Medical assessment for licensing of taxi drivers by Scottish Local Authorities

In the UK, licensing of taxi drivers is dealt with by localgovernment authorities. In Scotland, before the recent reorganizationof local government, taxi licensing was under the jurisdictionof District Councils, so a telephone survey was conducted ofall 52 mainland Scottish District Councils to ascertain theprocedures which were being employed in assessing medical fitnessto drive a taxi, for which there is no national standard. Medicalenquiries relevant to fitness to drive were being made by 41(79%) of local authorities, but in 38 (73%) this was limitedto a single question about health. No enquiry regarding healthstatus was being made by 11 (21%) District Councils (all serving< 100,000 population size). Only three Scottish DistrictCouncils conducted a routine medical examination of all applicants.Thirteen of the 15 large (> 100,000 population size), and20 of the 21 medium-sized (50,000–100,000) Scottish DistrictCouncils carried out medical examinations either when a relevantmedical disorder was declared by the applicant, or when theapplicant was above a defined age (which varied between localauthorities). The small local authorities (population < 50,000)examined only those applicants who declared medical disorders.This survey has shown considerable variation and limitationsin the approach of the previously existing Scottish DistrictCouncils to the assessment of medical fitness to drive of applicantsfor taxi licences. It is suggested that national standards andguidelines are required for medical fitness to drive in relationto taxi licensing.     

Flight crew physical fitness: a baseline analysis

INTRODUCTION: The purpose of this pilot study was to determine whether flight crew personnel are physically fit in comparison to published standards for the average American adult. SETTING: The study group consisted of pilots, paramedics and nurses in two similarly configured and geographically located rotor-wing air medical transport programs. METHODS: A physical fitness assessment of flight crew members was conducted. The results were compared with published standards for average adult males and females (AVG). Percentage of fat in body composition (FM%), aerobic fitness (VO2MAX), muscular endurance (ME), muscular strength (MS) and flexibility (FL) measurements were obtained using accepted testing methods. RESULTS: The study population consisted of 29 male and 21 female individuals. The following were their mean scores. Males averaged: pFAT = 19% (AVG = 20.0%); VO2MAX = 41.0 (AVG = 42.5); ME = 37.0 (AVG = 28.5); MS = 125.0 (AVG = 86.5); FL = 5.2 (AVG = 1.4); Females averaged: pFAT = 28.0% (AVG = 26.5%); VO2MAX (AVG = 34.0); ME = 27.0 (AVG = 21.0); MS = 83.0 (AVG = 76.5); FL = 4.5 (AVG = 3.4). CONCLUSION: These baseline data suggest the study population of air medical flight crew was physically fit compared to the average American adult.     

A study on how a 6-month aerobic exercise program can modify coronary risk factors depending on their severity in middle-aged sedentary women

It is well known that physical exercise can reduce coronary risk factors. But how an aerobic exercise modifies coronary risk factors in relation to severity and physical fitness is still controversial. Fifty-four middle-aged women (mean age, 55 years) completed a 6-month on-site and home-based anaerobic threshold-level exercise program. The changes in coronary risk factor profiles were observed during the pre-intervention and intervention periods. Before the intervention (during control period), most coronary risk factors showed a rather unfavorable trend. After the program, their mean body weight decreased from 56.7 to 55.7 kg (p>0.05) and the proportion of body fat from 30.9 to 27.9% (p>0.05) without any reduction in lean body mass. Systolic blood pressure (SBP) decreased from 129.0 to 125.0 mm Hg (p>0.05) and diastolic blood pressure from 79.5 to 76.6 mm Hg (p>0.05). Fasting plasma glucose (FPG) declined from 109.6 to 103.4 mg/dl (p>0.05). Changes in SBP and FPG were most remarkable in their respective worst tertile. Serum lipids improved only modestly. Maximum oxygen uptake increased from 23.6 to 26.1 ml/kg/min (p>0.01). However, no significant correlations were found between changes in coronary risk factors and those in physical fitness. We conclude that the 6-month aerobic exercise program would modify women’s coronary risk factors depending on their initial values, probably independently of the changes in physical fitness.     

16～22岁高身材青少年体质与健康状况分析

目的：研究16～22岁高身材有少年体质与健康状况。方法：以1995年全国学生体质健康调研16～22岁男女青少年114917人为对象,按马丁身高分类标准分成8类,分析其中高身材者体质现状和健康问题。结果：1995年群体中处于马丁6段以上的高身材者比1991年明显增多,达到特高身材（男≥185.0cm,女≥1720cm）的比1991年增加约一倍。高身材青少年中近视和龋齿患病率较高,存在着身体柔韧性院,肌耐力水平低和耐力跑成绩不如其他身高段的现象。结论：高身材青少年并非意味着体质与健康状况有更高的优势,应采取措施促进其健康成长。     

Differential cardiorespiratory response to combined exercise with different combinations of forearm and calf exercise

The purpose of this study was to examine whether cardiorespiratory responses to combined rhythmic exercise (60 contractions · min^–1) was affected by different combinations of upper and lower limb exercise in seven healthy women. Six different rhythmic exercises were compared: 6-min rhythmic handgrip at 10% of isometric maximal voluntary contraction (MVC) (H10); 6-min rhythmic plantar flexion at 10% MVC (P10); exhausting rhythmic handgrip at 50% MVC (H50); exhausting rhythmic plantar flexion at 50% MVC (P50); H50 was added to P10 (P1OH50); and P50 was added to H10 (H10P50). Exercise duration, after handgrip was combined with plantar flexion (P10H50), was shorter than that of H50, although the exercise duration of HIOP50 was not significantly different from P50. No significant difference was found between the difference from rest in oxygen uptake ( O₂) during H10P50 and the sum of O₂ during H10 and P50. Also, the differences from rest in forearm blood flow ( FBF) and calf blood flow ( CBF) during H10P50 were not significantly different from FBF in H10 and from CBF in P50. In contrast, O₂ in P10H50 was lower than the sum of O₂ in P10 and H50 (P < 0.05), and J FBF in P10H50 was lower than that in H50 (P < 0.05) , while CBF was not significantly different between P1OH50 and P10. The changes in heart rate from rest (d HR) during the combined exercises were lower than the sums of HR in the corresponding single exercises (P < 0.05). These results demonstrated an inhibitory summation of several cardiorespiratory responses to combined exercise resulting in a reduction in exercise performance which would seem to occur easily when upperlimb exercise is added to lower limb exercise.     

Contribution of Cardiorespiratory Fitness to the Obesity Paradox

Until recently, cardiorespiratory fitness (CRF) has been overlooked as a potential modifier of the inverse association between obesity and mortality (the so-called obesity paradox), observed in patients with known or suspected cardiovascular (CV) disease. Evidence from five observational cohort studies of 30,104 patients (87% male) with CV disease indicates that CRF significantly alters the obesity paradox. There is general agreement across studies that the obesity paradox persists among patients with low CRF, regardless of whether adiposity is assessed by body mass index, waist circumference, or percentage body fat. However, among patients with high CRF, risk of all-cause mortality is lowest for the overweight category in some, but not all, studies, suggesting that higher levels of fitness may modify the relationship between body fatness and survival in patients manifesting an obesity paradox. Further study is needed to better characterize the joint contribution of CRF and obesity on mortality in diverse populations.     

Effect of long-term physical training on plasma testosterone,androstenedione, luteinizing hormone and sex-hormone-binding globulin capacity

The effect of 6-months' physical training on plasma testosterone, androstenedione and luteinizing hormone levels and the binding capacity of sex-hormone-binding globulin (SHBG capacity) were studied in thirty-nine army recruits. Highly significant increases in mean plasma testosterone (21 %), androstenedione (25%) and LH (25%) were observed during the training period and were associated with a mean 16% increase in the estimated maximal oxygen uptake. The mean increases in hormone levels tended to be greater in the well conditioned group than in the poorly conditioned group. The mean ratio of testosterone to SHBG capacity increased by 32% (P<0.05), which may be in relationship with the various training-induced effects.     

高强度间歇训练与中等强度持续训练对冠心病患者心肺功能影响的Meta分析

背景　冠心病（CHD）是心血管疾病的头号杀手，患病率和发病率一直居高不下，运动作为CHD患者的重要干预手段，一直受到广泛关注。高强度间歇训练（HIIT）与中等强度持续训练（MICT）对于改善CHD患者的心肺功能均显示出有效性，但研究结果尚存争议。因此，选择更合理的运动干预手段，对CHD患者的康复至关重要。目的　探讨HIIT与MICT对CHD患者心肺功能的影响，为CHD患者运动处方的制订提供合理依据。方法　计算机检索PubMed、EMBase、The Cochrane Library、Web of Science、中国生物医学文献数据库（CBM）、中国知网（CNKI）、维普网和万方数据知识服务平台，搜集应用HIIT与MICT干预CHD患者心肺功能的文献，检索时限均为建库至2020年11月。收集第一作者、发表时间、国家、总样本、性别、年龄、运动类型、运动周期、运动频率、运动处方（HIIT、MICT）、结局指标〔峰值摄氧量（VO2peak），无氧阈（VO2AT），最大心率（HRmax），血压（BP），呼吸交换比率（RER），CO2通气当量斜率（VE/VCO2 Slope），静息心率（HRrest）〕等信息，采用Cochrane偏倚风险评估工具对纳入的研究进行方法学质量评估，采用Review Manage 5.3和Stata 15.1软件进行统计学分析。结果　共纳入了12篇文献，其中存在低、中、高风险的研究分别为3篇、8篇和1篇。纳入研究总样本量为618例，其中接受HIIT、MICT干预的样本量分别为305例和313例。Meta分析结果显示：HIIT对VO2peak〔MD=1.63，95%CI（0.64，2.62），P=0.001〕、VO2AT〔MD=2.62，95%CI（0.82，4.42），P=0.004〕、HRmax〔MD=5.41，95%CI（2.28，8.53），P=0.000 7〕、SBP〔MD=3.16，95%CI（0.26，6.06），P=0.03〕的改善效果均优于MICT。两种运动模式对RER〔MD=0.01，95%CI（-0.01，0.03），P=0.27〕、VE/VCO2 Slope〔MD=-0.26，95%CI（-1.87，1.34），P=0.75〕、HRrest〔MD=1.19，95%CI（-0.42，2.80），P=0.15〕、DBP〔MD=2.56，95%CI（-0.21，5.32），P=0.07〕的改善效果比较，差异无统计学意义。亚组分析结果显示，对于干预周期在12周及以上的患者，HIIT对于VO2peak、RER、VO2AT和HRmax的改善效果优于MICT（P<0.05）；而干预周期在12周以下的患者，两种运动模式对于各指标的改善效果比较，差异无统计学意义（P>0.05）。结论　HIIT在改善患者VO2peak、VO2AT、HRmax以及BP方面均优于MICT，且干预周期12周及以上的CHD患者HIIT较MICT改善心肺功能的优势更明显。