Histological assessment of intermediate - and long-term creatine monohydrate supplementation in mice and rats

Creatine monohydrate (CrM) supplementation appears to be relatively safe based on data from short-term and intermediate-term human studies and results from several therapeutic trials. The purpose of the current study was to characterize pathological changes after intermediate-term and long-term CrM supplementation in mice [healthy control and SOD1 (G93A) transgenic] and rats (prednisolone and nonprednisolone treated). Histological assessment (18-20 organs/tissues) was performed on G93A mice after 159 days, and in Sprague-Dawley rats after 365 days, of CrM supplementation (2% wt/wt) compared with control feed. Liver histology was also evaluated in CD-1 mice after 300 days of low-dose CrM supplementation (0.025 and 0.05 g · kg^-1 · day^-1) and in Sprague-Dawley rats after 52 days of CrM supplementation (2% wt/wt) with and without prednisolone. Areas of hepatitis were observed in the livers of the CrM-supplemented G93A mice (P < 0.05), with no significant inflammatory lesions in any of the other 18-20 tissues/organs that were evaluated. The CD-1 mice also showed significant hepatic inflammatory lesions (P < 0.05), yet there was no negative effect of CrM on liver histology in the Sprague-Dawley rats after intermediate-term or long-term supplementation nor was inflammation seen in any other tissues/organs (P = not significant). Dietary CrM supplementation can induce inflammatory changes in the liver of mice, but not rats. The observed inflammatory changes in the murine liver must be considered in the evaluation of hepatic metabolism in CrM-supplemented mice. Species differences must be considered in the evaluation of toxicological and physiological studies.

Will residential aged care facilities meet long-term demand?

Purpose – This paper aims to provide an invaluable insight into long-term forecasting of demand for aged care facilities. This will ensure the provision of adequate supply by government bodies, stakeholders and developers in order to meet the anticipated level of demand, without creating an over-supply or an under-supply scenario.

Design/methodology/approach – Using an innovative approach, different data sources were collectively used to forecast separate individual supply and demand levels, which were then examined together in order to measure the difference between the two variables between 2009-2020. A case study approach was used for Victoria, Australia.

Findings – The paper finds that, although there is excess supply between 2009-2010 and 2019-2020, the period between 2010 and 2019 will experience an under-supply period which cannot be easily rectified over the short term.

Research limitations/implications – The case study was limited to residential care facilities in Victoria, Australia, although some countries have substantially different age profiles and accommodation supply for older residents. Forecasts are based on information sources from various data suppliers and collectively analysed.

Practical implications – The results are also of direct interest to place managers and planning authorities who are charged with providing medium- and long-term visions and plans for specific locations. This type of research is essential when planning for the eventual aging of the population, where the methodology can be replicated in different areas. Most importantly, this research approach provides a solid basis for decisions regarding the supply of residential aged care facilities as opposed to a simple estimate.

Originality/value – The study adopted a unique approach to analysing the individual supply and demand components for aged care facilities over the long term. This approach is able to accurately determine when there will be an under-supply or over-supply situation and thus provide the opportunity to address the difference before it occurs. This will allow informed decisions about planning aged care facilities in the future to be made as required.

Study protocol for the translating research in elder care (TREC): Building context through case studies in long-term care project (project two)

Background: The organizational context in which healthcare is delivered is thought to play an important role in mediating the use of knowledge in practice. Additionally, a number of potentially modifiable contextual factors have been shown to make an organizational context more amenable to change. However, understanding of how these factors operate to influence organizational context and knowledge use remains limited. In particular, research to understand knowledge translation in the long-term care setting is scarce. Further research is therefore required to provide robust explanations of the characteristics of organizational context in relation to knowledge use.
Aim: To develop a robust explanation of the way organizational context mediates the use of knowledge in practice in long-term care facilities.
Design: This is longitudinal, in-depth qualitative case study research using exploratory and interpretive methods to explore the role of organizational context in influencing knowledge translation. The study will be conducted in two phases. In phase one, comprehensive case studies will be conducted in three facilities. Following data analysis and proposition development, phase two will continue with focused case studies to elaborate emerging themes and theory. Study sites will be purposively selected. In both phases, data will be collected using a variety of approaches, including non-participant observation, key informant interviews, family perspectives, focus groups, and documentary evidence (including, but not limited to, policies, notices, and photographs of physical resources). Data analysis will comprise an iterative process of identifying convergent evidence within each case study and then examining and comparing the evidence across multiple case studies to draw conclusions from the study as a whole. Additionally, findings that emerge through this project will be compared and considered alongside those that are emerging from project one. In this way, pattern matching based on explanation building will be used to frame the analysis and develop an explanation of organizational context and knowledge use over time. An improved understanding of the contextual factors that mediate knowledge use will inform future development and testing of interventions to enhance knowledge use, with the ultimate aim of improving the outcomes for residents in long-term care settings.

Long-term effects of a playground markings and physical structures on children's recess physical activity levels

Objective : The aim of the study was to investigate the impact of a playground redesign intervention across time on children's recess physical activity levels using combined physical activity measures and to evaluate the potential influence of covariates on the intervention effect.

Method : Fifteen schools located in areas of high deprivation in one large city in England each received £20,000 through a national £10 million Sporting Playgrounds Initiative to redesign the playground environment based on a multicolored zonal design. Eleven schools served as matched socioeconomic controls. Physical activity levels during recess were quantified using heart rate telemetry and accelerometry at baseline, 6 weeks and 6 months following the playground redesign intervention. Data were collected between July 2003 and January 2005 and analyzed using multilevel modeling.

Results : Statistically significant intervention effects were found across time for moderate-to-vigorous and vigorous physical activity assessed using both heart rate and accelerometry.

Conclusions : The results suggest that a playground redesign, which utilizes multicolor playground markings and physical structures, is a suitable stimulus for increasing children's school recess physical activity levels.

Comparison of pQCT parameters between ulna and radius in retired elite gymnasts : the skeletal benefits associated with long-term gymnastics are bone- and site-specific

Objectives: To compare the skeletal benefits associated with gymnastics between ulna and radius.
Methods: 19 retired artistic gymnasts, aged 18-36 years, were compared to 24 sedentary women. Bone mineral content (BMC), total and cortical bone area (ToA, CoA), trabecular and cortical volumetric density (TrD, CoD) and cortical thickness (CoTh) were measured by pQCT at the 4% and 66% forearm.
Results: At the 4% site, BMC and ToA were more than twice greater at the radius than ulna whereas at the 66% site, BMC, ToA, CoA, CoTh and SSIpol were 20 to 51% greater at the ulna than radius in both groups (p<0.0001). At the 4% site, the skeletal benefits in BMC of the retired gymnasts over the non-gymnasts were 1.9 times greater at the radius than ulna (p<0.001), with enlarged bone size at the distal radius only. In contrast, the skeletal benefits at the 66% site were twice greater at the ulna than radius for BMC and CoA (p<0.01).
Conclusion: Whereas the skeletal benefits associated with long-term gymnastics were greater at the radius than ulna in the distal forearm, the reverse was found in the proximal forearm, suggesting both bones should be analysed when investigating forearm strength.

Skeletal benefits after long-term retirement in former elite female gymnasts

Bone strength benefits after long-term retirement from elite gymnastics in terms of bone geometry and volumetric BMD were studied by comparing retired female gymnasts to moderately active age-matched women. In a cross-sectional study, 30 retired female gymnasts were compared with 30 age-matched moderately active controls. Bone geometric and densitometric parameters were measured by pQCT at the distal epiphyses and shafts of the tibia, femur, radius, and humerus. Muscle cross-sectional areas were assessed from the shaft scans. Independent t-tests were conducted on bone and muscle variables to detect differences between the two groups. The gymnasts had retired for a mean of 6.1 ± 0.4 yr and were engaged in ≤2 h of exercise per week since retirement. At the radial and humeral shafts, cortical cross-sectional area (CSA), total CSA, BMC, and strength strain index (SSIpol) were significantly greater (13–38%, p ≤ 0.01) in the retired gymnasts; likewise, BMC and total CSA were significantly greater at the distal radius (22–25%, p ≤ 0.0001). In the lower limbs, total CSA and BMC at the femur and tibia shaft were greater by 8–11%, and trabecular BMD and BMC were only greater at the tibia (7–8%). Muscle CSA at the forearm and upper arm was greater by 15–17.6% (p ≤ 0.001) but was not different at the upper and lower leg. Past gymnastics training is associated with greater bone mass and bone size in women 6 yr after retirement. Skeletal benefits were site specific, with greater geometric adaptations (greater bone size) in the upper compared with the lower limbs.