In this study of middle-aged to older men with cardiac disease, the best method for determining body fat was circumferences. This technique was accurate, easy to administer, inexpensive, and had a lower error potential than the other techniques. Skinfold measurements were also closely related to hydrostatic weighing, but should be performed only by experienced practitioners because there is a greater potential for tester error in certain patients. In the future, near-infrared interactance measurements may be a viable technique for body composition assessment in patients with cardiac disease. However, algorithms specific to the population of patients with cardiac disease being tested must be developed before this technique can be routinely recommended for body composition assessment. Bioelectrical impedance assessment by either method is not recommended for patients with cardiac disease, as it consistently underestimated percent body fat when compared to hydrostatic weighing in this population.

The purpose of this study was to determine (a) the major challenges in providing specialized therapies to infants, toddlers, and preschoolers with disabilities; (b) what models of service delivery are used and why;(c) what makes the provision of therapy services go well; and (d) what strategies are used for overcoming barriers to effective services. Focus groups were conducted with early intervention therapists, nontherapist professionals, administrators, and parents. Results showed that a shortage of pediatric therapists and policy/administrative constraints caused services to be of lower quality than desired. We also found that concepts of "needing" therapy were muddled and that most people said that "more is better" as long as the quality is high enough.Children with disabilities or who are at risk for disabilities often require intervention in motor and communication development, so occupational therapy, physical therapy, or speech-language therapy are frequently involved. Early intervention services also consist, however, of "generalists" such as early childhood professionals (e.g., early childhood teachers) and other nontherapist professionals (e.g., early childhood special educators, social workers). Furthermore, families are key players as members of their child's intervention team through both informal and formal activities. This study explores stakeholders' perceptions of therapy and the capability of the current number of therapists to meet the demands for therapy. Shortages of occupational therapists, physical therapists, and speech-language pathologists have been documented in terms of the estimated numbers required to serve the numbers of children needing services (Yoder, Coleman, &cGallagher, 1990), in terms of current vacancies (Council for Allied Health in North Carolina, 1994), and in terms of the numbers needed to form essential team configurations (Wolery et al., 1994). Even if existing vacancies were to be filled, however, it is unknown whether, according to families' perceptions, the need for specialized therapies would be met (McWilliam et al., 1995; Sontag & Schacht, 1993). Research on professionals' perspectives on therapy services is scant. Among school-based professionals, opinions of and knowledge about related services have varied (Giangreco, Edelman, &c Dennis, 1991; Tomes &c Sanger, 1986). The literature suggests mixed reactions of families to therapy services. In general, families have been found to place great importance on therapy (Hinojosa, 1990; McWilliam et al., 1995; Sontag St Schacht, 1993). They have also reported wanting therapy services to be more child and family centered-less rigid and therapy centered (Lawlor &c Cada, 1993). Early intervention therapists can provide services in many ways. Beyond simple distinctions of setting (home, classroom, office, hospital), therapists can be more or less directive with parents, can work in general classrooms or in separate therapy rooms, can include or exclude parents in therapy sessions, and can work with others or alone in execu...

Nutritional advice to optimise athletic performance is often not applicable for the majority of people who exercise for health or weight maintenance. A common perception by laypersons is that exercising on an empty stomach (fasted) increases fat oxidation, hence aids fat loss (1) . However research on feeding around exercise mainly focuses on performance in trained or semi-trained individuals (2) . Furthermore, research is most commonly undertaken on males, despite accepted gender difference in substrate metabolism and energy expenditure (EE) (3) . This study aimed to investigate the impact of CHO consumption before and after treadmill exercise on substrate utilization and total EE in untrained men and women.Fifteen healthy, untrained subjects (7 male, 8 female) aged 21-33 years undertook a randomised crossover study. Subjects completed 2 treatments, separated by a washout period ( ‡ 3 days), following an overnight fast. At each treatment subjects exercised for £ 30 min on a treadmill at approximately 70 % VO2 max, with 30 g of maltodextrin or placebo ingested either before or after exercise. EE (kJ/min), and Fat and CHO utilization (g/hr) during and over 3 hours post exercise were estimated by indirect calorimetry. This study was approved by the University of Surrey Faculty of Health and Medical Sciences Ethics Committee.Fat oxidation rates between CHO and placebo were only significantly different during exercise for males (placebo > CHO), and during recovery for females (placebo > CHO). Over the whole study a significant difference in total fat oxidation (g) between the two feeding regimes was observed in females (P = 0.034) but not males (see Table 1). Males had a significantly greater difference in total fat oxidation (g) (P = 0.018) and % EE from fat oxidation (P = 0.037) compared with females between treatments. Significant gender differences in EE (kcal/d/kg) were observed during recovery following CHO intake only with males expended 160 kcal/d/kg more than females (P = 0.05).

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