This study determined the time course for changes in muscle swelling and plasma volume following high (HI) and low-intensity resistance exercise with blood-flow restriction (LI-BFR). Ten male participants (22.1±3.0 yrs) completed three experimental conditions: high-intensity exercise (HI - 80% of 1RM), low-intensity exercise with BFR (LI-BFR -20% of 1RM, and 160 mmHg of BFR), and control (CON - no exercise or BFR). Muscle cross-sectional area (mCSA), muscle thickness, thigh circumference, and percentage change in plasma volume (PV%∆) were measured. mCSA was significantly greater than rest values at 15 min post-exercise (p<0.01) for HI and LI-BFR, and at 75 min post-exercise (p<0.01) for HI. Muscle thickness was significantly greater than rest immediately post-exercise (p<0.01) and 30 min post-exercise (p<0.01) for HI and LI-BFR, and at 60 min post-exercise for HI (p=0.01). Muscle thickness was greater for BFR immediately post-exercise compared to HI (p=0.01) post-exercise. Thigh circumference was significantly greater from rest at 15 min post-exercise (p=0.01) and at 75 min post-exercise for both LI-BFR (p=0.03) and HI (p<0.01). PV%∆ significantly decreased from rest immediately post-exercise for both HI (p<0.01) and LI-BFR (p<0.01). In conclusion, BFR exercise induces changes in muscle swelling and plasma volume similar to those observed at high-intensities.
IntroductionPoor access to quality healthcare is one of the most important reasons of high maternal and neonatal mortality in India, particularly in poorer states like Bihar. India has implemented initiatives to promote institutional maternal deliveries. It is important to ensure that health facilities are adequately equipped and staffed to provide quality care for mothers and newborns.MethodsWe conducted a cross-sectional study of 190 primary health centres (PHCs) and 36 district hospitals (DHs) across all districts in Bihar to assess the readiness of facilities to provide quality maternal and neonatal care. Infrastructure, equipment and supplies and staffing were assessed using the WHO service availability and readiness assessment and Indian public health standard guidelines. Additionally, we used household survey data to assess the quality of care reported by mothers delivering at study facilities.ResultsPHCs and DHs were found to have 61% and 67% of the mandated structural components to provide maternal and neonatal care, on average, respectively. DHs were, on average, slightly better equipped in terms of infrastructure, equipment and supplies by comparison to PHCs. DHs were found to be inadequately prepared to provide neonatal care. Lack of recommended handwashing stations and bins at both DHs and PHCs suggested low levels of hygiene. Only half of the essential drugs were available in both DHs and PHCs. While no association was revealed between structural capacity and patient-reported quality of care, adequacy of staffing was positively associated with the quality of care in DHs.ConclusionExamining all DHs and a representative sample of PHCs in Bihar, this study revealed the gaps in structural components that need to be filled to provide quality care to mothers and newborns. Access to quality care is essential if progress in reducing maternal and neonatal mortality is to be achieved in this high-burden state.
Internal marketing has been an area of interest for the past few decades, and the rapid growth on internal marketing literature has evolved the concept further. However, this theoretical advancement has not been able to empirically strengthen the concept, and there exists disagreement on the key components of internal marketing. Thus, this article endeavours to identify the dimensions of internal marketing by probing in the extant literature. In addition, the aim of the article was to develop a robust and valid instrument for measuring internal marketing. Data were collected from qualitative study and from 154 employees of financial service sector. Analyses revealed 11 significant dimensions of internal marketing, namely, senior leadership and vision, inter-functional coordination, internal communications, organization structure and changes, staffing, training and development, incentive systems, physical environment, strategic rewards and empowerment. Construct validity and reliability were empirically ascertained along with the determination of the good fit for the proposed model. The study highlighted the difference between strategic rewards and incentive systems as perceived by the employees. In addition, organization structure and change factors were tested to be significant, providing empirical evidence of their vital role in developing and implementing internal marketing practices in service firms. The article concludes by discussing the possible implications and future research avenues.
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