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Biomedical subjects

Andrew M Jones

Publications and source records attributed to Andrew M Jones.

At least 37 records · Page 2Linked to original sources
PubMed2005

Effects of prior warm-up regime on severe-intensity cycling performance.

PURPOSE: The purpose of the present study was to determine the effect of three different warm-up regimes on cycling work output during a 7-min performance trial. METHODS: After habituation to the experimental methods, 12 well-trained cyclists completed a series of 7-min performance trials, involving 2 min of constant-work rate exercise at approximately 90% VO2max and a further 5 min during which subjects attempted to maximize power output. This trial was performed without prior intervention and 10 min after bouts of moderate, heavy, or sprint exercise in a random order. Pulmonary gas exchange was measured breath by breath during all performance trials. RESULTS: At the onset of the performance trial, baseline blood [lactate] was significantly elevated after heavy and sprint but not moderate exercise (mean +/- SD: control, 1.0 +/- 0.3 mM; moderate, 1.0 +/- 0.2 mM; heavy, 3.0 +/- 1.1 mM; sprint, 5.9 +/- 1.5 mM). All three interventions significantly increased the amplitude of the primary VO2 response (control, 2.59 +/- 0.28 L x min(-1); moderate, 2.69 +/- 0.27 L x min(-1); heavy, 2.78 +/- 0.26 L x min(-1); sprint, 2.78 +/- 0.30 L x min(-1)). Mean power output was significantly increased by prior moderate and heavy exercise but not significantly reduced after sprint exercise (control, 330 +/- 42 W; moderate, 338 +/- 39 W; heavy, 339 +/- 42 W; sprint, 324 +/- 45 W). CONCLUSIONS: These data indicate that priming exercise performed in the moderate- and heavy-intensity domains can improve severe-intensity cycling performance by ~2-3%, the latter condition doing so despite a mild lactacidosis being present at exercise onset.

Adult↗
PubMed2005

Oxygen uptake dynamics: from muscle to mouth--an introduction to the symposium.

The purpose of this paper is to provide an introduction to the study of oxygen uptake (VO(2)) dynamics or kinetics. Following the onset of exercise, both muscle and pulmonary VO(2) rise in a near-exponential fashion towards the anticipated "steady-state" VO(2) demand. However, it can take 2-4 min, or even longer at higher work rates, before this steady state is attained. Slow VO(2) kinetics increase the so-called O(2) deficit and obligate a greater contribution from anaerobic mechanisms of ATP production (involving the breakdown of muscle high energy phosphates and lactate production from glycogen) to meet the ATP requirement of the exercise task. A primary goal in this area of research is therefore to elucidate the physiological mechanisms which control and/or limit the rate at which muscle VO(2) increases following the onset of exercise. At higher intensities of exercise, a continued increase in both muscle and pulmonary VO(2) is observed with time despite the external work rate remaining constant. This continued rise in VO(2), beyond the anticipated steady-state requirement for the work rate, has been termed the VO(2) "slow component," and establishing the mechanistic basis for this phenomenon is another important goal of research in this field. This paper provides an overview of some of the factors which might contribute to both the fundamental and slow phases of the VO(2) kinetics and, in so doing, provides general background material for the more specific papers that follow.

Exercise↗
PubMed2005

Validity of a single-visit protocol to estimate the maximum lactate steady state.

INTRODUCTION: The maximum lactate steady state (MLSS) represents the highest intensity of exercise at which a balance exists between the rate of lactate production and the rate of lactate clearance. The MLSS is an important determinant of endurance exercise performance but its determination, which involves 4-5 laboratory visits, is labor-intensive and time consuming. PURPOSE: To compare the MLSS estimated from a single-visit protocol (MLSSsingle) with the traditional, directly measured MLSS (MLSStrad). METHODS: Following an incremental treadmill test for the determination of VO2peak, eight endurance-trained runners completed: 1) a series of 4-5 constant-speed treadmill runs of up to 30-min duration, on separate days, for determination of the MLSStrad; and 2) a single-visit protocol consisting of two constant-speed treadmill runs of 20-min duration at approximately 65 and 90% VO2peak separated by 40 min of rest, for determination of MLSSsingle. Blood lactate concentration ([La]), oxygen uptake (VO2), and heart rate (HR) were measured every 5 min in all treadmill runs. Comparisons between values were made using paired t-tests. RESULTS: The MLSSsingle significantly underestimated the MLSStrad with respect to speed (13.4 +/- 1.2 vs 16.4 +/- 1.6 km x h(-1), P = 0.002), HR (148 +/- 8 vs 170 +/- 10 b x min(-1), P < 0.001), blood [La] (2.3 +/- 1.5 vs 3.9 +/- 1.0 mmol x L(-1); P = 0.01), and % VO2peak utilized (75 +/- 8 vs 90 +/- 2%, P = 0.002). The MLSStrad speed and MLSSsingle speed were poorly correlated (r = 0.29, P = 0.49). CONCLUSION: The single-visit method of determining the MLSS substantially underestimates the actual MLSS.

Adult↗
PubMed2004

Prospective surveillance for Pseudomonas aeruginosa cross-infection at a cystic fibrosis center.

We have performed a 4-year prospective surveillance for Pseudomonas aeruginosa cross-infection at a large regional adult cystic fibrosis center. Despite purpose-built facilities in a new building and the practice of strict hygiene, P. aeruginosa cross-infection has continued. In contrast, individuals segregated from the cohort of patients with chronic P. aeruginosa infection but who attend the same center have not acquired infection with transmissible P. aeruginosa strains. Simple infection control measures alone do not prevent the spread of transmissible P. aeruginosa strains between individuals with cystic fibrosis. However, in our clinic patient segregation effectively controlled spread of such strains.

Adult↗
PubMed2004

Effect of work rate on the functional 'gain' of Phase II pulmonary O2 uptake response to exercise.

It has recently been reported that the 'gain' of Phase II increase in pulmonary oxygen uptake (i.e. the 'fundamental' increase in V(O(2)) per unit increase in work rate; G(p)) does not attain the anticipated value of approximately 10 ml min(-1)W(-1) following the onset of high-intensity exercise. In the present study, we hypothesised that G(p) would fall significantly below 10 ml min(-1)W(-1) only when the work rate exceeded the so-called 'critical power' (CP). Seven healthy males completed several 'square-wave' transitions from 'unloaded' cycling to work rates requiring 60 and 90% of the gas exchange threshold (GET), 40 and 80% of the difference between the GET and V(O(2)) peak (i.e. below and above the CP, respectively), and 100, 110 and 120% of V(O(2)) peak. Pulmonary V(O(2)) was measured breath-by-breath and V(O(2)) kinetics were determined using non-linear regression techniques. The asymptotic G(p) was significantly lower at work rates above (7.2-8.6 ml min(-1)W(-1)) compared to work rates below (9.3-9.7 ml min(-1)W(-1)) the CP (P < 0.05). We conclude that the gain of Phase II increase in V(O(2)) becomes significantly reduced when the work rate exceeds the CP.

Adult↗
PubMed2004

Influence of nitric oxide synthase inhibition on pulmonary O2 uptake kinetics during supra-maximal exercise in humans.

We have recently reported that inhibition of nitric oxide synthase (NOS) with N(G)-nitro-L-arginine methyl ester (L-NAME) accelerates the 'phase II' pulmonary O2 uptake (VO2) kinetics following the onset of moderate and heavy intensity submaximal exercise in humans. These data suggest that the influence of nitric oxide (NO) on mitochondrial function is an important factor in the inertia to aerobic respiration that is evident in the transition from a lower to a higher metabolic rate. The purpose of the present study was to investigate the influence of L-NAME on pulmonary VO2 kinetics following the onset of supra-maximal exercise, where it has been suggested that O2 availability represents an additional limitation to VO2 kinetics. Seven healthy young men volunteered to participate in this study. Following an incremental cycle ergometer test for the determination of VO2max, the subjects returned on two occasions to perform a 'step' exercise test from a baseline of unloaded cycling to a work rate calculated to require 105% VO2max, preceded either by systemic infusion of L-NAME (4 mg kg(-1) in 50 ml saline) or 50 ml saline as a control (Con). Pulmonary gas exchange was measured on a breath-by-breath basis throughout the exercise tests. The duration of 'phase I' was greater with L-NAME (Con: 14.0 +/- 2.1 versus L-NAME: 16.0 +/- 1.6 s; P = 0.03), suggestive of a slower cardiovascular adaptation following the onset of exercise. However, the phase II VO2 time constant was reduced by 44% with L-NAME (Con: 36.3 +/- 17.3 versus L-NAME: 20.4 +/- 8.3 s; P = 0.01). The accumulation of blood lactate during exercise was also reduced with L-NAME (Con: 4.0 +/- 1.1 versus L-NAME: 2.7 +/- 2.1 mM; P = 0.04). These data indicate that skeletal muscle NO production represents an important limitation to the acceleration of oxidative metabolism following the onset of supra-maximal exercise in humans.

Adult↗
PubMed2004

Nitric oxide synthase inhibition with L-NAME reduces maximal oxygen uptake but not gas exchange threshold during incremental cycle exercise in man.

We hypothesized that the effective inhibition of nitric oxide synthase (NOS), achieved via systemic infusion of N(G)-nitro-l-arginine methyl ester (l-NAME), would reduce the gas exchange threshold (GET) and the maximal oxygen uptake (V(.)(O(2)max)) during incremental cycle exercise in man if NO is important in the regulation of muscle vasodilatation. Seven healthy males, aged 18-34 years, volunteered to participate in this ethically approved study. On two occasions, the subjects completed an incremental exercise test to exhaustion on an electrically braked cycle ergometer following the infusion of either l-NAME (4 mg kg(-1) in 50 ml saline) or placebo (50 ml saline, CON). At rest, the infusion of l-NAME resulted in a significant increase in mean arterial pressure (MAP; CON vs. l-NAME, 89 +/- 8 vs. 103 +/- 11 mmHg (mean +/- s.d.; P < 0.05)) and a significant reduction in heart rate (HR; CON vs. l-NAME, 60 +/- 12 vs. 51 +/- 8 beats min(-1); P < 0.01). At submaximal work rates, there was no significant difference in V(.)(O(2)) between the conditions and no difference in the GET (CON vs. l-NAME, 1.94 +/- 0.47 vs. 2.01 +/- 0.41 l min(-1)). However, at higher work rates, differences in V(.)(O(2)) between the conditions became more pronounced such that V(.)(O(2)max) was significantly lower with l-NAME (CON vs. l-NAME, 4.02 +/- 0.41 vs. 3.80 +/- 0.34 l min(-1); P < 0.05). The reduction in V(.)(O(2)max) was associated with a reduction in HR(max) (CON vs. l-NAME, 186 +/- 10 vs. 178 +/- 7 beats min(-1); P < 0.01). These results demonstrate that NOS inhibition with l-NAME has no effect on GET but reduces V(.)(O(2)max) during large muscle group exercise in man, presumably by direct or indirect effects on cardiac output and muscle blood flow.

Adult↗
PubMed2004

Effect of prior multiple-sprint exercise on pulmonary O2 uptake kinetics following the onset of perimaximal exercise.

We hypothesized that the metabolic acidosis resulting from the performance of multiple-sprint exercise would enhance muscle perfusion and result in a speeding of pulmonary oxygen uptake (VO2)kinetics during subsequent perimaximal-intensity constant work rate exercise, if O2 availability represented a limitation to VO2 kinetics in the control (i.e., no prior exercise) condition. On two occasions, seven healthy subjects completed two bouts of exhaustive cycle exercise at a work rate corresponding to approximately 105% of the predetermined Vo2 peak, separated by 3 x 30-s maximal sprint cycling and 15-min recovery (MAX1 and MAX2). Blood lactate concentration (means +/- SD: MAX1: 1.3 +/- 0.4 mM vs. MAX2: 7.7 +/- 0.9 mM; P < 0.01) was significantly greater immediately before, and heart rate was significantly greater both before and during, perimaximal exercise when it was preceded by multiple-sprint exercise. Near-infrared spectroscopy also indicated that muscle blood volume and oxygenation were enhanced when perimaximal exercise was preceded by multiple-sprint exercise. However, the time constant describing the primary component (i.e., phase II) increase in VO2 was not significantly different between the two conditions (MAX1: 33.8 +/- 5.5 s vs. MAX2: 33.2 +/- 7.7 s). Rather, the asymptotic "gain" of the primary Vo2 response was significantly increased by the performance of prior sprint exercise (MAX1: 8.1 +/- 0.9 ml.min(-1).W(-1) vs. MAX2: 9.0 +/- 0.7 ml.min(-1).W(-1); P < 0.05), such that VO2 was projecting to a higher "steady-state" amplitude with the same time constant. These data suggest that priming exercise, which apparently increases muscle O2 availability, does not influence the time constant of the primary-component VO2 response but does increase the amplitude to which VO2 may rise following the onset of perimaximal-intensity cycle exercise.

Adaptation, Physiological↗
PubMed2004

Using simulation-based inference with panel data in health economics.

Panel datasets provide a rich source of information for health economists, offering the scope to control for individual heterogeneity and to model the dynamics of individual behaviour. However the qualitative or categorical measures of outcome often used in health economics create special problems for estimating econometric models. Allowing a flexible specification of the autocorrelation induced by individual heterogeneity leads to models involving higher order integrals that cannot be handled by conventional numerical methods. The dramatic growth in computing power over recent years has been accompanied by the development of simulation-based estimators that solve this problem. This review uses binary choice models to show what can be done with conventional methods and how the range of models can be expanded by using simulation methods. Practical applications of the methods are illustrated using data on health from the British Household Panel Survey (BHPS).

Bayes Theorem↗
PubMed2004

Measurement and explanation of socioeconomic inequality in health with longitudinal data.

This paper presents a method to compare indices of inequality in health that are based on short-run and long-run measures of health and income. For pure health inequality (as measured by the Gini coefficient) and income-related health inequality (as measured by the concentration index), we show how measures derived from longitudinal data can be related to cross section Gini and concentration indices that have been typically reported in the literature to date, along with measures of health mobility inspired by the literature on income mobility. We also show how these measures of mobility can be usefully decomposed into the contributions of different factors. We apply these methods to investigate the degree of income-related mobility in the GHQ measure of psychological well-being in the first nine waves of the British Household Panel Survey (BHPS). This reveals that dynamics increase the absolute value of the concentration index of GHQ on income by 15%, or 1.7% per year on average, for men, and 5%, or 0.6% per year, for women.

Cross-Sectional Studies↗
PubMed2004

Explaining income-related inequalities in doctor utilisation in Europe.

This paper presents new international comparative evidence on the factors driving inequalities in the use of GP and specialist services in 12 EU member states. The data are taken from the 1996 wave of the European Community Household Panel (ECHP). We examine two types of utilisation (the probability of a visit and the conditional number of positive visits) for two types of medical care: general practitioner and medical specialist visits using probit, truncated Negbin and generalised Negbin models. We find little or no evidence of income-related inequity in the probability of a GP visit in these countries. Conditional upon at least one visit, there is even evidence of a somewhat pro-poor distribution. By contrast, substantial pro-rich inequity emerges in virtually every country with respect to the probability of contacting a medical specialist. Despite their lower needs for such care, wealthier and higher educated individuals appear to be much more likely to see a specialist than the less well-off. This phenomenon is universal in Europe, but stronger in countries where either private insurance cover or private practice options are offered to purchase quicker and/or preferential access. Pro-rich inequity in subsequent visits adds to this access inequity but appears more related to regional disparities in utilisation than to other factors. Despite decades of universal and fairly comprehensive coverage in European countries, utilisation patterns suggest that rich and poor are not treated equally.

Decision Making↗
PubMed2004

Randomised double blind placebo controlled trial investigating the effect of calcium and vitamin D supplementation on bone mineral density and bone metabolism in adult patients with cystic fibrosis.

BACKGROUND: Low bone mineral density (BMD) is prevalent in adults with cystic fibrosis and might be related to calcium and vitamin D malabsorption from the gastrointestinal tract. The aim of this study was to investigate the effect of calcium and vitamin D supplementation on BMD and bone metabolism in these subjects. METHODS: Patients were invited to participate if they had a BMD Z score of -1 or less in the lumbar spine, proximal femur or distal forearm. Patients were randomised to receive calcium 1 g+vitamin D 800 IU or placebo daily, in addition to their regular vitamin D supplements (900 IU/day). BMD and bone biochemical markers were measured before and after 1 year of treatment. RESULTS: After 12 months, the treatment group (n=15) showed a reduced rate of bone loss compared with the control group (n=15) in the lumbar spine (mean difference 1.9% [CI -0.9% to 4.6%]), total hip (mean difference 0.7% [CI -2.2% to 3.5%]) and distal forearm (mean difference 1.7% [CI -2.2% to 5.5%]), but these changes did not reach statistical significance. There was also a trend towards a reduction in bone turnover in the treatment group. CONCLUSIONS: Calcium and vitamin D supplementation reduced the rate of bone turnover and bone loss in adult patients with cystic fibrosis, but these changes did not reach statistical significance. These data suggest that a longer term trial of this simple intervention would be justified.

Absorptiometry, Photon↗
PubMed2004

Socio-economic status, health and lifestyle.

The role of lifestyle in mediating the relationship between socio-economic characteristics and health has been discussed extensively in the epidemiological and economic literatures. Previous analyses have not considered a formal framework incorporating unobservable heterogeneity. In this paper, we develop a simple economic model in which health is determined (partially) by lifestyle, which depends on preferences, budget and time constraints and unobservable characteristics. We estimate a recursive empirical specification consisting of a health production function and reduced forms for the lifestyle equations using Maximum Simulated Likelihood (MSL) for a multivariate probit (MVP) model with discrete indicators of lifestyle choices and self-assessed health (SAH) on British panel data from the 1984 and 1991 Health and Lifestyle Survey (HALS). We find that sleeping well, exercising, and not smoking in 1984 have dramatic positive effects on the probability of reporting excellent or good SAH in 1991, and that these effects are much larger having accounted for endogeneity. The failure of epidemiological analyses to account for unobserved heterogeneity can explain their low estimates of the relevance of lifestyle in the socio-economic status-health relationship. Indicators for prudent alcohol consumption and eating breakfast in 1984 are not found to be statistically significant determinants of SAH in 1991.

Choice Behavior↗
PubMed2004

How did dentists respond to the introduction of global budgets in Taiwan? An evaluation using individual panel data.

In response to the introduction of global budgets, dentists might alter their supply behaviour, changing the number of visits, the amount of expenditure, and the type of services provided. We develop two-way fixed effects models to estimate these effects using a panel data constructed from outpatient dental care expenditures claims from the Taiwanese National Health Insurance system. The availability of a long panel allows us to estimate a "policy effect" for each dentist in the panel. The overall effect of global budgets is to constrain costs but there is evidence of a change in the mix of services. Male and younger dentists have higher policy effects than female and older dentists. Global budgets favour dentists in deprived areas and there is some evidence of increases in the expenditure per visit and the volume of composite resin fillings.

Age Factors↗
PubMed2004

Effects of training status and exercise intensity on phase II VO2 kinetics.

PURPOSE: To test the hypotheses that: 1) the time constant for the fast component of .VO2 kinetics (tau1) at exercise onset would be faster in trained than in untrained subjects for both moderate and heavy exercise, and that 2) tau1 would become progressively slower in untrained subjects at higher power outputs but be invariant in trained subjects. METHODS: Eight untrained subjects (.VO2peak: 42.9 +/- 5.1 mL.kg-1.min-1) and seven trained cyclists (.VO2peak: 66.6 +/- 2.5 mL.kg-1.min-1) completed square-wave transitions to power outputs requiring 60% and 80% of gas exchange threshold (GET), and 50% of the difference between GET and .VO2 peak (50%Delta) from a baseline of "unloaded" cycling. .VO2 was measured breath-by-breath and individual responses were modeled using nonlinear regression techniques. RESULTS: A repeated measures ANOVA revealed that the tau1 was significantly smaller (i.e., the kinetics were faster) in the trained compared with the untrained subjects and that tau1 became significantly greater (i.e., the kinetics were slowed) at higher power outputs both in the untrained (60%GET: 17.8 +/- 3.8 s, 80%GET: 21.5 +/- 6.6 s, and 50%Delta: 23.5 +/- 2.8 s) and the trained (60%GET: 8.9 +/- 1.3 s, 80%GET: 11.7 +/- 2.5 s, and 50%Delta: 15.2 +/- 2.0 s) subjects (P < 0.05). CONCLUSION: Phase II .VO2 kinetics became progressively slower at higher power outputs in both trained and untrained subjects. That a greater tau1 was evident at a higher power output within the moderate exercise intensity domain (<GET), where O2 availability is presumed not to be limiting, indicates that the slowing of the phase II .VO2 kinetics may be attributed to other factors besides O2 availability such as the recruitment of higher threshold motor units.

Adult↗
PubMed2004

Lipid-lipoproteins in children: an exercise dose-response study.

PURPOSE: To study the effect of exercise volume on pre- and early-pubertal children's lipid-lipoprotein profile. METHODS: Thirty-four children (15 girls) completed 12 wk of exercise training, preceded by a 12-wk control period. Sixteen (7 girls and 9 boys) expended an additional 422 +/- 5 kJ.kg BM (LOW, 100 kcal.kg), whereas 18 (8 girls and 10 boys) expended an additional 586 +/- 7 kJ.g (MOD, 140 kcal.kg) as a result of the training program. They all exercised on three nonconsecutive days per week at 80 +/- 1% HRpeak. Exercise duration was individualized to match energy expenditure targets. Plasma TG, TC, and HDL-C were measured precontrol, pretraining, and posttraining. LDL-C, TC/HDL-C, and LDL-C/HDL-C were also calculated. RESULTS: Group mean lipid-lipoprotein concentrations did not change as a result of training energy expenditure in either of the groups (P > 0.05). Dietary composition, habitual physical activity, and body composition were also relatively stable over the intervention period (P > 0.05). In the LOW, but not the MOD group, peak VO2 (mL.kg.min) tended to increase over the intervention period (P = 0.07). Pearson's product moment correlation analyses indicated that pretraining concentrations of TG, TC, LDL-C, TC/HDL-C, and LDL-C/HDL-C were all related to the small changes seen in the lipid-lipoprotein profile (P < 0.01). CONCLUSION: Additional energy expenditure of 422 or 586 kJ.kg, as a direct result of aerobic exercise training over a 12-wk period, did not cause significant alterations in the lipid-lipoprotein profile in pre- and early-pubertal children. This may indicate that the exercise volume was insufficient, the lipoprotein profiles of the majority of children in this study were classified as "desirable," or more likely a combination of these factors.

Child↗
PubMed2004

Muscle glycogen depletion alters oxygen uptake kinetics during heavy exercise.

PURPOSE: To test the hypothesis that muscle fiber recruitment patterns influence the oxygen uptake (VO2) kinetic response, constant-load exercise was performed after glycogen depletion of specific fiber pools. METHODS: After validation of protocols for the selective depletion of Type I and II muscle fibers, 19 subjects performed square-wave exercise at 80% VT (moderate) and at 50% of the difference between VT and VO2max (heavy) without any prior depleting exercise (CON), after HIGH (10 x 1-min exercise bouts at 120% VO2max), and after LOW (3 h of exercise at 30% VO2max) exercise. RESULTS: Differences in VO2 kinetic parameters were only observed in heavy exercise AFTER HIGH: the VO2 primary component was higher (1.75 +/- 0.12 L x min) compared with CON (1.65 +/- 0.11 L x min, P < 0.05), and the VO2 slow component was lower (0.18 +/- 0.03 L x min) compared with CON (0.24 +/- 0.04 L x min, P < 0.05). CONCLUSIONS: The results indicate that the VO2 response to heavy constant-load exercise can be altered by depletion of glycogen in the Type II muscle fibers, lending support to the theory that muscle fiber recruitment influences both the VO2 primary and slow component amplitudes during heavy intensity exercise.

Glycogen↗