Nagia S. Ali

Haemorheology in Exercise and Training

AbstractDisruption of the normal rheological properties of blood is considered an independent risk factor for cardiovascular disease and plays a significant role in the aetiology of atherothrombogenesis. The acute increase in whole blood viscosity may unfavourably affect the microcirculatory blood flow and oxygen delivery to the tissues. It is universally accepted that exercise and physical activity performed on a regular basis has health benefits. However, the effects of exercise on the rheological properties of blood have not received much research attention. Recent, limited evidence indicates that the viscosities of whole blood and plasma increase in response to a variety of exercise protocols. The increase in whole blood viscosity is mainly attributed to an increase in haematocrit and plasma viscosity, whereas the deformability and aggregability of red blood cells remain unaltered. The increases in plasma viscosity and haematocrit have been ascribed to exercise-induced haemoconcentration as a result of fluid transfer from the blood to the interstitial spaces. The haemorheological changes associated with strenuous exercise appear to be linked with enhanced oxidative stress and depletion of antioxidant capacity, and that may affect oxygen delivery and availability to the tissues.Although significant advances have been made in many areas of exercise haematology, the long-term effects of endurance training on blood rheology have been very briefly examined and the exact effect of training has not as yet been determined. Available cross-sectional and longitudinal studies indicate that the blood of endurance athletes is more dilute and this has been attributed to an expansion of blood volume, particularly plasma volume as a result of training. The low haematocrit values in trained athletes represent a hydration condition rather than iron stores deficiency. It has been suggested that this hypervolaemia and blood dilutional effect of endurance training may be advantageous for heat dissipation and greater cardiac stroke volume and lower heart rates during exercise. Enhanced blood fluidity also facilitates oxygen delivery to the exercising muscles because of a reduced resistance to blood flow within the microcirculation. Furthermore, the increase in plasma volume may contribute to the body water pool and help offset dehydration. The influence of strength and power training on blood rheology is not known. The physiological mechanisms responsible for and the functional consequences of the haemorheological changes associated with exercise to a large extent remain speculative. The paradox of haematocrit and blood rheology in exercise and training warrants additional studies. Likewise, further investigations are necessary to determine the possible link between overtraining and blood rheological profiles.

Prediction of Coronary Heart Disease Preventive Behaviors in Women: A Test of the Health Belief Model

ABSTRACT Coronary heart disease (CHD) risk increases with age, and this increase is more dramatic in women than men. The incidence of CHD is lower in premenopausal women compared with men. After menopause, the risk of mortality from CHD increases in women. The purpose of this study was to test predictors of CHD preventive behaviors using an adapted form of the Health Belief Model (HBM) in a sample of 178 women. The predictor variables were perceptions of susceptibility to CHD, perceptions of seriousness of CHD, general health motivation, social support, and knowledge of risk factors of CHD. Regression results revealed that susceptibility to CHD, seriousness of CHD, knowledge of risk factors of CHD, and general health motivation together explained 76% of the variance of CHD behaviors. Implications for future research and for improving education about consistent adoption of CHD preventive behaviors are discussed.

Aggregation and Activation of Blood Platelets in Exercise and Training

AbstractThis article presents an overview of the progress that has been made in recent years in our understanding of the interaction between exercise and platelets in health and disease. Although platelets are important in normal haemostasis, recent evidence emphasises the pivotal role of abnormal platelet function in acute coronary artery diseases, myocardial infarction, unstable angina and stroke. In light of the positive health benefits of exercise, interest has been heightened on the association between exercise and platelet aggregation and function, not only in normal healthy subjects but also in patients. However, the study of exercise effects on blood platelets are highly contentious because of the fact that the analytical methods employed to study platelets are bedevilled by numerous methodological problems. While exercise effects on platelet aggregation and function in healthy individuals have been extensively examined, the evidence reported has been conflicting. Somewhat less contradictory are the results generated from studies in patients with coronary heart disease, as the preponderance of evidence available would strongly suggest that platelet aggregation and function are increased with exercise. Several drugs are known to influence platelet aggregation and function, the most examined among these medications is aspirin (acetylsalicylic acid). However, aspirin appears to be ineffective to attenuate exercise-induced increases in platelet aggregation and activation. Few studies are available on the effect of training on blood platelets and the exact effects of exercise training on platelet activation and function is not as yet known. This lack of information makes further studies particularly important, in order to clarify whether there are favourable effects of exercise training on platelet aggregation and function in health and disease.

Interaction between alcohol and exercise: physiological and haematological implications.

AbstractAlcohol use, particularly excessive alcohol consumption is one of the most serious health risks in the world. A relationship between sport, exercise and alcohol consumption is clear and long-standing. Alcohol continues to be the most frequently consumed drug among athletes and habitual exercisers and alcohol-related problems appear to be more common in these individuals. Alcohol use is directly linked to the rate of injury sustained in sport events and appears to evoke detrimental effects on exercise performance capacity. The model of alcohol consumption in human experimental studies has either been acute (single dose) or chronic (repeated doses over a period). These studies suggested that alcohol consumption decreases the use of glucose and amino acids by skeletal muscles, adversely affects energy supply and impairs the metabolic process during exercise. In addition, chronic alcohol use is associated with increased citrate synthase activity and decreased cross-sectional area of type I, IIa and IIb fibres. There is evidence to suggest that exercise may attenuate the ethanol-induced decline in hepatic mitochondria and accelerates ethanol metabolism by the liver. Exercise training seems to reduce the extent of the oxidative damage caused by ethanol. Evidence generated from in vitro experiments and animal studies have also suggested that ethanol administration decreased skeletal muscle capillarity and increased pyruvate kinase and lactate dehydrogenase activities. Substantial epidemiological evidence has been accrued showing that moderate ingestion of alcohol may reduce the incidence of cardiovascular diseases. Although the existing evidence is often confusing and disparate, one of the mechanisms by which alcohol may reduce the incidence of mortality of cardiovascular diseases is through raising levels of high-density lipoprotein cholesterol. Available evidence suggests that exercise and moderate alcohol consumption may have favourable effects on blood coagulation and fibrinolysis; however, compelling experimental evidence is lacking to endorse this notion. Occasional and chronic alcohol consumption is usually linked with unfavourable alterations in platelet aggregation and function and may be associated with platelet-related thrombus formation. Although the effects of alcohol consumption on the rheological properties of the blood are not known, recent experimental evidence suggests that alcohol use following exercise is associated with unfavourable changes in the main determinants of blood viscosity. It is well documented that alcohol use modulates the immune system and impairs host defence. Compelling evidence is also mounting to suggest that chronic alcohol use is linked with adverse effects on the body systems and organs including the brain, the cardiovascular system and the liver.

Transcultural nursing concepts and experiences in nursing curricula.

Future trends in the convergence of a multicultural world continue to intensify the need to educate nurses to deliver culturally focused care. A descriptive survey was conducted to examine curricular trends related to the teaching of transcultural nursing (TCN) in nursing curricula of baccalaureate and higher degree schools of nursing in the United States. Faculty development and qualifications to teach transcultural nursing were identified as well as methods for collaboration between schools of nursing. Although TCN concepts are incorporated into most curricula, wide variation exists as to content, depth, and level of integration. Implications call for collaboration with accrediting agencies, including state boards of nursing, to strengthen expected outcomes related to culture, curricular reviews of nursing courses regarding the incorporation of TCN concepts and experiences, collaboration on culturally focused field experiences, faculty development, and networking across schools to expand available resources.

Online Education: Needs Assessment for Faculty Development

The rapidly evolving paradigm of technology-based education has increased the number of faculty teaching online. The role of faculty has changed from the traditional classroom instruction format to an online community of learning. Therefore, faculty development in online education becomes a critical component during this transitional period. A survey of faculty of the College of Applied Science and Technology in a midwestern university was conducted to identify their level of perceived expertise in online teaching and the priorities of areas to be addressed in faculty development sessions. Benners five-stage sequential transformation from novice to expert was used to construct the questionnaire. Results showed that faculty who taught online perceived their level of expertise to range from advanced beginner to competent, whereas faculty who had not taught online were at the novice and advanced beginner levels. Redesigning and rethinking faculty roles emerged as the number one priority area to be addressed in continuing education sessions. Implications for faculty development for online education sessions are presented.

Barriers to osteoporosis prevention in perimenopausal and elderly women

EDUCATIONAL OBJECTIVES TEST 10: 054785 CEU CREDITS: 1 COST:

Integration of global health concepts in nursing curricula: a national study.

10 On completion of this article, the reader should be able to: 1. Identify risk factors to the development of osteoporosis 2. Discuss recommended calcium Intake and exercise participation for perimenopausal and elderly women 3. Describe benefits and barriers to estrogen-replacement therapy 4. Summarize the effects of smoking and alcohol intake on the development of osteoporosis

Web-based professional education for advanced practice nursing: a consumer guide for program selection.

The concept of global health is evolving with a growing recognition that international social, political, economic, environmental, and cultural issues affect health and health care around the world. Nurse faculty are challenged to find ways to prepare future nurses to provide care in an environment that is increasingly affected by globalization. This article presents results of a national survey of schools of nursing designed to identify a consensus definition for global health, attributes of the concept, and ways in which global health is identified and addressed in nursing curricula. Attributes of global health identified in this study are congruent with the literature. Implications for educators are presented, along with examples of how technology can be used to facilitate global interactions.

Effects of posture and ergometer-specific exercise modality on plasma viscosity and plasma fibrinogen: the role of plasma volume changes.

As Web-based education becomes increasingly available, there are more educational opportunities to pursue an advanced practice degree. Despite the increasing number of schools delivering Web-based education courses and programs, evaluation of these programs is primarily in beginning stages. The purposes of this article are first to present a scenario of how a Midwestern nursing school developed, implemented, and continually evaluates Web-based education in its masters program, and second to present a consumer guide for program selection. Elements in the guide are derived from program accrediting agencies, the literature, and distance learning experiences. The consumers guide is presented for nurses interested in exploring or continuing the completion of an advanced practice degree.