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reased ease of topography matching during placement.This study investigated whether carbohydrate-energy replacement immediately after prolonged endurance exercise attenuates insulin sensitivity the following morning, and whether exercise improves insulin sensitivity the following morning independent of an exercise-induced carbohydrate deficit. Oral glucose tolerance and whole-body insulin sensitivity were compared the morning after three evening conditions, involving (1) treadmill exercise followed by carbohydrate replacement drink (200 or 150 g maltodextrin for males and females, respectively; CHO-replace); (2) treadmill exercise followed by a non-caloric, taste-matched placebo (CHO-deficit); or (3) seated rest with no drink provided (Rest). Treadmill exercise involved 90 minutes at ~80% age-predicted maximum heart rate. Seven males and two females (aged 23 ± 1 years; body mass index 24.0 ± 2.7 kg·m-2) completed all conditions in a randomized order. selleck chemicals Matsuda index improved by 22% (2.2 [0.3, 4.0] au, p = .03) and HOMA2-IR improved by 10% (-0.04 [-0.08, 0.00] au, p = .04) in CHO-deficit versus CHO-replace, without corresponding changes in postprandial glycemia. Outcomes were similar between Rest and other conditions. These data suggest that improvements to insulin sensitivity in healthy populations following acute moderate/vigorous intensity endurance exercise may be dependent on the presence of a carbohydrate-energy deficit. NOVELTY • Restoration of carbohydrate balance following acute endurance exercise attenuated whole-body insulin sensitivity • Exercise per se failed to enhance whole-body insulin sensitivity • Maximizing or prolonging the post-exercise carbohydrate deficit may enhance acute benefits to insulin sensitivity.

Chronic hepatitis C virus (HCV) infection is one of the main causes of hepatocellular carcinoma. Before initiating a multilevel HCV screening intervention, we sought to (1) describe concordance between the electronic health record (EHR) data warehouse and manual medical record review in recording aspects of HCV testing and treatment and (2) estimate the percentage of patients with chronic HCV infection who initiated and completed HCV treatment using manual medical record review.

We examined the medical records for 177 patients (100 randomly selected patients born during 1945-1965 without evidence of HCV testing and 77 adult patients of any birth cohort who had completed HCV testing) with a primary care or relevant specialist visit at an academic health care system in Tampa, Florida, from 2015 through 2018. We used the Cohen κ coefficient to examine the degree of concordance between the searchable data warehouse and the medical record review abstractions. Descriptive statistics characterized referral to and to characterize treatment initiation and completion.

The purpose of this study was to employ the theoretical domains framework (TDF) to identify behaviour change factors related to leisure-time physical activity (LTPA) in spinal cord injury (SCI) ambulators.

A cross-sectional design was employed. Among 43 SCI ambulators, the TDF behaviour change factors were assessed, along with the duration, types, and intensities of LTPA performed over the previous week.

The TDF behaviour change factors identified as barriers to LTPA included knowledge, beliefs about capabilities, coping planning, and goal conflict. Approximately 71.81 mins/day (

 = 75.41) was spent doing LTPA. Participants reported aerobic and resistance training activities, along with several other types of LTPA (e.g., rock climbing). Coping planning, action planning, goal conflict, and skills explained significant variance in time spent on LTPA (





= 0.259,

 < 0.01), but only action planning uniquely predicted LTPA.

Greater use of coping and action planning, lower levels of goal conflict te skills training in adapted activities like gardening, cycling, and rock-climbing for ambulators with SCI.This is a tale in three parts. It begins with an exploration of the story of Princess Tsahai, daughter of Haile Selassie, and the highly successful British campaign led by suffragette E. Sylvia Pankhurst to bring British-style nursing and medicine to Ethiopia in the 1940s and 1950s. Second, it examines the role of foreign women, most notably Swedish missionary nurses, in building health services and nursing capacity in the country. Finally, it examines the way in which nursing brought together gendered notions of expertise and geopolitical pressures to redefine expectations for Ethiopian women as citizens of the new nation-state.In the 1920s, neurology was a fledgling discipline. Various attempts were made to establish programs relating to neurological care and research. One such initiative was the Neurological Study Unit (NSU) at the Yale School of Medicine. My aim is to chronicle the early years of the NSU (1924-40) the motivations for establishing the unit, its structure, its challenges, and its evolution. I have studied all documents related to the NSU at Manuscripts & Archives, Yale University Library. The NSU was heralded as a "combined attack on a single problem from many angles." It was slow to develop, however, and had a number of missing elements. While some of this may have been due to a lack of funds and the absence of a dedicated neurologist, it was also the result of a failure to conceptualize a neurological unit, the slow evolution-into-existence of a nascent and fledgling medical discipline, growing pains and frictions within the leadership, a university-based rather than a hospital-based model of operation, and turf wars between neurology and allied disciplines.Advocates of homeopathic vaccines, also known as nosodes, reimagined the risks and benefits of vaccination from 1999 to 2015 by comparing "risky" vaccines to "risk-free" nosodes. I argue that nosodes allowed for a complementary argument to anti-vaccine discourse, fundamentally altering what had been framed as a choice between the risks of vaccination and the risks of vaccine-preventable disease. Despite evidence of their efficacy being flawed, advocates presented nosodes as an alternative to vaccines and a middle ground between anti-vaccination and vaccination. While a campaign from 2013 to 2015 tried to expose nosodes as ineffective, I argue that the campaign was unsuccessful. Instead, the mainstream media brought more attention to nosodes. The history of nosodes further complicates the history of vaccines and alternative medicine in Canada by adding vaccine alternatives to the growing literature on vaccine hesitancy.