Min For Women Research Articles

Anxiety and visceral sensitivity relate to gastrointestinal symptoms in runners but not pre- or during-event nutrition intake.

Previous research has shown anxiety to relate to gastrointestinal (GI) symptoms in endurance athletes, but it remains unclear whether competition-related fueling is impacted by anxiety. This study examined whether general anxiety, pre-race anxiety, and visceral sensitivity were associated with nutritional intake before and during endurance running races. A total of 149 (86 female, 63 male) runners participated in this cross-sectional survey study. Assessments, which were carried out at a median of eight hours after races finished, included the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA)-Trait, Visceral Sensitivity Index (VSI), perceived pre-race anxiety (0-10), during-race GI symptoms (total, upper, and lower), and intakes of energy, macronutrients, fluid, and caffeine for the pre-race period (4 h before) and during races. Spearman's correlations were used to examine associations between variables. A two-sided P value ≤0.01 was used as the threshold for significance. Median race durations were 139.5 and 126.9 min for women and men, respectively. VSI scores were positively correlated with total during-race GI symptoms, while STICSA-Trait scores were positively correlated with total and upper during-race GI symptoms (ρ=0.22-0.25; P<0.01). No significant correlations were observed between measures of anxiety/visceral sensitivity and nutrient intakes before or during races. In a sample of primarily recreational runners, greater anxiety and visceral sensitivity did not translate to lower intakes of energy, macronutrients, fluid, etc. around competition. Further work is needed in other settings, especially with high-level athletes, to understand the impact of competition anxiety on fueling choices.

Abstract TP81: Healthcare Disparities For Thrombolysis In Patients Presenting With Stroke-like Symptoms At A Comprehensive Stroke Center

Background: Stroke is a leading cause of death and disability. Early presentation allows clinicians to use tPA for acute stroke therapy to improve outcomes. However, healthcare disparities among different racial/ethnic and gender groups remain a limitation for uniform access to acute stroke therapy. We investigated if such gender and racial disparity exist in tPA administration at a large community comprehensive stroke center (CSC). Methods: Retrospective analysis of a prospective cohort of patients was conducted of patient with acute stroke symptoms who presented to a CSC between May 2018 and May 2022. Demographics, time from last known normal (LKN), rate of tPA administration and door to needle time (DTN) was calculated. Univariate analysis between groups was performed using one-way ANOVA for mean, Kruskal-Wallis test for median and p-value &amp;lt;0.05 was considered significant. Results: Total number of patients presenting to our CSC during the study period with stroke like symptoms was 3901. Of this index cohort, 401 (10.2%) were administered tPA - 207 (51.6%) women and 194 (48.3%) men. Women were significantly older [67.5 ± 15.1 years compared to men, 62.6 ± 13.3 years (p=0.027)]. Average time of LKN to arrival was 124 ± 3.8 min for women and 130 ± 4.9 min for men (p=0.298). Black women’s DTN was longer compared to white women ( 50.9 ± 3.15 min v. 41.5 ± 2.07 min, p=0. 0103). However, proportion of Black women receiving tPA did not differ from white women [87/770 (11.3%) v. 113/1041 (10.9%), p=0.824]. Race disparity was noted among Black men compared to white men for tPA administration [64/798 (8.0%) v 119/1226 (9.7%), p=0.018]. No gender or racial disparity was noted among tPA recipients regarding mRS at discharge [white men v. white women v. Black men v. Black women - 2 (IQR 1,4) v. 3 (IQR 1,4) v. 3 (IQR 1,4) v. 3 (IQR 1,4), p=0.211]. Conclusions: At a large volume, urban, non-academic comprehensive stroke center, overall gender, or racial factors were similar for discharge outcome. However, a delay in tPA administration among Black women and lower incidence of tPA administration in Black men compared to their respective white counterparts need to be validated in larger registries.

Reducing gap in pre-hospital delay between women and men presenting with ST-elevation myocardial infarction.

This study aimed to analyse changes in pre-hospital delay over time in women and men presenting with ST-elevation myocardial infarction (STEMI) in Switzerland. AMIS Plus registry data of patients admitted for STEMI between 2002 and 2019 were analysed using multivariable quantile regression including the following covariates: interaction between sex and admission year, age, diabetes, pain at presentation, myocardial infarction (MI) history, heart failure history, hypertension, and renal disease. Among the 15,350 patients included (74.5% men), the median (interquartile range) delay between 2002 and 2019 was 150 (84; 345) min for men and 180 (100; 414) min for women. The unadjusted median pre-hospital delay significantly decreased over time for both sexes but the decreasing trend was stronger for women. Specifically, the unadjusted sex differences in delay decreased from 60 min in 2002 (P = 0.0042) to 40.5 min in 2019 (P = 0.165). The multivariable model revealed a significant interaction between sex and admission year (P = 0.038) indicating that the decrease in delay was stronger for women (-3.3 min per year) than for men (-1.6 min per year) even after adjustment. The adjusted difference between men and women decreased from 26.93 min in 2002 to -1.97 min for women in 2019. Over two decades, delay between symptom onset and hospital admission in STEMI decreased significantly for men and women. The decline was more pronounced in women, leading to the sex gap disappearing in the adjusted analysis for 2019.

Duration of second stage of labor and factors associated with prolonged second stage: A national population-based study in France

ObjectivesProlonged second stage of labor could be associated with an increase in maternal and neonatal morbidity. However, in France, no consensual definition of prolonged 2nd stage of labor exists and therefore factors associated with prolonged second stage have not yet been studied. From national population-based data, we aimed at defining the prolonged 2nd stage of labor in France and identifying its associated factors for women with epidural. Study designFrom the French national perinatal survey of 2016, we included all women who reached 2nd stage of labor and delivered at term of a singleton infant in cephalic presentation. We studied the distribution of the duration of the 2nd stage according to parity and defined prolonged 2nd stage as the 90th percentile. Among women with epidural, factors associated with a prolonged 2nd stage of labor were then explored by univariate and multilevel multivariable analysis, to take the cluster effect into account. The proportional change of variance was estimated for each multivariate model. ResultsAmong the 8154 women included, 3574 were nulliparous and 4580 multiparous. Prolonged second stage was defined as a duration of more than 89.6 min and 30.6 min for nulliparous and multiparous women without epidural; and respectively 185.7 min and 120.1 min for women with epidural analgesia. The factors associated with prolonged 2nd stage of labor were respectively for nulliparous and multiparous women, macrosomia (aOR 1.74 [1.03–2.94] and ORa 2.52 [1.69–3.76]), prenatal preparation classes (aOR 1.47 [1.04–2.08] and aOR 1.56 [1.21–2.01]), a prolonged 1st stage (aOR 1.47 [1.14–1.87] and aOR 1.52 [1.19–1.95]) and delivery in a public maternity unit (aOR 2.68 [1.50–4.78] and aOR 3.12 [1.88–5.17]). Women’s characteristics accounted for 3.4% of the variance and maternity organizational characteristics for 26.1%. ConclusionIn France, prolonged 2nd stage of labor can be defined as a 2nd stage exceeding 3 h in nulliparous and 2 h in multiparous women with epidural analgesia. The identification of its associated factors allows determining a target population of women at risk of prolonged 2nd stage and improve their 2nd stage’s management.

Delay between symptom onset and hospital admission in patients with ST-elevation myocardial infarction: different trends in men and women

Abstract Introduction The aim of this study was to analyse whether prehospital delay in ST-elevation myocardial infarction (STEMI) has changed in men and women since 2002. Methods We used data from the AMIS Plus registry of patients who were admitted for STEMI between 2002 and 2019. Patients who were transferred from another hospital or were resuscitated before admission were excluded. Patient delay was defined as the difference between symptom onset and hospital admission time. Trends in delay according to gender were depicted by medians per year with a 95% confidence interval. Differences between men and women were tested using the Mann-Whitney test. To analyse the adjusted effect of gender on delay, multivariable quantile regression was applied including the interaction between gender and admission year as well as the covariates age, diabetes, pain at presentation and myocardial infarction (MI) history. Results Among the 15,154 patients included (74.5% men), the overall median (IQR) delay between 2002 and 2019 was 150 (84; 345) minutes for men and 180 (100; 415) for women. Women were older (71.3y vs. 62.8y, p&amp;lt;0.001), had more often diabetes (20.0% vs. 16.9%, p&amp;lt;0.001), but less often MI history (11.2% vs. 14.9%, p&amp;lt;0.001) and less often pain at presentation (92.0% vs. 94.8%, p&amp;lt;0.001). The unadjusted median delay decreased over the admission years. The decreasing trend was stronger in women than men: the unadjusted difference in delay between men and women decreased from 60 min in 2002 (p=0.003) to 15 min in 2019 (p=0.155) (Fig 1). The multivariable model confirmed a significant interaction between gender and admission year (p=0.042) indicating that the decrease in delay was stronger for women (−3.1 min per year) than for men (−1.4 min per year) even after adjustment. The adjusted difference between men and women decreased from 27.4 min in 2002 to −1.6 min for women in 2019. Additional independent predictors of longer delay were the covariates age (+1.6 min per additional year, p&amp;lt;0.001) and diabetes (+27.1 min, p&amp;lt;0.001). Conversely, pain at admission (−46.3 min, p&amp;lt;0.001) and MI history (−32.9 min, p&amp;lt;0.001) predicted a shorter delay. Conclusions The difference in delay between symptom onset and hospital admission in STEMI patients between men and women steadily diminished from 2002 to 2019. This might indicate that the public and health professionals' awareness of STEMI in women has ameliorated over time. Unadjusted delay according to gender Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): AMIS Plus Foundation

Physiological and Perceived Exertion Responses during International Karate Kumite Competition.

PurposeInvestigate the physiological responses and rating of perceived exertion (RPE) in elite karate athletes and examine the relationship between a subjective method (Session-RPE) and two objective heart-rate (HR)-based methods to quantify training-load (TL) during international karate competition.MethodsEleven karatekas took part in this study, but only data from seven athletes who completed three matches in an international tournament were used (four men and three women). The duration of combat was 3 min for men and 2 min for women, with 33.6±7.6 min for the first interval period (match 1–2) and 14.5±3.1 min for the second interval period (match 2–3). HR was continuously recorded during each combat. Blood lactate [La-] and (RPE) were measured just before the first match and immediately after each match.ResultsMeans total fights time, HR, %HRmax, [La-], and session-RPE were 4.7±1.6 min, 182±9 bpm, 91±3%, 9.02±2.12 mmol.L-1 and 4.2±1.2, respectively. No significant differences in %HRmax, [La-], and RPE were noticed across combats. Significant correlations were observed between RPE and both resting HR (r=0.60; P=0.004) and mean HR (r=0.64; P=0.02), session-RPE and Banister training-impulse (TRIMP) (r=0.84; P<0.001) and Edwards TL (r=0.77; P<0.01).ConclusionInternational karate competition elicited near-maximal cardiovascular responses and high [La-]. Training should therefore include exercise bouts that sufficiently stimulate the zone between 90 and 100% HRmax. Karate coaches could use the RPE-method to follow competitor's competition loads and consider it in their technical and tactical training.

Participation and Performance Trends in Triple Iron Ultra-triathlon – a Cross-sectional and Longitudinal Data Analysis

The aims of the present study were to investigate (i) the changes in participation and performance and (ii) the gender difference in Triple Iron ultra-triathlon (11.4 km swimming, 540 km cycling and 126.6 km running) across years from 1988 to 2011. For the cross-sectional data analysis, the association between with overall race times and split times was investigated using simple linear regression analyses and analysis of variance. For the longitudinal data analysis, the changes in race times for the five men and women with the highest number of participations were analysed using simple linear regression analyses. During the studied period, the number of finishers were 824 (71.4%) for men and 80 (78.4%) for women. Participation increased for men (r(2)=0.27, P<0.01) while it remained stable for women (8%). Total race times were 2,146 ± 127.3 min for men and 2,615 ± 327.2 min for women (P<0.001). Total race time decreased for men (r(2)=0.17; P=0.043), while it increased for women (r(2)=0.49; P=0.001) across years. The gender difference in overall race time for winners increased from 10% in 1992 to 42% in 2011 (r(2)=0.63; P<0.001). The longitudinal analysis of the five women and five men with the highest number of participations showed that performance decreased in one female (r(2)=0.45; P=0.01). The four other women as well as all five men showed no change in overall race times across years. Participation increased and performance improved for male Triple Iron ultra-triathletes while participation remained unchanged and performance decreased for females between 1988 and 2011. The reasons for the increase of the gap between female and male Triple Iron ultra-triathletes need further investigations.

A non-exercise prediction model for estimation of cardiorespiratory fitness in adults

DOI: http://dx.doi.org/10.5007/1980-0037.2012v14n3p287 A ferramenta mais precisa para avaliacao da aptidao cardiorrespiratoria e o teste cardiopulmonar de esforco. Entretanto, para sua utilizacao, sao necessarios equipamentos de custo elevado, tecnicos bem treinados e tempo, restringindo sua utilizacao em estudos populacionais. Desta forma, o objetivo do estudo foi desenvolver modelos de predicao da aptidao cardiorrespiratoria de adultos, por meio de variaveis de simples mensuracao. Foram utilizados os dados de 8.293 sujeitos, sendo 5.291 homens e 3.235 mulheres. A amostra constituiu-se de dados retrospectivos da cidade de Florianopolis – SC, abrangendo sujeitos entre 18 e 65 anos. Para estimar o consumo de oxigenio de pico (VO2pico), mensurado de maneira direta, foram associados os dados de: idade, massa corporal, condicionamento, estatura, frequencia cardiaca pre-esforco, dislipidemia, hipertensao arterial, tabagismo, diabetes. Apos a realizacao dos procedimentos estatisticos por intermedio de regressao linear multipla, foram desenvolvidas duas equacoes para o sexo masculino e duas para o sexo feminino. O modelo completo para o sexo masculino apresenta R2 ajustado de 0,531 e erro padrao de estimativa (EPE) de 7,15 ml-1∙kg-1∙min, enquanto que o modelo completo para o sexo feminino apresenta R2 ajustado de 0,436 e EPE de 5,68 ml-1∙kg-1∙min. Conclui-se que o modelo desenvolvido de predicao da aptidao cardiorrespiratoria e uma alternativa viavel e pratica para predicao do VO2pico em estudos epidemiologicos ou quando um teste cardiopulmonar de esforco nao for possivel ou acessivel.

Equações de predição da aptidão cardiorrespiratória de adultos sem teste de exercícios físicos

The most accurate tool for assessment of cardiorespiratory fitness is cardiopulmonary exercise testing (CPET). However, CPET requires expensive equipment, trained technicians and time, which limits their use in population studies. In view of this issue, the present study aims to develop regression equations for predicting the cardiorespiratory fitness of adults using simple measurement variables. The study used data from 8,293 subjects, 5,291 male and 3,235 female (age range, 18 to 65 years). The sample was recruited in Florianopolis, Santa Catarina. To develop equations for prediction of peak oxygen uptake (VO2peak), the data associated were: fitness, age, body mass, height, resting heart rate, hypertension, diabetes, dyslipidemia and smoking. After statistical analyses, two equations for men and two for women were developed. The complete equations showed an adjusted R2 = 0.531 and a standard error of estimate (SEE) = 7.15 ml-1∙kg-1∙min for men and R2 = 0.436 and SEE = 5.68 ml-1∙kg-1∙min for women. We conclude that the model developed for prediction of cardiorespiratory fitness is feasible and practical for prediction of VO2peak in epidemiological studies or when CPET cannot be performed.

Association of current work and sleep situations with excessive daytime sleepiness and medical incidents among Japanese physicians.

The aim of the present study was to clarify the current work and sleep situations of physicians in Japan and to clarify the association between these situations and excessive daytime sleepiness as well as medical incidents. A self-administered questionnaire survey was conducted among the members of the Japan Medical Association in 2008. The randomly selected subjects comprised 3,000 male physicians and 1,500 female physicians. Valid responses were obtained from 3,486 physicians (2,298 men and 1,188 women). Mean sleep duration was 6 h 36 min for men and 6 h 8 min for women. The prevalence of lack of rest due to sleep deprivation was 30.4% among men and 36.6% among women; the prevalence of insomnia was 21.0% and 18.1%, respectively; and the prevalence of EDS was 3.5%. The adjusted odds ratio for EDS was high for physicians who reported short sleep duration, lack of rest due to sleep deprivation, and a high frequency of on-call/overnight work. Physicians who had experienced a medical incident within the previous one month accounted for 19.0% of participants. The adjusted odds ratio for medical incidents was high for those subjected to long working hours, high frequency of on-call/overnight works, lack of rest due to sleep deprivation, and insomnia. In order to facilitate optimal health management for physicians as well as securing medical safety, it is important to fully consider the work and sleep situations of physicians.

Syndromic management of sexually transmitted diseases in Botswana's primary health care: quality of care aspects.

To evaluate the quality of care of the syndromic management of sexually transmitted diseases (STDs) in Botswana's primary health care. Participative observations of 224 consecutive consultations of patients with STDs (135 females and 89 males) by nurses. Twenty-one cases were excluded because no STD checklist was filled in. Criteria for acceptable history taking, physical examination and correct treatment were agreed upon. The quality of history taking and physical examination was acceptable for 25% and 23% of the women and for 54% and 57% of the men, respectively. Approximately, 65% of the women and 81% of the men received appropriate treatment. On average, consultations took 5.4 min for women and 4.6 min for men. STD contacts comprised 11% of STD cases. Advice on partner notification was provided to 66% of the women and 86% of men, and 75% and 89%, respectively, were counselled on the use of condoms. In half of the health facilities the lack of a fixed light source was the main constraint in carrying out a vaginal speculum examination. The availability of antibiotics and condoms was excellent. In 40% of the health facilities, all STD algorithms were displayed in the consultation room. One-third of women and one-fifth of men did not receive appropriate treatment for their STD, in spite of excellent provision of drugs. Although Botswana health workers perform relatively well on partner notification and counselling, there is considerable scope for improving the quality of medical history and clinical examination, especially in women. Emphasis should be given on training health workers in clinical examinations, in particular in pelvic examinations, and to supervision and in-service training.

Treadmill Exercise Testing in an Epidemiologic Study of Elderly Subjects

We sought to characterize the physical performance of older subjects in a community-based study of aging and fitness and to establish norms of oxygen consumption during exercise in this group. A community-based census identified 3057 age-eligible individuals of whom 2092 individuals (68.4%) agreed to participate in the overall study. Of these, 1101 subjects between 55 and 94 years of age who were free of known heart disease and able to perform treadmill exercise were tested using the Cornell protocol. Of these 1101 subjects, 73.8% of women and 89.5% of men (p < .001) exceeded what was considered a minimal threshold workload [i.e., > or =2 min of exercise and a respiratory exchange ratio (RER) > or = 1.00]. Moreover, 32.9% of women and 52.7% of men achieved a RER > or = 1.10 and were considered to have achieved maximal exercise. For all subjects who exceeded the minimal exercise workload, the mean exercise duration was 10.0 +/- 4.0 min for women and 13.2 +/- 4.6 min for men. Peak VO2/kg x min(-1) decreased linearly with age for both women (y = 38.33 - 0.27 x age + 1.12 H) and men (y = 41.78 - 0.26 x age + 12.65 H - 0.15 H x age), (p < .001 for sex difference), where H is defined as presence (=1) or absence (=0) of a disease condition. However, this sex-related difference disappeared when VO2/kg x min(-1) was adjusted for lean body mass. Thus, from a community-based sample of older persons, we have provided data (by 5-year age groups) for rates of participation in treadmill exercise testing and the success rate for achieving maximal exercise. Oxygen consumption and other exercise data are presented for older, healthy subjects as well as for those with various chronic diseases associated with aging (excluding those with cardiac or cerebrovascular disease). Exercise duration, peak VO2/kg x min(-1) (normalized for total and lean body mass), and peak exercise heart rate declined with age. Most of the sex difference in peak VO2/kg x min(-1) could be explained by the greater percent of body fat in women.

Sex differences in performance-matched marathon runners

Six male and six female runners were chosen on the basis of age (20-30 years) and their performance over the marathon distance (mean time = 199.4, SEM 2.3 min for men and 201.8, SEM 1.8 min for women). The purpose was to find possible sex differences in maximal aerobic power (VO2max), anaerobic threshold, running economy, degree and utilization of VO2max (when running a marathon) and amount of training. The results showed that performance-matched male and female marathon runners had approximately the same VO2max (about 60 ml.kg-1.min-1). For both sexes the anaerobic threshold was reached at an exercise intensity of about 83% of VO2max, or 88%-90% of maximal heart rate. The females' running economy was poorer, i.e. their oxygen uptake during running at a standard submaximal speed was higher (P less than 0.05). The heart rate, respiratory exchange ratio and blood lactate concentration also confirmed that a given running speed resulted in higher physiological strain for the females. The percentage utilization of VO2max at the average marathon running speed was somewhat higher for the females, but the difference was not significant. For both sexes the oxygen uptake at average speed was 93%-94% of the oxygen uptake corresponding to the anaerobic threshold. Answers to a questionnaire showed that the females' training programme over the last 2 months prior to running the actual marathon comprised almost twice as many kilometers of running per week compared to the males (60 and 33 km, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Metabolic and hormonal responses to long-distance swimming in cold water.

The acute effects of long-distance swimming in cold water on selected hormonal and metabolic variables were evaluated on 22 long-distance swimmers (16 males and 6 females) during a 32-km swimming competition (La Traversée Internationale du Lac St-Jean). The water temperature was 18.5 degrees C and the mean performance times were 8 h and 32 min for men (M) and 9 h and 1 min for women (F). The blood samples were withdrawn in the fasting state during the week preceding the event and within 30 min after completion of the race. A positive correlation was obtained, for both groups, between percent body fat and rectal temperature measured at the end of the competition. After the competition, an increase in plasma epinephrine, norepinephrine, cortisol, thyroxine, free fatty acids, lactate, a decrease in glucose and insulin and no change in growth hormone, triiodothyronine, triglycerides, and cholesterol concentrations were observed in both groups. The increase in plasma thyroxine was more pronounced in the slower swimmers while the change in blood cortisol concentrations was higher in the subjects having the most acute decrease in body temperature. Male and female swimmers have a similar metabolic and hormonal response to a long-distance swimming competition in cold water.