Innovation to motivation—pilot study of a mobile phone intervention to increase physical activity among sedentary women

ObjectivesThis uncontrolled pilot study assessed changes in pedometer-measured step counts and self-reported physical activity during a 3-week mobile phone-based intervention. We also explored whether age, BMI, and psychosocial factors were associated with changes in step counts.MethodsForty-one sedentary adult women in San Francisco, California were asked to report their pedometer steps using a study-supplied mobile phone from June to September 2008. In the second and third weeks, daily prompts delivered by the mobile phone encouraged participants to increase steps by 20% from the previous week.ResultsMean age was 48 years. Average daily total steps increased by approximately 800 or 15% over three weeks (p < 0.001). Lower BMI, no antidepressant use, and lower self-reported health status were associated with higher step counts at baseline. Improvements in self-reported will-power were associated with increases in step counts (p < 0.001). Neither age (p = 0.55) nor BMI (p = 0.13) was significantly associated with changes in activity over the 3 weeks.ConclusionsThe intervention appeared to motivate sedentary women to increase their physical activity. A randomized controlled clinical trial is warranted and feasible.     

Screen time is associated with depression and anxiety in Canadian youth

ObjectiveThis study examined the relationships between screen time and symptoms of depression and anxiety in a large community sample of Canadian youth.MethodParticipants were 2482 English-speaking grade 7 to 12 students. Cross-sectional data collected between 2006 and 2010 as part of the Research on Eating and Adolescent Lifestyles (REAL) study were used. Mental health status was assessed using the Children's Depression Inventory and the Multidimensional Anxiety Scale for Children—10. Screen time (hours/day of TV, video games, and computer) was assessed using the Leisure-Time Sedentary Activities questionnaire.ResultsLinear multiple regressions indicated that after controlling for age, sex, ethnicity, parental education, geographic area, physical activity, and BMI, duration of screen time was associated with severity of depression (β = 0.23, p < 0.001) and anxiety (β = 0.07, p < 0.01). Video game playing (β = 0.13, p < .001) and computer use (β = 0.17, p < 0.001) but not TV viewing were associated with more severe depressive symptoms. Video game playing (β = 0.11, p < 0.001) was associated with severity of anxiety.ConclusionScreen time may represent a risk factor or marker of anxiety and depression in adolescents. Future research is needed to determine if reducing screen time aids the prevention and treatment of these psychiatric disorders in youth.     

Gender differences in the longitudinal associations of depressive symptoms and leisure-time physical activity with cognitive decline in ≥ 57 year-old Taiwanese

ObjectiveThis study investigates the role of gender in the associations of long-term depressive symptoms and leisure-time physical activity (LTPA) with the risk of cognitive decline in elderly Taiwanese.MethodWe analyzed 3679 subjects (age ≥ 57) in the 2003 and 2007 datasets of the Taiwan Longitudinal Survey on Aging, of which data were collected via face-to-face interviews by trained interviewers. We excluded proxy respondents. Multivariable logistic regression analysis examined the associations of long-term depressive symptoms (increased symptoms: CES-D10 scores from < 10 to ≥ 10; decreased symptoms: from ≥ 10 to < 10) and LTPA (frequency, duration, and intensity) with cognitive decline (a decrease of two or more SPMSQ scores).ResultsWomen had significant higher percentages of cognitive impairment, compared to men, at the baseline (5.9 vs. 1.5%; χ² = 51.24, p < 0.001) and end-point (10.8 vs. 5.2%;χ² = 39.5, p < 0.001). Men with long-term depressive symptoms had 5.28 greater odds of cognitive decline (OR = 5.28, 95%CI = 2.84–9.82, p < 0.001) and men with increased depressive symptoms had 2.09 greater odds (2.09, 1.24–3.51, p = 0.006). No such association was observed in women. Men with consistently high LTPA had 65% (0.35, 0.19–0.65, p = 0.001) and women with increased LTPA had 43% (0.57, 0.34–0.93, p = 0.024) reduction in odds of developing cognitive decline.ConclusionWe found gender differences in the longitudinal association between depressive symptoms and cognitive decline. Long-term LTPA may loosen the association between long-term depressive symptoms and cognitive decline. These findings are useful in the identification of vulnerable elderly in the Taiwanese population and public health interventions should focus on assisting their cognitive aging.     

Weight control success and depression by gender with respect to weight control behaviors

Background/ObjectiveThere are many methods for weight loss and they vary among people. Some are yet to be proven as appropriate regarding its physical or mental side effect. The aim of this study was to investigate the relationship between weight control success and depression by weight control behaviors (WCB) dividing them into appropriate and inappropriate.Subjects/MethodsWe used data from the 2016 Korea National Health and Nutrition Examination Survey (KNHANES). A total of 4506 people were included in the study. The depression was measured by the 9-item Patient Health Questionnaire as a dependent variable. Using multiple regression analysis to determine the association between weight control success and depression with appropriate and inappropriate WCB, in men and women, separately.ResultsWe found that appropriate WCB was associated with decreased depression in women who had both success and fail (success: β = −0.16, S.E = 0.50, p < .001; fail: β = −0.09, S.E = 0.04, p = 0.04), whereas inappropriate WCB increased depression in men regardless of success or failure at weight control (success: β = 0.41, p = 0.02; fail: β = 0.22, p = 0.02). Thus, women who are successful at weight control and use appropriate WCB are more likely to have a decrease in depressive symptoms. However, men are most affected by using inappropriate WCB and can have an increase in depressive symptoms as a result.ConclusionThe findings have implications for encouraging the use of appropriate WCB for those attempting to control weight, especially in women.     

Family history and perceived risk of diabetes,cardiovascular disease,cancer, and depression

BackgroundFamily history is a useful and inexpensive tool to assess risks of multifactorial diseases. Family history enables individualized disease prevention, but its effects on perceived risks of various diseases need to be understood in more detail. We examined how family history relates to perceived risk of diabetes mellitus, cardiovascular disease (CVD), cancer, and depression, and whether these associations are independent of or moderated by sociodemographic factors, health behavior/weight status (smoking, alcohol consumption, physical activity, BMI [kg/m²]), or depressive symptoms.MethodsParticipants were Finnish 25–74-year-olds (N = 6258) from a population-based FINRISK 2007 study. Perceived absolute lifetime risks (Brewer et al., 2004; Becker, 1974; Weinstein and Nicolich, 1993; Guttmacher et al., 2004; Yoon et al., 2002) and first-degree family history of CVD, diabetes, cancer and depression, and health behaviors were self-reported. Weight and height were measured in a health examination.ResultsFamily history was most prevalent for cancer (36.7%), least for depression (19.6%). Perceived risk mean was highest for CVD (2.8), lowest for depression (2.0). Association between family history and perceived risk was strongest for diabetes (β = 0.34, P < 0.001), weakest for depression (β = 0.19, P < 0.001). Adjusting for sociodemographics, health behavior, and depressive symptoms did not change these associations. The association between family history and perceived risk tended to be stronger among younger than among older adults, but similar regardless of health behaviors or depressive symptoms.DiscussionAssociation between family history and perceived risk varies across diseases. People's current understandings on heritability need to be acknowledged in risk communication practices. Future research should seek to identify effective strategies to combine familial and genetic risk communication in disease prevention.     

Feasibility and effects of a group-based resistance and aerobic exercise program for individuals with severe schizophrenia: A multidisciplinary approach

PurposePeople with schizophrenia/schizoaffective disorders have a higher risk of morbidity and premature mortality compared to the general population in part due to sedentary lifestyles. The aim of this pilot study was to investigate the feasibility and effects of aerobic (AT) and resistance training (RT) on individuals with schizophrenia/schizoaffective disorders.MethodsEight males and five females (mean age 44.6 ± 3 years) were randomized to either twice weekly exercise (n = 7) or usual care (control) (n = 6). Functional exercise capacity (six minute walk distance (6MWD)), muscular strength, anthropometric measures, and domains of mental health were measured at baseline and after 12 weeks. Data are presented as means ± SEM.ResultsThe exercise group demonstrated a 27.7 ± 22.3 m increase in 6MWD while the control group showed a decrease of 28.3 ± 26.6 m (between-group difference, p = 0.1). There was a significant strength increase for exercise (28.3 ± 8.8%, p = 0.01) but not for control (12.5 ± 8.5%, p = 0.2). The exercise group had a significant improvement in total Mental Health Inventory (MHI) score (p < 0.03) with no change for control. Gain in 6MWD was directly associated with improvement in total MHI score (r = 0.8, p = 0.009) as was reduction in depressive symptoms (r = ?0.9, p < 0.001) among all participants. Attendance at exercise sessions averaged 72 ± 4.4% with no dropouts. Reduction in depressive symptoms correlated with greater adherence to exercise (r = ?0.93, p = 0.02).ConclusionsA 12-week community-based AT and RT program results in significant improvements in overall mental health, muscular strength and a trend for improvement in functional exercise capacity. Among all participants, improvement in functional exercise capacity was associated with improvement in overall mental health as well as a reduction in depressive symptoms. Reduction in depressive symptoms was associated with greater adherence to exercise. A group exercise program for individuals with schizophrenia/schizoaffective disorder is feasible when implemented by a multidisciplinary team.     

Hepatitis B vaccination uptake and correlates of serologic response among HIV-infected and uninfected men who have sex with men (MSM) in Bangkok,Thailand

BackgroundVaccination against hepatitis B virus (HBV) is recommended for all HBV-susceptible men who have sex with men (MSM). There is limited information on correlates of immunity to HBV vaccination in this group. We present serologic response rates to hepatitis B vaccine and identify factors associated with impaired response among HIV-uninfected and HIV-infected Thai MSM.MethodologyHBV-susceptible volunteers were offered hepatitis B vaccination at months zero, one, and six. We measured baseline (pre-vaccination) total serum IgG and IgG subclasses (all participants), baseline CD4 count, and plasma HIV-1 viral load (PVL) (HIV+ participants). HBV serologies were retested at 12 months. Serologic responses were compared between all groups in men receiving three vaccine doses.Results511/651 HIV-negative and 64/84 HIV-positive participants completed the three-dose series. Response rates in HIV-uninfected and -infected participants were 90.1% vs. 50.0% (p < 0.0001). Median pre-vaccination IgG was higher among non-responders than responders overall (1238.9.0 vs. 1057.0 mg/dL, p = 0.003) and among HIV-infected participants (1534.0 vs. 1244.5 mg/dL, p = 0.005), but not significantly among HIV-uninfected participants (1105.5 vs. 1054.3 mg/dL, p = 0.96). Pre-vaccination IgG1 and IgG3 levels were higher among HIV-positive than HIV-negative participants (median 866.0 vs. 520.3, and 105.8 vs. 83.1 mg/dL, respectively, p < 0.0001). Among HIV-infected participants, median CD4 count in non-responders was 378 cells/μL vs. 431 cells/μL in responders (p = 0.20). Median PVL in non-responders was 64,800 copies/mL vs. 15500 copies/mL in responders (p = 0.04). Participants with pre-vaccination plasma IgG >1550 mg/dL and PVL >10,000 copies/mL were almost always non-responsive (p < 0.01).ConclusionsHIV infection was associated with poor vaccine responses. High plasma viral load, elevated pre-vaccination total serum IgG and elevated pre-vaccination IgG1 are associated with poorer response to vaccination among HIV-infected MSM. In this group, the combination of high PVL and pre-vaccination total IgG is highly predictive of vaccine failure.     

Análisis de fiabilidad y validez de tres cuestionarios de autoinforme para valorar la actividad física realizada por adolescentes españoles

ObjectiveTo analyse the reliability and validity of the Weekly Activity Checklist (WAC), the One Week Recall (OWR), and the Godin-Shephard Leisure Time Exercise Questionnaire (GLTEQ) in Spanish adolescents.MethodsA total of 78 adolescents wore a pedometer for one week, filled out the questionnaires at the end of this period and underwent a test to estimate their maximal oxygen consumption (VO₂max). The reliability of the questionnaires was determined by means of a factor analysis. Convergent validity was obtained by comparing the questionnaires’ scores against the amount of physical activity quantified by the pedometer and the VO₂max reported.ResultsThe questionnaires showed a weak internal consistency (WAC: α = 0.59-0.78; OWR: α = 0.53-0.73; GLTEQ: α = 0.60). Moderate statistically significant correlations were found between the pedometer and the WAC (r = 0.69; p <0.01) and the OWR (r = 0.42; p <0.01), while a low statistically significant correlation was found for the GLTEQ (r = 0.36; p = 0.01). The estimated VO₂max showed a low level of association with the WAC results (r = 0.30; p <0.05), and the OWR results (r = 0.29; p <0.05). When classifying the participants as active or inactive, the level of agreement with the pedometer was moderate for the WAC (k = 0.46) and the OWR (r = 0.44), and slight for the GLTEQ (r = 0.20).ConclusionOf the three questionnaires analysed, the WAC showed the best psychometric performance as it was the only one with respectable convergent validity, while sharing low reliability with the OWR and the GLTEQ.     

SMS text message reminders to improve infant vaccination coverage in Guatemala: A pilot randomized controlled trial

BackgroundPatient reminder systems are an evidence-based way to improve childhood vaccination rates but are difficult to implement in low- and middle-income countries (LMICs). Short Message Service (SMS) texts may offer a potential low-cost solution, especially in LMICs where mobile phones are becoming more ubiquitous.ObjectiveTo determine if an SMS-based vaccination reminder system aimed at improving completion of the infant primary immunization series is feasible and acceptable in Guatemala.MethodsA pilot randomized controlled trial was conducted at two public health clinics in Guatemala City. Infants aged 8–14 weeks presenting for the first dose of the primary immunization series were enrolled in March–April 2013. Participants randomized into the intervention received three SMS reminders one week before the second and third dose. A follow-up acceptability survey was administered to both groups.ResultsThe participation rate was 86.8% (321/370); 8 did not own a cell phone and 12 could not use SMS. 96.9% of intervention parents were sent at least one SMS reminder prior to visit 2 and 96.3% prior to visit 3. Both intervention and usual care participants had high rates of vaccine and visit completion, with a non-statistically significant higher percentage of children in the intervention completing both visit 2 (95.0% vs. 90.1%, p = .12) and visit 3 (84.4% vs. 80.7%, p = .69). More intervention vs. usual care parents agreed that SMS reminders would be helpful for remembering appointments (p < .0001), agreed to being interested in receiving future SMS reminders (p < .0001), and said that they would be willing to pay for future SMS reminders (p = .01).ConclusionThis proof of concept evaluation showed that a new application of SMS technology is feasible to implement in a LMIC with high user satisfaction. Larger studies with modifications in the SMS system are needed to determine effectiveness (Clinical Trial Registry NCT01663636).     

Effect of exercise intensity on depressive symptoms in women

Exercise has been shown to relieve depressive symptoms, yet optimal exercise intensity for treating depression has not been established. The mechanisms that explain the antidepressant effect of exercise also require investigation. The purpose of this study was to test (a) the effect of two different exercise intensities prescribed for aerobic training on depressive symptoms, and (b) a previously proposed psychological mechanism for this effect: self-efficacy. Sedentary women scoring ≥14 on the Beck Depression Inventory-II (BDI-II) were randomized to one of two aerobic training groups that differed on exercise intensity (high [65–75% MaxVO₂ reserve] or low [40–55% MaxVO₂ reserve]), or to a stretching control group for 10 weeks. Main outcome variables included depressive symptoms (BDI-II) and self-efficacy (exercise self-efficacy [ESE] and depression coping self-efficacy [DCSE]), which were measured at study entry, 5 and 10 weeks later. Participants in all groups (high, n = 18; low, n = 18; stretching, n = 18) had significant reductions in depressive symptoms at Week 5 (p < .001) and Week 10 (p < .001). The BDI-II change scores did not differ significantly among the groups (p = .066). Follow-up analyses controlling for baseline BDI-II scores showed that the high intensity group had significantly fewer depressive symptoms than the low intensity and stretching control groups at weeks 5 and 10 (p < .05). There was no significant association between changes in aerobic capacity and changes in depressive symptoms (r = ?.099, p = .491). At 10 weeks, both ESE (p = .013) and DCSE (p < .001) increased significantly for the whole sample, with no significant group difference (p = .613 for ESE, p = .277 for DCSE). Controlling for baseline scores, the increase remained significant for ESE (p = .005) but not for DCSE (p = .629). Partial correlations showed significant negative relationships between both types of self-efficacy and depressive symptoms at Week 5 and Week 10 (p < .02). We concluded that both high and low intensity aerobic exercise, as well as stretching exercise were associated with reductions in mild to moderate depressive symptoms in initially sedentary women. Changes in depression were associated with changes in ESE and DCSE.     

Effects of aerobic exercise on sexual functioning in depressed adults

ObjectiveExercise appears to be generally comparable to antidepressant medication in reducing depressive symptoms. The current study examines the effects of aerobic exercise, compared to antidepressant medication and placebo pill, on sexual function among depressed adults.MethodsTwo hundred clinically depressed adults, aged 40 years and over, who were sedentary and generally overweight, were randomized to 4 months of Aerobic Exercise, Sertraline (Zoloft), or Placebo pill, for the treatment of depression. Exercise condition participants engaged in walking, running, or biking, 30 min/day, 3 days/week, to 70–85% of their heart rate reserve, in either a supervised group setting or independently at home. Before and following treatment, participants completed the Arizona Sexual Experiences Questionnaire (ASEX) and the Hamilton Rating Scale for Depression (HAM-D). An ANCOVA was performed to test the effects of treatment on post-treatment sexual function, controlling for age, sex, body mass index, diabetes, hypertension, pretreatment HAM-D scores, and pretreatment ASEX scores.ResultsThe treatment group main effect was significant (p = .02); exercisers had better post-treatment ASEX scores (adjusted ASEX M = 16.6) compared to the placebo group (adjusted ASEX M = 18.3; p = .01). Exercisers had post-treatment ASEX scores that were marginally better compared to the sertraline group, but this difference did not reach statistical significance (adjusted ASEX M = 17.9; p = .05).ConclusionAerobic exercise, which has been associated with reduced symptoms of depression comparable to antidepressant medication, appears to result in greater improvement in sexual function compared to placebo pill. A nonsignificant trend towards better sexual function among exercisers compared to antidepressant medication may be attributable to medication-related sexual side effects.     

A prospective study of screen time in adolescence and depression symptoms in young adulthood

ObjectivesThe purpose of this study was to examine the association between screen time in adolescence and depressive symptoms in young adulthood in a population-based cohort study of Danish adolescents.MethodsData were from a cohort of adolescents who were followed-up in young adulthood for a period of up to 12 years (1997–2010, mean 8.8 years, n = 435). Information on television viewing, computer use, total screen time and other determinants of depression were obtained in adolescence. Depressive symptoms were obtained in young adulthood using the Major Depression Inventory (MDI) and classified as mild, moderate or severe depression. Mixed regression models were used to examine the associations, with adjustment for major confounders.ResultsIn multivariable adjusted analyses, each additional hour/day spent watching television or screen viewing in adolescence was associated with 1.36 (95% CI 0.73–1.98) and 1.05 (95% CI 0.50–1.60), respectively, greater MDI depression summary score in young adulthood (p < 0.001). In logistic regression models, each additional hour/day spent watching television or screen viewing was associated with 1.64 (95% CI 1.18–2.27) and 1.58 (95% CI 1.18–2.12), respectively, greater odds of prevalent depression in young adulthood, and dose–response relationships were indicated. Additional adjustment for either cardiorespiratory fitness or BMI did not materially change the results. No significant associations were observed between adolescent computer use and depressive symptoms in young adulthood.ConclusionsLimiting screen time, particularly television viewing, during adolescence may be important for preventing depression in young adulthood.     

A randomized clinical trial of home-based exercise combined with a slight caloric restriction on obesity prevention among women

ObjectiveThe study investigated the effectiveness of home-based exercise combined with a slight caloric restriction on weight change during 12 months in non-obese women.MethodsA randomized clinical trial with a factorial design was conducted from 2003 to 2005. Two hundred three middle-aged women (Rio de Janeiro/Brazil), 25–45 years, were randomly assigned to one of two groups: control (CG) and home-based exercise (HB). The HB group received a booklet on aerobic exercise that could be practiced at home (3 times/week–40 min/session), in low-moderate intensity, during 12 months. Both groups received dietary counseling aimed at a slight energy restriction of 100–300 calories per day.ResultsThe HB experienced a greater weight loss in the first 6 months (?1.4 vs. ?0.8 kg; p = 0.04), but after 12 months there was no differences between groups (?1.1 vs. ?1.0; p = 0.20). Of the serum biochemical markers, HDL cholesterol showed major change, with an increase at month 12 of 18.3 mg/dl in the HB compared to 9.5 in the CG (p < 0.01).ConclusionHome-based exercise promoted greater weight reduction during the first 6 months after which no further benefits are observed. Continuous favorable changes in HDL cholesterol after 1 year suggest that home-based exercise promote health benefits.     

Burn and earn: A randomized controlled trial incentivizing exercise during fall semester for college first-year students

ObjectiveTo examine the viability of monetary incentives to increase fitness-center use and maintain/improve the Body Mass Indexes (BMIs) of first-year students over the fall semester.MethodRandomized-controlled trial with no-treatment and incentive conditions involving 117 first-year students. For 12 weeks, students in the incentive condition received monetary payments ranging from $10 to $38.75 for meeting researcher-set fitness-center use goals that were identical across conditions. Fitness-center use was monitored through electronic ID-card check-in and check-out records at the campus fitness center.Results63% of incentive-condition participants met the weekly fitness-center use goals on average compared to only 13% of control-condition participants, a significant difference, p < 0.001. Goal achievement significantly decreased over time, p < 0.01 and at roughly the same rate in the control and incentive conditions, p = 0.23. Average BMI increases over the fall semester in the control (24.2 (0.6) to 24.6 (0.6)kg/m²) versus incentive condition (23.1 (0.4) to 23.5 (0.4)kg/m²) were not significantly different (p = 0.70).ConclusionWeekly monetary incentives resulted in significantly more first-year students meeting weekly fitness-center use goals. However, the increased fitness-center use by the incentive condition did not prevent an increase in BMI during fall semester.     

Pedometer-assessed physical activity of Singaporean youths

ObjectiveThe aim of the study was to investigate the pedometer-assessed physical activity of Singaporean youths using an objective measurement of physical activity.Methods and resultsPedometer step count was monitored over the entire week in 877 participants aged 9–18 years in three schooling cohorts [primary (age, 9–12 years; n = 150 males; 156 females), secondary (age, 13–16 years; n = 137 males; 138 females) and junior college (age, 17–18 years; n = 140 males; 156 females)] in Singapore during July to September 2009. Analyses identified significant main effects for step count taken outside of school compared to within school (mean (SD): 5568 (4796) vs. 3881 (3149), p < 0.05). However, no significant difference was found for steps accumulated within or outside school in boys and girls across the schooling levels (steps × sex × level interaction, p > 0.05). Step counts were not significantly different between weekdays or weekends (9719 (6063) vs. 9483 (8056), p > 0.05), across schooling levels and between male and female participants (sex × level and steps × level × sex interactions, all p > 0.05).ConclusionStep count decline is drastic for male adolescents after primary school but remains low across the schooling levels for female participants. Aggregated daily step count fell short by up to 35% of the 16,000 and 13,000 steps recommended respectively for male and female youths.     

Relationships between depression,gender, and unhealthy weight loss practices among overweight or obese college students

IntroductionUnhealthy weight loss practices are common among female college students. It is unknown if these practices are also most common among women in the subset of overweight or obese college students or if these practices are related to depression. We examined the relationship between gender, depression, and unhealthy weight loss practices among overweight or obese college students.MethodsStudents (body mass index between 25.0 and 34.9 kg/m²) from three Southern California universities (M_age = 22 years, SD = 4; 70% women) were recruited from May 2011 to May 2012 for participation in a weight loss clinical trial (N = 404). Logistic regressions were performed with baseline data to assess the cross-sectional relationship between self-reported unhealthy weight loss practices and gender and depression as measured by the Center for Epidemiologic Studies Depression short form.ResultsTwenty-nine percent of participants reported engaging in at least one unhealthy weight loss behavior (e.g., fasting, purging) over the last 30 days, with no differences by gender. Self-report of at least one unhealthy weight loss behavior was associated with report of symptoms of depression (e^B = 1.14 [confidence interval, CI: 1.08–1.20]), adjusting for potential confounders. Interactions between gender and depression were not significant (e^B = 1.04 [CI: 0.93–1.16]).ConclusionAmong an overweight or obese sample of college students, unhealthy weight loss practices were equally common in both genders, and students with depressive symptomatology were at greatest risk. Obesity interventions targeting overweight or obese college students should educate both men and women about the dangers of unhealthy weight loss practices. In addition, screening for depression can help identify students who would benefit from additional supportive and coping strategies and resources.     

Development and Analysis of Item Response Theory-based Short-form Depression Severity Scales Based on the HDRS and MADRS

ObjectivesThe Hamilton Depression Rating Scale (HDRS) is the most frequently used primary endpoint for antidepressant clinical trials. This study developed and evaluated the psychometric characteristics of 3 item response theory (IRT)-based short-form depression severity scales based on combinations of the HDRS and Montgomery-Asberg Depression Rating Scale (MADRS) items.Study DesignA secondary analysis was completed using data from 1027 subjects with major depressive disorder participating in 2 antidepressant clinical trials. Data were collected using the HDRS and MADRS throughout the 6-week clinical trials. Maier, Bech, and Gibbons brief depression scales were calculated based on the HDRS.ResultsThree short-form depression severity (DS) scales were developed based on clinician recommendations and IRT analyses, (DS-1, 7 items; DS-2, 8 items; DS-3, 10 items). Internal consistency reliability of the short forms was 0.87 to 0.93. DS were more reliable across the range of the depression than the HDRS or MADRS. The DS scales were correlated 0.27 to 0.29 with HDRS, 0.55 to 0.85 with MADRS, and ?0.25 to ?0.34 with Quality of Enjoyment and Satisfaction Questionnaire scores at baseline. In 1 clinical trial, none of the depression outcome measures demonstrated statistically significant differences between the paroxetine and placebo groups. In the second clinical trial, there were significant between-group differences in DS-1 (P = .004; ES = 0.46), DS-2 (P <.001; ES = 0.59), DS-3 (P <.001; ES = 0.63), Bech (P = .007; ES = 0.43), Maier (P = .009; ES = 0.41), Gibbon (P = .003; ES = 0.47), HDRS (P = .007; ES = 0.43), and MADRS (P = .001; ES = 0.54) scores.ConclusionsThe IRT-based short-form depression measures were reliable, valid, and responsive in patients with major depressive disorder. Effect sizes were comparable or better to other depression severity scales.     

Waterpipe and Cigarette Smoking Among College Athletes in the United States

PurposeTobacco use using a waterpipe is an emerging trend among college students. Although cigarette smoking is low among college athletes, waterpipe tobacco smoking may appeal to this population. The purpose of this study was to compare cigarette and waterpipe tobacco smoking in terms of their associations with organized sport participation.MethodsIn the spring of 2008, we conducted an online survey of 8,745 college students at eight institutions as part of the revised National College Health Assessment. We used multivariable regression models to assess the associations between tobacco use (cigarette and waterpipe) and organized sports participation.ResultsParticipants reported participation in varsity (5.2%), club (11.9%), and intramural (24.9%) athletics. Varsity athletes and individuals who were not varsity athletes had similar rates of waterpipe tobacco smoking (27.6% vs. 29.5%, p = .41). However, other types of athletes were more likely than their counterparts to have smoked waterpipe tobacco (35.1% vs. 28.7%, p < .001 for club sports and 34.8% vs. 27.7%, p < .001 for intramural sports). In fully-adjusted multivariable models, sports participants of any type had lower odds of having smoked cigarettes, whereas participants who played intramural sports (odds ratio = 1.15, 95% confidence interval = 1.03, 1.29) or club sports (odds ratio = 1.15, 95% confidence interval = 1.001, 1.33) had significantly higher odds of having smoked waterpipe tobacco.ConclusionsCollege athletes are susceptible to waterpipe tobacco use. In fact, compared with their nonathletic counterparts, club sports participants and intramural sports participants generally had higher odds of waterpipe tobacco smoking. Allure for waterpipe tobacco smoking may exist even for individuals who are traditionally considered at low risk for tobacco use.     

Prevalence of physical activity in European adults — Compliance with the World Health Organization's physical activity guidelines

BackgroundAdults are recommended to engage in at least 150 min/week of moderate-to-vigorous physical activity (PA).PurposeThis study aimed to examine the level of compliance with PA recommendations among European adults.MethodsUsing data from European Social Survey round 6, PA self-report data was collected from 52,936 European adults from 29 countries in 2012. Meeting PA guidelines was assessed using World Health Organization criteria.Results61.47% (60.77% male, 62.05% female) of European adults reported to be engaged in moderate to vigorous PA at least 30 min on 5 or more days per week. The likelihood of achieving the PA recommended levels was higher among respondents older than 18–24. For those aged 45–64 years the likelihood increased 65% (OR = 1.65, 95% CI: 1.51–1.82, p < 0.001) and 112% (OR = 2.12, 95% CI: 1.94–2.32, p < 0.001) for males and females, respectively. Those who were high school graduates were more likely to report achieving the recommended PA levels than those with less than high school education (males: OR = 1.19, 95% CI: 1.12–1.27, p < 0.001; females: OR = 1.13, 95% CI: 1.06–1.20, p < 0.001).ConclusionAlthough about 60% of European adults reported achieving the recommended levels of PA, there is much room for improvement among European adults, particularly among relatively inactive subgroups.     

Vitamin D,bone mineral density and body mass index in eating disorder patients

AimTo investigate associations of vitamin D with BMD and BMI in ED patients.MethodsVitamin D, BMD and BMI for 50 patients admitted to a specialised ED inpatient unit were measured. Patients were aged 15–54 years with BMI 8–25 kg/m².ResultsOf the patients, 18% were vitamin D deficient. There was a significant linear relationship between vitamin D and BMD T-score at the lumbar spine (p = 0.029), femoral neck (p < 0.001) and total hip (p = 0.001). There was no relationship between vitamin D and BMI. There was a significant linear relationship between BMI and BMD T-score at the lumbar spine (p < 0.001), femoral neck (p = 0.008) and total hip (p = 0.001).ConclusionsLow vitamin D and low BMI are associated with low BMD in ED patients. Despite widespread belief that it is not necessary, our findings suggest it is appropriate to measure vitamin D in ED patients. It should not be assumed ED patients take supplements.