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PurposeIn rodents, a single exercise bout performed 24 h prior to a single doxorubicin treatment provides cardio-protection. This study investigated whether performing this intervention prior to every doxorubicin treatment for breast cancer reduced subclinical cardiotoxicity and treatment symptoms.MethodsTwenty-four women with early stage breast cancer were randomly assigned to perform a 30-min, vigorous-intensity treadmill bout 24 h prior to each of four doxorubicin-containing chemotherapy treatments or to usual care. Established echocardiographic and circulating biomarkers of subclinical cardiotoxicity, as well as blood pressure and body weight were measured before the first and 7–14 days after the last treatment. The Rotterdam symptom checklist was used to assess patient-reported symptoms.ResultsThe exercise and usual care groups did not differ in the doxorubicin-related change in longitudinal strain, twist, or cardiac troponin. However, the four total exercise bouts prevented changes in hemodynamics (increased cardiac output, resting heart rate, decreased systemic vascular resistance, p < 0.01) and reduced body weight gain, prevalence of depressed mood, sore muscles, and low back pain after the last treatment (p < 0.05) relative to the usual care group. No adverse events occurred.ConclusionsAn exercise bout performed 24 h prior to every doxorubicin treatment did not have an effect on markers of subclinical cardiotoxicity, but had a positive systemic effect on hemodynamics, musculoskeletal symptoms, mood, and body weight in women with breast cancer. A single exercise bout prior to chemotherapy treatments may be a simple clinical modality to reduce symptoms and weight gain among women with breast cancer.

Exercise professionals (with the appropriate academic and practical training) have the knowledge to provide information to patients that is based on sound physiologic principles, a clear awareness of the contraindications to exercise, and an extensive understanding of research and its practical application. In Canada, exercise professionals who have undertaken advanced academic and practical preparation are recognized through the comprehensive certifications provided by the Canadian Society for Exercise Physiology (CSEP), which include the CSEP-Certified Personal Trainer and the CSEP-Certified Exercise Physiologist certifications.2 As physicians specializing in exercise science and other allied health professionals, we cannot endorse personal training designations that do not require postsecondary education in exercise science.

Over 100 000 solid organ transplants are performed worldwide each year and this has a significant impact on physical function and quality of life. However, the capacity for exercise in solid-organ recipients is reduced. Regular physical activity improves most of the indices of fitness in these patients but, with few exceptions, they do not reach the values seen in healthy controls. The reason for the 40–60% reduction in maximal exercise capacity is not clear; the disease process, need for life long immunosuppression and sedentary lifestyle all contribute. The interaction between exercise and immunosuppressing medication merits research as does the specifics of the exercise prescription for these patients. This paper reviews important features of this rapidly expanding group of patients and suggests clinical considerations in the application of exercise in this population.

Background—Pulmonary diffusing capacity for carbon monoxide (Dlco), alveolar capillary membrane diffusing capacity (Dm), and pulmonary capillary blood volume (Vc) are all significantly reduced after exercise. Objective—To investigate whether measurement position affects this impaired gas transfer. Methods—Before and one, two, and four hours after incremental cycle ergometer exercise to fatigue, single breath Dlco, Dm, and Vc measurements were obtained in 10 healthy men in a randomly assigned supine and upright seated position. Results—After exercise, Dlco, Dm, and Vc were significantly depressed compared with baseline in both positions. The supine position produced significantly higher values over time for Dlco (5.22 (0.13) v 4.66 (0.15) ml/min/mm Hg/l, p = 0.022) and Dm (6.78 (0.19) v 6.03 (0.19) ml/min/mm Hg/l, p = 0.016), but there was no significant position effect for Vc. There was a similar pattern of change over time for Dlco, Dm, and Vc in the two positions. Conclusions—The change in Dlco after exercise appears to be primarily due to a decrease in Vc. Although the mechanism for the reduction in Vc cannot be determined from these data, passive relocation of blood to the periphery as the result of gravity can be discounted, suggesting that active vasoconstriction of the pulmonary vasculature and/or peripheral vasodilatation is occurring after exercise.

I was disappointed to learn that the National Park Service has preliminary plans to bring commercial concessions, extensive parking facilities, and a paved thoroughfare to Assateague Island National Seashore. Perhaps this type of development is

Spread of a non-indigenous ascidian (NIA), Botryllus schlosseri (Tunicata: Ascidiacea), has been detected since 2006 in coastal waters of Newfoundland. This species has been of economic concern because NIA can be a costly nuisance for bivalve aquaculture. The presence of this temperate-adapted species in Newfoundland represents an extension of its global range into subarctic waters. In 2010 and 2011, we investigated the population dynamics of B. schlosseri in Arnold’s Cove, Placentia Bay, Newfoundland and Labrador, Canada. Experiments testing the influence of season, depth, and substrate type on larval recruitment rates were conducted within the harbour over a period of 20 mo. Seasonal cycle of colony (adult) abundance was determined from video surveys of a belt transect of the wharf. The seasonal window of recruitment was from August to mid-October (ca. 2.5 mo), constrained to temperatures ≥13°C. Peak recruitment was observed coincident with maximum seasonal temperature in September. Recruitment was greatest at 1 m depth on PVC plates. Colonies were present year-round on wharf structures and exhibited seasonal fluctuations in percent cover, from <1% in May to ca. 3% in October. Seasonal increase in colony abundance was constrained to temperatures ≥5°C. These findings provide a population-level understanding of how a temperate-adapted, non-indigenous species is established and maintained in a subarctic environment. Our results suggest that 1 sampling site may adequately represent the spatial scale of ≤10s of metres within a marina, and NIA monitoring could target specific seasons, depths, and substrate types for optimal species detection.

A collection of fifteen articles by colleagues and former students of Professor Willis of Abilene Christian University. The papers deal with the topic of worship from a variety of perspectives and, in different connections, with the life and thought of ancient Israel. These include the participation of foreigners in the worship of ancient Israel, the prophetic critique of the cult, the tradition of the construction of the Jerusalem temple, women and prayer in the Deutero-canonical literature, various ethical aspects of worship and the value placed on the internal dynamics of worship offered to God, the Psalms and ancient Near Eastern mourning customs, and some of the implications of the Old Testament tradition regarding worship for contemporary communities of faith. A select bibliography of Willis's writings is also included.

To assess the impact of air travel on swelling of the ‘at risk' arm of women treated for breast cancer. Women treated for breast cancer from Canada (n = 60) and from within Australia (n = 12) attending a dragon boat regatta in Queensland, Australia participated. Women were measured within 2 weeks prior to their flight, on arrival in Queensland and, for 40 women travelling from Canada, measured again 6 weeks following return to Canada. Changes to extracellular fluid were measured using a single-frequency bioimpedance device (BIA). Each arm was measured separately using a standardized protocol to obtain the inter-limb impedance ratio. An increase in the ratio indicates accumulated fluid. Information regarding medical management of participants' breast cancer, use of compression garment and history of exercise were also obtained. For most women (95%), air travel did not adversely affect the impedance ratio. The BIA ratio of long-haul travellers was 1.007 ± 0.065 prior to the flight and 1.006 ± 0.087 following the flight. The ratio of short-haul travellers was 0.994 ± 0.033 and following the flight was 1.001 ± 0.038. Air travel did not cause significant change in BIA ratio in the ‘at-risk' arm for the majority of breast cancer survivors who participated in dragon boat racing. Further research is required to determine whether these findings are generalizable to the population of women who have been treated for breast cancer.

Climate change is expected to bring potentially significant changes to Washington State’s natural, institutional, cultural, and economic landscape. Addressing climate change impacts will require a sustained commitment to integrating climate information into the day-to-day governance and management of infrastructure, programs, and services that may be affected by climate change. This paper discusses fundamental concepts for planning for climate change and identifies options for adapting to the climate impacts evaluated in the Washington Climate Change Impacts Assessment. Additionally, the paper highlights potential avenues for increasing flexibility in the policies and regulations used to govern human and natural systems in Washington.