Effect of low-load resistance training with different degrees of blood flow restriction in patients with knee osteoarthritis: study protocol for a randomized trial

Background Knee osteoarthritis (KOA) is a common degenerative disease that causes pain, functional impairment, and reduced quality of life. Resistance training is considered as an effective approach to reduce the risk of muscle weakness in patients with KOA. Blood flow restriction (BFR) with low-load resistance training has better clinical outcomes than low-load resistance training alone. However, the degree of BFR which works more effectively with low-load resistance training has not been determined. The purpose of this study is to evaluate the effectiveness of different degrees of BFR with low-load resistance training in patients with KOA on pain, self-reported function, physical function performance, muscle strength, muscle thickness, and quality of life. Methods This is a study protocol for a randomized, controlled trial with blinded participants. One hundred individuals will be indiscriminately assigned into the following groups: two training groups with a BFR at 40% and 80% limb occlusion pressure (LOP), a training group without BFR, and a health education group. The three intervention groups will perform strength training for the quadriceps muscles twice a week for 12 weeks, while the health education group will attend sessions once a week for 12 weeks. The primary outcome is pain. The secondary outcomes include self-reported function, physical function performance, muscle strength of the knee extensors, muscle mass of the quadriceps, quality of life, and adverse events. Intention-to-treat analysis will be conducted for individuals who withdraw during the trial. Discussion Previous studies have shown that BFR with low-load resistance training is more effective than low-load resistance training alone; however, a high degree of BFR may cause discomfort during training. If a 40% LOP for BFR could produce similar clinical outcomes as an 80% LOP for BFR, resistance training with a low degree of BFR can be chosen for patients with KOA who are unbearable for a high degree of BFR. Trial registration Chinese Clinical Trial Registry ChiCTR2000037859 (http://www.chictr.org.cn/edit.aspx?pid=59956&htm=4). Registered on 2 September 2020

The Development of Home-School Partnership Courses: A Practice Based on Xingzhi Tao’s Life Education Theory

Home-school partnership plays a critical role in student growth and the home-school partnership courses provide important paths to achieving ideal results of the partnership. Under the guidance of the three principles of “life is education”, “society is school” and “integrating teaching, learning and practice” in Xingzhi Tao’s life education theory, Shandong 271 Education Group developed the parent school course and the family civilization course, which turn out to be a systematic support for the home-school partnership program. This paper analyses the status quo of home-school cooperation in China and focuses elaborations on the components and practice of the two courses in Shandong 271 Education Group.

The Development of Home-School Partnership Courses: A Practice Based on Xingzhi Tao’s Life Education Theory

Home-school partnership plays a critical role in student growth and the home-school partnership courses provide important paths to achieving ideal results of the partnership. Under the guidance of the three principles of “life is education”, “society is school” and “integrating teaching, learning and practice” in Xingzhi Tao’s life education theory, Shandong 271 Education Group developed the parent school course and the family civilization course, which turn out to be a systematic support for the home-school partnership program. This paper analyses the status quo of home-school cooperation in China and focuses elaborations on the components and practice of the two courses in Shandong 271 Education Group.

Pharmacist-Facilitated Interactive E-Learning for Patients Newly Initiated on Warfarin: A Randomised Controlled Study

It is not known whether electronic-learning (e-learning) is effective for educating hospital inpatients about complex medications such as warfarin. This prospective randomised controlled study compared pharmacist-facilitated e-learning with standard pharmacist-delivered face-to-face education on patients’ or their unpaid carers’ knowledge of warfarin and satisfaction with warfarin education as well as the time that was spent by pharmacists in delivering warfarin education. Adult English-speaking patients (or their carers) who had been prescribed warfarin were randomised to receive standard pharmacist face-to-face education (control) or an e-learning module on a tablet device facilitated by a pharmacist (intervention). All of the participants received written warfarin information and were presented with the opportunity to ask any questions that they may have had to a pharmacist. Fifty-four participants completed the study (27 per group). The participants who received e-learning had median correct Oral Anticoagulation Knowledge (OAK) test scores of 85% compared to 80% for standard education (p = 0.14). The participants in both groups were satisfied with the information that they received. There was a trend towards pharmacists spending less time on warfarin education for the e-learning group than in the standard education group (25.5 vs. 33 min, respectively, p = 0.05). Education delivered via pharmacist-facilitated e-learning was non-inferior in terms of patient or carer warfarin knowledge compared to standard pharmacist-delivered education.

Elite School Education Group Policy and Low-Performing Schools in China

Education inequality has been a challenging issue worldwide, and disparity across schools constitutes a significant proportion of total inequality. Effective policies to turn around low-performing schools (LPS) are therefore of great importance to both governments and students. The Elite School Education Group (ESEG) policy is an emerging one, and it has quickly become very influential in China, a country with one of the largest and most diversified education systems in the world. Under this policy, elite public schools (EPS), which have exceptionally enriched educational resources (i.e., high-quality teachers, strong principal leadership, excellent school cultures, etc.), are encouraged by the government to build school groups with LPS. Within the school group under the elite school brand, branch schools (i.e., the previous LPS) can share all kinds of resources from the EPS (including teachers and principals), and they may even utilize the prestige of the brand itself as a means to attract high-performing students. The ESEG policy enables the delivery of multiple turnaround interventions to LPS in an autonomous way, through building partnerships between EPS and LPS. While some LPS are successfully turned around, some are not. It depends on the effectiveness of the reforms undertaken in the branch schools. Of particular importance is the access to strong principal leadership, excellent teachers, and the school cultures from EPS. Incentives for EPS to participate in this reform include obtaining flexibility in personnel management, expanding school scale and influence, and mobilizing other resources. Despite the potential positive influence on the branch schools, the ESEG policy may have a more complex influence on the entire education ecology than initially expected. Indeed, there are now some concerns that the ESEG is creating new LPS, because more and more high-performing students are drawn out of normal schools and attracted to the ESEG-partnered schools during admission. Thus, the effectiveness of the ESEG policy should not be solely based on attracting high-performing students, but on improving overall education quality.

Adherence Improvement in Glaucoma Patients: Effects of Educational Intervention Using an Eye Drop Chart

Purpose: To evaluate the effects of an educational intervention using an eye drop chart and supplementary education on glaucoma patients’ adherence.Methods: In this multicenter prospective study, medically treated glaucoma patients were educated on the administration of eye drops using an eye drop chart. At the time of recruitment, all of the patients completed a questionnaire on demographic characteristics and adherence. Three months after the initial educational intervention, the patients were randomly divided into two groups: an education group and a control group. The education group received supplementary education. Immediately thereafter and at 6 months, all of the patients completed the questionnaire on adherence again. Changes in instillation behavior, the relationship between the adherence score and demographic characteristics, and factors contributing to an improvement in adherence and intraocular pressure were then analyzed.Results: The adherence scores were significantly higher in patients with fewer medications, a higher annual income and higher educational level, and an urban residence (p = 0.038, p = 0.033, p = 0.041 and p = 0.047, respectively). Education on the administration of eye drops and use of the eye drop chart improved adherence scores from 23.05 ± 3.52 to 21.30 ± 3.95 (p = 0.021) and significantly reduced the average intraocular pressure from 14.3 ± 2.9 to 12.4 ± 3.1 mmHg (p < 0.001). Working indoors (odds ratio [OR] = 5.47, p = 0.032) and supplementary education at 3 months (OR = 4.53, p = 0.030) were also correlated with improved adherence.Conclusions: An eye drop chart is an effective tool for improving adherence and intraocular pressure control in glaucoma patients. Improvement in adherence was especially notable in patients whose work predominantly involved indoor activity. The effectiveness of the eye drop chart was improved by supplementary education.

Education Differences in Older Adults' Performance on Online Assessments of Inductive Reasoning and Verbal Memory

Paper-and-pencil measures of inductive reasoning and verbal memory administered in-person are well-established methods for measuring cognitive ability in adults. However, given recent increases in the use of online surveys, particularly during the COVID-19 pandemic when in-person research with older adults became difficult, we investigated whether these cognitive measures could be administered effectively online and whether older adults’ performance on these measures of inductive reasoning and verbal memory might differ by education level. Data were collected online between mid-May and mid-June of 2020 from 292 individuals aged 66-90 years (M=69.1, SD=3.3). The sample was primarily White (91%) and had more women (62%) than men; 83 participants had a graduate-level education (master’s/doctoral degree), 101 had an associate’s or bachelor’s degree, and 108 had less than an associate’s degree. Three measures of inductive reasoning (Number Series, Letter Sets, and Word Series) and two measures of verbal memory (Immediate Recall and Delayed Recall of a list of 20 words) were completed by participants on an online platform. One-way MANOVA found a significant main effect for education group on the inductive reasoning measures (Wilks’ lambda=.93, p=.001). However, follow-up univariate ANOVAs indicated significant differences by education group only for Number Series, with Tukey post hoc tests showing that the graduate-level and college-degree groups performed significantly better than the group with less than an associate’s degree. Factorial repeated-measures ANOVA found a significant decline between immediate and delayed recall (p&lt;.001) and that this difference varied by education group (p=.003). Implications of these findings will be discussed.

Presidential Symposium: From Global to Local: An Age-Inclusive and Rights-Based Approach to Gerontological Education

In June 2020, the Gerontological Society of America (GSA) joined in solidarity in the movement to condemn the entrenched racism undermining American society and build upon a gero-rich international historical base of supporting human rights. However, as gerontological educators, we need to expand on the conversation of racism to the broader global discussion of inclusivity and elimination of discrimination. A global focus on human rights of older persons, which began in 1982 at the World Assembly on Aging and has led to the current discussion of the proposed UN Convention on the Rights of Older Persons. The Academy of Gerontology in Higher Education (AGHE) is GSA's education group of colleges and universities that offers education, training, curricular innovations, and research programs in the field of aging. The work of this group is grounded in an age-inclusive and rights-based perspective, and members are committed to an international view demonstrated through AGHE’s tagline Global Leaders in Advancing Education on Aging; This symposium explores the role of age-inclusivity and a rights-based perspective in gerontology and geriatrics education and offers both challenges and best practices for moving forward. The first presentation explores the meaning of age-inclusivity in aging education in a global context and asks how do we build upon our international roots? Our second presenter shares a proposed framework for a rights-based approach to gerontology education. The third presentation explores an example of a rights-based training program. We conclude with a lively discussion focusing on how to take action through education.

Association between magnesium in drinking water and atrial fibrillation incidence: a nationwide population-based cohort study, 2002–2015

Background Atrial fibrillation (AF) is a common heart rhythm disorder and a risk factor of adverse cardiovascular diseases. Established causes do not fully explain the risk of AF and unexplained risk factors might be related to the environment, e.g. magnesium in drinking water. Low magnesium levels in drinking water might be associated with higher risk of cardiovascular diseases including AF. With detailed individual data from nationwide registries and long-term magnesium exposure time series, we had a unique opportunity to investigate the association between magnesium in drinking water and AF. Objective We evaluated the association between magnesium concentration in drinking water and AF risk. Methods A nationwide register-based cohort study (2002–2015) was used including individuals aged ≥30 years. Addresses were linked with water supply areas (n = 2418) to obtain time-varying drinking water magnesium exposure at each address. Five exposure groups were defined based on a 5-year rolling time-weighted average magnesium concentration. AF incidence rate ratios (IRRs) between exposure groups were calculated using a Poisson regression of incidence rates, adjusted for sex, age, and socioeconomic position. Robustness of results was investigated with different exposure definitions. Results The study included 4,264,809 individuals (44,731,694 person-years) whereof 222,998 experienced an incident AF. Magnesium exposure ranged from 0.5 to 62.0 mg/L (mean = 13.9 mg/L). Estimated IRR (95% CI) compared to the referent exposure group (< 5 mg/L) was 0.98 (0.97–1.00) for the second lowest exposure group (5–10 mg/L), and 1.07 (1.05–1.08) for the two highest exposure groups (15–62 mg/L). Strongest positive associations were observed among those aged ≥80 years and with lowest education group. An inverse association was found among individuals with highest education group. Conclusion There might be a small beneficial effect on AF of an increase in magnesium level in drinking water up to 10 mg/L, though an overall positive association was observed. The unexpected positive association and different associations observed for subgroups suggest a potential influence of unaccounted factors, particularly in vulnerable populations. Future research on magnesium in drinking water and cardiovascular diseases needs to focus on contextual risk factors, especially those potentially correlating with magnesium in drinking water.

Health Behaviors in Austrian Apprentices and School Students During the COVID-19 Pandemic

Background: The COVID-19 pandemic has disrupted our daily lives, which in turn has impacted health behaviors. Young people have been particularly affected. This study aimed to assess health behaviors in Austrian apprentices and high school students during the COVID-19 pandemic and whether vaccination willingness is affected by health behaviors. Methods: Two online surveys were conducted via REDCap with 1442 apprentices (female: 53.5%, male: 45.4%) from March 29th to May 18th, 2021 and 563 school students (female: 79.6%, male: 18.6%) from June 19th to July 2nd, 2021. The two samples were matched to account for sociodemographic differences and analyses were run on the matched sample. Besides the health behaviors smoking, alcohol consumption, cannabis consumption and exercise, health status and vaccination willingness were also assessed. Results: Health behaviors were affected by both education group and gender. Apprentices reported significantly more smoking than high school students and this difference was more pronounced in women (all p<0.01). Alcohol consumption was higher in apprentices than school students, but only in women (p<0.01). There was a trend for the two education groups to differ in their cannabis use as well (p=0.05). Apprentices took part in more weekly exercise (p<0.0001), but high school students reported better average health status (p<0.001). When included in the same model, health behaviors did not affect vaccine willingness, but education group did, with high school students showing a higher willingness to receive the COVD-19 vaccine than apprentices. Conclusions: These findings support the argument that education type is an important factor for health behaviors, but this is also mediated by gender. Appropriate interventions for adolescents are needed to prevent adverse health behavior changes following the COVID-19 pandemic.