Conhecimento e atitudes da área da saúde frente ao risco de contaminação por hepatites ao fazer as unhas

Pós-graduação em Saúde Coletiva - FMB

Crop, Native Vegetation, and Biofuels: Response of White- Tailed Deer to Changing Management Priorities

The expansion of the cellulosic biofuels industry throughout the United States has broad-scale implications for wildlife management on public and private lands. Knowledge is limited on the effects of reverting agriculture to native grass, and vice versa, on size of home range and habitat use of white-tailed deer (Odocoileus virginianus). We followed 68 radio-collared female deer from 1991 through 2004 that were residents of DeSoto National Wildlife Refuge (DNWR) in eastern Nebraska, USA. The refuge was undergoing conversion of vegetation out of row-crop agriculture and into native grass, forest, and emergent aquatic vegetation. Habitat in DNWR consisted of 30% crop in 1991 but removing crops to establish native grass and wetland habitat at DNWR resulted in a 44% reduction in crops by 2004. A decrease in the amount of crops on DNWR contributed to a decline in mean size of annual home range from 400 ha in 1991 to 200 ha in 2005 but percentage of crops in home ranges increased from 21% to 29%. Mean overlap for individuals was 77% between consecutive annual home ranges across 8 years, regardless of crop availability. Conversion of crop to native habitat will not likely result in home range abandonment but may impact disease transmission by increasing rates of contact between deer social groups that occupy adjacent areas. Future research on condition indices or changes in population parameters (e.g., recruitment) could be incorporated into the study design to assess impacts of habitat conversion for biofuel production.

Metronidazole Immediate Release Formulations: A Fasting Randomized Open-Label Crossover Bioequivalence Study in Healthy Volunteers

Metronidazole is a BCS (Biopharmaceutics Classification System) class 1 drug, traditionally considered the choice drug in the infections treatment caused by protozoa and anaerobic microorganisms. This study aimed to evaluate bioequivalence between 2 different marketed 250 mg metronidazole immediate release tablets. A randomized, open-label, 2 x 2 crossover study was performed in healthy Brazilian volunteers under fasting conditions with a 7-day washout period. The formulations were administered as single oral dose and blood was sampled over 48 h. Metronidazole plasma concentrations were determined by a liquid chromatography mass spectrometry (LC-MS/MS) method. The plasma concentration vs. time profile was generated for each volunteer and the pharmacokinetic parameters C-max, T-max, AUC(0-t), AUC(0-infinity), k(e), and t(1/2) were calculated using a noncompartmental model. Bioequivalence between pharmaceutical formulations was determined by calculating 90% CIs (Confidence Intervall) for the ratios of C-max, AUC(0-t), and AUC(0-infinity) values for test and reference using log-transformed data. 22 healthy volunteers (11 men, 11 women; mean (SD) age, 28 (6.5) years [range, 21-45 years]; mean (SD) weight, 66 (9.3) kg [range, 51-81 kg]; mean (SD) height, 169 (6.5) cm [range, 156-186 cm]) were enrolled in and completed the study. The 90% CIs for C-max (0.92-1.06), AUC(0-t) (0.97-1.02), and AUC(0-infinity) (0.97-1.03) values for the test and reference products fitted in the interval of 0.80-1.25 proposed by most regulatory agencies, including the Brazilian agency ANVISA. No clinically significant adverse effects were reported. After pharmacokinetics analysis, it concluded that test 250 mg metronidazole formulation is bioequivalent to the reference product according to the Brazilian agency requirements.

Langzeitergebnisse nach Trabekulektomie bei Glaukompatienten

Hintergrund: Die antimetabolitgestützte Trabekulektomie stellt seit längeren denrnGoldstandard bei medikamentös nicht ausreichend therapierbaren Glaukomen dar. Kurz- und mittelfristige Erfolge wurden durch viele Studien bestätigt. Allerdings unterliegen diese sehr unterschiedlichen Erfolgsdefinitionen. Eine strikte Druckkontrolle ≤ 15 mm Hg ohne zusätzliche medikamentöse Therapie erscheint sinnvoll einen risikofreien Therapieerfolg zu bewerten. Es existieren nur wenige Langzeitstudien mit diesem Erfolgskriterium. Die durchgeführte Studie soll einen Eindruck der ophthalmologischen Versorgung trabekulektomierter Patienten an der Universitätsaugenklinik Mainz über einen bewusst langen Zeitraum bieten. Patienten und Methoden: In diese retrospektiven Studie wurden alle Patienten, die aufgrund einer fortgeschrittenen Glaukomerkrankung in den Jahren 1996, 2001 oder 2006 eine Trabekulektomie erhielten, aufgenommen. Von den 723 Augen der 664 Patienten dieser Jahrgänge konnten 447 (61,8%) nachverfolgt werden. Die Zusammensetzung der Patienten war mit anderen Studien vergleichbar. 28% konnten mindestens 7 Jahre, 10% sogar 10 Jahre nachverfolgt werden. Esrnwurde untersucht, ob ein signifikanter Zusammenhang zwischen dem ophthalomologisch-internistischem Entlassstatus (Visus, Tensio, Gesichtsfeld,rnGlaukomtyp, Voroperationen, Medikation, Vorerkrankungen, Art der Operation) undrnder erstrebten Kontrolle des Intraokulardruckes besteht. Ergebnisse: Die mittlere Nachbeobachtungszeit betrug 4,3 ± 3,4 Jahre. Nach 1, 3,rn5, 7 und 10 Jahren wiesen 217 (82,1%) (p < 0,001), 133 (67,7%) (p < 0,001), 70rn(50%) (p < 0,001), 59 (47,7%) (p = 0,056) und 16 (38,1%) (p = 0,06) Augen Intraokulardrücke ≤ 15 mm Hg ohne zusätzliche Antiglaukomatosa auf. Nichtrnstatistisch signifikant waren die 7- und 10-Jahresergebnisse. Mit Hilfe von Antiglaukomatosa waren es insgesamt, 225 (85,1%), 156 (79,7%), 87 (62,5%), 93 (75%) und 23 (54,7%) (alle p < 0,001). Die mediane Überlebenszeit für IOD ≤ 15 mm Hg ohne Medikation betrug 7,4 Jahre ± 5 Monate. Druckobergrenzen von ≤ 18 bzw. 21 mm Hg erfüllten bis zu 20% mehr Patienten. Der mittlere Visus von 0,32 ± 6 Stufen blieb nach einem mittleren postoperativen Abfall auf 0,25 ± 5 Stufen in den Folgeuntersuchungen stabil. Er zeigte ab dem 3-Jahresintervall keine statistisch signifikante Verschlechterung zum präoperativen Visus. 5,8 Jahre ± 80 Tage betrug die mediane Überlebenszeit für ein stabiles Gesichtsfeld. Gesichtsfelddaten, MD und PSD zeigten keine statistisch signifikante Verschlechterung (p > 0,05). Risikofaktoren für ein Scheitern der Operation waren Patientenalter (RR = 1,01, KI: 0,95 - 1,34, p = 0,043), arterielle Hypertonie (RR = 1,87, KI: 1,21-2,9, p = 0,005) und männliches Geschlecht (RR = 1,24; KI: 1,07 – 1,43; p = 0,004). Komplikationen waren passagere okuläre Hypotonien an 85 (19%), Fistulation an 46(10,2%), Aderhautschwellung an 29 (6,4%) –abhebung an 14 (3,1%), retinale Amotio an 9 (2%), hypotone Makulopathie an 5 (1,1%) und Hypertonien an 70 (15,6%) Augen. 150 (33,5%) Augen erhielten einen Folgeeingriff, 117 (26%) eine Phakoemulsifikation, 149 (33%) eine Fadenlockerung, 122 (27%) 5-FU-Injektionen, 42 (9,4%) eine Fadennachlegung, 33 (7,4%) ein Needling, 26 (5,8%) eine Zyklophotokoagulation, 19 (4,3%) eine Re-TE und 9 (2%) sonstige chirurgische Revisionen. Schlussfolgerung: Die Kontrolle des Augeninnendruckes ≤ 15 mm Hg ohne zusätzliche Medikation erreichten viele Patienten über einen langen Nachbeobachtungszeitraum. Die Häufigkeit der Komplikationen oder nötiger Folgeeingriffe war meist niedriger als in vergleichbaren Studien. Selbst Patienten mit hohem Risikoprofil hatten gute Ergebnisse. Aufgrund mangelnder Gesichtsfelddaten fanden sich keine Hinweise auf statistisch relevantes Fortschreiten des Glaukoms zur angestrebten medikationsfreien Druckkontrolle. Weitere Studien für einen Untersuchungszeitraum von 10 Jahren mit gleichen Erfolgskriterien wie in der vorliegenden Arbeit mit genauer Analyse der Gesichtsfelddaten wären wünschenswert, um zu belegen, dass die guten Langzeitergebnisse nach Trabekulektomie an der Universitätsaugenklinik Mainz auch eine Glaukomprogredienz dauerhaft verhindern. Damit stellt die an der Universitätsaugenklinik Mainz durchgeführte antimetabolitgestützte Trabekulektomie und deren postoperative Nachbetreuung an einer repräsentativen Population eine sichere und komplikationsarme Methode dar.

In search of optimal compression therapy for venous leg ulcers: a meta-analysis of studies comparing diverse [corrected] bandages with specifically designed stockings

OBJECTIVE: In search of an optimal compression therapy for venous leg ulcers, a systematic review and meta-analysis was performed of randomized controlled trials (RCT) comparing compression systems based on stockings (MCS) with divers bandages. METHODS: RCT were retrieved from six sources and reviewed independently. The primary endpoint, completion of healing within a defined time frame, and the secondary endpoints, time to healing, and pain were entered into a meta-analysis using the tools of the Cochrane Collaboration. Additional subjective endpoints were summarized. RESULTS: Eight RCT (published 1985-2008) fulfilled the predefined criteria. Data presentation was adequate and showed moderate heterogeneity. The studies included 692 patients (21-178/study, mean age 61 years, 56% women). Analyzed were 688 ulcerated legs, present for 1 week to 9 years, sizing 1 to 210 cm(2). The observation period ranged from 12 to 78 weeks. Patient and ulcer characteristics were evenly distributed in three studies, favored the stocking groups in four, and the bandage group in one. Data on the pressure exerted by stockings and bandages were reported in seven and two studies, amounting to 31-56 and 27-49 mm Hg, respectively. The proportion of ulcers healed was greater with stockings than with bandages (62.7% vs 46.6%; P < .00001). The average time to healing (seven studies, 535 patients) was 3 weeks shorter with stockings (P = .0002). In no study performed bandages better than MCS. Pain was assessed in three studies (219 patients) revealing an important advantage of stockings (P < .0001). Other subjective parameters and issues of nursing revealed an advantage of MCS as well. CONCLUSIONS: Leg compression with stockings is clearly better than compression with bandages, has a positive impact on pain, and is easier to use.

Dust record from the EPICA Dome C ice core, Antarctica, covering 0 to 800 kyr BP

Dust can affect the radiative balance of the atmosphere by absorbing or reflecting incoming solar radiation and it can be a source of micronutrients, such as iron, to the ocean. It has been suggested that production, transport, and deposition of dust is influenced by climatic changes on glacial-interglacial timescales. Here we present a high-resolution aeolian dust record from the EPICA Dome C ice core in East Antarctica, which provides an undisturbed climate sequence over the last eight climatic cycles. We find that there is a significant correlation between dust flux and temperature records during glacial periods that is absent during interglacial periods. Our data suggests that dust flux is increasingly correlated with Antarctic temperature as climate becomes colder. We interpret this as progressive coupling of Antarctic and lower latitudes climate. Limited changes in glacial-interglacial atmospheric transport time Mahowald et al. (1999, doi:10.1029/1999JD900084), Jouzel et al. (2007, doi:10.1126/science.1141038), and Werner et al. (2002, doi:10.1029/2002JD002365) suggest that the sources and lifetime of dust are the major factors controlling the high glacial dust input. We propose that the observed ~25-fold increase in glacial dust flux over all eight glacial periods can be attributed to a strengthening of South American dust sources, together with a longer atmospheric dust particle life-time in the upper troposphere resulting from a reduced hydrological cycle during the ice ages.

Abrupt shifts of the Sahara-Sahel boundary during Heinrich stadials demonstrated on a sediment core transect

Relict dune fields that are found as far south as 14° N in the modern-day African Sahel are testament to equatorward expansions of the Sahara desert during the Late Pleistocene. However, the discontinuous nature of dune records means that abrupt millennial-timescale climate events are not always resolved. High-resolution marine core studies have identified Heinrich stadials as the dustiest periods of the last glacial in West Africa although the spatial evolution of dust export on millennial timescales has so far not been investigated. We use the major-element composition of four high-resolution marine sediment cores to reconstruct the spatial extent of Saharan-dust versus river-sediment input to the continental margin from West Africa over the last 60 ka. This allows us to map the position of the sediment composition corresponding to the Sahara-Sahel boundary. Our records indicate that the Sahara-Sahel boundary reached its most southerly position (13° N) during Heinrich stadials and hence suggest that these were the periods when the sand dunes formed at 14° N on the continent. Heinrich stadials are associated with cold North Atlantic sea surface temperatures which appear to have triggered abrupt increases of aridity and wind strength in the Sahel. Our study illustrates the influence of the Atlantic meridional overturning circulation on the position of the Sahara-Sahel boundary and on global atmospheric dust loading.

Neogene palaeoclimate reconstructions in Anatolia (Turkey)

Neogene basins are widespread in Turkey and contain important lignite deposits. In this study, we reconstruct quantitatively the Late Oligocene-Miocene climate evolution in western and central Anatolia by applying the Coexistence Approach to the palynoflora. The obtained results are compared with the data derived from the published and ongoing studies in western and central Anatolia palynofloras by application of the Coexistence Approach. The Coexistence Approach results show that the sedimentation mainly developed on terrestrial environment under the warm subtropical climatic conditions and marine influence during the Chattian and Aquitanian period in western Anatolia (16.5-21.3°C of mean annual temperature (MAT) and 5.5-13.3°C of mean temperature of coldest month (CMT)). After the regression of the sea during the Burdigalian period, the vegetation developed under the terrestrial conditions, which had started in the Burdigalian time in western and central Anatolia and continued in the early-middle Serravallian period. Warm subtropical climate is suggested during the Chattian and Aquitanian period in western Anatolia and becomes cooler in subtropical conditions because of decreasing of the P/A-ratio during the latest Burdigalian-Langhian. The climate was subtropical in western and central Anatolia during the Early-Late Serravalian due to the increasing of the subtropical elements (17.2 to 20.8°C of MAT and 9.6 to13.1°C of CMT). Besides, decreasing of the CMT and MAT values in western and central Anatolia supports the latest Chattian-earliest Aquitanian warming and middle Miocene climatic optimum that is also globally observed. Warm temperate climatic conditions are observed in the Late Miocene. During the early-middle Tortonian, the values are 15.6 to 20.8°C for the MAT, 5.5 to 13.3°C for the CMT and 823 and 1520 mm for the mean annual precipitation (MAP). They had also dry seasons due to lower boundary of MAP lying at 823mm during the middle-Late Tortonian. The palaeotopography of central Anatolia was higher when compared to that of western Anatolia because dominance of the mountain forests was present during the Middle-Late Miocene in central Anatolia. This study provides the first quantitative model for Late Oligocene-Miocene palaeoclimatic evolution in western and central Anatolia.

Seawater carbonate chemistry and calcification during a study of barrier reef flat in Moorea, French Polynesia, 1998

The relative contribution of soft bottoms to the community metabolism (primary production, respiration and net calcification) of a barrier reef flat has been investigated at Moorea (French Polynesia). Community metabolism of the sedimentary area was estimated using in situ incubations in perspex chambers, and compared with estimates of community metabolism of the whole reef flat obtained using a Lagrangian technique (Gattuso et al., 1996. Carbon flux in coral reefs. 1. Lagrangian measurement of community metabolism and resulting air-sea CO2 disequilibrium. Mar. Ecol. Prog. Ser. 145, 109-121). Net organic carbon production (E), respiration (R) and net calcification (G) of sediments were measured by seven incubations performed in triplicate at different irradiance. Respiration and environmental parameters were also measured at four randomly selected additional stations. A model of Photosynthesis-irradiance allowed to calculate oxygen (O2), organic carbon (CO2) and calcium carbonate (CaCO3) evolution from surface irradiance during a diel cycle. As chlorophyll a content of the sediment was not significantly different between stations, primary production of the sediment was considered as homogeneous for the whole lagoon. Thus, carbon production at the test station can be modelled from surface light irradiance. The modelled respiration was two times higher at the test station than the mean respiration of the barrier reef, and thus underestimated sediment contribution to excess production. Sediments cover 40-60% of the surface and accounted for 2.8-4.1% of organic carbon excess production estimated with the modelled R and 21-32% when mean R value was considered. The sedimentary CaCO3 budget was a very minor component of the whole reef budget.

(Table 1) Age determination of sediment core MD02-2589

Sortable silt mean grain sizes together with oxygen and carbon isotopic data produced on the benthic foraminiferal species Fontbotia wuellerstorfi are used to construct high-resolution records of near-bottom flow vigour and deep water ventilation at a core site MD02-2589 located at 2660 m water depth on the southern Agulhas Plateau. The results suggest that during glacial periods (marine oxygen isotope stages 2 and 6, MIS 2 and MIS 6, respectively), there was a persistent contribution of a well-ventilated water mass within the Atlantic to Indian oceanic gateway with a d13C signature similar to present-day Northern Component Water (NCW), e.g., North Atlantic Deep Water (NADW). The records of chemical ventilation and near-bottom flow vigor reflect changes in the advection of northern source waters and meridional variability in the location of the Antarctic Circumpolar Current and its associated fronts. We suggest that during Termination II (TII), changes in chemical ventilation are largely decoupled from near-bottom physical flow speeds. A mid-TII climate optimum is associated with a low-flow speed plateau concurrent with a period of increased ventilation shown in the benthic d13C of other Southern Ocean records but not in our benthic d13C of MD02-2589. The climate optimum is followed by a period of southern cooling around 128 ka coincident with a stronger influence of NCW to interglacial levels at around 124 ka. All proxy records show a near synchronous and rapid shift during the transition from MIS 5a-4 (73 ka). This large event is attributed to a rapid decrease in NADW influence and replacement over the Agulhas Plateau by southern source waters.

Physical activity cost in children following an acquired brain injury - a comparative study

Background: Alterations in energy expenditure during activity post head injury has not been investigated due primarily to the difficulty of measurement. Objective: The aim of this study was to compare energy expenditure during activity and body composition of children following acquired brain injury (ABI) with data from a group of normal. controls. Design: Energy expenditure was measured using the Cosmed K4b(2) in a group of 15 children with ABI and a group of 67 normal children during rest and when walking and running. Mean number of steps taken per 3 min run was also recorded and body composition was measured. Results: The energy expended during walking was not significantly different between both groups. A significant difference was found between the two groups in the energy expended during running and also for the number of steps taken as children with ABI took significantly less steps than the normal controls during a 3 min run. Conclusions: Children with ABI exert more energy per activity than healthy controls when controlled for velocity or distance. However, they expend less energy to walk and run when they are free to choose their own desirable, comfortable pace than normal controls. (C) 2003 Elsevier Ltd. All rights reserved.

Dietary analysis and patterns of nutritional supplement use in normal and age-related macular disease affected subjects:a prospective cross-sectional study

Background: Poor diet is thought to be a risk factor for many diseases, including age-related macular disease (ARMD), which is the leading cause of blind registration in those aged over 60 years in the developed world. The aims of this study were 1) to evaluate the dietary food intake of three subject groups: participants under the age of 50 years without ARMD (U50), participants over the age of 50 years without ARMD (O50), and participants with ARMD (AMD), and 2) to obtain information on nutritional supplement usage. Methods: A prospective cross-sectional study designed in a clinical practice setting. Seventy-four participants were divided into three groups: U50; 20 participants aged < 50 years, from 21 to 40 (mean ± SD, 37.7 ± 10.1 years), O50; 27 participants aged > 50 years, from 52 to 77 (62.7 ± 6.8 years), and ARMD; 27 participants aged > 50 years with ARMD, from 55 to 79 (66.0 ± 5.8 years). Participants were issued with a three-day food diary, and were also asked to provide details of any daily nutritional supplements. The diaries were analysed using FoodBase 2000 software. Data were input by one investigator and statistically analysed using Microsoft Excel for Microsoft Windows XP software, employing unpaired t-tests. Results: Group O50 consumed significantly more vitamin C (t = 3.049, p = 0.005) and significantly more fibre (t = 2.107, p = 0.041) than group U50. Group ARMD consumed significantly more protein (t = 3.487, p = 0.001) and zinc (t = 2.252, p = 0.029) than group O50. The ARMD group consumed the highest percentage of specific ocular health supplements and the U50 group consumed the most multivitamins. Conclusions: We did not detect a deficiency of any specific nutrient in the diets of those with ARMD compared with age- and gender-matched controls. ARMD patients may be aware of research into use of nutritional supplementation to prevent progression of their condition.

Short-term stability in refractive status despite large fluctuations in glucose levels in diabetes mellitus type 1 and 2

Purpose: This work investigates how short-term changes in blood glucose concentration affect the refractive components of the diabetic eye in patients with long-term Type 1 and Type 2 diabetes. Methods: Blood glucose concentration, refractive error components (mean spherical equivalent MSE, J0, J45), central corneal thickness (CCT), anterior chamber depth (ACD), crystalline lens thickness (LT), axial length (AL) and ocular aberrations were monitored at two-hourly intervals over a 12-hour period in: 20 T1DM patients (mean age ± SD) 38±14 years, baseline HbA1c 8.6±1.9%; 21 T2DM patients (mean age ± SD) 56±11 years, HbA1c 7.5±1.8%; and in 20 control subjects (mean age ± SD) 49±23 years, HbA1c 5.5±0.5%. The refractive and biometric results were compared with the corresponding changes in blood glucose concentration. Results: Blood glucose concentration at different times was found to vary significantly within (p<0.0005) and between groups (p<0.0005). However, the refractive error components and ocular aberrations were not found to alter significantly over the day in either the diabetic patients or the control subjects (p>0.05). Minor changes of marginal statistical or optical significance were observed in some biometric parameters. Similarly there were some marginally significant differences between the baseline biometric parameters of well-controlled and poorly-controlled diabetic subjects. Conclusion: This work suggests that normal, short-term fluctuations (of up to about 6 mM/l on a timescale of a few hours) in the blood glucose levels of diabetics are not usually associated with acute changes in refractive error or ocular wavefront aberrations. It is therefore possible that factors other than refractive error fluctuations are sometimes responsible for the transient visual problems often reported by diabetic patients. © 2012 Huntjens et al.

The transformed-stationary approach: a generic and simplified methodology for non-stationary extreme value analysis

Statistical approaches to study extreme events require, by definition, long time series of data. In many scientific disciplines, these series are often subject to variations at different temporal scales that affect the frequency and intensity of their extremes. Therefore, the assumption of stationarity is violated and alternative methods to conventional stationary extreme value analysis (EVA) must be adopted. Using the example of environmental variables subject to climate change, in this study we introduce the transformed-stationary (TS) methodology for non-stationary EVA. This approach consists of (i) transforming a non-stationary time series into a stationary one, to which the stationary EVA theory can be applied, and (ii) reverse transforming the result into a non-stationary extreme value distribution. As a transformation, we propose and discuss a simple time-varying normalization of the signal and show that it enables a comprehensive formulation of non-stationary generalized extreme value (GEV) and generalized Pareto distribution (GPD) models with a constant shape parameter. A validation of the methodology is carried out on time series of significant wave height, residual water level, and river discharge, which show varying degrees of long-term and seasonal variability. The results from the proposed approach are comparable with the results from (a) a stationary EVA on quasi-stationary slices of non-stationary series and (b) the established method for non-stationary EVA. However, the proposed technique comes with advantages in both cases. For example, in contrast to (a), the proposed technique uses the whole time horizon of the series for the estimation of the extremes, allowing for a more accurate estimation of large return levels. Furthermore, with respect to (b), it decouples the detection of non-stationary patterns from the fitting of the extreme value distribution. As a result, the steps of the analysis are simplified and intermediate diagnostics are possible. In particular, the transformation can be carried out by means of simple statistical techniques such as low-pass filters based on the running mean and the standard deviation, and the fitting procedure is a stationary one with a few degrees of freedom and is easy to implement and control. An open-source MAT-LAB toolbox has been developed to cover this methodology, which is available at https://github.com/menta78/tsEva/(Mentaschi et al., 2016).

The modulation of outdoor running speed : the influence of gradient

This thesis aimed to investigate the way in which distance runners modulate their speed in an effort to understand the key processes and determinants of speed selection when encountering hills in natural outdoor environments. One factor which has limited the expansion of knowledge in this area has been a reliance on the motorized treadmill which constrains runners to constant speeds and gradients and only linear paths. Conversely, limits in the portability or storage capacity of available technology have restricted field research to brief durations and level courses. Therefore another aim of this thesis was to evaluate the capacity of lightweight, portable technology to measure running speed in outdoor undulating terrain. The first study of this thesis assessed the validity of a non-differential GPS to measure speed, displacement and position during human locomotion. Three healthy participants walked and ran over straight and curved courses for 59 and 34 trials respectively. A non-differential GPS receiver provided speed data by Doppler Shift and change in GPS position over time, which were compared with actual speeds determined by chronometry. Displacement data from the GPS were compared with a surveyed 100m section, while static positions were collected for 1 hour and compared with the known geodetic point. GPS speed values on the straight course were found to be closely correlated with actual speeds (Doppler shift: r = 0.9994, p < 0.001, Δ GPS position/time: r = 0.9984, p < 0.001). Actual speed errors were lowest using the Doppler shift method (90.8% of values within ± 0.1 m.sec -1). Speed was slightly underestimated on a curved path, though still highly correlated with actual speed (Doppler shift: r = 0.9985, p < 0.001, Δ GPS distance/time: r = 0.9973, p < 0.001). Distance measured by GPS was 100.46 ± 0.49m, while 86.5% of static points were within 1.5m of the actual geodetic point (mean error: 1.08 ± 0.34m, range 0.69-2.10m). Non-differential GPS demonstrated a highly accurate estimation of speed across a wide range of human locomotion velocities using only the raw signal data with a minimal decrease in accuracy around bends. This high level of resolution was matched by accurate displacement and position data. Coupled with reduced size, cost and ease of use, the use of a non-differential receiver offers a valid alternative to differential GPS in the study of overground locomotion. The second study of this dissertation examined speed regulation during overground running on a hilly course. Following an initial laboratory session to calculate physiological thresholds (VO2 max and ventilatory thresholds), eight experienced long distance runners completed a self- paced time trial over three laps of an outdoor course involving uphill, downhill and level sections. A portable gas analyser, GPS receiver and activity monitor were used to collect physiological, speed and stride frequency data. Participants ran 23% slower on uphills and 13.8% faster on downhills compared with level sections. Speeds on level sections were significantly different for 78.4 ± 7.0 seconds following an uphill and 23.6 ± 2.2 seconds following a downhill. Speed changes were primarily regulated by stride length which was 20.5% shorter uphill and 16.2% longer downhill, while stride frequency was relatively stable. Oxygen consumption averaged 100.4% of runner’s individual ventilatory thresholds on uphills, 78.9% on downhills and 89.3% on level sections. Group level speed was highly predicted using a modified gradient factor (r2 = 0.89). Individuals adopted distinct pacing strategies, both across laps and as a function of gradient. Speed was best predicted using a weighted factor to account for prior and current gradients. Oxygen consumption (VO2) limited runner’s speeds only on uphill sections, and was maintained in line with individual ventilatory thresholds. Running speed showed larger individual variation on downhill sections, while speed on the level was systematically influenced by the preceding gradient. Runners who varied their pace more as a function of gradient showed a more consistent level of oxygen consumption. These results suggest that optimising time on the level sections after hills offers the greatest potential to minimise overall time when running over undulating terrain. The third study of this thesis investigated the effect of implementing an individualised pacing strategy on running performance over an undulating course. Six trained distance runners completed three trials involving four laps (9968m) of an outdoor course involving uphill, downhill and level sections. The initial trial was self-paced in the absence of any temporal feedback. For the second and third field trials, runners were paced for the first three laps (7476m) according to two different regimes (Intervention or Control) by matching desired goal times for subsections within each gradient. The fourth lap (2492m) was completed without pacing. Goals for the Intervention trial were based on findings from study two using a modified gradient factor and elapsed distance to predict the time for each section. To maintain the same overall time across all paced conditions, times were proportionately adjusted according to split times from the self-paced trial. The alternative pacing strategy (Control) used the original split times from this initial trial. Five of the six runners increased their range of uphill to downhill speeds on the Intervention trial by more than 30%, but this was unsuccessful in achieving a more consistent level of oxygen consumption with only one runner showing a change of more than 10%. Group level adherence to the Intervention strategy was lowest on downhill sections. Three runners successfully adhered to the Intervention pacing strategy which was gauged by a low Root Mean Square error across subsections and gradients. Of these three, the two who had the largest change in uphill-downhill speeds ran their fastest overall time. This suggests that for some runners the strategy of varying speeds systematically to account for gradients and transitions may benefit race performances on courses involving hills. In summary, a non – differential receiver was found to offer highly accurate measures of speed, distance and position across the range of human locomotion speeds. Self-selected speed was found to be best predicted using a weighted factor to account for prior and current gradients. Oxygen consumption limited runner’s speeds only on uphills, speed on the level was systematically influenced by preceding gradients, while there was a much larger individual variation on downhill sections. Individuals were found to adopt distinct but unrelated pacing strategies as a function of durations and gradients, while runners who varied pace more as a function of gradient showed a more consistent level of oxygen consumption. Finally, the implementation of an individualised pacing strategy to account for gradients and transitions greatly increased runners’ range of uphill-downhill speeds and was able to improve performance in some runners. The efficiency of various gradient-speed trade- offs and the factors limiting faster downhill speeds will however require further investigation to further improve the effectiveness of the suggested strategy.