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BACKGROUND: The prevalence of ankle sprains in females has higher than in males. A deficit in ankle dorsiflexion range of motion (DFROM) is a substantial contributor to ankle injuries, resulting in hampering exercise performance. Tissue flossing improves joint ROM and enhances performance. However, evidence of how floss band (FB) intervention influences the ankle joint and calf muscle is still lacking, particularly in women. We investigated comparing the effectiveness of FB applied to ankle joint versus calf muscle on exercise performance. METHODS: This study was a randomized, counterbalanced crossover trial. Eighteen recreationally women received functional movements without wrapping FB (WF), movements with wrapping the FB around the ankle joint (FAG), and movements with wrapping the FB around the calf muscle (FCM). Main outcome measures included ankle dorsiflexion range of motion (DFROM), pressure pain threshold (PPT), agility test before and 5 (POST5), 30 (POST30), and 60 (POST60) minutes after each of the three interventions in random order. Two-way repeated measures analysis of variance and effect size (Cohen's d) were statistically analyzed. RESULTS: FAG significantly increased ankle DFROM at POST5 (p = 0.01, d = 0.5), POST30 (p = 0.03, d = 0.48), and POST60 (p = 0.001, d = 0.75). FCM significantly increased at POST30 (p = 0.01, d = 0.35) and POST60 (p = 0.004, d = 0.37). Furthermore, FAG significantly improved agility at POST5 (p < 0.001, d = 0.39), POST30 (p = 0.004, d = 0.44), and POST60 (p = 0.007, d = 0.45); however, FCM only did at POST5 (p = 0.04, d = 0.29). The pressure pain threshold on the calf muscle did not significantly change. CONCLUSIONS: FAG and WF enhance ankle ROM and agility immediately. Moreover, FAG demonstrates a prolonged effect of agility for 1 h. Practitioners may take this information into account for choosing efficient applications.

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BACKGROUND: Current healthcare trends emphasize the use of shared decision-making (SDM) for renal replacement treatment (RRT) in patients with chronic kidney disease (CKD). This is crucial to understand the relationship between SDM and illness perception of CKD patients. Few studies have focused on SDM and illness perception status of CKD patients and the impact of illness perception on RRT after SDM. METHODS: In this cross-sectional study, we used a questionnaire with purposive sampling from March 2019 to February 2020 at the nephrology outpatient department of a medical center in southern Taiwan. The nephrology medical team in this study used the SHARE five-step model of SDM to communicate with the patients about RRT and Brief Illness Perception Questionnaire (BIPQ) was applied to evaluate illness perception of these patients at the beginning of SDM. According to the SDM decision time, the study participants were classified general and delayed SDM groups. The distribution between SDM groups was estimated using independent two sample t-test, chi-squared test or Fisher's exact test. The correlation between illness perception and SDM decision time were illustrated and evaluated using Spearman's correlation test. A p-value less than 0.05 is statistically significant. RESULTS: A total of 75 patients were enrolled in this study. The average time to make a dialysis decision after initiating SDM was 166.2 ± 178.1 days. 51 patients were classified as general group, and 24 patients were classified as delayed group. The median SDM decision time of delayed group were significantly longer than general group (56 vs. 361 days, P < 0.001). Our findings revealed that delayed group was significantly characterized with not created early surgical assess (delayed vs. general: 66.7% vs. 27.5%, p = 0.001) compared to general group. The average BIPQ score was 54.0 ± 8.1 in our study. We classified the patients into high and low illness perception group according to the median score of BIPQ. The total score of BIPQ in overall participants might increase by the SDM decision time (rho = 0.83, p = 0.830) and the linear regression line also showed consistent trends between BIPQ and SDM decision time in correspond cohorts. However, no statistically significant findings were found. CONCLUSIONS: The patients with advanced chronic kidney disease took an average of five and a half months to make a RRT decision after undergoing SDM. Although there is no statistical significance, the trend of illness perception seems correlated with decision-making time. The stronger the illness perception, the longer the decision-making time. Furthermore, shorter decision times may be associated with earlier establishment of surgical access. We need more research exploring the relationship between illness perception and SDM for RRT in CKD patients.

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Flexibility, specifically that in the amplitude of sagittal-plane range of motion (ROM), can improve jump landing patterns and reduce the potential for sports injury. The use of floss bands (FLOSS) reportedly increases joint range of motion (ROM) in the shoulder, ankle, and elbow joints. However, little research on the effectiveness of FLOSS on the knee joint has been conducted. This study investigated the effects of FLOSS on knee ROM, static balance, single-leg-hop distance, and landing stabilization performance in women. This study had a crossover design. Twenty active female college students without musculoskeletal disorders were randomly assigned to receive a FLOSS intervention or elastic bandage (ELA) control on their dominant knees. The participants underwent FLOSS and ELA activities on two occasions with 48 h of rest between both sets of activities. The outcomes were flexibility of the quadriceps and hamstrings, how long one could maintain a single-leg stance (with and without eyes closed), distance on a single-leg triple hop, and score on the Landing Error Scoring System (LESS); these outcomes were evaluated at preintervention and postintervention (immediately following band removal and 20 min later). After the FLOSS intervention, the participants' hamstring flexibility improved significantly (immediately after: p = 0.001; 20 min later: p = 0.002), but their quadricep flexibility did not. In addition, FLOSS use did not result in worse single-leg stance timing, single-leg triple-hop distance, or landing stabilization performance relative to ELA use. Compared with the ELA control, the FLOSS intervention yielded significantly better LESS at 20 min postintervention (p = 0.032), suggesting that tissue flossing can improve landing stability. In conclusion, the application of FLOSS to the knee improves hamstring flexibility without impeding static balance, and improves single-leg hop distance and landing stabilization performance in women for up to 20 min. Our findings elucidate the effects of tissue flossing on the knee joint and may serve as a reference for physiotherapists or athletic professionals in athletic practice settings.

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This study investigated the effects of home-based nutritional and telemedicine-based resistance exercise interventions on improving body composition, blood biochemistry, and lower-limb functional performance. In total, 66 obese patients with mild-to-moderate knee osteoarthritis were randomly divided into a diet control group (D), elastic band resistance exercise group (E), and diet control plus elastic band exercise group (D + E). Each group was supervised by a clinical dietitian and follow-up was conducted via telephone calls or a communication application to track the participants' progress. After 12 weeks of intervention, the D (p < 0.001) and D + E (p < 0.001) groups achieved significant weight loss. The D + E group exhibited a significant reduction in body fat relative to the D (p = 0.019) and E (p = 0.012) groups. Compared with the D (p = 0.002) and E (p = 0.019) groups, the D + E group achieved significant improvements in the timed up-and-go test and Western Ontario and McMaster Universities Osteoarthritis total scale. The D + E group experienced significant improvements in total cholesterol (p = 0.001), low-density lipoprotein cholesterol (p = 0.01), and triglyceride levels (p = 0.007) relative to other groups. In conclusion, individual diet control intervention combined with telemedicine-based resistance exercise intervention significantly improved the body composition, blood biochemistry, and lower-limb functional performance of the investigated population with comorbid conditions.

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The transition from traditional handover methods to electronic handover is extremely stressful to nurses. This psychometric evaluation study tested the validity and reliability of the perception and adaptation readiness of electronic handover system scales for hospital nurses. A total of 253 Taiwanese nurses from a medical center participated in this study from January to March 2018. The perception and adaptation readiness of electronic handover system scales were self-developed, and content validity was tested via content validity index of the scale. Exploratory factor analysis and confirmatory factor analysis were utilized to test construct validity, while reliability was tested by Cronbach's α coefficient. Four factors explained 50.77% of the total variance in the perception of electronic handover system scale. Three factors accounted for 53.43% of the total variance in the adaptation readiness of electronic handover system scale. The confirmatory factor analysis results indicated a three-factor construct for both scales. Cronbach's α coefficients were 0.83 and 0.91 for the perception and adaptation readiness of the electronic handover system scale, respectively. The scales could be used to assess nurses' perceptions and adaptation readiness of electronic handover, while the assessing result serves as a reference for implementing educational and supportive interventions to facilitate adaptation in nurses.

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Whether the implementation of feasible, equipment-free, and simple core exercises in warm-up routines in physical education classes for school-aged children is beneficial remains unclear. Therefore, this study investigated the effects of a core conditioning in the warm-up routine of physical education classes on trunk muscular endurance, movement capability, and flexibility in this population. In these pre- and post-test control group experiments, 52 healthy, school-aged children (aged 10-11 years) were cluster randomized allocated to either the dynamic core exercise (DCE) group or general physical education (GPE) group. The DCE group performed a 10-min core exercise routine twice per week for six consecutive weeks; the GPE group performed traditional physical education warm-up exercises regularly. The children were assessed by conducting the trunk muscular endurance test (i.e., dynamic curl-up, static curl-up, plank, and lateral plank), functional movement screen (FMS), and single-leg balance test before and after the intervention. At the end of the intervention, the DCE group demonstrated a significant effect on trunk muscular endurance, movement capability (i.e., FMS scores), flexibility, and balance (each p < 0.001, effect size: 0.38-1.3). Furthermore, the DCE group showed significant improvements in all outcome measurements compared with the GPE group (p < 0.05, effect size: 0.29-1.68). These data may provide a reference for incorporating additional core stability exercises in the warm-up routine of physical education classes in school-aged children in the future.

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CONTEXT: Warm-up exercise is an essential preexercise routine for athletes to optimize performance. However, the benefits of combined warm-up protocols remain unclear. OBJECTIVE: This comparative study investigated the acute effects of dynamic stretching (DS) followed by static stretching (SS), self-myofascial release using a foam rolling (FR) device, or vibration foam rolling (VFR) as a warm-up exercise to improve flexibility, power, agility, and specific skills in elite table tennis players. DESIGN: A crossover study. SETTING: University. PARTICIPANTS: Twenty-three elite table tennis players. INTERVENTIONS: Players completed 3 different interventions in a random order (DS + SS, DS + FR, and DS + VFR). The target muscle groups included the bilateral posterior calf, posterior thigh, anterior thigh, back, and shoulder. MAIN OUTCOME MEASURES: Sit-and-reach test for flexibility, board jump test for lower-extremity power, medicine ball throw test for upper-extremity power, Edgren Side Step Test for agility, and ball speed of table tennis was assessed before and after intervention. RESULTS: After intervention, significant increases in flexibility (15.2%, 20.4%, and 23.8%); lower-limb power (4.5%, 6.6%, and 6.3%); upper-limb power (9.6%, 8.5%, and 9.1%); and ball speed (7.4%, 7.6%, and 7.7%) were observed for DS + SS, DS + FR, and DS + VFR, respectively (all P < .001). In addition, only DS coupled with FR (5.1%) and DS in conjunction with VFR (2.7%) significantly improved agility (P < .001). However, no significant improvements in agility were observed after DS + SS. In addition, no one protocol was superior to the other in all outcomes. CONCLUSION: The authors suggest that a combination of DS with FR or VFR as warm-up exercises significantly improved flexibility, power, ball speed, in addition to agility in elite table tennis players. Coach and athletic professionals may take this information into account for choosing more effective warm-up protocols to enhance performance.

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Dynamic stretching (DS) is performed to increase sports performance and is also used primarily for transiently increasing range of motion (ROM). Recently, vibration foam rolling (VFR) has emerged. Its underlying concept is that it combines foam rolling techniques with local vibration to improve ROM and muscular activation concurrently. This crossover study investigated the effects of DS or DS followed by VFR (DS + VFR) during warm-ups on flexibility, muscle stiffness, power, and agility of the lower limbs in badminton athletes. Forty badminton players performed DS or DS + VFR as warm-up exercises on two occasions in a randomized order. The target muscle groups were the bilateral shoulder, anterior and posterior thigh, posterior calf, and lower back. Main outcome measures: The primary outcome was knee range of motion (ROM), and the secondary outcomes were muscle stiffness, lower limb power (countermovement jump [CMJ]), and agility. Results indicated that the protocols improved performance. DS increased knee flexion ROM (% change = 1.92, ES = 0.3, p = 0.033), CMJ height (% change = 5.04, ES = 0.2, p = 0.004), and agility (% change = -4.97, ES = 0.4, p < 0.001) but increased quadriceps muscle stiffness (% change = 3.74, ES = 0.3, p = 0.001) and increased gastrocnemius muscle stiffness (% change = 10.39, ES = 0.5, p = 0.001). DS + VFR increased knee extension ROM (% change =2.87, ES = 0.4, p = 0.003), reduced quadriceps muscle stiffness (% change = -2.79, ES = 0.3, p = 0.017), CMJ height (% change = 2.41, ES = 0.1, p = 0.037), and agility (% change = -4.74, ES = 0.2, p < 0.001). DS + VFR was not significantly superior to DS, except for muscle stiffness reduction. Taken together, we suggest that practitioners consider DS as a first line of warm-up exercise to increase ROM, CMJ height, and agility in athletes. Moreover, the addition of VFR to DS results in a large reduction of muscle stiffness, potentially reducing the risk of sports injury. Athletes, coaches and athletic professionals may consider them when selecting effective warm-up practices to augment athletic performance.

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Vibration rolling (VR) has emerged as a self-myofascial release (SMR) tool to aid exercise performance when warming up. However, the benefits of VR on exercise performance when combined with dynamic muscle contraction are unclear. The purpose of this study was to investigate the immediate effects of the combination of VR with dynamic muscle contraction (DVR), VR, and static stretching (SS) during warm-up on range of motion (ROM), proprioception, muscle strength of the ankle, and agility in young adults. In this crossover design study, 20 recreationally active adults without musculoskeletal disorders completed three test sessions in a randomized order, with 48 h of rest between each session. Participants completed one warm-up intervention and its measurements on the same day; different warm-up interventions and measurements were performed on each of the three days. The measurements included ankle dorsiflexion and plantarflexion ROM, ankle joint proprioception, muscle strength, and agility. After DVR and VR intervention, ankle dorsiflexion ROM (both DVR and VR, p < 0.001), plantarflexion ROM (both DVR and VR, p < 0.001), plantar flexor muscle strength (DVR, p = 0.007; VR, p < 0.001), and agility (DVR, p = 0.016; VR, p = 0.007) significantly improved; after SS intervention, ankle dorsiflexion and plantar flexion ROM (dorsiflexion, p < 0.001; plantar flexion, p = 0.009) significantly improved, but muscle strength and agility were not enhanced. Compared with SS, DVR and VR significantly improved ankle plantar flexor muscle strength (p = 0.008 and p = 0.001, respectively). Furthermore, DVR significantly improved ankle dorsiflexion compared with VR (p < 0.001) and SS (p < 0.001). In conclusion, either DVR, VR, or SS increased ankle ROM, but only DVR and VR increased muscle strength and agility. In addition, DVR produced considerable increases in ankle dorsiflexion. These findings may have implications for warm-up prescription and implementation in both rehabilitative and athletic practice settings.

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Pneumonia leads to changes in body composition and weakness due to the malnourished condition. In addition, patient family caregivers always have a lack of nutritional information, and they do not know how to manage patients' nutritional intake during hospitalization and after discharge. Most intervention studies aim to provide nutritional support for older patients. However, whether long-term nutritional intervention by dietitians and caregivers from patients' families exert clinical effects-particularly in malnourished pneumonia-on nutritional status and readmission rate at each interventional phase, from hospitalization to postdischarge, remains unclear. To investigate the effects of an individualized nutritional intervention program (iNIP) on nutritional status and readmission rate in older adults with pneumonia during hospitalization and three and six months after discharge. Eighty-two malnourished older adults with a primary diagnosis of pneumonia participated. Patients were randomly allocated to either a nutrition intervention (NI) group or a standard care (SC) group. Participants in the NI group received an iNIP according to energy and protein intake requirements in addition to dietary advice based on face-to-face interviews with their family caregivers during hospitalization. After discharge, phone calls were adopted for prescribing iNIPs. Anthropometry (i.e., body mass index, limb circumference, and subcutaneous fat thickness), blood parameters (i.e., albumin and total lymphocyte count), hospital stay, Mini-Nutritional Assessment-Short Form (MNA-SF) score, target daily calorie intake, total calorie intake adherence rate, and three-major-nutrient intakes were assessed during hospitalization and three and six months after discharge. Both groups received regular follow-up through phone calls. Furthermore, the rate of readmission resulting from pneumonia was recorded after discharge. During hospital stay, the NI group showed significant increases in daily calorie intake, total calorie intake adherence rate, and protein intake compared with the SC group (p < 0.05); however, no significant difference was found in anthropometry, blood biochemical values, MNA-SF scores, and hospital stay. At three and six months after discharge, the NI group showed significantly higher daily calorie intake and MNA-SF scores (8.2 vs. 6.5 scores at three months; 9.3 vs. 7.6 scores at six months) than did the SC group (p < 0.05). After adjusting for sex, the readmission rate for pneumonia significantly decreased by 77% in the NI group compared with that in the SC group (p = 0.03, OR: 0.228, 95% CI: 0.06-0.87). A six-month iNIP under dietitian and patient family nutritional support for malnourished older adults with pneumonia can significantly improve their nutritional status and reduce the readmission rate.

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An effective patient transfer, or handover, among healthcare professionals can help prevent communication-related medical errors, and a reliable electronic handover informatics system can standardize the handoff process. Adapting to a new handover system may cause stress for nurses. This descriptive qualitative study aimed to explore the perceptions and transition experiences of hospital nurses in adopting and adapting to a new handover informatics system. Thirty-eight nurses at a medical center in Taiwan participated in the study from December 2016 to January 2017. The researcher conducted five focus group interviews and analyzed all responses using content analysis. Results showed three major themes: "Perceptions of challenges and barriers related to the transition to a new handover informatics system," "Perceptions of benefits and strategies to the transition to a new handover informatics system," and "Suggestions for successful implementation of a new handover informatics system." Five subthemes emerged from the first theme, and six subthemes emerged from the second theme. The results of this study could enhance our understanding of nurses' perceptions and experiences with transition to a new handover informatics system and could provide a reference for hospitals to develop individualized strategies to facilitate the implementation of a handover informatics system.

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OBJECTIVES: The aim of this study was to explore the effects of laser acupuncture on improvement of recovery and muscle performance in delayed muscle soreness (DOMS) when applied before exercise. METHODS: This randomized, blinded, and controlled study included healthy participants (n = 40) who were randomized into laser acupuncture and placebo groups. Laser acupuncture was applied to the Tianquan (PC2) and Chihtseh acupoints (LU5) at a dose of 36 J and energy density of 9.7 J/cm2 before inducing DOMS. The placebo group received sham laser acupuncture with no laser output. Visual analog scale (VAS), proprioception, pressure pain threshold (PPT), arm circumference, and muscle strength were observed at the baseline and 24, 48, 72, and 96 h after induction of DOMS. RESULTS: Significant changes in the VAS (F4, 43.96 = 31.47; p = 0.001), PPT (F4, 1.35 = 35.07; p = 0.001), normalized arm circumference (F4, 0.001 = 3.87; p = 0.005), and normalized muscle strength (F4, 0.31 = 24.99; p = 0.001) were observed within the groups over time (p < 0.05), but there were no significant differences between the two groups (p > 0.05). Normalized arm circumference was significantly different between the two groups at 48 and 72 h after induction of DOMS (p < 0.05). CONCLUSION: Photobiomodulation therapy on Tianquan (PC2) and Chihtseh acupoints (LU5) before the exercise did not significantly decrease DOMS and increase muscle performance. Laser acupuncture as a supplemental therapy seemed to have no effect on DOMS prevention.

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BACKGROUND & PROBLEMS: In recent years, improved mobile capacities and mobile-device computing capabilities as well as a maturing mobile-communications infrastructure have combined to promote the development and widespread use of mobile healthcare applications. Mobile healthcare supports the self-management of chronic diseases, enhances healthcare quality, and reduces medical costs. Due to the low rate of iCKD usage in our hospital, we set up a project team that was tasked to improve the rate of iCKD usage among chronic disease patients. PURPOSE: To improve the iCKD usage rate from the current 5.8% to 9.3%. RESOLUTIONS: Questionnaire-based survey results indicated that the main reasons for the low iCKD usage rate in our hospital were: negative attitudes toward iCKD as a helpful tool in disease management, lack of awareness of the importance of using iCKD, unfamiliarity with how to operate smartphone applications, low numbers of iCKD physician referrals for patients, and slow Internet speeds. The improvement strategy included providing instructions on iCKD use, organizing a practical learning program, designing and printing a mobile healthcare referral form, and holding related events. RESULTS: The rate of iCKD usage increased to 21.3% after the intervention. CONCLUSIONS: The project team successfully increased the iCKD usage rate by getting more patients involved in mobile healthcare, which is expected to have a positive impact on the success of patient self-management.

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Warm-up is an essential component for optimizing performance before an exercise session. This study investigated that the immediate effects of vibration rolling (VR), nonvibration rolling (NVR), and static stretching as a part of a warm-up regimen on the flexibility, knee joint proprioception, muscle strength, and dynamic balance of the lower extremity in young adults. Compared with the preintervention, VR induced the range of motion of knee flexion and extension significantly increased by 2.5% and 6%, respectively, and isokinetic peak torque and dynamic balance for muscle strength and dynamic balance increased by 33%-35% and 1.5%, respectively. In the three conditions, most outcomes between VR and NVR were comparable; however, the participants had a significantly higher knee joint reposition error after NVR than after VR, indicating that NVR would have a hampering knee joint proprioception effect. In particular, compared with static stretching, VR significantly increased the quadriceps muscle strength by 2-fold and dynamic balance by 1.8-fold. These findings suggest that athletic professionals may take VR into account for designing more efficient and effective preperformance routine to improve exercise performances. VR has high potential to translate into an on-field practical application.

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PURPOSE: This study aimed to examine the effects of two exercise regimes on physiological and postprandial lipemic responses. METHODS: Thirty-six active men (peak oxygen uptake [V˙O2peak], 46.5 ± 6.4 mL·kg·min) were randomly assigned to a high-intensity interval exercise (HIIE), involving 10 × 60 s cycling at 85% V˙O2peak interspersed with 120 s recovery; a moderate-intensity continuous exercise (MICE), involving 50 min continuous exercise at 65% V˙O2peak; and a nonexercise control (Con). In the next morning after evening exercising, fasting blood samples were obtained. Additional blood samples were obtained 1-4 h after eating a given high-fat meal that based on participants' body mass. Carbohydrate and fat oxidation rates were measured before and after the meal. RESULTS: After exercise, glucose and insulin concentrations decreased by 33% and 70% in MICE compared with those in HIIE (P = 0.00-0.03). During the 1- to 2-h postprandial periods, the fat oxidation rate increased by 24%-37% in HIIE that that in MICE and Con (P = 0.01-0.03); however, the carbohydrate oxidation rate was not significantly different among the conditions (P = 0.28). During the postprandial period, insulin (P = 0.02-0.04) and triglyceride (P = 0.02-0.03) concentrations were lower in HIIE than those in MICE and Con. No difference was observed in free fatty acid or the total areas under the curve of triglyceride and free fatty acid among the conditions (P = 0.24-0.98). CONCLUSION: Acute MICE improved glucose and insulin metabolism immediately after exercise. However, HIIE performed in the evening exerts more favorable effects than MICE for decreasing postprandial insulin and triglyceride levels and increasing fat oxidation in the next morning.

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BACKGROUND/OBJECTIVE: Although the functional movement screen (FMS) has been widely applied for screening athletes, no previous study has used FMS scores to examine the association between distinct training seasons in high school baseball players. The aims of this study were to ascertain the functional movement screen (FMS) scores differences between the preparative period (PPP) and the competitive period (CPP) among high school baseball players and further determine whether FMS can be used as a tool to predict injuries during two major periods. METHODS: Fifty-five male high school baseball players (age 15.3 ±â€¯1.7 years; height 1.7 ±â€¯0.8 m; weight 64.6 ±â€¯11.5 kg) volunteered. Athletic injuries were reported through a self-report questionnaire. Players performed the FMS during the PPP and the CPP. A receiver operator characteristic (ROC) curve to calculate a cutoff total composite score ≤ 14 for the relationship between the FMS score and injury. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and an area under the curve (AUC) were calculated. RESULTS: FMS individual task score and total composite score were significantly lower in the CPP than in the PPP. However, a cutoff total composite score ≤14 for risk of injury, determined through a ROC curve, represented a low sensitivity of 58%, NPV of 66%, an AUC of 69%, specificity of 79%, and PPV of 71%. CONCLUSION: Although the low sensitivity and NPV and AUC scores indicated that the FMS does not accurately predict the risk of injury, the FMS individual task and total composite scores differed significantly between the PPP and CPP. Therefore, FMS could be used as a tool to identify physical deficiencies between distinct training seasons; however, utilizing the FMS as a screening tool for injury prediction in particular during the CPP in this population would not be recommended.

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Inter-professional practice (IPP), necessary in today's healthcare environment, should be guided and practiced through inter-professional education (IPE). Within the context of an effective IPE program, collaborative medical professionals must be cognizant of the demands of patients' integrated care, organize a collaborative inter-professional team, and achieve the objectives of patient-centered care. However, the many challenges of IPE include insufficient understanding of inter-professional care, occupational culture-related boundary issues, lack of a college education, and insufficient support from academic and medical institutions. This article suggests adopting effective strategies to promote inter-professional recognition, create a harmonious medical culture, eliminate barriers to education, and enhance support for academic and medical institutions. Inter-professional collaboration between academic and clinical institutions must provide resources and substantive professional training. Effectively implementing IPE and IPP is expected to elicit trust, respect, and efficient communication from team members.

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PURPOSE: This study aimed to determine how high-intensity interval training (HIIT) protocols featuring matched times but distinct sprint durations affect cardiorespiratory and metabolic responses and performance. METHODS: Thirty-eight recreationally active men (age 21 ± 2 yr) were assigned to one of three interval training groups: long-duration high-intensity (HIIT60s; 8 × 60 s at 85%-90% V˙O2max; 120-s recovery at 30% V˙O2max), short-duration high-intensity (HIIT10s; 48 × 10 s at 85%-90% V˙O2max; 20-s recovery at 30% V˙O2max), and control (regular physical activity without HIIT). Before and after a 4-wk training period (three sessions per week), participants performed graded exercise tests and repeated sprint tests, based on which their aerobic and anaerobic capacities were assessed. Skinfold thickness, blood, and metabolic responses were also measured before and after intervention. RESULTS: After the 4-wk training period, V˙O2max was significantly increased (P < 0.01) in HIIT60s (52 ± 9 vs 61 ± 12 mL·kg·min) and HIIT10s (53 ± 10 vs 61 ± 10 mL·kg·min), but there were no changes in the control group (50 ± 7 vs 52 ± 7 mL·kg·min). Skinfold thickness in the abdomen and thigh did not differ significantly among the groups, but a significantly greater decrease in 14%-25% in HIIT60s and a decrease in 20% in HIIT10s after training (P < 0.05) were found. Blood lactate, total cholesterol, triglyceride, cortisol, and insulin concentrations were not significantly different among the three groups (P > 0.05), but testosterone concentration in the HIIT10s was higher after training than before (P < 0.05). CONCLUSION: The higher incremental aerobic performance and lower skinfold thickness in HIIT60s versus HIIT10s reflected similar adaptations, but the higher repeated sprint performance was observed only in responses to HIIT60s, which may elicit greater anaerobic adaptations.

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BACKGROUND: Weekly training volumes for triathlete are typically higher and may cause fatigue and musculoskeletal injury risk. High-intensity interval training (HIT) is a potent time-efficient strategy to induce adaptations normally associated with traditional endurance training. Therefore, the aim of this study was to investigate the effect of two weeks of in-season HIT on exercise capacity and hormonal responses in young triathletes. METHODS: Twelve adolescent triathletes performed 18 sessions of HIT over 2 weeks including swim, cycle, and run events. The 6-day training blocks were separated by 1 day of recovery. Pre- and post-training, peak oxygen uptake (VO2peak) and exercise performance were assessed, and blood samples were obtained to detect changes in hormone and metabolite levels. RESULTS: VO2peak was significantly higher (P=0.02) post-training (56.4±8.1 mL·min-1·kg-1) versus pre-training (55.1±7.5 mL·min-1·kg-1). Mean power and total work during 6×10 s repeated-sprint tests significantly increased (P=0.03) after HIT. Additionally, 750 m swim time (pre- vs. post: 689.7±102.5 s vs. 662.0±75 s, P=0.01) and 20 km cycling time (pre- vs. post: 1856.6±274.8 s vs. 1705.4±266.8 s, P=0.02) were significantly lower post-training compared to pre-training, but there was no significant difference in 5 km run time after HIT (pre- vs. post: 1315.8±81.3 s vs. 1292.0±112.9 s, P=0.31). In contrast to pre-training, ammonia concentration was significantly increased (P<0.01) and creatine kinase concentration was significantly decreased (P=0.02) post-training. CONCLUSIONS: These findings suggest that two weeks of HIT using HRpeak as a monitor of physiological intensity improved VO2peak, sprint performance, and triathlon-specific performance in adolescent triathletes and attenuated levels of muscle damage.

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Purpose. To conduct a meta-analysis and systematic review examining whether Tai Chi Chuan could have mental and physical benefits for patients with knee osteoarthritis. Methods. MEDLINE, PUBMED, EMBASE, and CINAHL databases were searched for relevant studies. Data of the studies were collected, and outcomes were classified using the International Classification of Functioning, Disability, and Health model. Effect sizes of the mental and physical components were determined, along with the recommendation grades of Philadelphia Panel Classification System for Tai Chi Chuan on knee osteoarthritis. Results. Eleven studies were selected and retrieved from the databases. The results of meta-analysis revealed that the effects of Tai Chi Chuan were observed for physical components in the body functions and structures domain. The effects favoring Tai Chi Chuan were observed in the physical component in the activities and participation domain. Insufficient data was included in the meta-analysis of the mental component. Conclusions. The review revealed that Tai Chi Chuan had beneficial outcomes for patients with knee osteoarthritis. The evidence-based results represented that it had small-to-moderate effects on body functions and structures, activities, and participation of physical component. However, there was insufficient evidence to support that Tai Chi Chuan had beneficial mental effect.