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Deemed consent legislation for deceased organ donation was introduced in England in 2020, and is considered a vital part of the new UK NHS Blood and Transplant’s 10-year strategy to increase consent for organ donation. Despite the legislation containing safeguards to protect the public, the introduction of deemed consent creates ethical, psychological and social un/certainties for healthcare professionals in their practice. In this paper, we offer insights into healthcare professionals’ perspectives on deemed consent, drawn from interview data with 24 healthcare professionals in an NHS Trust in England, prior to the introduction of the legislation. Whilst participants supported deemed consent in principle, they were concerned that it would present a threat to the nature of donation as a ‘gift’; the notion of informed consent (or non-consent); and the autonomy of donors, their relatives, and their own roles as health professionals, posing dilemmas for practice. We argue that healthcare professionals present themselves as guardians of potential (non)donors and thus as having ethics and integrity in their own practice. We draw conclusions around the values and principles that matter to healthcare professionals when contemplating consent in deceased donation which will be useful for organ donation committees and ethics forums.

This study quantified the physiological and biomechanical effects of the 20 lb (9.07 kg, males) and 14 lb (6.35 kg, females) weighted vest used in CrossFit, and whether they were predisposed to injury. Twenty subjects (10 males, 10 females) undertook walking (0%, 5% and 10% gradient) and running trials in two randomised study visits (weighted vest/no weighted vest). Physiological demand during walking was increased with the vest at 10% but not 5% or 0% with no change in gait variables. In the running trial, the weighted vest increased oxygen uptake (males; females) (+0.22L/min, p < 0.01; +0.07 L/min, p < 0.05), heart rate (+11bpm, p < 0.01; +11bpm, p < 0.05), carbohydrate oxidation (+0.6 g/min, p < 0.001; +0.2 g/min, p < 0.01), and energy expenditure (+3.8 kJ/min, p < 0.001; +1.5 kJ/min, p < 0.05) whilst blood lactate was increased only in males (+0.6 mmol/L, p < 0.05). There was no change in stride length or frequency. Weighted vest training increases physiological stress and carbohydrate oxidation without affecting measured gait parameters. Practitioner summary: We examined the effect of weighted vest training prescribed in CrossFit (20 lb/9.07 kg, males and 14 lb/6.35 kg, females) in a randomised controlled trial. We found that physiological stress is increased in both sexes, although three-fold greater in males, but with no change in biomechanical gait that predisposes to lower-limb injury.

Background: Aerobic exercise is well recognised as an effective treatment for people with type 2 diabetes but the optimal amount of aerobic exercise to improve glycaemic control remains to be determined. Thus, a meta-analysis and meta-regression were carried out to assess this. Methods: Medline, Cochrane, Embase, and Web of Science databases were searched up until 15th December 2020 for the terms “aerobic exercise AND glycaemic control”, “type 2 diabetes AND exercise”, and “exercise AND glycaemic control AND Type 2 diabetes AND randomised control trial”. We included (i) randomised control trials of ≥12 weeks, (ii) trials where participants had type 2 diabetes and were aged 18 or over, (iii) the trial reported HbA1c concentrations pre- and post-intervention. Two reviewers selected studies and extracted data. Data are reported as standardized mean difference (SMD) and publication bias was assessed using funnel plots. Results: 5364 original titles were identified. 16 studies were included in the metaanalysis. Aerobic exercise reduced HbA1c vs. control (SMD = 0.56 (95% CI 0.3 – 0.82), p < 0.001). There were also significant reductions in BMI (SMD = 0.76 (95% CI 0.25 – 1.27), p < 0.05). There was no dose-response relationship between improvement in HbA1c and the intensity and volume of the intervention (p >0.05). Conclusion: 12-week or longer aerobic exercise programmes improve glycaemic control, and BMI in adults with type 2 diabetes. Longer or more intense interventions appear to confer no additional benefit on HbA1c.