Teacher education for sustainable development within national frameworks: Squaring the circle from a German perspective

This article deals with the question of how teacher education and teacher training in Germany – of which many aspects have been fragmentized – can nevertheless provide teachers with an adequate opportunity to systematically develop their professional competences in the field of education for sustainable development (ESD). Based on current education policy goals and relevant empirical research, the article offers a theory intended to cause coherence between three phases of teacher education and training in Germany, thereby integrating academic theory and ESD practice more consistently. Particular attention is given to teacher educators, educational managers, researchers and decision makers, who often have not acquired solid expertise in the specific area of ESD themselves. Their active inclusion is the key success factor in the intrinsic processes regarding organizational development at teacher education institutions

Has the Time Come to Start a Dialogue About the Role of Nutrition and Our Inner Microbiomes In Education? Teacher and Faculty Perspectives

The purpose of this study is to determine if educational professionals at the high school and college levels believe that their students should be required to complete a Health and Nutrition and/or a Microbiology course for graduation. The study used both a descriptive survey and a questionnaire as data collection instruments. The study population was comprised of 655 teachers and instructors from high schools, colleges and universities across the U.S.A.   Quantitative analysis was conducted using descriptive statistics. Qualitative analysis of open ended responses was organized into multiple themes. While all the participants strongly agreed that our nation (U.S.A.) is facing critical challenges in overcoming the new trends in obesity, diabetes, infectious diseases and other related epidemics, as well as on the role of education in solving the matters, they differ on what to do and how to prepare the current and future generations. At the college level, while over half of all the participants (61.22%) preferred to see Microbiology as a part of the graduation requirement from college, only 41.22% of the same participants felt comfortable in making Nutrition a part of the graduation requirement.  At the high school level, while 42.59% of all the participants saw no problem in including Nutrition as a part of the graduation requirement from high school, only 10.53% of the same participants felt comfortable including Microbiology as a graduation requirement from high school.  More detailed outcomes are presented in this paper. However, more participating college instructors compared to high school teachers did not think either of the topics should be mandated for graduation from high school or college; the only exception would be if these two fields of study were part of their selected academic program. Instead, this group of participants suggested making changes to existing course design and content (such as the required “health” or Biology classes), which would offer valuable additions to the existing curriculum and prepare students in health and nutrition. Finally, almost all of the participants provided various reasons and justifications for their perspectives on the matter.  The study also shows a significant role for administrators and academic leaders in this requirement process (decision making process for the curricula). Recommendations based on the findings are provided and discussed below. Keywords: General education, Nutrition, Microbiology, Human Microbiomes, Obesity, Diabetes, Illness prevention, Infectious diseases, Education, burden of disease, educational reform

The Diagnostic Value of Adenosine Stress-Contrast Echocardiography for Diagnosis of Coronary Artery Disease in Hypertensive Patients: Comparison to Tl-201 Single-Photon Emission Computed Tomography

Background: The use of the vasodilating agent adenosine as stressor in conjunction with myocardial contrast echocardiography has not been extensively evaluated in hypertensive patients. Our aim was to evaluate the diagnostic value of adenosine myocardial contrast echocardiography (MCE) in comparison to single-photon emission computed tomography (SPECT), with reference to angiographic findings, in a hypertensive population. Methods: Fifty hypertensive subjects, treated with standard antihypertensive treatment, were submitted to adenosine stress MCE, adenosine SPECT, and coronary angiography within a 1-month period, without any intervening events. Results: Sensitivity, specificity, and accuracy were 88%, 89%, 88% for MCE and 80%, 94%, 85% for SPECT, respectively (P = not significant). In the analysis by coronary territory, it appears that MCE and SPECT are both more accurate in detecting lesions of the anterior than of the posterior coronary system, as suggested by the good concordance to angiography results in the left anterior descending artery territory (k = 0.640 and 0.671, respectively). Agreement with angiographic findings was moderate for the right coronary artery (k = 0.561 and 0.539, respectively), whereas left circumflex artery lesions were more accurately detected by MCE than by SPECT (k = 0.533 and 0.400, respectively), that is, MCE appears to be superior in the left circumflex artery territory. Conclusions: In hypertensive patients, adenosine MCE has similar overall diagnostic accuracy with SPECT for assessment of coronary artery disease but is superior in the left circumflex artery territory. © 2007 American Journal of Hypertension, Ltd

Alcohol Consumption and Aortic Root Dilatation: Insights from the Corinthia Study

Aortic diameter and progression to thoracic aortic aneurysm are influenced by several factors. In this study, we investigated the association of alcohol consumption with aortic root and ascending aorta dilatation. In the context of the Corinthia study, we examined 1751 patients with echocardiography. Several demographic and clinical characteristics were recorded. Alcohol consumption was assessed based on a questionnaire of frequency, type, and quantity. Accordingly, patients were categorized as everyday alcohol consumers (EDACs) and as social drinkers (SoD). Everyday alcohol consumers were further categorized to group 1: 0 to 1 drink/d; group 2: 1 to 2 drinks/d; and group 3: ≥3 drinks/d. From the study population, 40% were categorized as EDAC and had an increased aortic root diameter (AoRD) and an elevated AoRD index compared with SoD. Interestingly, there was a stepwise increase in aortic root and ascending aorta diameter according to daily alcohol consumption. Specifically, patients consuming ≥3 drinks of alcohol/d had increased indexed aortic by 1.4 mm/m2 compared with SoD even after adjustment for possible confounders. Daily alcohol consumption is associated with increased aortic root diameter. These findings may have important clinical implications, especially in patients with borderline or dilated aortic root, and merit further investigation. © The Author(s) 2019

Acute systemic inflammation induced by influenza A (H1N1) vaccination causes a deterioration in endothelial function in HIV-infected patients

Objectives Vaccination of HIV-infected patients against the influenza A/H1N1 subtype was proposed as a mandatory precautionary measure during the 2009 pandemic. The immediate cardiovascular effects of the novel vaccine have been largely unexplored. We investigated the impact of vaccination on indices of endothelial function in a cohort of HIV-infected patients. Methods We included 24 HIV-infected patients in a study with a randomized, sham procedure-controlled design. A monovalent, adjuvanted vaccine against influenza A/H1N1 was used in the vaccine arm (n = 16); patients in the control group (n = 8) were subjected to a sham procedure. Endothelial function, as assessed by flow-mediated dilatation (FMD), and inflammatory markers were assessed prior to and 8 and 48 h post vaccination. Results FMD deteriorated following vaccination (baseline, 6.5 +/- 1.1%; 8 h, 1.1 +/- 1.5%; 48 h, 2.0 +/- 1.4%; P = 0.04). The white blood cell count increased at 8 h and remained elevated at 48 h. Soluble intercellular adhesion molecule-1 levels decreased after vaccination; the maximum decrease was noted at 48 h. Conversely, the sham procedure did not induce changes in endothelial function or inflammatory markers, apart from a reduction in the white blood cell count at 48 h. Conclusions Acute systemic inflammation induced by vaccination against the influenza A/H1N1 virus resulted in a deterioration in endothelial function in HIV-infected patients, and this effect was sustained for at least 48 h. Our findings may have important implications in view of the high cardiovascular risk that HIV infection carries. The effect of the novel vaccine on endothelial function should be weighed against the immunological protection that it confers

Safety of myocardial flash-contrast echocardiography in combination with dobutamine stress testing for the detection of ischaemia in 5250 studies

Objective: The purpose of the present study was to provide evidence regarding the safety of real-time flash-contrast echocardiography combined with dobutamine-atropine stress echo (DASE). Background: The combination of perfusion assessment using myocardial contrast echocardiography (MCE) with DASE has shown very promising results for the diagnosis of coronary artery disease. Concerns have, however, been expressed regarding the safety of the use of echo-contrast agents in echocardiography. Design: 5250 individuals (70.8% men, aged 64.6 years (SD 10.6)) were submitted to DASE, with concurrent MCE using a low mechanical index technique with the administration of high-energy impulses in order to assess replenishment time. Results: No deaths or myocardial infarctions were observed. Sustained ventricular tachycardia (VT) or fibrillation requiring resuscitation occurred in two cases (0.04%). The incidence of other arrhythmic events was: sustained VT not requiring resuscitation, 10 (0.18%); nonsustained VT, 18 (0.34%); atrial tachycardia, 4 (0.08%); atrial fibrillation, 25 (0.48%). Other observed adverse events included: intense headache, 52 (1%); intense back pain, 26 (0.5%). Vagal reactions with marked systolic blood pressure falls were observed in 45 cases (0.9%). Hypersensitivity reactions were reported in 23 cases (0.44%), although no serious cases of hypersensitivity requiring hospitalisation were recorded. The sensitivity, specificity and overall accuracy of DASE/MCE were 92%, 61% and 85%, respectively. Conclusions: This report of safety data regarding stress-contrast echocardiography in a large series of subjects suggests that this is an exceptionally safe technique, given that in 5250 studies no study-related deaths or myocardial infarctions were encountered, whereas serious adverse events requiring hospitalisation were extremely rare (one in 2625 studies)

The impact of sedentary behavior patterns on carotid atherosclerotic burden: Implications from the Corinthia epidemiological study

Background and aims: Sedentary lifestyle, unlike leisure time physical activity (PA), is associated with atherosclerosis progression. Regarding the interrelationship between television watching, as a sedentary behavior pattern, and cardiovascular disease burden, few data exist. Methods: In this cross-sectional epidemiological study based on 2043 inhabitants of the Corinthia region, in Greece, ultrasonography was used to measure carotid intima-media thickness (IMT) in both carotid arteries. The average (meanIMT) and maximum thickness (maxIMT) were determined as representative values of subclinical atherosclerosis. We evaluated PA using the self-reported International Physical Activity Questionnaire (IPAQ). Based on specific questions, the average hours per week spent on watching television (TV), videos or DVD was calculated for each participant. Results: According to TV viewing time, subjects were categorized into the low (≤7 h/week), moderate (7˃ TV hours/week ≤21) and high (˃21 h/week) TV viewing time groups. Prevalence of carotid atheromatic plaque was lower in the low TV viewing time group compared to the moderate and high TV viewing time groups (p = 0.02). TV viewing time was associated with increased carotid IMT (p = 0.03) and the prevalence of carotid atheromatic plaque (p = 0.02), even after adjustment for age, body mass index, cardiovascular risk factors or history of cardiovascular disease. Subjects in the high TV viewing time group have 80% increase odds of carotid atheromatic plaque compared to patients categorized in the low TV viewing time group (p = 0.01). Conclusions: The present findings have important public health implications, providing a better understanding of the components of sedentary behavior that are associated with atherosclerotic progression. © 2019 Elsevier B.V

Relationship of depressive symptoms with arterial stiffness and carotid atherosclerotic burden in the Corinthia study

Background: It has been long hypothesized that emotional factors and depression may play role in the development of cardiovascular diseases. Aim: The aim of this study was to examine the association between depression, arterial stiffness and atheromatic burden in carotid arteries. Design and methods: Corinthia study is a cross-sectional epidemiological study conducted in subjects aged 40-99 years, inhabitants of the homonym region of Greece. Intima media thickness (IMT) was measured in the left and right common carotid artery, carotid bulb and internal carotid artery. The average of the measurements (mean IMT) and the maximum IMT were determined as the representative value of carotid atherosclerosis burden. Pulse wave velocity was used to evaluate arterial stiffness. The Zung Self-Rating Depression Scale was used to evaluate depressive symptoms in subjects <65 years and the Geriatric Depression Scale in those >65 years. Results: In this analysis, we included data from 1510 participants. In older subjects (i.e. >65 years), maximum IMT was significantly increased in subjects with depression compared to those without (1.57 6 0.97 mm vs. 1.74 6 1.05 mm, P = 0.04). Similarly, the prevalence of atheromatic plaques was higher in subjects with depression (46% vs. 34%, P = 0.005). In the younger subgroup (<65years), there was no difference in mean and maximum IMT. Pulse wave velocity was found higher in the presence of depression (8.35 6 2.36m/s vs. 7.88 6 1.77m/s, P = 0.007). No differences emerged for the rest of the variables assessed in the individual subgroups. Conclusions: There is an age-dependent association between depression, arterial stiffness and carotid atheromatic burden highlighting the interplay between cardiovascular diseases and emotional status. © The Author(s) 2020. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved

The impact of sleeping duration on atherosclerosis in the community: insights from the Corinthia study

Purpose: Sleep is an essential physiologic process whose disturbances have been regarded as a risk factor in various pathophysiologic processes, including atherosclerosis and cardiovascular disease. Although the negative influence of short sleep duration has been well-established, recent data suggest a possible harmful effect of prolonged sleeping pattern. Methods: In the setting of the Corinthia cross-sectional study, self-reported night sleep duration was recorded in 1752 apparently healthy individuals and was classified as normal sleep duration (NSD, 7–8 h), short sleep duration (SSD, 6–7 h), very short sleep duration (VSSD, < 6 h), and long sleep duration (LSD, > 8 h). Carotid duplex ultrasonography was performed in order to measure the mean and maximum carotid intima-media thickness (cIMT) as a non-invasive marker of atherosclerosis. Results: Subjects with LSD and VSSD had significantly higher mean cIMT (VSSD: 1.02 ± 0.45 mm, SSD: 0.95 ± 0.35, NSD: 0.96 ± 0.38 mm, LSD: 1.07 ± 0.52 mm; p < 0.001) and maximum cIMT (VSSD: 1.39 ± 0.9 mm, SSD: 1.25 ± 0.71 mm, NSD: 1.23 ± 0.76 mm, LSD: 1.41 ± 0.93 mm). Following a regression analysis adjusting for known cardiovascular risk factors, individuals with LSD and VSSD had higher mean cIMT by 0.054 mm and 0.067 mm respectively compared to those with NSD. Conclusion: A balanced sleeping duration of 6–8 h is associated with decreased mean and maximum IMT while both very short sleep duration and long sleep duration are associated with increased carotid intima-media thickness, a marker of subclinical atherosclerosis. © 2021, Springer Nature Switzerland AG