Journal Articles
Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915
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Item "You've got to look after yourself, to be able to look after them" a qualitative study of the unmet needs of caregivers of community based primary health care patients.(BioMed Central Limited, 12/11/2018) Kuluski K; Peckham A; Gill A; Arneja J; Morton-Chang F; Parsons J; Wong-Cornall C; McKillop A; Upshur REG; Sheridan NBACKGROUND: There is growing reliance on unpaid caregivers to provide support to people with care needs. Integrated care approaches that aim to coordinate primary care with community care known as community based primary health care (CBPHC) has been a key policy initiative across health systems; however most attention has been paid to the needs of patients and not caregivers. The objective of this paper was to explore the unmet needs of caregivers of older adults with complex care needs receiving CBPHC. METHODS: This qualitative descriptive study entailed one-to-one interviews with 80 caregivers from Canada and New Zealand where roles, experiences and needs were explored. Interview text related to unmet need was reviewed inductively and core themes identified. RESULTS: Three themes were identified across CBPHC sites: unrecognized role; lack of personal resources; and no breaks even when services are in place. CONCLUSIONS: To support caregivers, models of care such as CBPHC need to look beyond the patient to meaningfully engage caregivers, address their needs and recognize the insight they hold. This knowledge needs to be valued as a key source of evidence to inform developments in health and social care.Item Using a kayak paddle power-meter in the sport of whitewater slalom(Research Group on Physical Activity and Sports Sciences (GICAFD). Department of Didactic General and Specific Training, University of Alicante, 1/03/2020) Macdermid PW; Gilbert C; Jayes JThe purpose of this paper was to demonstrate the use of a kayak-paddle power-meter to enhance scientific understanding, quantification of athlete assessment and training prescription in slalom kayaking. Data was collected from a continental-championship race, in addition to the author’s work, which included testing and prescribing training for elite athletes preparing for national and international competition. Results indicate that work rate varies considerably over a competition run (CV=74.4-80.5 %). Intra-athlete performance between two competition runs of one of the leading competitors differed by 1.1% or 0.94 s, while power output decreased by 9.0 % for the fastest run due to an increase in number of steering strokes (11 vs 3). Turning strokes had greater impulse (208 vs 94 N∙s), peak force (362 vs 321 N), and a lower rate of peak force development (810 vs 1925 N∙s-1). Methods to identify biomechanical/technical issues via analysis of force profiles per stroke exhibit bilateral comparisons of strength, while quantification of physical and physiological capability is determined through power output. Training zones are categorised into seven zones (Easy, Threshold, Critical Power, Speed Endurance, Speed and Strength) enabling coaches and athletes to implement specific training programmes targeting key facets of performance. The importance of testing venue is established where river technicality grade (I, II and IV) showed power output at the onset of blood lactate to be 120, 90, and 84 W, respectively. This paper thus supports the efficacy of using a paddle power-meter to enhance scientific understanding of slalom kayak racing through real-world competition analysis capability along with enabling the quantification of training prescription and monitoring based around work rate capability during sport specific testing, in conjunction with technical, physical and physiological qualities.Item Dietary thiols in exercise: oxidative stress defence, exercise performance, and adaptation(BioMed Central, 2017) McLeay Y; Stannard S; Houltham S; Starck CSEndurance athletes are susceptible to cellular damage initiated by excessive levels of aerobic exercise-produced reactive oxygen species (ROS). Whilst ROS can contribute to the onset of fatigue, there is increasing evidence that they play a crucial role in exercise adaptations. The use of antioxidant supplements such as vitamin C and E in athletes is common; however, their ability to enhance performance and facilitate recovery is controversial, with many studies suggesting a blunting of training adaptations with supplementation. The up-regulation of endogenous antioxidant systems brought about by exercise training allows for greater tolerance to subsequent ROS, thus, athletes may benefit from increasing these systems through dietary thiol donors. Recent work has shown supplementation with a cysteine donor (N-acetylcysteine; NAC) improves antioxidant capacity by augmenting glutathione levels and reducing markers of oxidative stress, as well as ergogenic potential through association with delayed fatigue in numerous experimental models. However, the use of this, and other thiol donors may have adverse physiological effects. A recent discovery for the use of a thiol donor food source, keratin, to potentially enhance endogenous antioxidants may have important implications for endurance athletes hoping to enhance performance and recovery without blunting training adaptations.Item Physical activity participation in community dwelling stroke survivors: Synergy and dissonance between motivation and capability. A qualitative study(Elsevier, 2016) Morris JH; Oliver T; Kroll T; Joice SA; Willaims BObjectives The evidence supporting benefits of physical activity (PA) on fitness, functioning, health and secondary prevention after strokeis compelling. However, many stroke survivors remain insufficiently active. This study explored survivors’ perspectives and experiences ofPA participation to develop an explanatory framework that physiotherapists and other health professionals can use to develop person-specificstrategies for PA promotion.Design Qualitative study using semi-structured in-depth interviews. Data was audio-recorded and transcribed. Analysis followed theFramework Approach.Setting Community setting, interviews conducted within participants’ homes.Participants Community dwelling stroke survivors (n = 38) six months or more after the end of their rehabilitation, purposively selected bydisability, PA participation and socio-demographic status.Results Findings suggest that survivors’ beliefs, attitudes, and physical and social context generated synergy or dissonance between motivation(desire to be active) and capability (resources to be active) for PA participation. Dissonance occurred when motivated survivors had limitedcapability for activity, often leading to frustration. Confidence to achieve goals and determination to overcome barriers, acted as activitycatalysts when other influences were synergistic. We illustrate these relationships in a dynamic explanatory model that can be used to supportboth novel interventions and personal activity plans.Conclusions This study suggests a shift is required from purely pragmatic approaches to PA promotion towards conceptual solutions. Under-standing how synergy or dissonance between motivation and capability influence individual survivors’ behaviour will support physiotherapists and other health professionals in promoting PA. This study provides a model for developing person-centred, tailored interventions that address barriers encountered by stroke survivors.Item Acute effects of whey protein, alone and mixed with other macronutrients, on blood pressure and heart rate in older men(BioMed Central Ltd, 2022-12) Oberoi A; Giezenaar C; Lange K; Jones KL; Horowitz M; Chapman I; Soenen SBACKGROUND: Caloric supplements are increasingly used by older people, aiming to increase their daily protein intake. These high caloric drinks, rich in glucose and whey-protein in particular, may result in potential harmful decreases in blood pressure (BP). The effect of ingesting whey-protein with glucose and fat on BP is unknown. It has also been assumed that the maximum fall in systolic blood pressure occurs within 2 h of a meal. METHODS: This study aimed to determine in older men, the effects of whey-protein, alone and mixed with other macronutrients, on systolic (SBP) and diastolic (DBP) blood pressure and heart rate (HR) in older men for 3 h. Thirteen older men (age 75 ± 2yrs; body mass index (BMI) 25.6 ± 0.6 kg/m2) ingested a drink on separate study days: (i) 70 g whey-protein (P280); (ii) 14 g whey-protein, 28 g carbohydrate, 12.4 g fat (M280); (iii) 70 g whey-protein, 28 g carbohydrate, 12.4 g fat (M504); or (iv) a non-caloric control drink (C). RESULTS: SBP decreased after all three nutrient drinks compared to the C, with the greatest reduction after the M504 drink (P = 0.008). Maximal decreases in SBP (C: -14 ± 2 mmHg, P280: -22 ± 2 mmHg, M280: -22 ± 4 mmHg, M504: -24 ± 3 mmHg) occurred about 2 h after drink ingestion and this fall was sustained thereafter (120-180 min: P280 and M504 vs. C P < 0.05). Maximum DBP decreases and HR increases occurred after M504, with no differences between the effects of the P280 and M280 drinks. CONCLUSIONS: The effects of whey-protein containing drinks to lower BP and increase HR appear to be primarily dependent on their energy content rather than macronutrient composition and may persist for at least 3 h after ingestion,. Pure whey-protein drinks may represent the best approach to maximize protein intake without increasing the potential for deleterious BP falls in older people. TRIAL REGISTRATION: ACTRN12614000846628 , 14/03/2019.Item Effect on the mechanical properties of type I collagen of intra-molecular lysine-arginine derived advanced glycation end-product cross-linking(Elsevier, 28/11/2017) Collier TA; Nash A; Birch HL; de Leeuw NHNon-enzymatic advanced glycation end product (AGE) cross-linking of collagen molecules has been hypothesised to result in significant changes to the mechanical properties of the connective tissues within the body, potentially resulting in a number of age related diseases. We have investigated the effect of two of these cross-links, glucosepane and DOGDIC, on the tensile and lateral moduli of the collagen molecule through the use of a steered molecular dynamics approach, using previously identified preferential formation sites for intra-molecular cross-links. Our results show that the presence of intra-molecular AGE cross-links increases the tensile and lateral Young’s moduli in the low strain domain by between 3.0 - 8.5 % and 2.9 - 60.3 % respectively, with little effect exhibited at higher strains.
