The effect of a daily quiz (TOPday) on self-confidence, enthusiasm, and test results for biomechanics

Many students in Biomedical Sciences have difficulty understanding biomechanics. In a second-year course, biomechanics is taught in the first week and examined at the end of the fourth week. Knowledge is retained longer if the subject material is repeated. However, how does one encourage students to repeat the subject matter? For this study, we developed ‘two opportunities to practice per day (TOPday)’, consisting of multiple-choice questions on biomechanics with immediate feedback, which were sent via e-mail. We investigated the effect of TOPday on self-confidence, enthusiasm, and test results for biomechanics. All second-year students (n = 95) received a TOPday of biomechanics on every regular course day with increasing difficulty during the course. At the end of the course, a non-anonymous questionnaire was conducted. The students were asked how many TOPday questions they completed (0–6 questions [group A]; 7–18 questions [group B]; 19–24 questions [group C]). Other questions included the appreciation for TOPday, and increase (no/yes) in self-confidence and enthusiasm for biomechanics. Seventy-eight students participated in the examination and completed the questionnaire. The appreciation for TOPday in group A (n = 14), B (n = 23) and C (n = 41) was 7.0 (95 % CI 6.5–7.5), 7.4 (95 % CI 7.0–7.8), and 7.9 (95 % CI 7.6–8.1), respectively (p < 0.01 between A and C). Of the students who actively participated (B and C), 91 and 80 % reported an increase in their self-confidence and enthusiasm, respectively, for biomechanics due to TOPday. In addition, they had a higher test result for biomechanics (p < 0.01) compared with those who did not actively participate (A). In conclusion, the teaching method ‘TOPday’ seems an effective way to encourage students to repeat the subject material, with the extra advantage that students are stimulated to keep on practising for the examination. The appreciation was high and there was a positive association between active participation, on the one hand, and self-confidence, enthusiasm, and test results for biomechanics on the other

Impact of lifelong exercise training on endothelial ischemia-reperfusion and ischemic preconditioning in humans.

Reperfusion is essential for ischemic tissue survival, but causes additional damage to the endothelium (i.e. ischemia-reperfusion [IR] injury). Ischemic preconditioning (IPC) refers to short repetitive episodes of ischemia that can protect against IR. However, IPC efficacy attenuates with older age. Whether physical inactivity contributes to the attenuated efficacy of IPC to protect against IR injury in older humans is unclear. We tested the hypotheses that lifelong exercise training relates to 1) attenuated endothelial IR and 2) maintained IPC efficacy that protects veteran athletes against endothelial IR. In 18 sedentary male individuals (SED, 20 years, 63±7 years) and 20 veteran male athletes (ATH, >5 exercise hours/week for >20 years, 63±6 years), we measured brachial artery endothelial function with flow-mediated dilation (FMD) before and after IR. We induced IR by 20-minutes of ischemia followed by 20-minutes of reperfusion. Randomized over 2 days, participants underwent either 35-minute rest or IPC (3 cycles of 5-minutes cuff inflation to 220 mmHg with 5-minutes of rest) before IR. In SED, FMD decreased after IR (median [interquartile range]): (3.0% [2.0-4.7] to 2.1% [1.5-3.9], P=0.046) and IPC did not prevent this decline (4.1% [2.6-5.2] to 2.8% [2.2-3.6],P=0.012). In ATH, FMD was preserved after IR (3.0% [1.7-5.4] to 3.0% [1.9-4.1], P=0.82) and when IPC preceded IR (3.2% [1.9-4.2] to 2.8% [1.4-4.6],P=0.18). These findings indicate that lifelong exercise training is associated with increased tolerance against endothelial IR. These protective, preconditioning effects of lifelong exercise against endothelial ischemia-reperfusion may contribute to the cardio-protective effects of exercise training

Vascular Function and Structure in Veteran Athletes after Myocardial Infarction.

PURPOSE: Although athletes demonstrate lower cardiovascular risk and superior vascular function compared with sedentary peers, they are not exempted from cardiac events (i.e., myocardial infarction [MI]). The presence of an MI is associated with increased cardiovascular risk and impaired vascular function. We tested the hypothesis that lifelong exercise training in post-MI athletes, similar as in healthy controls, is associated with a superior peripheral vascular function and structure compared with a sedentary lifestyle in post-MI individuals. METHODS: We included 18 veteran athletes (ATH) (>20 yr) and 18 sedentary controls (SED). To understand the effect of lifelong exercise training after MI, we included 20 veteran post-MI athletes (ATH + MI) and 19 sedentary post-MI controls (SED + MI). Participants underwent comprehensive assessment using vascular ultrasound (vascular stiffness, intima-media thickness, and endothelium (in)dependent mediated dilatation). Lifetime risk score was calculated for a 30-yr risk prediction of cardiovascular disease mortality of the participants. RESULTS: ATH demonstrated a lower vascular stiffness and smaller femoral intima-media thickness compared with SED. Vascular function and structure did not differ between ATH + MI and SED + MI. ATH (4.0% ± 5.1%) and ATH + MI (6.1% ± 3.7%) had a significantly better lifetime risk score compared with their sedentary peers (SED: 6.9% ± 3.7% and SED + MI: 9.3% ± 4.8%). ATH + MI had no secondary events versus two recurrent MI and six elective percutaneous coronary interventions within SED + MI (P < 0.05). CONCLUSION: Although veteran post-MI athletes did not have a superior peripheral vascular function and structure compared with their sedentary post-MI peers, benefits of lifelong exercise training in veteran post-MI athletes relate to a better cardiovascular risk profile and lower occurrence of secondary events

Entering a new era of body indices: the feasibility of a body shape index and body roundness index to identify cardiovascular health status.

BACKGROUND: The Body Mass Index (BMI) and Waist Circumference (WC) are well-used anthropometric predictors for cardiovascular diseases (CVD), but their validity is regularly questioned. Recently, A Body Shape Index (ABSI) and Body Roundness Index (BRI) were introduced as alternative anthropometric indices that may better reflect health status. OBJECTIVE: This study assessed the capacity of ABSI and BRI in identifying cardiovascular diseases and cardiovascular disease risk factors and determined whether they are superior to BMI and WC. DESIGN AND METHODS: 4627 Participants (54±12 years) of the Nijmegen Exercise Study completed an online questionnaire concerning CVD health status (defined as history of CVD or CVD risk factors) and anthropometric characteristics. Quintiles of ABSI, BRI, BMI, and WC were used regarding CVD prevalence. Odds ratios (OR), adjusted for age, sex, and smoking, were calculated per anthropometric index. RESULTS: 1332 participants (27.7%) reported presence of CVD or CVD risk factors. The prevalence of CVD increased across quintiles for BMI, ABSI, BRI, and WC. Comparing the lowest with the highest quintile, adjusted OR (95% CI) for CVD were significantly different for BRI 3.2 (1.4-7.2), BMI 2.4 (1.9-3.1), and WC 3.0 (1.6-5.6). The adjusted OR (95% CI) for CVD risk factors was for BRI 2.5 (2.0-3.3), BMI 3.3 (1.6-6.8), and WC 2.0 (1.6-2.5). No association was observed for ABSI in both groups. CONCLUSIONS: BRI, BMI, and WC are able to determine CVD presence, while ABSI is not capable. Nevertheless, the capacity of BRI as a novel body index to identify CVD was not superior compared to established anthropometric indices like BMI and WC

Does new-onset postoperative atrial fibrillation after coronary artery bypass grafting affect postoperative quality of life?

Objectives: New-onset postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery. We investigated the effect of POAF on quality of life after coronary artery bypass grafting. Methods: All patients who underwent nonemergency coronary artery bypass grafting between March 2009 and January 2011 were requested to complete a Short Form-36 Health Survey before and 6 months after the procedure. Norm-based scores of 8 health status domains and 2 component summary scores were calculated. Only patients undergoing first-time coronary artery bypass grafting, with no history of atrial fibrillation, were included in the analyses. Results: Of 1608 patients, 360 (22.4%) had POAF diagnosed. Twenty-eight patients died within half a year after the procedure (1.7% in the no POAF group and 1.8% in the POAF group; P = .90). After excluding these patients, data from 1580 patients were analyzed. Preoperative questionnaires were returned by 66% of the patients and postoperative questionnaires by 65%. Preoperative scores did not differ between patients with and without POAF in any subcategory (0/10). After the procedure, 4 of 10 scores were worse in the group with POAF compared to patients without POAF. Patients without POAF improved in all subcategories (10/10) after the procedure, whereas those with POAF did so in only 7 of 10. Multilinear regression showed POAF to be an independent negative predictor for improved quality of life 6 months postoperatively in 7 of 10 subcategories, including both mental and physical component summary scores. Conclusions: New-onset POAF does affect 6-month postoperative mental and physical health, possibly warranting more aggressive POAF treatment

The unadjusted odds of CVD and CVD risk factor prevalence for ABSI, BRI, BMI, and WC.

<p>ABSI: A Body Shape Index; BRI: Body Roundness Index; BMI: Body Mass Index; WC; Waist Circumference.</p><p>Ranges in parentheses are 95% confidence intervals. The between cut points are 0.077, 0.080, 0.083, and 0.086 for ABSI; 2.8, 3.5, 3.9, 4.7 for BRI; 22.1, 23.7, 25.2, and 27.1 for BMI; 0.89, 0.94, 0.98, 1.04 for WC (males); 0.78, 0.82, 0.87, 0.94 for WC (females). *Significant at P<0.05; ^<i>Φ</i>Significant at P<0.01.</p><p>The unadjusted odds of CVD and CVD risk factor prevalence for ABSI, BRI, BMI, and WC.</p

Characteristics of the total study population and according to cardiovascular disease status.

<p>Abbreviations: ABSI, A Body Shape Index; BRI, Body Roundness Index; BMI, Body Mass Index; MI, Myocardial Infarction; norm PA, norm physical activity;</p><p>Data presented as mean (SD) or proportion (number).</p><p>*significantly different from ‘<i>Controls’</i>;</p><p>** significantly different from ‘ <i>CVD risk factors</i>’.</p><p>Characteristics of the total study population and according to cardiovascular disease status.</p

Correlations between ABSI, BMI, BRI, and WC.

<p><b>A.</b> Correlation between ABSI and BMI. Increase in ABSI and increase in BMI show a poor yet significant correlation (<i>r</i> = 0.087, <i>P</i><0.001). <b>B.</b> Correlation between ABSI and WC. Increase in ABSI and increase in WC show a significant correlation (<i>r</i> = 0.678, <i>P</i><0.001). <b>C.</b> Correlation between BRI and BMI. Increase in BRI and increase in BMI show a significant correlation (<i>r</i> = 0.780, <i>P</i><0.001). <b>D.</b> Correlation between BRI and WC. Increase in BRI and increase in WC show a significant correlation (<i>r = </i>0.898, <i>P</i><0.001). <b>E.</b> Correlation between BRI and ABSI. Increase in BRI and increase in ABSI show a significant correlation (<i>r = </i>0.642, <i>P</i><0.001).</p

Correlations between body size and shape.

<p>ABSI: A Body Shape Index; BRI: Body Roundness Index; BMI: Body Mass Index; WC; Waist Circumference.</p><p>Correlation coefficients between height, weight, ABSI, BMI, BRI, and WC among the NES study population (n = 4627). **Correlation is significant at the 0.01 level (2-tailed). *Correlation is significant at the 0.05 level (2-tailed).</p><p>Correlations between body size and shape.</p