On January 12th, 2022, Healthcare published our latest peer-reviewed research on Heart Rate Variability (HRV). The paper is titled “Trends in Daily Heart Rate Variability Fluctuations Are Associated with Longitudinal Changes in Stress and Somatisation in Police Officers” and is part of a special issue on Mental and Behavioral Healthcare. In this blogpost, I will attempt to summarize the article and how it complements our prior research in more lay language.
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The aim of the present study was to find early markers for overreaching that are applicable in sport practice. In a group of elite soccer players aged 15–18, the stress–recovery balance and reaction times before and after exercise were assessed. Overreaching was indicated by an elevated submaximal heart rate during a sport-specific field test. Submaximal changes in heart rate were prospectively monitored by means of monthly Interval Shuttle Run Tests during two competitive seasons. Out of 94 players, seven players with an elevated heart rate of at least one month could be included in the study, together with seven controls, matched for age, body composition, training and performance level. The stress–recovery balance was assessed with the Dutch version of the Recovery Stress Questionnaire (RESTQ-Sport). The soccer players with an elevated heart rate reported a disturbed stress–recovery balance (Mann–Whitney test, P<0.05). An ANOVA for repeated measures of reaction times revealed a significant main effect of time (F 1,12=13.87, P<0.01) indicating an improvement of psychomotor speed. No differences between groups were found. We conclude that soccer players with an elevated submaximal heart rate of at least one month share a disturbed stress–recovery balance, but they could not be distinguished from controls based on reaction time after strenuous exercise.
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BACKGROUND: Early mobilization has been proven effective for patients in intensive care units (ICUs) to improve functional recovery. However, early mobilization of critically ill, often mechanically ventilated, patients is cumbersome because of the attachment to tubes, drains, monitoring devices and muscle weakness. A mobile treadmill with bodyweight support may help to initiate mobilization earlier and more effectively. The aim of this study is to assess the effectiveness of weight-supported treadmill training in critically ill patients during and after ICU stay on time to independent functional ambulation. METHODS: In this randomized controlled trial, a custom-built bedside body weight-supported treadmill will be used and evaluated. Patients are included if they have been mechanically ventilated for at least 48 hours, are able to follow instructions, have quadriceps muscle strength of Medical Research Council sum-score 2 (MRC 2) or higher, can sit unsupported and meet the safety criteria for physical exercise. Exclusion criteria are language barriers, no prior walking ability, contraindications for physiotherapy or a neurological condition as reason for ICU admission. We aim to include 88 patients and randomize them into either the intervention or the control group. The intervention group will receive usual care plus bodyweight-supported treadmill training (BWSTT) daily. The BWSSTT consists of walking on a mobile treadmill while supported by a harness. The control group will receive usual care physiotherapy treatment daily consisting of progressive activities such as bed-cycling and active functional training exercises. In both groups, we will aim for a total of 40 minutes of physiotherapy treatment time every day in one or two sessions, as tolerated by the patient. The primary outcome is time to functional ambulation as measured in days, secondary outcomes include walking distance, muscle strength, status of functional mobility and symptoms of post-traumatic stress. All measurements will be done by assessors who are blinded to the intervention on the regular wards until hospital discharge. DISCUSSION: This will be the first study comparing the effects of BWSTT and conventional physiotherapy for critically ill patients during and after ICU stay. The results of this study contribute to a better understanding of the effectiveness of early physiotherapy interventions for critically ill patients. TRIAL REGISTRATION: Dutch Trial Register (NTR) ID: NL6766. Registered at 1 December 2017.
Due to the existing pressure for a more rational use of the water, many public managers and industries have to re-think/adapt their processes towards a more circular approach. Such pressure is even more critical in the Rio Doce region, Minas Gerais, due to the large environmental accident occurred in 2015. Cenibra (pulp mill) is an example of such industries due to the fact that it is situated in the river basin and that it has a water demanding process. The current proposal is meant as an academic and engineering study to propose possible solutions to decrease the total water consumption of the mill and, thus, decrease the total stress on the Rio Doce basin. The work will be divided in three working packages, namely: (i) evaluation (modelling) of the mill process and water balance (ii) application and operation of a pilot scale wastewater treatment plant (iii) analysis of the impacts caused by the improvement of the process. The second work package will also be conducted (in parallel) with a lab scale setup in The Netherlands to allow fast adjustments and broaden evaluation of the setup/process performance. The actions will focus on reducing the mill total water consumption in 20%.
