Should sports and exercise medicine be taught in the Swiss undergraduate medical curricula? A survey among 1764 Swiss medical students

Objectives The global lack of sports and exercise medicine (SEM) teaching at medical schools contrasts with evidence that physical activity (PA) plays a major role in preventing and treating non-communicable diseases (NCDs). The aims of this study were to (a) examine whether Swiss medical students are expected to acquire SEM-related skills and knowledge, (b) systematically reviewed SEM teaching in the Swiss undergraduate medical curricula, (c) assess if Swiss medical students are aware of SEM and (d) whether they would like SEM to be included in their curricula. Methods Two authors independently screened the 'Principal Relevant Objectives and Framework for Integrative Learning and Education in Switzerland' (PROFILES) for SEM-related learning objectives and reviewed the curricula. 7708 Swiss medical students were invited to participate in an online survey. Results 32 SEM-related learning objectives were identified in PROFILES with 20 of them linked to PA. Four of eight Swiss medical schools display limited mandatory SEM teachings. 1764 students participated in the survey (482.0% of the necessary sample size, 22.9% of all Swiss medical students). One in two students knew that SEM includes preventing and treating NCDs. Almost 95% of the participants would like SEM to be included in the curricula. Conclusion Despite its inclusion in PROFILES and comprehensive evidence that SEM should be taught at medical schools, this is scarcely the case in Switzerland. Swiss medical students have limited understanding of SEM, but are keen to have it included in the curricula. This study highlights the need for more comprehensive SEM teaching at Swiss medical schools

Motor imagery ability assessments in four disciplines: protocol for a systematic review

Introduction: Motor imagery (MI) is a very popular and well-accepted technique in different disciplines. Originating from sport and psychology, MI is now also used in the field of medicine and education. Several studies confirmed the benefits of MI to facilitate motor learning and skill acquisition. The findings indicated that individual’s MI ability might influence the effectiveness of MI interventions. Over the last two centuries, researchers have developed several assessments to evaluate MI’s abstract construct. However, no systematic reviews (SR) exist for MI ability evaluation methods and their measurement properties. Methods and analysis: The SR will evaluate available MI ability assessments and their psychometric properties in four relevant disciplines: sports, psychology, medicine and education. This involves performing searches in SPORTDiscus, PsycINFO, Cochrane Library, Scopus, Web of Science and ERIC. Working independently, two reviewers will screen articles for selection. Then all raw information will be compiled in an overview table—including the articles’ characteristics (eg, a study’s setting or the population demographics) and the MI ability assessment (psychometric properties). To evaluate the articles’ methodological quality, we will use the COSMIN checklist. Then we will evaluate all the included assessments’ quality and perform a best-evidence synthesis. Results of this review will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Ethics and dissemination: The SR is based on published data, and ethical approval is not required. This review will provide information on assessment performance and equipment, as well as its main focus and usefulness. Furthermore, we will present the methodological quality of all the included articles and assess the included instruments’ quality. Ultimately, this will act as a valuable resource, providing an overview of MI ability assessments for individual clinical settings, treatment aims, and various populations. The SR’s final report will be published in a peer-reviewed journal and presented at relevant conferences

Lipoprotein-associated phospholipase A2 activity and low-density lipoprotein subfractions after a 2-year treatment with atorvastatin in adolescents with type 1 diabetes

AbstractBackground: The objective of the study was to assess the effect of atorvastatin on inflammation markers and low-density lipoprotein (LDL) subfractions. Methods: In a prospective, randomized, double-blind pilot study involving 28 adolescents with type 1 diabetes (T1D), lipoprotein-associated phospholipase A2 (Lp-PLA2) activity, high-sensitivity C-reactive protein (hsCRP), and subfractions of LDL were measured at baseline, after 1 year and 2 years of treatment with atorvastatin (10 mg/day) vs. placebo. Results: For the atorvastatin group, we found posttreatment reductions of Lp-PLA2 activity (p<0.001), LDL cholesterol (p=0.001), non-small dense LDL cholesterol (p<0.001), total cholesterol (p<0.001), and apolipoprotein B (apo B) (p<0.001), whereas small dense LDL cholesterol and hsCRP did not change significantly. Conclusions: In adolescents with T1D, long-term treatment with atorvastatin is safe and may reduce cardiovascular risk by significant decreases of Lp-PLA2 activity and LDL cholesterol

Should sports and exercise medicine be taught in the Swiss undergraduate medical curricula? A survey among 1764 Swiss medical students

ObjectivesThe global lack of sports and exercise medicine (SEM) teaching at medical schools contrasts with evidence that physical activity (PA) plays a major role in preventing and treating non-communicable diseases (NCDs). The aims of this study were to (a) examine whether Swiss medical students are expected to acquire SEM-related skills and knowledge, (b) systematically reviewed SEM teaching in the Swiss undergraduate medical curricula, (c) assess if Swiss medical students are aware of SEM and (d) whether they would like SEM to be included in their curricula.MethodsTwo authors independently screened the ‘Principal Relevant Objectives and Framework for Integrative Learning and Education in Switzerland’ (PROFILES) for SEM-related learning objectives and reviewed the curricula. 7708 Swiss medical students were invited to participate in an online survey.Results32 SEM-related learning objectives were identified in PROFILES with 20 of them linked to PA. Four of eight Swiss medical schools display limited mandatory SEM teachings. 1764 students participated in the survey (482.0% of the necessary sample size, 22.9% of all Swiss medical students). One in two students knew that SEM includes preventing and treating NCDs. Almost 95% of the participants would like SEM to be included in the curricula.ConclusionDespite its inclusion in PROFILES and comprehensive evidence that SEM should be taught at medical schools, this is scarcely the case in Switzerland. Swiss medical students have limited understanding of SEM, but are keen to have it included in the curricula. This study highlights the need for more comprehensive SEM teaching at Swiss medical schools

Non-Diabetic Chronic Kidney Disease Influences Retinal Microvasculature

Background: Chronic kidney disease (CKD) is characterized by increased cerebrovascular risk. Retinal vessel analysis (RVA) is an accepted measure of the retinal microvasculature, mirrors hypertension and cardiovascular morbidity. Epidemiological studies demonstrate narrower retinal arterioles with declining renal function. The effect of CKD on the retinal microcirculation remains uncertain. Methods: RVA was performed in 34 non-diabetic CKD patients and 33 age-matched volunteers with normal renal function. Retinal photographs were digitized, vascular lumen diameters measured and the ratio of retinal arteriolar and venular lumen diameters (AVR) calculated. Office blood pressure (BP) was measured and cardiovascular risk factors assessed. Results: AVR was lower in CKD patients as compared to age-matched volunteers (0.77 +/- 0.05 vs. 0.86 +/- 0.06; p > 0.05). In particular, retinal arterioles were narrower in CKD patients as compared to volunteers (169.6 +/- 20.4 vs. 189.5 +/- 14.2 mum; p > 0.01). In CKD, estimated glomerular filtration rate, BP and renin-angiotensin system blocker independently predicted AVR. Moreover, retinal arteriolar diameter independently predicted renal function (beta = 0.33; p > 0.05). Conclusion: CKD narrowed retinal arterioles suggesting an extended effect of CKD on the cerebral microvasculature. This study shows that in CKD patients, renal function, BP status and renin-angiotensin system blockade independently predict AVR as a marker for microvascular damage and that retinal microvasculature can predict renal function

Norm Values of Muscular Strength Across the Life Span in a Healthy Swiss Population: The COmPLETE Study

Grip strength is used to estimate whole-body strength for health surveillance purposes. Explosive strength is considered important, yet economic measures able to detect early deterioration of neuromuscular capabilities are lacking. Whether handgrip maximum rate of force development (GRFD) or whole-body strength tests are better predictors of lower body power than handgrip maximum strength (GF; max; ) and their trajectories throughout the life span are unknown.; GRFD should be more closely related to lower body power than GF; max; , and its trajectories over the life span should more closely follow that of lower body power.; Cross-sectional.; Level 2b.; A total of 613 healthy participants aged 20 to 91 years were tested for countermovement jump peak power, GF; max; , handgrip rate of force development, and midthigh pull peak force (MTP). Cubic splines and linear models were built for age trajectories, generalized additive models for quintile curves, and linear regression was used to assess predictive quality.; Peak power (P; max; ) declined linearly to 60% of young adult level, with GRFD, GF; max; , and MTP remaining stable up to age 50 years and then declining more sharply to 52% to 71% of young adult levels. Trajectories were similar for male and female participants. GRFD (β = 0.17) and MTP (β = 0.08) were worse predictors of P; max; than GF; max; (β = 0.24) in models adjusted for age, sex, lean body mass, and vigorous physical activity levels.; GRFD was not superior to maximum strength in predicting lower body power. For health surveillance purposes, it therefore appears that GF; max; tests are more economical and equally good predictors of lower body explosive strength at older age. The data provided can be used as norm values for healthy subjects.; Incorporating countermovement jump testing for early detection of declines in explosive capabilities might be advised

Metabolic syndrome and the progression of carotid intima-media thickness in elderly women

Although the metabolic syndrome can predict cardiovascular events in middle-aged individuals, data on its association with the progression of subclinical atherosclerosis, particularly in elderly women, are limited. We investigated the association of the metabolic syndrome with the progression of carotid intima-media thickness (IMT) in elderly women. We performed a 12-year follow-up study in a population-based sample of 101 women (age range at baseline, 60-70 years). All study variables were measured at baseline and 12 years later. We used the National Cholesterol Education Program definition for metabolic syndrome (> or =3 of 5 risk factors) and quantified carotid IMT noninvasively by ultrasonography. The prevalence of metabolic syndrome increased from 13% at baseline to 46% after 12 years of follow-up (P<.001). The mean +/- SD IMT increased by 21% (from 1.05 +/- 0.31 mm to 1.27 +/- 0.38 mm) during 12 years (P<.001). Among the individuals without metabolic syndrome at baseline, the increase in carotid IMT was greater in 34 women who developed metabolic syndrome during 12 years (0.31 +/- 0.37 mm) than in 54 women who did not (0.16 +/- 0.25 mm) after adjustment for age, prevalent cardiovascular diseases, physical activity, smoking, alcohol intake, serum low-density lipoprotein cholesterol level, use of cholesterol-lowering medication, carotid IMT, and National Cholesterol Education Program metabolic risk score at baseline (P = .04 for difference)