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Prebiotics are a class of functional foods which target beneficial microbial species of the gut to benefit host health. They consist of dietary fibres which, after ingestion, are degraded and fermented by microorganisms in the colon. Arabinoxylan (AX) is an important member of the prebiotic family. This non-digestible fibre is commonly found in cereal grains such as wheat and rice. Human in vivo studies have demonstrated that consumption of various species of AXs has profound effects on gut microorganisms. AX exists in different structures across cereal types. Structural differences of AXs impact their cleavage, degradation, and fermentation by gut microbiota. However, this structural diversity also makes it difficult to compare and contrast studies of different AXs. Nevertheless, common bacterial targets of prebiotics across all AX structures include Bifidobacterium spp. and Lactobacillus spp., which are both beneficial to human health. Existing research on AXs has primarily focused on wheat derived AX. As the structure of rice AXs varies significantly from that of wheat AXs, more research is needed on the effects of rice AXs on gut microbiota. This narrative review synthesises the current understandings of how prebiotic AX affects gut microbiota and its implications for human health.

Introduction Levels of physical activity and health status are substantially influenced during the early adulthood years. The purpose of this research was to evaluate the health and physical activity characteristics of undergraduate paramedic and nursing students. Methods This research comprised a descriptive and inter-discipline survey of a sample of university students enrolled in healthcare programs. The health status and physical activity patterns of paramedic and nursing undergraduate students were assessed using the 36-item Short Form Health Survey (SF-36) and the International Physical Activity Questionnaire (IPAQ), respectively. Statistical comparisons for health status — total, eight health dimensions and weekly metabolic equivalent were performed. Results A total of 226 undergraduate students were surveyed with 66.4% enrolled in the paramedic, 17.7% in the nursing, and 15.9% enrolled in the double degree nursing/paramedic Bachelor programs. Results for the SF-36 total show a significant difference in health status between the undergraduate programs (p=0.001). Reduced health dimensions were also revealed among first year students. Results for the IPAQ shows a significant difference in physical activity between the programs (p=0.03). Comparison between IPAQ and year of study show a significant difference between groups (p=0.03). Conclusion Substantially reduced health status and physical activity patterns were shown in nursing students compared to paramedic students and among first year university undergraduates. This research highlights the need to further investigate the health status and physical activity patterns within university healthcare students.

Introduction Rice bran arabinoxylan compound (RBAC) is a nutraceutical for enhancing a depleted immune system during and after cancer treatment. This pilot feasibility trial aims to evaluate the effects of RBAC on cancer patients' quality of life during active treatment, compared to placebo, using a validated questionnaire. Other outcome measures include changes in inflammatory and nutritional status, cytokine profile, and gut microbiota. Methods/Design The study will recruit 50 participants from a regional cancer center in Australia. Patients aged 18–70, diagnosed with solid organ cancers stage II and above, and currently undergoing active systemic therapies, are eligible. Random allocation of participants into two groups is stratified based on metastatic status and treatment type. The dosage is either 3 g/day of RBAC or placebo in identical packaging. The participants, study coordinator, and treating oncologists are blinded to the interventions. Data collections are at baseline and at four follow-up sessions, which are six weeks apart (24 weeks). Statistical analysis will involve a protected p-value with multiple dependent values and analyzed by ANOVA with repeated measures on the occasion of testing and with both a full Bonferroni or Sidak corrections applied to protect against Type I errors. Any observed significance warrants further analysis with pairwise comparisons. Analysis of covariance will also be performed to assess any influence of the demographic data, cancer diagnosis, as well as changes in physical activity, dietary habits, and complementary medicine usage. Comparisons of gut microbiota will be based on the analysis of the fecal microbiome using 16S ribosomal ribonucleic acid amplicon sequencing. The proposed research timeline is from October 2018 to May 2022. Trial registration ANZCTR. Reg No: ACTRN12619000562178p.

IntroductionParamedics are mobile health care workers who respond to trauma and medical emergencies. Worldwide, paramedics exhibit disturbingly high rates of injury and illness with increased markers of poor health, such as obesity and hypertension, being common. The primary aim of this study was to explore the self-reported health status of paramedics in New South Wales, Australia, by gender and geographic rostering pattern and to compare it with that of the Australian general population. A secondary aim was to examine paramedics’ attitudes towards exercise.MethodsIn 2015, paramedics employed by NSW Ambulance were invited to complete a web-based survey which composed of the Medical Outcomes Survey Short Form 36 (SF-36), and measures of attitudes towards exercise. Demographic information and participants’ height and weight (for calculating Body Mass Index (BMI)) were also collected. Normative comparator data for the Australian general population (BMI and SF-36 scores) were sourced from the Household Income Labour Dynamics in Australia 2015 survey.ResultsOf the approximately 3,300 paramedics invited to participate, 747 completed the survey (507 male, 240 female). Mean age and mean years of service were 41.5 ±9.5 (SD) and 13.6 ±9.0 respectively. There were no differences in SF-36 scores except for the Vitality domain where males scored higher than females (p2 ± 3.99 vs. 26.81 kg/m2 ± 4.67, p = 0.001). Compared to the Australian population, paramedics scored higher in the Physical Function domain (p2 vs.26.47 ±5.42, pConclusionsParamedics scored lower on the SF-36 than the general population, which can indicate a lower health-related quality of life. High BMI and low SF-36 scores may be related to a perceived inability to engage in regular exercise and the effects of shift work, especially in regional areas. Increasing BMI can be associated with the development of markers of poor health. Attention is needed to ensure that these essential health care providers are “fit for duty”. This survey should be repeated longitudinally to examine trends in the health status of paramedics. Nationally and internationally, ambulance management can and should foster innovative health promotion programs and paramedics themselves need to recognise and value good health.

A number of factors (biogenic amine deficiency, genetic, environmental, immunologic, endocrine factors and neurogenesis) have been identified as mechanisms which provide unitary explanations for the pathophysiology of depression. Rather than a unitary construct, the combination and linkage of these factors have been implicated in the pathogenesis of depression. That is, environmental stressors and heritable genetic factors acting through immunologic and endocrine responses initiate structural and functional changes in many brain regions, resulting in dysfunctional neurogenesis and neurotransmission which then manifest as a constellation of symptoms which present as depression.

The purpose of this study is to assess the effect of manual acupuncture on experimental pain parameters in healthy participants.The experimental design was a repeated-measures, three-group pre- and postprocedure. All subjects participated in a control, sham, and acupuncture procedure, separated by 1 week, in a counterbalanced sequence to forestall an order effect.Data were collected in a laboratory environment.The participants included 12 healthy young men (mean age 21.3 ± 2.6 years; height 183.8 ± 5 cm; weight 77.7 ± 9.5 kg).The control procedure comprised assessing the experimental pain parameters before and after a quiet rest for 20 minutes. The sham procedure was performed with the needle inserted bilaterally 1-1.5 cm outside each acupoint. The manual acupuncture procedure was performed at two bilateral acupoints of LI-4 (Large Intestine 4, Hegu) and ST-44 (Stomach 44, Nei Ting).Pain parameters assessed included the pain threshold, nociceptive reflex threshold, and nociceptive reflex amplitude.Repeated-measures analysis of variance between pre- and postcontrol, sham, and acupuncture procedures for pain threshold, nociceptive reflex threshold, and nociceptive reflex amplitude revealed no significant difference.Manual acupuncture at bilateral acupoints LI-4 and ST-44 did not show a change in pain threshold, nociceptive flexion reflex threshold, or the nociceptive reflex amplitude in healthy participants.

The purpose of this study was to assess the reliability of the RIII reflex threshold and Pain threshold in three repeated trials using electrocutaneous stimuli. Each trial was separated by a mean of 4.3 +/- 2.9 days (between-trials) and included two repeated measurements (within-trial) of the RIII reflex threshold (RIII-T) and the Pain threshold (PT) separated by 20 min. The participants were 14 healthy males (mean age +/- SD, 23.5 +/- 5.3 years). There was a significant difference between the RIII-T and PT. The reliability of the RIII-T and PT shows a between-trials coefficient of variance (CV(SEM)) of 16.1 and 16.9%, respectively. The within-trial CV(SEM) for RIII-T and PT was 5.4 and 4.3%, respectively. There was a significant correlation between the RIII-T threshold and PT. The parallel association and correlation of the RIII-T with the PT suggests that the RIII-T is valid in experimental pain studies under standardised resting conditions.

Physical exercise has been shown to inhibit experimental pain response in the post-exercise period. Modulation of the pain system may be differentiated between muscle sites engaging in contractile activity. The purpose of this study was to assess the pain response at remote and local muscle sites following aerobic exercise at different work intensities. Participants included 10 healthy and physically active males (mean age ± SD, 21.2 ± 3.4). Somatic pressure pain threshold (PPT) at the rectus femoris (local) and brachioradialis (remote) muscle site was measured at before (Pre), 5 min after (Post1), and 15 min after (Post2) aerobic cycling exercise at 70 and 30 % of peak oxygen uptake (VO2peak) performed on different occasions in a counterbalanced order, separated by minimum of 3 days interval. Repeated measures ANOVA for PPT reveals significant main effect for time (f = 3.581, p = 0.049, observed power = 0.588) and muscle site (f = 17.931, p = 0.002, observed power = 0.963). There was a significant interaction shown for exercise intensity by time (f = 11.390, p = 0.012, observed power = 0.790). PPT at rectus femoris following cycling exercise at 70 % of VO2peak reveals a significant increase between Pre-Post1 (p = 0.040). PPT for rectus femoris following cycling exercise at 30 % of VO2peak revealed a significant decrease between Pre-Post1 (p = 0.026) and Pre-Post2 (p = 0.008). The PPT for brachioradialis following cycling exercise at 30 % of VO2peak revealed a significant decrease between Pre-Post1 (p = 0.011) and Pre-Post2 (p = 0.005). These results show that aerobic exercise increases PPT locally at the exercise muscle site following exercise at 70 % of VO2peak but reduces PPT following exercise at 30 % of VO2peak.

The purpose of this study was to investigate muscle pain intensity rating using a 10-point category-ratio pain intensity scale during self-paced cycling exercise within three trials. Eleven subjects (age 21.4 ± 2.6 years; VO2 peak 3.3 ± 0.9 L·min-1) performed a 60-min cycling trial on three occasions. During each trial subjects cycled at the utmost work intensity for 60-min. To simulate competitive training, 1-min maximal effort sprints were performed every 10-mins into the trial. Ambient temperature and relative humidity were set at 33 ± 0.7 oC and 63 ± 2.0%, respectively. During exercise, subjects ranked the muscle pain intensity at 5 min intervals and following each sprint effort. Simple main effects revealed that muscle pain intensity ratings were significantly lower in trial 3 compared with trial 1 at the 50 min [F = 4.5(2 30); p = 0.015, eta2 = 0.05], 55 min [F = 4.89(2, 30); p = 0.011; eta2 = 0.05], and 60 min [F = 3.6(2, 30); p = 0.034; eta2 = 0.04] time interval. Repeated measures ANOVA revealed a significant increase in the mean distance cycled amongst the trials (p < 0001). These results indicate an attenuation in muscle pain intensity rating with endurance exercise training when performed over three trials. The reduced pain intensity rating may be due to adjustments in cadence and gear selection amongst the trials.

Evidence based practice (EBP) is a system of applying the most current and valid high quality evidence to support clinical decision making in a healthcare setting. In the twenty five years since its inception, EBP has become the accepted benchmark for excellence in healthcare. Although the system emerged within the biomedical sciences, in the years since EBP has become normative across all healthcare modalities from dentistry, allied health to complementary and alternative medicine (CAM). Practicing evidence based medicine within any modality potentially offers the patient the best available care based on high quality evidence. Yet it is the nature of the evidence that provokes some questions about the suitability of EBP across all modalities of healthcare. The meta analysis of randomized controlled trial (RCT) stands at the pinnacle of the hierarchy of evidence in EBP. This forms a challenge to CAM due to the difficulty in reducing the elementals of a holistic naturopathic assessment of a patient into an answerable question to be tested within a RCT. On one level this makes EBP paradigmatically incompatible with CAM, yet on another level it presents the opportunity to redefine the parameters of what is considered high level evidence. EBP has become a tool, and at times a weapon wielded by governments and health insurance companies to direct healthcare funding and policy. The implications of the nature of accepted evidence are becoming far reaching. The pursuit of the best available healthcare for each individual is the focus of EBP. However, the injudicious use of this system to direct health policy is fraught with biomedical bias and dominance. This issue raises the challenge to CAM to present high level evidence according to the rules of evidence, or face the annihilation of centuries of empirical knowledge.

The purpose of this study was to investigate muscle pain intensity rating using a 10-point category-ratio pain intensity scale during self-paced cycling exercise within three trials. Eleven subjects (age 21.4 ± 2.6 years; VO2 peak 3.3 ± 0.9 L·min(-1)) performed a 60-min cycling trial on three occasions. During each trial subjects cycled at the utmost work intensity for 60-min. To simulate competitive training, 1-min maximal effort sprints were performed every 10-mins into the trial. Ambient temperature and relative humidity were set at 33 ± 0.7 (o)C and 63 ± 2.0%, respectively. During exercise, subjects ranked the muscle pain intensity at 5 min intervals and following each sprint effort. Simple main effects revealed that muscle pain intensity ratings were significantly lower in trial 3 compared with trial 1 at the 50 min [F = 4.5(2 30); p = 0.015, eta(2) = 0.05], 55 min [F = 4.89(2, 30); p = 0.011; eta(2) = 0.05], and 60 min [F = 3.6(2, 30); p = 0.034; eta(2) = 0.04] time interval. Repeated measures ANOVA revealed a significant increase in the mean distance cycled amongst the trials (p0001). These results indicate an attenuation in muscle pain intensity rating with endurance exercise training when performed over three trials. The reduced pain intensity rating may be due to adjustments in cadence and gear selection amongst the trials. Key PointsMuscle pain intensity rating was significantly reduced with three repeated cycling endurance trials.Attenuation in muscle pain intensity rating appeared at 50, 55, 60 mins into exercise within the third trial.The attenuation in muscle pain intensity with training is apparent despite an increase in cycling distance performance.The decline in muscle pain rating and increased cycling performance may be associated with adjustment in cadence and gear selection amongst the endurance trails.

The purpose of this investigation was to evaluate the influence of lean body mass (LBM) and body weight (BW) on the thermoregulatory responses and endurance performance of male and female athletes in warm, humid environments. Ten (5 males, 5 females) healthy, moderately trained athletes with varying physiques performed a self-paced 30-min run on a motorized treadmill in warm (30 degrees C), humid (60% relative humidity) conditions, with the aim of running the greatest distance possible. Males completed one trial, while females completed two trials, one in each of the follicular (Fol) and luteal (Lut) phases of the menstrual cycle in a randomized fashion. There were no significant differences among groups for distance run (males, 5.2 +/- 0.4 km; Fol, 4.9 +/- 0.1 km; Lut, 4.7 +/- 0.1 km). However, following analysis of covariance accounting for LBM and BW, the distances run were significantly different. The adjusted means for distance run after accounting for LBM were 3.4 km for males (P < 0.05), 5.9 km for Fol, and 5.6 km for Lut. Adjusted means accounting for BW resulted in run distances of 6.5 km for males (P < 0.05), 4.2 km for Fol, and 4.0 km for Lut. Thermoregulatory responses such as rectal and skin temperatures were similar among groups. Avenues of heat loss and gain were altered relative to the menstrual cycle phase. The results suggest that one reason for the disparity in performance between male and female athletes over similar race distances might in part be related to unequal body characteristics and in particular to differences in LBM.

Peter S Micalos,1 Mayuresh S Korgaonkar,2 Eric J Drinkwater,3 Jack Cannon,3 Frank E Marino3 1School of Biomedical Sciences, Charles Sturt University, Bathurst, 2Brain Dynamics Centre, Westmead Millennium Institute, University of Sydney Medical School, Sydney, 3School of Human Movement Studies, Charles Sturt University, Bathurst, NSW, Australia Objective: The purpose of this research was to assess the functional brain activity and perceptual rating of innocuous somatic pressure stimulation before and after exercise rehabilitation in patients with chronic pain. Materials and methods: Eleven chronic pain patients and eight healthy pain-free controls completed 12 weeks of supervised aerobic exercise intervention. Perceptual rating of standardized somatic pressure stimulation (2 kg) on the right anterior mid-thigh and brain responses during functional magnetic resonance imaging (fMRI) were assessed at pre- and postexercise rehabilitation. Results: There was a significant difference in the perceptual rating of innocuous somatic pressure stimulation between the chronic pain and control groups (P=0.02) but no difference following exercise rehabilitation. Whole brain voxel-wise analysis with correction for multiple comparisons revealed trends for differences in fMRI responses between the chronic pain and control groups in the superior temporal gyrus (chronic pain > control, corrected P=0.30), thalamus, and caudate (control > chronic, corrected P=0.23). Repeated measures of the regions of interest (5 mm radius) for blood oxygen level-dependent signal response revealed trend differences for superior temporal gyrus (P=0.06), thalamus (P=0.04), and caudate (P=0.21). Group-by-time interactions revealed trend differences in the caudate (P=0.10) and superior temporal gyrus (P=0.29). Conclusion: Augmented perceptual and brain responses to innocuous somatic pressure stimulation were shown in the chronic pain group compared to the control group; however, 12-weeks of exercise rehabilitation did not significantly attenuate these responses. Keywords: fMRI, pain network, central sensitization, BOLD-signal response&nbsp

during exercisehave been investigated with the application of variousexercise modes. Most of the research investigatingmetabolic changes with exercise have based the exer-ciseintensityonaerobiccapacitywhileagrowingnum-ber of studies are investigatingthe metabolic responsesto exercise using isokinetic protocols [5,10,12,24]. Anadvantage of isokinetic exercise is that it is possibleto isolate muscle groups and quantify the change inmuscle torque output over the exercise period. In onestudy [12], a significant correlationwas foundbetweenthe change in blood lactate and the degree of musclefatigue as defined and measured by a reduction in theforce-generating capacity of the total neuromuscularsystem. Therefore, the purpose of this study was toquantify the NH