Reduced mood variability is associated with enhanced performance during ultrarunnning

Ultrarunning requires extraordinary endurance but the psychological factors involved in successful ultrarunning are not well understood. One widely held view is that fluctuations in mood play a pivotal role in performance during endurance events. However, this view is primarily based on comparisons of mood before and after marathons and shorter running events. Indeed, to date no study has explicitly examined mood changes during a competive ultramarathon. To address this issue, we measured mood fluctuations in athletes competing in the Hardmoors 60, a 100 km, single day continuous trail-ultramarathon, and examined how variation in mood related to performance, as measured by completion time. The key finding was that the variability of athletes Total Mood Disturbance (TMD) score was significantly and positively correlated with completion time, consistent with the idea that mood is an important factor in determining race performance. Athletes also experienced a significant increase in tension immediately prior to race onset. This effect was more pronounced in less experienced athletes and significantly attenuated by measurement stage 1 at 35.4 km, which suggests the effect was driven by the release of pre-competition anxiety. Depression, anger and TMD were significantly lower at the pre-race measurement compared to the baseline measurement taken the week before. Consistent with previous studies, there were also significant increases in fatigue, anger and TMD during the race. The data are interpreted in terms of the Psychobiological model of endurance and may have broader implications for the understanding of endurance performance in other domains.

A low-threshold intervention to increase physical activity and reduce physical inactivity in a group of healthy elderly people in Germany: Results of the randomized controlled MOVING study

Background Lack of physical activity (PA) and a high level of physical inactivity (PI) are associated with a higher risk for mortality and responsible for several non-communicable diseases including cardiovascular disease. Higher age is associated with a decrease of PA and an increasing level of PI. Studies have shown that interventions in the elderly have the potential to increase the amount of PA and to decrease the level of PI. However, most interventions are complex, elaborated, time- and resource-consuming. Here, we examined the effect of individual feedback-letters reporting the measured PA and PI in a sample of elderly people in Germany. Primary outcomes of the study were overall PA and PI after 6 months in the intervention group compared to a control group. Methods We examined data from the MOVING intervention study (RCT) for people aged ≥ 65 years living in the northeast of Germany. At baseline, 3 and 6-months follow-up, all study participants wore a 3-axis accelerometer over a period of seven consecutive days. After the baseline measurement, the participants were randomized into intervention and control group. Participants in the intervention group received automatically generated, individualized feedback letters reporting their PA and PI by mail after the baseline measurement and after the 3-months follow-up. A Two-Way Mixed ANOVA with repeated measures was calculated with light, moderate and overall PA as well as PI as dependent variables, and group (between subject) and time (inner subject) as factors. The analysis based on retrospective data from the MOVING study (2016–2018). Results N = 258 patients were recruited. N = 166 participants could be included in the analysis, thereof N = 97 women (58.4%). The mean age was 70.8 years (SD 4.8). At baseline, the participants had a mean wearing time of 5,934.5 minutes (SD = 789.5) per week, which corresponds to about 14 hours daily on average. The overall PA in the intervention group at the 6-months follow up was 2488.8 (95% CI 2358.9–2618.2) minutes and 2408.2 (95% CI 2263.0–2553.4) minutes in the control group. There was no statistically significant interaction effect (time*group) between the intervention and control group for the depending variables. Sensitivity analyses showed significant small positive effects of the interaction time*partnership, F(2, 300) = 3.020, p = 0.05, partial η2 = 0.020. Discussion On average, study participants had high levels of PA at baseline and showed a good adherence in wearing the accelerometer. Both is likely due to selection in the convenience study sample. Thus, some ceiling effect reduced the overall intervention effect somewhat. At baseline, the weekly average of PI was 3436.7 minutes, which correspondents to about 8.2 hours per day and about 57% of participants’ daily waking time. The average level of PI could be slightly decreased in both study groups. Trial registration number DRKS00010410, 17 May 2017.

564 Freedom from Urethral Catherisation – Using QI Methodology to Improve Patient Outcome and Experiences

Aim To reduce catheter burden on patients who could instead be free of urethral catheter and taught intermittent self-catheterisation (ISC). Method 2 PDSA (Plan, Do, Study, Act) cycles were performed over a 21-month period from February 2018 to November 2020. Using multiple nurse-led TWOC clinics, data was extracted using nurse-completed proformas and electronic patient records to determine: TWOC rate; urethral catheter-free rate; and ISC rate. Following baseline measurement, interventions were made, such as centralisation of TWOC services, emphasis on ISC teaching and the introduction of industry-nurse led clinics. Results At baseline, TWOC rate, urethral catheter-free rate and ISC rate were 55.7%, 68% and 28.2%, respectively. Following centralisation of TWOC services and emphasis on ISC teaching in Cycle 1, urethral catheter-free rate rose to 77.8% whilst ISC rate fell to 25%. Cycle 2 followed the introduction of industry-nurse led clinics. Following this, urethral catheter-free rate rose further to 81.6%, with ISC rate rising dramatically to 56.3% Conclusions To those capable, ISC frees patients of catheter burden and its sequalae. Evidently, a greater onus on ISC training will increase the number of patients left catheter-free.

Exploring personalized postoperative non-invasive tissue oximetry in DIEP flap breast reconstruction

Early detection of vascular compromise after autologous breast reconstruction is crucial to enable timely re-exploration for flap salvage. Several studies proposed non-invasive tissue oximetry for early identification of ischemia of deep inferior epigastric perforator (DIEP) flaps. The present study aimed to explore the utility of non-invasive tissue oximetry following DIEP flap surgery using a personalized oxygenation threshold. Methods Patients undergoing immediate/delayed DIEP flap surgery were included in this prospective observational study. DIEP flap tissue oxygenation (StO2) was monitored continuously using near-infrared spectroscopy. A baseline measurement was performed by positioning one sensor at the marked position of the major inferior epigastric perforator on the abdomen. A new sensor was positioned postoperatively on the transplanted tissue. In unilateral procedures, postoperative StO2 values of the native breast were also obtained. Measurements were continued for 24 h. Results Thirty patients (42 flaps) were included. Fourteen patients (46.7%) had an uncomplicated postoperative course. A minor complication was observed in thirteen patients; in five patients, at least one major complication occurred, requiring re-exploration. Median StO2 readings were significantly lower in patients with major complications compared to uncomplicated cases. In fourteen unilateral DIEP flap procedures, StO2 values of the native breast were similar to the preoperative baseline measurement (92%; p = 0.452). Conclusions Non-invasive tissue oximetry following DIEP flap surgery could aid in early detection of vascular compromise. StO2 values of the native breast and abdominal wall preoperatively can be used interchangeably and can serve as personalized reference value. Level of evidence: Level IV, diagnostic / prognostic study.

Microbiological safety of ready-to-eat foods in hospital and university canteens in Hanoi, Vietnam

The aim of this study is to analyze and document the microbiological safety and quality of ready-to-eat foods in hospital and university canteens in Hanoi, Vietnam. A total of 420 ready-to-eat food products from 21 canteens were sampled in July 2018 and May 2019. The ratio of samples exceeding the unsatisfactory level for Total Plate Count (TPC) was 31%. Escherichia coli, Listeria and Staphylococcus aureus were detected in 35 (8.3%), 99 (24%), 46 (11%) samples, with 3%, 10% and 0% exceeding the unsatisfactory level, respectively. The Total Plate Count (TPC), Listeria, Bacillus cereus, E. coli, S. aureus ranged from below detection limit to 5x10 9 , 4.6x10 5 , 6.2x10 3 , 3.4x10 3 , 7.6x10 3 CFU/g, respectively. Listeria monocytogenes was isolated from 3/420 samples (0.7%). In addition, there were 21 out of 410 samples (5%) contaminated with Salmonella. Overall, our data indicate frequent problems with the microbiological quality and safety of these canteen foods in Hanoi, and provide a baseline measurement that will allow environmental health officers and food microbiologists to develop targeted intervention strategies to reduce the economical and public health risk associated with these foods.

The effects of collaboration scripts on the number and quality of student interactions in a social annotation tool

Social Annotation (SA) tools can be used to facilitate active and collaborative learning when students have to study academic texts. However, making these tools available does not ensure students participate in argumentative discussions. Scaffolding students by means of collaborations scripts geared towards collaboration and discussion encourages students to engage in meaningful, high-quality interactions. We conducted an experiment with students (n=59) in a course running at a Dutch university, using the SA tool Perusall. A control group received normal instructions, while an experimental group received scaffolding through collaboration scripts. The results showed a significant increase in the number of responses to fellow students for the experimental group compared to the control group. The quality of the annotations, measured on levels of Bloom’s taxonomy, increased significantly for the experimental group compared to both its baseline measurement and the control group. However, when scaffolding was faded out over subsequent assignments these differences became non-significant. The experimental groups’ increased quality of annotations did not remain over time, suggesting that internalization of the scripts was not achieved.

Thermal Disparity among Fingers and Its Amelioration by CO2-Water Bathing in Connective Tissue Disease Patients

Objective. Correlation between a low finger temperature and thermal disparity among fingers was studied in connective tissue disease (CTD) patients. Whether the thermal disparity may be ameliorated by hand immersion in a warm carbon dioxide- (CO2-) water bath was analyzed. Methods. CTD patients with suspected peripheral circulation disorder underwent a thermography test. From before to 30 min after hand immersion in CO2-water (CO2 bathing; 1000 ppm CO2, 42°C, 10 min), the nailfold temperatures were measured. The mean temperature (m-Temp) and the coefficient of variation of the temperature ( CV = SD / m ‐ Temp of one hand; the mean of CVs of both hands was adopted as the indicator of thermal disparity) were monitored. The correlation between m-Temp and CV was also analyzed. Results. Forty-seven (45 females and 2 males) patients were included, 32 of whom had Raynaud’s phenomenon. The m-Temp was 30.8 ± 3.0 ° C at the baseline, increased to 35.3 ± 1.0 ° C immediately after CO2 bathing, and remained significantly higher than that at the baseline until 30 min after ( 32.1 ± 1.9 ° C ). The CV was 0.0291 ± 0.0247 at the baseline, decreased to 0.0135 ± 0.0039 immediately after CO2 bathing, and remained significantly lower than the baseline until 30 min after ( 0.0163 ± 0.0143 ). Between m-Temp and CV, a negative correlation was observed throughout the measurements. Conclusion. Thermal disparity was observed at baseline measurement in CTD patients. Warm CO2 bathing markedly ameliorated the disparity, and this amelioration remained until after 30 min. Throughout the observation, the lower the m-Temp, the more severe the thermal disparity among fingers.

33 An Evidence Based Laser Therapy Algorithm for the Treatment of Burn Scars

Introduction Hypertrophic scarring after burn injury can be extremely painful, cause profound itching, and affect the way patients view themselves and how the outside world perceives them. We have utilized laser therapy as a modality for scar modulation for our patients since 2013. In 2014, we initiated and completed a prospective IRB approved study to evaluate the outcome of scars treated with fractional CO2 laser therapy (FLT) utilizing objective and subjective tools. Recently, we have completed a prospective study evaluating the use of pulse dye laser (PDL) therapy and the impact on post-burn pruritis. In reviewing the outcomes from these two studies, we have developed an evidence-based laser therapy algorithm for burn scar management. Methods The FLT study entailed a series of three CO2 laser treatments minimally 4–6 weeks apart with scar measurements and POSAS form completion performed prior to each laser treatment and four weeks after the last FLT. Scar measurements that included color, pliability, and scar thickness; and completion of the POSAS form were obtained prior to each laser therapy session and four weeks after the third laser treatment. The measurements of color, pliability, and scar thickness were measured with the Colorimeter, Cutometer, and ultrasound. The PDL study utilized the 5-D Itch scale to evaluate post-burn pruritis. A baseline measurement was obtained prior to any laser treatments. Each patient underwent two PDL sessions and a 5-D itch scale was completed four to six weeks after the second PDL session. The baseline measurement was then compared to the final 5-D itch scale measurement. Results Data from the FLT study is in Table 1 and shows that there were statistically significant improvements in the Patient and Observer POSAS scores, patient rated Itch score, scar thickness, and measured skin density. Changes to patient rated scar pain, scar color, and pliability were noted but were not of statistical significance. Data from the PDL study is in Table 2 and shows a statistically significant decrease in the treated patients’ post-burn pruritis. Conclusions In reviewing the outcomes of these two studies, we have developed an algorithm based on our studies. All of our patients undergoing laser therapy receive two PDL sessions that are four to six weeks apart followed by 3 FLT sessions. The use of both PDL and FLT decreases post-burn pruritis, decreases scar thickness, decreases pain, and increases patient satisfaction as shown in our research.