Qualitative study of adversity activated development and resilience in adolescents and young adults with congenital heart disease and their parents

What is it like to have a medical condition that few people have ever heard about? How does it feel to have to question whether daily physical activities are dangerous for you, whilst you watch your friends enjoy those activities without a care? Can you imagine that you need to have a complicated heart surgery, with risks such as paralysis or death? Or even imagine facing the painful recovery period and scars after such a surgery? Then imagine that you are a child or teenager dealing with this medical condition when all your friends are simply occupied with school and normal life. Now consider that surgery has been undertaken to extend your lifespan, but the operation is so new that the long-term outcomes are just not known? All you really know is that you might have ‘surgical repairs’ to your heart and symptoms may be relieved or managed by medications or cardiac devices, but you are never going to be cured. What if you had already experienced painful, frightening, lonely and tedious hospitalisations and you were forced to put your life on hold to re-enter that situation, time and time again. This may be your life, as a Congenital Heart Disease or CHD patient. How do such patients cope and in many cases even thrive? This chapter will review current international literature regarding the medical and personal impact of CHD. Our qualitative study of the perspectives of young CHD patients and their parents contributes to the Australian story of CHD, as well as highlighting the potential for CHD related adversity to promote personal development.

A history of heart interventions moderates the relationship between psychological variables and the presence of chest pain in older women with self-reported coronary heart disease

Objectives: This study examines the hypothesis that a past history of heart interventions will moderate the relationship between psychosocial factors (stressful life events, social support, perceived stress, having a current partner, having a past diagnosis of depression or anxiety over the past 3 years, time pressure, education level, and the mental health index) and the presence of chest pain in a sample of older women. Design: Longitudinal survey over a 3-year period. Methods: The sample was taken from a prospective cohort study of 10,432 women initially aged between 70 and 75 years, who were surveyed in 1996 and then again in 1999. Two groups of women were identified: those reporting to have heart disease but no past history of heart interventions (i.e., coronary artery bypass graft/angioplasty) and those reporting to have heart disease with a past history of heart interventions. Results: Binary logistic regression analysis was used to show that for the women with self-reported coronary heart disease but without a past history of heart intervention, feelings of time pressure as well as the number of stressful life events experienced in the 12 months prior to 1996 were independent risk factors for the presence of chest pain, even after accounting for a range of traditional risk factors. In comparison, for the women with self-reported coronary heart disease who did report a past history of heart interventions, a diagnosis of depression in the previous 3 years was the significant independent risk factor for chest pain even after accounting for traditional risk factors. Conclusion: The results indicate that it is important to consider a history of heart interventions as a moderator of the associations between psychosocial variables and the frequency of chest pain in older women. Statement of Contribution: What is already known on this subject? Psychological factors have been shown to be independent predictors of a range of health outcomes in individuals with coronary heart disease, including the presence of chest pain. Most research has been conducted with men or with small samples of women; however, the evidence does suggest that these relationships exist in women as well as in men. What does this study add? Most studies have looked at overall relationships between psychological variables and health outcomes. The few studies that have looked at moderators have mainly examined gender as a moderator. To our knowledge, this is the first published study to examine a history of heart interventions as a moderator of the relationship between psychological variables and the presence of chest pain.

Effects of wireless sensor network uncertainties on output-only modal analysis employing merged data of multiple tests

The use of Wireless Sensor Networks (WSNs) for Structural Health Monitoring (SHM) has become a promising approach due to many advantages such as low cost, fast and flexible deployment. However, inherent technical issues such as data synchronization error and data loss have prevented these distinct systems from being extensively used. Recently, several SHM-oriented WSNs have been proposed and believed to be able to overcome a large number of technical uncertainties. Nevertheless, there is limited research verifying the applicability of those WSNs with respect to demanding SHM applications like modal analysis and damage identification. This paper first presents a brief review of the most inherent uncertainties of the SHM-oriented WSN platforms and then investigates their effects on outcomes and performance of the most robust Output-only Modal Analysis (OMA) techniques when employing merged data from multiple tests. The two OMA families selected for this investigation are Frequency Domain Decomposition (FDD) and Data-driven Stochastic Subspace Identification (SSI-data) due to the fact that they both have been widely applied in the past decade. Experimental accelerations collected by a wired sensory system on a large-scale laboratory bridge model are initially used as clean data before being contaminated by different data pollutants in sequential manner to simulate practical SHM-oriented WSN uncertainties. The results of this study show the robustness of FDD and the precautions needed for SSI-data family when dealing with SHM-WSN uncertainties. Finally, the use of the measurement channel projection for the time-domain OMA techniques and the preferred combination of the OMA techniques to cope with the SHM-WSN uncertainties is recommended.

Influence of high-intensity interval training on adaptations in well-trained cyclists

The purpose of the present study was to examine the influence of 3 different high-intensity interval training regimens on the first and second ventilatory thresholds (VT1 and VT2), anaerobic capacity (ANC), and plasma volume (PV) in well-trained endurance cyclists. Before and after 2 and 4 weeks of training, 38 well-trained cyclists (VO2peak = 64.5 +/- 5.2 ml[middle dot]kg-1[middle dot]min-1) performed (a) a progressive cycle test to measure VO2peak, peak power output (PPO), VT1, and VT2; (b) a time to exhaustion test (Tmax) at their VO2peak power output (Pmax); and (c) a 40-km time-trial (TT40). Subjects were assigned to 1 of 4 training groups (group 1: n = 8, 8 3 60% Tmax at Pmax, 1:2 work-recovery ratio; group 2: n = 9, 8 x 60% Tmax at Pmax, recovery at 65% maximum heart rate; group 3: n = 10, 12 x 30 seconds at 175% PPO, 4.5-minute recovery; control group: n = 11). The TT40 performance, VO2peak, VT1,VT2, and ANC were all significantly increased in groups 1, 2, and 3 (p < 0.05) but not in the control group. However, PV did not change in response to the 4-week training program. Changes in TT40 performance were modestly related to the changes in VO2peak, VT1, VT2, and ANC (r = 0.41, 0.34, 0.42, and 0.40, respectively; all p < 0.05). In conclusion, the improvements in TT40 performance were related to significant increases in VO2peak, VT1,VT2, and ANC but were not accompanied by significant changes in PV. Thus, peripheral adaptations rather than central adaptations are likely responsible for the improved performances witnessed in well-trained endurance athletes following various forms of high-intensity interval training programs.

Extremely cold and hot temperatures increase the risk of ischaemic heart disease mortality : epidemiological evidence from China

Objective: To examine the effects of extremely cold and hot temperatures on ischaemic heart disease (IHD) mortality in five cities (Beijing, Tianjin, Shanghai, Wuhan and Guangzhou) in China; and to examine the time relationships between cold and hot temperatures and IHD mortality for each city. Design: A negative binomial regression model combined with a distributed lag non-linear model was used to examine city-specific temperature effects on IHD mortality up to 20 lag days. A meta-analysis was used to pool the cold effects and hot effects across the five cities. Patients: 16 559 IHD deaths were monitored by a sentinel surveillance system in five cities during 2004–2008. Results: The relationships between temperature and IHD mortality were non-linear in all five cities. The minimum-mortality temperatures in northern cities were lower than in southern cities. In Beijing, Tianjin and Guangzhou, the effects of extremely cold temperatures were delayed, while Shanghai and Wuhan had immediate cold effects. The effects of extremely hot temperatures appeared immediately in all the cities except Wuhan. Meta-analysis showed that IHD mortality increased 48% at the 1st percentile of temperature (extremely cold temperature) compared with the 10th percentile, while IHD mortality increased 18% at the 99th percentile of temperature (extremely hot temperature) compared with the 90th percentile. Conclusions: Results indicate that both extremely cold and hot temperatures increase IHD mortality in China. Each city has its characteristics of heat effects on IHD mortality. The policy for response to climate change should consider local climate–IHD mortality relationships.

Every One, Every Day

Creative Statement: “There are those who see Planet Earth as a gigantic living being, one that feeds and nurtures humanity and myriad other species – an entity that must be cared for. Then there are those who see it as a rock full of riches to be pilfered heedlessly in a short-term quest for over-abundance. This ‘cradle to grave’ mentality, it would seem, is taking its toll (unless you’re a virulent disbeliever in climate change). Why not, ask artists Priscilla Bracks and Gavin Sade, take a different approach? To this end they have set out on a near impossible task; to visualise the staggering quantity of carbon produced by Australia every year. Their eerie, glowing plastic cube resembles something straight out of Dr Who or The X Files. And, like the best science fiction, it has technical realities at its heart. Every One, Every Day tangibly illustrates our greenhouse gas output – its 27m3 volume is approximately the amount of green-house gas emitted per capita, daily. Every One, Every Dayis lit by an array of LED’s displaying light patterns representing energy use generated by data from the Australian Energy Market. Every One, Every Day was formed from recycled, polyethylene – used milk bottles – ‘lent’ to the artists by a Visy recycling facility. At the end of the Vivid Festival this plastic will be returned to Visy, where it will re-enter the stream of ‘technical nutrients.’ Could we make another world? One that emulates the continuing cycles of nature? One that uses our ‘technical nutrients’ such as plastic and steel in continual cycles, just like a deciduous tree dropping leaves to compost itself and keep it’s roots warm and moist?” (Ashleigh Crawford. Melbourne – April, 2013) Artistic Research Statement: The research focus of this work is on exploring how to represent complex statistics and data at a human scale, and how produce a work where a large percentage of the materials could be recycled. The surface of Every One, Every Day is clad in tiles made from polyethylene, from primarily recycled milk bottles, ‘lent’ to the artists by the Visy recycling facility in Sydney. The tiles will be returned to Visy for recycling. As such the work can be viewed as an intervention in the industrial ecology of polyethylene, and in the process demonstrates how to sustain cycles of technical materials – by taking the output of a recycling facility back to a manufacturer to produce usable materials. In terms of data visualisation, Every One, Every Day takes the form of a cube with a volume of 27 cubic meters. The annual per capita emissions figures for Australia are cited as ranging between 18 to 25 tons. Assuming the lower figure, 18tons per capital annually, the 27 cubic meters represents approximately one day per capita of CO2 emissions – where CO2 is a gas at 15C and 1 atmosphere of pressure. The work also explores real time data visualisation by using an array of 600 controllable LEDs inside the cube. Illumination patterns are derived from a real time data from the Australian Energy Market, using the dispatch interval price and demand graph for New South Wales. The two variables of demand and price are mapped to properties of the illumination - hue, brightness, movement, frequency etc. The research underpinning the project spanned industrial ecology to data visualization and public art practices. The result is that Every One, Every Day is one of the first public artworks that successfully bring together materials, physical form, and real time data representation in a unified whole.

The effect of exercise repetition on the frequency characteristics of motor output force : Implications for Achilles tendinopathy rehabilitation

Objectives: To investigate the frequency characteristics of the ground reaction force (GRF) recorded throughout the eccentric Achilles tendon rehabilitation programme described by Alfredson. Design: Controlled laboratory study, longitudinal. Methods: Nine healthy adult males performed six sets (15 repetitions per set) of eccentric ankle exercise. Ground reaction force was recorded throughout the exercise protocol. For each exercise repetition the frequency power spectrum of the resultant ground reaction force was calculated and normalised to total power. The magnitude of peak relative power within the 8-12 Hz bandwidth and the frequency at which this peak occurred was determined. Results: The magnitude of peak relative power within the 8-12 Hz bandwidth increased with each successive exercise set and following the 4th set (60 repetitions) of exercise the frequency at which peak relative power occurred shifted from 9 to 10 Hz. Conclusions: The increase in magnitude and frequency of ground reaction force vibrations with an increasing number of exercise repetitions is likely connected to changes in muscle activation with fatigue and tendon conditioning. This research illustrates the potential for the number of exercise repetitions performed to influence the tendons' mechanical environment, with implications for tendon remodelling and the clinical efficacy of eccentric rehabilitation programmes for Achilles tendinopathy.