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ENTICE aimed to use co-creative methodologies in order to build a solid creation pipeline for medical experiential content. The project has developed and evaluated immersive learning resources and tools aiming to support well-defined learning objectives using tangible and intangible resources (AR/VR/MR, 3D printing) that are highly sought in the fields of anatomy and surgery. In this paper the preliminary results from the evaluation of the learning resources and tools in 3 countries as well as the lessons learnt are presented towards to the improvement of the medical education process.

BACKGROUND Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is a leading cause of mortality and morbidity. Patient knowledge about AF and its management is paramount but often limited. Patients need to be appropriately informed about treatment options, medicinal adherence and potential consequences of non-adherence, while also understanding treatment goals and expectations from it. m-health applications experienced an explosion both in their availability and their acceptance as “soft interventions” for patient engagement and education. However, the prolific nature of such solutions revealed a gap in evidence base regarding their efficacy and impact. Virtual Patients (VPs), interactive computer simulations, have been used as learning activities in modern health care education. VPs demonstrably improved cognitive and behavioral skills and thus they have been effectively implemented across undergraduate and postgraduate curricula. However, their application in patient education has been rather limited so far. OBJECTIVE This work aims to implement and evaluate the efficacy of a mobile deployed VP regimen for the education and engagement of AF patients on crucial topics regarding their condition. A mobile VP application is developed with the goal of each VP being a simple scenario with a set goal and very specific messages and will be subsequently attempted and evaluated. METHODS A mobile VP player application is created so as to be utilized for the design of three educational scenarios for AF management. A pseudo-randomized control trial for the efficacy of Virtual Patients (VPs) is planned to be executed in three sites in Greece, Ukraine and Kazakhstan for AF patients. After recruiting and exclusion, patients from Greece, Kazakhstan and Ukraine are aimed to participate in the study. The A Welch’s t-test will be used to demonstrate the performance of patients’ evaluation of the VP experience. RESULTS Our study is at the development stage. A preliminary study regarding the system’s development and feasibility has started in December 2022. The results of our study are expected to be available in 2023 or when the needed sample size is achieved. CONCLUSIONS This study aims to evaluate and demonstrate the first significant evidence for the value of VP resources in outreach and training endeavors for patients’ empowerment and healthy habit building on AF.

Considerable attention nowadays has been given to collaborative learning as a powerful way of learning, however, the ability to provide student-centered learning, meet student needs and provide them with the opportunity to learn, is a challenging task and has received significant research attention. CLUEDUP proposes an innovative educational protocol that integrates game-based learning with pedagogical approaches that matches students’ needs and skills and promotes collaborative interactive and decision-based learning.

The aim of this study was to assess the impact of the integration of tablets and a mobile application for fitness development into a PE lesson in primary education, in schools that did not apply a ‘one tablet per child’ policy, on students’ intrinsic motivation for the PE lesson. Four 5th grade and four 6th grade classes (145 students aged 10–12 years) were assigned either to an experimental or a control group. The experimental group used 4 tablets and an age-appropriate, kid-friendly fitness app, whereas the control group did the same fitness program without technology. Students’ intrinsic motivation for the PE lesson attended was assessed in both cases through anonymous questionnaires. The experimental group students reported a higher level of interest and enjoyment than the control group students, although students’ perceived effort, perceived competence and feeling of pressure did not differ significantly between the two groups. The experimental lesson proved to be equally motivational for both boys and girls, and for both 5th and 6th graders. In the experimental lesson, the students particularly appreciated the usefulness of the activity for their body, certain features of the app used and that they trained in subgroups, whereas the PE teachers were freed from the duty of repeatedly demonstrating exercises and had more time to provide individualized feedback to students.

Aim: To present the relevant research results that enhance the possibilities presented today with the use of multimedia applications. An attempt was made to explain its importance in the learning process in general and motor skills in particular. At the same time, we try to define the implementation process and the flags that need attention for the best possible results. Nowadays the use of digital technology has reached very high levels. Especially in the last two years with the COVID-19 pandemic, where distance learning was most used. Teachers have learned to use these digital tools to create attractive lessons for their students, who are already introduced to digital technology in their lives. The use of multimedia in education, as many research suggests, is a modern learning tool in the classroom, but recently they have been used in both physical education and sport. The effectiveness of multimedia use is based on the theory of visualization of information that helps the student store this information in their memory for subsequent recall, make the course more attractive/pleasant, so students are motivated to learn. In PA and sports it is used as a helpful tool, since the master of learning is practice. The means used to present multimedia in the classroom can be tablets, mobile phones, a laptop with a large screen view at the same time.

β-Thalassemia (BT) is one of the most common genetic diseases worldwide and is caused by mutations affecting β-globin production. The only curative treatment is allogenic hematopoietic stem/progenitor cells (HSPCs) transplantation, an approach limited by compatible donor availability and immunological complications. Therefore, transplantation of autologous, genetically-modified HSPCs is an attractive therapeutic option. However, current gene therapy strategies based on the use of lentiviral vectors are not equally effective in all patients and CRISPR/Cas9 nuclease-based strategies raise safety concerns. Thus, base editing strategies aiming to correct the genetic defect in patients’ HSPCs could provide safe and effective treatment. Here, we developed a strategy to correct one of the most prevalent BT mutations (IVS1-110 [G>A]) using the SpRY-ABE8e base editor. RNA delivery of the base editing system was safe and led to ∼80% of gene correction in the HSPCs of patients with BT without causing dangerous double-strand DNA breaks. In HSPC-derived erythroid populations, this strategy was able to restore β-globin production and correct inefficient erythropoiesis typically observed in BT both in vitro and in vivo. In conclusion, this proof-of-concept study paves the way for the development of a safe and effective autologous gene therapy approach for BT.

Aim: The objective of this study was to assess the efficacy and safety of intravenous TXA administration in elderly patients undergoing hip fracture surgery focusing on the effect of various dosages. Methods: A systematic search of PubMed, Embase and Cochrane Library was conducted until February 2021. Our primary outcome was peri-operative total blood loss, while secondary outcomes included transfusion rate, mean count of transfused RBC units and thromboembolic events’ incidence. A subgroup analysis was performed with respect to TXA dosage. Results: Out of 146 records identified, 10 randomized controlled studies met the selection criteria. Data synthesis revealed that TXA resulted in a significant reduction in total blood loss by 229.45 ml in favor of TXA; 95% CI: [189.5, 269.4] and transfusion rate by 40%, RR = 0.60; 95% CI: [0.47, 0.78]. No increase in thromboembolic events rate was observed (RR = 1.08, 95% CI: [0.68, 1.69]) Furthermore, sub-analysis with respect to TXA dosage showed no significant difference in total blood loss reduction between “single” and “multiple doses” studies (223 vs 233.5 ml, p = 0.85.), while a trend for lower complications rate was observed in patients receiving a single dose of

Beta-like globin gene expression is developmentally regulated during life by transcription factors, chromatin looping and epigenome modifications of the β-globin locus. Epigenome modifications, such as histone methylation/demethylation and acetylation/deacetylation and DNA methylation, are associated with up- or down-regulation of gene expression. The understanding of these mechanisms and their outcome in gene expression has paved the way to the development of new therapeutic strategies for treating various diseases, such as β-hemoglobinopathies. Histone deacetylase and DNA methyl-transferase inhibitors are currently being tested in clinical trials for hemoglobinopathies patients. However, these approaches are often uncertain, non-specific and their global effect poses serious safety concerns. Epigenome editing is a recently developed and promising tool that consists of a DNA recognition domain (zinc finger, transcription activator-like effector or dead clustered regularly interspaced short palindromic repeats Cas9) fused to the catalytic domain of a chromatin-modifying enzyme. It offers a more specific targeting of disease-related genes (e.g., the ability to reactivate the fetal γ-globin genes and improve the hemoglobinopathy phenotype) and it facilitates the development of scarless gene therapy approaches. Here, we summarize the mechanisms of epigenome regulation of the β-globin locus, and we discuss the application of epigenome editing for the treatment of hemoglobinopathies.

Motor neuron diseases are untreatable with common pharmacological approaches. Spinal muscular atrophy (SMA) is caused by SMN1 gene mutations leading to lowered SMN expression. Symptoms are alleviated in infants with a higher copy number of the SMN2 gene, which, however, displays a splicing defect resulting in low SMN levels. Amyotrophic lateral sclerosis (ALS) is caused by a number of mutations, with C9orf72 repeat expansions the most common genetic cause and SOD1 gain-of-function mutations the first genetic cause identified for this disease. Genetic therapies based on oligonucleotides that enhance SMN2 splicing and SMN production or lower SOD1 expression have shown promise in initial clinical trials for individuals with SMA and ALS harboring SOD1 mutations, respectively. Gene addition/silencing approaches using adeno-associated viruses (AAVs) are also currently under clinical investigation in trials for SMA and ALS. Here we provide a brief overview of these efforts and their advantages and challenges. We also review genome editing approaches aimed at correcting the disease-causing mutations or modulating the expression of genetic modifiers, e.g., by repairing SOD1 mutations or the SMN2 splicing defect or deleting C9orf72 expanded repeats. These studies have shown promising results to approach therapeutic trials that should significantly lower the progression of these deadly disorders.

The purpose was to assess the effect of an 11-week resisted swim training program using a water parachute on the inter-arm coordination in front crawl swimming. Fourteen female swimmers were divided into a control and an experimental group, and followed the same training program, except for the use of a water parachute by the experimental group in specific sprint sets. Before and after the intervention, the underwater motion of the swimmers was recorded using four camcorders and the digitisation process was undertaken manually. The two-way repeated measures analyses of variance revealed a significant increase of the swimming velocity, due to a significant increased stroke rate, because of the significant reduction of the total stroke duration, only in the experimental group. Moreover, their absolute and relative duration of the propulsive pull and push phases increased significantly, while the absolute and relative duration of their non-propulsive entry & catch and recovery phases decreased significantly. These modifications caused a significant increase in the index of coordination. Thus, this 11-week sprint resisted intervention program seems to improve the propulsion continuity and could be considered as an effective form of training, increasing the stroke rate and consequently the swimming velocity.

The purpose of the study was to investigate the effect of exergames «Wii Nintendo Sports» on psychological and physiological parameters of young adults. In the present study, twenty (N = 20) students of the School of Physical Education and Sport Sciences of Democritus University of Thrace aged from 20 to 25 years old volunteered. The participants were randomly divided into two groups, the experimental (N = 10) and control group (N = 10). The experimental group used as a training method the exergames «Wii Nintendo Sports», while the control group did not participate in any training program. The experimental group participated in a 10 weeks pilot study of Nintendo’s Wii sports, with three 30 min sessions a week. Subjective vitality, body weight, body mass index, maximum oxygen uptake and maximum heart rate of the participants were examined, before and after the intervention program. Results of the present study revealed that exergames did not affect the participants’ body weight, body mass index, maximum oxygen uptake and maximum heart rate. On the contrary, it was found that only the experimental group achieved a significantly better subjective vitality, between the pre- and post-test. In conclusion, exergames are effective tools for achieving a better subjective vitality in young adults.

β-hemoglobinopathies are caused by mutations affecting the adult hemoglobin production. In sickle cell disease (SCD), the β6 Glu→Val substitution leads to sickle hemoglobin (HbS) polymerization and red blood cell (RBC) sickling. In β-thalassemia, reduced β-globin production leads to precipitation of uncoupled α-chains causing ineffective erythropoiesis and the production of poorly hemoglobinized RBCs. Transplantation of autologous, genetically modified hematopoietic stem/progenitor cells (HSPCs) is an attractive therapeutic option. The clinical severity of β-hemoglobinopathies is alleviated by the co-inheritance of mutations causing hereditary persistence of fetal Hb (HPFH). HPFH mutations clustering 200 nucleotides upstream of the TSS of the fetal γ-globin (HBG) genes either disrupt the binding site (BS) of the fetal Hb (HbF) repressor LRF or generate a de novo BS for the KLF1 activator. To reactivate γ-globin expression, nuclease-based approaches have been explored. However, nucleases generate double-strand breaks (DSBs), raising safety concerns for clinical applications. Base editing (BE) allows the introduction of point mutations without generating DSBs. In this study, we designed BE systems to introduce a variety of HPFH or HPFH-like mutations in the -200 region of the HBG promoters. First, we screened in erythroid cell lines known and novel BEs, and we selected combinations of BEs and guide RNAs that edit alternative bases of the -200 region. We then developed a clinically-relevant protocol based on RNA-transfection to deliver the BE system to HSPCs. The expression profile of genes activated by RNA stimuli revealed no immune response in HSPCs. A progenitor assay indicated no alteration in the growth and multilineage differentiation of edited HSPCs. We applied this protocol to SCD and β-thalassemia HSPCs, achieving editing efficiencies up to ~70% of the HBG promoters. In RBCs differentiated from edited SCD HSPCs, RT-qPCR, HPLC and flow cytometry showed a potent γ-globin reactivation with a high frequency of HbF + cells and a concomitant decrease in the HbS content/cell. Importantly, the pathological RBC sickling phenotype was corrected in the samples derived from edited HSPCs. Similarly, in β-thalassemia samples, RT-qPCR and HPLC analyses showed strong γ-globin induction and decrease of the α-globin precipitates. HbF expression rescued the delay in erythroid differentiation and ineffective erythropoiesis characterizing β-thalassemia, as demonstrated by the increased RBC enucleation rate and the reduced apoptosis and oxidative stress. We then compared BE strategies that either disrupt the LRF BS or create a de novo KLF1 BS in single colonies derived from erythroid progenitors. Generation of the KLF1 BS was associated with higher levels of HbF compared to the LRF BS disruption. These results suggest that eviction of the LRF repressor is sufficient to reactivate HBG genes, but recruitment of an activator is more effective to achieve high levels of gene expression. HbF expression induced by both LRF BS disruption and KLF1 BS generation was sufficient to rescue the SCD cell phenotype, but higher HbF levels - achieved only through KLF1 BS generation - were necessary to fully correct the β-thalassemia phenotype. In the majority of cases, we detected no DSB-induced insertions, deletions, or large genomic rearrangements in base-edited samples. Accordingly, DSB-induced DNA damage response (DDR) was absent in base-edited HSPCs, as measured by evaluating the expression of p21, a readout of p53-induced DDR. DNA off-target activity was assessed by GUIDE-seq and targeted sequencing of the potential off-target sites in edited HSPCs, while RNA off-target activity was evaluated by RNA-seq in HSPCs. Finally, BE-treated HSPCs were transplanted in immunodeficient mice to evaluate the engraftment and differentiation capability of edited HSCs. We detected good frequencies of human cells with up to ~60% of edited promoters in the peripheral blood of transplanted mice. In conclusion, we developed a clinically-relevant strategy to perform efficient BE in the HBG promoters that led to therapeutically-relevant HbF levels and rescued both the SCD and β-thalassemia phenotypes, thus providing sufficient proof of efficacy and safety to enable the clinical development of base-edited HSPCs for the therapy of β-hemoglobinopathies. Disclosures El Nemer: Hemanext: Consultancy.

BACKGROUND Thyroid cancer (TC) is one of the fastest growing cancers all over the world. Differentiated thyroid cancer (DTC) is the most frequent subtype of TC. When appropriate treatment is given, the prognosis for the patient is generally excellent. Despite the generally good prognosis of thyroid carcinomas, the symptoms may range from emotional to physical discomfort, depending on the thyroid hormone status, which can severely affect the patient. Moreover, the diagnostic and therapeutic procedures that DTC patients have to undergo, such as thyroidectomy and radioiodine therapy, significantly affect their mental and physical well-being. Often, the physician only addresses the favorable prognosis of DTC compared with other cancer types and neglects to assess issues related to the quality of life (QoL) of the patient; this was the reason we decided to design a mobile app for DTC patients and their caregivers. OBJECTIVE The aim of this study is to research the feasibility and applicability of an mHealth app tailored to DTC patients, as reflected in their QoL. The main features of the developed app offer access to useful information about thyroid cancer, diagnostic tests, and the appropriate therapy administered to DTC patients. METHODS Based on the existing literature, we created an up-to-date information platform regarding TC and especially DTC. In order to develop an effective app that can be implemented in current health care, we designed a section where the patient and physician can keep a medical record in an effort to enable access to such information at any time. Finally, we designed a user-friendly notification program, including pill prescription, follow-up tests, and doctor visit reminders in order to equally facilitate the lives of the patient and physician. RESULTS Having developed this mobile app, we aim to conduct a pilot quasiexperimental interventional trial. Our intention is to enroll at least 30 TC patients and assign them to intervention or control groups. Both groups will receive standard care for treating and monitoring TC, and the intervention group will also receive and use the DTC app. TC patients’ QoL will be assessed for both control and intervention groups in order to examine the effectiveness of the DTC app. QoL will be assessed through the QoL core questionnaire European Organisation for Research and Treatment of Cancer (EORTC) QLQ-THY34 in combination with the EORTC QLQ-C30 questionnaire through quantitative statistical analysis. CONCLUSIONS The use of mHealth apps can play a significant role in patient education, disease self-management, remote monitoring of patients, and QoL improvement. However, the main limitation of the majority of existing studies has been the lack of assessing their usefulness as well as the absence of specific instruments to carry out this assessment. In light of those considerations, we developed a mobile app tailored to the needs of DTC patients. Furthermore, we evaluated its contribution to the QoL of the patients by using the EORTC QLQ-THY34 questionnaire, an accurate and safe instrument for the evaluation of the QoL in TC patients, while supporting future planned endeavors in the field. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/13409

BACKGROUND Globally, online and local area network–based (LAN) digital education (ODE) has grown in popularity. Blended learning is used by ODE along with traditional learning. Studies have shown the increasing potential of these technologies in training medical doctors; however, the evidence for its effectiveness and cost-effectiveness is unclear. OBJECTIVE This systematic review evaluated the effectiveness of online and LAN-based ODE in improving practicing medical doctors’ knowledge, skills, attitude, satisfaction (primary outcomes), practice or behavior change, patient outcomes, and cost-effectiveness (secondary outcomes). METHODS We searched seven electronic databased for randomized controlled trials, cluster-randomized trials, and quasi-randomized trials from January 1990 to March 2017. Two review authors independently extracted data and assessed the risk of bias. We have presented the findings narratively. We mainly compared ODE with self-directed/face-to-face learning and blended learning with self-directed/face-to-face learning. RESULTS A total of 93 studies (N=16,895) were included, of which 76 compared ODE (including blended) and self-directed/face-to-face learning. Overall, the effect of ODE (including blended) on postintervention knowledge, skills, attitude, satisfaction, practice or behavior change, and patient outcomes was inconsistent and ranged mostly from no difference between the groups to higher postintervention score in the intervention group (small to large effect size, very low to low quality evidence). Twenty-one studies reported higher knowledge scores (small to large effect size and very low quality) for the intervention, while 20 studies reported no difference in knowledge between the groups. Seven studies reported higher skill score in the intervention (large effect size and low quality), while 13 studies reported no difference in the skill scores between the groups. One study reported a higher attitude score for the intervention (very low quality), while four studies reported no difference in the attitude score between the groups. Four studies reported higher postintervention physician satisfaction with the intervention (large effect size and low quality), while six studies reported no difference in satisfaction between the groups. Eight studies reported higher postintervention practice or behavior change for the ODE group (small to moderate effect size and low quality), while five studies reported no difference in practice or behavior change between the groups. One study reported higher improvement in patient outcome, while three others reported no difference in patient outcome between the groups. None of the included studies reported any unintended/adverse effects or cost-effectiveness of the interventions. CONCLUSIONS Empiric evidence showed that ODE and blended learning may be equivalent to self-directed/face-to-face learning for training practicing physicians. Few other studies demonstrated that ODE and blended learning may significantly improve learning outcomes compared to self-directed/face-to-face learning. The quality of the evidence in these studies was found to be very low for knowledge. Further high-quality randomized controlled trials are required to confirm these findings.

β-hemoglobinopathies are genetic anemias caused by a reduced or abnormal synthesis of the adult β-globin chain. In β-thalassemia, the reduced (β+) or absent (β0) production of adult β-chains causes α-globin precipitation and death of red blood cell (RBC) precursors. In sickle cell disease (SCD), a single amino acid change (β6Glu→Val) in the adult hemoglobin (Hb) βS-chain causes Hb polymerization with consequent red blood cell (RBC) sickling, vaso-occlusive crises, organ damage and reduced life expectancy. The co-inheritance of genetic mutations causing a sustained fetal γ-globin chain production in adult life (hereditary persistence of fetal hemoglobin, HPFH) reduces the clinical severity of β-hemoglobinopathies. HPFH mutations in the promoter of the two γ-globin genes, HBG1 and HBG2 disrupt the binding sites (BS) for transcriptional repressors (e.g., BCL11A and LRF). Recently, we demonstrated that CRISPR/Cas9-mediated disruption of the LRF BS in the HBG promoters via non-homologous end joining and microhomology-mediated end joining (MMEJ) repair mechanisms mimics the effect of HPFH mutations by impairing the LRF binding and re-activating the γ-globin expression (Weber, Frati et al., Science Advances, 2020). Efficient editing of the LRF BS (≥ 3 γ-globin promoters in >70% of SCD hematopoietic stem/progenitor cells (HSPCs)) resulted in a robust HbF reactivation and a concomitant reduction in βS-globin levels recapitulating the phenotype of asymptomatic SCD-HPFH patients. RBCs derived from edited HSPCs displayed HbF levels sufficient to correct the SCD cell phenotype. Similarly, LRF BS targeting in β0-thalassemic cells results in HbF reactivation potentially correcting the α/β-like globin imbalance. Xenotransplantation of human HSPCs edited using several gRNAs targeting the LRF BS showed a robust engraftment of edited cells that were capable to differentiate into multiple lineages. HBG editing in engrafted cells ranged from 26% to 76% with a decrease (-33%) of editing events compared to the input HSPCs, partially due to a reduced occurrence of MMEJ-mediated events in hematopoietic stem cells (HSCs). Erythroid progenitors (BFU-E) obtained ex vivo from engrafted human cells, showed a relevant γ-globin expression (~40% of the total β-like chain) despite of the reduction in the number of edited promoters per BFU-E after transplantation. Moreover, mature RBCs ex vivo differentiated from edited human cells ensure therapeutically relevant HbF levels. Sequencing of top-scoring off-targets identified by GUIDE-seq showed a relatively high off-target activity within an intergenic site devoid of known regulatory elements both in vitro and in vivo in primary human cells treated with one of the gRNAs targeting the LRF BS. Although the occurrence of this off-target event in repopulating cells suggests that it has no detrimental effect on HSC engraftment and multilineage differentiation, we tested high fidelity Cas9 variants to reduce off-target activity in primary HSPCs. Finally, we used CAST-Seq assay to evaluate the potential chromosomal rearrangements in edited primary human cells in vitro and in vivo. To minimize the potential genotoxicity associated to Cas9 nuclease-mediated double-strand breaks (DSBs) in the genome, we explored the base editing system to introduce C>T point mutations in the LRF BS without generating DSBs. The absence of the canonical SpyCas9 NGG PAM close to the LRF BS, prompted us to use known and novel base editors containing non-NGG Cas9 variants that allowed the editing of up to 6 out of 8 cytosines of the LRF BS in erythroid cell lines and in primary HSPCs from SCD patients. These C>T conversions include not only known HPFH mutations but also mutations that can further impair LRF binding. In the majority of cases, we detected no insertions or deletions in base-edited samples, as compared to nuclease-edited samples. The 4.9-kb deletion that can be generated upon cleavage of the two identical HBG promoters by the Cas9 nuclease was barely detected in base-edited samples. Importantly, disruption of the LRF BS by non-NGG enzymes led to HbF de-repression, without affecting erythroid differentiation. This work identifies the LRF BS as an effective and safe therapeutic target for the treatment of β-hemoglobinopathies. Disclosures Casini: Alia Therapeutics: Current Employment, Current equity holder in publicly-traded company. Thrasher:Rocket Pharmaceuticals: Consultancy, Membership on an entity's Board of Directors or advisory committees; Generation bio: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Equity ownership; 4Bio Capital: Consultancy, Membership on an entity's Board of Directors or advisory committees; Orchard Therapeutics: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Equity ownership.

The purpose of this study was to use the Dynamical Systems Theory as a framework to examine whether there is a difference between an exergame-based and a traditional object control (OC) skills training program, in early elementary school children. In addition the children's enjoyment while playing Xbox Kinect (XbK) games compared to traditional approaches (TA) was also investigated. Sixty-six elementary students were randomly divided into three individual groups of 22 children each, one control group and two experimental groups (TA, XbK). The control group did not receive any structured OC skills training program, while the two experimental groups performed a specific OC skills training program for 8 weeks, two times per week, and 30 min per session. The test of gross motor development 2 was used to assess the OC skills of the participants at the pre-test, post-test and retention test. At the end of each OC training session (XbK and TA) participants completed the modified Physical Activity Enjoyment Scale. Two-way analyses of variance with repeated measures, were conducted to determine effect of training program groups (XbK, TA, Control) and measurements (pre-test, post-test, retention test) across time on OC skills performance. Analysis of the data illustrated that the post-test OC scores and the 1-month retention test OC scores were remarkably greater than pre-test OC scores for both experimental groups and not for the control group. In addition, the XbK approach mean scores on enjoyment were slightly higher than the TA approach. Conclusively, findings suggest that the use of XbK gaming console as an intervention is a valuable, feasible and pleasant approach in order to improve OC skills of elementary school children.

The year 1948, as a starting point both of this study and of the organised military sport for Greece, was particularly hectic, since the newly liberated country was embroiled in the Civil War while, simultaneously, it was trying to reconstitute itself. The next two decades were marked by the foundation and the activities of the Higher Coordinating Committee for Sport in the Armed Forces (Anotera Syntonistiki Epitropi Athlitismou Enoplon Dynameon – A.S.E.A.E.D.). This Committee organised and materialised the first steps of the newly established organised sports activities of the Hellenic Armed Forces and evolved as a result, into the Supreme Council for Sport in the Armed Forces (Anotato Symvoulio Athlitismou Enoplon Dynameon) in year 1968. Due to the lack of specific and thorough research on the topic during this era, the purpose of this study was to identify references and the original sources (archives both of the A.S.E.A.E.D. and of the Hellenic National Defense General Staff) and to highlight and reve...

Gourgoulis, V, Valkoumas, I, Boli, A, Aggeloussis, N, and Antoniou, P. Effect of an 11-week in-water training program with increased resistance on the swimming performance and the basic kinematic characteristics of the front crawl stroke. J Strength Cond Res 33(1): 95-103, 2019-The purpose of the study was to assess the effect of an 11-week in-water training program with increased resistance on the swimming performance and the basic kinematic characteristics of the front crawl stroke in young female swimmers. Twelve swimmers were matched in pairs according to their best performance in 50-m front crawl swimming and then were randomly assigned to an experimental or to a control group. Both groups followed exactly the same swimming training program. The only exception was that the experimental group performed a sprint training section with increased resistance pulling a water parachute, whereas the control group performed the same section without parachute. Before and after the intervention program, the best performance of both groups in 50-, 100-, and 200-m front crawl swimming were assessed. Moreover, the basic kinematic characteristics of the stroke were calculated during 50-m front crawl swimming with maximal intensity. Two-way repeated measures analyses of variance revealed significant improvement in the best performance in all swimming distances only in the experimental group (3.22-7.26%). As far as the basic kinematic characteristics of the stroke are concerned, significant modifications were found only in the mean swimming velocity in the experimental group (2.18%), whereas no significant changes were observed in the stroke length, the stroke rate, and the duration of the propulsive, and nonpropulsive phases in both groups. Thus, the findings of the current study revealed a positive effect of the in-water resistance training program in the swimming performance of young female swimmers of moderate performance level, without any negative influence in the basic kinematic characteristics of the stroke.

The purpose of this study was to use the Eccles' expectancy-value model of choice as a framework to examine university students' expectancy beliefs and task values in exergaming systems compared to those in physical education activities. Two hundred and thirty two first-year undergraduate students at the Democritus University of Thrace completed questionnaires assessing their expectancy-related beliefs, subjective task values, and intention for future participation in the physical education and the exergames fields. Participants' activity level was also assessed using the Godin and Shephard leisure-time exercise questionnaire. Results indicated that expectancy-related beliefs and task values are positively correlated and both constructs are correlated to intention to participate in the future for the physical education and the exergames fields. Expectancy-related beliefs, task values, and intentions across fields, however, were not correlated supporting the hypothesis that exergames represent a distinct field from traditional physical education activities. Physical education was considered as more important and more useful than exergames, nevertheless inactive students found exergames to be more interesting than physical education activities. In addition inactive students had higher beliefs about ability and higher intention for future participation in exergames activities were compared to those of physical education. Conclusively, findings support the notion that exergames could be integrated into physical education and recreation programs in order to attract inactive young adults.

The purpose of the current study was to investigate the acute effect of sprint resisted front crawl swimming on the propulsive forces of the hand. Eight female swimmers swam 25 m with maximal intensity, with and without added resistance. A bowl with a capacity of 2.2, 4 and 6 L was used as low, moderate and high added resistance, respectively. The underwater motion of the swimmer’s right hand was recorded using 4 cameras (60 Hz) and the digitization was undertaken using the Ariel Performance Analysis System. Repeated-measures ANOVA revealed that the velocity of the hand, the pitch and the sweepback angles of the hand, as well as the magnitude and the relative contribution of the drag and lift forces were not significantly modified and thus the magnitude of the resultant force did not change. Moreover, the magnitude of the effective force, as well as the angle formed between the resultant force and the axis of the swimming propulsion were not significantly affected. Thus, it could be concluded that resistance added as in this study did not alter the pattern of the propulsive hand forces associated with front crawl sprinting.

The purpose of this study was to determine whether there is a difference between an exergame-based and a traditional balance training program, in undergraduate Physical Education students. Thirty two third-year undergraduate students at the Democritus University of Thrace were randomly divided into two training program groups of 16 students each, a traditional and a Nintendo Wii group. The two training program groups performed a specific balance program for 8 weeks, two times per week, and 24 min per session. The Nintendo Wii group used the interactive games Wii Fit Plus of the Nintendo Wii console, as a training method to improve their balance, while the traditional group used an exercise program with mini trampoline and inflatable discs. Before and after the completion of the eight-week balance program, participants completed a single leg static balance assessment for both limbs on the Biodex stability system. Two-way analyses of variance (ANOVAs), with repeated measures on the last factor, were conducted to determine effect of training program groups (traditional, Nintendo Wii) and measures (pre-test, post-test) on balance test indices (SI, API, and MLI). Where initial differences between groups were verified, one-way analyses of covariance (ANCOVAs) were applied. Analysis of the data illustrated that both groups demonstrated an improvement in SI, API and MLI mean scores for the right and the left limp as well. Conclusively, findings support the effectiveness of using the Nintendo Wii gaming console as an intervention for undergraduate Physical Education students, and specifically, its effects on physical function related to balance competence.

Blended learning With the concerns and dissatisfaction with e-learning, educators are searching for alternative instructional delivery solutions to relieve the above problems. The blended e-learning system has been presented as a promising alternative learning approach. While blended learning has been recognized as having a number of advantages, insufficient learning satisfaction is still an obstacle to its successful adoption. Therefore, the purpose of this study was to evaluate students’ satisfaction with blended learning course delivery compared to a traditional face-to-face class format in a general multimedia course in physical education. Forty six (n=46) undergraduate students, between the ages of 20-22 years old, were randomly assigned into two teaching method groups: Classroom Lecture Instruction (CLI) and Blended Lecture Instruction (BLI). For the data collection at the end of this study, students completed an online satisfaction questionnaire.Independent sample t-test analysis was conducted to measure students’ satisfaction towards the CLI and BLI methods. Results indicated that a blended course delivery is preferred over the traditional lecture format. These finding suggest that students' satisfaction could increase when the instructor provides learning environments not only in a traditional classroom, but in an asynchronous online system as well.

The main idea behind this study was to explore the educational potential of multimedia blogging for academic disciplines such as Physical Education (PE) that are not heavily based on written discourse and where multiple representations are important in learning. A class blog was utilized as a means for PE students to reflect on and showcase their performances of four specific basketball skills, through creating multimedia posts on these skills and receiving comments from their instructors, peers and an external expert. The effectiveness of multimedia blogging was evaluated, in terms of the acquisition of knowledge of the specific basketball skills and the self-efficacy in Information and Communication Technologies (ICT), as compared to that of an equivalent multimedia website which lacked the blogging component. Students' responses to the blogging activity were also investigated. The sample were 70 undergraduate PE students who were assigned to two groups, one of which used the class blog (Group A, N = 35) and the other one the website (Group B, N = 35), both for 11 weeks. The study followed a pretest/posttest experimental design, taking before and after measurements of each group through written questionnaires. Participation in the blogging activity did have a positive impact on students' ICT self-efficacy, given that Group A students exhibited significant gains in Internet self-efficacy as well as in multimedia processing and blogging self-efficacy, whereas those of Group B did not. Students' responses to the blogging activity were also positive. However, within both groups no significant increase was found in students' knowledge of the basketball skills. The implications of the findings for higher education and future research are discussed.

The aim of the present study was: (a) the creation of an Online Learning Community (OLC) for the implementation of an environmental education (EE) project in secondary education, and (b) the investigation of the potential impact of student participation in the OLC on students’ knowledge and attitudes regarding the natural environment, on students’ social skills as well as their attitudes towards Information and Communication Technologies (ICT) and their ICT skills. The sample were 27 lower secondary school students (aged 12–13 years old) who collaborated within an OLC set up by their teacher by means of the free Yahoo Groups service in order to complete an EE project. The experimental intervention lasted for 10 weeks. Before and after the intervention, the students filled in a questionnaire addressing: a) their knowledge and attitudes regarding the natural environment, b) their social skills and c) their attitudes and skills regarding ICT. The study revealed that the OLC was a viable solution for supporti...

The purpose of this study was to determine the effect of information literacy on students' perception toward the educational services offered by an asynchronous course management system (e-Class) for the support of the traditional instruction method in tertiary physical education (PE) institutions. Participants were 211 PE students between the ages of 19 and 24 years, who were sorted into three groups according to their information literacy level: high, medium, and low users of technology. Data was collected using an online survey during a one-week period. One-way analyses of variances (ANOVAs) revealed significant differences between the three user groups, in each factor of the perception questionnaire: ‘interaction’, ‘participation’, ‘educational material’, ‘usefulness,’ and ‘user control’. In the above factors, the high and medium user groups reported better results than the low-technology user group. In conclusion, learner familiarity with computer and online technologies made positive contributions t...

The purpose of this study was to examine the effects on sprint swimming performance after low- and high-intensity active recovery (AR) as compared to passive recovery. Ten male competitive swimmers (age: 17.9 ± 2.3 years; body mass: 73.2 ± 4.0 kg; height: 1.81 ± 0.04 m, 100-m best time: 54.90 ± 1.96 seconds) performed 8 × 25-m sprints with 120-second rest intervals followed by a 50-m sprint 6 minutes later. During the 120-second and the 6-minute interval periods swimmers rested passively (PAS) or swam at an intensity of 40% (ACT40; 36 ± 8% of the V(O2)max) and 60% (ACT60; 59 ± 7% of the V(O2)max) of their individual 100-m velocity. Performance time of the 8 × 25-m after ACT60 was slower compared with PAS and ACT40, but no difference was observed between ACT40 and PAS conditions (PAS: 12.15 ± 0.48, ACT40: 12.23 ± 0.54, ACT60: 12.35 ± 0.57 seconds, p0.05). Performance time of the 50-m sprint was no different between conditions (PAS: 26.45 ± 0.91; ACT40: 26.30 ± 1.18; ACT60: 26.21 ± 1.19 seconds; p0.05). Blood lactate concentration was not different between PAS, ACT40, and ACT60 after the 8 × 25-m and the 50-m sprints (p0.05). Passive recovery, or low intensity of AR (40% of the 100-m velocity), is advised to maintain repeated 25-m sprint swimming performance when a 2-minute interval period is provided. Active recovery at an intensity corresponding to 60% of the 100-m velocity decreases performance during the 25-m repeated sprints without affecting the performance time on a subsequent longer duration sprint (i.e., 50 m).

The purpose of this study was to determine the effectiveness of a hybrid learning approach to deliver a computer science course concerning the Microsoft office PowerPoint 2003 program in comparison to delivering the same course content in the form of traditional lectures. A hundred and seventy-two first year university students were randomly assigned into two teaching method groups: traditional lecture instruction (TLI) and hybrid lecture instruction (HLI). Each group received six 95-min periods of instruction divided into 4 sections: a) 5-min brief outline of the key learning points, b) 40-min lecture on general knowledge c) 45-min constructivist-inspired learning activities and d) 5-min summary on key learning points. In the beginning and the end of this study students completed a 17-item multiple choice knowledge test. Two-way analysis of variances (ANOVA), with repeated measures on the last factor, were conducted to determine effect of method groups (TLI, HLI) and measures (pre-test, post-test) on knowledge test. The measures main effect was significant, as well as the groups x measures interaction effect. Two independent-samples t test were conducted to follow up the significant interaction. Differences in mean ratings of knowledge performance between the two teaching groups were not significantly different at first measure, while the TLI method group yielded a significantly lower mean rating at second measure. The findings indicated that HLI approach might be a superior option for undergraduate students on learning the Microsoft office PowerPoint 2003 program.

The aim of this study was to examine the acute effect of front crawl sprint resisted swimming with different added resistances on the kinematic characteristics of the stroke and the orientation of the hand. Ten female swimmers swam four maximal trials (25 m) with small, moderate, large, and no added resistance respectively. Four camcorders were used to record the underwater motion of the right hand and digitizing was undertaken using the Ariel Performance Analysis System. Stroke rate, the stroke length, and mean swimming velocity were significantly decreased, whereas the total duration of the stroke and the relative duration of the pull and push phases were significantly increased during resisted swimming. The increase in the total duration of the stroke was accompanied by an increase in absolute pull length, while no alterations were observed in relative pull length or medial-lateral displacements of the hand. Moreover, the mean resultant velocity of the hand, as well as the pitch and the sweepback angles of the hand were not modified. In conclusion, resisted swimming appears to be a specific form of training, at least regarding its acute effect, although long-term effects should be investigated further.

Teachers’ continuing professional development, that is an essential part of their professional career, is the subject of constant demand of them and of each educational reform interest. The rapid growth of technology and the choices of teaching and learning that it provides give possibilities for synchronous and asynchronous methods of distance continuing training which get over the problems traditional face to face methods create. A synchronous e-learning software provide virtual environment of teaching in which the possibility for enhance interactive and collaborative learning is given. The purpose of the present study was to investigate the perspectives of physical educators for the synchronous online teaching method process. The participants were 15 in-service teachers of elementary physical education who took part in a training program which was conducted with the synchronous Centra software. The results show the participants’ satisfaction from the particular instructive method and their conviction that it allows the active presence and the collaborative learning, without influences by the lack of physical presence in the same space of instructor and learners.

The purpose of the research was to determine the influence of hand paddles on the arm coordination in female front crawl swimmers. Ten female swimmers swam at a maximal intensity 25 m without, with small hand paddles (116 cm), and with large hand paddles (286 cm). Four S-VHS cameras were used to record the underwater motion of both arms, and the digitizing of selected points onto the subject's body was undertaken using the Ariel Performance Analysis System. The mean swimming velocity, the stroke length, the stroke rate, the relative duration of the separate phases of the stroke, and the index of coordination were then calculated. The index of coordination was defined as the time interval between the propulsive phases of the 2 arms expressed as a percentage of the mean duration of the stroke cycle. The results showed that when the hand paddles were worn, the mean swimming velocity (p < 0.05) and the stroke length (p < 0.05) were significantly increased, whereas the stroke rate was significantly decreased (p < 0.05). When large paddles were worn, the relative duration of the whole propulsive phase was significantly decreased (p < 0.05), and the relative duration of the nonpropulsive phase was significantly increased (p < 0.05). However, the index of coordination was remained unchanged under the 3 measurement conditions (p = 0.895). It was concluded that in front crawl hand-paddled swimming, significant increases of the swimming velocity was not caused by modifications in the pattern of arm coordination. Thus, hand-paddled swimming should not be used as a tool to alter the time sequence of the application of propulsive forces generated from the 2 arms.