Online Health Information-Seeking Behaviour among People of African Descent in the United Kingdom: A Qualitative Study

Effective public health interventions rely on understanding how individuals access, interpret, and utilise health information. Studying the health information-seeking behaviour (HISB) of a community can provide valuable insights to inform strategies that address community health needs and challenges. This study explored the online HISBs of People of African Descent (PoAD) in the United Kingdom (UK), a demographic that comprises four percent of the UK population and has a 92.8% active Internet usage rate. Data on the HISB were collected from 21 PoAD across various UK regions through online semi-structured interviews before being analysed using reflexive Thematic Analysis (TA). The participants ranged in age from 20 to 70 years and had a mean age of 42.8 (SD ± 11.4). Our analysis of the interview transcripts revealed five key themes: Internet usage and preferences, attitudes toward social media, barriers to seeking health information online, trust in online health information, and cultural influences on online HISB. Our findings indicate a proactive engagement among PoAD in seeking health information online that is underscored by a preference for professional sources over ethnic congruence. However, concerns about misinformation exist, and there are barriers to accessing health information online, including data privacy, unreliable information, and information relevance and overload. We also found that cultural factors and traditional beliefs impact the adoption of Internet-based interventions among PoAD, highlighting the need for culturally sensitive approaches. Preferences regarding the frequency and delivery of online health information varied among participants, with a majority preferring a weekly update. This study emphasises the critical need for accessible, culturally appropriate, secure, and reliable online health resources tailored to the needs and preferences of the PoAD.

Deloading Practices in Strength and Physique Sports: A Cross-sectional Survey

BACKGROUND

This study explored the deloading practices of competitive strength and physique athletes. A 55-item anonymised web-based survey was distributed to a convenience-based, cross-sectional sample of competitive strength and physique athletes (n = 246; males = 181 [73.6%], females = 65 [26.4%]; age = 29.5 ± 8.6 years) who had 8.2 ± 6.2 years of resistance training and 3.8 ± 3.1 years of competition experience.

RESULTS

All athletes deloaded within training with energy and fatigue management being the main reasons to do so. The typical duration of a deload was 6.4 ± 1.7 days, integrated into the training programme every 5.6 ± 2.3 weeks. Deloading was undertaken using a proactive, pre-planned strategy (or in combination with an autoregulated approach) and undertaken when performance stalled or during periods of increased muscle soreness or joint aches. Athletes reported that training volume would decrease (through a reduction in both repetitions per set and sets per week), but training frequency would remain unchanged during deloads. Additionally, athletes reported that training intensity (load lifted) would decrease, and effort would be reduced (facilitated through an increase in repetitions in reserve). Athletes would generally maintain the same exercise selection during deloading. For athletes that supplemented deloading with additional recovery modalities (n = 118; 48%), the most reported strategies were massage, static stretching and foam rolling.

CONCLUSION

Results from this research might assist strength and physique athletes and coaches to plan their deloading. Future research should empirically investigate the findings from this study to further evaluate the potential utility of deloading in strength and physique sports.

Kinetics and Kinematics of the Free-Weight Back Squat and Loaded Jump Squat

ABSTRACT

Thompson, SW, Lake, JP, Rogerson, D, Ruddock, A, and Barnes, A. Kinetics and kinematics of the free-weight back squat and loaded jump squat. J Strength Cond Res 37(1): 1-8, 2023-The aim of this study was to compare kinetics and kinematics of 2 lower-body free-weight exercises, calculated from concentric and propulsion subphases, across multiple loads. Sixteen strength-trained men performed back squat 1 repetition maximum (1RM) tests (visit 1), followed by 2 incremental back squat and jump squat protocols (visit 2) (loads = 0% and 30-60%, back squat 1RM). Concentric phase and propulsion phase force-time-displacement characteristics were derived from force plate data and compared using analysis of variance and Hedges' g effect sizes. Intrasession reliability was calculated using intraclass correlation coefficient (ICC) and coefficient of variation (CV). All dependent variables met acceptable reliability (ICC >0.7; CV < 10%). Statistically significant 3-way interactions (load × phase × exercise) and 2-way main effects (phase × exercise) were observed for mean force, velocity (30-60% 1RM), power, work, displacement, and duration (0%, 30-50% 1RM) ( p < 0.05). A significant 2-way interaction (load × exercise) was observed for impulse ( p < 0.001). Jump squat velocity ( g = 0.94-3.80), impulse ( g = 1.98-3.21), power ( g = 0.84-2.93), and work ( g = 1.09-3.56) were significantly larger across concentric and propulsion phases, as well as mean propulsion force ( g = 0.30-1.06) performed over all loads ( p < 0.001). No statistically significant differences were observed for mean concentric force. Statistically longer durations ( g = 0.38-1.54) and larger displacements ( g = 2.03-4.40) were evident for all loads and both subphases ( p < 0.05). Ballistic, lower-body exercise produces greater kinetic and kinematic outputs than nonballistic equivalents, irrespective of phase determination. Practitioners should therefore use ballistic methods when prescribing or testing lower-body exercises to maximize athlete's force-time-displacement characteristics.

“I Want to Create So Much Stimulus That Adaptation Goes Through the Roof”: High-Performance Strength Coaches' Perceptions of Planned Overreaching

Functional overreaching (FOR) occurs when athletes experience improved athletic capabilities in the days and weeks following short-term periods of increased training demand. However, prolonged high training demand with insufficient recovery may also lead to non-functional overreaching (NFOR) or the overtraining syndrome (OTS). The aim of this research was to explore strength coaches' perceptions and experiences of planned overreaching (POR); short-term periods of increased training demand designed to improve athletic performance. Fourteen high-performance strength coaches (weightlifting; n = 5, powerlifting; n = 4, sprinting; n = 2, throws; n = 2, jumps; n = 1) participated in semistructured interviews. Reflexive thematic analysis identified 3 themes: creating enough challenge, training prescription, and questioning the risk to reward. POR was implemented for a 7 to 14 day training cycle and facilitated through increased daily/weekly training volume and/or training intensity. Participants implemented POR in the weeks (~5–8 weeks) preceding competition to allow sufficient time for performance restoration and improvement to occur. Short-term decreased performance capacity, both during and in the days to weeks following training, was an anticipated by-product of POR, and at times used as a benchmark to confirm that training demand was sufficiently challenging. Some participants chose not to implement POR due to a lack of knowledge, confidence, and/or perceived increased risk of athlete training maladaptation. Additionally, this research highlights the potential dichotomy between POR protocols used by strength coaches to enhance athletic performance and those used for the purpose of inducing training maladaptation for diagnostic identification.

No effect of nitrate-rich beetroot juice on microvascular function and blood pressure in younger and older individuals: a randomised, placebo-controlled double-blind pilot study

Background/Objectives

To compare the effects of supplemental inorganic nitrate (NO₃) on microvascular endothelial function and blood pressure in younger vs. older participants.

Subjects/Methods

25 individuals participated in a double-blind, randomised, placebo-controlled crossover pilot study. Participants were stratified by age (18–35 and ≥55 years) and consumed a single dose beetroot juice (providing 6.4 mmol NO₃) or NO₃-depleted beetroot juice. Blood pressure, microvascular function (via Laser Doppler Flowmetry; LDF) and urinary NO₃ were assessed, and the effects of NO₃ supplementation on cardiovascular parameters were compared between participants and conditions using mixed-design ANOVA.

Results

Treatments and methods were well tolerated, and no adverse events were reported. Urinary NO₃ increased 3 h following ingestion in both groups, (P = 0.02). Levels remained elevated at 24 h post consumption in younger participants only (P = 0.02). Beetroot juice had no effect on blood pressure in either group nor on microcirculatory endothelial function.

Conclusions

Beetroot juice had no effect on blood pressure or microvascular endothelial function in young and older individuals. Dosage and timing regimens for supplemental beetroot juice should be avenues for further inquiry.

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background

Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies.

Methods

In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality.

Findings

Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference –1·69 [–9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5–8] vs 6 [5–8] cm H₂O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52–23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75–0·86]; p<0·0001).

Interpretation

Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status.

Funding

No funding.

Investigating the sleep habits in individual and team-sport athletes using the Athlete Sleep Behavior Questionnaire and the Pittsburgh Sleep Quality Index

Objectives

There is limited large-scale data on maladaptive sleep practices in elite adult athletes and their influence on sleep characteristics. This study aimed to identify differences in sleep behaviours between individual and team-sport athletes using two sleep questionnaires.

Material and Methods

407 (237 male, 170 female) elite adult athletes across sixteen sports (9 individual-sports, 7 team-sports) completed the Athlete Sleep Behavior Questionnaire (ASBQ) and the Pittsburgh Sleep Quality Index (PSQI).

Results

Individual-sport athletes reported greater total sleep time and higher sleep efficiency than team-sport athletes (p<0.05, d=0.28-0.29). There were no differences between global scores for the PSQI, however, there was a difference between global scores for the ASBQ as well as multiple individual items from both questionnaires (p<0.05), indicating poorer behaviours in team-sport athletes.

Discussion

Team-sport athletes displayed more maladaptive pre-sleep behaviours and poorer sleep characteristics than individual-sport athletes.

A Novel Approach to 1RM Prediction Using the Load-Velocity Profile: A Comparison of Models

The study aim was to compare different predictive models in one repetition maximum (1RM) estimation from load-velocity profile (LVP) data. Fourteen strength-trained men underwent initial 1RMs in the free-weight back squat, followed by two LVPs, over three sessions. Profiles were constructed via a combined method (jump squat (0 load, 30-60% 1RM) + back squat (70-100% 1RM)) or back squat only (0 load, 30-100% 1RM) in 10% increments. Quadratic and linear regression modeling was applied to the data to estimate 80% 1RM (kg) using 80% 1RM mean velocity identified in LVP one as the reference point, with load (kg), then extrapolated to predict 1RM. The 1RM prediction was based on LVP two data and analyzed via analysis of variance, effect size (g/ηp2), Pearson correlation coefficients (r), paired t-tests, standard error of the estimate (SEE), and limits of agreement (LOA). p < 0.05. All models reported systematic bias < 10 kg, r > 0.97, and SEE < 5 kg, however, all linear models were significantly different from measured 1RM (p = 0.015 <0.001). Significant differences were observed between quadratic and linear models for combined (p < 0.001; ηp2 = 0.90) and back squat (p = 0.004, ηp2 = 0.35) methods. Significant differences were observed between exercises when applying linear modeling (p < 0.001, ηp2 = 0.67-0.80), but not quadratic (p = 0.632-0.929, ηp2 = 0.001-0.18). Quadratic modeling employing the combined method rendered the greatest predictive validity. Practitioners should therefore utilize this method when looking to predict daily 1RMs as a means of load autoregulation.

The Effectiveness of Two Methods of Prescribing Load on Maximal Strength Development: A Systematic Review

Background

Optimal prescription of resistance exercise load (kg) is essential for the development of maximal strength. Two methods are commonly used in practice with no clear consensus on the most effective approach for the improvement of maximal strength.

Objective

The primary aim of this review was to compare the effectiveness of percentage 1RM (% 1RM) and repetition maximum targets (RM) as load prescription methods for the development of maximal strength.

Methods

Electronic database searches of MEDLINE, SPORTDiscus, Scopus, and CINAHL Complete were conducted in accordance with PRISMA guidelines. Studies were eligible for inclusion if a direct measure of maximal strength was used, a non-training control group was a comparator, the training intervention was > 4 weeks in duration and was replicable, and participants were defined as healthy and between the ages of 18–40. Methodological quality of the studies was evaluated using a modified Downs and Black checklist. Percentage change (%) and 95% confidence intervals (CI) for all strength-based training groups were calculated. Statistical significance (p < 0.05) was reported from each study.

Results

Twenty-two studies comprising a total of 761 participants (585 males and 176 females) were found to meet the inclusion criteria. 12 studies were returned for % 1RM, with 10 for RM. All studies showed statistically significant improvements in maximal strength in the training groups (31.3 ± 21.9%; 95% CI 33.1–29.5%). The mean quality rating for all studies was 17.7 ± 2.3. Four studies achieved a good methodological rating, with the remainder classified as moderate.

Conclusions

Both % 1RM and RM are effective tools for improving maximal strength. % 1RM appears to be a better prescriptive method than RM potentially due to a more sophisticated management of residual fatigue. However, large heterogeneity was present within this data. Lower body and multi-joint exercises appear to be more appropriate for developing maximal strength. Greater consensus is required in defining optimal training prescriptions, physiological adaptations, and training status.

Electronic supplementary material

The online version of this article (10.1007/s40279-019-01241-3) contains supplementary material, which is available to authorized users.

Overreaching and overtraining in strength sports and resistance training: A scoping review

To date, little is known about overreaching (OR) and the overtraining syndrome (OTS) in strength sports and resistance training (RT) populations. However, the available literature may elucidate the occurrence of both conditions in these populations. A scoping review was conducted. SPORTDiscus, Scopus and Web of Science were searched in a robust and systematic manner, with relevant articles analysed. 1170 records were retrieved during an initial search, with a total of 47 included in the review. Two broad themes were identified during data extraction: 1) overreaching in strength sports; 2) overreaching and overtraining syndrome in RT. Short-term periods of OR achieved with either high-volume or high-intensity RT can elicit functional OR (FOR) but there is also evidence that chronic high-volume and/or intensity RT can lead to non-functional overreaching (NFOR). There is minimal evidence to suggest that true OTS has occurred in strength sports or RT based on the studies entered during this review. More research is needed to develop robust guiding principles for practitioners. Additionally, due to the heterogeneous nature of the existing literature, future research would benefit from the development of practical tools to identify and diagnose the transition from FOR to NFOR, and subsequently OTS in strength athletes and RT populations.

ABBREVIATIONS

RT: Resistance training; OR: Overreaching; FOR: Functional overreaching; NFOR: Non-functional overreaching; OTS: Overtraining syndrome; WP: Weightlifting performance.

Correction to: The Effectiveness of Two Methods of Prescribing Load on Maximal Strength Development: A Systematic Review

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Contrasting Effects of Short-Term Mediterranean and Vegan Diets on Microvascular Function and Cholesterol in Younger Adults: A Comparative Pilot Study

The Mediterranean diet has been shown to improve cardiovascular health. Vegan diets have demonstrated similar benefits, albeit in fewer studies. In a comparative pilot study, we compared the effects of a short-term Mediterranean Diet (MD) and Vegan Diet (VD) on microvascular function and cholesterol levels in a healthy population. Twenty-four young (aged 18 to 35 years) healthy volunteers followed a four-week intervention (MD = 12; VD = 12) ad libitum. Pre and post-intervention anthropometrics, microvascular function (assessed via LDF and expressed as raw CVC and %CVC MAX), dietary-analysis data (Calories, Protein, Carbohydrates, Total Fat, Saturated Fat, Fibre), Mean Arterial Pressure (MAP), Blood Pressure, Total Cholesterol (TC), High Density Lipoprotein (HDL-C) and TC:HDL-C were compared. MD participants reduced Total Fat intake (p = 0.05). Saturated Fat decreased (MD: p = < 0.001; VD: p = 0.004) and Fibre increased (MD: p = 0.02; VD: p = < 0.001) in both groups. Dietary changes reflected improvements in plateau raw CVC in the MD group (p = 0.005), and a reduction in TC (p = 0.045) and weight loss (p = 0.047) in the VD group. The MD led to improvements in microvascular function; the VD led to reduced TC and weight loss. Although both diets might offer CVD risk-reduction benefits, evidence for the MD appeared to be stronger due to changes in vasodilatory ability and NO bioavailability.

Antioxidants for preventing and reducing muscle soreness after exercise: a Cochrane systematic review

OBJECTIVE

To determine whether antioxidant supplements and antioxidant-enriched foods can prevent or reduce delayed-onset muscle soreness after exercise.

METHODS

We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, SPORTDiscus, trial registers, reference lists of articles and conference proceedings up to February 2017.

RESULTS

In total, 50 studies were included in this review which included a total of 1089 participants (961 were male and 128 were female) with an age range of 16-55 years. All studies used an antioxidant dosage higher than the recommended daily amount. The majority of trials (47) had design features that carried a high risk of bias due to selective reporting and poorly described allocation concealment, potentially limiting the reliability of their findings. We rescaled to a 0-10 cm scale in order to quantify the actual difference between groups and we found that the 95% CIs for all five follow-up times were all well below the minimal important difference of 1.4 cm: up to 6 hours (MD -0.52, 95% CI -0.95 to -0.08); at 24 hours (MD -0.17, 95% CI -0.42 to 0.07); at 48 hours (mean difference (MD) -0.41, 95% CI -0.69 to -0.12); at 72 hours (MD -0.29, 95% CI -0.59 to 0.02); and at 96 hours (MD -0.03, 95% CI -0.43 to 0.37). Thus, the effect sizes suggesting less muscle soreness with antioxidant supplementation were very unlikely to equate to meaningful or important differences in practice.

CONCLUSIONS

There is moderate to low-quality evidence that high-dose antioxidant supplementation does not result in a clinically relevant reduction of muscle soreness after exercise of up to 6 hours or at 24, 48, 72 and 96 hours after exercise. There is no evidence available on subjective recovery and only limited evidence on the adverse effects of taking antioxidant supplements.

Physical activity for people with young-onset dementia and carers: protocol for a scoping review

BACKGROUND

Physical activity has been cited as a potential symptomatic treatment option for people living with dementia. At present, much of the research concerning physical activity and dementia considers older adults, and there are several review articles summarising the evidence in this area. Less is known about physical activity for younger people with dementia, despite the marked differences in needs and preferences between the two groups. The aim of this scoping review is to systematically explore and critically appraise the current state of the evidence regarding physical activity for people with young-onset dementia and carers.

METHODS

Several electronic databases (i.e. MEDLINE, SPORTDiscus, CINAHL, Cochrane Library, PsycINFO, Applied Social Sciences Index & Abstracts (ASSIA) and Scopus), grey literature (i.e. NICE Evidence Search (UK) and targeted international organisations e.g. Alzheimer's Society (UK), Age UK, Young Dementia UK, Alzheimer's Association (USA), Dementia Australia) and trial registries (i.e. UK Clinical Trials Gateway, International Clinical Trials Registry Platform and EU Clinical Trials Register) will be searched for published and unpublished evidence regarding physical activity for people with young-onset dementia and carers. Studies included in the review will be subjected to a narrative synthesis to explore similarities and differences, both within and between studies, to identify patterns and themes and to postulate explanations for research findings (e.g. how and why certain interventions or programmes have worked (or not); factors that might have influenced the findings ).

DISCUSSION

This will be the first review to systematically explore and critically appraise the current state of the evidence regarding physical activity for people with young-onset dementia and carers. It is hoped that findings from this review will be used to inform the development of future physical activity interventions, to serve as a basis for consultation with key stakeholders and to identify appropriate outcome measures relevant to people with young-onset dementia and carers.

SYSTEMATIC REVIEW REGISTRATION

At present, scoping reviews are not eligible for registration on the international prospective register of systematic reviews (i.e. PROSPERO).

Antioxidants for preventing and reducing muscle soreness after exercise

BACKGROUND

Muscle soreness typically occurs after intense exercise, unaccustomed exercise or actions that involve eccentric contractions where the muscle lengthens while under tension. It peaks between 24 and 72 hours after the initial bout of exercise. Many people take antioxidant supplements or antioxidant-enriched foods before and after exercise in the belief that these will prevent or reduce muscle soreness after exercise.

OBJECTIVES

To assess the effects (benefits and harms) of antioxidant supplements and antioxidant-enriched foods for preventing and reducing the severity and duration of delayed onset muscle soreness following exercise.

SEARCH METHODS

We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, SPORTDiscus, trial registers, reference lists of articles and conference proceedings up to February 2017.

SELECTION CRITERIA

We included randomised and quasi-randomised controlled trials investigating the effects of all forms of antioxidant supplementation including specific antioxidant supplements (e.g. tablets, powders, concentrates) and antioxidant-enriched foods or diets on preventing or reducing delayed onset muscle soreness (DOMS). We excluded studies where antioxidant supplementation was combined with another supplement.

DATA COLLECTION AND ANALYSIS

Two review authors independently screened search results, assessed risk of bias and extracted data from included trials using a pre-piloted form. Where appropriate, we pooled results of comparable trials, generally using the random-effects model. The outcomes selected for presentation in the 'Summary of findings' table were muscle soreness, collected at times up to 6 hours, 24, 48, 72 and 96 hours post-exercise, subjective recovery and adverse effects. We assessed the quality of the evidence using GRADE.

MAIN RESULTS

Fifty randomised, placebo-controlled trials were included, 12 of which used a cross-over design. Of the 1089 participants, 961 (88.2%) were male and 128 (11.8%) were female. The age range for participants was between 16 and 55 years and training status varied from sedentary to moderately trained. The trials were heterogeneous, including the timing (pre-exercise or post-exercise), frequency, dose, duration and type of antioxidant supplementation, and the type of preceding exercise. All studies used an antioxidant dosage higher than the recommended daily amount. The majority of trials (47) had design features that carried a high risk of bias due to selective reporting and poorly described allocation concealment, potentially limiting the reliability of their findings.We tested only one comparison: antioxidant supplements versus control (placebo). No studies compared high-dose versus low-dose, where the low-dose supplementation was within normal or recommended levels for the antioxidant involved.Pooled results for muscle soreness indicated a small difference in favour of antioxidant supplementation after DOMS-inducing exercise at all main follow-ups: up to 6 hours (standardised mean difference (SMD) -0.30, 95% confidence interval (CI) -0.56 to -0.04; 525 participants, 21 studies; low-quality evidence); at 24 hours (SMD -0.13, 95% CI -0.27 to 0.00; 936 participants, 41 studies; moderate-quality evidence); at 48 hours (SMD -0.24, 95% CI -0.42 to -0.07; 1047 participants, 45 studies; low-quality evidence); at 72 hours (SMD -0.19, 95% CI -0.38 to -0.00; 657 participants, 28 studies; moderate-quality evidence), and little difference at 96 hours (SMD -0.05, 95% CI -0.29 to 0.19; 436 participants, 17 studies; low-quality evidence). When we rescaled to a 0 to 10 cm scale in order to quantify the actual difference between groups, we found that the 95% CIs for all five follow-up times were all well below the minimal important difference of 1.4 cm: up to 6 hours (MD -0.52, 95% CI -0.95 to -0.08); at 24 hours (MD -0.17, 95% CI -0.42 to 0.07); at 48 hours (MD -0.41, 95% CI -0.69 to -0.12); at 72 hours (MD -0.29, 95% CI -0.59 to 0.02); and at 96 hours (MD -0.03, 95% CI -0.43 to 0.37). Thus, the effect sizes suggesting less muscle soreness with antioxidant supplementation were very unlikely to equate to meaningful or important differences in practice. Neither of our subgroup analyses to examine for differences in effect according to type of DOMS-inducing exercise (mechanical versus whole body aerobic) or according to funding source confirmed subgroup differences. Sensitivity analyses excluding cross-over trials showed that their inclusion had no important impact on results.None of the 50 included trials measured subjective recovery (return to previous activities without signs or symptoms).There is very little evidence regarding the potential adverse effects of taking antioxidant supplements as this outcome was reported in only nine trials (216 participants). From the studies that did report adverse effects, two of the nine trials found adverse effects. All six participants in the antioxidant group of one trial had diarrhoea and four of these also had mild indigestion; these are well-known side effects of the particular antioxidant used in this trial. One of 26 participants in a second trial had mild gastrointestinal distress.

AUTHORS' CONCLUSIONS

There is moderate to low-quality evidence that high dose antioxidant supplementation does not result in a clinically relevant reduction of muscle soreness after exercise at up to 6 hours or at 24, 48, 72 and 96 hours after exercise. There is no evidence available on subjective recovery and only limited evidence on the adverse effects of taking antioxidant supplements. The findings of, and messages from, this review provide an opportunity for researchers and other stakeholders to come together and consider what are the priorities, and underlying justifications, for future research in this area.

Vegan diets: practical advice for athletes and exercisers

With the growth of social media as a platform to share information, veganism is becoming more visible, and could be becoming more accepted in sports and in the health and fitness industry. However, to date, there appears to be a lack of literature that discusses how to manage vegan diets for athletic purposes. This article attempted to review literature in order to provide recommendations for how to construct a vegan diet for athletes and exercisers. While little data could be found in the sports nutrition literature specifically, it was revealed elsewhere that veganism creates challenges that need to be accounted for when designing a nutritious diet. This included the sufficiency of energy and protein; the adequacy of vitamin B12, iron, zinc, calcium, iodine and vitamin D; and the lack of the long-chain n-3 fatty acids EPA and DHA in most plant-based sources. However, via the strategic management of food and appropriate supplementation, it is the contention of this article that a nutritive vegan diet can be designed to achieve the dietary needs of most athletes satisfactorily. Further, it was suggested here that creatine and β-alanine supplementation might be of particular use to vegan athletes, owing to vegetarian diets promoting lower muscle creatine and lower muscle carnosine levels in consumers. Empirical research is needed to examine the effects of vegan diets in athletic populations however, especially if this movement grows in popularity, to ensure that the health and performance of athletic vegans is optimised in accordance with developments in sports nutrition knowledge.

The weight-loss experience: a qualitative exploration

Background

Long-term weight management consists of weight-loss, weight-loss maintenance, and weight-gain stages. Qualitative insights into weight management are now appearing in the literature however research appears to be biased towards explorations of weight-loss maintenance. The qualitative understanding of weight loss, which begets weight-loss maintenance and might establish the experiences and behaviours necessary for successful long-term weight management, is comparatively under-investigated. The aim of this study was to investigate the weight-loss experiences of a sample of participants not aligned to clinical intervention research, in order to understand the weight-loss experiences of a naturalistic sample.

Methods

Participants (n = 8) with weight-loss (n = 4) and weight-maintenance experiences (n = 4) were interviewed using a semi-structured interview to understand the weight-loss experience. Interview data was analysed thematically using Framework Analysis and was underpinned by realist meta-theory.

Results

Weight loss was experienced as an enduring challenge, where factors that assisted weight loss were developed and experienced dichotomously to factors that hindered it. Participants described barriers to (dichotomous thinking, environments, social pressures and weight centeredness) and facilitators of (mindfulness, knowledge, exercise, readiness to change, structure, self-monitoring and social support) their weight-loss goals in rich detail, highlighting that weight loss was a complex experience.

Conclusions

Weight loss was a difficult task, with physical, social, behavioural and environmental elements that appeared to assist and inhibit weight-loss efforts concurrently. Health professionals might need to better understand the day-to-day challenges of dieters in order to provide more effective, tailored treatments. Future research should look to investigate the psycho-social consequences of weight-loss dieting, in particular self-imposed social exclusion and spousal sabotage and flexible approaches to treatment.

The Use of High-Flux Albumin Haemofiltration (HFAF) with Evaclio EC-2C™ in the Management of Liver Failure as a Bridge to Transplantation

A 44-year-old male who developed liver failure four years after orthotopic liver transplant was managed using high-flux albumin haemofiltration as a bridge to transplant. The technique, which involves using conventional haemofiltration with a plasma component separator using a filter with a sieving coefficient of 20% for albumin, is described.

Experimental and numerical investigation of the equilibrium geometry of liquid lenses

The equilibrium configuration of a nonwetted three fluid system takes the form of a floating liquid lens, where the lens resides between an upper and lower phase. The axisymmetric profiles of the three interfaces can be computed by solving the nonlinear Young-Laplace differential equation for each interface with coupled boundary conditions at the contact line. Here we describe a numerical method applicable to sessile or pendant lenses and provide a free, downloadable Mathematica Player file which uses a graphical interface for analyzing and plotting lens profiles. The results of the calculations were compared to optical photographs of various liquid lens systems which were analyzed using basic ray-tracing and Moiré imaging. The lens profile calculator, together with a measurement of the lens radius for a known volume, provides a simple and convenient method of determining the spreading coefficient (S) of a liquid lens system if all other fluid parameters are known. If surfactants are present, the subphase surface tension must also be self-consistently determined. A procedure is described for extracting characteristic features in the optical images to uniquely determine both parameters. The method gave good agreement with literature values for pure fluids such as alkanes on water and also for systems with a surfactant (hexadecane/DTAB), which show a transition from partial wetting to the pseudopartial wetting regime. Our technique is the analog of axisymmetric drop shape analysis, applied to a three fluid system.

Client-centered hypnotherapy for tinnitus: who is likely to benefit?

In this study we prospectively analyzed 41 patients, 15 females and 26 males with a mean age of 54, who underwent three sessions of client-centered hypnotherapy for their tinnitus. Of these patients, 28 (68%) showed some benefit for their tinnitus 3 months after completing their hypnosis, and 13 (32%) showed no evidence of improvement for their tinnitus. Hearing loss was associated with a nonbeneficial outcome for tinnitus treated with hypnotherapy. Of the nonbeneficial group, 46% had a hearing loss of 30 db or more in their better-hearing ear compared to less than 15% in the beneficial group, a significant difference (X2 = 6.34, df = 1, p < 0.02). Client-centered hypnotherapy can be offered to anyone who wants to have therapy for their tinnitus; in those with significant hearing loss the benefit may be less.