The road to gold: Training and peaking characteristics in the year prior to a gold medal endurance performance

Purpose: To describe training variations across the annual cycle in Olympic and World Champion endurance athletes, and determine whether these athletes used tapering strategies in line with recommendations in the literature. Methods: Eleven elite XC skiers and biathletes (4 male; 28±1 yr, 85±5 mL. min-1. kg-1 V̇O2max, 7 female, 25±4 yr, 73±3 mL. min-1. kg-1 V̇O2max) reported one year of day-to-day training leading up to the most successful competition of their career. Training data were divided into periodization and peaking phases and distributed into training forms, intensity zones and endurance activity forms. Results: Athletes trained ∼800 h/500 sessions.year-1, including ∼500 h. year-1 of sport-specific training. Ninety-four percent of all training was executed as aerobic endurance training. Of this, ∼90% was low intensity training (LIT, below the first lactate threshold) and 10% high intensity training (HIT, above the first lactate threshold) by time. Categorically, 23% of training sessions were characterized as HIT with primary portions executed at or above the first lactate turn point. Training volume and specificity distribution conformed to a traditional periodization model, but absolute volume of HIT remained stable across phases. However, HIT training patterns tended to become more polarized in the competition phase. Training volume, frequency and intensity remained unchanged from pre-peaking to peaking period, but there was a 32±15% (P<.01) volume reduction from the preparation period to peaking phase. Conclusions: The annual training data for these Olympic and World champion XC skiers and biathletes conforms to previously reported training patterns of elite endurance athletes. During the competition phase, training became more sport-specific, with 92% performed as XC skiing. However, they did not follow suggested tapering practice derived from short-term experimental studies. Only three out of 11 athletes took a rest day during the final 5 days prior to their most successful competition

Collaboration between home care staff, leaders and care partners of older people with mental health problems: A focus on personhood

Aim: To explore home care staff and leaders’ experiences of collaborating with care partners of older people with mental health problems through a personhood perspective.Background: Collaboration with care partners is a political aim in recent white papers in Norway and internationally. Home care services regularly work closely with care partners, but there are many indications that the collaboration does not work satisfactorily.Methods: The study had a qualitative design and comprised eight health professionals in two focus groups and in-depth interviews with three leaders in one home care district. The data were analysed using a thematic framework analysis building on previous research on personhood. COREQ reporting guidelines were used to ensure comprehensive reporting.Results: Four themes were identified in the analysis: ‘Non-negotiated relationships’, Contradictory agendas’, ‘Weak paternalism’ and ‘Moral compromise’.Conclusion: There seems to be a lack of facilitation of collaborative relationships through all levels of the home care organisation. The interactions between care partners and home care staff sometimes appear to produce low or negative levels of emotional energy, and situations where the personhood of neither of them is respected occurs. Paying attention to the four modes of being as a framework for understanding personhood, creates the foundation for a person-centred approach that enhances the potential of creating stronger partnership in care relationships.https://doi.org/10.1111/scs.1271434pubpub

Evidence for widespread alterations in cortical microstructure after 32 h of sleep deprivation

Cortical microstructure is influenced by circadian rhythm and sleep deprivation, yet the precise underpinnings of these effects remain unclear. The ratio between T1-weighted and T2-weighted magnetic resonance images (T1w/T2w ratio) has been linked to myelin levels and dendrite density and may offer novel insight into the intracortical microstructure of the sleep deprived brain. Here, we examined intracortical T1w/T2w ratio in 41 healthy young adults (26 women) before and after 32 h of either sleep deprivation (n = 18) or a normal sleep-wake cycle (n = 23). Linear models revealed significant group differences in T1w/T2w ratio change after 32 h in four clusters, including bilateral effects in the insular, cingulate, and superior temporal cortices, comprising regions involved in attentional, auditory and pain processing. Across clusters, the sleep deprived group showed an increased T1w/T2w ratio, while the normal sleep-wake group exhibited a reduced ratio. These changes were not explained by in-scanner head movement, and 95% of the effects across clusters remained significant after adjusting for cortical thickness and hydration. Compared with a normal sleep-wake cycle, 32 h of sleep deprivation yields intracortical T1w/T2w ratio increases. While the intracortical changes detected by this study could reflect alterations in myelin or dendritic density, or both, histological analyses are needed to clarify the precise underlying cortical processes.publishedVersio

Organizing Shared Digital Reading in Groups: Optimizing the Affordances of Text and Medium

Children develop their language when they explore and talk about literary texts. In this study, we explore the design of shared digital reading as a basis for critical reflection on the reading situation in an institutional context with its given opportunities and limitations. We examine six videotaped readings of one specific picture book app, with a focus on the strategies used by teachers in early childhood education and care institutions to control children’s access to the medium and the types of verbal engagement (about the story and about the medium) that are generated by these different strategies. We use qualitative and quantitative analysis of video data. A qualitative categorization of the readings reveals the strategies Show, Show & Share, and Share. In analyzing the participants’ verbal and multisensory engagement, we find that the Show strategy generates more utterances, especially about the story, as well as more time spent on dialogue.publishedVersio

A Photo Score for Aesthetic Outcome in Sagittal Synostosis:An ERN CRANIO Collaboration

European Reference Network (ERN) CRANIO is focused on optimizing care for patients with rare or complex craniofacial anomalies, including craniosynostosis and/or rare ear, nose, and throat disorders. The main goal of ERN CRANIO is to collect uniform data on treatment outcomes for multicenter comparison. We aimed to develop a reproducible and reliable suture-specific photo score that can be used for cross-center comparison of phenotypical severity of sagittal synostosis and aesthetic outcome of treatment. We conducted a retrospective study among nonsyndromic sagittal synostosis patients aged &lt;19 years. We included preoperative and postoperative photo sets from 6 ERN CRANIO centers. Photo sets included bird's eye, lateral, and anterior-posterior views. The sagittal synostosis photo score was discussed in the working group, and consensus was obtained on its contents. Interrater agreement was assessed with weighted Fleiss' Kappa and intraclass correlation coefficients.The photo score consisted of frontal bossing, elongated skull, biparietal narrowness, temporal hollowing, vertex line depression, occipital bullet, and overall phenotype. Each item was scored as normal, mild, moderate, or severe. Results from 36 scaphocephaly patients scored by 20 raters showed kappa values ranging from 0.38 [95% bootstrap CI: 0.31, 0.45] for biparietal narrowness to 0.56 [95% bootstrap CI: 0.47, 0.64] for frontal bossing. Agreement was highest for the sum score of individual items [intraclass correlation coefficients agreement 0.69 [95% CI: 0.57, 0.82]. This is the first large-scale multicenter study in which experts investigated a photo score to assess the severity of sagittal synostosis phenotypical characteristics. Agreement on phenotypical characteristics was suboptimal (fair-moderate agreement) and highest for the summed score of individual photo score items (substantial agreement), indicating that although experts interpret phenotypical characteristics differently, there is consensus on overall phenotypical severity.</p

European all-cause excess and influenza-attributable mortality in the 2017/18 season: should the burden of influenza B be reconsidered?

Objectives Weekly monitoring of European all-cause excess mortality, the EuroMOMO network, observed high excess mortality during the influenza B/Yamagata dominated 2017/18 winter season, especially among elderly. We describe all-cause excess and influenza-attributable mortality during the season 2017/18 in Europe. Methods Based on weekly reporting of mortality from 24 European countries or sub-national regions, representing 60% of the European population excluding the Russian and Turkish parts of Europe, we estimated age stratified all-cause excess morality using the EuroMOMO model. In addition, age stratified all-cause influenza-attributable mortality was estimated using the FluMOMO algorithm, incorporating influenza activity based on clinical and virological surveillance data, and adjusting for extreme temperatures. Results Excess mortality was mainly attributable to influenza activity from December 2017 to April 2018, but also due to exceptionally low temperatures in February-March 2018. The pattern and extent of mortality excess was similar to the previous A(H3N2) dominated seasons, 2014/15 and 2016/17. The 2017/18 overall all-cause influenza-attributable mortality was estimated to be 25.4 (95%CI 25.0-25.8) per 100,000 population; 118.2 (116.4-119.9) for persons aged 65. Extending to the European population this translates into over-all 152,000 deaths. Conclusions The high mortality among elderly was unexpected in an influenza B dominated season, which commonly are considered to cause mild illness, mainly among children. Even though A(H3N2) also circulated in the 2017/18 season and may have contributed to the excess mortality among the elderly, the common perception of influenza B only having a modest impact on excess mortality in the older population may need to be reconsidered.Peer Reviewe