Effect of Exercise Training on Lipoprotein Subclass Particle Concentrations and Sizes in Older Women: Results from a Randomized Controlled Trial.

BACKGROUND: Evidence suggests that lipoprotein subclass particles are critical markers of cardiovascular disease (CVD) risk. Older women have increased CVD risk related to age. The purpose of this study was to determine whether low and moderate doses of exercise influence lipoprotein subclasses. METHODS: Women (60-75 years) were randomized into groups for 16 weeks of moderate-intensity exercise training at a low or moderate dose (33.6 and 58.8 kJ/kg body weight weekly, respectively). Lipoprotein subclasses were determined by nuclear magnetic resonance spectroscopy before and after the training. RESULTS: The average weekly exercise duration was 109 and 164 min, for low- and moderate-dose groups, respectively. In the low-dose group, high-density lipoprotein particle (HDL-P) concentration decreased (Δ = -1.9 ± 3.1 µmol/L, mean ± SD, p = 0.002) and mean HDL-P size increased (Δ = 0.1 ± 0.3 nm, p = 0.028). In the moderate-dose group, mean HDL-P size (Δ = 0.1 ± 0.2 nm; p = 0.024) and low-density lipoprotein particle size increased (Δ = 0.4 ± 3.9 nm; p = 0.007). Baseline body mass index, peak oxygen consumption and age were associated with changes in a few lipoprotein subclasses. CONCLUSIONS: In this sample of inactive older women, moderate-intensity exercise training at a dose equivalent to or even lower than the minimally recommended level by public health agencies induced changes in lipoprotein subclasses in line with reduced CVD risk. However, higher doses are encouraged for greater health benefits.

Rapid Transition to Online Learning for Baccalaureate Students: Teamwork During a Pandemic.

BACKGROUND: This article describes how a college of nursing (CON) converted its traditional undergraduate academic program to a 100% online program within 2 weeks of being informed of the need for curricular modifications due to the COVID-19 pandemic. METHOD: The college faculty met online prior to implementation to discuss student needs and special considerations. Clinical simulation experiences were developed based on International Association for Clinical Simulation and Learning (INACSL) standards and delivered through virtual simulation. RESULTS: Students evaluated the clinical simulation experiences in each course using Likert-style measures and reported positive experiences overall. Each cohort of students, including the May 2020 graduating seniors, successfully completed all of their classes for progression to the next semester or graduation. CONCLUSION: The successful conversion of traditional academic programs into a virtual environment requires leadership, collaboration, and teamwork. This CON had positive outcomes and offers lessons learned for future implementation. [J Nurs Educ. 2021;60(7): 397-399.].

Management of Coinfections in Patients with Human Immunodeficiency Virus.

In addition to chronic use of antiretrovirals to maintain suppression of human immunodeficiency virus (HIV), many persons living with HIV are coinfected with tuberculosis, hepatitis B, or hepatitis C. These coinfections can be successfully treated or managed alongside HIV infection. Clinicians should follow practice guidelines to appropriately screen patients with HIV for these coinfections and initiate treatment when necessary. The most significant concern when treating any of these coinfections is to avoid drug-drug interactions with the patient's antiretrovirals. Several excellent practice guidelines exist for treatment of these common HIV coinfections.

Energy expenditure responses to exercise training in older women.

Previous studies have shown inconsistent findings regarding how structured exercise affects energy expenditure (EE). This study was designed to determine the changes in EE and physical activity following exercise training in older women. Nonobese (body mass index = 25.8 ± 3.4 kg·m-2) women (60-75 years, n = 72) completed a 4-month supervised aerobic exercise training of lower- or higher-dose (33.6 and 58.8 kJ·kg-1 body weight weekly, respectively) at 50-55% of heart rate reserve. Total daily EE (TDEE) by the doubly labeled water method, resting metabolic rate (RMR) via indirect calorimetry, and physical activity by accelerometer were determined before and at the end of exercise training. Nonexercise activity thermogenesis (NEAT) was calculated. Following exercise training, the changes in components of TDEE and total physical activity did not differ by group. In the entire sample, TDEE, RMR, NEAT and total physical activity did not change (P > 0.05 for all). However, a significant baseline physical activity × time interaction was found for several of the variables. Data were therefore stratified into tertiles of baseline physical activity. In the high tertile, TDEE remained unchanged, but total physical activity decreased (P = 0.012). In contrast, in the middle and low tertiles, NEAT remained unchanged, and total physical activity increased (P < 0.05 for both). In conclusion, aerobic exercise training did not change TDEE, RMR, NEAT, or total physical activity in this sample of older women. Exercise dose did not, but baseline physical activity levels might, influence EE responses and total physical activity changes.