346 resultados para Cardiorespiratory


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It is estimated that more than half the U.S. adult population is overweight or obese as classified by a body mass index of 25.0–29.9 or ≥30 kg/m 2, respectively. Since the current treatment approaches for long-term maintenance of weight loss are lacking, the National Institutes of Health state that an effective approach may be to focus on weight gain prevention. There is a limited body of literature describing how adults maintain a stable weight as they age. It is hypothesized that weight stability is the result of a balance between energy consumption and energy expenditure as influenced by diet, lifestyle, behavior, genetics and environment. The purpose of this research was to examine the dietary intake and behaviors, lifestyle habits, and risk factors for weight change that predict weight stability in a cohort of 2101 men and 389 women aged 20 to 8 7 years in the Aerobic Center Longitudinal Study regardless of body weight at baseline. At baseline, participants completed a maximal exercise treadmill test to determine cardiorespiratory fitness, a medical history questionnaire, which included self-reported measures of weight, dietary behaviors, lifestyle habits, and risk factors for weight change, a three-day diet record, and a mail-back version of the medical history questionnaire in 1990 or 1995. All analyses were performed separately for men and women. Results from multivariate regression analyses indicated that the strongest predictor of follow-up weight for men and women was previous weight, accounting for 87.0% and 81.9% of the variance, respectively. Age, length of follow-up and eating habits were also significant predictors of follow-up weight in men, though these variables only explained 3% of the variance. For women, length of follow-up and currently being on a diet were significantly associated with follow-up weight but these variables explained only an additional 2% of the variance. Understanding the factors that influence weight change has tremendous public health importance for developing effective methods to prevent weight gain. Since current weight was the strongest predictor of previous weight, preventing initial weight gain by maintaining a stable weight may be the most effective method to combat the increasing prevalence of overweight and obesity. ^

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The different demands of competition coupled with the morphological and physiological characteristics of cyclists have led to the appearance of cycling specialities. The aims of this study were to determine the differences in the anthropometric and physiological features in road cyclists with different specialities, and to develop a multivariate model to classify these specialities and predict which speciality may be appropriate to a given cyclist. Twenty male, elite amateur cyclists were classified by their trainers as either flat terrain riders, hill climbers, or all-terrain riders. Anthropometric and cardiorespiratory studies were then undertaken. The results were analysed by MANOVA and two discriminant tests. Most differences between the speciality groups were of an anthropometric nature. The only cardiorespiratory variable that differed significantly (p < 0.05) was maximum oxygen consumption with respect to body weight (VO2max/kg). The first discriminant test classified 100% of the cyclists within their true speciality; the second, which took into account only anthropometric variables, correctly classified 75%. The first discriminant model allows the likely speciality of still non-elite cyclists to be predicted from a small number of variables, and may therefore help in their specific training.

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This study investigated the changes in cardiorespiratory response and running performance of 9 male ?Talent Identification? (TID) and 6 male Senior Elite (SE) Spanish National Squad triathletes during a specific cycle-run test. The TID and SE triathletes (initial age 15.2±0.7 vs. 23.8±5.6 years, p=0.03; tests through the competitive period and the preparatory period, respectively, of two consecutive seasons: Test 1 was an incremental cycle test to determine the ventilatory threshold (Thvent); Test 2 (C-R) was 30 min constant load cycling at the Thvent power output followed by a 3-km time trial run; and Test 3 (R) was an isolated 3-km time trial control run, in randomized counterbalanced order. In both seasons the time required to complete the C-R 3-km run was greater than for R in TID (11:09±00:24 vs. 10:45±00:16 min:ss, pmenor que 0.01; and 10:24±00:22 vs. 10:04±00:14, p=0.006, for season 2005/06 and 2006/07, respectively) and SE (10:15±00:19 vs. 09:45±00:30, pmenor que 0.001 and 09:51±00:26 vs. 09:46±00:06, p= 0.02 for season 2005/06 and 2006/07, respectively). Compared to the first season, completion of the time trial run was faster in the second season (6.6%, pmenor que 0.01 and 6.4%, pmenor que 0.01, for C-R and R test, respectively) only in TID. Changes in post-cycling run performance were accompanied by changes in pacing strategy but only slight or non-significant changes in the cardiorespiratory response. Thus, the negative effect of cycling on performance may persist, independently of the period, over two consecutive seasons in TID and SE triathletes; however A improvements over time suggests that monitoring running pacing strategy after cycling may be a useful tool to control performance and training adaptations in TID. O2max 77.0±5.6 vs. 77.8±3.6 mL·kg-1·min-1, NS) underwent three TE D EP C C

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La adolescencia es un período de crecimiento y desarrollo crítico e importante para la adquisición de hábitos saludables, en los que tanto la alimentación como la actividad física tienen un papel destacado. Junto con el primer año de vida, los requerimientos de energía y nutrientes son mayores que en cualquier otro periodo. Dentro de la nutrición, las vitaminas se ven involucradas en múltiples procesos celulares y tisulares, y sus deficiencias se vinculan a enfermedades crónicas degenerativas en la edad adulta como las cardiovasculares, cáncer, diabetes y osteoporosis, pero cuyos factores de riesgo se establecen a edades más tempranas. Las concentraciones sanguíneas de vitaminas están influenciadas en gran medida por la ingesta dietética, pero existen otros factores del individuo, entre los que cabe citar la composición corporal, la actividad física y condición física que, junto a la genética, podrían desempeñar un papel crucial. La presente memoria de Tesis Doctoral tiene como objetivo analizar el estado en vitaminas liposolubles y su relación con diversos factores de salud, entre los que destacan la composción corporal, hábitos dietéticos, actividad física y condición física en adolescentes Europeos. El trabajo está basado en los datos del estudio HELENA (“Healthy Lifestyle in Europe by Nutrition in Adolescence”). Se han analizado un total de 1089 adolescentes procedentes de diez ciudades en nueve paises europeos. Los principales resultados de este trabajo indican; a) La existencia de un estado deficiente en vitaminas liposolubles en adolescentes Europeos, especialmente de vitamina D, que alcanza valores del 80%. b) La estación del año, la latitud, el índice de masa corporal, la condición física, la ingesta de calcio dietético, los suplementos vitamínicos y la edad son las variables más relacionadas con el estado de vitamina D. c) A su vez, la capacidad cardiorrespiratoria puede predecir los niveles de vitamina D en los chicos, mientras que la fuerza muscular y masa magra parecen influir en los niveles de vitamina D en las chicas. La grasa corporal y el índice de masa corporal se correlaccionan negativamente con los niveles de vitamina D, especialmente en chicos. d) Un estado de vitamina D óptimo provoca una mejora de la masa ósea sólo cuando se tiene un nivel adecuado de actividad física. e) Se identifica la necesidad de establecer un consenso sobre los rangos aceptables y puntos de corte para las concentraciones sanguíneas de estas vitaminas en este grupo de población, ya que los actuales están extrapolados de la población adulta ABSTRACT Adolescence is a critical period of physiological growth and development as well as for the acquisition of healthy behaviors where both diet and physical activity play a major role. Apart from the first year of life, both energy and nutrient requirements are greatest during adolescence and the way to spend this energy by movement is also crucial. Vitamins are specifically involved in multiple cellular and tissue processes, and there is increasing evidence that deficiencies at these early ages could contribute to risk factors of chronic diseases like cardiovascular and cerebrovascular disease, cancer, diabetes and osteoporosis in adulthood, regardless data are scarce for younger ages. Vitamin concentrations are largely influenced by diet but other individual factors like body composition, physical activity or fitness together with genetics could play also an important role. The current thesis analyzes the liposoluble vitamin status in European adolescents and their relation with several health related factors, like body composción, dietary intake, physical activity and fitness. The work is based on data from the HELENA study ("Healthy Lifestyle in Europe by Nutrition in Adolescence"), for which a total of 1089 adolescents from ten different cities, in nine European countries were recruited. The main outcomes of this thesis are: a) There is a high liposoluble vitamin deficiency prevalence in European adolescents, specifically for vitamin D, which is presenting almost 80% of the adolescents. b) Season, latitude, BMI, fitness, dietary calcium intake, supplements intake and age are highly related to 25(OH)D concentrations found in European adolescents. c) Cardiorespiratory fitness may predict 25(OH)D concentrations in male adolescents, whereas upper limbs muscular strength and FFM may predict 25(OH)D concentrations in young females. Fat mass and BMI are inversely related to 25(OH)D concentrations, especially in males. d) The effect of 25(OH)D concentrations on bone mineral content in adolescents depends on physical activity levels. e) There is a need to establish a consensus on acceptable ranges and cut-offs of blood concentrations of these vitamins during adolescence, as currently they are extrapolated from adults.

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Objective: To examine the association of breakfast consumption with objectively measured and self-reported physical activity, sedentary time and physical fitness. Design: The HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Cross-Sectional Study. Breakfast consumption was assessed by two non-consecutive 24 h recalls and by a ‘Food Choices and Preferences’ questionnaire. Physical activity, sedentary time and physical fitness components (cardiorespiratory fitness, muscular fitness and speed/agility) were measured and self-reported. Socio-economic status was assessed by questionnaire. Setting: Ten European cities. Subjects: Adolescents (n 2148; aged 12?5–17?5 years). Results: Breakfast consumption was not associated with measured or self-reported physical activity. However, 24 h recall breakfast consumption was related to measured sedentary time in males and females; although results were not confirmed when using other methods to assess breakfast patterns or sedentary time. Breakfast consumption was not related to muscular fitness and speed/agility in males and females. However, male breakfast consumers had higher cardiorespiratory fitness compared with occasional breakfast consumers and breakfast skippers, while no differences were observed in females. Overall, results were consistent using different methods to assess breakfast consumption or cardiorespiratory fitness (all P#0?005). In addition, both male and female breakfast skippers (assessed by 24 h recall) were less likely to have high measured cardiorespiratory fitness compared with breakfast consumers (OR50?33; 95% CI 0?18, 0?59 and OR50?56; 95 %CI 0?32, 0?98,respectively). Results persisted across methods. Conclusions: Skipping breakfast does not seem to be related to physical activity,sedentary time or muscular fitness and speed/agility as physical fitness components in European adolescents; yet it is associated with both measured and self-reported cardiorespiratory fitness, which extends previous findings.

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En la literatura se ha descrito el perfil antropométrico y la respuesta psicofisiológica en escalada deportiva en roca, pero hasta la fecha, no se habían analizado las diferencias existentes entre sus principales modalidades. El objetivo de la presente tesis fue describir las características antropométricas del escalador de competición y comprobar la existencia de diferencias entre los participantes de distintas modalidades, así como analizar la respuesta psico-fisiológica durante la ejecución de un búlder y una vía, además de evaluar las diferencias entre su realización a vista o tras un ensayo. Para ello, efectuamos dos estudios diferentes: en el primero participaron voluntariamente 61 hombres y 18 mujeres, participantes en cuatro pruebas del circuito nacional de competición de escalada durante el año 2009, tres de ellas de la modalidad de dificultad a vista y una de búlder. Se realizaron mediciones antropométricas, prueba de fuerza de prensión manual antes y después de competir, y se cumplimentó un cuestionario donde se evaluaba la percepción del esfuerzo y la experiencia deportiva. En el segundo estudio, 23 escaladores, 15 hombres y 8 mujeres, divididos en tres grupos en función de su nivel de rendimiento, realizaron de manera voluntaria distintas pruebas durante tres días separados entre sí al menos 48 horas. El primer día rellenaron un cuestionario sobre su experiencia deportiva y nivel de rendimiento, fueron pesados, tallados y sometidos a un escáner de cuerpo completo en densitómetro con objeto de medir la composición corporal. El segundo día realizaron previo calentamiento, un búlder a vista y, tras un descanso de 15 minutos, escalaron una vía a vista acorde con su nivel. El tercer día, después de calentar y disponer de 20 minutos para ensayarlo, repitieron la escalada del búlder. Tras un descanso de 15 minutos y 20 minutos de ensayo, realizaron un segundo intento a la vía. Se registraron los valores en la respuesta cardiorrespiratoria, se obtuvieron muestras de lactato en sangre del lóbulo de la oreja y se realizaron pruebas de fuerza de prensión manual antes y después de la escalada. También se pasó un cuestionario para medir la ansiedad y autoconfianza así como el esfuerzo percibido. Los resultados no mostraron diferencias antropométricas significativas entre los participantes en competiciones de búlder y los que participaron en competiciones de escalada de dificultad a vista. Se dieron diferencias en la pérdida de fuerza antes y después de escalar entre dichos participantes. Las mujeres obtuvieron menor fuerza de prensión manual que los hombres pero la misma pérdida de fuerza entre el instante antes de competir y el posterior. La respuesta fisiológica durante la ejecución del búlder fue menor que la obtenida durante la ejecución de la vía. Hubo pérdida de fuerza de prensión manual entre el instante anterior y el posterior a ejecutar la vía, pero no al hacer el búlder. Sin embargo, no se dieron diferencias en la ansiedad y la autoestima provocada por ambas modalidades, por lo que deducimos que la ejecución de un búlder y una vía presentan una respuesta fisiológica distinta. Proponemos que la respuesta está relacionada, sobre todo, con las variables de ejecución, de tal manera que a mayor distancia y/o tiempo recorrido en la escalada, mayor será la contribución anaeróbica al esfuerzo y la fatiga manifestada como pérdida de fuerza que, en el caso del búlder, fue mínima o inexistente. En el segundo intento, tras un ensayo de 20 minutos en el búlder, se consiguió mejorar el rendimiento respecto al primer intento, que se manifestó con un aumento en la distancia recorrida. Sin embargo, en la vía no se dieron diferencias entre ambos intentos, ni en la ejecución, ni en la respuesta fisiológica, ni en la ansiedad, ni siquiera en la fuerza de prensión manual. ABSTRACT It has been described in the literature the anthropometric profile and psychophysiological response in rock climbing, but so far not been analyzed differences between its main modalities. The aim of this thesis was to describe the anthropometric characteristics of the climber competitor and check for differences between participants of different modalities and to analyze the psycho-physiological response during the execution of a boulder and a route also to assess differences between on sight and redpoint attempts. We made two different studies: in the first 61 men and 18 women who attended four competitions of national climbing circuit in 2009, three of them on-sight difficulty competitions and a boulder competition participated voluntarily. Anthropometric measurements, a hand grip strength test before and after competing were registered for each climber, and a questionnaire which assessed perception of effort and the climbing experience was fulfilled. In the second study, various tests were conducted on 23 volunteer climbers, 15 men and 8 women, during three days separated for, at least, 48 hours of resting, divided into three groups according to their performance. The first day, climbers completed a questionnaire on their experience and performance level. It was recorded weight, height and they underwent a full body scan densitometer in order to measure body composition. The second day, after previous warming-up, they climbed a boulder on sight and, after a break of 15 minutes, climbed a route on-sight according to their level. The third day, after warming-up and have 20 minutes to try it, they repeated the bouldering climbing. After a break of 15 minutes and 20 minutes of essaying, they made a second attempt at the route. Values in the cardiorespiratory response were recorded, blood lactate samples were obtained from earlobe, and hand grip strength was tested before and after the climb. They also filled a questionnaire to measure anxiety and self-confidence and perceived exertion. The results showed no significant anthropometric differences between participants in bouldering competitions and participants in competitions on-sight difficulty climbing. There were found differences in strength loss before and after climbing between those participants. Women had less hand grip strength than men but the same loss of strength between the records carried out before and after competing. The physiological response recorded for boulder climbing was lower than the obtained for the route. There was loss of hand grip strength between the time before and after running the route but not for bouldering. However, there were no differences in anxiety and self-esteem caused by both modalities, so we conclude that the implementation of a boulder and a route have different physiological responses. We think that this response is mainly related to performance variables, as a greater distance and/or travel time on the climb, the higher the anaerobic contribution to the effort and fatigue as manifested by loss of strength in the case of the boulder was minimal or nonexistent. In the second attempt after 20 minutes in the boulder better performance was achieved on the first attempt, which was manifested by an increment of climbing distance. However, there were the differences in the route between the two attempts, either in execution or in the physiological response, or anxiety, or even in hand grip strength.

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Changes in arterial distensibility have been widely used to identify the presence of cardiovascular abnormalities like hypertension. Pulse wave velocity (PWV) has shown to be related to arterial distensibility. However, the lack of suitable techniques to measure PWV nonintrusively has impeded its clinical usefulness. Pulse transit time (PTT) is a noninvasive technique derived from the principle of PWV. PTT has shown its capabilities in cardiovascular and cardiorespiratory studies in adults. However, no known study has been conducted to understand the suitability and utility of PTT to estimate PWV in children. Two computational methods to derive PWV from PTT values obtained from 23 normotensive Caucasian children (19 males, aged 5-12 years old) from their finger and toe were conducted. Furthermore, the effects of adopting different postures on the PWV derivations were investigated. Statistical analyses were performed in comparison with two previous PWV studies conducted on children. Results revealed that PWV derived from the upper limb correlated significantly (P

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Background and objective: There are no data about the influence of anaesthetics on cardiovascular variables during pressure support ventilation of the lungs through the laryngeal mask airway. We compared propofol, sevoflurane and isoflurane for maintenance of anaesthesia with the ProSeal (R) laryngeal mask airway during pressure support ventilation. Methods: Sixty healthy adults undergoing peripheral musculo-skeletal surgery were randomized for maintenance with sevoflurane end-tidal 29%, isoflurane end-tidal 1.1% or propofol 6 mg kg(-1) h(-1) in oxygen 33% and air. Pressure support ventilation comprised positive end-expiratory pressure set at 5 cmH(2)O, and pressure support set 5 cmH(2)O above positive end-expiratory pressure. Pressure support was initiated when inspiration produced a 2 cmH(2)O reduction in airway pressure. A blinded observer recorded cardiorespiratory variables (heart rate, mean blood pressure, oxygen saturation, air-way occlusion pressure, respiratory rate, expired tidal volume, expired minute volume and end-tidal CO2), adverse events and emergence times. Results: Respiratory rate and minute volume were 10-21% lower, and end-tidal CO2 6-11% higher with the propofol group compared with the sevoflurane or isoflurane groups, but otherwise cardiorespiratory variables were similar among groups. No adverse events occurred in any group. Emergence times were longer with the propofol group compared with the sevoflurane or isoflurane groups (10 vs. 7 vs. 7 min). Conclusion: Lung ventilation is less effective and emergence times are longer with propofol than sevoflurane or isoflurane for maintenance of anaesthesia during pressure support ventilation with the ProSeal (R) laryngeal mask airway. However, these differences are small and of doubtful clinical importance.

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Although safety is recognized as a critical issue in functional capacity evaluations (FCEs), it has rarely been investigated. This paper reports on the findings of a study which examined safety aspects of a new approach to FCE. Fourteen rehabilitation clients with chronic back pain participated in the study. Aspects examined included the pre-FCE screening procedures, the monitoring of performance and safety during the FCE, and the end of FCE measures and follow-up procedures. Support was found for the screening procedures of the approach, particularly blood pressure measurement, and for the combined approach to monitoring of the persons performance from biomechanical, physiological and psychophysical perspectives. Issues for FCE safety in general are identified and discussed, including the importance of screening procedures to determine readiness for FCEs and the issue of load handling in FCEs, especially in relation to clients with chronic back pain.

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The metabolic syndrome (MS) is associated with cardiovascular risk exceeding that expected from atherosclerotic risk factors, but the mechanism of this association is unclear. We sought to determine the effects of the MS on myocardial and vascular function and cardiorespiratory fitness in 393 subjects with significant risk factors but no cardiovascular disease and negative stress echocardiographic findings. Myocardial function was assessed by global strain rate, strain, and regional systolic velocity (s(m)) and diastolic velocity (e(m)) using tissue Doppler imaging. Arterial compliance was assessed using the pulse pressure method, involving simultaneous radial applanation tonometry and echocardiographic measurement of stroke volume. Exercise capacity was measured by expired gas analysis. Significant and incremental variations in left ventricular systolic (s(m), global strain, and strain rate) and diastolic (e(m)) function were found according to the number of components of MS (p <0.001). MS contributed to reduced systolic and diastolic function even in those without left ventricular hypertrophy (p <0.01). A similar dose-response association was present between the number of components of the MS and exercise capacity (p <0.001) and arterial compliance. The global strain rate and em were independent predictors of exercise capacity. In conclusion, subclinical left ventricular dysfunction corresponded to the degree of metabolic burden, and these myocardial changes were associated with reduced cardiorespiratory fitness.' Subjects with MS who also have subclinical myocardial abnormalities and reduced cardiorespiratory fitness may have a higher risk of cardiovascular disease events and heart failure. (C) 2005 Elsevier Inc. All rights reserved.

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BACKGROUND: Brain stem death can elicit a potentially manipulable cardiotoxic proinflammatory cytokine response. We investigated the prevalence of this response, the impact of donor management with tri-iodothyronine (T3) and methylprednisolone (MP) administration, and the relationship of biomarkers to organ function and transplant suitability. METHODS: In a prospective randomized double-blinded factorially designed study of T3 and MP therapy, we measured serum levels of interleukin-1 and -6 (IL-1 and IL-6), tumor necrosis factor-alpha (TNF-alpha), C-reactive protein, and procalcitonin (PCT) levels in 79 potential heart or lung donors. Measurements were performed before and after 4 hr of algorithm-based donor management to optimize cardiorespiratory function and +/-hormone treatment. Donors were assigned to receive T3, MP, both drugs, or placebo. RESULTS: Initial IL-1 was elevated in 16% donors, IL-6 in 100%, TNF-alpha in 28%, CRP in 98%, and PCT in 87%. Overall biomarker concentrations did not change between initial and later measurements and neither T3 nor MP effected any change. Both PCT (P =0.02) and TNF-alpha (P =0.044) levels were higher in donor hearts with marginal hemodynamics at initial assessment. Higher PCT levels were related to worse cardiac index and right and left ventricular ejection fractions and a PCT level more than 2 ng x mL(-1) may attenuate any improvement in cardiac index gained by donor management. No differences were observed between initially marginal and nonmarginal donor lungs. A PCT level less than or equal to 2 ng x mL(-1) but not other biomarkers predicted transplant suitability following management. CONCLUSIONS: There is high prevalence of a proinflammatory environment in the organ donor that is not affected by tri-iodothyronine or MP therapy. High PCT and TNF-alpha levels are associated with donor heart dysfunction. (C) 2009 Lippincott Williams & Wilkins, Inc.

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Whole Body Vibrations consist of a vibration stimulus mechanically transferred to the body. The impact of vibration treatment on specific muscular activity, neuromuscular, and postural control has been widely studied. We investigated whole body vibration (WBV) effect on oxygen uptake and electromyographic signal of the rectus femoris muscle during static and dynamic squat. Fourteen healthy subjects performed a static and dynamic squat with and without vibration. During the vibration exercises, a significant increase was found in oxygen uptake (P=0.05), which increased by 44% during the static squat and 29.4% during the dynamic squat. Vibration increased heart rate by 11.1 ± 9.1 beats.min-1 during the static squat and 7.9 ± 8.3 beats.min-1 during the dynamic squat. No significant changes were observed in rate of perceived exertion between the exercises with and without vibration. The results indicate that the static squat with WBV produced higher neuromuscular and cardiorespiratory system activation for exercise duration ?60 sec. Otherwise, if the single bout duration was higher than 60 sec, the greater cardiorespiratory system activation was achieved during the dynamic squat with WBV while higher neuromuscular activation was still obtained with the static exercise.

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Introduction Up to 10% of infants require stabilisation during transition to extrauterine life. Enhanced monitoring of cardiorespiratory parameters during this time may improve stabilisation outcomes. In addition, technology may facilitate improved preparation for delivery room stabilisation as well as NICU procedures, through educational techniques. Aim To improve infant care 1) before birth via improved training, 2) during stabilisation via enhanced physiological monitoring and improved practice, and 3) after delivery, in the neonatal intensive care unit (NICU), via improved procedural care. Methods A multifaceted approach was utilised including; a combination of questionnaire based surveys, mannequin-based investigations, prospective observational investigations, and a randomised controlled trial involving preterm infants less than 32 weeks in the delivery room. Forms of technology utilised included; different types of mannequins including a CO2 producing mannequin, qualitative end tidal CO2 (EtCO2) detectors, a bespoke quantitative EtCO2 detector, and annotated videos of infant stabilisation as well as NICU procedures Results Manual ventilation improved with the use of EtCO2 detection, and was positively assessed by trainees. Quantitative EtCO2 detection in the delivery room is feasible, EtCO2 increased over the first 4 minutes of life in preterm infants, and EtCO2 was higher in preterm infants who were intubated. Current methods of heart rate assessment were found to be unreliable. Electrocardiography (ECG) application warrants further evaluation. Perfusion index (PI) monitoring utilised in the delivery room was feasible. Video recording technology was utilised in several ways. This technology has many potential benefits, including debriefing and coaching in procedural healthcare, and warrants further evaluation. Parents would welcome the introduction of webcams in the NICU. Conclusions I have evaluated new methods of improving infant care before, during, and after stabilisation in the DR. Specifically, I have developed novel educational tools to facilitate training, and evaluated EtCO2, PI, and ECG during infant stabilisation. I have identified barriers in using webcams in the NICU, to now be addressed prior to webcam implementation.

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INTRODUCTION: Sleepiness is a cardinal symptom in obstructive sleep apnoea (OSA) but most patients have unspecific symptoms. Arterial stiffness, evaluated by pulse wave velocity (PWV), is related to atherosclerosis and cardiovascular (CV) risk. Arterial stiffness was reported to be higher in patients with OSA, improving after treatment with continuous positive airway pressure (CPAP). This study aims to assess whether the same effect occurs in patients with OSA and without sleepiness. METHODS AND ANALYSIS: This observational study assesses the CV effect of CPAP therapy on a cohort of patients with moderate-to-severe OSA; the effect on the subcohorts of sleepy and non-sleepy patients will be compared. A systematic and consecutive sample of patients advised CPAP therapy will be recruited from a single outpatient sleep clinic (Centro Hospitalar de Lisboa Central-CHLC, Portugal). Eligible patients are male, younger than 65 years, with confirmed moderate-to-severe OSA and apnoea-hypopnea index (AHI) above 15/hour. Other sleep disorders, diabetes or any CV disease other than hypertension are exclusion criteria. Clinical evaluation at baseline includes Epworth Sleepiness Scale (ESS), and sleepiness is defined as ESS above 10. OSA will be confirmed by polygraphic study (cardiorespiratory, level 3). Participants are advised to undertake an assessment of carotid-femoral PWV (cf-PWV) and 24 hours evaluation of ambulatory blood pressure monitoring (ABPM), at baseline and after 4 months of CPAP therapy. Compliance and effectiveness of CPAP will be assessed. The main outcome is the variation of cf-PWV over time.