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Aims: Cardiovascular disease (CVD) is the leading cause of mortality in patients with end‐stage renal disease (ESRD) receiving maintenance haemodialysis treatment. This study investigated the effect of a 12‐week intradialytic progressive resistance training (PRT) intervention on pulse wave velocity (PWV) and associated haemodynamic, anthropometric, and hematologic outcomes in patients with ESRD. Methods: Twenty‐two patients with ESRD (59% men, 71.3 ± 11.0 years) were recruited. Supervised PRT (three sets of 11 exercises) was prescribed three times per week during routine dialysis. The primary outcome was brachial‐ankle PWV via applanation tonometry. Secondary outcomes included augmentation index, brachial and aortic blood pressures, endothelial progenitor cells, C‐reactive protein, blood lipids and anthropometrics. Results: The intradialytic PRT regimen resulted in no significant change in PWV between control and intervention periods [mean difference = 0 (95% CI = −0.1 to 0.1); P = 0.58]. Similarly, no significant change was noted in any secondary outcome measures between the control and intervention periods. Post‐hoc analyses limited to high adherers (≥75% attendance; n = 11) did not differ from the primary analysis, indicating no dose–response effect of our intervention. Conclusion: Our 12‐week PRT intervention did not change PWV or any secondary outcomes. Future studies should determine if higher dosages of intradialytic PRT (i.e. longer duration and/or higher intensity) can be applied as a method to improve arterial stiffness to potentially reduce cardiovascular disease and associated mortality this cohort. Summary at a Glance: This crossover study examined the effects of a 12‐week supervised progressive resistance training intervention in 22 haemodialysis patients. No changes were found in brachial‐ankle pulse wave velocity or any of the secondary outcomes. [ABSTRACT FROM AUTHOR]

Introduction This study assessed the feasibility and efficacy of a novel resistance training device used within an intradialytic progressive resistance training (PRT) intervention. Methods Non-randomized, within-subjects crossover design with outcomes assessed at baseline (week 0), postcontrol (week 13) and post-PRT intervention (week 26). Twenty-two hemodialysis patients (59% men, 71 ± 11 years) performed PRT three sessions per week for 12 weeks. The resistance training device was developed to enable the performance of 2 upper body and 3 lower body exercises, unilaterally and bilaterally, both before and during dialysis, with loads of 2.5 to 59 kg. Feasibility outcomes included adverse events, adherence and training load progression. Changes in upper and lower body muscular strength, six-minute walk, aspects of health-related quality of life (HRQoL) and depression were evaluated. Findings The PRT intervention was delivered without serious adverse events, resulted in 71.2% ± 23.3% adherence and significant adaptation of all training loads from pre to mid to post training (83.8%-185.6%, all P < 0.05). Lower body strength (P < 0.001) and HRQoL subscales (Role-Physical, Social Functioning, Role-Emotional) significantly increased (all P < 0.01) and a trend toward reduced depression was noted (P = 0.06). No significant changes were noted in other outcomes. Discussion PRT using the novel resistance training device was feasible and improved measures of physical and psychological health. This device can be utilized in most dialysis centers. Future studies are required to evaluate dose-response effects of PRT prescriptions in subpopulations, and the translation of PRT to standard dialysis practice. [ABSTRACT FROM AUTHOR]

Fish passage barriers at road-stream crossings are widely recognized as salmon spp. habitat restoration priorities in Washington State and throughout the Pacific Northwest of the USA. More than 3,500 fish passage barriers (mostly culverts) have been repaired in Washington streams since 1999, costing more than US$139 million. We evaluated fish passage at 77 randomly selected culverts (new and repaired) that were issued permits during three time periods (1998, 2003, and 2007). This sample represents approximately 85% of the fish passage culverts permitted in the Puget Sound region of Washington State during the last 10 years. All study culverts were permitted for fish passage under the Washington Department of Fish and Wildlife's (WDFW) hydraulic project approval (HPA) permitting process and evaluated using physical criteria in the WDFW's fish passage barrier standard. Our results indicate that 30% of culverts (23 of 77) permitted under the HPA process for fish passage were, in fact, barriers. Culverts permitted as no-slope (one of the most common design types) or as an unknown design type were barriers in 45% of cases. Most culvert failures were due to noncompliance with permit provisions, particularly culvert slope, and a lack of critical evaluation of proposed plans in the context of site conditions by permitting biologists. We found no relationship between barrier status and permit date, experience of permitting biologists, quality of permit, or project sponsor type (private, public, or restoration entity). These results indicate the need for mechanisms to ensure better compliance from project sponsors and an improved process to critically evaluate the adequacy of proposed plans in the context of project site conditions. [ABSTRACT FROM AUTHOR]

This article reviews the literature addressing exercise programs for dialysis patients to identify elements necessary for sustaining exercise programs in this population. Literature searches for publications (January 1980–February 2009) in Medline (OVID), PubMed, CINAHL (EBSCO), EBSCOhost EJS, ProQuest Central, Web of Science, Cochrane Library, Google Scholar, ScienceDirect, SpringerLink (Kluwer), and Wiley Interscience (Blackwell) were performed. Reference lists from relevant articles were hand-searched for further publications. Criteria for inclusion included full-text primary research and review articles focused on exercise for adult hemodialysis patients. One hundred and seventy one publications were found with a primary focus on exercise in hemodialysis. Of these, 28 primary research and 14 review articles addressed one or more aspects of sustainability of hemodialysis exercise programs. Factors contributing to sustainable exercise programs included: dedicated exercise professionals; encouragement to exercise intradialytically; dialysis and medical staff commitment; adequate physical requirements of equipment and space; interesting and stimulating; cost implications need to be addressed; exercise is not for everyone; requires individual prescription; and there is no age barrier to exercise on hemodialysis. [ABSTRACT FROM AUTHOR]