The Influence of Exercise Empowerment on Life Stress

Background: Psychological stress – when an individual perceives that the environment exceeds their ability to meet the demands placed on them - is common in college students and exercise, and specifically instructional physical activity courses, is frequently cited as a one method of stress reduction. Objective: Determine any relationship between exercise empowerment and perceived life stress for those participating in instructional physical activity courses (IPAC). Methods: All undergraduate students (n = 3388) enrolled in IPAC in 15-week IPAC at a large university were surveyed on perceived life stress (PSS), empowerment in exercise (EES), and specific demographic variables. Results: 944 of 3388 enrolled students (Nov. 2015, April 2016) completed the survey. The data revealed GPA (p \u3c 0.002), sex (p \u3c 0.000), and EES (p \u3c 0.001) showed differences for PSS. It was determined that EES, sex, and GPA predicted PSS differently for students according to their year in college. Conclusions: For freshman and seniors, sex and lower GPA were a stronger predictor of PSS with no mitigating effect of exercise empowerment. For sophomores and juniors the level of life stress was lower at higher levels of exercise empowerment. These findings support a complex relationship between exercise empowerment and life stress. While exercise is cited as a method for stress reduction the relationship between exercise empowerment and life stress for college-aged students is not as straightforward as it may seem

Competitive Orientations and Motives of Adult Sport and Exercise Participants

Participants in four different adult sport and exercise programs (running club, exercise classes, cardiac rehabilitation program, senior games) completed measures of competitive orientation and participation motivation. Our samples were older and more diverse than samples of previous research, and their competitive orientations and motives were similarly diverse. Multivariate analyses revealed gender and sample differences. Males were higher than females on competitiveness and win orientation, and runners were less win-oriented than other groups, but overall, all groups were similar to previous college-age samples in competitive orientation. Groups varied on specific motives, with females rating fitness, flexibility, affiliation, and appearance higher than males did. Generally, participants were diverse in orientations and motives, and positive about their participation. Research and conceptual models of sport orientation must extend beyond achievement motives to capture the diversity of adult participants. Program directors and instructors who offer activities and approaches to match this diversity will encourage wider participation and provide a more satisfying experience for more participants

Exploration de l'utilisation par les étudiants en médecine des principes d'auto-explication et de réflexion structurée pendant l'externat

Background: While educators observe gaps in clerkship students’ clinical reasoning (CR) skills, students report few opportunities to develop them. This study aims at exploring how students who used self-explanation (SE) and structured reflection (SR) for CR learning during preclinical training, applied these learning strategies during clerkship. Methods: We conducted an explanatory sequential mixed-methods study involving medical students. With a questionnaire, we asked students how frequently they adopted behaviours related to SE and SR during clerkship. Next, we conducted a focus group with students to explore why they adopted these behaviours. Results:  Fifty-two of 198 students answered the questionnaire and five participated in a focus group. Specific behaviours adopted varied from 50% to 98%. We identified three themes about why students used these strategies: as “just in time” learning strategies; to deepen their understanding and identify gaps in knowledge; to develop a practical approach to diagnosis. A fourth theme related to the balance between learning and assessment and its consequence on adopting SE behaviours. Conclusions: Students having experienced SE and SR regularly in preclinical training tend to transpose these strategies into the clerkship providing them with a practical way to reflect deliberately and capture learning opportunities of the unpredictable clinical context.Contexte : Alors que les éducateurs observent des lacunes dans les compétences de raisonnement clinique (RC) des étudiants en externat, ces derniers font état de peu d'occasions de les développer. Cette étude vise à explorer comment les étudiants qui ont utilisé l'auto-explication (SE) et la réflexion structurée (SR) pour l'apprentissage du raisonnement clinique pendant la formation préclinique, ont appliqué ces stratégies d'apprentissage pendant l'externat. Méthodes : Nous avons mené une étude séquentielle explicative à méthodes mixtes auprès d'étudiants en médecine. À l'aide d'un questionnaire, nous avons demandé aux étudiants à quelle fréquence ils adoptaient des comportements liés à la SE et à la RS pendant l'externat. Ensuite, nous avons organisé un groupe de discussion avec les étudiants afin d'explorer les raisons pour lesquelles ils ont adopté ces comportements. Résultats : Cinquante-deux étudiants sur 198 ont répondu au questionnaire et cinq ont participé à un groupe de discussion. Les comportements spécifiques adoptés variaient de 50 % à 98 %. Nous avons identifié trois thèmes concernant les raisons pour lesquelles les étudiants ont utilisé ces stratégies : comme stratégies d'apprentissage "juste à temps" ; pour approfondir leur compréhension et identifier les lacunes dans les connaissances ; pour développer une approche pratique du diagnostic. Un quatrième thème concernait l'équilibre entre l'apprentissage et l'évaluation et ses conséquences sur l'adoption de comportements SE. Conclusions : Les étudiants qui ont fait l'expérience de l'ES et de la RS régulièrement au cours de leur formation préclinique ont tendance à transposer ces stratégies dans l'externat, ce qui leur fournit un moyen pratique de réfléchir délibérément et de saisir les opportunités d'apprentissage dans un contexte clinique imprévisible

Mood and Performance Anxiety in High School Basketball Players: A Pilot Study

International Journal of Exercise Science 10(4): 604-618, 2017. Participation in competitive sport may impact psychological measures, such as mood and performance anxiety, which in turn may impact enjoyment, adherence, continued participation, and so on. This study assessed the feasibility – in terms of process, resources, management, and potential scientific value– of measuring the effect of varying competitive challenges upon the mood and performance anxiety measures of high school athletes. The participants (n=12) consisted of the boys’ varsity basketball team at a high school in a rural Midwestern community. Participants completed the Profile of Mood States (POMS) to assess mood and the Sport Anxiety Scale-2 (SAS-2) to assess performance anxiety, respectively. Survey administration occurred at baseline and prior to games designated as non-conference, conference, and state tournament. A-priori feasibility measures were achieved in this prospective design. Significant correlations on the subscale measures were found on the POMS and SAS-2 administered before the four conditions in this study; Chronbach’s alpha ranged from 0.54- 0.94 across conditions for POMS subscales, and Chronbach’s alpha ranged from 0.73-0.97 across all conditions for SAS-2 subscales, respectively. Significant differences were found across conditions in the POMS subscale confusion [F(3,33) = 5.71, p = 0.01] and in the SAS-2 subscale worry [F(3,33) = 6.13, p=0.01]. These preliminary findings suggest that the competitive conditions in this study significantly affected some measures of mood and performance anxiety in high school basketball players. These findings warrant further investigation, as well as suggest coaches could gather such information from their players, ultimately aiding in player development and team performance

Exploring medical students’ use of principles of self-explanation and structured reflection during clerkship

Background: While educators observe gaps in clerkship students’ clinical reasoning (CR) skills, students report few opportunities to develop them. This study aims at exploring how students who used self-explanation (SE) and structured reflection (SR) for CR learning during preclinical training, applied these learning strategies during clerkship. Methods: We conducted an explanatory sequential mixed-methods study involving medical students. With a questionnaire, we asked students how frequently they adopted behaviours related to SE and SR during clerkship. Next, we conducted a focus group with students to explore why they adopted these behaviours. Results:  Fifty-two of 198 students answered the questionnaire and five participated in a focus group. Specific behaviours adopted varied from 50% to 98%. We identified three themes about why students used these strategies: as “just in time” learning strategies; to deepen their understanding and identify gaps in knowledge; to develop a practical approach to diagnosis. A fourth theme related to the balance between learning and assessment and its consequence on adopting SE behaviours. Conclusions: Students having experienced SE and SR regularly in preclinical training tend to transpose these strategies into the clerkship providing them with a practical way to reflect deliberately and capture learning opportunities of the unpredictable clinical context

A Constant Balancing Act: Delivering Sustainable University Instructional Physical Activity Programs

The goal of university instructional physical activity programs (IPAPs) is to provide quality instruction through best practices to encourage college students to lead healthy and physically active lifestyles. As IPAPs have continued to decline due to enrollment and budgetary concerns, the importance of quality and sustainability has become particularly paramount. Furthermore, it is imperative to the existence of IPAPs that we strive to learn and share with each other in order to independently survive, but more essentially to flourish collectively, as we are better together. In our varied experience, while some IPAPs face unique challenges, many obstacles are common, regardless of institution size and composition. This paper will offer the perspectives of four strikingly different colleges and universities in their quest to navigate challenges in delivery, maintain and support quality instruction, and advocate for IPAPs

The Max b-HLH-LZ Can Transduce into Cells and Inhibit c-Myc Transcriptional Activities

The inhibition of the functions of c-Myc (endogenous and oncogenic) was recently shown to provide a spectacular therapeutic index in cancer mouse models, with complete tumor regression and minimal side-effects in normal tissues. This was achieved by the systemic and conditional expression of omomyc, the cDNA of a designed mutant of the b-HLH-LZ of c-Myc named Omomyc. The overall mode of action of Omomyc consists in the sequestration of Max and the concomitant competition of the Omomyc/Max complex with the endogenous c-Myc/Max heterodimer. This leads to the inhibition of the transactivation of Myc target genes involved in proliferation and metabolism. While this body of work has provided extraordinary insights to guide the future development of new cancer therapies that target c-Myc, Omomyc itself is not a therapeutic agent. In this context, we sought to exploit the use of a b-HLH-LZ to inhibit c-Myc in a cancer cell line in a more direct fashion. We demonstrate that the b-HLH-LZ domain of Max (Max*) behaves as a bona fide protein transduction domain (PTD) that can efficiently transduce across cellular membrane via through endocytosis and translocate to the nucleus. In addition, we show that the treatment of HeLa cells with Max* leads to a reduction of metabolism and proliferation rate. Accordingly, we observe a decrease of the population of HeLa cells in S phase, an accumulation in G1/G0 and the induction of apoptosis. In agreement with these phenotypic changes, we show by q-RT-PCR that the treatment of HeLa cells with Max* leads to the activation of the transcription c-Myc repressed genes as well as the repression of the expression of c-Myc activated genes. In addition to the novel discovery that the Max b-HLH-LZ is a PTD, our findings open up new avenues and strategies for the direct inhibition of c-Myc with b-HLH-LZ analogs

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570