Facilitators and barriers to online group work in higher education within health sciences - a scoping review.

INTRODUCTION: In health education, group work is essential to prepare students for working in health care and medical teams. Following the widespread adoption of online teaching, group work increasingly takes place in online environments. Although successful group work can provide good learning outcomes, it is unclear what facilitates or hinders online group work in health science education, and to what extent this topic has been addressed. Thus, this scoping review aimed to identify the facilitators and barriers to online group work in higher health education, provide an overview of the scientific literature related to the topic, and identify knowledge gaps in the research. METHODS: This scoping review was guided by the methodological framework described by Arksey and O'Malley, and reporting is in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Review (PRISMA-ScR). Eight online databases were searched for scientific articles published between 2012 and 2022. At least two researchers independently screened records and full-text articles and charted data including article characteristics and key information related to the research question. Findings were categorized and summarized based on the Community of Inquiry Framework. RESULTS: After screening 3671 records and 466 full-text articles, 39 articles met the inclusion criteria. The review revealed smaller group size, consistency in group composition and joint responsibility to be facilitators. Challenges with group communication, scheduling synchronous meetings and technical issues were identified as barriers. Our findings supported the importance of all three elements of the Community of Inquiry Framework: social, cognitive, and teaching presence. CONCLUSION: This review provides an overview of facilitators and barriers to online group work in health science education. However, there is a need for further investigation of these factors and studies addressing this topic from the teachers' perspective.

Free School Meal Improves Educational Health and the Learning Environment in a Small Municipality in Norway.

It has been suggested that school meals could have an impact on students' learning environments; however, existing research in this field is scarce and inconclusive. The purpose of this study was to explore teachers' and school administrators' experiences with the introduction of a free school meal and whether this influenced the learning environment. The study was conducted in upper primary and lower secondary schools in a small municipality in Norway. In this qualitative study, 17 informants participated in semi-structured in-depth interviews. The interviews were recorded, transcribed, and coded using NVivo. Thematic analysis was conducted using systematic text condensation (STC). The main findings are that in the informants' experience, a free school meal led to reduced absenteeism during lunchtime and positive social interactions among students, social equalization, and a more peaceful atmosphere during lunchtime. In conclusion, the introduction of a free school meal had a positive impact on the students' educational health and the learning environment, and contributed to social equalization as all the students shared the same healthy school meal.

A pooled analysis of molecular epidemiological studies on modulation of DNA repair by host factors.

Levels of DNA damage represent the dynamics between damage formation and removal. Therefore, to better interpret human biomonitoring studies with DNA damage endpoints, an individual's ability to recognize and properly remove DNA damage should be characterized. Relatively few studies have included DNA repair as a biomarker and therefore, assembling and analyzing a pooled database of studies with data on base excision repair (BER) was one of the goals of hCOMET (EU-COST CA15132). A group of approximately 1911 individuals, was gathered from 8 laboratories which run population studies with the comet-based in vitro DNA repair assay. BER incision activity data were normalized and subsequently correlated with various host factors. BER was found to be significantly higher in women. Although it is generally accepted that age is inversely related to DNA repair, no overall effect of age was found, but sex differences were most pronounced in the oldest quartile (>61 years). No effect of smoking or occupational exposures was found. A body mass index (BMI) above 25 kg/m2 was related to higher levels of BER. However, when BMI exceeded 35 kg/m2, repair incision activity was significantly lower. Finally, higher BER incision activity was related to lower levels of DNA damage detected by the comet assay in combination with formamidopyrimidine DNA glycosylase (Fpg), which is in line with the fact that oxidatively damaged DNA is repaired by BER. These data indicate that BER plays a role in modulating the steady-state level of DNA damage that is detected in molecular epidemiological studies and should therefore be considered as a parallel endpoint in future studies.

Student's experiences with online teaching following COVID-19 lockdown: A mixed methods explorative study.

BACKGROUND: The COVID-19 pandemic lead to a sudden shift to online teaching and restricted campus access. AIM: To assess how university students experienced the sudden shift to online teaching after closure of campus due to the COVID-19 pandemic. MATERIAL AND METHODS: Students in Public Health Nutrition answered questionnaires two and 12 weeks (N = 79: response rate 20.3% and 26.6%, respectively) after the lockdown in Norway on 12 March 2020 and participated in digital focus group interviews in May 2020 (mixed methods study). FINDINGS AND DISCUSSION: Two weeks into the lockdown, 75% of students reported that their life had become more difficult and 50% felt that learning outcomes would be harder to achieve due to the sudden shift to online education. Twelve weeks into the lockdown, the corresponding numbers were 57% and 71%, respectively. The most pressing concerns among students were a lack of social interaction, housing situations that were unfit for home office purposes, including insufficient data bandwidth, and an overall sense of reduced motivation and effort. The students collaborated well in digital groups but wanted smaller groups with students they knew rather than being randomly assigned to groups. Most students agreed that pre-recorded and streamed lectures, frequent virtual meetings and student response systems could improve learning outcomes in future digital courses. The preference for written home exams over online versions of previous on-campus exams was likely influenced by student's familiarity with the former. The dropout rate remained unchanged compared to previous years. CONCLUSION: The sudden shift to digital teaching was challenging for students, but it appears that they adapted quickly to the new situation. Although the concerns described by students in this study may only be representative for the period right after campus lockdown, the study provide the student perspective on a unique period of time in higher education.

Paternal benzo[a]pyrene exposure affects gene expression in the early developing mouse embryo.

The health of the offspring depends on the genetic constitution of the parental germ cells. The paternal genome appears to be important; e.g., de novo mutations in some genes seem to arise mostly from the father, whereas epigenetic modifications of DNA and histones are frequent in the paternal gonads. Environmental contaminants which may affect the integrity of the germ cells comprise the polycyclic aromatic hydrocarbon, benzo[a]pyrene (B[a]P). B[a]P has received much attention due to its ubiquitous distribution, its carcinogenic and mutagenic potential, and also effects on reproduction. We conducted an in vitro fertilization (IVF) experiment using sperm cells from B[a]P-exposed male mice to study effects of paternal B[a]P exposure on early gene expression in the developing mouse embryo. Male mice were exposed to a single acute dose of B[a]P (150 mg/kg, ip) 4 days prior to isolation of cauda sperm, followed by IVF of oocytes from unexposed superovulated mice. Gene expression in fertilized zygotes/embryos was determined using reverse transcription-qPCR at the 1-, 2-, 4-, 8-, and blastocyst cell stages of embryo development. We found that paternal B[a]P exposure altered the expression of numerous genes in the developing embryo especially at the blastocyst stage. Some genes were also affected at earlier developmental stages. Embryonic gene expression studies seem useful to identify perturbations of signaling pathways resulting from exposure to contaminants, and can be used to address mechanisms of paternal effects on embryo development.

Paternal Benzo[a]pyrene Exposure Modulates MicroRNA Expression Patterns in the Developing Mouse Embryo.

Little attention has been given to how microRNA expression is affected by environmental contaminants exposure. We investigate the effects of paternal exposure to benzo[a]pyrene (B[a]P) on miRNA expression in the developing mouse embryo. Male mice were exposed to B[a]P (150 mg/kg i.p.), and their sperm was used four days later in in-vitro fertilization experiments. Twenty embryos each from 2-, 8-cell and the blastocyst stage were used for genome-wide miRNA expression profiling. Paternal exposure to B[a]P affected the expression of several miRNAs, and the target genes for some of the dysregulated miRNAs were enriched in many different pathways that are likely to be relevant for the developing mouse embryo. By linking the miRNA target genes to publicly available databases, we identified some miRNA target genes that may serve as global markers of B[a]P-mediated genotoxic stress. The dysregulated miRNAs may provide valuable knowledge about potential transgenerational effects of sublethal exposure to chemicals.

Preconceptional paternal glycidamide exposure affects embryonic gene expression: single embryo gene expression study following in vitro fertilization.

Recognition of early determinants of disease onset has sparked an interest in paternally transmitted factors and their impact on the developing embryo. Acrylamide (AA), a widely distributed xenobiotic compound, is converted to its active metabolite glycidamide (GA) by the CYP2E1 enzyme. Based on its capacity to induce dominant lethal mutations, we hypothesized that paternal GA exposure would have a negative impact on embryonic genome activation, via GA-DNA and protamine adducts persisting in the fertilizing sperm. Using a combination of in vitro fertilization (IVF) techniques and RT-qPCR single embryo gene expression (SEGE), we studied the expression of key DNA repair genes and genes important for embryo development, at the 1-, 2-, 4- and 8-cell stage of the developing mouse embryo. Compared to controls paternal GA-exposure gave rise to an altered pattern of embryonic gene expression, with an initial reduced expression at early stages followed by increased expression at the 8-cell stage.

Compliance, tolerability and safety of two antioxidant-rich diets: a randomised controlled trial in male smokers.

It has been suggested that antioxidants attenuate oxidative stress and prevent oxidative stress-related diseases. Paradoxically, randomised controlled trials (RCT) using pharmacological doses of antioxidant supplements have demonstrated harmful effects in smokers. The aim of the present study was to test the compliance, tolerability and safety of two food-based antioxidant-rich diets in smokers. One of the diets provided antioxidants at levels similar to that used in RCT using supplements which previously have generated harmful effects. The present study followed a randomised, parallel-arm dietary intervention for 8 weeks (n 102) in male smokers (age ≥ 45 years). Participants were randomised to either antioxidant-rich diet, kiwi fruit or control groups. The antioxidant-rich foods provided about 300 mmol antioxidants/week from a wide range of plant-based food items. The kiwi fruit group consumed three kiwi fruits/d. Compliance to both diets was good. Only mild, undesirable events were reported by a minority of the participants. The safety of both diets was demonstrated as no potentially harmful or pro-oxidative effects were observed. In the antioxidant-rich diet group, the mean intake of antioxidants increased from 30 mmol/d at baseline to 62 mmol/d during the intervention. In conclusion, we have demonstrated that male smokers can comply with two food-based antioxidant-rich diets. Furthermore, the present study is the first to demonstrate the tolerability and safety of dietary antioxidants at levels similar to dosages provided in RCT using supplements. Such diets may be useful in future studies investigating whether dietary antioxidants may reduce oxidative stress and related diseases.

Supplementation of a western diet with golden kiwifruits (Actinidia chinensis var.'Hort 16A':) effects on biomarkers of oxidation damage and antioxidant protection.

BACKGROUND: The health positive effects of diets high in fruits and vegetables are generally not replicated in supplementation trials with isolated antioxidants and vitamins, and as a consequence the emphasis of chronic disease prevention has shifted to whole foods and whole food products. METHODS: We carried out a human intervention trial with the golden kiwifruit, Actinidia chinensis, measuring markers of antioxidant status, DNA stability, plasma lipids, and platelet aggregation. Our hypothesis was that supplementation of a normal diet with kiwifruits would have an effect on biomarkers of oxidative status. Healthy volunteers supplemented a normal diet with either one or two golden kiwifruits per day in a cross-over study lasting 2 × 4 weeks. Plasma levels of vitamin C, and carotenoids, and the ferric reducing activity of plasma (FRAP) were measured. Malondialdehyde was assessed as a biomarker of lipid oxidation. Effects on DNA damage in circulating lymphocytes were estimated using the comet assay with enzyme modification to measure specific lesions; another modification allowed estimation of DNA repair. RESULTS: Plasma vitamin C increased after supplementation as did resistance towards H2O2-induced DNA damage. Purine oxidation in lymphocyte DNA decreased significantly after one kiwifruit per day, pyrimidine oxidation decreased after two fruits per day. Neither DNA base excision nor nucleotide excision repair was influenced by kiwifruit consumption. Malondialdehyde was not affected, but plasma triglycerides decreased. Whole blood platelet aggregation was decreased by kiwifruit supplementation. CONCLUSION: Golden kiwifruit consumption strengthens resistance towards endogenous oxidative damage.

Both base excision repair and nucleotide excision repair in humans are influenced by nutritional factors.

Lack of reliable assays for DNA repair has largely prevented measurements of DNA repair from being included in human biomonitoring studies. Using newly developed modifications of the comet assay we tested whether a fruit- and antioxidant-rich plant-based intervention could affect base excision repair (BER) and nucleotide excision repair (NER) in a group of 102 male volunteers. BER and NER repair capacities were measured in lymphocytes before and after a dietary intervention lasting 8 weeks. The study had one control group, one group consuming three kiwifruits per day and one group consuming a variety of antioxidant-rich fruits and plant products in addition to their normal diet. DNA strand breaks were reduced following consumption of both kiwifruits (13%, p = 0.05) and antioxidant-rich plant products (20%, p = 0.02). Increased BER (55%, p = 0.01) and reduced NER (-39%, p < 0.01) were observed in the group consuming a wide variety of plant products. Reduced NER was also observed in the kiwifruit group (-38%, p = 0.05), but BER was not affected in this group. Here we have demonstrated that DNA repair is affected by diet and that modified versions of the comet assay can be used to assess activity of different DNA repair pathways in human biomonitoring studies.

Polymorphisms in base excision repair genes as colorectal cancer risk factors and modifiers of the effect of diets high in red meat.

BACKGROUND: A diet high in red meat is an established colorectal cancer (CRC) risk factor. Carcinogens generated during meat cooking have been implicated as causal agents and can induce oxidative DNA damage, which elicits repair by the base excision repair (BER) pathway. METHODS: Using a family-based study, we investigated the role of polymorphisms in 4 BER genes (APEX1 Gln51His, Asp148Glu; OGG1 Ser236Cys; PARP Val742Ala; and XRCC1 Arg194Trp, Arg280His, Arg399Gln) as potential CRC risk factors and modifiers of the association between diets high in red meat or poultry and CRC risk. We tested for gene-environment interactions using case-only analyses (n = 577) and compared statistically significant results with those obtained using case-unaffected sibling comparisons (n = 307 sibships). RESULTS: Carriers of the APEX1 codon 51 Gln/His genotype had a reduced CRC risk compared with carriers of the Gln/Gln genotype (odds ratio (OR) = 0.15, 95% CI = 0.03-0.69, P = 0.015). The association between higher red meat intake (>3 servings per week) and CRC was modified by the PARP Val762Ala single-nucleotide polymorphisms (SNP; case-only interaction P = 0.026). This SNP also modified the association between higher intake of high-temperature cooked red meat (case-only interaction P = 0.0009). CONCLUSIONS: We report evidence that the BER pathway PARP gene modifies the association of diets high in red meat cooked at high temperatures with risk of CRC. IMPACT: Our findings suggest a contribution to colorectal carcinogenesis of free radical damage as one of the possible harmful effects of a diet high in red meat.

Comet assay-based methods for measuring DNA repair in vitro; estimates of inter- and intra-individual variation.

DNA repair is one of the important determinants of susceptibility to cancer. It is therefore useful to be able to measure DNA repair capacity in samples from population studies. Our aim was, first, to develop a simple comet-based in vitro assay for nucleotide excision repair (NER), similar to that already in use for base excision repair (BER), and then to apply these in vitro assays to lymphocyte samples collected on several occasions from healthy subjects, to gain an impression of the degree of intra- and inter-individual variability. The in vitro assay consists of an incubation of lymphocyte extract with substrate nucleoid DNA from cells pretreated with specific damaging agent; either photosensitiser plus light to induce 8-oxoguanine, for BER, or short wavelength ultraviolet light irradiation for NER. In the new NER assay, which requires magnesium but not adenosine triphosphate, there was significant accumulation of UV-dependent incisions during a 30-min incubation of extract with DNA. We found significant correlations between individual repair rates from samples taken on different occasions; i.e. individuals have a characteristic repair capacity. There was also significant variation between individuals, to the extent of about fourfold for BER and tenfold for NER. There was no correlation between BER and NER rates. The BER and NER assays are simple to perform and can provide valuable information in molecular epidemiological studies in which DNA instability is an endpoint.

Plasma concentration of folate as a biomarker for the intake of fruit and vegetables: the Hordaland Homocysteine Study.

BACKGROUND: Nutritional biomarkers may be used to assess dietary exposure without the errors commonly associated with self-reported dietary data. OBJECTIVE: The objective was to examine the association between plasma folate and intake of folate, fruit, and vegetables in a large cohort of healthy adults consuming foods that had not been fortified with folic acid. DESIGN: The present study population included 5533 middle-aged (47-49 y) and old (71-74 y) subjects from the Hordaland Homocysteine Study. The participants completed a food-frequency questionnaire and provided blood samples for chemical analyses. RESULTS: We observed a significant difference in plasma concentrations of folate across increasing quartiles of fruit, vegetable, and orange juice consumption. The difference in plasma folate between the highest and lowest quartiles was 1.97 (95% CI: 1.86, 2.07) nmol/L for fruit intake, 1.79 (95% CI: 1.69, 1.89) nmol/L for vegetable intake, and 2.69 (95% CI: 2.51, 2.87) nmol/L for orange juice intake. A significant inverse relation was observed across increasing quartiles of milk and bread intakes. The difference between the highest and lowest quartiles was -1.03 (95% CI: -1.13, -0.92) nmol/L for milk and -1.60 (95% CI: -1.69, -1.50) nmol/L for bread. CONCLUSION: Plasma folate concentration may be a useful biomarker for the intake of fruit and vegetables in populations consuming unfortified food products. The association can be attenuated by and should be corrected for individual intake of folic acid supplements.

Urinary excretion of flavonoids reflects even small changes in the dietary intake of fruits and vegetables.

BACKGROUND: Due to the random and systematic measurement errors associated with current dietary assessment instruments, there is a need to develop more objective methods of measuring the intake of foods of importance to human health. OBJECTIVE: The purpose of this study was to test whether urinary excretion of flavonoids could be used to identify subjects who are meeting Norwegian recommendations for fruit and vegetable intake (5 servings per day) from individuals who are consuming the national average amount of fruits and vegetables (2 servings per day). DESIGN: Twenty-four-hour urine samples were collected in a strict crossover controlled feeding study. Forty healthy subjects (19-34 years) were included in the study. After a 1-week run-in period, one group was given a controlled diet that included 2 servings (300 g) of fruits and vegetables daily for 14 days, while the other group was given a diet containing 5 servings (750 g) per day. Following a 2-week washout and a 1 week run-in period, the regimens were switched between the groups. RESULTS: An increased intake of mixed fruits and vegetables from 2 to 5 servings per day significantly enhanced urinary excretion of eriodictyol, naringenin, hesperetin, quercetin, kaempferol, isorhamnetin, and tamarixetin. The citrus flavonoids naringenin and hesperetin showed a steep dose-response relationship to dietary intake of fruits and vegetables, whereas the association to eriodictyol, quercetin, kaempferol, isorhamnetin, and tamarixetin was more moderate. CONCLUSION: The present study indicates that urinary excretion of dietary flavonoids may be used to assess changes of mixed fruit and vegetable intake corresponding to an increase from the present national intake in Norway to the recommended amount of 5 servings of fruits and vegetables daily.