bluuebunny/crossref_metadata_2025 huggingface dataset:
A case report of upgrading to cardiac resynchronization therapy in a patient with congenitally corrected transposition of great arteries and dextrocardia
Authors: Šimka Jakub , Sedláček Kamil , Praus Rudolf , Pařízek Petr
Published: September 2023

Background

Congenitally corrected transposition of the great arteries (CCTGA) is a rare congenital heart anomaly. Physiological correction may be associated with a long pre-symptomatic period in many patients and delayed accidental diagnosis. Additional related congenital malformations may increase the complexity of cardiac interventions.

Case summary

A 59-year-old man with known dextrocardia, situs viscerum inversus, and CCTGA was scheduled for upgrading of a dual-chamber pacemaker to cardiac resynchronization therapy to treat heart failure related to a progressive systolic dysfunction of the systemic right ventricle (RV). Because of the specific anatomy of this patient, the therapeutic procedure was complicated by the cannulation of the Marshall vein. Nevertheless, the left ventricular lead was successfully implanted into the coronary sinus lateral branch. At the 3-month follow-up, the patient remarkably reported a significant functional improvement, despite no favourable reverse remodelling of the systemic RV.

Discussion

Upgrade of a pacemaker to biventricular pacing was feasible in this patient, who had CCTGA and dextrocardia, which resulted in symptomatic improvement at follow-up. Pre-implant contrast cardiac computed tomography angiography was essential for visualizing the venous-specific anatomy in this patient, who suffered from congenital heart disease. Conduction system pacing represents a potential alternative for the patient to prevent or treat pacing-related heart failure.
Unicentric Castleman’s disease associated with malignant cardiac Amyloid-A amyloidosis: a case report
Authors: Schuetz Thomas , Schiller Dietmar , Klingel Karin , Gattermeier Martin , Poelzl Gerhard
Published: September 2023

Background

Unicentric Castleman’s disease (UCD), a lymphoproliferative disorder characterized by enlargement of the lymph nodes, is a rare cause of Amyloid-A amyloidosis. While patients usually present with impaired kidney function and proteinuria, heart involvement is neither common nor the main cause of signs and symptoms.

Case summary

We present a patient who was admitted to the hospital for impaired exercise capacity. Diagnostic work-up revealed severe left ventricular hypertrophy suggestive of cardiac amyloidosis. Although Congo red staining of endomyocardial biopsies was initially negative, subsequent immunohistochemical staining against serum amyloid A finally confirmed the diagnosis of cardiac amyloidosis. 18F-fluorodeoxyglucose positron emission tomography/computed tomography revealed a tumour located in dorsal of the duodenum. Fine-needle aspiration biopsy of the tumour was suggestive but could not confirm the presence of UCD beyond reasonable doubt. Rapid worsening of heart failure symptoms warranted urgent surgical tumourectomy, which resulted in immediate post-operative lowering of serum amyloid protein. However, post-operative cardiogenic shock could not be stabilized even with veno-arterial extracorporeal membrane oxygenation, and the patient eventually died. The UCD of the hyaline vascular (HV) subtype was confirmed by pathologic work-up of the excised tumour.

Discussion

This case report presents for the first time a patient with malignant cardiac Amyloid-A amyloidosis caused by unicentric Castleman’s disease of the HV subtype. Since the disease progresses swiftly, rapid diagnosis is essential for potential curative treatment.
Extensive cardiovascular involvement in a young boy with Gaucher’s disease: a case report
Authors: Naderian Mohammadreza , Khederlou Hamid , Hosseinsabet Ali , Salarifar Mojtaba
Published: September 2023

Background

Lysosomal storage diseases (LSDs) are rare, progressive, multi-organ disorders caused by inherited enzyme deficiencies. Gaucher’s disease (GD) is the most prevalent form of LSDs.

Case summary

A 19-year-old Caucasian male presented with exertional dyspnoea. Physical examination revealed a Grade III/VI systolic diamond murmur at the heart base and a Grade IV/VI systolic murmur at the apex. Electrocardiogram showed signs of left ventricular hypertrophy (LVH). Trans-thoracic echocardiography (TTE) and trans-oesophageal echocardiography (TEE) demonstrated moderate LVH, severe aortic valve stenosis, severe supra-valvular aortic stenosis, and moderate mitral stenosis with severe degenerative mitral valve regurgitation. Bone marrow biopsy and aspiration confirmed the presence of characteristic Gaucher's cells. The patient underwent the Bentall procedure and mitral valve replacement and was discharged in good condition.

Discussion

Gaucher’s disease exhibits three clinical phenotypes, and cardiovascular involvement is commonly seen in GD Type III. Valvular calcification and ascending aorta involvement are frequent cardiovascular manifestations. Although severe valvular heart involvement is rare in GD, cardiac valve surgery has shown favourable outcomes in previous studies and our case.
Pre-screening for non-diagnostic coronary computed tomography angiography
Authors: Hakimjavadi Ramtin , Lu Juan , Yam Yeung , Dwivedi Girish , Small Gary R , Chow Benjamin J W
Published: September 2023

Aims

Indiscriminate coronary computed tomography angiography (CCTA) referrals for suspected coronary artery disease could result in a higher rate of equivocal and non-diagnostic studies, leading to inappropriate downstream resource utilization or delayed time to diagnosis. We sought to develop a simple clinical tool for predicting the likelihood of a non-diagnostic CCTA to help identify patients who might be better served with a different test.

Methods and results

We developed a clinical scoring system from a cohort of 21 492 consecutive patients who underwent CCTA between February 2006 and May 2021. Coronary computed tomography angiography study results were categorized as normal, abnormal, or non-diagnostic. Multivariable logistic regression analysis was conducted to produce a model that predicted the likelihood of a non-diagnostic test. Machine learning (ML) models were utilized to validate the predictor selection and prediction performance. Both logistic regression and ML models achieved fair discriminate ability with an area under the curve of 0.630 [95% confidence interval (CI) 0.618–0.641] and 0.634 (95% CI 0.612–0.656), respectively. The presence of a cardiac implant and weight >100 kg were among the most influential predictors of a non-diagnostic study.

Conclusion

We developed a model that could be implemented at the ‘point-of-scheduling’ to identify patients who would be best served by another non-invasive diagnostic test.
Recurrences of ventricular tachycardia after stereotactic arrhythmia radioablation arise outside the treated volume: analysis of the Swiss cohort
Authors: Herrera Siklody Claudia , Schiappacasse Luis , Jumeau Raphaël , Reichlin Tobias , Saguner Ardan M , Andratschke Nicolaus , Elicin Olgun , Schreiner Frederic , Kovacs Boldizsar , Mayinger Michael , Huber Adrian , Verhoeff Joost J C , Pascale Patrizio , Solana Muñoz Jorge , Luca Adrian , Domenichini Giulia , Moeckli Raphael , Bourhis Jean , Ozsahin Esat M , Pruvot Etienne
Published: September 2023

Aims

Stereotactic arrhythmia radioablation (STAR) has been recently introduced for the management of therapy-refractory ventricular tachycardia (VT). VT recurrences have been reported after STAR but the mechanisms remain largely unknown. We analysed recurrences in our patients after STAR.

Methods and results

From 09.2017 to 01.2020, 20 patients (68 ± 8 y, LVEF 37 ± 15%) suffering from refractory VT were enrolled, 16/20 with a history of at least one electrical storm. Before STAR, an invasive electroanatomical mapping (Carto3) of the VT substrate was performed. A mean dose of 23 ± 2 Gy was delivered to the planning target volume (PTV). The median ablation volume was 26 mL (range 14–115) and involved the interventricular septum in 75% of patients. During the first 6 months after STAR, VT burden decreased by 92% (median value, from 108 to 10 VT/semester). After a median follow-up of 25 months, 12/20 (60%) developed a recurrence and underwent a redo ablation. VT recurrence was located in the proximity of the treated substrate in nine cases, remote from the PTV in three cases and involved a larger substrate over ≥3 LV segments in two cases. No recurrences occurred inside the PTV. Voltage measurements showed a significant decrease in both bipolar and unipolar signal amplitude after STAR.

Conclusion

STAR is a new tool available for the treatment of VT, allowing for a significant reduction of VT burden. VT recurrences are common during follow-up, but no recurrences were observed inside the PTV. Local efficacy was supported by a significant decrease in both bipolar and unipolar signal amplitude.
S1-2 Findings from the children and adolescent working group project on whole systems approaches to whole school physical activity promotion across Europe
Authors: Morris Jade
Published: September 2023

This talk will focus on a working group project investigating the research, policy and practice needs related to co-developing a whole-school system approach to physical activity (PA).

The World Health Organization (2018) calls for all countries to implement a whole-system approach and positions school as an opportune site for increasing PA opportunities for children. Yet, current research reveals that most whole-school approaches fail to create impactful and sustainable changes. Consistent limitations include a focus on short-term initiatives that fail to address the many ingredients required to promote systems change through addressing organisational structure and culture within and beyond school settings. While contemporary guidance provides an in-depth understanding of “what” factors to address within the school, the system still lacks an understanding of “how” to address each factor required to create impactful and sustainable change. It is essential that the implementation of the different ingredients that form the school system are co-developed with multi-stakeholders from within and beyond the school environment.

Project description

To establish the research, policy and practice needs related to co-developing a whole-school systems approach to PA, this project includes three stages.

First, we drew on an extensive European network to identify and categorise stakeholders involved in influencing and/or operationalising whole-school PA across the region.

Second, we will conduct a needs analysis to systematically identify training needs. We will conduct six focus groups across Europe to gain diverse stakeholders perspectives on the required training needs aligned to capabilities, opportunities, and motivation (COM-B). Finally, we will be using the aforementioned insights to create a policy briefing on whole-school systems-based PA training needs. We will conduct two virtual stakeholder events to consult on the findings and gather further insights, offering contextual different within and between countries.

Conclusion

The policy briefing will provide recommendations for working across national contexts relating to school-based PA, providing guidance for policymakers and practitioners. We anticipate these insights will promote the development of bottom-up and top-down approaches to create ‘systems’ change within the school context.

Funding

This project is supported by the WHO European Office for Prevention and Control of Noncommunicable Diseases.
S5-5 Developing an individual-based advice for sports participation and physical activity in children using the concept of Physical Literacy
Authors: Singh Amika , Veldman Sanne
Published: September 2023

Purpose

Practitioners, researchers and policy makers have been looking for ways to change the negative trend observed in physical activity (PA) behaviour in children. An individual PA advice for children, based on the concept of physical literacy (PL), might offer an important avenue to support and motivate children to be physically active in a way that fits their needs and skills. Due to the holistic approach of PL, this concept is suitable for the development of an individual PA advice to motivate children to be physically active for life. Therefore, we aim to develop a feasible tool to provide children aged 4 to 12 years with an individual PA advice in the Dutch school setting.

Method

In this project, experts on the different areas of PL collaborate to create a tool feasible for implementation in the Dutch primary school setting. Experts will comprise children, parents, practitioners, researchers and policy makers.

First, available measurement instruments on (elements of) PL will be reviewed. This will help us determine what instruments are best suitable to be used in the Dutch setting to create ‘input’ for a tool. Secondly, we will examine how data from these instruments can be harmonized to create an individual PA advice. This step will involve close collaborations with ICT while adhering to privacy rules and regulations. During this step we will also examine how the translation from ‘input’ to ‘output’, an individual PA advice, might have to differ for different age groups. Thirdly, we will develop a plan for the implementation in the Dutch setting and educational context. This involves feasibility in terms of finances as well as feasibility from a practical point of view.

Conclusion

By creating a tool to develop an individual PA advice, we hope to support and motivate children and parents to engage in PA that will last a life time. Throughout the process, relevant stakeholders will be involved in any step needed to ensure acceptability, feasibility and sustainability.

Funding

This project is funded by the Dutch Ministery of Health, Welfare, and Sports.
S7-4 Active transport to physical exercise places among older adults living in different urban zones
Authors: Keskinen Kirsi E , Tuomola Essi-Mari , Rantanen Taina , Portegijs Erja
Published: September 2023

Purpose

Motorized transport to and from places of physical exercise (PE) causes considerable amounts of carbon emissions. We study how locations of home and PE place on urban zones (UZs), reflecting options for transport modes, relate to use of active transport (AT) among older adults. No previous knowledge on the topic exists.

Methods

Data of AGNES study participants reporting at least one regular PE place <10 km from home (n = 819, mean 79 years, 58% women, Jyväskylä Finland) were combined with geospatial data on UZ. Using digital mapping, participants located their PE places (N = 2171) and reported transport mode (active/passive) used. Type of UZ (pedestrian/public transport/car) of participants’ home and PE places and distance from home to PE place were defined in GIS. For analyses, participants were grouped according to home UZ, shares of PE places in each UZ defined, and differences in total number of PE places and median distance tested with Kruskal-Wallis test. In each group, use of AT (vs. passive) to PE place was regressed for PE place’s UZ and distance, and adjusted for car availability, difficulty walking 2 km, age, sex, and years of education using a mixed model nested in participants.

Results

In all groups, participants had more PE places in their home UZ than in other UZs. Median distance to and number of PE places did not differ across groups (for both p>.05). Overall, between-participant differences explained 22 % of total variance in AT. Compared to AT to PE place in home UZ, odds for AT were higher to PE place in car zones among those living in pedestrian (OR 5.1 95%CI 1.7-15.4) and public transport zones (OR 3.6 95%CI 1.3-8.4).

The odds for AT were lower to PE place in pedestrian zones among those living in public transport (OR 0.2 95%CI 0.1-0.4) or car zones (OR 0.02 95%CI 0.001-0.3). In all groups, longer distance was negatively associated with AT.

Conclusions

Older adults’ transport mode choices cannot be concluded from the UZ of home or PE place. Proximity to PE places is important to facilitate AT use.

Funding Source

Ministry of Education and Culture.
S12-2 The effectiveness of a peer-led school-based walking intervention on adolescent girls’ physical activity: the Walking In ScHools (WISH) study
Authors: Carlin Angela , O'Kane S Maria , Doherty Leanne C , Gallagher Alison M , Lahart Ian M , Jago Russell , McDermott Gary , Faulkner Maria , Murphy Marie H
Published: September 2023

Purpose

Adolescent girls are failing to meet current physical activity (PA) guidelines. PA behaviours track from childhood to adulthood so providing adolescent girls with opportunities to be physically active may have benefits well beyond childhood. The effects of walking interventions on adult health are known, however less is understood about the potential of walking to promote PA in adolescents. Following the WISH pilot feasibility study that reported an increase in light intensity PA, a full trial has been undertaken to evaluate the effectiveness of a novel school-based walking intervention at increasing PA levels of adolescent girls.

Methods

The WISH study is a clustered randomised controlled trial in which a peer-led, school-based, brisk walking intervention is compared to usual PA in adolescent girls (12-14years). Data was collected at four timepoints over a 13-month period. Following baseline data collection, schools were randomly allocated to intervention (n = 9) or control (n = 9). In intervention schools, older pupils (aged 15-18years) were trained as walk leaders and led younger girls in 10-15min walks before school and at break-times across the school year (20-22weeks). The primary outcome was accelerometer-measured total PA (post-intervention). Secondary outcomes included anthropometry, quality of life and sleep.

Results

In total, 590 participants (mean(SD) age 12.6(0.6)years) were recruited from 18 schools across Northern Ireland (n = 9) and the Republic of Ireland (n = 9). Within the intervention schools, 149 walk leaders were trained (mean(SD) age 17.1(0.8)years). At baseline (n = 535), mean(SD) time spent in moderate to vigorous PA (MVPA) was 39.2(17.1)mins/day and only 66 (12%) girls achieved PA guidelines of 60minutes MVPA per day. Post-intervention interviews were conducted with n = 18 walk leaders and n = 9 teachers. Focus groups (n = 9) were conducted with a mix of high and low attenders. Data analysis is ongoing, and the process evaluation is underway (both will be complete by May 2023).

Conclusion

To our knowledge, this is the first fully powered trial to investigate the effectiveness of a peer-led brisk walking intervention in adolescent girls. The current study builds on a promising pilot trial which confirmed the feasibility of the intervention. If the intervention increases PA, it has potential to be implemented widely.
S12-3 School-based physical activity promotion in a cross-cultural context: interventions from France and Spain
Authors: Bachouri-Muniesa Hisham , Fabre Nicolas , Aibar Alberto , Lhuisset Lena , Asún-Dieste Sonia , Bois Julien , Julián-Clemente José A , Ibor Eduardo , Zaragoza Javier
Published: September 2023

Purpose

School-based interventions seems to be effective to promote active lifestyles among youth but recent literature shows that these interventions have a lack of effectiveness and very few report data on its sustainability. In the same way, few of these interventions are being replicated in different contexts than their beginning. Therefore, the balance between the adaptability and fidelity of a programme in a new context is nowadays an implementation gap.

Project

For this reason, the 2PASS-4Health (Promoting PA in Secondary Schools for Health) project has created a collaborative network between different European universities with the purpose of promoting Health-Enhancing Physical Activity (HEPA) in adolescents in a school-based environment. This project was made to identify the good practices and the main problems linked to the design, implementation, evaluation, and sustainability of interventions aimed at HEPA promotion. In this line, two school-based (effective) interventions in a cross-cultural context have been disseminated and developed, at the same time, both in France and Spain respectively to examine the key parts in the process of fidelity, adaptability and sustainability of them.

The intervention developed in France, took place in Tarbes, a little city in the south of the country. In the other side of the Pyrenees, the other intervention took place in Jaca (Spain), in the north of Aragon’s region. Both interventions adopted a multi-level approach involving all parts of the educational community: students, families, teachers and policymakers. The research team (all together) with the school’s staff developed the interventions by a co-creational process helped by local policymakers. As a result of these interventions, an intervention guide was developed. This tool can be used by stakeholders to disseminate and adapt these school-based interventions to make their effects sustainable over time (sustainability).

Conclusion

The collaborative line of this project renders visible the possibility of connecting cross-cultural educational contexts, through common elements in similar school-based interventions, with the aim of creating environments that promote HEPA.
S15-2 Physical activity, sedentary behaviour, and cognitive function among older adults: a bibliometric analysis of literature from 2002 to 2022
Authors: Yang Zhen , Marent Pieter-Jan , Hotterbeex Pauline , van Uffelen Jannique
Published: September 2023

Purpose

Physical activity and sedentary behaviour have received intense interest in recent decades from a variety of stakeholders due to their diverse association with cognitive function, which is a key component in maintaining health of older adults. The aim of this bibliometric analysis is to reveal the developmental structure, research hotspots, and predict future trends in the field of physical activity, sedentary behaviour, and cognitive function research among older adults.

Methods

This study adhered strictly to the step-by-step guideline of bibliometric analysis. Publications in this field from 2002 to 2022 were retrieved from the Web of Science Core Collection. Only original articles and review articles published in English were included in the analysis. A cubic polynomial was applied to determine the publication trends. CiteSpace (6.1.R4 Basic) and VOSviewer (1.6.18) were performed to obtain collaborative networks, reference co-cited networks, and keyword co-occurrence networks, as well as to perform burst analysis to predict future trends.

Results

A total of 1093 publications were retrieved, of which 73.56% obtained research grants. The publications were cited 30,317 times. Within two decades there was rapid growth in publications in this field. The USA (329 items, 30.10%) and China (136 items, 12.44%) were the top contributors, and the USA had the strongest collaborative network. University of British Columbia (41 items, 3.75%) and University of California System (40 items, 3.66%) were the most active institutions. Liu-Ambrose T (32 items, 2.93%) and Shimada H (20 items, 1.83%) contributed to the largest number of publications. Journal of Aging and Physical Activity, and Frontiers in Aging Neuroscience were the most active journals. Reference co-cited networks, and keyword co-occurrence networks revealed that hotspots in this field were age, nursing home resident, tai chi, and perceptions, while future trends in this field were healthy ageing, qi gong, sedentary behaviour, and falls.

Conclusions

There has been an increased research interest in the interrelationships between physical activity, sedentary behaviour, and cognitive function in older adults in the past two decades. Our findings will help researchers, practitioners, and other stakeholders to understand the structure and hotspots in this relevant field of research.

Funding

Not applicable.
O.1.1-1 Burnout and recovery need among Flemish secondary school teachers: what type of physical activity-intensity matters?
Authors: Verhavert Yanni , Van Hoof Elke , Zinzen Evert , De Martelaer Kristine , Van Cauwenberg Jelle , Deliens Tom
Published: September 2023

Purpose

Teacher burnout is a topic of concern for educational institutions and thus it is important to investigate how teacher burnout can be managed or prevented. Previous research showed that physical activity (PA) may be effective in reducing burnout, but research regarding the optimal PA-intensity is lacking. Therefore, the aim of this study was to investigate the association between PA-intensities, burnout and recovery need in secondary school teachers in Flanders.

Methods

One thousand nine hundred and nine secondary school teachers were included in this cross-sectional study. In September-October 2019, all teachers completed an online-questionnaire assessing burnout dimensions (i.e., emotional exhaustion, depersonalization and personal accomplishment), recovery need, and PA-intensities per domain (i.e., walking, moderate-intensity PA and vigorous-intensity PA in the following domains: work-related PA, active transport, leisure-time PA, domestic & garden PA), as well as sociodemographic and work-related factors. Multiple linear regression models were applied to identify which PA intensities are significantly associated with the burnout dimensions and recovery need. Adjusted (i.e., adjusted for all PA intensities within each PA domain) and unadjusted models (i.e., PA intensities per domain separately) were created.

Results

The unadjusted models showed that depersonalization was positively associated with moderate-intensity PA at work and moderate-intensity domestic & garden PA, and that more personal accomplishment was associated with more walking at work and during transport. The adjusted models showed that emotional exhaustion and recovery need were negatively associated with vigorous-intensity PA during leisure-time and positively associated with moderate-intensity domestic & garden PA, and that more depersonalization was associated with more walking during leisure-time.

Conclusion

Walking at work, during transport and during leisure-time, moderate-intensity PA at work, vigorous-intensity PA during leisure-time and moderate-intensity domestic & garden PA may be important factors when it comes to managing or preventing burnout and recovery need. Due to the cross-sectional study design, no conclusions about the causal relationship can be made. Future research should use longitudinal or experimental designs to get more insight into causality.
O.1.1-3 Measuring the mental health benefits of community-based physical activity programmes-what are the most important indicators for pragmatic evaluation?
Authors: Aisling McGrath , Murphy Niamh , Evan Matthews , Annemarie Wagemakers , Mark Tully , Kirsten Verkooijen
Published: September 2023

Purpose

While health enhancing physical activity (HEPA) initiatives can improve mental health, there is a lack of standardised measures to evaluate mental health outcomes. The need for the current work emerged from discussions amongst researcher and practitioner members of the HEPA promotion in socially disadvantaged groups Working Group of the HEPA Europe network. This study aimed to identify the most relevant indicators of mental health and well-being in community-based HEPA initiatives in Europe, and determine optimal assessment methods.

Methods

An adapted, two round, Delphi method (guided by an indicator framework to categorise mental health indicators based on the dual-continua and socio-ecological models) was conducted with 20 experts in the field of mental health and physical activity from Denmark, the Netherlands, the UK, and Ireland. Experts selected the most important indicators and agreed consensus on definitions and their application, where consensus ≥50% signified important indicators.

Results

Experts compiled 66 (n = 21 outcome, n = 45 determinant) indicators. Top rated indicators for the evaluation of HEPA initiatives were self-rated mental health (69.2%), physical activity (69.2%) life satisfaction (53.8%), stress (53.8%), loneliness (53.8%), social participation, network, connection and support (53.8%). Consensus on definition and application of the nine indicators varied (44.4% - 100%), with no consensus on a standardised measurement tool reached.

Conclusions

While this study highlights a lack of conformity for evaluating mental health and wellbeing outcomes, it suggests utility in an agreed definition and application of nine indicators for the evaluation of HEPA initiatives, with social determinants of particularly high importance across all countries. Suggested measures are provided to aid community based practitioners measure mental health outcomes of physical activity programmes. Further research is recommended to develop a standardised measurement tool that can be utilised across other European countries and its implementation tested.
O.1.1-9 Clinical symptoms and body composition correlates with cardiorespiratory fitness in adults with bipolar disorder: FINEXT-BD study
Authors: Gorostegi-Anduaga Ilargi , Etxaniz-Oses José , Tous-Espelosin Mikel , Maldonado-Martin Sara , Lopez Purificación , Gonzalez-Pinto Ana
Published: September 2023

Purpose

Bipolar disorder (BD) is a mental illness involving mood disorder, characterized by alternating normal mood, manic and depressive symptom. People with BD are associated with an unhealthy lifestyle. Assessment of cardiorespiratory fitness (CRF) indicates the overall health and can be directly measured and assessed by the cardiopulmonary exercise test and peak oxygen uptake (VO2peak), respectively. The CRF in the BD population may be altered due to sex, age, depression symptoms, and inactivity. The aim of this study was to analyze possible correlations of CRF with clinical symptoms and body composition variables.

Methods

Participants (n = 53, 44.9 ± 13.2 yr old) with BD were assessed with (1) body mass index and fat body mass (FBM) percentage; (2) upright bicycle ergometer using an incremental ramp protocol to get the VO2peak; and (3) symptoms of the disease [Hamilton Depression Rating Scale (HRSD) and Clinical Global Impressions Scale (CGI-S)]. Correlation analyses were performed among clinical symptoms, BMI, and VO2peak.

Results

The studied population showed overweight based on BMI (29.4±6.8 kg/m2), and obesity taking into account the fat mass percentage (33.6±10.6 %). According to Kaminsky et al., participants were classified in the 40th percentile with a low physical condition (VO2peak =25.8±8.4 mL·kg-1·min-1). Spearman's rho correlation coefficients demonstrated an inverse relationship between VO2peak (mL·kg−1·min−1) and HRSD (B=-0.286; P = 0.040); VO2peak (mL·kg−1·min−1) and CGI-S (B=-0.277; P = 0.047); and VO2peak (mL·kg−1·min−1) and FBM (B=-0.606; P < 0.001).

Conclusions

In population with BD a significantly higher CRF was detected in those with lower clinical symptoms, as well as lower FBM. Exercise interventions for improving CRF should be promoted in this population to better control clinical symptoms.
O.1.1-10 Determinants of mental health: do body mass index, perceived stress and acculturation impact the mental health of international medical students?
Authors: Umami Afriza , Molnár Regina , Paulik Edit
Published: September 2023

Background

International medical students are more likely to experience mental health issues. In addition to the acculturation challenges, people living with obesity often struggle with mood and anxiety disorders. The aim of this study was to investigate the association between mental health and nutritional status of international medical students, focusing on body mass index (BMI), perceived stress and acculturation.

Methods

This was a cross-sectional study among international medical students at the University of Szeged, Hungary between April and October 2021. A self-administered survey was used to obtain the data. Questionnaires were asked regarding the perceived stress scale (PSS), the modified Stephenson multigroup acculturation scale (SMAS), BMI, and sociodemographic characteristics. The data were analysed using SPSS 28.0 with a multiple logistic regression model.

Results

A total of 326 international medical students participated in the study. 49.7% of the students reported poor mental health and 5.2% were underweight and 10.1% were obese. We have found that perceived stress and acculturation were associated with poor mental health after adjusting for covariates. Higher perceived stress was likely to increase poor mental health (OR = 8.50; 95% CI = 3.82 – 8.93, P < 0.001), similar to acculturation where marginalization was more likely to have poor mental health (OR = 6.42; 95% CI = 2.39 – 9.03, P = 0.011). Meanwhile, the association between poor mental health and BMI in total was not significant, but underweight students were less likely to have poor mental health in the multivariable analysis (OR = 0.23; 95% CI = 0.06 – 0.86, P = 0.029).

Conclusions

The results of the study can be used to advise academic institutions to help international students integrate into the local students and local communities. The arts and other free time activities, and sports could help to alleviate mental conditions including anxiety, depression, and burnout.
O.1.2-2 Delivering enjoyable group-based physical activity programmes to older adults: a qualitative exploration of the views of exercise instructors
Authors: Creighton Rachel M , Blackburn Nicole E , Paradis Kyle F , Tully Mark A
Published: September 2023

Purpose

Enjoyable group-based physical activity programmes provide an engaging opportunity for older adults to experience healthy ageing promotion. To understand the programme delivery context, we explored how exercise instructors seek to make their existing sessions enjoyable.

Methods

A semi-structured interview guide was used to qualitatively investigate how exercise instructors create the conditions to promote an enjoyable experience. Exercise instructors (n = 9) who were experienced in delivering group-based exercise programmes to community-dwelling older adults were interviewed. The mean interview length was 50 minutes.

Results

Reflexive thematic analysis generated three main themes: 1) Identifying individual expectations and motives for engagement. Exercise instructors recognised that safety was a foundational aspect of the exercise programme, so that older adults could enjoy exercising confidently. 2) Adopting a tailored approach to meet the needs of older adults. Exercise instructors ensured that the exercises were inclusive of all abilities so that older adults could enjoy exercising collectively. 3) Encouraging collective participation through the development of social support networks. Exercise instructors created a relaxed social atmosphere, facilitating social support, so that older adults could enjoy being part of the group and experience belonging.

Conclusions

In summary, exercise instructors reported that tailoring sessions to meet the identified needs of older adults and encouraging the group to foster social support can create the conditions to promote an enjoyable experience. The findings can inform the promotion of enjoyment and engagement into existing programs. Findings can be used by exercise instructors, policy makers, researchers, and civil society organisations to ensure that opportunities for healthy ageing are sustainable. Longer-term group-based physical activity opportunities are required to ensure that older adults can experience belonging in a group they enjoy being active in, and which encourages the development of external social networks they may not otherwise have. For the purpose of the presentation, the primary focus is on how exercise instructors can incorporate the social elements of enjoyment in group-based physical activity programmes for older adults, across the dynamic progression of group identity.

Support/Funding Source

This study was funded by a Postgraduate Studentship from the Department for the Economy (DfE) in Northern Ireland.
O.1.2-4 Evaluation of a multifaceted implementation plan for a computer-tailored physical activity intervention: a mixed methods study
Authors: Peels Denise , Boekhout Janet , Van Nassau Femke , Lechner Lilian , Bolman Catherine , Berendsen Brenda
Published: September 2023

Background

Although there are many proven effective physical activity (PA) interventions for older adults, implementation in a real world setting is often lacking, limiting their actual impact on public health. This study describes the systematic development of a multifaceted implementation plan and evaluates its use during implementation of the evidence-based computer-tailored Active Plus PA intervention. Important lessons learned during this process will be presented.

Methods

The implementation plan was developed following the steps of Implementation Mapping, linking multilevel determinants of implementation to implementation theory and strategies. Municipalities (n = 33) were invited to implement the intervention among their inhabitants aged 65 years and older. Quantitative and qualitative data were gathered within municipalities to assess the implementation process, i.e. achievement of the performance objectives (i.e. sub-behaviours of implementers) and utilization of implementation strategies. We also assessed implementation determinants (i.e. perceptions of the intervention characteristics, the inner setting of the organization and the outer setting) before, during and after utilization of the implementation plan.

Results

A total of 8 municipalities (i.e. 24% adoption) implemented Active Plus, and 624 people aged over 65 participated in the intervention (8% adoption). Implementation strategies were used adequately. Execution of the performance objectives for adoption and implementation was relatively high (75-100%). Maintenance objectives were executed to a lesser degree (13-63%). No positive changes in implementation determinants were observed and none of the municipalities decided to further continue intervention implementation.

Conclusion

Implementation Mapping was found to be a useful protocol to develop and evaluate the implementation plan. Yet, implementers’ determinants did not change favorably, and municipalities did not continue intervention implementation, although implementation strategies were used as intended. We might have not addressed the most relevant determinants with the selected implementation strategies. Whereas the current implementation plan mainly targeted implementation determinants related to the individual and the perceived intervention characteristics, a stronger focus on strategies targeting implementation determinants related to the inner setting, the outer setting and the implementation process itself is recommendable. In addition, it is advisable to use a more iterative approach, evaluating goals and determinants regularly, and consequently adapting the required implementation strategies.
O.1.2-5 How to make physical activity part of daily life for elderly using the IPitup activity bench: CrossCare research
Authors: Vanhaverbeke Miel , Thysen Maarten
Published: September 2023

Purpose

The main goal of IPitup is to lower the threshold to physical activity and to encourage people to become more active in public spaces. To do so IPitup (npo) offers a package that is built around the activity bench, an urban sitting furniture that provides a wide range of strength, balance and cardiovascular exercises. An app and training courses for coaches complete the offer. They provide the possibility to easily put into practice the WHO guidelines for physical activity. Within the CrossCare project, IPitup focussed specifically on prevention among elderly to allow them to remain physically active in their own living environment.

Project description

At first the market demand was mapped and stakeholders were identified. An extensive survey (n = 229) then provided insights into the movement patterns of the primary end-users and illustrated among others the interest in the existing IPitup package. 93% was found to be convinced of the importance of physical activity and 92% considered the activity bench suitable for use by elderly.

Thanks to input of secondary and tertiary users and with the help of live tests and co-creation sessions, it became clear which adjustments should be made to the activity bench and the accompanying services.

Input from elderly, caregivers, local residents, healthcare professionals and local governments made clear the importance of a comprehensive approach. Getting seniors to become more physically active requires more than just creating an movement-friendly environment (hardware). This only makes sense if sufficient attention goes to an adapted offer (software), which must be organized in a way that people get motivated to actively engage (orgware).

In the end the concept was successfully implemented in various environments. Post-research practice suggested the project is replicable in other countries.

Conclusions

In elderly there is a clear acknowledgment and conviction about the importance of physical activity. Based on input from various stakeholders, specific adjustments were made to the activity bench and its supporting services. This seems to make the IPitup concept a valuable tool to lower the threshold for older people to become more active in daily life.

Interreg project supported by four healthcare research institutes.
O.1.3-3 Factors related to the implementation and scale-up of physical activity interventions in Ireland: a qualitative study with policy makers, funders, researchers and practitioners
Authors: Murphy Joey , Mansergh Fiona , O'Donoghue Gráinne , van Nassau Femke , Cooper Jemima , Grady Caera , Murphy Niamh , Bengoechea Enrique Garcia , Murphy Marie , Cullen Benny , Woods Catherine
Published: September 2023

Purpose

Current literature reports a gap between development of effective interventions to promote physical activity and their systematic uptake into real-world settings. Factors relating to implementation and scale-up of physical activity interventions have been examined, however the perspectives of multiple stakeholders from different domains are not well researched. The purpose of this study was to examine the perceived factors related to physical activity intervention implementation and scale-up in different domains from different stakeholders on the island of Ireland.

Methods

Intervention providers, coordinators, researchers, funders and policy makers in Ireland were invited to take part in a semi-structured interview exploring factors related to the implementation and scale-up of eleven different physical activity interventions. A thematic analysis was conducted to identify factors related to the implementation and scale-up of the included interventions. The data collection and analysis were guided by the Consolidated Framework for Implementation Research.

Results

Thirty-eight participants took part in the interviews (11 providers, 11 coordinators, 6 researchers, 6 policy makers and 4 funders) exploring factors related to physical activity intervention implementation and scale-up. Themes identified related to intervention 1) planning (e.g. intervention development and practical considerations); 2) delivery (e.g. organisational structures, staffing and delivery resources); 3) reflection, evaluation and updating of the intervention; and 4) scale-up (e.g. ensuring fidelity and scale-up considerations). Furthermore, participants referred to the ongoing commitment, engagement, and support needed from relevant stakeholders, communities and researchers throughout the implementation process.

Conclusions

This research highlights multiple factors, that are inter-related, and influence the implementation of PA interventions, but also identifies many strategies that can be utilised to enable greater likelihood of success. Future research and practice needs to consider how different factors are experienced at different implementation stages and by the different stakeholder groups involved. As one participant noted, “The intervention doesn’t go into an ideal world, it goes out into a pragmatic world”, highlighting the need to understand what implementation strategies work for who and in what contexts.

Funding Source

This work was funded by the Health Research Board (HRB APA-2017–030).
O.1.3-4 The MOVING policy index: assessing physical activity policy in 30 European countries
Authors: O'Mara Jennifer , Vlad Ioana , Oldridge-Turner Kate , Helleve Arnfinn , Harbron Janetta , Klepp Knut-Inge , Allen Kate
Published: September 2023

Purpose

Physical activity policies play a key role in creating healthier environments where population health and prevention of non-communicable diseases is prioritised. However, fewer than one in five adolescents in Europe meet the daily physical activity recommendations of 60 minutes a day. Greater policy action is needed by national governments to create enabling environments which promote physical activity. The MOVING policy index assesses national government action in physical activity policy across 30 European countries.

Methods

Physical activity policy actions in 30 European countries were identified through a comprehensive scan with a set methodology, including verification by in-country government experts. These policy actions were benchmarked using evidence-informed aspirational attributes that assess the strength of policy design.

Results

Of the 30 European countries analysed, more than half did not take a comprehensive approach to physical activity policy, implementing policy actions across three key domains: active societies, people and environments. Policy action was concentrated in public communication, followed by physical activity promotion in schools and the community. Policies that offer physical activity opportunities in the workplace and training in physical activity promotion and that give physical activity training, assessment and counselling in healthcare settings received less attention from governments.

The least action was taken on policy targeting active environments, such as active design guidelines and transport infrastructure, including promoting public and active transport. Eleven of the 30 European countries did not implement any policy actions in either policy area. Countries that did implement policy actions in these areas, received mostly poor assessments for their policy design. For example, 15 out of 22 countries that implemented policy actions on building structures received a poor assessment.

Conclusions

Greater action on better designed policy actions in physical activity is urgently needed across the 30 European countries analysed. Key gaps are seen in policies targeting the built environment and infrastructure for active transport. The MOVING policy index results can be used by policymakers, researchers and civil society, both at European or country level to inform advocacy for and design of physical activity policies.