bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extracorporeal membrane oxygenation after prosthetic valve replacement in a child with neonatal Marfan syndrome: a case report
Authors: Wadia Toranj , Desai Ajay , Hoschtitzky J Andreas , Naqvi Nitha 
Published: August 2022

Abstract

Background
Neonatal Marfan syndrome (nMFS), the most severe form of Marfan syndrome, is a rare condition that presents a clinical and treatment challenge. nMFS has high infant mortality related to progressive valvular dysfunction. Valve replacement in this setting improves long-term prognosis but carries high morbidity and mortality. Thus, sharing clinical experience in treating such patients is valuable.

Case summary
A 2 year old with nMFS underwent tricuspid valve annuloplasty and prosthetic mitral valve replacement. Postoperative management was complicated by pulmonary hypertension, cardiogenic shock, and arrythmias. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) helped overcome these challenges but posed a high risk for prosthetic valve thrombosis (PVT). Despite decompression of the left atrium (LA) with an LA vent, the left ventricle (LV) was distended because of aortic regurgitation and no native cardiac output. We lowered the ECMO flow under echocardiographic guidance; used inodilators and pacing to encourage transmitral flow and reduce LV afterload. The patient completed a successful 6-day ECMO run with good end-organ perfusion. At last follow up, she was 6 years old, enjoying school, home-ventilated through the tracheostomy, and mobilizing with walking aids/wheelchair.

Discussion
Valve replacement can improve life quality and expectancy for patients with nMFS. Lowering ECMO flow under echocardiography guidance till the aortic valve is seen to open; coupled with inodilators, pacing and adequate anticoagulation can be a safe way to deliver VA-ECMO for cardiogenic shock after prosthetic valve replacement. Further research is needed to show if this strategy prevents prosthetic valve thrombosis and provides sufficient haemodynamic support and myocardial rest.
Association of atrial depolarization variability and cardiac autonomic regulation with sudden cardiac death in coronary artery disease
Authors: Hekkanen Jenni J , Kenttä Tuomas V , Tulppo Mikko P , Kiviniemi Antti M , Ukkola Olavi H , Junttila M Juhani , Huikuri Heikki V , Perkiömäki Juha S 
Published: August 2022

Abstract

Aims
To evaluate the prognostic significance of the temporal variability of P-wave morphology, specifically in relation to cardiac autonomic regulation.

Methods and results
We analyzed the standard deviation of P-wave residuum (PWRSD) from five consecutive beats of the standard 12-lead ECG in 1236 patients with angiographically verified coronary artery disease (CAD). We evaluated the prognostic value of PWRSD, of PWRSD and PWR in relation to the 24 h standard deviation of normal-to-normal intervals (PWRSD/SDNN and PWR/SDNN). After 8.7 ± 2.2 years of follow-up on average, 43 patients (3.5%) experienced sudden cardiac death (SCD) or were resuscitated from sudden cardiac arrest (SCA), 34 (2.8%) succumbed to non-sudden cardiac death (NSCD) and 113 (9.1%) to non-cardiac death (NCD). In the Cox regression analysis, PWRSD (≥0.002727) had a significant univariate (uv) [hazard ratio (HR): 4.27, 95% confidence interval (CI): 2.26–8.08, P = 0.000008] and multivariate (mv) (HR: 2.58, 95% CI: 1.31–5.08, P = 0.006) association with SCD/SCA but not with NSCD (uv P = 0.76, mv P = 0.33) or NCD (uv P = 0.57, mv P = 0.66). All the studied P-morphology parameters retained a significant association with the risk of SCD/SCA after relevant adjustment (mv P-values from 0.00003 to &lt;0.05) but not with NSCD or NCD. When dichotomized PWRSD, PWR, PWRSD/SDNN, and PWR/SDNN were added to the clinical risk model for SCD/SCD, the C-index increased from 0.799 to 0.834 and integrated discrimination index and net reclassification index improved significantly (P &lt; 0.001).

Conclusion
Variability of P-morphology representing temporo-spatial heterogeneity of atrial depolarization, specifically when combined with cardiac autonomic regulation, independently predicts the risk of SCD in patients with CAD.
Causes, circumstances, and potential preventability of cardiac arrest in the young: insights from a state-wide clinical and forensic registry
Authors: Paratz Elizabeth D , van Heusden Alexander , Zentner Dominica , Morgan Natalie , Smith Karen , Thompson Tina , James Paul , Connell Vanessa , Pflaumer Andreas , Semsarian Christopher , Ingles Jodie , Parsons Sarah , Stub Dion , Gerche Andre La 
Published: August 2022

Abstract

Aims
The causes, circumstances, and preventability of young sudden cardiac arrest remain uncertain.

Methods and results
A prospective state-wide multi-source registry identified all out-of-hospital cardiac arrests (OHCAs) in 1–50 year olds in Victoria, Australia, from 2019 to 2021. Cases were adjudicated using hospital and forensic records, clinic assessments and interviews of survivors and family members. For confirmed cardiac causes of OHCA, circumstances and cardiac history were collected. National time-use data was used to contextualize circumstances. 1319 OHCAs were included. 725 (55.0%) cases had a cardiac aetiology of OHCA, with coronary disease (n = 314, 23.8%) the most common pathology. Drug toxicity (n = 226, 17.1%) was the most common non-cardiac cause of OHCA and the second-most common cause overall. OHCAs were most likely to occur in sleep (n = 233, 41.2%). However, when compared to the typical Australian day, OHCAs occurred disproportionately more commonly during exercise (9% of patients vs. 1.3% of typical day, P = 0.018) and less commonly while sedentary (39.6 vs. 54.6%, P = 0.047). 38.2% of patients had known standard modifiable cardiovascular risk factors. 77% of patients with a cardiac cause of OHCA had not reported cardiac symptoms nor been evaluated by a cardiologist prior to their OHCA.

Conclusion
Approximately half of OHCAs in the young have a cardiac cause, with coronary disease and drug toxicity dominant aetiologies. OHCAs disproportionately occur during exercise. Of patients with cardiac cause of OHCA, almost two-thirds have no standard modifiable cardiovascular risk factors, and more than three-quarters had no prior warning symptoms or interaction with a cardiologist.
Development of the health promoting sports club—national audit tool
Authors: Johnson Stacey , Vuillemin Anne , Lane Aoife , Dowd Kieran , Geidne Susanna , Kokko Sami , Donaldson Alex , Seghers Jan , Whiting Stephen , Van Hoye Aurélie 
Published: August 2022

Abstract

Background
Sports clubs have requested support from national governing authorities to invest in health promotion (HP), by developing policies, guidelines and dedicated funding. This article outlines the development of a national audit tool to review policies development and implementation to support HP in sports clubs.

Methods
A five-step process was undertaken by an international project team: (i) a rapid literature review to identify items assessing policies in physical activity, HP and sports, (ii) a thematic analysis to categorize items, (iii) a Delphi method to analyze item relevance, country specificity, reformulation, validation and organization, (iv) face validity through an online survey and in-depth interviews with expert representatives on physical activity and sports and (v) audit tool finalization though project team consensus.

Results
Eight sources were reviewed with 269 items identified. Items were coded into 25 categories with 3 broad themes: policies, actors and settings-based approach. The Delphi study extracted and refined 50 items and categorized them into 10 sections. After revisions from 22 surveys and 8 interviews, consensus was reached by the international project team on 41 items categorized into 11 sections: Role of ministry or department; Policies; Communication; Implementation and Dissemination; Evaluation and Measurement methods; Sub-national-level policies; Funding and Coordination; Participative approach; Actors and Stakeholders; National sporting events; Case studies and Implicated stakeholders.

Conclusion
To progress HP in the sports club context it is necessary to understand existing national-level policies. This national audit tool will aid in monitoring and assessing national policies for health promoting sports clubs.
S01-1 Using data and analytics to fully understand the barriers, and motivations to physical activity within a city setting
Authors: Scott Chris 
Published: August 2022

Abstract

Issue/problem
By 2050, 68% of the world's population will live in cities. With increasing urbanisation there is a need for policymakers to fully understand the current situation within their society when it comes to being physically active.

Description of the problem
In 2018, four global cities began a collaborative approach based on data and analytics to identify the barriers, and motivations to physical activity within a city setting. They needed to answer three questions:
The challenge is to understand to what extent inactivity is due to supply constraints that can be addressed by making physical activity more attractive and accessible, vs. demand constraints-perceived lack of time or being afraid to participate.

Results (effects/changes)
Using population survey information and databases on the locations of programmes, facilities and green space, our analysis has proven what works and what doesn't in each of the cities. For example, ethnic groups with lower levels of physical activity show higher levels of motivation to be active than other groups. Suggesting that lack of interest is not the reason for lower participation. We also found clear evidence of the impact and importance of facility access. Across all cities, access to facilities is correlated with levels of activity - with more active areas on average having almost 2.5 times more facilities than less active areas.

Lessons
There are 3 learnings from this project:

Main messages
A collaboration using data and analytics and best-practice sharing has enabled policymakers to apply evidence-led decision-making and have tangible impact on the lives of their citizens.
S01-3 Determining the social and economic value of football in England
Authors: Birdsall-Strong Lottie 
Published: August 2022

Abstract

Background
In 2015 the Department of Culture, Media and Sport in England set out its new guidelines to redefine what success in sport means. This new focus on the social impact of sport including physical wellbeing, mental wellbeing, individual development and social and community development, meant that any funding decisions will be made based on the outcomes that the sporting body can deliver. The Football Association have therefore begun a detailed assessment of the social and economic value of football in England.

Methods
Using national participation surveys of approximately 9000 individuals aged 16-75, we calculated the association between regular football participation and several health and social outcomes. This was combined with a review of published studies through to December 2019 examining the relationship between football, physical activity and disease risk outcomes across the life-course. This evidence base was then modelled with the estimated national football participation rate and the latest figures on national disease prevalence across 10 different diseases, to quantify the true value of football to society.

Results
Preliminary results have shown that football participation contributes to more than £10 billion to society each year across England. Team sport participants also reported significantly higher levels of happiness, confidence and trust compared to individuals who played no sport, or just individual sport. This impact also varies depending on the demographic groups including women, children and low-socioeconomic groups.

Conclusions
This analysis shows the large contribution of grassroots football to the nation's economy and to health and social wellbeing of individuals and communities. Moreover, it has proven the unique benefits of team sport participation and shown to policymakers which type of sports and activities contribute the most value to society.
S04-4 Tracking participants in the Jackpot.fit program and progress in dissemination of the Austrian sport promotion initiative
Authors: Novak Bernhard , Großschädl Lena , Lackinger Christian , Ruf Wolfgang , Strehn Albert , Titze Sylvia 
Published: August 2022

Abstract

Background
In 2015 a co-operation between the social insurance and the organized sport has been established in order to install Jackpot.fit, a standardized sports club based program, initially in 8 regions in Styria, a federal state of Austria. Inactive adults receive information about the long-term exercise program during a 3-week residential stay in a health resort. We aim to investigate who attends Jackpot.fit, the adherence to the program in 2019 as well as the progress of dissemination of Jackpot.fit since 2016.

Methods
Participantś personal data were collected by telephone at the registration. Instructors documented the participants' attendance each single session with a standardized form. The number of participating regions as well as courses within the regions were monitored by the evaluator.

Results
Between 2016 and 2019 2624 people (70.8% female; age: M = 57.1, SD = 9.1 years; BMI = 25.8, SD = 4.3 kg/m2) registered for Jackpot.fit and 84.3% (n = 2212) attended as participants in at least one session. Between September and December 2019, 824 people registered for the courses with an adherence rate as follows: 291 (35.3%) visited 75% or more, 200 (24.3%) between 50% and 74.9% and 232 (28.2%) less than 49.9% of all 638 provided sessions. 101 (12.3%) registered but never attended once. The number of regions rose from 8 in 2016 to 28 in 2019 and the number of courses from 25 to 55 over the same period.

Conclusions
According to the total number of participants, regions, and courses the dissemination moves forward. Further strategies to improve adherence must be developed.

Acknowledgement
The project is supported by the Gesundheitsfonds Steiermark and the Bundessport Förderungsfonds.
S05-1 Online tool to stimulate physical activity for older people with dementia - development and dissemination
Authors: Preller Liesbeth 
Published: August 2022

Abstract
Physical activity (PA) stimulates physical health, quality of life, and potentially cognition in people with dementia. However, home dwelling older people with dementia are in general less active than peers. For those attending daycare, the amount of physical activity is highly dependent on the centre's policy. For those without daycare, municipalities are responsible for support but generally there is no attention to PA for this target group. Professionals and volunteers in day care centers, and informal caregivers lack awareness and knowledge to support the people with dementia. Figures on users of other online information on PA show that video's and practical information are highly rated.
As part of a research consortium with 4 scientific partners, we were funded for dissemination of research outcomes to practice and policy. We therefore decided to build an online tool with easy to understand instruction movies and background information on theme's like strong legs and physical activity friendly layout of spaces. Human movement scientists provided the technical exercise information. We tested the information on user-friendliness among professionals. The instrument was launched in the week of World Alzheimer's day 2019. The tool has been viewed often since then. We will present development and dissemination of the tool and will discuss ongoing optimization.
S05-3 How do participants evaluate peer-led walking groups of older adults? Implementation issues related to the ‘Lekker Actief'-project in Flanders
Authors: Boen Filip , Verbaandert Elien , Vanderlinden Julie , van Uffelen Jannique , Seghers Jan , Iserbyt Peter , Fransen Katrien 
Published: August 2022

Abstract
Community-based walking groups constitute a promising avenue to increase both the levels of physical activity and the social connectedness of older adults. In addition, while peer-led walking groups seem to be as effective as professional-led programs, they are more cost-effective and socially integrative. In collaboration with a Flemish socio-cultural organization for older adults (i.e., OKRA), we designed the health-promoting program “Lekker Actief” (i.e., “Tastily active”).
This program included an individualized walking scheme for 10 weeks adapted to older adults' fitness level. In addition, in each local meeting point a formal peer leader (i.e., a volunteering older adult who was responsible to implement the guidelines) organized a weekly group walk. Our study involved 19 participating meeting points, counting 504 older adults in total (Mage = 69.2 years) who signed up for the program. In 9 meeting points, peer leadership was distributed among several older adults to create a structure of shared leadership, while in the other 10 meetings points, leadership was assigned to the formal peer leader only.
This presentation will focus on how this (shared) peer leadership was implemented and evaluated. We will draw conclusions to inspire future interventions and policies targeting peer leadership in walking groups for older adults.
S05-4 Progressive muscle-strengthening exercise is feasible among older people in the ‘Strength in Old Age Program'
Authors: Starck Heli , Kalmari Pirjo , Saloranta Eerika , Borodulin Katja 
Published: August 2022

Abstract
Strong legs and good balance increase mobility and prevent falls in old age. Gym exercise is an effective way to improve muscle strength in old age, particularly when organized in a progressive training program. Current challenge is to recognize and motivate older people to join muscle-strengthening exercise groups. The national “Strength in Old Age Program” (2005-) aims to launch guided strength and balance exercises for independently living older adults with decreased functional capacity. One core activity is to find and motivate old people to participate in a progressive 8-12-week muscle strengthening exercise program. We aimed to increase participation in the organized activity and support participation after the progressive program had ended, to improve the exercise facilities at local level, and to study the perceived benefits from the participants in the Program. Setting was real-life setting, i.e. no case-control trials were set. Good practices were developed to recognize and recruit participants for the program: perform functional capacity tests in locations where old people go as part of their routines, such as free flu vaccination events, use screening questionnaires systematically for all, and activate/guide health care professionals to refer the high-risk patients to gym training. Further, as many municipalities were limited in their gym facilities, the program developed the following solutions: collaborate with private sector service providers, purchase only the essential leg-strengthening devices and use cheap solutions, improve the quality of training by increasing training frequency and combine nutritional advice. The program aimed to improve sustainability of training, where several approaches were found successful: educate peers who instruct gym groups in future, develop the chain of professional exercise counselling from health care to sport sector, and provide free-of-charge gym training sessions to continue after their progressive program. The participants (Survey of exercise group participants, n = 1022) of the progressive gym training program perceived mostly good or strong benefits from their participation in the program. Participants who attended gym training felt the highest impact on muscle strength, fitness and activities of daily living, when compared to other types of training groups (eg balance training) in the program.
Conclusion suggests that gym exercise is a feasible good practice that should be encouraged in real-life setting.
S06-3 Supporting our lifelong engagement: mothers and teens exercising (SOLE MATES); from formative research to feasibility testing
Authors: Murtagh Elaine , Corr Méabh , Barnes Alyce , McMullen Jaimie , Morgan Philip 
Published: August 2022

Abstract

Background
Health promotion efforts have largely failed to effectively support adolescent girls to meet public health guidelines for physical activity (PA). Engaging mothers in the promotion of PA for their daughters is an important strategy to facilitate behaviour change. This paper provides an overview of the development of the SOLE MATES programme - a novel mother-daughter intervention.

Methods
This programme of research follows the MRC guidance for development and evaluating complex interventions (Craig, 2008). Two reviews were conducted to synthesise the evidence base on (1) mother-daughter PA interventions and (2) adolescent girls' perceptions of PA participation. The behaviour change wheel (BCW) framework was then used to design the components of an intervention to improve adolescent girls' PA (Michie et al, 2011). Finally, a single-arm feasibility trial was conducted to examine recruitment, data collection, acceptability, resources and participant responses.

Results
Our evidence reviews showed that only a limited number of interventions designed exclusively to target mothers and daughters have been conducted. In addition, programmes for adolescent girls should focus on alternative activities aside from the competitive team-based sports often offered.
The BCW design process resulted in a group-based face-to-face intervention, involving six intervention functions (education, persuasion, incentivisation, training, modelling, enablement) and 18 behaviour change techniques. The 6-week programme includes weekly educational and practical group sessions plus home tasks and the provision of participant resources. In addition to encouraging participants to walk regularly, the programme also aims to empower mothers to be role models for their daughters positive health behaviour.
Participants in the feasibility study were mothers (n = 27) with daughters (n = 31) aged 12-16 years. Eligibility rates were 93.4%, and baseline activity levels were low. Programme content, measures and facilitators were acceptable. Daily steps increased in mothers (+2,875, p = 0.009) and daughters (+1,393, p = 0.007).

Conclusions
We demonstrate the value of formative research in the intervention development process. We show that it is feasible to increase the PA levels of teenage girls through an inter-generational multi-component PA programme. The SOLE MATES programme should now be examined for effectiveness using a RCT. If successful the scale-up and sustainability of the programme should be explored.