Publications by authors named "Thomas Rosemann"

623 Publications

Effects of plyometric jump training on soccer player's balance: a systematic review and meta-analysis of randomized-controlled trials.

Biol Sport 2021 Sep 6;39(3):765-778. Epub 2021 Oct 6.

Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland.

Plyometric jump training (PJT) can be used for improving balance through bilateral and unilateral jump-landing drills. Since the increased number of articles testing the effects of PJT on dynamic and static balance, it is relevant to summarize the evidence and determine the effects across different original articles. This systematic review with meta-analysis was conducted to assess the effects of PJT programs on dynamic and static balance in soccer players. The data sources utilized were Cochrane, Medline (PubMed), SPORTDiscus, and Web of Science. (i) Soccer players of any age or sex without injury, illness, or other clinical conditions; (ii) PJT-based programs restricted to a minimum of three weeks (duration); (iii) passive or active control groups; (iv) pre-post interventions values of dynamic and/or static balance; (v) randomized-controlled trials; and (vi) peerreviewed original full-text studies written in English, Portuguese, and/or Spanish. The database search initially identified 803 titles. From those, eight articles were eligible for the systematic review and meta-analysis. The results showed no significant differences between PJT and active controls in dynamic anterior, postero-medial, or postero-lateral balance for both left and right legs (p > 0.05). Additionally, no significant differences were found between PJT and active controls in terms of static balance (p = 0.495). The current evidence suggests that PJT has no significant advantage over active control groups in terms of dynamic or static balance.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5114/biolsport.2022.107484DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9331326PMC
September 2021

Dietary Intake of Vegan and Non-Vegan Endurance Runners-Results from the NURMI Study (Step 2).

Nutrients 2022 Jul 30;14(15). Epub 2022 Jul 30.

Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland.

Nowadays, the growing popularity of distance running has been accompanied by the increasing prevalence of vegan and vegetarian diets, especially among endurance athletes. The present study aimed to examine the association between diet type and dietary intake of distance runners competing at distances longer than 10 km. From a total of 317 participants, 211 endurance runners (57% females) were considered the final sample after applying the exclusion criteria. Runners were assigned to three groups based on the self-reported diet types: 95 omnivores, 40 vegetarians, and 76 vegans. Data collection was conducted using an online survey with questions about sociodemographic information, dietary intake, and dietary-associated motives. A comprehensive food frequency questionnaire with 53 food groups (categorized in 14 basic-plus three umbrella-food clusters) was used to assess dietary intake. Vegan runners had a higher intake of "beans and seeds", "fruit and vegetables", and "dairy alternatives", as well as lower intakes of "oils" than other two groups. Vegetarian runners had a lower intake of "dairy products" and "eggs" than omnivores. A greater intake of "alcohol" and a lower intake of "meat alternatives" was observed in omnivorous runners compared to vegans and vegetarians. Despite the existence of a tendency toward the consumption of health-related food clusters by vegan runners, further investigations are needed to verify the predominance of vegans in health-oriented dietary patterns.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/nu14153151DOI Listing
July 2022

Quality and variation of care for chronic kidney disease in Swiss general practice: A retrospective database study.

PLoS One 2022 11;17(8):e0272662. Epub 2022 Aug 11.

Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland.

Background: Chronic kidney disease (CKD) is a common condition in general practice. Data about quality and physician-level variation of CKD care provided by general practitioners is scarce. In this study, we evaluated determinants and variation of achievement of 14 quality indicators for CKD care using electronic medical records data from Swiss general practice during 2013-2019.

Methods: We defined two patient cohorts from 483 general practitioners, one to address renal function assessment in patients with predisposing conditions (n = 47,201, median age 68 years, 48.7% female) and one to address care of patients with laboratory-confirmed CKD (n = 14,654, median age 80 years, 57.5% female). We investigated quality indicator achievement with mixed-effect logistic regression and expressed physician-level variation as intraclass correlation coefficients (ICCs) and range odds ratios (rORs).

Results: We observed the highest quality indicator achievement rate for withholding non-steroidal anti-inflammatory drug prescription in patients with CKD staged G2-3b within 12 months of follow-up (82.6%), the lowest for albuminuria assessment within 18 months of follow-up (18.1%). Highest physician-level variation was found for renal function assessment during 18 months of follow-up in patients with predisposing conditions (diabetes: ICC 0.31, rOR 26.5; cardiovascular disease: ICC 0.28, rOR 17.4; hypertension: ICC 0.24, rOR 17.2).

Conclusion: This study suggests potentially unwarranted variation in general practice concerning RF assessment in patients affected by conditions predisposing for CKD. We further identified potential gaps in quality of CKD monitoring as well as lower quality of CKD care for female patients and patients not affected by comorbidities.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0272662PLOS
August 2022

Enoxaparin for primary thromboprophylaxis in symptomatic outpatients with COVID-19 (OVID): a randomised, open-label, parallel-group, multicentre, phase 3 trial.

Lancet Haematol 2022 Aug 30;9(8):e585-e593. Epub 2022 Jun 30.

Department of Angiology, University Hospital Zurich, Zurich, Switzerland; University of Zurich, Zurich, Switzerland.

Background: COVID-19 is a viral prothrombotic respiratory infection. Heparins exert antithrombotic and anti-inflammatory effects, and might have antiviral properties. We aimed to investigate whether thromboprophylaxis with enoxaparin would prevent untoward hospitalisation and death in symptomatic, but clinically stable outpatients with COVID-19.

Methods: OVID was a randomised, open-label, parallel-group, investigator-initiated, phase 3 trial and was done at eight centres in Switzerland and Germany. Outpatients aged 50 years or older with acute COVID-19 were eligible if they presented with respiratory symptoms or body temperature higher than 37·5°C. Eligible participants underwent block-stratified randomisation (by age group 50-70 vs >70 years and by study centre) in a 1:1 ratio to receive either subcutaneous enoxaparin 40 mg once daily for 14 days versus standard of care (no thromboprophylaxis). The primary outcome was a composite of any untoward hospitalisation and all-cause death within 30 days of randomisation. Analysis of the efficacy outcomes was done in the intention-to-treat population. The primary safety outcome was major bleeding. The study was registered in ClinicalTrials.gov (NCT04400799) and has been completed.

Findings: At the predefined formal interim analysis for efficacy (50% of total study population), the independent Data Safety Monitoring Board recommended early termination of the trial on the basis of predefined statistical criteria having considered the very low probability of showing superiority of thromboprophylaxis with enoxaparin for the primary outcome under the initial study design assumptions. Between Aug 15, 2020, and Jan 14, 2022, from 3319 participants prescreened, 472 were included in the intention-to-treat population and randomly assigned to receive enoxaparin (n=234) or standard of care (n=238). The median age was 57 years (IQR 53-62) and 217 (46%) were women. The 30-day risk of the primary outcome was similar in participants allocated to receive enoxaparin and in controls (8 [3%] of 234 vs 8 [3%] of 238; adjusted relative risk 0·98; 95% CI 0·37-2·56; p=0·96). All hospitalisations were related to COVID-19. No deaths were reported during the study. No major bleeding events were recorded. Eight serious adverse events were recorded in the enoxaparin group versus nine in the control group.

Interpretation: These findings suggest thromboprophylaxis with enoxaparin does not reduce early hospitalisations and deaths among outpatients with symptomatic COVID-19. Futility of the treatment under the initial study design assumptions could not be conclusively assessed owing to under-representation of older patients and consequent low event rates.

Funding: SNSF (National Research Programme COVID-19 NRP78: 198352), University Hospital Zurich, University of Zurich, Dr-Ing Georg Pollert (Berlin), Johanna Dürmüller-Bol Foundation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/S2352-3026(22)00175-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9243568PMC
August 2022

The Influence of Environmental Conditions on Pacing in Age Group Marathoners Competing in the "New York City Marathon".

Front Physiol 2022 14;13:842935. Epub 2022 Jun 14.

Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland.

The two aspects of the influence of environmental conditions on marathon running performance and pacing during a marathon have been separately and widely investigated. The influence of environmental conditions on the pacing of age group marathoners has, however, not been considered yet. The aim of the present study was to investigate the association between environmental conditions (i.e., temperature, barometric pressure, humidity, precipitation, sunshine, and cloud cover), gender and pacing of age group marathoners in the "New York City Marathon". Between 1999 and 2019, a total of 830,255 finishes (526,500 males and 303,755 females) were recorded. Time-adjusted averages of weather conditions for temperature, barometric pressure, humidity, and sunshine duration during the race were correlated with running speed in 5 km-intervals for age group runners in 10 years-intervals. The running speed decreased with increasing temperatures in athletes of age groups 20-59 with a pronounced negative effect for men aged 30-64 years and women aged 40-64 years. Higher levels of humidity were associated with faster running speeds for both sexes. Sunshine duration and barometric pressure showed no association with running speed. In summary, temperature and humidity affect pacing in age group marathoners differently. Specifically, increasing temperature slowed down runners of both sexes aged between 20 and 59 years, whereas increasing humidity slowed down runners of <20 and >80 years old.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fphys.2022.842935DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9237513PMC
June 2022

Comparison of motivational short interventions to improve smokers' health behaviour (the COSMOS study) - a pragmatic cluster-randomised two-arm trial in general practice.

Nicotine Tob Res 2022 Jun 27. Epub 2022 Jun 27.

Institute of Primary Care, University Hospital Zurich, University of Zurich, Switzerland.

Introduction: Helping smokers to quit is an important task of general practitioners (GPs). However, achieving tobacco abstinence is difficult, and smokers who fail may still want to improve their health in other ways. Therefore, Swiss GPs developed a multithematic coaching concept that encourages health behaviour changes beyond smoking cessation alone. We compared the effectiveness of such coaching with state-of-the-art smoking cessation counselling.

Methods: This study was a pragmatic cluster-randomised two-arm trial with 56 GPs in German-speaking Switzerland and 149 of their cigarette smoking patients. GPs were instructed in either multithematic health coaching or smoking cessation counselling. After 12 months, we compared their patients' improvements in cigarette consumption, body weight, physical inactivity, alcohol consumption, stress, unhealthy diet, and a health behaviour of their own choice, using hierarchical logistic regression models and Fisher's exact and t-Tests.

Results: Over 95% of all participants achieved clinically relevant improvements in at least one health behaviour, with no difference between study arms (health coaching vs. smoking cessation counselling: aOR = 1.21, 95% CI = [0.03-50.76]; and aOR = 1.78, 95% CI = [0.51-6.25] after non-responder imputation). Rates of clinically relevant improvements in the individual health behaviours did not differ between study arms either (they were most frequent in physical activity, achieved by 3 out of 4 patients), nor did the extent of the improvements.

Conclusions: Multithematic health coaching and state-of-the art smoking cessation counselling were found to be comparable interventions, both in terms of smoking cessation success and, quite unexpectedly, their effects on other health behaviours.

Implications: The findings of our study suggest that in general practice, multithematic health coaching is an effective smoking cessation intervention, and conversely, monothematic smoking cessation counselling also achieves the beneficial effects of a multithematic health behaviour intervention. This opens up the possibility for GPs to support their smoking patients in improving their health behaviour in additional and more flexible ways.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/ntr/ntac159DOI Listing
June 2022

Health status of recreational runners over 10-km up to ultra-marathon distance based on data of the NURMI Study Step 2.

Sci Rep 2022 Jun 18;12(1):10295. Epub 2022 Jun 18.

Institute of Primary Care, University of Zurich, Zurich, Switzerland.

Endurance running is well-documented to affect health beneficially. However, data are still conflicting in terms of which race distance is associated with the maximum health effects to be obtained. Therefore, the aim of this study was to compare the health status of endurance runners over different race distances. A total of 245 recreational runners (141 females, 104 males) completed an online survey. Health status was assessed by measuring eight dimensions in two clusters of health-related indicators (e.g., body weight, mental health, chronic diseases and hypersensitivity reactions, medication intake) and health-related behaviors (e.g., smoking habits, supplement intake, food choice, healthcare utilization). Each dimension consisted of analytical parameters derived to a general domain score between 0 and 1. Data analysis was performed by using non-parametric ANOVA and MANOVA. There were 89 half-marathon (HM), 65 marathon/ultra-marathon (M/UM), and 91 10-km runners. 10-km runners were leaner than both the HM and M/UM runners (p ≤ 0.05). HM runners had higher health scores for six dimensions (body weight, mental health, chronic diseases and hypersensitivity reactions, medication intake, smoking habits, and health care utilization), which contributed to an average score of 77.1% (score range 62-88%) for their overall state of health. Whereas 10-km and M/UM runners had lesser but similar average scores in the overall state of health (71.7% and 72%, respectively). Race distance had a significant association with the dimension "chronic diseases and hypersensitivity reactions" (p ≤ 0.05). Despite the null significant associations between race distance and seven (out of eight) multi-item health dimensions, a tendency towards better health status (assessed by domain scores of health) among HM runners was found compared to other distance runners. However, the optimal state of health across all race distances supported the notion that endurance running contributed to overall health and well-being.Trial registration number: ISRCTN73074080. Retrospectively registered 12th June 2015.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-022-13844-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9206639PMC
June 2022

The Performance, Physiology and Morphology of Female and Male Olympic-Distance Triathletes.

Healthcare (Basel) 2022 Apr 25;10(5). Epub 2022 Apr 25.

Programa de Pós-Graduação em Medicina Translacional, Department of Physiology, Federal University of São Paulo, São Paulo 04021-001, Brazil.

Sex differences in triathlon performance have been decreasing in recent decades and little information is available to explain it. Thirty-nine male and eighteen female amateur triathletes were evaluated for fat mass, lean mass, maximal oxygen uptake (VO max), ventilatory threshold (VT), respiratory compensation point (RCP), and performance in a national Olympic triathlon race. Female athletes presented higher fat mass ( = 0.02, = 0.84, power = 0.78) and lower lean mass ( < 0.01, = 3.11, power = 0.99). VO max ( < 0.01, = 1.46, power = 0.99), maximal aerobic velocity (MAV) ( < 0.01, = 2.05, power = 0.99), velocities in VT ( < 0.01, = 1.26, power = 0.97), and RCP ( < 0.01, = 1.53, power = 0.99) were significantly worse in the female group. VT (%VO max) ( = 0.012, = 0.73, power = 0.58) and RCP (%VO max) ( = 0.005, = 0.85, power = 0.89) were higher in the female group. Female athletes presented lower VO max value, lower lean mass, and higher fat mass. However, females presented higher values of aerobic endurance (%VO max), which can attenuate sex differences in triathlon performance. Coaches and athletes should consider that female athletes can maintain a higher percentage of MAV values than males during the running split to prescribe individual training.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/healthcare10050797DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9140916PMC
April 2022

Attractiveness of medical disciplines amongst Swiss first-year medical students allocated to different medical education tracks: cross-sectional study.

BMC Med Educ 2022 Apr 7;22(1):252. Epub 2022 Apr 7.

Institute of Primary Care, University and University Hospital Zurich, Zurich, Switzerland.

Background: As most countries, Switzerland is experiencing a shortage of physicians especially in general practice and new medical education tracks with respective focusses have been started in response. This study investigated Swiss medical students' career openness and attractiveness of different medical disciplines as well as the concordance of students' career intentions with assigned medical education tracks.

Methods: Cross-sectional study surveying first year medical students assigned to four different Swiss medical education tracks with distinctive additional education focuses (ETH Zurich: medical technology and engineering, University of St. Gallen and University of Lucerne: primary healthcare and University of Zurich: no distinctive focus).

Results: We surveyed 354 medical students (response rate across all included medical education tracks 71.1%), 64.8% female, mean age 20 years. Regarding career openness, we found that 52.8% of medical students had neither a strong commitment nor a strong reservation for any of the proposed career options and 17.0% had a strong commitment. Among medical disciplines, medical subspecialties were attractive to the largest part of students (inpatient subspecialties attractive for 71%, outpatient for 58%), attractiveness of general practice was moderate (30%), academic (22%) and industrial sector (17%) careers were least attractive. Proportions of medical students attracted to general practice were similar at medical education tracks with focus on primary healthcare compared to other medical education tracks (32.2% vs. 25.8%, p = 0.391). Conversely, proportions of medical students attracted to academic or industry careers were significantly higher at the ETH Zurich compared to other medical education tracks (37.2%, vs. 13.1%, p < 0.001 and 31.9%, vs. 8.8%, p < 0.001 respectively).

Conclusion: While most first-year medical students were open to careers in many medical disciplines, attractiveness of disciplines varied strongly. Students attracted to academic or industrial careers accumulated at the medical education track with concordant teaching focus but students attracted to general practice did not accumulate at medical education tracks focused on primary healthcare. For medical education tracks with primary care teaching focus this is both a challenge and an opportunity to specifically counteract the shortage of general practitioners in Switzerland.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12909-022-03313-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8986963PMC
April 2022

Who Is Running in the D-A-CH Countries? An Epidemiological Approach of 2455 Omnivorous, Vegetarian, and Vegan Recreational Runners-Results from the NURMI Study (Step 1).

Nutrients 2022 Feb 5;14(3). Epub 2022 Feb 5.

Institute of Primary Care, University of Zurich, 8000 Zurich, Switzerland.

Accompanied by the growing popularity of distance running, the prevalence of vegan and vegetarian diets in endurance runners has increased across the globe and especially in German-speaking (D-A-CH: Germany, Austria, Switzerland) countries. The present study aimed to investigate and compare the epidemiological characteristics associated with diet types and running behaviors of recreational endurance runners. From a total number of 7422 runners who started to fill in the online survey, 3835 runners completed the questionnaire. After data clearance, 2455 distance runners (mean age: 37 years; 56% females, 44% males) were selected as the final sample and classified as 1162 omnivores (47.4%), 529 vegetarians (21.5%), and 764 vegans (31.1%). Sociodemographic information and general characteristics in training and competition were evaluated using a questionnaire-based approach. A significant association was found between diet type and race distance ( < 0.001). In females, vegan ultra-marathoners and omnivorous half-marathoners had better individual running records among dietary groups. Sex differences in running performance had a minimizing trend with increasing race distance. Most runners reported independent race preparation (90%) over less than four months (73%). From an epidemiological viewpoint, the present findings suggest a central role of plant-based diets in running performance and behaviors among active distance runners in D-A-CH countries and that vegetarian and vegan diets are compatible with competitive running.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/nu14030677DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8839653PMC
February 2022

The Sex Difference in 6-h Ultra-Marathon Running-The Worldwide Trends from 1982 to 2020.

Medicina (Kaunas) 2022 Jan 25;58(2). Epub 2022 Jan 25.

Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal.

The 6-h ultra-marathon is the shortest time-limited ultra-marathon race, but little has been investigated regarding this race format. Previously, only the age of peak performance in the context of longer time-limited ultra-marathons was determined. The purpose of this study was to investigate the trends in 6-h ultra-marathon races from 1982 to 2020 for female and male ultra-runners, the participation and performance by countries, the age of peak performance, and the differences in performance regarding countries. The sample included 23,203 female ultra-runners, aged 18-83 years, and 87,264 male ultra-runners, aged 18-85 years, who were finishers in a 6-h ultra-marathon held between 1982 and 2020. The age of peak performance was tested using the Kruskal-Wallis test, followed by the Bonferroni Correction. The difference in performance by countries was verified using a linear regression model with the fastest runners from Russia in women, and Tunisia in men, used as reference. Over the years, the men-to-women ratio decreased. The mean age was 43.20 ± 9.30 years for female and 46.09 ± 10.17 years for male runners. Athletes in younger age groups were faster than athletes in older age groups. Most female and male participants originated from Germany. Women from Russia (10.01 ± 1.28 km/h) and men from Tunisia (12.16 ± 1.46 km/h) were the fastest. In summary, in 6-h ultra-marathons held between 1982 and 2020, the participation for both women and men increased, while the men-to-women ratio decreased. The mean age was higher in men compared to women. Most female and male runners originated from Germany, but the fastest women were from Russia, and the fastest men from Tunisia. Future studies need to investigate whether Russian women and Tunisian men are also the best in other distance-limited ultra-marathon races, such as 12-h and 24-h.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/medicina58020179DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8876730PMC
January 2022

Physical (in)activity, and its predictors, among Brazilian adolescents: a multilevel analysis.

BMC Public Health 2022 02 3;22(1):219. Epub 2022 Feb 3.

Medbase St. Gallen Am Vadianplatz, Vadianstrasse 26, 9001, St. Gallen, Switzerland.

Background: Physical activity is a multifactorial trait, determined by both individual and environmental characteristics, it seems relevant to understand the determinants related to youth guidelines accomplishment. The present study aimed to verify the differences between the Brazilian federative units regarding to the prevalence of youth physical activity guidelines accomplishment and to investigate the determinants related to the inter-individual differences in this accomplishment.

Methods: Sample comes from the 2015 Brazilian National School Health Survey (PeNSE), comprising 99,570 adolescents (51,527 girls, 13-17y), enrolled in 3039 schools. Adolescents reported the time they spend in moderate-to-vigorous physical activity daily, and they were categorized as active or inactive, if the guidelines were achieved, or not, respectively, and multilevel statistical analyses were used, including both child and school-level variables. Multilevel Binomial model was computed in the SuperMix software.

Results: The majority of the adolescents did not comply with the physical activity guidelines daily, where Bahian children complied the least, while those from Amazonas, Tocantins, and Mato Grosso do Sul complied the most. Boys (OR: 2.305; 95%CI: 2.277-2.334), older adolescents (OR: 1.044; 95%CI: 1.036-1.051), and those who spent more time in active travelling to/from school (OR: 1.001; 95%CI: 1.001-1.001) complied more the physical activity guidelines. At the school level, adolescents from larger schools (OR: 0.957; 95%CI: 0.928-0.986) tended to comply less with the guidelines.

Conclusion: Significant differences between Brazilian federative units in youth daily physical activity guidelines compliance were observed, highlighting the role of individual but also environmental constraints in the Brazilian adolescents' engagement in physical activity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12889-021-12336-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8811962PMC
February 2022

Origin of the Fastest 5 km, 10 km and 25 km Open-Water Swimmers-An Analysis from 20 Years and 9819 Swimmers.

Int J Environ Res Public Health 2021 10 29;18(21). Epub 2021 Oct 29.

Department of Physiology, Federal University of São Paulo, São Paulo 04021-001, Brazil.

In elite pool swimmers competing at world class level, mainly athletes from the United States of America and Australia are dominating. Little is known, however, for the nationality of dominating swimmers in elite open-water long-distance swimming races such as the official FINA races over 5 km, 10 km and 25 km-held since 2000. The aim of this study was to investigate the participation and performance trends by nationality of these elite open-water swimmers. Race results from all female and male swimmers competing in 5 km, 10 km and 25 km FINA races between 2000 and 2020 were analyzed. A total of 9819 swimmers competed between 2000 and 2020 in these races. The five countries that figure most times among the top ten in 5 km, 10 km and 25 km races over the years were Italy, Germany, Russia, Brazil and the Netherlands. In 10 km races, considering the all the athletes from each country, male athletes from Germany, Italy, and France presented faster race times than the other countries. In 10 km, female athletes presented no significant difference among the countries. In 5 and 25 km races, there were no differences between countries, for male and female athletes. Moreover, comparing only the 10 best results (top 10) from each country, there were no differences between countries in 5 km, 10 km and 25 km, for male and female athletes. Men were faster than women for all three distances. In summary, male swimmers from Europe (i.e., Germany, Italy, France) are dominating the 10 km FINA races. In the 5 km and 25 km FINA races, there is no dominating nationality, but among the top five countries in the top 10 over the years, three are European countries.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph182111369DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8583531PMC
October 2021

The Effect of Muscle Strength on Marathon Race-Induced Muscle Soreness.

Int J Environ Res Public Health 2021 10 27;18(21). Epub 2021 Oct 27.

Human and Exercise Physiology Division, Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia 74690-900, Brazil.

Background: Muscle soreness after a competition or a training session has been a concern of runners due to its harmful effect on performance. It is not known if stronger individuals present a lower level of muscle soreness after a strenuous physical effort. The aim of this study was to investigate whether the pre-race muscle strength or the V˙O2max level can predict muscle soreness 24, 48 and 72 h after a full marathon in men.

Methods: Thirty-one marathon runners participated in this study (age, 40.8 ± 8.8 years old; weight, 74.3 ± 10.4 kg; height, 174.2 ± 7.6 cm; maximum oxygen uptake, V˙O2max, 57.7 ± 6.8 mL/kg/min). The isokinetic strength test for thigh muscles and the V˙O2max level was performed 15-30 days before the marathon and the participants were evaluated for the subjective feeling of soreness before, 24, 48 and 72 h after the marathon.

Results: The participants presented more pain 24 h after the race (median = 3, IQR = 1) than before it (median = 0, IQR = 0) ( < 0.001), and the strength values for the knee extensor muscles were significantly associated with muscle soreness assessed 24 h after the race ( = 0.028), but not 48 ( = 0.990) or 72 h ( = 0.416) after the race. The V˙O2max level was not associated with the muscle pain level at any moment after the marathon.

Conclusions: Marathon runners who presented higher muscular strength for the knee extensor muscles presented lower muscle soreness 24 h after the race, but not after 48 h or 72 h after the race. Therefore, the muscle soreness level 3 days after a marathon race does not depend on muscle strength.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph182111258DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8583638PMC
October 2021

Long-Term Effects of Financial Incentives for General Practitioners on Quality Indicators in the Treatment of Patients With Diabetes Mellitus in Primary Care-A Follow-Up Analysis of a Cluster Randomized Parallel Controlled Trial.

Front Med (Lausanne) 2021 26;8:664510. Epub 2021 Oct 26.

Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland.

The effect of financial incentives on the quality of primary care is of high interest, and so is its sustainability after financial incentives are withdrawn. To assess both long-term effects and sustainability of financial incentives for general practitioners (GPs) in the treatment of patients with diabetes mellitus based on quality indicators (QIs) calculated from routine data from electronic medical records. Randomized controlled trial using routine data from electronic medical records of patients with diabetes mellitus of Swiss GPs. During the study period of 24 months, all GPs received bimonthly feedback reports with information on their actual treatment as reflected in QIs. In the intervention group, the reports were combined with financial incentives for quality improvement. The incentive was stopped after 12 months. Proportion of patients meeting the process QI of annual HbA1c measurements and the clinical QI of blood pressure levels below 140/85 mmHg. A total of 71 GPs from 43 different practices were included along with 3,854 of their patients with diabetes mellitus. Throughout the study, the proportion of patients with annual HbA1c measurements was stable in the intervention group (78.8-78.9%) and decreased slightly in the control group (81.5-80.2%) [odds ratio (OR): 1.21; 95% CI: 1.04-1.42, < 0.05]. The proportion of patients achieving blood pressure levels below 140/85 mmHg decreased in the control group (51.2-47.2%) and increased in the intervention group (49.7-51.9%) (OR: 1.18; 95% CI: 1.04-1.35, < 0.05) where it peaked at 54.9% after 18 months and decreased steadily over the last 6 months. After the withdrawal of financial incentives for the GPs after 12 months, some QIs still improved, indicating that 1 year might be too short to observe the full effect of such interventions. The decrease in QI achievement rates after 18 months suggests that the positive effects of time-limited financial incentives eventually wane.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fmed.2021.664510DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8576070PMC
October 2021

Characteristics and health care costs in patients with a diagnostic imaging for low back pain in Switzerland.

Eur J Health Econ 2022 Jul 30;23(5):823-835. Epub 2021 Oct 30.

Institute of Primary Care, University and University Hospital Zürich, Pestalozzistrasse 24, 8091, Zürich, Switzerland.

Low back pain (LBP) is one of the most common musculoskeletal disorders worldwide and a frequent cause for health care utilization with a high economic burden. A large proportion of diagnostic imaging in patients with LBP is inappropriate and can cause more harm than good, which in turn can lead to higher health care costs. The aim of this study was to determine characteristics and health care costs for patients with a diagnostic imaging for LBP in Switzerland. Groupe Mutuel, one of the biggest health care insurance companies in Switzerland and covering approximately 12% of the population, provided data for this analysis. Patients were identified by diagnostic imaging for the lumbar spine in 2016 or 2017. The study period was 2015-2019, that is one year before and two years after the year of imaging. Regression analysis models were used to identify patient variables associated with higher health care costs. A total of 75,296 patients (57% female, mean age: 54.5 years) were included into the study. Magnetic resonance imaging was the most commonly used diagnostic method (44.3%). Patients generated annual mean health care costs of 518,488,470 CHF (466,639,621 Euro) in the whole observation period; 640 million CHF (576 million Euro) in the index year. Overall, costs for LBP patients were 72% higher compared with the costs of no LBP patients. Our findings confirm the economic burden of LBP and highlight the importance of ongoing efforts to improve prevention, diagnostics and patient care in patients with LBP.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10198-021-01397-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9170616PMC
July 2022

Training and Racing Behaviors of Omnivorous, Vegetarian, and Vegan Endurance Runners-Results from the NURMI Study (Step 1).

Nutrients 2021 Oct 7;13(10). Epub 2021 Oct 7.

Institute of Primary Care, University of Zurich, 8000 Zurich, Switzerland.

As a key modulator of training adaptations and racing performance, nutrition plays a critical role in endurance runners' success, and the training/racing behaviors of runners are potentially affected by their diet types. The present study aimed to investigate whether distance runners with a vegan diet (i.e., devoid of foods or ingredients from animal sources), vegetarian diet (i.e., devoid of meat and flesh foods), and omnivorous diet (i.e., a mixed diet with no restriction on food sources) have different training and racing patterns in general and based on race distance subgroups. A total of 3835 recreational runners completed an online survey. Runners were assigned to dietary (omnivorous, vegetarian, and vegan) and race distance (<21 km, half-marathon, and marathon/ultra-marathon) groups. In addition to sociodemographic information, a complete profile of data sets focusing on running and racing behaviors/patterns was evaluated using a questionnaire-based epidemiological approach. There were 1272 omnivores (47% females), 598 vegetarians (64% females), and 994 vegans (65% females). Compared to vegans and vegetarians, omnivorous runners prepared for a longer time period for running events, had a higher number of half-marathons and marathons completed with a better finish time, and had more reliance on training under supervision ( < 0.05). The present findings indicate an important association of diet types with patterns of training and racing amongst endurance runners that may be related to different motives of omnivorous, vegetarian, and vegan runners for participating in events.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/nu13103521DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8537760PMC
October 2021

Treatment Patterns in Patients with Diagnostic Imaging for Low Back Pain: A Retrospective Observational Study.

J Pain Res 2021 7;14:3109-3120. Epub 2021 Oct 7.

Institute of Primary Care, University and University Hospital Zurich, Zürich, Switzerland.

Purpose: Low back pain (LBP) is one of the most frequent reasons for medical consultations. Literature suggests a large evidence-performance gap, especially regarding pain management. Therefore, the monitoring of treatment patterns is important to ensure high quality of treatment. This study aimed to describe treatment patterns specific to patients with diagnostic imaging of the spine for LBP.

Patients And Methods: The study was retrospective observational and based on health claims data from 2015 to 2019 provided by a Swiss health insurance company covering around 12% of the population. Patients, ≥18 years of age, with diagnostic imaging of the spine were included and observed 12 months before and after imaging. Patients with back surgery or comorbidities associated with the use of pain medications were excluded.

Results: In total, 60,822 patients (mean age: 53.5 y, 56.1% female) were included and 85% received at least one pain medication. Of these, non-steroidal anti-inflammatory drugs, paracetamol, or opioids were prescribed in 88.6%, 70.7%, and 40.3% of patients, respectively. Strong opioids were used in 17% of patients given opioids. Patients with combinations of diagnostic imaging methods had the highest odds of receiving pain medication prescriptions (1.81, 95% CI: 1.66, 1.96, P < 0.001). Prescribed defined daily doses corresponded to short-term therapies.

Conclusion: Although the majority of patients received non-opioid short-term therapies, we found a substantial use of opioids, and in particular, a relative high usage of strong opioids. Our results highlighted the importance of both patient and healthcare provider awareness regarding the prudent treatment of LBP.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/JPR.S328033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8504656PMC
October 2021

Adolescent female handball players present greater bone mass content than soccer players: A cross-sectional study.

Bone 2022 01 25;154:116217. Epub 2021 Sep 25.

Human and Exercise Physiology Division, Faculty of Physical Education and Dance, Federal University of Goiás, Brazil.

Background: Osteoporosis is a systemic disease affecting half of women over the age of 50 years. Considering that almost 90% of peak of bone mass is achieved until the second decade of life, ensuring a maximal bone mineral content acquisition may compensate for age-associated bone loss. Among several other factors, physical activity has been recommended to improve bone mass acquisition. However, it is unknown whether athletes involved with sports with different impact loading characteristics differ in regards to bone mass measurements.

Aim: To compare the bone mass content, bone mass density and lean mass of young female soccer players (odd-impact loading exercise), handball players (high-impact loading exercises) and non-athletes.

Methods: A total of 115 female handball players (15.5 ± 1.3 years, 165.2 ± 5.6 cm and 61.9 ± 9.3 kg) and 142 soccer players (15.5 ± 1.5 years, 163.7 ± 6.6 cm and 56.5 ± 7.7 kg) were evaluated for body composition using a dual-emission X-ray absorptiometry system, and 136 female non-athletes (data from NHANES) (15.1 ± 1.32 years, 163.5 ± 5.8 cm and 67.2 ± 19.4 kg) were considered as the control.

Results: Handball players presented higher bone mass content values than soccer players for upper limbs (294.8 ± 40.2 g and 270.7 ± 45.7 g, p < 0.001), lower limbs (1011.6 ± 145.5 g and 967.7 ± 144.3 g, p = 0.035), trunk (911.1 ± 182.5 g and 841.6 ± 163.7 g, p = 0.001), ribs (312.4 ± 69.9 g and 272.9 ± 58.0 g, p < 0.001), spine (245.1 ± 46.8 g and 222.0 ± 45.1 g, p < 0.001) and total bone mass (2708.7 ± 384.1 g and 2534.8 ± 386.0 g, p < 0.001). Moreover, non-athletes presented lower bone mass content for lower limbs (740.6 ± 132.3 g, p < 0.001), trunk (539.7 ± 98.6 g, p < 0.001), ribs (138.2 ± 29.9 g, p < 0.001), pelvis (238.9 ± 54.6 g, p < 0.001), spine (152.8 ± 26.4 g, p < 0.001) and total bone mass (1987.5 ± 311.3 g, p < 0.001) than both handball and soccer players. Handball players also presented higher bone mass density values than soccer players for trunk, ribs and spine (p < 0.05) and handball and soccer players presented higher bone mass density than non-athletes for all measurements (p < 0.005). Finally, the non-athletes' lower limb lean mass was lower than soccer and handball players values (p < 0.05).

Conclusion: Adolescent females engaged in handball training for at least one year present higher bone mass contents than those who are engaged in soccer training, which, in turn, present higher bone mass contents than non-athletes. These results might be used by physicians and healthcare providers to justify the choice of a particular sport to enhance bone mass gain in female adolescents.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.bone.2021.116217DOI Listing
January 2022

Supplement intake in half-marathon, (ultra-)marathon and 10-km runners - results from the NURMI study (Step 2).

J Int Soc Sports Nutr 2021 Sep 27;18(1):64. Epub 2021 Sep 27.

Institute of Primary Care, University of Zurich, Zurich, Switzerland.

The primary nutritional challenge facing endurance runners is meeting the nutrient requirements necessary to optimize the performance and recovery of prolonged training sessions. Supplement intake is a commonly used strategy by elite and recreational distance runners to meet nutritional recommendations. This study was conducted to investigate the patterns of supplement intake among different groups of distance runners and the potential association between supplement intake and sex, age, running and racing experiences.In a cross-sectional design, from a total of 317 runners participating in this survey, 119 distance runners were involved in the final sample after data clearance, assigned into three groups of 10-km runners (n = 24), half-marathoners (n = 44), and (ultra-)marathoners (n = 51). Personal characteristics, training and racing experiences, as well as patterns of supplement intake, including type, frequency, and dosage, were evaluated by questionnaire. Food Frequency Questionnaire was implemented to assess macronutrient intake. ANOVA and logistic regression were used for statistical analysis.While 50 % of total distance runners reported consuming supplements regularly, no differences between distance groups in consumption of carbohydrate/protein, mineral, or vitamin supplements were observed (p > 0.05). In addition, age, sex, running and racing experience showed no significant association with supplement intake (p > 0.05). Vitamin supplements had the highest intake rate in runners by 43 % compared to minerals (34 %) and carbohydrate/protein supplements (19 %).The present findings provide a window into the targeted approaches of long-distance runners as well as their coaches and sport nutrition specialists when applying and suggesting sustainable nutritional strategies for training and competition.Trial registration: ISRCTN73074080. Retrospectively registered 12th June 2015.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12970-021-00460-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477506PMC
September 2021

Changes in Sex Difference in Time-Limited Ultra-Cycling Races from 6 Hours to 24 Hours.

Medicina (Kaunas) 2021 Sep 1;57(9). Epub 2021 Sep 1.

Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland.

: Existing research shows that the sex differences in distance-limited ultra-cycling races decreased with both increasing race distance and increasing age. It is unknown, however, whether the sex differences in time-limited ultra-cycling races will equally decrease with increasing race distance and age. This study aimed to examine the sex differences regarding performance for time-limited ultra-cycling races (6, 12, and 24 h). Data were obtained from the online database of the Ultra-Cycling Marathon Association (UMCA) of time-limited ultra-cycling races (6, 12, and 24 h) from the years 1983-2019. A total of 18,241 race results were analyzed to compare cycling speed between men and women by calendar year, age group (<29; 30-39; 40-49; 50-59; 60-69; >70 years), and race duration. The participation of both men (85.1%) and women (14.9%) increased between 1983 and 2019. The age of peak performance was between 40 and 59 years for men and between 30 and 59 years for women. Between 2000 and 2019, more men (63.1% of male participants and 52.2% of female participants) competed in 24 h races. In the 24 h races, the sex difference decreased significantly in all age groups. Men cycled 9.6% faster than women in the 12 h races and 4% faster in the 24 h races. Both women and men improved their performance significantly across the decades. Between 2000 and 2019, the improvement in the 24 h races were 15.6% for men and 21.9% for women. The sex differences in cycling speed decreased between men and women with increasing duration of ultra-cycling races and with increasing age. Women showed a greater performance improvement than men in the last 20 years. The average cycling speed of men and women started to converge in the 24 h races.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/medicina57090923DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8469116PMC
September 2021

The Effects of Exercise Difficulty and Time-of-Day on the Perception of the Task and Soccer Performance in Child Soccer Players.

Children (Basel) 2021 Sep 10;8(9). Epub 2021 Sep 10.

Institute of Primary Care, University of Zurich, 8006 Zurich, Switzerland.

In soccer, accurate kicking skills are important determinants of successful performance. A successful kick must meet several criteria, including speed, accuracy, and timing. In fact, players who are able to kick the ball more accurately under various difficulties, such as time pressure, space constraints, the opponent's pressure, and the distance between the kicking point and the goal, have a clear advantage during soccer games. The aim of the present study was to investigate the effect of exercise difficulty and time-of-day on perceived task difficulty and kicking performance. Accordingly, 32 boys (age: 11 ± 0.7 years; height: 1.45 ± 0.07 m; body-mass: 38.9 ± 7.8 kg) performed shooting accuracy tests under two difficulty levels (distance (long-distance (LD) vs. short-distance (SD)) and time pressure (Without-time-pressure (WTP) vs. With-time-pressure (TP)) at 08:00 h and 17:00 h. Absolute-error, variable-error, and constant-error were evaluated during the kicking tasks, in addition to ball velocity and shooting quality. Moreover, rating-of-perceived-exertion score (RPE), feeling-scale (FS), and perceived difficulty were completed immediately at the end of each test. The results showed that shooting quality was not affected by the time-of-day, but it was better in WTP vs. TP ( < 0.05), and in SD vs. LD ( < 0.05), respectively. Higher values for FS and lower values for RPE were observed in the morning compared to the afternoon ( < 0.05) and in WTP vs. TP ( < 0.05). In conclusion, specific soccer skills of boys were not time-of-day dependent, but they may be associated with time pressure and task difficulty.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/children8090793DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8464736PMC
September 2021

Vegan vs. omnivore diets paradox: A whole-metagenomic approach for defining metabolic networks during the race in ultra-marathoners- a before and after study design.

PLoS One 2021 23;16(9):e0255952. Epub 2021 Sep 23.

Institute of Primary Care, University of Zurich, Zurich, Switzerland.

Background: The effect of vegan diets on metabolic processes in the body is still controversial in ultra endurance athletes. The study aims to determine gut microbiome adaptation to extreme exercise according to vegan or omnivore diet consumed in ultra-marathoners. We also seek to evaluate long-term vegan diets' effects on redox homeostasis, and muscle fatigue, and assess energy availability.

Methods: Seventy participants will be assigned to the study, including 35 vegan ultra-marathoners and 35 omnivores competing in the Sri-Chinmoy ultra marathon race. Research data will be collected from the participants at four steps (three visits to the research laboratory and the race day) throughout the study. At the first visit (seven days before the race), fecal samples, and anthropometric measurements will be collected. Body composition will be measured using DXA. Participants will be informed about keeping detailed food records and will be asked to record their diet data and activity logs during the entire study period. At second visit, maximum oxygen consumption will be measured on treadmill. On race day, blood samples will be collected immediately before, and 0. min, 2 hours, and 24 hours after the race. Body weight will be measured before and after the race. The blood and fecal samples will be stored at -80 C until analysis. Plasma malondialdehyde, reactive oxygen metabolites, total antioxidant capacity, Heatshockprotein-70, and serum Orosomucoid-1 will be analyzed in blood samples. Fecal samples will be analyzed with shotgun metagenomic analysis and interpreted using bioinformatics pipeline (HumanN2). Statistical tests will be analyzed using SPSS version 23.0 and R Software.

Discussion: Study findings will determine the effects of the vegan diet on sports performance, revealing the multiple interactions between host and gut microbiome at the whole metagenomic level. Additionally, results will show the possible adaptation throughout the race by analyzing blood and fecal samples. Furthermore, by assessing energy availability and determining host-metabolite crosstalk for ultra-endurance athletes, possible nutritional deficiencies can be identified. Thus, advanced nutritional strategies can be developed based on metabolic needs.

Trial Registration: Current controlled trials, ISRCTN registry 69541705. Registered on 8 December 2019.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0255952PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8459986PMC
November 2021

Return to classes impact on mental health of university students during the COVID-19 pandemic.

Acta Neuropsychiatr 2022 Feb 15;34(1):24-29. Epub 2021 Sep 15.

Department of Physiology, Federal University of São Paulo, Brazil.

Background: The coronavirus disease 2019 (COVID-19) pandemic and the necessary social isolation and distancing measures - that were adopted to prevent spreading the virus, including the suspension of university classes - negatively impacted the mental health of young adults. The aim of the current study was to investigate whether returning to online classes, even not presential, during the social isolation of the COVID-19 pandemic, affected the mental health of university students.

Methods: Forty students (10 men and 30 women) (age, 22.3 ± 3.8 years; body mass, 62.5 ± 17.8 kg; height, 165.6 ± 8.7 cm) from undergraduate health courses participated in the study. The students answered a self-administered questionnaire designed to gather personal and quarantine information as well as information about the frequency of depression (PHQ-9) and anxiety (GAD-7) symptoms. The questionnaire was answered before and after the return to online classes.

Results: There was a significantly lower frequency of depression symptoms after the return to online classes (Z = -2.27; p = 0.02). However, there was no difference in anxiety symptoms before and after returning to online classes (Z = -0.51; p = 0.61).

Conclusions: Return to online classes positively impacted the mental health (decrease of frequency of depression symptoms) of university students. Future studies are needed to observe whether the changes observed after returning to school are maintained over time.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1017/neu.2021.31DOI Listing
February 2022

Effect of Briefing on Acupuncture Treatment Outcome Expectations, Pain, and Adverse Side Effects Among Patients With Chronic Low Back Pain: A Randomized Clinical Trial.

JAMA Netw Open 2021 09 1;4(9):e2121418. Epub 2021 Sep 1.

Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland.

Importance: In observational studies, patients' treatment outcome expectations have been associated with better outcomes (ie, a placebo response), whereas concerns about adverse side effects have been associated with an in increase in the negative effects of treatments (ie, a nocebo response). Some randomized trials have suggested that communication from clinicians could affect the treatment outcomes by changing patients' expectations.

Objective: To investigate whether treatment outcome expectations and reported adverse side effects could be affected by different briefing contents before a minimal acupuncture treatment in patients with chronic low back pain (CLBP).

Design, Setting, And Participants: This randomized single-blinded clinical trial was conducted among patients with CLBP at 1 outpatient clinic in Switzerland who had a pain intensity of at least 4 on a numeric rating scale from 0 to 10. Different recruitment channels were used to enroll patients. Data were collected from May 2016 to December 2017 and were analyzed from June to November 2018.

Interventions: Patients were randomized to receive either a regular expectation briefing or a high expectation briefing (effectiveness) and either a regular adverse side effect briefing or an intense adverse side effect briefing (adverse side effect) in a 2 × 2 factorial design. The intervention (briefing sessions and written materials) was standardized and delivered before the acupuncture treatment, with additional booster informative emails provided during the 4-week, 8-session acupuncture course.

Main Outcomes And Measures: The primary end point was the patients' expectations regarding the effectiveness of the acupuncture treatment (Expectation for Treatment Scale [ETS]) after the briefing and the subsequent pain intensity (numeric rating scale). The primary end point for the adverse side effect briefing was the adverse side effect score at the end of the acupuncture treatment, derived from session-by-session assessments of adverse side effects.

Results: A total of 152 patients with CLBP (mean [SD] age, 39.54 [12.52] years; 100 [65.8%] women) were included. The estimated group difference (regular vs high) for the ETS was -0.16 (95% CI -0.81 to 0.50, P = .64), indicating no evidence for a difference between intervention groups. There was also no evidence for a difference in pain intensity at the end of the acupuncture treatment between the groups with different expectation briefings. The adverse side effects score in the group with the intense adverse side effect briefing were estimated to be 1.31 times higher (95% CI, 0.94 to 1.82; P = .11) than after a regular adverse side effect briefing, but the finding was not statistically significant.

Conclusions And Relevance: In this study, suggestions regarding treatment benefits (placebo) and adverse side effects (nocebo) did not affect treatment expectations or adverse side effects. Information regarding adverse side effects might require more research to understand nocebo responses.

Trial Registration: German Clinical Trials Register Identifier: DRKS00010191.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1001/jamanetworkopen.2021.21418DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8433606PMC
September 2021

Sex Differences in Supplement Intake in Recreational Endurance Runners-Results from the NURMI Study (Step 2).

Nutrients 2021 Aug 13;13(8). Epub 2021 Aug 13.

Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland.

It has been well-documented that female and male athletes differ in many physiological and psychological characteristics related to endurance performance. This sex-based difference appears to be associated with their nutritional demands including the patterns of supplement intake. However, there is a paucity of research addressing the sex differences in supplement intake amongst distance runners. The present study aimed to investigate and compare supplement intake between female and male distance runners (10 km, half-marathon, (ultra-)marathon) and the potential associations with diet type and race distance. A total of 317 runners participated in an online survey, and 220 distance runners (127 females and 93 males) made up the final sample after a multi-stage data clearance. Participants were also assigned to dietary (omnivorous, vegetarian, vegan) and race distance (10-km, half-marathon, marathon/ultra-marathon) subgroups. Sociodemographic characteristics and the patterns of supplement intake including type, frequency, dosage, and brands were collected using a questionnaire. One-way ANOVA and logistic regression were used for data analysis. A total of 54.3% of female runners and 47.3% male runners reported consuming supplements regularly. The frequency of supplement intake was similar between females and males (generally or across dietary and distance subgroups). There was no significant relationship for sex alone or sex interactions with diet type and race distance on supplement intake ( < 0.05). However, a non-significant higher intake of vitamin and mineral (but not CHO/protein) supplements was reported by vegan and vegetarian (but not by omnivorous) females compared to their male counterparts. In summary, despite the reported findings, sex could not be considered as a strong modulator of supplement intake among different groups of endurance runners.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/nu13082776DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8402241PMC
August 2021

Supplement Intake in Recreational Vegan, Vegetarian, and Omnivorous Endurance Runners-Results from the NURMI Study (Step 2).

Nutrients 2021 Aug 10;13(8). Epub 2021 Aug 10.

Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland.

Nutrient deficiency is a common cause of underperformance in endurance athletes, and supplement intake is frequently considered compensatory for vegan and vegetarian athletes specifically. This study aimed to investigate the patterns of supplement intake among vegan, vegetarian, and omnivorous distance (>10 km) runners and its association with age, sex, and race distance. From a total of 317 runners who participated in an online survey, 220 distance runners (mean age: 38.5 years; mean BMI: 21.75 kg/m) were selected for the final sample after data clearance and assigned to 100 omnivores, 40 vegetarians, or 80 vegans. Sociodemographic information, racing experience, and patterns of supplement intake, including type, frequency, dosage, etc., were collected using a questionnaire. Macronutrient intake was assessed using a food frequency questionnaire. ANOVA and logistic regression were used for data analysis. The prevalence of supplement intake was 51% for total runners and 72% among vegan runners. Age, sex, and race distance had no significant effect on the type of supplement intake ( > 0.05). Compared to omnivores and vegetarians, vegan runners reported consuming more vitamin (but not carbohydrate/protein or mineral) supplements ( < 0.05). Vitamin B, magnesium, and multivitamin had the most prevalent use amongst micronutrient supplements. This study points to a central role for supplementary nutritional strategies in different groups of distance runners. The present findings may help future investigations by design to identify specific requirements of endurance runners when adhering to specific kinds of diet particularly plant-based diets.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/nu13082741DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8399632PMC
August 2021

Testing and Prescribing Vitamin B12 in Swiss General Practice: A Survey among Physicians.

Nutrients 2021 Jul 29;13(8). Epub 2021 Jul 29.

Institute of Primary Care, University of Zurich, University Hospital Zurich, 8091 Zurich, Switzerland.

Testing and prescribing vitamin B12 (also known as cobalamin) is increasing in Switzerland but substantial variation among general practitioners (GPs) with respect to testing has been noted. In this study, we aimed at exploring GPs' mindsets regarding vitamin B12 testing and prescribing. A cross-sectional study was conducted using an online survey distributed by e-mail to Swiss GPs. The questionnaire explored mindsets related to testing and prescribing vitamin B12 in specific clinical situations, as well as testing and prescribing strategies. The questionnaire was sent to 876 GPs and 390 GPs responded (44.5%). The most controversial domains for testing and prescribing vitamin B12 were idiopathic fatigue (57.4% and 43.4% of GPs agreed, respectively) and depressive symptoms (53.0% and 35.4% of GPs agreed, respectively). There was substantial variation among GPs with regard to testing strategies (89.5% of GPS used a serum cobalamin test, 71.3% of GPS used holotranscobalamin, and 27.6% of GPs used homocysteine or methylmalonic acid). Intramuscular injection was the predominantly prescribed route of application (median of 87.5% of the prescriptions). In this study, we focus on discordant mindsets that can be specifically targeted by using educational interventions, and research questions that still need answering specifically about the effectiveness of vitamin B12 for idiopathic fatigue.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/nu13082610DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8398177PMC
July 2021

Erratum: Hołub et al. Predicting Breaststroke and Butterfly Stroke Results in Swimming Based on Olympics History. 2021, , 6621.

Int J Environ Res Public Health 2021 Aug 9;18(16). Epub 2021 Aug 9.

Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland.

In the original article [...].
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph18168401DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8393593PMC
August 2021
-->