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The aim of the study was to search for appropriate, informative, accessible and reproducible method for testing of elite rowers. Six healthy elite rowers (5 male and 1 female) aged 24±7 underwent two types of exercise testing (ET). Exercise performance of rowers was evaluated by means of: i) standard maximal RAMP cycle test, which is considered to be the gold standard measurement in sports medicine; ii) ET specific for rowers with the use of Concept rowing machine. Both protocols of ET were designed according to International Guidelines for Exercise Testing and Prescription Tests were conducted with simultaneously HR monitoring (Garmin) and breath-by-breathe gas-exchange analysis with the use of desktop metabolic analyzer Fitmate PRO (Cosmed, Italy). A range of physiologic parameters were under consideration: VO2, HR, attained power, minute ventilation and anaerobic threshold (AT). Undertaken comparative analysis demonstrated no significant differences in major analysed physiologic parameters during both tests. The obtained data enabled us to conclude that cycling ET with the use of maximal ramp incremental protocol is an informative, accessible, reproducible and appropriate method for testing of elite rowers. Conducting both exercise tests cycling and rowing may highlight the limiting factors of specific physical workability in rowers. Copyright © 2019 by SCITEPRESS - Science and Technology Publications, Lda. All rights reserved. ; A03.21.0006, 02. ; The work was supported by Act 211 Government of the Russian Federation, contract # 02.A03.21.0006.

The last decade has seen sweeping changes in US health care policy. With more changes on the way, the emerging field of comparative effectiveness research-the science of determining how different treatments work best for different conditions-is critical for patients and clinicians who wish to make wise decisions regarding therapeutic choices. Comparative Effectiveness Research is the first textbook to offer an introduction to this topic. Written by an experienced university educator and researcher, the goal of this text is to provide readers with a gentle introduction to this diverse field. This accessible text facilitates participatory learning by including inquiries and links to web-based resources. This book will be a welcome addition to any number of courses in medicine, public health, nursing, dentistry, and allied health-or to the reference shelf of the working medical practitioner.--Publisher.

Cover -- Title -- Copyright -- Contents -- Acknowledgments -- Chapter 1: Introduction -- Chapter Overview -- References -- Chapter 2: Opioids -- Pharmacology -- Medical Uses -- Opioid Prescribing: Past and Present -- Special Populations -- Adverse Effects -- Gastrointestinal Adverse Effects -- Respiratory Adverse Effects -- CNS Depression and Somnolence -- Hyperalgesia -- Pruritus (Itching) -- Urinary Retention -- Overdose -- Risk Factors for Overdose -- Misuse -- Treatment of Opioid Use Disorder -- Conclusions -- References -- Chapter 3: Stimulants -- Introduction and Therapeutic Uses -- Pharmacodynamics and Pharmacokinetics -- Pharmacology -- Physiologic and Adverse Effects -- Stimulant Intoxication -- Acute versus Chronic Effects -- Pharmacokinetics -- Abuse Potential -- Pharmacokinetic Contribution -- Abuse-Deterrent Formulations -- Individual Characteristics -- Summary -- References -- Chapter 4: Benzodiazepines -- Use and Misuse -- Uses -- Self-Medication -- Sedative Use Disorder -- Long-Term Effects -- Safe Prescribing -- Risk Factors for Misuse -- Prescription Drug Monitoring Programs -- Urine Drug Screening -- Medication Monitoring -- Intoxication -- Withdrawal -- Presentation -- Pharmacologic Treatment -- Treatment of Sedative Use Disorder -- Conclusions -- References -- Chapter 5: Misuse and Abuse of Over-the-Counter Medicines -- Introduction -- Key Categories of OTC Medicines of Abuse and Misuse -- Opioids and Compound Analgesics -- Stimulants -- Sedative Antihistamines -- Dextromethorphan -- Nicotine Replacement Therapy -- Laxatives -- Who and How Many Are Affected by OTC Medicine Abuse? -- Preventing Harm and Providing Support -- Relationship between OTC and Prescription Medicine Use and Abuse -- Summary -- References -- Chapter 6: Nonmedical Prescription Drug Use in Adolescents and Young Adults

The session rate of perceived exertion method (sRPE) has often been utilized in sports activities in which quantification of external training loads is challenging. The multi-modal, constantly varied nature of high intensity functional training (HIFT) represents a significant hurdle to calculate external work and the sRPE method may provide an elegant solution to this problem. However, no studies have investigated the psychometric properties of sRPE within HIFT interventions. Twenty-five healthy men and women participated in six weeks of HIFT. Rate of perceived exertion and heart rate were assessed within every training session throughout the duration of the intervention. Compared to criterion heart rate-based measures, we observed sRPE method is a valid tool across individual, group, and sex levels. However, poor reliability in participants' abilities to correctly match rate of perceived exertion with the relative level of physiologic effort (i.e., percentile of maximum heart rate) currently limits the utility of this strategy within HIFT. When applied, the validity and reliability of the sRPE seem to improve over time, and future research should continue to explore the potential of this monitoring strategy within HIFT interventions.

Aim: To provide a clinical practice guideline for the use of testosterone including identification of patients, laboratory testing, dosing, post-treatment monitoring, and follow-up care in women with hypoactive sexual desire disorder (HSDD). Methods: The International Society for the Study of Women's Sexual Health appointed a multidisciplinary panel of experts who performed a literature review of original research, meta-analyses, review papers, and consensus guidelines regarding testosterone use in women. Consensus was reached using a modified Delphi method. Outcomes: A clinically useful guideline following a biopsychosocial assessment and treatment approach for the safe and efficacious use of testosterone in women with HSDD was developed including measurement, indications, formulations, prescribing, dosing, monitoring, and follow-up. Results: Although the Global Position Statement endorses testosterone therapy for only postmenopausal women, limited data also support the use in late reproductive age premenopausal women, consistent with the International Society for the Study of Women's Sexual Health Process of Care for the Management of HSDD. Systemic transdermal testosterone is recommended for women with HSDD not primarily related to modifiable factors or comorbidities such as relationship or mental health problems. Current available research supports a moderate therapeutic benefit. Safety data show no serious adverse events with physiologic testosterone use, but long-term safety has not been established. Before initiation of therapy, clinicians should provide an informed consent. Shared decision-making involves a comprehensive discussion of off-label use, as well as benefits and risks. A total testosterone level should not be used to diagnose HSDD, but as a baseline for monitoring. Government-approved transdermal male formulations can be used cautiously with dosing appropriate for women. Patients should be assessed for signs of androgen excess and total testosterone levels monitored to maintain concentrations ...

Background: The Global Consensus Position Statement on the Use of Testosterone Therapy for Women (Global Position Statement) recommended testosterone therapy for postmenopausal women with hypoactive sexual desire disorder (HSDD). Aim: To provide a clinical practice guideline for the use of testosterone including identification of patients, laboratory testing, dosing, post-treatment monitoring, and follow-up care in women with HSDD. Methods: The International Society for the Study of Women's Sexual Health appointed a multidisciplinary panel of experts who performed a literature review of original research, meta-analyses, review papers, and consensus guidelines regarding testosterone use in women. Consensus was reached using a modified Delphi method. Outcomes: A clinically useful guideline following a biopsychosocial assessment and treatment approach for the safe and efficacious use of testosterone in women with HSDD was developed including measurement, indications, formulations, prescribing, dosing, monitoring, and follow-up. Results: Although the Global Position Statement endorses testosterone therapy for only postmenopausal women, limited data also support the use in late reproductive age premenopausal women, consistent with the International Society for the Study of Women's Sexual Health Process of Care for the Management of HSDD. Systemic transdermal testosterone is recommended for women with HSDD not primarily related to modifiable factors or comorbidities such as relationship or mental health problems. Current available research supports a moderate therapeutic benefit. Safety data show no serious adverse events with physiologic testosterone use, but long-term safety has not been established. Before initiation of therapy, clinicians should provide an informed consent. Shared decision-making involves a comprehensive discussion of off-label use, as well as benefits and risks. A total testosterone level should not be used to diagnose HSDD, but as a baseline for monitoring. Government-approved transdermal male ...

Background: The Global Consensus Position Statement on the Use of Testosterone Therapy for Women (Global Position Statement) recommended testosterone therapy for postmenopausal women with hypoactive sexual desire disorder (HSDD). Aim: To provide a clinical practice guideline for the use of testosterone including identification of patients, laboratory testing, dosing, post-treatment monitoring, and follow-up care in women with HSDD. Methods: The International Society for the Study of Women's Sexual Health appointed a multidisciplinary panel of experts who performed a literature review of original research, meta-analyses, review papers, and consensus guidelines regarding testosterone use in women. Consensus was reached using a modified Delphi method. Outcomes: A clinically useful guideline following a biopsychosocial assessment and treatment approach for the safe and efficacious use of testosterone in women with HSDD was developed including measurement, indications, formulations, prescribing, dosing, monitoring, and follow-up. Results: Although the Global Position Statement endorses testosterone therapy for only postmenopausal women, limited data also support the use in late reproductive age premenopausal women, consistent with the International Society for the Study of Women's Sexual Health Process of Care for the Management of HSDD. Systemic transdermal testosterone is recommended for women with HSDD not primarily related to modifiable factors or comorbidities such as relationship or mental health problems. Current available research supports a moderate therapeutic benefit. Safety data show no serious adverse events with physiologic testosterone use, but long-term safety has not been established. Before initiation of therapy, clinicians should provide an informed consent. Shared decision-making involves a comprehensive discussion of off-label use, as well as benefits and risks. A total testosterone level should not be used to diagnose HSDD, but as a baseline for monitoring. Government-approved transdermal male ...

Background: The Global Consensus Position Statement on the Use of Testosterone Therapy for Women (Global Position Statement) recommended testosterone therapy for postmenopausal women with hypoactive sexual desire disorder (HSDD). Aim: To provide a clinical practice guideline for the use of testosterone including identification of patients, laboratory testing, dosing, post-treatment monitoring, and follow-up care in women with HSDD. Methods: The International Society for the Study of Women's Sexual Health appointed a multidisciplinary panel of experts who performed a literature review of original research, meta-analyses, review papers, and consensus guidelines regarding testosterone use in women. Consensus was reached using a modified Delphi method. Outcomes: A clinically useful guideline following a biopsychosocial assessment and treatment approach for the safe and efficacious use of testosterone in women with HSDD was developed including measurement, indications, formulations, prescribing, dosing, monitoring, and follow-up. Results: Although the Global Position Statement endorses testosterone therapy for only postmenopausal women, limited data also support the use in late reproductive age premenopausal women, consistent with the International Society for the Study of Women's Sexual Health Process of Care for the Management of HSDD. Systemic transdermal testosterone is recommended for women with HSDD not primarily related to modifiable factors or comorbidities such as relationship or mental health problems. Current available research supports a moderate therapeutic benefit. Safety data show no serious adverse events with physiologic testosterone use, but long-term safety has not been established. Before initiation of therapy, clinicians should provide an informed consent. Shared decision-making involves a comprehensive discussion of off-label use, as well as benefits and risks. A total testosterone level should not be used to diagnose HSDD, but as a baseline for monitoring. Government-approved transdermal male ...

Background: The Global Consensus Position Statement on the Use of Testosterone Therapy for Women (Global Position Statement) recommended testosterone therapy for postmenopausal women with hypoactive sexual desire disorder (HSDD). Aim: To provide a clinical practice guideline for the use of testosterone including identification of patients, laboratory testing, dosing, post-treatment monitoring, and follow-up care in women with HSDD. Methods: The International Society for the Study of Women's Sexual Health appointed a multidisciplinary panel of experts who performed a literature review of original research, meta-analyses, review papers, and consensus guidelines regarding testosterone use in women. Consensus was reached using a modified Delphi method. Outcomes: A clinically useful guideline following a biopsychosocial assessment and treatment approach for the safe and efficacious use of testosterone in women with HSDD was developed including measurement, indications, formulations, prescribing, dosing, monitoring, and follow-up. Results: Although the Global Position Statement endorses testosterone therapy for only postmenopausal women, limited data also support the use in late reproductive age premenopausal women, consistent with the International Society for the Study of Women's Sexual Health Process of Care for the Management of HSDD. Systemic transdermal testosterone is recommended for women with HSDD not primarily related to modifiable factors or comorbidities such as relationship or mental health problems. Current available research supports a moderate therapeutic benefit. Safety data show no serious adverse events with physiologic testosterone use, but long-term safety has not been established. Before initiation of therapy, clinicians should provide an informed consent. Shared decision-making involves a comprehensive discussion of off-label use, as well as benefits and risks. A total testosterone level should not be used to diagnose HSDD, but as a baseline for monitoring. Government-approved transdermal male ...

A measurement is always afflicted with some degree of uncertainty. A correct understanding of the different types of uncertainty, their naming, and their definition is of crucial importance for an appropriate use of the measuring instruments. However, in perioperative and intensive care medicine, the metrological requirements for measuring instruments are poorly defined and often used spuriously. The correct use of metrological terms is also of crucial importance in validation studies. The European Union published a new directive on medical devices, mentioning that in the case of devices with a measuring function, the notified body is involved in all aspects relating to the conformity of the device with the metrological requirements. It is therefore the task of scientific societies to establish the standards in their area of expertise. After adopting the same understandings and definitions (part 1), the different procedures for the validation of major quality criteria of measuring devices must be consensually established. In this metrologic review (part 2), we review the terms and definitions of validation, some basic processes leading to the display of an indication from a physiologic signal, and procedures for the validation of measuring instrument properties, with specific focus on perioperative and intensive care medicine including appropriate examples.

The long‐term impact on bone health of lifelong HIV infection and prolonged ART in growing and developing children is not yet known. Measures of bone health in youth must be interpreted in the context of expected developmental and physiologic changes in bone mass, size, density and strength that occur from fetal through adult life. Low bone mineral density (BMD) appears to be common in perinatally HIV‐infected youth, especially outside of high‐income settings, but data are limited and interpretation complicated by the need for better pediatric norms. The potential negative effects of tenofovir on BMD and bone mass accrual are of particular concern as this drug may be used more widely in younger children. Emphasizing good nutrition, calcium and vitamin D sufficiency, weight‐bearing exercise and avoidance of alcohol and smoking are effective and available approaches to maintain and improve bone health in all settings. More data are needed to inform therapies and monitoring for HIV‐infected youth with proven bone fragility. While very limited data suggest lack of marked increase in fracture risk for youth with perinatal HIV infection, the looming concern for these children is that they may fail to attain their expected peak bone mass in early adulthood which could increase their risk for fractures and osteoporosis later in adulthood.

Mobile health monitoring via non-invasive wearable sensors is poised to advance telehealth for older adults and other vulnerable populations. Extreme heat and other environmental conditions raise serious health challenges that warrant monitoring of real-time physiological data as people go about their normal activities. Mobile systems could be beneficial for many communities, including elite athletes, military special forces, and at-home geriatric monitoring. While some commercial monitors exist, they are bulky, require reconfiguration, and do not fit seamlessly as a simple wearable device. We designed, prototyped and tested an integrated sensor platform that records heart rate, oxygen saturation, physical activity levels, skin temperature, and galvanic skin response. The device uses a small microcontroller to integrate the measurements and store data directly on the device for up to 48+ h. continuously. The device was compared to clinical standards for calibration and performance benchmarking. We found that our system compared favorably with clinical measures, such as fingertip pulse oximetry and infrared thermometry, with high accuracy and correlation. Our novel platform would facilitate an individualized approach to care, particularly those whose access to healthcare facilities is limited. The platform also can be used as a research tool to study physiological responses to a variety of environmental conditions, such as extreme heat, and can be customized to incorporate new sensors to explore other lines of inquiry.

Mobile health monitoring via non-invasive wearable sensors is poised to advance telehealth for older adults and other vulnerable populations. Extreme heat and other environmental conditions raise serious health challenges that warrant monitoring of real-time physiological data as people go about their normal activities. Mobile systems could be beneficial for many communities, including elite athletes, military special forces, and at-home geriatric monitoring. While some commercial monitors exist, they are bulky, require reconfiguration, and do not fit seamlessly as a simple wearable device. We designed, prototyped and tested an integrated sensor platform that records heart rate, oxygen saturation, physical activity levels, skin temperature, and galvanic skin response. The device uses a small microcontroller to integrate the measurements and store data directly on the device for up to 48+ h. continuously. The device was compared to clinical standards for calibration and performance benchmarking. We found that our system compared favorably with clinical measures, such as fingertip pulse oximetry and infrared thermometry, with high accuracy and correlation. Our novel platform would facilitate an individualized approach to care, particularly those whose access to healthcare facilities is limited. The platform also can be used as a research tool to study physiological responses to a variety of environmental conditions, such as extreme heat, and can be customized to incorporate new sensors to explore other lines of inquiry.

Objective:The aim of this study was development of a sonification scheme to convey deviations in heart rate and oxygen saturation from a desired target level.Background:Maintaining physiologic parameters, such as oxygen saturation, within desired ranges, is challenging in many clinical situations. High rates of false positive alarms in clinical settings limit the utility of the alarms that trigger when thresholds are exceeded. Auditory displays that consider the semantic connotations of sounds and the processing limitations of human perception and cognition may improve monitoring.Method:Across two experiments, clinical practi-tioners were tested on their ability to (a) discriminate pairs of sounds (two-note discrimination task), (b) infer and discern the intended physiological connotation of each acoustic attribute (name-the-variable task), and (c) categorize the amount of change in an implied physiological variable into three levels of change: none, small, and large (change-magnitude task).Results:Considerable variation in performance was observed across the set of practitioners, ranging from near-perfect performance on all tasks, even with no prior exposure to the stimuli, to failure to reach a target accuracy criterion of 87.5% after ~80 min of training. On average, performance was well above chance on the name-the-variable and change-magnitude tasks during initial exposure and reached criterion within ~20 min of training on each task.Conclusion:The described sonification strategy may effectively communicate information about current heart rate and oxygen saturation status relative to desired target levels.Application:The results can be applied to clinical monitoring settings in which a stream of discrete auditory informational items is indicated.

BACKGROUND: The effects of noise on sleep and health have been evaluated in earlier studies using noise indices chosen on the basis of practical considerations and not on the physiologic mechanisms of sleep disturbance due to noise exposure. We investigated the neurophysiologic mechanisms of sleep and found that the arithmetic mean of the sound levels above a threshold ([Image: see text]) may be used effectively to evaluate the effects of nighttime noise exposure. However, the efficacy of using [Image: see text] has only been confirmed in a specific setting; therefore, the reliability of [Image: see text] in other situations should be investigated by applying it in epidemiologic studies. In this study, we aimed to obtain an alternative equation for calculating [Image: see text] from existing noise indices, given that detailed information on fluctuations in sound levels, needed to calculate [Image: see text] according to the definition, is not readily available. MATERIALS AND METHODS: We examined statistical relationships among noise indices namely [Image: see text] , the number of noise events above 60 and 70 dB (N(60) and N(70)), and the night equivalent sound level (L(night)). The study area was around the Kadena military airfield, where the sound levels were recorded at noise monitoring stations. RESULTS: [Image: see text] showed a very strong correlation with N(60) and N(70) but not with L(night). Among regression equations, an equation representing N(60) and the interaction between N(60) and L(night), which is equivalent to the product of N(60) and a linear expression of L(night), showed the highest prediction capability. CONCLUSION: We obtained a regression equation to calculate [Image: see text] from N(60) and L(night). Although this alternative equation for [Image: see text] is only applicable for military aircraft noise, it will aid the re-analysis of existing epidemiologic studies as well as further investigations on the relationship between noise exposure and health effects.