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Tämä tutkimus on gradututkielma aiheesta pedagoginen johtajuus ja rehtori uuden opettajan valintatilanteessa. Tutkimus kuvaa rehtorin/koulun johtajan asemaa uuden opettajan valintaprosessissa sekä rehtorin pedagogista johtajuutta. Tutkimuksessa kuvataan rehtorin näkökulmasta virkaan valittavan opettajan tärkeimpiä ominaisuuksia, joita rehtorit tulevilta opettajiltaan haluavat. Tutkimuksessa kuvataan myös lain vaatimukset viran täyttämisessä sekä koko valintaprosessi Hyvinkään opetuspalvelukeskuksessa.Tutkimusongelmat ovat tässä tutkimuksessa:1. Millaisia opettajia rehtorit/koulun johtajat haluavat kouluihinsa?a) mitkä opettajan ominaisuudet ovat tärkeitä?b) millä ominaisuuksilla ei ole suurta merkitystä?c) mitä rehtorit/koulun johtajat haluavat saada viran hakijasta tietää?2. Miten rehtorin valintaa ohjaavat opettajan ominaisuudet ilmenevät pedagogisessa johtamisessa?a) millaisena rehtori/koulun johtaja näkee opettajan roolin koulun kehittämisessä?b) miten rehtorin painottamat opettajan ominaisuudet sopivat hänen visioonsa omasta hyvästä koulustaan?Tutkimuksen kohteena on Hyvinkään ala-asteen rehtorit, joista 5 vastasi kyselylomakkeeseen. Ala-asteita Hyvinkäällä on 17. Tutkimuksen ongelmiin etsittiin vastauksia kyselylomakkeella, joka sisälsi ainoastaan avoimia kysymyksiä. Avoimia kysymyksiä ja niiden vastauksia on analysoitu ja tulkittu kvalitatiivisen tutkimuksen menetelmillä. Tutkimuksella pyritään tuomaan esille eräs näkökulma tutkittavasta ilmiöstä.Tutkimuksen tulosten mukaan rehtorit painottavat valintatilanteessa persoonallisuutta, yhteistyökykyä ja opettajan ammatillisia taitoja. Osalla tutkimukseen osallistuneista rehtoreista yhteys hänen pedagogisen johtamisen ja opettajavalinnan toimenpiteiden välillä oli selkeä. Osalla yhteys ei tullut ilmi.Asiasanat: rehtorit - johtajuus, rekrytointi - opettajat, virkanimitykset - opettajat, työhönotto
Kuormituskoetta käytetään sepelvaltimotaudin ja muidenkin sydänsairauksien diagnosoinnissa, ennusteen arvioinnissa, hoidon suunnittelussa ja seurannassa. Kuormituskokeen keskeisin etu on sen helppo saatavuus sekä avoterveydenhuollossa että erikoissairaanhoidossa. Rasitukseen liittyvien oireiden tai suorituskyvyn heikkenemisen yhteydessä kuormituskoe on edelleen arvokas perustutkimus. Sen käytön keskeisin rajoite liittyy sen diagnostiseen osuvuuteen, ja sepelvaltimotaudin ali- ja ylidiagnostiikan välttämiseksi kuormituskokeen käyttö tulisikin rajata liikuntakykyisiin potilaisiin, joilla taudin todennäköisyys ennen testiä on keskisuuri tai suuri. Kuormituskoe sopii potilaille, joiden lepo-EKG mahdollistaa riittävän luotettavan sydänlihasiskemian toteamisen ST-välin tulkinnan perusteella. Diagnostisen arvonsa lisäksi kuormituskoe antaa tietoa potilaan ennusteesta erityisesti hemodynaamisten rasitusvasteiden ja suorituskyvyn myötä ja ohjaa potilaskohtaisia hoitopäätöksiä. Kuormituskokeen löydösten kokonaisvaltainen huomioiminen parantaa sen diagnostista osuvuutta.
Objectives: Recent research has revealed multiple potential health benefits of frequent sauna bathing. Finland is a country with extraordinary sauna culture and bathing opportunities. However, coronavirus disease 2019 (COVID-19) pandemic introduced regulations and unprecedented closures to shared sauna facilities. In this study we aimed to examine the previously unknown baseline bathing frequency and its possible change during the epidemic. Design: We investigated several aspects of sauna bathing with self-reports: the frequency, its possible changes, reasons for change, and beliefs about its health effects among a representative sample of thousand Finns aged 18–75 years. This online survey was administered in May 2020. Results: Before the pandemic, 59 % of our respondents had enjoyed sauna at least once a week. Since the pandemic began, up to 23 % had reduced or stopped their bathing. This was often due to restricted sauna access. However, 11 % of respondents bathed more frequently and attributed this changeto seeking relaxation and passing time. These findings demonstrate a surprising flexibility in this health-promoting national pastime. Men were more active bathers than women overall and women under 35 enjoy sauna more seldom than older women. Only 7.9 % of all respondents bathed at least four times a week, exceeding a suggested threshold for maximum health benefits. Conclusions: Finnish people are active sauna bathers. The COVID-19 pandemic demonstrated that the frequency of bathing is dependent on good access to sauna facilities. This flexibility and wide access could be exploited to improve public health in the long term if more frequent bathing became a standard.
Hypertension is the most common modifiable risk factor for cardiovascular disease (CVD)1 and is a leading cause of death globally.2 Hypertension and CVD share common antecedent risk factors which include physical inactivity, obesity and excess alcohol intake.3 Though these established risk factors explain a large proportion of hypertension risk, its pathogenesis is still not fully established as it appears that other additional lifestyle and genetic factors may be involved. There is therefore a need to identify and evaluate putative risk factors that may increase our knowledge of hypertension development, may have causal or predictive relevance, and which will help develop preventive and management strategies.
Sudden cardiac death (SCD) is a global public health burden accounting for 15–20% of all deaths. Though established atherosclerotic risk factors explain a large proportion of the risk of SCD, these factors are often absent in a large proportion of SCD victims and the pathogenesis of SCD is still not fully established. It therefore appears that additional factors may be involved. Sauna bathing is a traditional Finnish activity that is mainly used for the purposes of relaxation and pleasure. Beyond its use for these purposes, sauna bathing has been linked with several health benefits. Emerging evidence suggests that sauna bathing is associated with reduced risk of adverse cardiovascular (CV) disease (CVD) and non-CVD outcomes as well as mortality. A number of reports have linked sauna bathing with reduced or increased risk of SCD, but the evidence is uncertain. This review summarizes available studies linking sauna bathing with SCD, the postulated mechanistic pathways underlying these associations, outlines areas of outstanding uncertainty, and the implications for prevention. We employed a comprehensive search for observational studies, randomized controlled trials (RCTs), and non-RCTs from MEDLINE and Embase since their inception until March 2019. Observational data suggest that regular sauna bathing is associated with a substantial risk reduction in SCD. Furthermore, the data suggest that a combination of regular physical activity and sauna baths confers substantial risk reduction for SCD compared with either modality alone. Few reports have linked sauna baths with SCDs, but these single case incidents have been attributed to the effects of dehydration, hypotension, and cardiac arrhythmias due to a combination of sauna exposure and alcohol consumption. Sauna bathing is generally safe for most healthy people and even among patients with stable CVD, if used sensibly and with caution. Plausible pathways underlying the protective effect of sauna bathing on SCD may be linked to the impact on CV function via reduced arterial stiffness, decreases in inflammation and oxidative stress, stabilization of the autonomic nervous system, beneficial changes in circulating lipid profiles and other CVD risk markers, and lowering of systemic blood pressure. Sauna is a potential novel tool to promote SCD prevention in addition to other known means, being an enjoyable way to take care of general health and well-being.
Objective: Sauna bathing has been suggested to promote mental well-being and relaxation, but the evidence is uncertain with respect to mental disorders. We aimed to assess the association of frequency of sauna bathing with risk of psychosis in the Kuopio Ischemic Heart Disease prospective population-based study. Subjects and Methods: Baseline sauna bathing habits were assessed in 2,138 men aged 42–61 years who had no history of psychotic disorders. Participants were classified into three groups based on the frequency of sauna bathing (once, 2–3, and 4–7 times per week). Results: During a median follow-up of 24.9 years, 203 psychotic disorders were recorded. A total of 537, 1,417, and 184 participants reported having a sauna bath once a week, 2–3 times, and 4–7 times per week, respectively. In Cox regression analysis adjusted for age, compared to men who had 1 sauna session per week, the hazard ratio (95% confidence intervals) of psychosis for 4–7 sauna sessions per week was 0.23 (0.09–0.58). In a multivariable model adjusted for several risk factors and other potential confounders, the corresponding hazard ratio was 0.21 (0.08–0.52). The association was similar after further adjustment for total energy intake, socioeconomic status, physical activity, and C-reactive protein (0.22 [0.09–0.54]) and was unchanged on additional adjustment for duration of a sauna session and temperature of the sauna bath (0.23 [0.09–0.57]). Conclusion: Our study suggests a strong inverse and independent association between frequent sauna bathing and the future risk of psychotic disorders in a general male population.
Background Takotsubo cardiomyopathy is characterized by transient regional systolic dysfunction of the left ventricle, mimicking myocardial infarction. Although systolic left ventricular (LV) function normalizes in most cases, the outcome is not always favourable. Recently, a rare electrocardiogram (ECG) finding, lambda wave ST elevation or ‘triangular QRS-ST-T waveform’, was suggested as a possible marker of poor outcome in Takotsubo patients Case summary After a brief episode of chest pain and shortness of breath, a 67-year-old woman developed cardiogenic shock. Her resting ECG showed widespread ST elevations, which soon evolved into a pattern of triangular QRS-ST-T waveforms in the inferior leads and V3–V6. Emergent coronary angiography was normal. The ejection fraction was 20% with apical ballooning and an LV thrombus. At 1-month follow-up, the patient was asymptomatic and the ECG showed only T-wave inversions. Discussion The triangular QRS-ST-T waveform ECG pattern has recently been introduced as a high-risk marker in the Takotsubo syndrome.
Sauna bath brings about numerous acute changes in hormone levels, partly akin to other stressful situations, partly specific for sauna. Norepinephrine increases in those accustomed to sauna bath. Sweating increases the production of antidiuretic hormone, and the renin-angiotensin system becomes activated. Of the anterior pituitary hormones, growth hormone (GH) and prolactin (PRL) secretion is increased. Also β-endorphin has been frequently reported to increase, whereas the responses of ACTH and cortisol are variable, probably depending on the type of sauna exposure. Sperm production decreases in particular in sauna-naïve men, but reduced fertility has not been associated with regular sauna habits. Minor sex differences exist, the hormonal responses being somewhat greater in women. Sauna-naïve women may experience mild disturbances in menstrual cycle, but no effects of fertility have been reported. The hormone responses are short-lived, normalizing soon after sauna exposure during the recovery. Adaptation to regular sauna use plays an important role in the responses, which attenuate upon frequent exposure.
Observational epidemiological evidence supports a linear and independent association between serum gamma-glutamyltransferase (GGT) concentrations and the risk of Alzheimer's disease (AD). However, the causality of this association has not been previously investigated. We sought to assess the causal nature of this association using a Mendelian randomization (MR) approach. Using inverse-variance weighted MR analysis, we assessed the association between GGT and AD using summary statistics for single nucleotide polymorphism (SNP)-AD associations obtained from the International Genomics of Alzheimer's Project of 17,008 individuals with AD and 37,154 controls. We used 26 SNPs significantly associated with GGT in a previous genome-wide association study on liver enzymes as instruments. Sensitivity analyses to account for potential genetic pleiotropy included MR-Egger and weighted median MR. The odds ratio of AD was 1.09 (95% confidence interval, 0.98 to 1.22; p = 0.10) per one standard deviation genetically elevated GGT based on all 26 SNPs. The results were similar in both MR-Egger and weighted median MR methods. Overall, our findings cannot confirm a strong causal effect of GGT on AD risk. Further MR investigations using individual-level data are warranted to confirm or rule out causality.
Background: There is limited information on whether the orderly display of limb lead ECGs (electrocardiograms) can facilitate students to determine frontal plane QRS complex wave electrical axis. Objectives: The study investigated whether the orderly display of limb lead ECGs can raise Chinese undergraduate intern’s diagnostic accuracy when determining frontal plane axis. Design: A total of 147 fifth-year undergraduate interns aged between 21 and 25 years were randomly arranged into 2 groups: one group was given classically displayed ECGs of limb leads while the other group was given orderly displayed ECGs of limb leads. They were then taught to determine frontal plane axis with one of the above displays. The intern’s diagnostic accuracy and time used were measured. Results: After teaching, the orderly display can more effectively raise diagnostic accuracy when determining axis as compared to the classical display (76.65 ± 23.16% vs. 68.88 ± 23.21%, P < 0.05), although diagnostic accuracy in axis determination was improved in both groups as compared to the axis determination at baseline (all P < 0.05). Conclusions: Orderly display of limb lead ECGs may raise Chinese intern’s diagnostic accuracy when determining frontal plane axis.
The beneficial effects of regular physical activity in promoting health and preventing chronic diseases are well documented. The relationship between regular physical activity and the risk of pneumonia is uncertain. We aimed to evaluate the magnitude and specificity of the prospective association between regular physical activity and the risk of pneumonia using a systematic review and meta-analysis of published observational cohort studies in general populations. Relevant studies with at least 1 year of follow-up were sought from inception until 15 September 2021 in MEDLINE, Embase, Web of Science, and manual search of relevant articles. Relative risks (RRs) with 95% confidence intervals (CIs) for the maximum versus the minimal amount of physical activity groups were pooled using fixed effects meta-analysis. The quality of the evidence was evaluated using the GRADE tool. A total of 10 prospective cohort studies comprising 1,044,492 participants and 7681 events were eligible. The pooled multivariable-adjusted RR (95% CI) of pneumonia comparing the most versus the least physically active groups was 0.69 (0.64–0.74). This association was significantly modified by type of outcome (p-value for meta-regression = .002): 0.82 (0.72–0.93) for incident pneumonia and 0.64 (0.59–0.70) for pneumonia-related mortality. There was no evidence of heterogeneity and publication bias. The GRADE quality of the evidence ranged from moderate to low. Aggregate analysis of 10 cohort studies shows that regular physical activity is associated with lowered risk of incident pneumonia and pneumonia-related mortality in the general population. Physical activity types that are attractive to and feasible for high-risk populations need to be identified and encouraged. Systematic review registration: PROSPERO 2021: CRD42021277514.
Both cardiorespiratory fitness (CRF) and frequency of sauna bathing (FSB) are each strongly and independently associated with sudden cardiac death (SCD) risk. However, the combined effect of CRF and FSB on SCD risk has not been previously investigated. We evaluated the joint impact of CRF and FSB on the risk of SCD in the Kuopio Ischemic Heart Disease prospective cohort study of 2291 men aged 42–61 years at recruitment. Objectively measured CRF and self-reported sauna bathing habits were assessed at baseline. CRF was categorized as low and high (median cutoffs) and FSB as low and high (defined as ≤2 and 3–7 sessions/week respectively). Multivariable adjusted hazard ratios (HRs) with confidence intervals (CIs) were calculated for SCD. During a median follow-up of 26.1 years, 226 SCDs occurred. Comparing high vs low CRF, the HR (95% CIs) for SCD in analysis adjusted for several established risk factors was 0.48 (0.34–0.67). Comparing high vs low FSB, the corresponding HR was 0.67 (0.46–0.98). Compared to men with low CRF & low FSB, the multivariate-adjusted HRs of SCD for the following groups: high CRF & high FSB; high CRF & low FSB; and low CRF & high FSB were 0.31 (0.16–0.63), 0.49 (0.34–0.70), and 0.71 (0.45–1.10) respectively. In a general male Caucasian population, the combined effect of high aerobic fitness (as measured by CRF) and frequent sauna baths is associated with a substantially lowered risk of future SCD compared with high CRF or frequent sauna bathing alone.
Heart rate (HR) and heart rate variability (HRV) can be monitored with wearable devices throughout the day. Resting HRV in particular, reflecting cardiac parasympathetic activity, has been proposed to be a useful marker in the monitoring of health and recovery from training. This study examined the validity of the wrist-based photoplethysmography (PPG) method to measure HR and HRV at rest. Recreationally endurance-trained participants recorded pulse-to-pulse (PP) and RR intervals simultaneously with a PPG-based watch and reference heart rate sensor (HRS) at a laboratory in a supine position (n = 39; 5-min recording) and at home during sleep (n = 29; 4-h recording). In addition, analyses were performed from pooled laboratory data (n = 11340 PP and RR intervals). Differences and correlations were analyzed between the HRS- and PPG-derived HR and LnRMSSD (the natural logarithm of the root mean square of successive differences). A very good agreement was found between pooled PP and RR intervals with a mean bias of 0.17 ms and a correlation coefficient of 0.993 (p < 0.001). In the laboratory, HR did not differ between the devices (mean bias 0.0 bpm), but PPG slightly underestimated the nocturnal recordings (bias −0.7 bpm, p < 0.001). PPG overestimated LnRMSSD both in the laboratory (bias 0.20 ms, p < 0.001) and nocturnal recordings (bias 0.17 ms, p < 0.001). However, very strong intraclass correlations in the nocturnal recordings were found between the devices (HR: 0.998, p < 0.001; LnRMSSD: 0.931, p < 0.001). In conclusion, PPG was able to measure HR and HRV with adequate accuracy in recreational athletes. However, when strict absolute values are of importance, systematic overestimation, which seemed to especially concern participants with low LnRMSSD, should be acknowledged.
Conflicts in marriage have been associated with potential risk of cardiovascular disease; however, there is lack of prospective evidence on the association between marriage satisfaction and sudden cardiac death (SCD). We aimed to assess the association between perceived level of marriage satisfaction and risk of SCD. This study employed the Kuopio Ischemic Heart Disease study, an ongoing prospective population-based study in Finland. Perceived level of marriage satisfaction was assessed in 2,262 men using a well-structured self-administered questionnaire. Multivariable adjusted Cox regression models were used to estimate hazard ratios (95% confidence interval [CI]) for SCD. During a median follow-up period of 25.9 years, 239 SCDs were recorded. The mean age of participants was 53 (SD 5.2) years. On adjustment for several conventional cardiovascular risk factors, hazard ratio (95% CI) of SCD was 1.90 (CI 1.09 to 3.32; p = 0.02) for men who were dissatisfied with their marriage, compared with men who were satisfied with their marriage. The association remained consistent on further adjustment for preexisting coronary heart disease, socioeconomic status, and years of education 1.86 (CI 1.07 to 3.25; p = 0.03). In conclusion, dissatisfied marriage is associated with an increased risk of SCD among middle-aged Caucasian men, independent of conventional cardiovascular risk factors.
Background: Previous evidence indicates that sauna bathing is related to a reduced risk of fatal cardiovascular disease (CVD) events in men. The aim of this study was to investigate the relationship between sauna habits and CVD mortality in men and women, and whether adding information on sauna habits to conventional cardiovascular risk factors is associated with improvement in prediction of CVD mortality risk. Methods: Sauna bathing habits were assessed at baseline in a sample of 1688 participants (mean age 63; range 53–74 years), of whom 51.4% were women. Multivariable-adjusted hazard ratios (HRs) were calculated to investigate the relationships of frequency and duration of sauna use with CVD mortality. Results: A total of 181 fatal CVD events occurred during a median follow-up of 15.0 years (interquartile range, 14. 1–15.9). The risk of CVD mortality decreased linearly with increasing sauna sessions per week with no threshold effect. In age- and sex-adjusted analysis, compared with participants who had one sauna bathing session per week, HRs (95% CIs) for CVD mortality were 0.71 (0.52 to 0.98) and 0.30 (0.14 to 0.64) for participants with two to three and four to seven sauna sessions per week, respectively. After adjustment for established CVD risk factors, potential confounders including physical activity, socioeconomic status, and incident coronary heart disease, the corresponding HRs (95% CIs) were 0.75 (0.52 to 1.08) and 0.23 (0.08 to 0.65), respectively. The duration of sauna use (minutes per week) was inversely associated with CVD mortality in a continuous manner. Addition of information on sauna bathing frequency to a CVD mortality risk prediction model containing established risk factors was associated with a C-index change (0.0091; P = 0.010), difference in − 2 log likelihood (P = 0.019), and categorical net reclassification improvement (4.14%; P = 0.004). Conclusions: Higher frequency and duration of sauna bathing are each strongly, inversely, and independently associated with fatal CVD events in middle-aged to elderly males and females. The frequency of sauna bathing improves the prediction of the long-term risk for CVD mortality
Objective To assess the association between frequency of sauna bathing and risk of future stroke. Methods Baseline habits of sauna bathing were assessed in 1,628 adult men and women aged 53–74 years (mean age, 62.7 years) without a known history of stroke in the Finnish Kuopio Ischemic Heart Disease prospective cohort study. Three sauna bathing frequency groups were defined: 1, 2–3, and 4–7 sessions per week. Hazard ratios (HRs) (95% confidence intervals [CIs]) were estimated for incident stroke. Results During a median follow-up of 14.9 years, 155 incident stroke events were recorded. Compared with participants who had one sauna bathing session per week, the age- and sex-adjusted HR (95% CI) for stroke was 0.39 (0.18–0.83) for participants who had 4–7 sauna sessions per week. After further adjustment for established cardiovascular risk factors and other potential confounders, the corresponding HR (95% CI) was 0.39 (0.18–0.84) and this remained persistent on additional adjustment for physical activity and socioeconomic status at 0.38 (0.18–0.81). The association between frequency of sauna bathing and risk of stroke was not modified by age, sex, or other clinical characteristics (p for interaction > 0.10 for all subgroups). The association was similar for ischemic stroke but modest for hemorrhagic stroke, which could be attributed to the low event rate (n = 34). Conclusions This long-term follow-up study shows that middle-aged to elderly men and women who take frequent sauna baths have a substantially reduced risk of new-onset stroke.
Nurse‐led counseling and systematic follow‐up has been shown to reduce cardiovascular risk factor levels. The study aim was to investigate if cardiovascular risk factor levels could be reduced in patients with coronary artery disease with a nurse‐led intervention and to report patients’ evaluations of nurse‐led counseling. The study design was a real‐life longitudinal follow‐up counseling intervention. Data were collected from November 2017 to May 2020. The nurse‐led intervention and patients’ follow‐up time was one year. Of the 78 patients recruited, 74 completed the study. The most significant findings were in the levels of total cholesterol, low‐density lipoprotein cholesterol and triglycerides at every follow‐up visit compared to their baseline levels, and that waist circumference decreased during the one‐year follow‐up. Patients assessed the quality of nurse‐led counseling to be very good, though it decreased slightly during follow‐up. The results suggest the integrated care path together with specialized and primary care for coronary artery disease patients need further development. More research is needed on how to strengthen patients’ self‐management and what kind of counseling would best promote it.
Background While it is well established that physical activity is associated with reduced risk of vascular and non‐vascular outcomes as well as mortality, evidence on the association between physical activity and dementia is inconsistent. We aimed to assess the associations of physical activity with the risk of dementia and Alzheimer’s disease (AD). Material and methods We analysed data on 2,394 apparently healthy men with good baseline cognitive function from the prospective population‐based Kuopio Ischaemic Heart Disease study. We assessed habits of physical activity at baseline using a 12‐month leisure‐time physical activity (LTPA) questionnaire. Using Cox regression, we calculated hazard ratios adjusted for body‐mass index, systolic blood pressure, smoking status, history of type‐2 diabetes, total cholesterol, high‐density lipoprotein cholesterol, alcohol consumption, history of coronary heart disease, and high‐sensitivity C‐reactive protein. Results During a median follow‐up of 24.9 years (interquartile range: 18.3‐26.9), 208 men developed dementia and 128 developed AD. Multivariable adjusted hazard ratios for dementia comparing top vs. bottom tertiles of physical activity were 0.97 (95% confidence intervals: 0.69‐1.38) for total physical activity volume, 0.96 (0.69‐1.34) for conditioning LTPA volume, and 1.13 (0.80‐1.61) for total LTPA volume. Corresponding hazard ratios for AD were 1.19 (0.76‐1.85), 0.98 (0.64‐1.49), and 1.22 (0.77‐1.93). Associations were consistent in analyses restricted to participants with ≥10 years of follow‐up. Conclusions In middle‐aged Caucasian men, various physical activity exposures were not associated with all‐cause dementia or AD. Future studies should address biases due to reverse causation and regression dilution and should involve objective measures of physical activity.
Purpose To investigate the associations of peak oxygen uptake (V̇ O2peak) and V̇ O2 at ventilatory threshold (V̇ O2 at VT) with arterial stiffness in adolescents. Methods The participants were 55 adolescents (36 girls, 19 boys) aged 16–19 years. Aortic pulse wave velocity (PWVao) and augmentation index (AIx%) were measured by non-invasive oscillometric device from right brachial artery level. V̇ O2peak was directly measured during a maximal ramp test on a cycle ergometer. V̇ O2 at VT was determined using the equivalents for ventilation (V̇ E/V̇ CO2 and V̇ E/V̇ O2). V̇ O2peak and V̇ O2 at VT were normalised for body mass (BM) and lean mass (LM). Data were analysed using linear regression analyses and analysis of covariance adjusted for age and sex. Results V̇ O2peak normalised for BM (β=−0.445, 95% CI −0.783 to −0.107) and V̇ O2peak normalised for LM (β=−0.386, 95% CI −0.667 to −0.106) were inversely associated with PWVao. A higher V̇ O2 at VT normalised for BM (β=−0.366, 95% CI −0.646 to −0.087) and LM (β=−0.321, 95% CI −0.578 to −0.064) was associated with lower PWVao. Adolescents in the lowest third of V̇ O2peak by LM (6.6 vs. 6.1 m/s, Cohen’s d=0.33) and V̇ O2 at VT by LM (6.6 vs. 6.0 m/s, Cohen’s d=0.33) had a higher PWVao than those in the highest third of V̇ O2peak or V̇ O2 at VT by LM. Conclusions Higher V̇ O2peak and V̇ O2 at VT by BM and LM were related to lower arterial stiffness in adolescents. Normalising V̇ O2peak and V̇ O2 at VT for LM would provide the most appropriate measure of cardiorespiratory fitness in relation to arterial stiffness.
Purpose This study examined the physiological, perceptual, and performance responses to a 2-week block of increased training load and compared whether responses differ between high-intensity interval (HIIT) and low-intensity (LIT) endurance training. Methods Thirty recreationally trained males and females performed a two-week block of 10 HIIT-sessions (INT, n = 15) or 70 % increased volume of LIT (VOL, n = 15). Running time in the 3000 m and basal serum and urine hormone concentrations were measured before (T1) and after the block (T2), and after a recovery week (T3). In addition, weekly averages of nocturnal heart rate variability (HRV) and perceived recovery were compared to the baseline. Results Both groups improved their running time in the 3000 m from T1 to T2 (INT -1.8 ± 1.6 %, p = 0.003; VOL -1.4 ± 1.7 %, p = 0.017) and T1 to T3 (INT -2.5 ± 1.6 %, p < 0.001; VOL -2.2 ± 1.9 %, p = 0.001). Resting norepinephrine concentration increased in INT from T1 to T2 (p = 0.01) and remained elevated at T3 (p = 0.018). The change in HRV from the baseline was different between the groups during the first week (INT -1.0 ± 2.0 % vs. VOL 1.8 ± 3.2 %, p = 0.008). Muscle soreness increased only in INT (p < 0.001) and the change was different compared to VOL across the block and recovery weeks (p < 0.05). Conclusions HIIT and LIT blocks increased endurance performance in a short period of time. Although both protocols seemed to be tolerable for recreational athletes, a HIIT-block may induce some negative responses such as increased muscle soreness and decreased parasympathetic activity.
The purpose of this study was to investigate acute responses of endurance (E + SA), strength (S + SA), and combined endurance and strength exercise (C + SA) followed by a traditional sauna bath (70° C, 18% relative humidity) on neuromuscular performance and serum hormone concentrations. Twenty-seven recreationally physically active men who were experienced with taking a sauna participated in the study. All the subjects performed a sauna bath only (SA) first as a control measurement followed by S + SA and E + SA (paired matched randomization) and C + SA. Subjects were measured PRE (before exercise), MID (immediately after exercise and before sauna), POST (after sauna), POST30min (30 minutes after sauna), and POST24h (24 hours after PRE). Maximal isometric leg press (ILPFmax) and bench press (IBPFmax) forces, maximal rate of force development (RFD) and countermovement vertical jump (CMVJ), serum testosterone (TES), cortisol (COR), and 22-kD growth hormone (GH22kD) concentrations were measured. All exercise loadings followed by a sauna decreased ILPFmax (−9 to −15%) and RFD (−20 to −26%) in POST. ILPFmax, RFD, and CMVJ remained at significantly (p ≤ 0.05) lowered levels after S + SA in POST24h. IBPFmax decreased in POST in S + SA and C + SA and remained lowered in POST24h. SA decreased ILPFmax and IBPFmax in POST and POST30min and remained lowered in ILPFmax (−4.1%) at POST24h. GH22kD, TES, and COR elevated significantly in all loadings measured in the afternoon in MID. SA only led to an elevation (15%) in TES in POST. The strength exercise followed by a sauna was the most fatiguing protocol for the neuromuscular performance. Traditional sauna bathing itself seems to be strenuous loading, and it may not be recommended 24 hours before the next training session. A sauna bath after the loadings did not further change the hormonal responses recorded after the exercise loadings.
The aim of this study was to compare heart rate variability -guided (HRVG) and predetermined (PD) block periodization of high intensity aerobic training (HIT). Endurance performance, neuromuscular performance, heart rate variability (HRV) and serum hormone concentrations were measured before, in the middle and after the 8-week training period in 24 endurance trained males. Both groups improved significantly maximal treadmill velocity (Vmax) (p < 0.001) and 3000m running performance (HRVG; p < 0.001 and PD; p = 0.001). The relative changes in Vmax and countermovement jump were significantly greater in HRVG (p < 0.05). Nocturnal heart rate decreased in both groups (p<0.01), but HRV (RMSSD, LF and TP) increased significantly only in HRVG (p<0.05). The significant increase in serum testosterone concentration was observed from mid to post in HRVG (p < 0.05). Significant correlations were found between individual Vmax changes and absolute serum testosterone levels. Individual baseline level of HF correlated significantly with Vmax changes in PD. Block periodization of HIT seems to be an effective way to improve endurance and running performance in already endurance trained males. Based on training induced increases in endurance and neuromuscular performance combined with significant changes in HRV and serum testosterone levels observed in HRVG, individually HRV -guided block training may be more optimal compared to predetermined training.
Background Both blood pressure and C-reactive protein (CRP) are each independently related to mortality risk. However, the combined effect of systolic blood pressure (SBP) and CRP on sudden cardiac death (SCD) risk has not been studied. Patients and methods We studied the joint impact of SBP and CRP and the risk of SCD in the Kuopio Ischemic Heart Disease prospective cohort study of 1953 men aged 42–61 years with no history of ischemic heart disease. Baseline investigations were conducted between March 1984 and December 1989. SBP and CRP were measured. SBP was divided based on median values to low and high (median cutoffs 132 mmHg) and CRP as low and high (median cut-off 1.30 mg/L). Hazard ratios (HRs) with confidence intervals (CIs) were calculated after multivariate adjustment. Results Subjects were followed-up for 23.2 years, and 137 SCDs occurred. In this study, elevated SBP (>132 mmHg) combined with elevated (CRP >1.30 mg/L) were associated with SCD risk. Adjustment for age, examination year, alcohol consumption, BMI, energy expenditure during exercise, total cholesterol, HDL-cholesterol, type 2 diabetes, smoking, antihypertension medication and aspirin use, the risk of SCD remained statistically significant (HR, 2,73, 95% CI, 1.62–4.60, p < .001). Further adjustment for socio-economic status, years of education and history of cardiovascular disease in a family the results were only slightly changed (HR, 2.65, 95% CI, 1.57–4.49, p < .001). Conclusions In our male cohort study, the joint effect of high SBP together with increased CRP levels is a risk predictor of SCD compared with low SBP and CRP.
Background Heat therapy has been suggested to improve cardiovascular function. However, the effects of hot sauna exposure on arterial compliance and the dynamics of blood flow and pressure have not been well documented. Thus, we investigated the short-term effects of sauna bathing on arterial stiffness and haemodynamics. Design The design was an experimental non-randomised study. Methods There were 102 asymptomatic participants (mean age, 51.9 years) who had at least one cardiovascular risk factor. Participants were exposed to a single sauna session (duration: 30 min; temperature: 73℃; humidity: 10–20%). Pulse wave velocity, augmentation index, heart rate, blood pressure, mean arterial pressure, pulse pressure, augmented pressure and left ventricular ejection time were assessed before, immediately after, and 30 min after a single sauna session. Results Sauna bathing led to reductions in pulse wave velocity, blood pressure, mean arterial pressure and left ventricular ejection time. Mean pulse wave velocity value before sauna was 9.8 m/s and decreased to 8.6 m/s immediately after sauna bathing (p < 0.001 for difference), and was 9.0 m/s after the 30-minute recovery period (p < 0.001 for analysis of variance). Systolic blood pressure was 137 mm Hg before sauna bathing, decreasing to 130 mm Hg after sauna (p < 0.001), which remained sustained during the 30-minute recovery phase (p < 0.001 for analysis of variance). After a single sauna session, diastolic blood pressure decreased from 82 to 75 mm Hg, mean arterial pressure from 99.4 to 93.6 mm Hg and left ventricular ejection time from 307 to 278 m/s (p < 0.001 for all differences). Pulse pressure was 42.7 mm Hg before the sauna, 44.9 mm Hg immediately after the sauna, and reduced to 39.3 mm Hg after 30-minutes recovery (p < 0.001 for analysis of variance). Heart rate increased from 65 to 81 beats/min post-sauna (p < 0.001); there were no significant changes for augmented pressure and pulse pressure amplification. Conclusion This study shows that pulse wave velocity, systolic blood pressure, diastolic blood pressure, mean arterial pressure, left ventricular ejection time and diastolic time decreased immediately after a 30-minute sauna session. Decreases in systolic blood pressure and left ventricular ejection time were sustained during the 30-minute recovery phase.
Emerging evidence suggests that sauna bathing is associated with reduced risk of cardiovascular and all-cause mortality events. However, the biochemical pathways by which sauna bathing might confer its effects on cardiovascular function are not certain. We aimed to study the acute effects of Finnish sauna bathing on various blood-based cardiovascular biomarkers. The study included 102 non-naive sauna users (54% male) with mean age of 51.9 years, who had at least one cardiovascular risk factor. Participants underwent a 30-min single sauna session (mean temperature, 73 °C). Biochemical profiling was conducted before, immediately after sauna and 30-min post-sauna. Overall median N-terminal pro-B-type natriuretic peptide (NT-proBNP) level (n = 20 participants) was 46.0 ng/L before sauna exposure, which increased to 50.5 ng/l immediately after sauna (median change, + 12.00%; p < 0.001) and remained persistent at 30-min post-sauna (median change from pre-sauna to post-30-min sauna, + 13.93%; p < 0.001). The changes were more evident in males compared with females. There were no significant changes in overall levels of high sensitivity C-reactive protein, creatine kinase, high sensitivity troponin I, and creatine kinase-MBm. However, levels of creatine kinase increased in males (median change immediately after sauna, + 2.99%; p = 0.024). Levels of NT-proBNP increased after sauna exposure. The increase in levels of creatine kinase was more evident in males. Long-term interventional studies are warranted to evaluate if these biomarkers are involved in pathways underlying the associations of sauna bathing with cardiovascular outcomes.
This study aimed to determine the effect of 16 minutes of thermal stress followed by 2 minutes of cold water immersion on the physiological parameters of fifty-five sedentary men (mean age 20.15±1.30 years), who were exposed to 16 minutes of sauna (temperature: 90-91℃; relative humidity: 14-16%) followed by 2 minutes of cold water immersion (12℃). The participants' somatic characteristics were determined before entering the sauna, and their body mass and blood pressure were measured before and after sauna treatment. Physiological parameters were monitored during the 16-minute sauna session and the 2-minute cold water immersion (CRIO) or shower. The subjects perspired 0.21-0.27 litres during the 18-minute session. Heart rate values did not differ significantly between groups during the 16-minute sauna session, but significantly (p<0.001) lower HR values were noted in the CRIO group than in the control group (68.6:105.7 and 57.5:90.7 bpm). The values of SBP and DBP did not differ significantly between groups before the sauna but were significantly (p<0.001) lower in the CRIO group after sauna (SBP – 122.0:127.3 mmHg, DBP – 89.9:76.3 mmHg). In both groups, the participants remained within the easy effort range during most of the 18-minute session (650.9 and 492.6 s). A 16-minute sauna session followed by 2 minutes of cold water immersion induces a significantly greater decrease in HR and BP (SBP and DBP) than a 16-minute sauna session followed by 30 seconds in the shower and a 90 s resting period. During cold water immersion, HR values often decrease to the bradycardia range. Heart rate increased steadily in both groups.