Automated Telephone Follow-up for Smoking Cessation in Smokers With Coronary Heart Disease: A Randomized Controlled Trial.

INTRODUCTION: Smokers with coronary heart disease (CHD) benefit from in-hospital cessation treatment, but relapse is common without ongoing support postdischarge. The purpose of this study was to determine if smoking abstinence would be higher after hospital discharge in smokers who received automated telephone follow-up (ATF) and nurse-counseling, compared with a standard care (SC) control group. METHODS: A total of 440 smokers hospitalized with CHD were randomly assigned to the ATF group (n = 216) or to the SC group (n = 224). Participants in the ATF group received automated phone calls 3, 14, 30, 60, 90, 120, 150, and 180 days after hospital discharge. The ATF system posed questions concerning smoking status, confidence in staying smoke-free, and need for assistance. If flagged by the ATF system, a nurse-counselor provided additional counseling by phone. Self-reported continuous smoking abstinence was assessed 26 and 52 weeks postdischarge using intention-to-treat analysis. The main outcome measure was continuous abstinence for weeks 1-26 postdischarge. RESULTS: Participants in the ATF group achieved higher abstinence rates for weeks 1-26 than those in the SC group (odds ratio [OR] = 1.53, 95% confidence interval [CI] = 1.01 to 2.33). There was no significant difference between groups in abstinence rates for weeks 27-52 (OR = 1.37; 95% CI = 0.89 to 2.09). CONCLUSIONS: ATF-mediated follow-up helped smokers with CHD achieve abstinence during the intervention period. There was a trend toward clinically important improvements for weeks 27-52; but between-group differences for this time point did not achieve statistical significance. CLINICAL TRIAL NUMBER: NCT00449852. IMPLICATIONS: Automated telephone follow-up exerts its effect by reinforcing participants' efforts to be smoke-free and by proactively linking people requiring assistance to individualized support (eg, telephone counseling). This study shows that automated telephone follow-up can assist smokers with CHD in remaining smoke-free; however, the success of automated telephone follow-up is limited to the treatment period and abstinence rates after the treatment period were not statistically different from among those receiving standard care. Extended treatment via automated telephone follow-up may provide a solution to extend cessation assistance beyond hospital discharge.

Sex-Specific Trends in Incidence and Mortality for Urban and Rural Ambulatory Patients with Heart Failure in Eastern Ontario from 1994 to 2013.

BACKGROUND: Differences in outcomes have previously been reported between urban and rural settings across a multitude of chronic diseases. Whether these discrepancies have changed over time, and how sex may influence these findings is unknown for patients with ambulatory heart failure (HF). We examined the temporal incidence and mortality trends by geography in these patients. METHODS AND RESULTS: We conducted a retrospective cohort study of 36,175 eastern Ontario residents who were diagnosed with HF in an outpatient setting from 1994 to 2013. The primary outcome was 1-year mortality. We examined temporal changes in mortality risk factors with the use of multivariable Cox proportional hazard models. The incidence of HF decreased in women and men across both rural and urban settings. Age-standardized mortality rates also decreased over time in both sexes but remained greater in rural men compared with rural women. CONCLUSIONS: The incidence of HF in the ambulatory setting was greater for men than women and greater in rural than urban areas, but mortality rates remained higher in rural men compared with rural women. Further research should focus on ways to reduce this gap in the outcomes of men and women with HF.

Sex differences in outcomes of heart failure in an ambulatory, population-based cohort from 2009 to 2013.

BACKGROUND: Heart failure remains a substantial cause of morbidity and mortality in women. We examined the sex differences in heart failure incidence, mortality and hospital admission in a population-based cohort. METHODS: All Ontario residents who were diagnosed with heart failure in an ambulatory setting between Apr. 1, 2009, and Mar. 31, 2014, were included in this study. Incident cases of heart failure were captured through physician billing using a validated algorithm. Outcomes were mortality and hospital admission for heart failure within 1 year of the diagnosis. Probability of death and hospital admission were calculated using the Kaplan-Meier method. The hazard of death was assessed using a multivariable Cox proportional hazard model. RESULTS: A total of 90 707 diagnoses of heart failure were made in an ambulatory setting during the study period (47% women). Women were more likely to be older and more frail, and had different comorbidities than men. The incidence of heart failure decreased during the study period in both sexes. The mortality rate decreased in both sexes, but remained higher in women than men. The female age-standardized mortality rate was 89 (95% confidence interval [CI] 80-100) per 1000 in 2009 and 85 (95% CI 75-95) in 2013, versus male age-standardized mortality rates of 88 (95% CI 80-97) in 2009 and 83 (95% CI 75-91) in 2013. Conversely, the rates of incident heart failure hospital admissions after heart failure diagnosis decreased in men and increased in women. INTERPRETATION: Despite decreases in overall heart failure incidence and mortality in ambulatory patients, mortality rates remain higher in women than in men, and rates of hospital admission for heart failure increased in women and declined in men. Further studies should focus on sex differences in health-seeking behaviour, medical therapy and response to therapy to provide guidance for personalized care.

An evaluation of CardioPrevent: a technology-enabled, health-behavior change program for the global reduction of cardiovascular risk.

PURPOSE OF REVIEW: Cardiovascular diseases (CVDs) are the leading cause of mortality globally. Primary CVD prevention programs have the potential to improve risk factor profiles and, ultimately, the risk of developing CVD. The present study presents an evaluation of CardioPrevent, a global cardiovascular risk reduction program. RECENT FINDINGS: Of the 478 participants enrolled in the CardioPrevent program, 308 and 236 had complete 6-month and 12-month data, respectively at the time of evaluation. At 6 months, the average reduction in the Framingham risk score was -19.5% (median = -26.5%). Women experienced a greater reduction in risk than men (-23.1 vs. -11.4%, P = 0.013). Significant improvements were observed in body composition, blood pressure, low-density lipoproteins, triglycerides, total cholesterol-to-high-density lipoprotein ratio, HbA1c, perceived stress, anxiety, depression, quality of life, physical activity, sitting time, fruit and vegetable consumption, and medication adherence. Improvements seen at 6 months were maintained at 12 months. The majority (98%) of participants were very satisfied with the program and would recommend it to others. SUMMARY: Results of this evaluation identified that CardioPrevent is an effective CVD risk reduction program with high satisfaction rates. CardioPrevent is an effective, scalable program with the capacity to reduce CVD risk among primary care patients.

Effect of an intervention to improve the cardiovascular health of family members of patients with coronary artery disease: a randomized trial.

BACKGROUND: Family members of patients with coronary artery disease (CAD) have higher risk of vascular events. We conducted a trial to determine if a family heart-health intervention could reduce their risk of CAD. METHODS: We assessed coronary risk factors and randomized 426 family members of patients with CAD to a family heart-health intervention (n = 211) or control (n = 215). The intervention included feedback about risk factors, assistance with goal setting and counselling from health educators for 12 months. Reports were sent to the primary care physicians of patients whose lipid levels and blood pressure exceeded threshold values. All participants received printed materials about smoking cessation, healthy eating, weight management and physical activity; the control group received only these materials. The main outcomes (ratio of total cholesterol to high-density lipoprotein [HDL] cholesterol; physical activity; fruit and vegetable consumption) were assessed at 3 and 12 months. We examined group and time effects using mixed models analyses with the baseline values as covariates. The secondary outcomes were plasma lipid levels (total cholesterol, low-density lipoprotein cholesterol, HDL cholesterol and triglycerides); glucose level; blood pressure; smoking status; waist circumference; body mass index; and the use of blood pressure, lipid-lowering and smoking cessation medications. RESULTS: We found no effect of the intervention on the ratio of total cholesterol to HDL cholesterol. However, participants in the intervention group reported consuming more fruit and vegetables (1.2 servings per day more after 3 mo and 0.8 servings at 12 mo; p < 0.001). There was a significant group by time interaction for physical activity (p = 0.03). At 3 months, those in the intervention group reported 65.8 more minutes of physical activity per week (95% confidence interval [CI] 47.0-84.7 min). At 12 months, participants in the intervention group reported 23.9 more minutes each week (95% CI 3.9-44.0 min). INTERPRETATION: A health educator-led heart-health intervention did not improve the ratio of total cholesterol to HDL cholesterol but did increase reported physical activity and fruit and vegetable consumption among family members of patients with CAD. Hospitalization of a spouse, sibling or parent is an opportunity to improve cardiovascular health among other family members. TRIAL REGISTRATION: clinicaltrials.gov, no NCT00552591.

Student definitions of ownership and perceived ways ownership influences writing in a biology laboratory class.

Laboratory courses offer a unique opportunity, and sometimes challenge, to engage students in projects where they can experience ownership and authentic science practices. An important science practice is writing, which can lead to increased learning about concepts and science communication. Experiencing a sense of ownership in research can lead to various student outcomes, such as increased motivation, greater interest in research, and higher retention in STEM fields. Although previous work has extracted aspects of ownership from students' descriptions of research experiences, studies have not examined directly how students define and perceive ownership. In addition, we do not have a clear idea of whether a sense of ownership is related to student attitudes toward scientific writing in a lab course setting. To better understand the relationship between ownership and writing directly from students' perspectives, we used analysis of student responses to surveys and interviews in an upper-division laboratory course. Using a grounded theory approach for the analysis of 167 survey responses and 9 interviews, we found that students have varying perceptions of project ownership, with the most frequent being opportunities to contribute ideas and shape the project (autonomy), doing the work, and leadership. Students largely perceived that increased ownership had positive influences on their writing, such as increased understanding and thinking, freedom in writing, and increased motivation. Learning about how students perceive ownership in the context of a lab course is useful for considering how lab course structure may support the development of a sense of ownership and may influence how we can engage students in meaningful writing practices.

A deterministic model based on evidence for the associations between kinematic variables and sprint kayak performance.

The aim of this narrative review was to propose a deterministic model based on a review of previous research documenting the evidence for the associations between average kayak velocity and kinematic variables in sprint kayaking. Literature was reviewed after searching electronic databases using key words 'kayak,' 'biomechanics,' 'velocity,' 'kinematics,' and 'performance.' Our kinematic deterministic model for sprint kayaking performance shows that the average kayak velocity is determined by kayak stroke displacement and stroke time. Stroke time had the strongest correlation with 200-m race time (r = 0.86, p < 0.001), and stroke rate (inversely proportional to stroke time) was strongly correlated with average horizontal velocity over two consecutive strokes at race pace (r = -0.83, p < 0.05). Increased stroke rate via decreased absolute water phase time and increased relative water phase time were indicative of more elite performance. There was no significant relationship between stroke displacement and velocity; however, a large decrease in stroke displacement may be detrimental to performance. Individual characteristics may be responsible for a paddlers' ability to achieve and sustain a given stroke rate. Coaches should theoretically focus interventions on increasing stroke rate while maintaining stroke displacement; however this hypothesis should be confirmed with prospective studies.

Community SES, perceived environment, and physical activity during home-based cardiac rehabilitation: is there a need to consider the urban vs. rural distinction?

Physical activity (MVPA) levels during home-based cardiac rehabilitation (CR) remain problematic. Consequently, the present study examined the association between MVPA and urban vs. rural residential status and the perceived environment in patients attending home-based CR. A total of 280 patients completed a questionnaire assessing demographic, clinical, MVPA, and perceived environmental variables measured at baseline and 3 months later. Patient addresses were geocoded and linked to the 2006 Canadian census to establish the urban/rural distinction. Results showed that urban and rural patients had similar baseline MVPA and improvements in MVPA by 3 months. Several perceived environmental variables were significantly related to MVPA throughout home-based CR that were common and urban/rural-specific. Therefore, although there does not appear to be an urban vs. rural advantage in MVPA levels during home-based CR, there does appear to be environmental/MVPA-specific relationships specific to urban and rural patients that may warrant attention.

An observational model for biomechanical assessment of sprint kayaking technique.

Sprint kayaking stroke phase descriptions for biomechanical analysis of technique vary among kayaking literature, with inconsistencies not conducive for the advancement of biomechanics applied service or research. We aimed to provide a consistent basis for the categorisation and analysis of sprint kayak technique by proposing a clear observational model. Electronic databases were searched using key words kayak, sprint, technique, and biomechanics, with 20 sources reviewed. Nine phase-defining positions were identified within the kayak literature and were divided into three distinct types based on how positions were defined: water-contact-defined positions, paddle-shaft-defined positions, and body-defined positions. Videos of elite paddlers from multiple camera views were reviewed to determine the visibility of positions used to define phases. The water-contact-defined positions of catch, immersion, extraction, and release were visible from multiple camera views, therefore were suitable for practical use by coaches and researchers. Using these positions, phases and sub-phases were created for a new observational model. We recommend that kayaking data should be reported using single strokes and described using two phases: water and aerial. For more detailed analysis without disrupting the basic two-phase model, a four-sub-phase model consisting of entry, pull, exit, and aerial sub-phases should be used.

CRISPR in Your Kitchen: an At-Home CRISPR Kit to Edit Genes in Saccharomyces cerevisiae Used during a Remote Lab Course.

The use of CRISPR-based experiments in an undergraduate course is appealing because of the ease of editing, and the relevance of CRISPR to current research. Before the COVID-19 pandemic, we developed an in-person lab for a high-enrollment course that allowed students to design and conduct CRISPR editing experiments in budding yeast, Saccharomyces cerevisiae. Post pandemic, the lab course moved online, and we lost the hands-on component. We subsequently developed an at-home kit that contained all the necessary materials for students to grow and transform S. cerevisiae with the DNA molecules necessary for CRISPR-Cas9 induced editing. Our at-home kits cost approximately $70 each to produce and were shipped to over 600 students during the 2020 to 2021 academic year. By adding the at-home experimental work to our remote, online lab course, students were able to generate loss-of-function mutants in ADE2 (causing a red color phenotype). Students were able to send edited yeast samples back to campus for sequencing, allowing for characterization of the different mutations that can occur due to CRISPR-Cas9 induced editing. Here, we described the protocol to produce and use the kits and summarized the student experience of using the at-home kit in a large enrollment, remote lab course. These kits provided opportunities to engage students in hands-on experimentation during a remote course and could also be used to reach learners in other domains, such as high schools and outreach programs.

Gender differences in satisfaction with life in patients with coronary heart disease: physical activity as a possible mediating factor.

The objective of the present study was to examine if time varying, mediating effect of physical activity plays an important role in the gender-satisfaction with life relationship. Six hundred four male and 197 female patients were included. Principal outcomes of interest were self-report satisfaction with life and physical activity at baseline, 6, 12 and 24 months. The Krull and MacKinnon procedure for hierarchical linear modeling showed that the change in physical activity mediated the gender-satisfaction with life over a 2 year period. Results from the current study suggest that increased physical activity partially explains why males report having increased well-being than females after hospitalization. This suggests that future interventions need to focus on reducing the gender disparity in physical activity to improve differences noted in satisfaction with life. If higher physical activity levels impact satisfaction with life positively, the importance of physical activity for female patients is warranted.

Ethylene levels are regulated by a plant encoded 1-aminocyclopropane-1-carboxylic acid deaminase.

Control of the levels of the plant hormone ethylene is crucial in the regulation of many developmental processes and stress responses. Ethylene production can be controlled by altering endogenous levels of 1-aminocyclopropane-1-carboxylic acid (ACC), the immediate precursor to ethylene or by altering its conversion to ethylene. ACC is known to be irreversibly broken down by bacterial or fungal ACC deaminases (ACDs). Sequence analysis revealed two putative ACD genes encoded for in the genome of Arabidopsis thaliana (A. thaliana) and we detected ACD activity in plant extracts. Expression of one of these A. thaliana genes (AtACD1) in bacteria indicated that it had ACD activity. Moreover, transgenic plants harboring antisense constructs of the gene decreased ACD activity to 70% of wild-type (WT) levels, displayed an increased sensitivity to ACC and produced significantly more ethylene. Taken together, these results show that AtACD1 can act as a regulator of ACC levels in A. thaliana.

Writing in your own voice: An intervention that reduces plagiarism and common writing problems in students' scientific writing.

In many of our courses, particularly laboratory courses, students are expected to engage in scientific writing. Despite various efforts by other courses and library resources, as instructors we are often faced with the frustration of student plagiarism and related writing problems. Here, we describe a simple Writing in Your Own Voice intervention designed to help students become more aware of different types of plagiarism and writing problems, avoid those problems, and practice writing in their own voice. In this article, we will introduce the types of plagiarism and writing problems commonly encountered in our molecular biology laboratory course, the intervention, and the results of our study. From the evaluation of 365 student reports, we found the intervention resulted in nearly 50% fewer instances of plagiarism and common writing problems. We also observed significantly fewer instances of severe plagiarism (e.g. several sentences copied from an external source). In addition, we find that the effects last for several weeks after the students complete the intervention assignment. This assignment is particularly easy to implement and can be a very useful tool for teaching students how to write in their own voices. © 2019 International Union of Biochemistry and Molecular Biology, 47(5):589-598, 2019.

Identifying Troublesome Jargon in Biology: Discrepancies between Student Performance and Perceived Understanding.

The excessive "jargon" load in biology may be a hurdle for developing conceptual understanding as well as achieving core competencies such as scientific literacy and communication. Little work has been done to characterize student understanding of biology--specific jargon. To address this issue, we aimed to determine the types of biology jargon terms that students struggle with most, the alignment between students' perceived understanding and performance defining the terms, and common errors in student-provided definitions. Students in two biology classes were asked to report their understanding of, and provide definitions for, course-specific vocabulary terms: 1276 student responses to 72 terms were analyzed. Generally, students showed an overestimation of their own understanding. The least accurate self-assessment occurred for terms to which students had substantial prior exposure and terms with discordant meanings in biology versus everyday language. Students were more accurate when assessing their understanding of terms describing abstract molecular structures, and these were often perceived as more difficult than other types of terms. This research provides insights about which types of technical vocabulary may create a barrier to developing deeper conceptual understanding, and highlights a need to consider student understanding of different types of jargon in supporting learning and scientific literacy.

Small changes, big gains: A curriculum-wide study of teaching practices and student learning in undergraduate biology.

A growing body of evidence has shown that active learning has a considerable advantage over traditional lecture for student learning in undergraduate STEM classes, but there have been few large-scale studies to identify the specific types of activities that have the greatest impact on learning. We therefore undertook a large-scale, curriculum-wide study to investigate the effects of time spent on a variety of classroom activities on learning gains. We quantified classroom practices and related these to student learning, assessed using diagnostic tests written by over 3700 students, across 31 undergraduate biology classes at a research-intensive university in the Pacific Northwest. The most significant positive predictor of learning gains was the use of group work, supporting the findings of previous studies. Strikingly, we found that the addition of worksheets as an active learning tool for in-class group activities had the strongest impact on diagnostic test scores. This particular low-tech activity promotes student collaboration, develops problem solving skills, and can be used to inform the instructor about what students are struggling with, thus providing opportunities for valuable and timely feedback. Overall, our results indicate that group activities with low barriers to entry, such as worksheets, can result in significant learning gains in undergraduate science.

Women's Heart Health: Knowledge, Beliefs, and Practices of Canadian Physicians.

BACKGROUND: Heart disease is a leading cause of morbidity and mortality in women. To date, the majority of knowledge regarding heart disease is based on research conducted in men. As a result, a male-oriented model of heart disease constitutes the basis for diagnostic and therapeutic strategies for both sexes. This article reports findings from the first survey of Canadian physicians to examine their knowledge, beliefs, and practices regarding heart disease in women. MATERIALS AND METHODS: This cross-sectional survey, adapted from an instrument used in the United States, was undertaken in the spring of 2015. A sample of 504 physicians from a randomly selected sample of online responses was produced. RESULTS: Overall, physician responses demonstrate a general lack of awareness regarding the prevalence and approaches to the identification of, and treatments for, heart disease in women. In addition, physicians did not provide high ratings of their own effectiveness in supporting female patients to prevent or manage heart disease. The barriers that physicians face and the strategies to support them in improving women's heart health were explored. CONCLUSIONS: There is a clear need to educate physicians about heart disease in women and its prevention and management. More female-specific research, prevention, and clinical programs will enhance our ability to significantly improve cardiovascular health in Canadian women.

The State of Affairs for Cardiovascular Health Research in Indigenous Women in Canada: A Scoping Review.

Cardiovascular disease (CVD) is the leading cause of death among Indigenous peoples in Canada. As rates of CVD rise, the impacts among the growing population of Indigenous women will emerge as an important health issue. The objective of this scoping review was to advance the state of knowledge about cardiovascular health research in Indigenous women in Canada. Five databases and grey literature (non-peer reviewed works) were searched to identify all studies that reported on the prevalence, pathophysiology, diagnosis, treatment, or interventions for CVD among adult Indigenous women in Canada, including First Nations, Métis, and Inuit. Searching identified 3194 potential articles; 61 of which were included. The most commonly researched topics were the prevalence of CVD, hypertension, and dyslipidemia. Rates of CVD and associated mortality among Indigenous women appear to have surpassed those of their nonindigenous counterparts. Very little research has examined the pathophysiology, diagnosis, and treatment of CVD. Gaps in the research identified the need for sex-based analyses, comparison with nonindigenous women, comprehensive longitudinal data, assessment of diagnosis criteria, development and evaluation of cardiovascular health interventions, and a better understanding of the role of culture and traditions in the prevention and treatment of CVD among Indigenous women. Although comprehensive CVD data are lacking, rates of CVD among Indigenous women in Canada are rising and are nearing or surpassing those of nonindigenous women. This review serves as a call to action to seek further research on the pathophysiology, diagnosis, and treatment of CVD among Indigenous women from across Canada.

Cell Surface N-Glycans Influence Electrophysiological Properties and Fate Potential of Neural Stem Cells.

Understanding the cellular properties controlling neural stem and progenitor cell (NSPC) fate choice will improve their therapeutic potential. The electrophysiological measure whole-cell membrane capacitance reflects fate bias in the neural lineage but the cellular properties underlying membrane capacitance are poorly understood. We tested the hypothesis that cell surface carbohydrates contribute to NSPC membrane capacitance and fate. We found NSPCs differing in fate potential express distinct patterns of glycosylation enzymes. Screening several glycosylation pathways revealed that the one forming highly branched N-glycans differs between neurogenic and astrogenic populations of cells in vitro and in vivo. Enhancing highly branched N-glycans on NSPCs significantly increases membrane capacitance and leads to the generation of more astrocytes at the expense of neurons with no effect on cell size, viability, or proliferation. These data identify the N-glycan branching pathway as a significant regulator of membrane capacitance and fate choice in the neural lineage.

Concepts first, jargon second improves student articulation of understanding.

In this experiment, students in a large undergraduate biology course were first exposed to the concepts without new technical vocabulary ("jargon") in a pre-class reading assignment. Their learning of the concepts and jargon was compared with that of an equivalent group of students in another section of the same course, whose pre-class reading presented both the jargon and concepts together in the traditional manner. Both groups had the same active-learning classes with the same instructor, and then completed the same post-test. Although the two groups performed the same on the multiple choice questions of the post-test, the group exposed to concepts first and jargon second included 1.5 times and 2.5 times more correct arguments on two free-response questions about the concepts. The correct use of jargon between the two groups was similar, with the exception of one jargon term that the control group used more often. These results suggest that modest instructional changes whereby new concepts are introduced in a concepts-first, jargon-second manner can increase student learning, as demonstrated by their ability to articulate their understanding of new concepts.

A Guide for Graduate Students Interested in Postdoctoral Positions in Biology Education Research.

Postdoctoral positions in biology education research (BER) are becoming increasingly common as the field grows. However, many life science graduate students are unaware of these positions or do not understand what these positions entail or the careers with which they align. In this essay, we use a backward-design approach to inform life science graduate students of postdoctoral opportunities in BER. Beginning with the end in mind, we first discuss the types of careers to which BER postdoctoral positions lead. We then discuss the different types of BER postdoctoral positions, drawing on our own experiences and those of faculty mentors. Finally, we discuss activities in which life science graduate students can engage that will help them gauge whether BER aligns with their research interests and develop skills to be competitive for BER postdoctoral positions.