Left atrial remodeling, early repolarization pattern, and inflammatory cytokines in professional soccer players

OBJECTIVES: Although regular physical exercise clearly reduces cardiovascular morbidity risk, long-term endurance sports practice has been recognized as a risk factor for atrial fibrillation (AF). However, the mechanisms how endurance sports can lead to AF are not yet clear. The aim of our present study was to investigate the influence of long-term endurance training on vagal tone, atrial size, and inflammatory profile in professional elite soccer players. METHODS: A total of 25 professional major league soccer players (mean age 24+/-4 years) and 20 sedentary controls (mean age 26+/-3 years) were included in the study and consecutively examined. All subjects underwent a sports cardiology check-up with physical examination, electrocardiography, echocardiography, exercise testing on a bicycle ergometer, and laboratory analysis [standard laboratory and cytokine profile: interleukin (IL)-6, tumor necrosis factor (TNF)-alpha, IL-8, IL-10]. RESULTS: Athletes were divided into two groups according to presence or absence of an early repolarization (ER) pattern, defined as a ST-segment elevation at the J-point (STE) >/=0.1mm in 2 leads. Athletes with an ER pattern showed significantly lower heart rate and an increased E/e' ratio compared to athletes without an ER pattern. STE significantly correlated with E/e' ratio as well as with left atrial (LA) volume. The pro-inflammatory cytokines IL-6, IL-8, TNF-alpha as well as the anti-inflammatory cytokine IL-10 were significantly elevated in all soccer players. However, athletes with an ER pattern had significantly higher IL-6 plasma levels than athletes without ER pattern. Furthermore, athletes with "high" level IL-6 had significantly larger LA volumes than players with "low" level IL-6. CONCLUSIONS: Athletes with an ER pattern had significantly higher E/e' ratios, reflecting higher atrial filling pressures, higher LA volume, and higher IL-6 plasma levels. All these factors may contribute to atrial remodeling over time and thus increase the risk of AF in long-term endurance sports.

Interviewing children and young people with learning disabilities: guidelines for researchers and multi-professional practice

We argue that it is important for researchers and service providers to not only recognize the rights of children and young people with learning disabilities to have a ‘voice’, but also to work actively towards eliciting views from all. A set of guidelines for critical self-evaluation by those engaged in systematically collecting the views of children and young people with learning disabilities is proposed. The guidelines are based on a series of questions concerning: research aims and ethics (encompassing access/gatekeepers; consent/assent; confidentiality/anonymity/secrecy, recognition, feedback and ownership; and social responsibility) sampling, design and communication

Injury incidence in a Spanish sub-elite professional football team: A prospective study during four consecutive seasons

The aim of this study was to investigate the injury incidence and injury characteristics of a Spanish sub-elite professional football team during four consecutive seasons. A team was followed prospectively from the season 2003-2004 to 2006-2007 and individual player exposure and time loss injuries were recorded during all club training sessions and matches. A total of 313 time-loss injuries were recorded. The mean injury incidence was 10.9 injuries/1000 hours (5.2 injuries/1000 training hours and 44.1 injuries/1000 match hours). The injury incidence during competitive matches was higher (p < 0.001) than in friendly matches (55.8 vs. 22.6 injuries/1000 hours). The incidence of major injuries (>28 days absence) was 0.4 injuries/1000 hours. The thigh was the most commonly (35%) injured region and caused 29% of all competitive match absence. Muscle injuries in the four main groups of the lower limbs (hamstrings, adductors, quadriceps and calf muscles) caused 43% of competitive match unavailability. The results of this study show that the risk to sustain a major injury in the course of the season was low for sub-elite footballers in comparison to elite players. Thigh strains were the first cause of absence in competition due to injury.

Nutritional intervention program in elite athletes: single case design research with one professional basketball player

The American College of Sports Medicine argues that sports performance is improved with optimal nutrition (ACSM position stand, MSSE 2009, Mar; 41(3):709-31). However, scientific evidence shows that professional athletes do not achieve nutritional recommendations (Farajian et al, IJSNEM 2004 Oct; 14(5):574-85; Shroeder et al EJSS 2004 Jun 4 (2):1; Nogueira & Da Costa, IJSNEM 2004; 14:684-697) Objectives: a) describe the nutritional practices of one professional basketball player b) carry out a long term nutritional intervention to adapt his diet to current recommendations.

Physiological demands of match-play in elite tennis: A case study

The physiological and perceptual demands together with match notation of a four-set tennis match were studied in two elite professional players during the preparation for the 2008 Davis Cup. The design of this case report is unique in that it is the first to describe the demands of prolonged match-play (197 min) over four sets in ecologically valid conditions. The variables measured before and after each set included blood lactate and glucose concentrations, body mass, and perception of effort. Stroke count for each rally and heart rate were recorded during each set while salivary cortisol concentration was determined before and after the match. The rally length decreased as the match progressed. The results showed significant physiological stress, with each player losing greater than 2.5% of body mass (as fluid) and having elevated salivary cortisol concentrations after the match. Heart rate and perception of effort were also increased following each set indicating increasing stress. However, blood lactate decreased following the fourth set while blood glucose was maintained. The results also suggest that elite players may adjust work rates or tactics to cope with the increased perception of effort. This report shows that four sets of tennis are associated with increasing stress and fatigue.

The Portuguese Administrative Elite, 1851-1910

The aim of this article is to examine the composition and patterns of recruitment of the ministries’directors-general, as well as to assess the interconnections between bureaucracy and politics, from the beginnings of Regeneração (1851) until the breakdown of Monarchy (1910). The post of director-general was considered one of “political trust”, that might be filled by individuals from outside the civil service, and the selection and de-selection of officeholders depended exclusively on the ministers’ will. Nonetheless, most directors-general were experienced bureaucrats, boasting a steady career as civil servants, and remained in office for long terms, regardless of ministerial discontinuities. In other words, High Administration became relatively immune to party-driven politics. Due to their professional background and lengthy tenure, directors-general were usually highly skilled specialists, combining technical expertise and practical knowledge of the wheels of state bureaucracy. Hence, they were often influential actors in policy-making, playing an active (and sometimes decisive) part behind the scenes, in both designing and implementing government policies. As regards their social profile, directors-general formed a cohesive and homogeneous elite group: being predominantly drawn from urban middle class milieus, highly educated, and appointed to office in their forties.

Se former à l'entretien motivationnel pour aider ses patients à changer: Les étudiants en médecine le confirment [Learning motivational interviewing to help patients change their health-related behaviors: medical students confirm it].

At the Lausanne University, 5th year medical students were trained in Motivational interviewing (MI). Eight hours of training improved their competence in the use of this approach. This experience supports the implementation of MI training in medical schools. Motivational interviewing allows the health professional to actively involve the patient in this behavior change process (drinking, smoking, diet, exercise, medication adherence, etc.), by encouraging reflection and reinforcing personal motivation and resources.

Multidisciplinary practice vs. inter-firm collaboration in professional services market

Yritysten välinen yhteistyö kasvaa asiantuntijamarkkinoilla. Suppean palvelutarjooman omaavat yritykset muodostavat laajempia palveluita yhdistämällä osaamisiaan kumppaneidensa kanssa. Näin muodostuvat yritysryhmittymät uhkaavat alaa hallitsevia monipuolisen palvelutarjooman omaavia kansainvälisiä moniosaajayrityksiä. Tämän diplomityön tavoitteena on selvittää minkälaisia hyötyjä moniosaajayritys voi saada näitä ryhmittymiä vastaan lisäämällä omaa yhteistyötään. Tavoitteeseen pääsemiseksi markkinoilla olevat yritysryhmittymät tunnistetaan ja selvitetään minkälaisia asioita asiakas pitää tärkeänä ostaessaan asiantuntijapalveluita. Toimialan trendit ja aikaisemmat tutkimukset yritysten välisestä yhteistyöstä sekä asiakkaan ostokäyttäytymisestä osoittavat, että yhteistyön avulla yrityksellä on mahdollisuus saavuttaa monia hyötyjä. Tietoa olemassa olevista yritysryhmittymistä ja asiakkaiden ostokäyttäytymisestä kerättiin haastattelemalla yhden kansainvälisen moniosaajayrityksen henkilöstöä sekä asiakkaita. Tuloksena löytyi yritysryhmittymiä, joista osa uhkaa moniosaajayrityksen kilpailuetua. Asiakkaiden ostokäyttäyminen suosi hieman enemmän asiantuntijapalveluiden hankkimista yritysryhmittymältä moniosaajayrityksen sijaan. Tekemällä yhteistyötä ja tarjoamalla tiettyjä palveluita yhdessä kumppanin kanssa, moniosaajayritys voi saavuttaa hyötyjä yritysryhmittymiä vastaan ja vaikuttaa positiivisesti asiakkaan ostokäyttäytymiseen.

Stability of relative oxygen pulse curve during repeated maximal cardiopulmonary testing in professional soccer players

During cardiopulmonary exercise testing (CPET), stroke volume can be indirectly assessed by O2 pulse profile. However, for a valid interpretation, the stability of this variable over time should be known. The objective was to analyze the stability of the O2 pulse curve relative to body mass in elite athletes. VO2, heart rate (HR), and relative O2 pulse were compared at every 10% of the running time in two maximal CPETs, from 2005 to 2010, of 49 soccer players. Maximal values of VO2 (63.4 ± 0.9 vs 63.5 ± 0.9 mL O2•kg-1•min-1), HR (190 ± 1 vs188 ± 1 bpm) and relative O2 pulse (32.9 ± 0.6 vs 32.6 ± 0.6 mL O2•beat-1•kg-1) were similar for the two CPETs (P > 0.05), while the final treadmill velocity increased from 18.5 ± 0.9 to 18.9 ± 1.0 km/h (P < 0.01). Relative O2 pulse increased linearly and similarly in both evaluations (r² = 0.64 and 0.63) up to 90% of the running time. Between 90 and 100% of the running time, the values were less stable, with up to 50% of the players showing a tendency to a plateau in the relative O2 pulse. In young healthy men in good to excellent aerobic condition, the morphology of the relative O2 pulse curve is consistent up to close to the peak effort for a CPET repeated within a 1-year period. No increase in relative O2pulse at peak effort could represent a physiologic stroke volume limitation in these athletes.

Relação entre índices fisiológicos aeróbios e desempenho em provas de curta e média duração em ciclistas de elite

Poucos são os estudos que possibilitam verificar quais as respostas fisiológicas são associadas ao desempenho em uma amostra de ciclistas de elite nacional. Portanto, o objetivo do presente estudo foi determinar e relacionar diferentes índices fisiológicos aeróbios com o desempenho em testes contra relógio de 4 e 20km em ciclistas de alto nível. A amostra foi composta por 14 ciclistas profissionais de elite nacional do sexo masculino (28,5 ± 4,7 anos, 73,47 ± 8,29 kg, 176 ± 6,76 cm), que realizaram um teste progressivo em laboratório para a determinação do consumo máximo de oxigênio (VO2max: 62,23 ± 8,28 ml·kg·min-1), intensidade relativa ao VO2max (iVO2max: 500,83 ± 58,65 w), economia de movimento (EM: 0,1166 ± 0,0362 ml·kg·min·w-1) e 1º e 2º limiares ventilatórios (LV1: 348,21 ± 43,26 w; LV2: 417,86 ± 60,79 w, respectivamente). Também foram submetidos a duas provas de 4 e 20km contra relógio. Para correlação entre os índices fisiológicos e desempenho, foi utilizado o coeficiente de correlação de Pearson (p< 0,05). Não foi encontrada correlação entre os índices fisiológicos (VO2max absoluto e relativo, iVO2max, EM, LV1 e LV2) e o desempenho de 4km (r= 0.38; 0.16; -0.33; 0.20; -0.50; -0.20, respectivamente) e 20km (r= 0.24; 0.01; -0.13; -0.12; -0.48; -0.19, respectivamente) contra relógio em atletas de alto nível. Estes resultados sugerem que tais variáveis não apresentam capacidade de explicar o desempenho em provas de contra relógio nas respectivas distâncias, provavelmente, devido à homogeneidade entre os sujeitos.

A formação profissional e a aplicação dos modelos de periodização do treinamento desportivo, por treinadores de judô de atletas de elite

Pós-graduação em Ciências da Motricidade - IBRC

Beta-alanine supplementation improves jumping power and affects severe-intensity performance in professional alpine skiers.

INTRODUCTION Supplementation with beta-alanine may have positive effects on severe-intensity, intermittent, and isometric strength-endurance performance. These could be advantageous for competitive alpine skiers, whose races last 45 to 150 s, require metabolic power above the aerobic maximum, and involve isometric muscle work. Further, beta-alanine supplementation affects the muscle force-frequency relationship, which could influence explosiveness. We explored the effects of beta-alanine on explosive jump performance, severe exercise energy metabolism, and severe-intensity ski-like performance. METHODS Nine male elite alpine skiers consumed 4.8 g/d beta-alanine or placebo for 5 weeks in a double-blind fashion. Before and after, they performed countermovement jumps (CMJ), a 90-s cycling bout at 110% VO2max (CLT), and a maximal 90-s box jump test (BJ90). RESULTS Beta-alanine improved maximal (+7 ± 3%, d = 0.9) and mean CMJ power (+7 ± 2%, d = 0.7), tended to reduce oxygen deficit (-3 ± 8%, p = .06) and lactate accumulation (-12 ± 31%) and enhance aerobic energy contribution (+1.3 ± 2.9%, p = .07) in the CLT, and improved performance in the last third of BJ90 (+7 ± 4%, p = .02). These effects were not observed with placebo. CONCLUSIONS Beta-alanine supplementation improved explosive and repeated jump performance in elite alpine skiers. Enhanced muscle contractility could possibly explain improved explosive and repeated jump performance. Increased aerobic energy production could possibly help explain repeated jump performance as well.

Análisis de sistemas dinámicos y complejos en la Liga Profesional de Balonmano de España = Complex and dynamical systems analysis in Spanish Professional Handball League

El propósito de esta tesis fue estudiar el rendimiento ofensivo de los equipos de balonmano de élite cuando se considera el balonmano como un sistema dinámico complejo no lineal. La perspectiva de análisis dinámica dependiente del tiempo fue adoptada para evaluar el rendimiento de los equipos durante el partido. La muestra general comprendió los 240 partidos jugados en la temporada 2011-2012 de la liga profesional masculina de balonmano de España (Liga ASOBAL). En el análisis posterior solo se consideraron los partidos ajustados (diferencia final de goles ≤ 5; n = 142). El estado del marcador, la localización del partido, el nivel de los oponentes y el periodo de juego fueron incorporados al análisis como variables situacionales. Tres estudios compusieron el núcleo de la tesis. En el primer estudio, analizamos la coordinación entre las series temporales que representan el proceso goleador a lo largo del partido de cada uno de los dos equipos que se enfrentan. Autocorrelaciones, correlaciones cruzadas, doble media móvil y transformada de Hilbert fueron usadas para el análisis. El proceso goleador de los equipos presentó una alta consistencia a lo largo de todos los partidos, así como fuertes modos de coordinación en fase en todos los contextos de juego. Las únicas diferencias se encontraron en relación al periodo de juego. La coordinación en los procesos goleadores de los equipos fue significativamente menor en el 1er y 2º periodo (0–10 min y 10–20 min), mostrando una clara coordinación creciente a medida que el partido avanzaba. Esto sugiere que son los 20 primeros minutos aquellos que rompen los partidos. En el segundo estudio, analizamos los efectos temporales (efecto inmediato, a corto y a medio plazo) de los tiempos muertos en el rendimiento goleador de los equipos. Modelos de regresión lineal múltiple fueron empleados para el análisis. Los resultados mostraron incrementos de 0.59, 1.40 y 1.85 goles para los periodos que comprenden la primera, tercera y quinta posesión de los equipos que pidieron el tiempo muerto. Inversamente, se encontraron efectos significativamente negativos para los equipos rivales, con decrementos de 0.50, 1.43 y 2.05 goles en los mismos periodos respectivamente. La influencia de las variables situacionales solo se registró en ciertos periodos de juego. Finalmente, en el tercer estudio, analizamos los efectos temporales de las exclusiones de los jugadores sobre el rendimiento goleador de los equipos, tanto para los equipos que sufren la exclusión (inferioridad numérica) como para los rivales (superioridad numérica). Se emplearon modelos de regresión lineal múltiple para el análisis. Los resultados mostraron efectos negativos significativos en el número de goles marcados por los equipos con un jugador menos, con decrementos de 0.25, 0.40, 0.61, 0.62 y 0.57 goles para los periodos que comprenden el primer, segundo, tercer, cuarto y quinto minutos previos y posteriores a la exclusión. Para los rivales, los resultados mostraron efectos positivos significativos, con incrementos de la misma magnitud en los mismos periodos. Esta tendencia no se vio afectada por el estado del marcador, localización del partido, nivel de los oponentes o periodo de juego. Los incrementos goleadores fueron menores de lo que se podría esperar de una superioridad numérica de 2 minutos. Diferentes teorías psicológicas como la paralización ante situaciones de presión donde se espera un gran rendimiento pueden ayudar a explicar este hecho. Los últimos capítulos de la tesis enumeran las conclusiones principales y presentan diferentes aplicaciones prácticas que surgen de los tres estudios. Por último, se presentan las limitaciones y futuras líneas de investigación. ABSTRACT The purpose of this thesis was to investigate the offensive performance of elite handball teams when considering handball as a complex non-linear dynamical system. The time-dependent dynamic approach was adopted to assess teams’ performance during the game. The overall sample comprised the 240 games played in the season 2011-2012 of men’s Spanish Professional Handball League (ASOBAL League). In the subsequent analyses, only close games (final goal-difference ≤ 5; n = 142) were considered. Match status, game location, quality of opposition, and game period situational variables were incorporated into the analysis. Three studies composed the core of the thesis. In the first study, we analyzed the game-scoring coordination between the time series representing the scoring processes of the two opposing teams throughout the game. Autocorrelation, cross-correlation, double moving average, and Hilbert transform were used for analysis. The scoring processes of the teams presented a high consistency across all the games as well as strong in-phase modes of coordination in all the game contexts. The only differences were found when controlling for the game period. The coordination in the scoring processes of the teams was significantly lower for the 1st and 2nd period (0–10 min and 10–20 min), showing a clear increasing coordination behavior as the game progressed. This suggests that the first 20 minutes are those that break the game-scoring. In the second study, we analyzed the temporal effects (immediate effect, short-term effect, and medium-term effect) of team timeouts on teams’ scoring performance. Multiple linear regression models were used for the analysis. The results showed increments of 0.59, 1.40 and 1.85 goals for the periods within the first, third and fifth timeout ball possessions for the teams that requested the timeout. Conversely, significant negative effects on goals scored were found for the opponent teams, with decrements of 0.59, 1.43 and 2.04 goals for the same periods, respectively. The influence of situational variables on the scoring performance was only registered in certain game periods. Finally, in the third study, we analyzed the players’ exclusions temporal effects on teams’ scoring performance, for the teams that suffer the exclusion (numerical inferiority) and for the opponents (numerical superiority). Multiple linear regression models were used for the analysis. The results showed significant negative effects on the number of goals scored for the teams with one less player, with decrements of 0.25, 0.40, 0.61, 0.62, and 0.57 goals for the periods within the previous and post one, two, three, four and five minutes of play. For the opponent teams, the results showed positive effects, with increments of the same magnitude in the same game periods. This trend was not affected by match status, game location, quality of opposition, or game period. The scoring increments were smaller than might be expected from a 2-minute numerical playing superiority. Psychological theories such as choking under pressure situations where good performance is expected could contribute to explain this finding. The final chapters of the thesis enumerate the main conclusions and underline the main practical applications that arise from the three studies. Lastly, limitations and future research directions are described.

Women sport injuries: a retrospective study of elite windsurfers

This study was designed to identify the injuries of professional women windsurfers, from their anatomical location, type of sport, context when they occurred, type of injury, the time of inactivity as a result of the same, the type of health care received and the relationship between the number of injuries and the position in the final classification of professional windsurfing competitions. We gave a retrospective questionnaire to 18 women elite windsurfers, who took part in the World Cup competition held in Fuerteventura (2008). Women are injured more frequently during training than competition (77.8%; p<0.05 vs. 20.5%). Women suffer leg injuries more than men (83.3%; p<0.05 vs. 14.3%) in freestyle. Serious injuries were more frequent for women (66.7%; p<0.05 vs. 28.2%) and the time of inactivity due to the injury was shorter for women (50%; p<0.05 vs. 20.5%). These results indicate that female windsurfers are more liable to suffer injuries, generally serious, during training sessions. Freestyle involves a greater risk of leg injuries for women. The knee is the area where most injuries occur, both for men and women, followed by the legs.