Longitudinal Intervention Study Research Articles

Food Literacy and Dietary Intake in German Office Workers: A Longitudinal Intervention Study.

Widespread patterns of poor dietary behavior are a key factor causing the increasing prevalence of chronic diseases around the world. Research has provided initial insights into the potential of food literacy (FL) to empower individuals to improve their dietary behavior. However, studies on FL interventions in working adults are scarce. The intervention delivered in this study was a comprehensive 3-week full time education-based workplace health promotion program (WHPP) that provided the participants with in-depth knowledge and skills regarding nutrition and health. We aimed to investigate the short- and long-term effects of the WHPP on FL and dietary intake (DI) and to examine the association between FL and DI in a sample of 144 German office workers (30.0% female). Using two random intercept mixed linear regression models, we found significant strong improvements for both FL (β = 0.52, p < 0.0001) and DI (β = 0.63, p < 0.0001) after the WHPP when compared to baseline. Significant long-term improvements at 18 months were strong for FL (β = 0.55, p < 0.0001) and weak for DI (β = 0.10, p < 0.0001). FL showed a significant moderate effect on DI across all measurement time points (β = 0.24, p < 0.0001). We conclude that well-designed WHPPs can induce long-term improvements in FL and DI, and that FL can be viewed as an asset to further expand food-related knowledge and skills and to enhance dietary behavior. Our study fills a gap of long-term findings regarding the role of FL in WHPPs and supports the idea of implementing FL in the development of comprehensive WHPPs to improve DI.

Instructional support in inquiry-based elementary school science classes: how does it relate to students’ science content knowledge and academic language proficiency?

Inquiry-based science instruction has been proposed as an optimal learning environment for language-integrated teaching. While its potential for developing both content knowledge and language skills has been shown for students with limited language proficiency, research focusing on mainstream classrooms has mainly considered domain-specific learning. Despite the effectiveness of inquiry-based science instruction for student outcomes, research on the role of specific aspects of instructional quality is limited. Addressing this research gap, the present study investigates the relationship between teachers’ instructional support during inquiry-based science classes and elementary school students’ learning gains in science content knowledge and academic language proficiency. Multilevel regression analyses are based on data from 459 German elementary school students from Grades 3 and 4 who participated in a longitudinal intervention study that took place over one school year. Our findings indicate a strong impact of students’ prior knowledge on learning outcomes and compositional effects for the language-related measures. Relations between teachers’ instructional support, as measured by the Classroom Assessment Scoring System (CLASS; Pianta et al., 2008), and students’ learning outcomes did not emerge. In interpreting the results, the overall mediocre quality of teachers’ instructional support needs to be considered.

Identifying Personality Characteristics and Indicators of Psychological Well-Being Associated With Attrition in the Motivation Makes the Move! Physical Activity Intervention: Randomized Technology-Supported Trial.

Data attrition has been a common problem in longitudinal lifestyle interventions. The contributors to attrition in technology-supported physical activity interventions have not been thoroughly studied. The present study examined the roles of personality characteristics and indicators of psychological well-being in data attrition within a technology-supported, longitudinal intervention study with overweight adults. Participants (N=89) were adults from the Motivation Makes the Move! intervention study. Data attrition was studied after a 3-month follow-up. Participants' personality characteristics were studied using the Short Five self-report questionnaire. Psychological well-being indicators were assessed with the RAND 36-item health survey, Positive and Negative Affect Schedule, and Beck Depression Inventory. Logistic regression analyses were conducted to assess the risk of discontinuing the study. The analyses were adjusted for sex, age, study group, and educational status. At the 3-month follow-up, 65 of 89 participants (73% of the initial sample) had continued in the study. Participants' personality characteristics and indicators of psychological well-being were not associated with the risk of dropping out of the study (all P values >.05). The results remained the same after covariate controls. Participant attrition was not attributable to personality characteristics or psychological well-being in the Motivation Makes the Move! study conducted with overweight adults. As attrition remains a challenge within longitudinal, technology-supported lifestyle interventions, attention should be paid to the potentially dynamic natures of personality and psychological well-being, as well as other elements beyond these. ClinicalTrials.gov NCT02686502; https://clinicaltrials.gov/ct2/show/NCT02686502.

The impact of a targeted education package on the knowledge, attitudes, and utilisation of patient reported outcome measures amongst chiropractors in Australia

BackgroundPatient Reported Outcome Measures (PROMs) have been shown to be valid and reliable indicators of health status and treatment outcomes, however, the current knowledge, understanding, and utilisation of PROMs within the Australian Chiropractic profession is limited. This study used the New World Kirkpatrick Model (NWKM) to evaluate whether an online PROM education package could improve knowledge, confidence, attitude, and utilisation of PROMs by chiropractors in Australia.MethodsA longitudinal cohort interventional study of chiropractors in Australia. The recruitment phase and data collection period occurred from November 2020 – May 2021. Participants completed three online surveys two weeks before, four weeks after, and 12 weeks after receiving an online education package that included ten evidence-based region-specific modules on PROMs. Survey questions were grouped into five subthemes for analysis according to the NWKM levels: (1) Reaction; (2) Learning - knowledge; (3) Learning – confidence; (4) Behaviour – attitude; (5) and Behaviour - utilisation).ResultsOf the 116 participants that enrolled in the study, 43 completed all three survey and were included in the analysis. There was very positive reaction to the education package with mean response scores (1–5 Likert scale) for the reaction questions ranging from 3.75 to 4.43. There was a small, but significant, increase in knowledge (out of 32) at four weeks (24.3 ± 6.1) and 12 weeks after receiving the education package (27.2 ± 5.5), compared to baseline (27.4 ± 5.1). There was no effect of the intervention on clinician confidence or attitude towards PROMs. Utilisation of function- and pain-related PROMs did not change after the intervention. There was a small and significant (p < 0.05) increase in utilisation of health-related PROMs 12 weeks after the intervention.ConclusionDespite modest improvements in knowledge, which were retained 12 weeks after the educational package was provided, there was no evidence that participant confidence, attitude, or utilisation of PROMs changed because of the intervention. While the respondents’ have positive attitudes and beliefs regarding PROMs use, further education surrounding the clinical translation process into clinical practice is required. Caution is advised when interpreting these findings due to the low participant response and completion rate with the potential for selection bias and the inability to generalise the results.

Functional changes in the oral microbiome after use of fluoride and arginine containing dentifrices: a metagenomic and metatranscriptomic study

BackgroundTooth decay is one of the most prevalent diseases worldwide, and efficient tooth brushing with a fluoride-containing dentifrice is considered fundamental to caries prevention. Fluoride-containing dentifrices have been extensively studied in relation to enamel resistance to demineralization. Arginine (Arg) has also been proposed as a promising prebiotic to promote pH buffering through ammonia production. Here, we present the first metagenomic (DNA sequencing of the whole microbial community) and metatranscriptomic (RNAseq of the same community) analyses of human dental plaque to evaluate the effect of brushing with fluoride (Fl) and a Fl+Arg containing dentifrices on oral microbial composition and activity. Fifty-three patients were enrolled in a longitudinal clinical intervention study with two arms, including 26 caries-active and 27 caries-free adults. After a minimum 1-week washout period, dental plaque samples were collected at this post-washout baseline, 3 months after the use of a 1450-ppm fluoride dentifrice, and after 6 months of using a 1450-ppm fluoride with 1.5% arginine dentifrice.ResultsThere was a shift in both the composition and activity of the plaque microbiome after 3 months of brushing with the fluoride-containing toothpaste compared to the samples collected at the 1-week post-washout period, both for caries-active and caries-free sites. Although several caries-associated bacteria were reduced, there was also an increase in several health- and periodontitis-associated bacteria. Over 400 genes changed proportion in the metagenome, and between 180 and 300 genes changed their expression level depending on whether caries-free or caries-active sites were analyzed. The metagenome and metatranscriptome also changed after the subjects brushed with the Fl+Arg dentifrice. There was a further decrease of both caries- and periodontitis-associated organisms. In both caries-free and caries-active sites, a decrease of genes from the arginine biosynthesis pathway was also observed, in addition to an increase in the expression of genes associated with the arginine deiminase pathway, which catabolizes arginine into ammonia, thereby buffering acidic pH. Bacterial richness and diversity were not affected by either of the two treatments in the two arms of the study.ConclusionsOur data demonstrate that long-term use of both assayed dentifrices changes the bacterial composition and functional profiles of human dental plaque towards a healthier microbial community, both in caries-free and caries-active sites. This observation was especially apparent for the Fl+Arg dentifrice. Thus, we conclude that the preventive benefits of tooth brushing go beyond the physical removal of dental plaque and that the active ingredients formulated within dentifrices have a positive effect not only on enamel chemistry but also on the metabolism of oral microbial populations.-kQdKShqK4FxgvJNrxZQaCVideo

Unexpected employee location is associated with injury during robberies

Millions of employees are victims of violent crimes at work every year, particularly those in the retail industry, who are frequent targets of robbery. Why are some employees injured while others escape from these incidents physically unharmed? Departing from prevailing models of workplace violence, which focus on the static characteristics of perpetrators, victims, and work environments, we examine why and when injuries during robberies occur. Our multimethod investigation of convenience-store robberies sought evidence from detailed coding of surveillance videos and matched archival data, preregistered experiments with formerly incarcerated individuals and customer service personnel, and a 3-y longitudinal intervention study in the field. While standard retail-industry safety protocols encourage employees to be out from behind the cash register area to be safer, we find that robbers are significantly more likely to injure or kill employees who are located there (versus behind the cash register area) when a robbery begins. A 3-y field study demonstrates that changing the safety training protocol-through providing employees with a behavioral script to follow should a robbery begin when they are on the sales floor-was associated with a significantly lower rate of injury during these robberies. Our research establishes the importance of understanding the interactive dynamics of workplace violence, crime, and conflict.

Short- and Long-Term Effects of a Prebiotic Intervention with Polyphenols Extracted from European Black Elderberry-Sustained Expansion of Akkermansia spp.

(1) Background: The intestinal microbiome has emerged as a central factor in human physiology and its alteration has been associated with disease. Therefore, great hopes are placed in microbiota-modulating strategies. Among various approaches, prebiotics, substrates with selective metabolization conferring a health benefit to the host, are promising candidates. Herein, we studied the prebiotic properties of a purified extract from European black elderberries, with a high and standardized content of polyphenols and anthocyanins. (2) Methods: The ELDERGUT trial represents a 9-week longitudinal intervention study divided into 3 distinct phases, namely a baseline, an intervention and a washout period, three weeks each. The intervention consisted of capsules containing 300 mg elderberry extract taken twice a day. Patient-reported outcomes and biosamples were collected weekly. Microbiome composition was assessed using 16S amplicon metagenomics. (3) Results: The supplementation was well tolerated. Microbiome trajectories were highly individualized with a profound shift in diversity indices immediately upon initiation and after termination of the compound. This was accompanied by corresponding changes in species abundance over time. Of particular interest, the relative abundance of Akkermansia spp. continued to increase in a subset of participants even beyond the supplementation period. Associations with participant metadata were detected.

Use of cyproheptadine hydrochloride (HCl) to reduce neuromuscular hypertonicity in stroke survivors: A Randomized Trial: Reducing Hypertonicity in Stroke

ObjectivesThe goal of this study was to examine how the administration and dosing of the anti-serotonergic medication cyproheptadine hydrochloride (HCl) affects involuntary muscle hypertonicity of the spastic and paretic hands of stroke survivors. Materials and MethodsA randomized, double-blinded, placebo-controlled longitudinal intervention study was performed as a component of a larger clinical trial. 94 stroke survivors with chronic, severe hand impairment, rated as levels 2 or 3 on the Chedoke-McMaster Stroke Assessment Stage of Hand (CMSA-H), were block randomized to groups receiving doses of cyproheptadine HCl or matched doses of placebo. Doses were increased from 4 mg BID to 8 mg TID over 3 weeks. Outcomes were assessed at baseline and after each of the three weeks of intervention. Primary outcome measure was grip termination time; other measures included muscle strength, spasticity, coactivation of the long finger flexors, and recording of potential adverse effects such as sleepiness and depression. Results89 participants (receiving cyproheptadine HCl: 44, receiving placebo: 45) completed the study. The Cyproheptadine group displayed significant reduction in grip termination time, in comparison with the Placebo group (p<0.05). Significant change in the Cyproheptadine group (45% time reduction) was observed after only one week at the 4mg BID dosage. The effect was pronounced for those participants in the Cyproheptadine group with more severe hand impairment (CMSA-H level 2) at baseline. Conversely, no significant effect of Group * Session interaction was observed for spasticity (p=0.6) or coactivation (p=0.53). There were no significant changes in strength (p=0.234) or depression (p=0.441) during the trial. ConclusionsUse of cyproheptadine HCl was associated with a significant reduction in relaxation time of finger flexor muscles, without adversely affecting voluntary strength, although spasticity and coactivation were unchanged. Decreasing the duration of involuntary flexor activity can facilitate object release and repeated prehensile task performance. RegistrationClinical Trial number: NCT02418949

Interleaved Assistance and Resistance for Exoskeleton Mediated Gait Training: Validation, Feasibility and Effects.

Strength and selective motor control are primary determinants of pathological gait in children with cerebral palsy (CP) and other neuromotor disorders. Emerging evidence suggests robotic application of task-specific resistance to functional movements may provide the opportunity to strengthen muscles and improve neuromuscular function during walking in children with CP. Such a strategy could be most beneficial to children who are more severely affected by the pathology but their ability to overcome such resistance and maintain functional ambulation remains unclear. The goal of this study was to design, validate and evaluate initial feasibility and effects of a novel exoskeleton strategy that provides interleaved assistance and resistance to knee extension during overground walking. One participant with CP (GMFCS III) was recruited and completed ten total visits, nine walking with the exoskeleton. Our results validated the controller's ability to parse the gait cycle into five discrete phases (mean accuracy 91%) and provide knee extension assistance during stance and resistance during swing. Following acclimation to the interleaved strategy, peak knee extension was significantly improved in both the left (mean 7.9 deg) and right (15.2 deg) limbs when walking with the exoskeleton. Knee extensor EMG during late swing phase increased to 2.7 (left leg) and 1.7 (right leg) times the activation level during baseline exoskeleton walking without resistance. These results indicate that this interleaved strategy warrants further investigation in a longitudinal intervention study, particularly in individuals who may be more severely affected such that they are unable to ambulate overground using an exoskeleton training strategy that only deploys targeted resistance to limb motion.

Communication between hospitals, Family Medicine Groups and community pharmacists during transitions of care interventions.

Pharmacist-led transitions of care (TOC) interventions have been associated with improved health outcomes. Community pharmacists' (CP) TOC communications have been described whereas limited evidence is available for hospital pharmacists (HP) and none for non-dispensing pharmacists, integrated into Family Medicine Groups (FMG). To assess information needs and perceptions about TOC communications of HP, FMG pharmacists (FMG-P) and CP and to identify optimal TOC practices and their barriers. In a cross-sectional design, a survey was distributed via email to the 70 pharmacists who participated in a multicenter, single group, longitudinal TOC intervention study for older adults at risk of medication-related harm. All pharmacists were surveyed on their TOC practices before the TOC study, as part of usual care. Pharmacists who followed TOC study patients were also surveyed on their TOC practices during the TOC study. Survey responses were received from 35 pharmacists (50%), including 8 HP, 6 FMG-P and 21 CP. The frequency of communication between pharmacists of different settings increased significantly during the TOC study, with more than 80% of pharmacists reporting satisfaction with the quality of the information provided. At hospital discharge, in optimal TOC, the FMG-P and CP reported that the most important information to transfer was the reasons of hospitalization, patient weight and height, and the therapeutic intent of the medications. The main barriers to TOC implementation were the lack of clinical information about patients for FMG-P and CP and understaffing for HP. FMG-P and CP reported a similar high degree of interest in assuming responsibility for the new extended scope of practice activities of medication adjustments according to therapeutic targets or laboratory results and the implementation of a plan for gradual dose increases or drug tapering. The surveyed pharmacists reported an increased frequency of communication and satisfaction with the information exchanged between the pharmacists of different settings during the TOC study compared to usual care, before the study. The pharmacists extended scope of practice offers new opportunities to optimize TOC interventions.

Mitigating structural racism to reduce inequities in sepsis outcomes: a mixed methods, longitudinal intervention study

BackgroundSepsis affects 1.7 million patients in the US annually, is one of the leading causes of mortality, and is a major driver of US healthcare costs. African American/Black and LatinX populations experience higher rates of sepsis complications, deviations from standard care, and readmissions compared with Non-Hispanic White populations. Despite clear evidence of structural racism in sepsis care and outcomes, there are no prospective interventions to mitigate structural racism in sepsis care, nor are we aware of studies that report reductions in racial inequities in sepsis care as an outcome. Therefore, we will deliver and evaluate a coalition-based intervention to equip health systems and their surrounding communities to mitigate structural racism, driving measurable reductions in inequities in sepsis outcomes. This paper presents the theoretical foundation for the study, summarizes key elements of the intervention, and describes the methodology to evaluate the intervention.MethodsOur aims are to: (1) deliver a coalition-based leadership intervention in eight U.S. health systems and their surrounding communities; (2) evaluate the impact of the intervention on organizational culture using a longitudinal, convergent mixed methods approach, and (3) evaluate the impact of the intervention on reduction of racial inequities in three clinical outcomes: a) early identification (time to antibiotic), b) clinical management (in-hospital sepsis mortality) and c) standards-based follow up (same-hospital, all-cause sepsis readmissions) using interrupted time series analysis.DiscussionThis study is aligned with calls to action by the NIH and the Sepsis Alliance to address inequities in sepsis care and outcomes. It is the first to intervene to mitigate effects of structural racism by developing the domains of organizational culture that are required for anti-racist action, with implications for inequities in complex health outcomes beyond sepsis.

Sustainability of physical work capacity two years post outpatient cardiac rehabilitation

Objective To determine if supervised training, after the completion of cardiac rehabilitation program, performed for a further two years would help maintain beneficial effects achieved during prolonged outpatient cardiac rehabilitation. Design Longitudinal parallel-grouped intervention study. Subjects Patients with coronary artery disease (n = 41, age 59.5 ± 9.3 years), who finished cardiac rehabilitation phase III in our outpatient cardiac rehabilitation facility. Intervention Two years of supervised exercise training consisting of endurance (either high intensity interval training or pyramid training) and resistance training sessions once a week. Main measurement Peak physical work capacity was assessed via an ergometry testing at the beginning and at the end of the study. Results Comparisons between end-of-cardiac rehabilitation and two years post cardiac rehabilitation revealed maintenance of peak physical work capacity after two years (begin vs end: 170 ± 59 W vs 167 ± 60 W; −0.5 ± 12.8%; p = 0.521). This was independent of exercise training protocols (percent change begin vs end: pyramid: 1.5 ± 11.8%; interval: −1.6 ± 13.4%; p = 0.459). Conclusion Improvement of physical exercise capacity gained during outpatient cardiac rehabilitation can be maintained for up to two years by once-weekly supervised exercise training. Long-term, group-based exercise programs offered at the end of cardiac rehabilitation might be an effective tool to help patients maintain their physical work capacity.

Effect of different hemodialysis modalities on hepcidin clearance in patients undergoing maintenance hemodialysis.

Hepcidin is a master regulator of iron utilization and takes part in the pathophysiology of anemia in maintenance hemodialysis (MHD) patients. Hepcidin is a moderate-molecular-weight substance and partially binds to plasma proteins in the circulation, which theoretically might be removed efficiently by hemoperfusion (HP). This study aimed to compare the effect of different dialysis modalities on hepcidin removal and discuss its effect on the iron and anemia status in MHD patients. In a longitudinal interventional study of 26 stable MHD patients, the serum hepcidin, β2-microglobulin (β2-MG), and intact parathyroid hormone (iPTH) were measured before and after one treatment session of hemodialysis (HD), hemodiafiltration (HDF), HD + HP, and HDF + HP, separately. One-way analysis of variance (ANOVA) was used to identify the effect of dialysis modalities on the intra-dialysis clearance ratios. The combined dialysis modalities (HD + HP and HDF + HP) achieved greater clearance ratios of serum hepcidin than HD and HDF alone, HD + HP vs. HD (16 ± 15% vs. 4 ± 13%, p < 0.001), HDF + HP vs. HDF (18 ± 5% vs. 10 ± 13%, p = 0.0036). Similarly, the combined dialysis modalities also performed better than HD and HDF alone in removing β2-MG. There was no significant difference in iPTH clearance among these four modalities, except that HDF + HP achieved a greater clearance ratio than HD. Furthermore, the anemia was improved after the 6-month treatment with regular HD/HDF plus HP, which was indicated by increasing hemoglobin (p = 0.0004) and reduction of erythropoiesis-stimulating agents (ESAs) resistance index (ERI) (p = 0.0431). Our findings suggest that the combined dialysis modalities of HD/HDF plus HP could achieve better clearance ratios of hepcidin than HD/HDF alone, thereby, might improve iron utilization, and benefit anemia management in MHD patients. Further studies with larger sample-size patients and longer follow-up duration are still needed.

RETROSPECTIVE STUDY ON PRESCRIPTION PATTERN OF DRUGS USED TO TREAT PREGNANCY INDUCED HYPERTENSION AND OTHER COMPLICATIONS

Objective:To Identify Pregnancy induced complications.The Aim of this study is to Analyse Prescription patterns of the drugs to treat Pregnancy induced Hypertension and other complications among pregnant women. Material And Methods Of The Study:This is a Retrospective Clinical Longitudinal Interventional study, conducted among 100 Pregnant Women at a study site of St. Joseph General Hospital. Relevant data such as Demographic details of patients, Risk factors Past medical history, Family history, Pregnancy Gravida, Last menstrual period and Last Child Birth were collected from previous one year old medical records. Statistical Consideration: All the Raw data which had collected was entered in MICROSOFT EXCEL SHEET 2007version, the Statistical analysis was done through SAS software version 9.4by an appropriate Statistical methods continues variables are Presented as Mean values- Standard deviation and categorical variables are presented as Percentages.Wehad estimated the Incidence proportion of PIH by age,Gravida and also estimated the Incidence of other complications. Results:Among 100 Patients, we estimated incidence proportion of PIH by age group of 26-30 years the incidence is 41.56% , Next category of age group is 21-25 years the incidence is 24.68%. And next PIH according to Gravida,58% had developed in Primi and 30% had developed in second gravida, also 8% in third gravid lastly 4% in fourth gravida. Also,The incidence proportion in pregnancy induced complications are Gestational diabetes mellitus-53%, Pre-eclampsia-4%,Others-43%. Conclusion:We conclude that among 100 Pregnant women most of them were having Pregnancy induced hypertension, the drug of choice is Labetolol-100mg,followed by Gestational diabetes mellitus and other complications Hypothyroidism, RH-ve factor, Urinary tract infections, Anaemia ,Oligohydramnios.

Growing Memories: Benefits of an early childhood maternal reminiscing intervention for emerging adults’ turning point narratives and well-being

The current study is an emerging adult follow-up of a longitudinal intervention study of maternal reminiscing (Growing Memories; N = 115). Mothers in the intervention condition were taught elaborative reminiscing skills when their children were 1.5–2.5 years old. We tested long-term effects of the intervention for emerging adults’ turning-point narratives and well-being at age 21 (n = 94; 82%). Emerging adults in the intervention condition displayed greater causal coherence (connections between past and present self) in their turning-point narratives and reported higher self-esteem and fewer depression symptoms than those in the control condition, even after accounting for personality traits and early childhood covariates. These findings suggest that maternal reminiscing has a long-term impact on their offsprings’ narrative identity and well-being.

Risks and Protective Factors of Hispanic Families and Their Young Children during the COVID-19 Pandemic.

This study examines the risk-related factors during the pandemic and protective factors that might reduce its effects on family functioning in a sample of 161 low-income Hispanic parents in the United States, recruited from an ongoing longitudinal intervention study. They were surveyed about family functioning six months into the pandemic. We focused on the associations between social (e.g., exposure to the virus) and economic (e.g., job loss) pandemic-related risks on parental stress, parenting, and children’s socioemotional problems and skills, as well as the degree to which coparenting support, parents’ positivity, economic support, and access to services and information mitigated (protected) the negative effects of these stressors on family functioning. We found that increases in economic risk were associated with more child competence skills, whereas increases in social risk were associated with less parental engagement. Positivity and economic support moderated the effects of economic risk on parental stress and engagement. These findings show that to intervene effectively with low-income Hispanic families, we need to strengthen and support the resources for coping with adversity.

Neuromuscular Aging: A Case for the Neuroprotective Effects of Dancing

Aim: We planned a cross-sectional investigation (study 1) and a longitudinal training intervention (study 2) to investigate whether recreational dancing affords greater neuroprotective effects against age-related neuromuscular junction (NMJ) degeneration compared to general fitness exercise training. Methods: In study 1, we recruited 19 older volunteers regularly practising dancing (older dancers [OD]) and 15 recreationally physically active older individuals (OA) and physical performance, muscle morphology, muscle function, and NMJ stability (from serum C-terminal agrin fragment [CAF] concentration) were assessed. In study 2, employing a longitudinal study design in a different cohort (composed of 37 older adults), we aimed to study whether a 6-month dancing intervention decreased CAF concentration compared to general fitness exercise training in older adults. Results: Our findings show that OD had a lower CAF concentration (suggesting an increased NMJ stability) compared to OA. This result was accompanied by superior functional performance despite no differences in muscle size. In study 2, we observed a reduction in CAF concentration only in the dancing group. Conclusion: Overall, these findings suggest that dancing is an effective training modality to promote neuroprotection and increase muscle function in healthy older individuals.

A two-week gaming abstinence reduces Internet Gaming Disorder and improves mental health: An experimental longitudinal intervention study

Since the COVID-19 outbreak, digital gaming has become a welcome pastime and distraction for many people. However, this phenomenon can have severe consequences; intensive digital gaming can foster the Internet Gaming Disorder (IGD) and negatively affect mental health. The present experimental longitudinal study investigated the consequences of a conscious abstinence from gaming in a German sample. The experimental group (N = 131; age: M = 26.21, SD = 7.70) did not engage in gaming for two weeks; the control group (N = 140; age: M = 25.10, SD = 4.94) maintained its gaming time and habits. Gaming-related variables and mental health-related variables were assessed via online surveys at five measurement time points (baseline, intermediate status, post-intervention, one-month follow-up, three-month follow-up). The intervention significantly reduced gaming time, gaming flow, IGD, daily stress, and anxiety symptoms. Moreover, we found a significant improvement in positive mental health. The effects were stable over the three months of the investigation. Thus, we could show that a conscious and controlled, short-term abstinence from gaming leads to reduced IGD and a better mental health. The present results emphasize that conscious periods of gaming abstinence could be an effective step in the clinical context and in mental health prevention programs, especially during a pandemic such as the COVID-19 outbreak.

Prevention of heart failure in type 2 diabetes by exercise intervention: protocol and design of the PROTECTION study

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): research Foundation - Flanders (FWO) Introduction Cardiac dysfunction is highly prevalent in patients with type 2 diabetes mellitus (T2DM), leading to increased risk of cardiac morbidity and premature death. Previous research underscored the high prevalence of a disturbed global longitudinal strain (GLS), a marker to predict this cardiac dysfunction, in both symptomatic and asymptomatic T2DM patients. Exercise-based therapy is recommended in the management of patients with type 2 diabetes. However, it remains unclear i) which type of exercise therapy to have the biggest effect on GLS and ii) which factors modify the effect of exercise therapy on GLS. Purpose The PROTECTION study will i) investigate the impact of exercise volume and intensity on GLS to optimize exercise prescription in T2DM and will ii) assess which patient-specific factors influence the change in GLS and physical fitness as a result of exercise intervention in T2DM. Methods and analyses The PROTECTION study is composed of two work packages (WP). In WP 1, 100 T2DM adults (50% male, aged 30-75 years) will be randomized to a usual care group or one of the three supervised exercise intervention groups (see Table 1) for a duration of 26 weeks. Outcome measures will be performed at baseline, 13, 26 and 52 weeks of follow-up. The primary outcomes are GLS and cardiac dimensions. Secondary outcomes include health-related physical fitness, blood biomarkers and physical activity behavior. Data will be analyzed by two-way ANOVA repeated measures. A two-tailed P-value &amp;lt;0.05 will be considered statistically significant. Parallel with the randomized controlled trial, a longitudinal intervention study (WP2) involving 107 adults (50% male, aged 30-75 years) with T2DM will be conducted. All participants will engage in a supervised intervention for 26 weeks, including a high volume of moderate intense physical activity (see Table 1). The main objective of this work package is to define determinants of change in GLS during an exercise intervention. Moreover, the interaction between diet-exercise, habitual physical activity-exercise and phenotype-exercise on change in GLS will be studied in great detail. Patient-specific data will be analyzed by multivariate regression analysis. A two-tailed P-value &amp;lt;0.05 will be considered statistically significant. Conclusion It is anticipated that the PROTECTION study will contribute to a better understanding on i) which exercise characteristics are preferred to maximally improve GLS in T2DM and on ii) the determinants of the responsiveness of GLS and physical fitness to exercise in T2DM.

Norwegian Secondary School Teachers’ Reflections on Models for Physical Activity During Schooltime: A Longitudinal Intervention Study

To prevent the negative trend regarding youths’ physical activity (PA) level, schools have been promoted as an appropriate arena for facilitating increased PA among youths. This study focuses on Norwegian secondary school teachers’ perceptions of models for PA during schooltime, by interviews before, during and after a PA intervention, where various PA models are implemented in a secondary school. An important finding is that implementation of PA at school must consider the complexity of the teacher’s practice, the diversity of students, and the need for flexibility among teachers in their daily practice. Our study show that facilitating PA in secondary school by using several methods, is experienced as the most preferable approach by the teachers, and this supports the idea of a whole-school approach. Future research should focus on interventions where teachers gain experience with all the models aimed at implementing PA in school.