Building the Capacity of Classroom Teachers as Extenders of Nutrition Education through Extension: Evaluating a Professional Development Model

Utilizing teachers as extenders may maximize the reach of Extension nutrition education programs; however, there is a need to identify effective professional development (PD) strategies to ensure quality implementation. Lesson study is a PD model that demonstrated improvements in school teachers’ self-efficacy and knowledge in various disciplines. In this study, fourth-grade teachers at two schools delivered nutrition education in their classrooms. Lesson study was examined to improve self-efficacy, content knowledge, and use of inquiry-based teaching strategies. While teachers at one school followed the lesson study model, teachers at the other school did not. Teachers reported time, resources, and funding were barriers to using lesson study and implementing the curriculum. Teachers who reported teaching nutrition previously declined in self-efficacy and knowledge. It is possible that they underestimated what would be required to teach this curriculum, resulting in a higher pre-test rating of self-efficacy compared to ratings after teaching the curriculum. This shift may have affected their motivation and willingness to participate fully in the lesson study process. Increasing teacher access to content experts during PD may improve teacher selfefficacy. Providing additional support and materials may increase the likelihood that teachers participate as extenders of Extension nutrition education programs

Association of Gene Variants with Seasonal Variation in Muscle Strength and Aerobic Capacity in Elite Skiers

Background: The training of elite skiers follows a systematic seasonal periodization with a preparation period, when anaerobic muscle strength, aerobic capacity, and cardio-metabolic recovery are specifically conditioned to provide extra capacity for developing ski-specific physical fitness in the subsequent competition period. We hypothesized that periodization-induced alterations in muscle and metabolic performance demonstrate important variability, which in part is explained by gene-associated factors in association with sex and age. Methods: A total of 34 elite skiers (20.4 ± 3.1 years, 19 women, 15 men) underwent exhaustive cardiopulmonary exercise and isokinetic strength testing before and after the preparation and subsequent competition periods of the World Cup skiing seasons 2015-2018. Biometric data were recorded, and frequent polymorphisms in five fitness genes, ACE-I/D (rs1799752), TNC (rs2104772), ACTN3 (rs1815739), and PTK2 (rs7460, rs7843014), were determined with specific PCR reactions on collected DNA. Relative percentage changes of cardio-pulmonary and skeletal muscle metabolism and performance over the two seasonal periods were calculated for 160 data points and subjected to analysis of variance (ANOVA) to identify hypothesized and novel associations between performance alterations and the five respective genotypes and determine the influence of age × sex. A threshold of 0.1 for the effect size (h2) was deemed appropriate to identify relevant associations and motivate a post hoc test to localize effects. Results: The preparation and competition periods produced antidromic functional changes, the extent of which varied with increasing importance for anaerobic strength, aerobic performance, cardio-metabolic efficiency, and cardio-metabolic/muscle recovery. Only peak RER (-14%), but not anaerobic strength and peak aerobic performance, and parameters characterizing cardio-metabolic efficiency, differed between the first and last studied skiing seasons because improvements over the preparation period were mostly lost over the competition period. A number of functional parameters demonstrated associations of variability in periodic changes with a given genotype, and this was considerably influenced by athlete "age", but not "sex". This concerned age-dependent associations between periodic changes in muscle-related parameters, such as anaerobic strength for low and high angular velocities of extension and flexion and blood lactate concentration, with rs1799752 and rs2104772, whose gene products relate to sarcopenia. By contrast, the variance in period-dependent changes in body mass and peak VO2 with rs1799752 and rs2104772, respectively, was independent of age. Likely, the variance in periodic changes in the reliance of aerobic performance on lactate, oxygen uptake, and heart rate was associated with rs1815739 independent of age. These associations manifested at the post hoc level in genotype-associated differences in critical performance parameters. ACTN3 T-allele carriers demonstrated, compared to non-carriers, largely different periodic changes in the muscle-associated parameters of aerobic metabolism during exhaustive exercise, including blood lactate and respiration exchange ratio. The homozygous T-allele carriers of rs2104772 demonstrated the largest changes in extension strength at low angular velocity during the preparation period. Conclusions: Physiological characteristics of performance in skiing athletes undergo training period-dependent seasonal alterations the extent of which is largest for muscle metabolism-related parameters. Genotype associations for the variability in changes of aerobic metabolism-associated power output during exhaustive exercise and anaerobic peak power over the preparation and competition period motivate personalized training regimes. This may help to predict and maximize the benefit of physical conditioning of elite skiers based on chronological characteristics and the polymorphisms of the ACTN3, ACE, and TNC genes investigated here

Wearable cardioverter-defibrillator as bridging to ICD in pediatric hypertrophic cardiomyopathy with myocardial bridging - a case report

Background: There is only limited experience with wearable cardioverter-defibrillators (WCD) in pediatric patients. We report on the successful application of a WCD in an adolescent patient with hypertrophic cardiomyopathy and myocardial bridging. Case presentation: A 15-year-old girl presented with a history of recurrent syncope, dyspnea, and vertigo with exercise. Diagnostic work-up revealed non-obstructive hypertrophic cardiomyopathy and signs of myocardial ischemia with exercise. Given this high-risk constellation, the patient was scheduled for prophylactic implantation of an implantable cardioverter-defibrillator (ICD). One month after initial presentation and days prior to the planned ICD implantation, the patient collapsed during an episode of sustained ventricular tachycardia (VT) while running. VT was terminated by WCD shock delivery. Following this event, computerized tomography scan revealed myocardial bridging of the left anterior descending coronary artery causing a 90% stenosis in systole. After coronary surgery, life threatening arrhythmias have not recurred, but due to progressive heart failure, the patient underwent successful heart transplantation after 2 years. Conclusions: The reported case highlights the importance and applicability of WCDs and the potentially malign nature of myocardial bridging in pediatric high-risk patients

Electrophysiological findings during re-do procedures after single-shot pulmonary vein isolation for atrial fibrillation with pulsed field ablation

Background: Pulsed field ablation (PFA) is a novel ablation technology recently adopted in the treatment of atrial fibrillation (AF). Currently, little is known about the durability of PFA ablation lesions. Methods: We investigated patients who underwent redo-ablation due to recurrent AF/atrial-flutter or tachycardia (AFL/AT) following PVI with PFA. We report electrophysiological findings and ablation strategy during redo-ablation. Results: Of 447 patients undergoing index PVI with PFA, 14 patients (age: 61.9±10.8 years; 7 (50.0%) males; left atrial volume index (n=10): 39.4±14.6 mL/m2) were referred for redo-ablation. Initial indication was paroxysmal-AF in 7 patients, persistent-AF in 6 and long-standing-persistent-AF in one patient. Mean time-to-recurrence was 4.9±1.9 months. Three patients received additional posterior-wall-isolation during index PFA. Twelve (85.7%) patients suffered AF recurrence and 5/12 had concomitant AFL. In the remaining 2 patients, one had a (box-dependent) AFL, and one had an atypical AT. No patients had all PVs reconnected. Reconnection in zero, one, two or three PVs was found in 35.7%, 21.4%, 14.3%, and 28.6% of patients, respectively. All 7 patients with zero or one reconnection with AF recurrence received additional/repeat posterior-wall-isolation during re-ablation, while in the others, PVs were re-isolated. Patients with only AFL/AT had no reconnection of PVs, and the substrate was successfully ablated. Conclusions: Durable PVI (all PV’s isolated) was observed in over one-third of patients at re-do. The predominant recurrent arrhythmia following PVI-only was AF. Concomitant (35.7%) or isolated (14.3%) AFL/AT recurrence was observed in 50% of patients.</p

Helper Syndrome and Pathological Altruism in nurses – a study in times of the COVID-19 pandemic

BackgroundPathological Altruism and the concept of Helper Syndrome are comparable. We focused on Schmidbauer’s description because it provides a comprehensive and testable definition. Nevertheless, this concept of Helper Syndrome has not yet been empirically investigated in a sample of helping professionals.AimTo investigate whether nurses working with covid-19 patients are more likely to have Helper Syndrome compared with individuals from non-helper professions.MethodsThe online survey took place between April 2021 and February 2022, in urban and rural regions of Salzburg, during the time of the COVID-19 pandemic. Nurses (n = 447) and controls (n = 295) were compared regarding Helper Syndrome characteristics. To measure characteristics of Helper Syndrome the following questionnaires were used: WHO-Five (WHO-5), selected scales of the Personality, Style and Disorder Inventory (PSSI) and the Freiburg Personality Inventory-Revised (FPI-R), the Alcohol Use Disorders Identification Test (AUDIT). Insecure gender identity and self-assessment of having a Helper Syndrome was measured by a Likert scale.ResultsIn both groups, Helper Syndrome was detected (nurses 29.5%, controls 30.5%). Participants with Helper Syndrome showed significant differences in personality styles and traits, namely significantly higher scores for Foreboding-Schizotypical Personality Style, Spontaneous-Borderline Personality Style, Amiable-Histrionic Personality Style, Ambitious-Narcissistic Personality Style, Loyal-Dependent Personality Style, Helpful-Selfless Personality Style, Carefully-Obsessive Personality Style, Optimistic-Rhapsodic Personality Style, Social Orientation, Strain, Emotionality and lower well-being. The only difference between nurses and controls was that nurses were significantly less open aggressive.ConclusionFor the first time, we were able to demonstrate Schmidbauer’s concept of Helper Syndrome. According to our data, we found a subgroup of individuals similar to Schmidbauer’s description of Helper Syndrome, but this sample was independent of helping or non-helping profession. These individuals seem to be at higher risk for psychiatric disorders

Depressive symptoms are more influenced by personality traits and styles than working in nursing—a study during the COVID-19 pandemic

BackgroundAccording to literature, the COVID-19 pandemic caused stressful working conditions for nurses, which may have a negative impact on their Well-Being and mental health.AimTo investigate whether nurses and non-helping professionals differ in their Well-Being. Furthermore, we analyzed, for the first time, which personality traits and styles are a risk factor for nurses’ wellbeing during COVID-19 pandemic.MethodsIn an online survey, the following psychological tests were used on nursing staff (n = 518) and non-helping professionals (n = 335): WHO-Five (WHO-5), the Personality, Style and Disorder Inventory (PSSI), and the Freiburg Personality Inventory-Revised (FPI-R).ResultsNurses and non-helping professionals did not differ significantly in terms of Well-Being. The Well-Being of nurses was correlated with the following personality traits and styles, namely Spontaneous-Borderline Personality Style, Silent-Depressive Personality Style, Strain, Emotionality, and Life Satisfaction. According to our results, 33% of participants suffered from clinically significant depressive symptoms.DiscussionAccording to our results, nurses are not more at risk for depression. However, it was shown that Well-Being during the pandemic is highly dependent on personality.ConclusionSpecific personality traits and styles are a greater predictor of depressive symptoms than profession. The stressful occupational environment during COVID-19 pandemic is not the only cause for depressive symptoms in nurses. Psychotherapeutic interventions are especially important for particular individuals and are necessary to prevent depressive symptoms during COVID-19 pandemic

The influence of marathon running on resting-state EEG activity: a longitudinal observational study

Physical activity (PA) has positive effects on various health aspects and neuronal functions, including neuronal plasticity. Exceeding a certain exercise frequency and duration has been associated with negative effects. Our study investigated the effects of excessive PA with a marathon run (MA) and regular PA (training and recovery phases) on electrocortical activity, as measured by electroencephalography (EEG). Thirty healthy marathon runners (26 male, 45 ± 9 yrs) were enrolled in the study. Four resting-state 32 channel EEG recordings were conducted: 12-8 weeks before MA (T-1), 14-4 days prior to MA (T0), 1-6 days after (T2), and 13-15 weeks after MA (T3). Power spectrum analyses were conducted using standardized Low-Resolution Electromagnetic Tomography (sLORETA) and included the following frequency bands: delta (1.5-6 Hz), theta (6.5-8.0 Hz), alpha1 (8.5-10 Hz), alpha2 (10.5-12.0 Hz), beta1 (12.5-18.0 Hz), beta2 (18.5-21.0 Hz), beta3 (21.5-30.0 Hz), and total power (1.5-30 Hz). Statistical nonparametric mapping showed reduced power both in the alpha-2 (log-F ratio = - 0.705, threshold log-F ratio =  ± 0.685, p < 0.05) and in the delta frequency band (log-F ratio = -0.699, threshold log-F ratio =  ± 0.685, p < 0.05) in frontal cortical areas after MA (T2 vs. T0). These effects diminished at long-term follow-up (T3). The results can be interpreted as correlates for subacute neuroplasticity induced by strenuous and prolonged PA. Although previous studies reported an increase in alpha frequency during and directly postexercise, the adverse observation a few days after exercise cessation suggests counterregulatory mechanisms, whose complex origin can be suspected in subcortical circuits, changes in neurotransmitter systems and modulation of affectivity

High-mobility group box 1 protein, receptor for advanced glycation end products and nucleosomes increases after marathon

Background: Prolonged and strenuous exercise has been linked to potential exercise-induced myocardial damages. One potential key to unmask the discussed underlying mechanisms of this subclinical cardiac damage could be markers of immunogenic cell damage (ICD). We investigated the kinetics of high-mobility group box 1 protein (HMGB1), soluble receptor for advanced glycation end products (sRAGE), nucleosomes, high sensitive troponin T (hs-TnT) and high sensitive C-reactive protein (hs-CRP) before and up to 12 weeks post-race and described associations with routine laboratory markers and physiological covariates. Methods: In our prospective longitudinal study, 51 adults (82% males; 43 ± 9 years) were included. All participants underwent a cardiopulmonary evaluation 10-12 weeks pre-race. HMGB1, sRAGE, nucleosomes, hs-TnT and, hs-CRP were analysed 10-12 weeks prior, 1-2 weeks before, immediately, 24 h, 72 h, and 12 weeks post-race. Results: HMGB1, sRAGE, nucleosomes and hs-TnT increased significantly from pre- to immediately post-race (0.82-2.79 ng/mL; 1132-1388 pg/mL; 9.24-56.65 ng/mL; 6-27 ng/L; p < 0.001) and returned to baseline within 24-72 h. Hs-CRP increased significantly 24 h post-race (0.88-11.5 mg/L; p < 0.001). Change in sRAGE was positively associated with change in hs-TnT (rs = 0.352, p = 0.011). Longer marathon finishing time was significantly associated with decreased levels of sRAGE [-9.2 pg/mL (β = -9.2, SE = 2.2, p < 0.001)]. Conclusion: Prolonged and strenuous exercise increases markers of ICD immediately post-race, followed by a decrease within 72 h. An acute marathon event results in transient alterations of ICD, we assume that this is not solely driven by myocyte damages