gains were seen in DXA lumbar spine area (P = 0.04) and bone mineral content (BMC;P = 0.03) at both ages. For total body bone area and BMC, the immature trained group increased significantly compared with controls (P < 0.05), whereas the mature trained group gained less than did controls (P < 0.01).

Conclusion: In this in vivo model, where a similar physical training program was performed by immature and mature female rats, we demonstrated that both age groups were sensitive to loading and that bone strength gains appeared to result more from changes in bone geometry than from improved material properties.

Cultural connections across time and place : Wardell's late 19th century Genazzano FCJ College Kew

The Catholic Church was profoundly affected by the 1872 Victorian Education Act, which made education secular, compulsory and free, and led to the withdrawal of state aid to religious schools. In order for the Church to run its own schools, it had to look overseas for help and invited religious teaching orders, such as the Faithful Companions of Jesus (FCJs) to set up schools in Victoria, Australia. In many instances purpose built buildings were designed by architects. William Wardell was well established in private practice in Sydney when he designed the new Convent and School, Kew, Victoria, for the FCJ Sisters, in the late 1880s. Building commenced just before the crash of Marvellous Melbourne. Less than half of the total concept of Wardell’s original plan was built. It opened for business in April 1891. Today this building forms the heart of the contemporary Genazzano FCJ College Kew. Many histories intersect in this commission. The vision for Catholic education in Victoria in the late 19th century is critical. The FCJs charism and their experience of teaching in Europe, in France, England, Ireland, Italy and Switzerland, provides a model for their work in Australia. At this time the importance of architecture to society is made manifest in education and its demands on building: if learning is valued then buildings should reflect this, for public buildings can shape morality. Wardell was trained as a Gothic Revival architect and his building participates in a broader medieval and Gothic tradition. Wardell’s original plan for this late Victorian Gothic style asymmetrical three-storeyed building, was designed to integrate a convent, school, chapel, and dormitories. This paper considers architectural history from diverse perspectives, educational, social, religious, economic and political, recognising the complexity of this project and the people who played a part in its conception and realisation.

Seasonal reduction in physical activity and flow-mediated dilation in children

Purpose: Cardiovascular disease is a process that has its origins in childhood. Endothelial dysfunction is the earliest detectable manifestation of cardiovascular disease. This study aimed to assess the impact of seasonal changes in physical activity (PA) and body composition on conduit artery endothelial function in children.

Method: We studied 116 children (70 girls aged 10.7 ± 0.3 yr and 46 boys aged 10.7 ± 0.3 yr) on two occasions; in the northern summer (June) and late autumn (November). We assessed flow-mediated dilation (FMD) using high-resolution Doppler ultrasound. Body composition was measured by dual-energy x-ray absorptiometry. PA was assessed using accelerometry.

Results: FMD (10.0% ± 4.3% to 7.9% ± 3.9%, P < 0.001) and PA (94.1 ± 34.8 to 77.8 ± 33.7 min·d-1, P < 0.01) decreased, while percentage body fat increased (27.6% ± 6.8% to 28.0% ± 6.6%, P < 0.001) between summer and autumn. Decreases in FMD correlated with decreases in high-intensity PA (r = 0.23, P = 0.04), and change in high-intensity PA was the only predictor of change in FMD. No relationships were evident between changes in body composition and FMD.

Conclusions: Vascular function decreased between summer and autumn in this cohort. There were no relationships between change in FMD and changes in body composition or low/moderate-intensity PA. The associations between FMD and high-intensity PA suggests that future interventions should encourage this form of behavior, particularly at the times of year associated with lower PA.

Association of high-sensitivity C-reactive protein with de novo major depression

Background: Although there is cross-sectional evidence that changes in the immune system contribute to the pathophysiology of depression, longitudinal data capable of elucidating cause and effect relationships are lacking.

Aims: We aimed to determine whether subclinical systemic inflammation, as measured by serum high-sensitivity C-reactive protein (hsCRP) concentration, is associated with an increased risk of de novo major depressive disorder.

Method: Major depressive disorder was diagnosed using a clinical interview (SCID-I/NP). This is a retrospective cohort study; from a population-based sample of 1494 randomly selected women recruited at baseline during the period 1994-7, 822 were followed for a decade and provided measures of both exposure and outcome. Of these women, 644 (aged 20-84 years) had no prior history of depression at baseline and were eligible for analysis.

Results: During 5827 person-years of follow-up, 48 cases of de novo major depressive disorder were identified. The hazard ratio (HR) for depression increased by 44% for each standard deviation increase in log-transformed hsCRP (ln-hsCRP) (HR = 1.44, 95% CI 1.04-1.99), after adjusting for weight, smoking and use of non-steroidal anti-inflammatory drugs. Further adjustment for other lifestyle factors, medications and comorbidity failed to explain the observed increased risk for depression.

Conclusions: Serum hsCRP is an independent risk marker for de novo major depressive disorder in women. This supports an aetiological role for inflammatory activity in the pathophysiology of depression.

Tobacco smoking as a risk factor for major depressive disorder : a population-based study

Background : Smoking is disproportionately prevalent among people with psychiatric illness.

Aims : To investigate smoking as a risk factor for major depressive disorder.

Method : A population-based sample of women was studied using case–control and retrospective cohort study designs. Exposure to smoking was self-reported, and major depressive disorder diagnosed using the Structured Clinical Interview for DSM–IV–TR (SCID–I/NP).

Results : Among 165 people with major depressive disorder and 806 controls, smoking was associated with increased odds for major depressive disorder (age-adjusted odds ratio (OR)=1.46, 95% CI 1.03–2.07). Compared with non-smokers, odds for major depressive disorder more than doubled for heavy smokers (>20 cigarettes/day). Among 671 women with no history of major depressive disorder at baseline, 13 of 87 smokers and 38 of 584 non-smokers developed de novo major depressive disorder during a decade of follow-up. Smoking increased major depressive disorder risk by 93% (hazard ratio (HR)=1.93, 95% CI 1.02–3.69); this was not explained by physical activity or alcohol consumption.

Conclusions : Evidence from cross-sectional and longitudinal data suggests that smoking increases the risk of major depressive disorder in women.

Effect of CHO ingestion on exercise metabolism and performance in different ambient temperatures

Two series of experiments were conducted to examine the effect of ingesting beverages with differing carbohydrate (CHO) concentrations and osmolalities on metabolism and performance during prolonged exercise in different environmental conditions. In series 1, 12 subjects performed three cycling exercise trials to fatigue at 70% ·VO_2peak in either 33°C(N = 6) (HT1) or 5°C (N = 6) (CT). Subjects ingested either a 14% CHO solution (osmolality = 390 mosmol·l^-1) (HCHO); a 7% CHO solution (330 mosmol·l^-1) (NCHO) or a placebo (90 mosmol·l^-1) (CON1). In series 2, six subjects performed the same three trials at 33°C (HT2), while ingesting either NCHO, a 4.2% CHO solution (240 mosmol·l^-1) (LCHO) or a placebo) (240 mosmol·l^-1) (CON2). Plasma glucose was higher (P < 0.05) in HCHO than NCHO, which in turn was higher (P < 0.05) than CON1 in both CT and HT1. Plasma glucose was lower (P < 0.05) in CON2 compared with NCHO and LCHO in HT2. The fall in plasma volume was greater(P < 0.05) in HCHO than other trials in both CT and HT1 but was not different when comparing the three trials in HT2. Exercise time was not different when comparing the trials in either HT1 or HT2 but was longer(P < 0.05) in NCHO compared with HCHO, which, in turn, was longer(P < 0.05) than CON1 in CT. These data demonstrate that, during prolonged exercise in the heat, fatigue is related to factors other than CHO availability. In addition, during exercise in 5°C a 7% CHO solution is more beneficial for exercise performance than a 14% CHO solution.

BDNF, metabolic risk factors, and resistance training in middle-aged individuals

Introduction and Purpose: Brain-derived neurotrophic factor (BDNF) and physical inactivity contribute to the development of the metabolic syndrome (MetS). There appears to be an association between BDNF and risk factors for MetS, and the effects of resistance training (RT) on BDNF and metabolic risk in middle-aged individuals with high and low numbers of metabolic risk factors (HiMF and LoMF, respectively) are unclear and are the focus of this research.

Methods: Forty-nine men (N = 25) and women (N = 24) aged 50.9 ± 6.2 yr were randomized to four groups, HiMF training (HiMFT), HiMF control (HiMFC), LoMF training (LoMFT), and LoMF control (LoMFC). Before and after 10 wk of RT, participants underwent tests for muscle strength and anthropometry, and a fasting blood sample was taken. Data were analyzed using Spearman correlations and repeated-measures ANOVA.

Results: BDNF was positively correlated with plasma triglycerides, glucose, HbA1C, and insulin resistance. BDNF was elevated in HiMF compared with LoMF (904.9 ± 270.6 vs 709.6 ± 239.8 respectively, P = 0.01). Training increased muscle strength and lean body mass but had no effect on BDNF levels or any examined risk factors.

Conclusion: BDNF levels correlated with risk factors for MetS and were elevated in individuals with HiMF. RT had no effect on BDNF levels or other risk factors for MetS. As RT has an effect on muscle strength and lean body mass, it should be added to other nonpharmacological interventions for middle-aged individuals with HiMF such as aerobic and/or diet.