Cognitive and psychosocial effects of an acute sun salutation intervention among adults with stress

Evidence suggests that yoga can improve executive functioning (EF) and psychological well-being, but there is no evidence whether flow-based, moderate-intensity forms of yoga can deliver similar benefits. The purpose of this randomized controlled trial was to test the aforementioned effects of engaging in a 30-min, video-guided sun salutation exercise (n = 25), relative to aerobic exercise (n = 22) and attentional control (n = 24). Low-active participants (Mage = 27.84; 87.3% female), with symptoms of stress, completed psychosocial assessments and tasks assessing EF, before and after the session. Results showed a significant group difference for state anxiety (p = .01, η_p² = 0.13) and stress (p < .05, η_p² = 0.09), in favor of the yoga group. No significant between-groups differences in EF were observed. Results suggest that video-guided, flow-based forms of yoga can induce immediate improvements in well-being, yet extended involvement may be required to realize performance improvements in memory and processing speed.     

Psychological Resilience in Older Residents of Long-Term Care Facilities: Occurrence and Associated Factors

ObjectivesThe researchers aimed to (1) explore the occurrence of psychological resilience in the face of a major life stressor and conflict in older residents of long-term care facilities (LTCFs), and (2) identify factors associated with resilience in this population.DesignLongitudinal cohort study using the Dutch InterRAI-LTCF cohort.Setting and participantsOlder residents (≥60 years old) of 21 LTCFs in the Netherlands.MethodsThe researchers selected 2 samples of residents who had at least 2 assessments surrounding (1) an incident major life stressor, or (2) incident conflict with other resident or staff. A resilient outcome was operationalized as not having clinically meaningful mood symptoms at the post-stressor assessment and equal or fewer mood symptoms at the post-stressor relative to the pre-stressor assessment. The researchers used 2 resilience outcomes per stressor: 1 based on observer-reported mood symptoms and 1 based on self-reported mood symptoms. The most important factors from among 21 potential resilience factors for each of the 4 operationalizations of resilience were identified using a backward selection procedure with 2-level generalized estimating equations analyses.ResultsForty-eight percent and 50% of residents were resilient in the face of a major life stressor, based on observer-reported (n = 248) and self-reported (n = 211) mood, respectively. In the face of conflict, 26% and 51% of the residents demonstrated resilience, based on the observer-reported (n = 246) and self-reported (n = 183) mood, respectively. Better cognitive functioning, a strong and supportive relationship with family, participation in social activities, and better self-reported health were most strongly associated with resilience in the face of a major life stressor. Better communicative functioning, absence of psychiatric diagnoses, a strong and supportive relationship with family, not being lonely, social engagement, and not reminiscing about life were most strongly associated with resilience in the face of conflict.Conclusions and ImplicationsFactors with a social aspect appear to be particularly important to psychological resilience in older LTCF residents, and provide a potential target for intervention in the LTCF setting.     

Exercise interventions ameliorate neuropsychiatric symptoms in dementia: A meta-analysis

ObjectivesThis meta-analysis was aimed at systematically synthesizing the effects of exercise interventions on neuropsychiatric symptoms in individuals with dementia. The possible moderators that may influence intervention effects were also examined.MethodsWe searched seven databases (PubMed, Web of Science, SCOPUS, SportDiscus, Ebsco, China National Knowledge Infrastructure, and Wanfang) for randomized clinical trials. The pooled effect sizes were computed by the standardized mean difference (SMD) from post-intervention scores using random-effects models. Potential moderators were also explored by performing subgroup analyses and meta-regression. The risk of bias for included studies was evaluated by the Cochrane Risk of Bias 2.0 Tool.ResultsA total of 22 effect sizes from 17 studies (n = 1344) fulfilled the inclusion criteria. The results indicated that exercise interventions had a small but significant effect on neuropsychiatric symptoms in dementia (SMD = −0.27, 95% CI [−0.40,−0.14], p < 0.001). Subgroup analyses showed that intervention frequency and disease severity moderated the effects. Specifically, interventions with medium-frequency (3 times/week) had a positive effect on neuropsychiatric symptoms (SMD = −0.5, 95% CI [−0.65, −0.34], p < 0.001), but not with low-frequency (1–2 times/week) (SMD = −0.07, 95% CI [−0.22, 0.08], p = 0.38) or high-frequency (4–7 times/week) (SMD = −0.11, 95% CI [−0.36, 0.14], p = 0.38). Interventions had a beneficial effect on neuropsychiatric symptoms in people with mild dementia (SMD = −0.48, 95% CI [−0.71, −0.26], p < 0.001), and moderate dementia (SMD = −0.21, 95%CI [−0.37, 0.05], p < 0.05), but not severe dementia (SMD = −0.01, 95% CI [−0.33, 0.3], p = 0.94).ConclusionsExercise interventions effectively improve neuropsychiatric symptoms in mild and moderate dementia patients. Interventions occurring three times per week were associated with significant effects. Our findings provide evidence that exercise interventions may be an accessible and effective means for improving dementia patients' neuropsychiatric symptoms.     

Types of stroke-related deficits and their impact on family caregiver’s depressive symptoms,burden, and quality of life

BackgroundStroke caregiving has been associated with higher rates of caregiver burden, depression, and lower quality of life compared to non-caregivers. Little is known about relationships between stroke survivors’ Cognitive/Emotional and Motor/Functional deficits and caregivers’ outcomes.ObjectiveTo determine the relationship between stroke survivors’ Cognitive/Emotional deficits and Motor/Functional deficits and caregivers’ depression, burden, and quality of life.MethodThis is a retrospective secondary data analysis. The sample consisted of 109 caregivers of stroke survivors. Step-wise linear multiple regression analyses were conducted to determine if Cognitive/Emotional deficits and/or Motor/Functional deficits, were predictive of caregivers’ depressive symptoms, burden, physical quality of life, and mental quality of life.ResultsThe Cognitive/Emotional deficits category was a better predictor than the Motor/Functional deficit of caregivers’ depressive symptoms, burden, and mental quality of life. The Cognitive/Emotional deficit score positively predicted both depression (β = .49, p < .001) and burden (β = 0.39, p < .001) and negatively predicted mental quality of life (β = ?0.42, p < .001), though it did not significantly predict physical quality of life (β = ?0.01, p = .90). The motor/functional deficits failed to significantly predict any of the caregiver outcomes (all p-values >.05).ConclusionsThe Cognitive/Emotional deficits appear to impact caregiver well-being more than the Motor/Functional deficits. Understanding the impact of Cognitive/Emotional and Motor/Functional deficits on caregivers can help clinicians identify caregivers at the highest risk for negative outcomes.     

Exercise for Falls and Fracture Prevention in Long Term Care Facilities: A Systematic Review and Meta-Analysis

BackgroundThe overall effect of exercise on falls and fracture prevention in long term care facilities remains controversial. In this study, we aimed to analyze the impact and the characteristics of the most effective physical exercise regime to prevent falls and fractures in this particular setting.MethodsOur search looked for randomized controlled trials published in English language between January 1974 and June 2012 in electronic databases including MEDLINE, EMBASE, PubMed, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database, Allied and Complementary Medicine, and Occupational Therapy Seeker that specifically tested the effect of exercise on falls and/or fractures in long term care residents. Two investigators independently extracted data and assessed study quality. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was applied throughout the systematic review and meta-analysis.ResultsTwelve studies were selected that included 1292 participants. Most of the participants were women (68%) with a mean age of 83.9 ± 9 years. The intervention period was between 3 and 24 months, and the most commonly performed intervention were balance and resistance training exercises. Meta-analysis showed that exercise has a preventive effect on falls (risk ratio [RR] = 0.77, 95% confidence interval [CI], 0.64–0.92; I² = 72.18, P < .001). This effect was stronger when mixing several types of exercises (RR = 0.71, 95% CI, 0.55–0.90; I² = 72.07, P < .001), for at least 1–3 months (RR = 0.65, 95% CI, 0.43–0.98; I² = 61.821; P < .001) or for more than 6 months (RR = 0.70, 95% CI, 0.56–0.87; I² = 68.407; P < .001), with a frequency of at least 2–3 times per week (RR = 0.74, 95% CI, 0.60–0.91; I² = 68.092; P < .001). Physical exercise did not show any effect on fracture prevention (RR = 0.57, 95% CI, 0.21–1.57; I² = 48.805).ConclusionsCombined, frequent and long-term exercise programs are effective to prevent falls in long term care facilities. No effect of exercise on fracture prevention was observed in this population.     

Exergaming as a Physical Exercise Strategy Reduces Frailty in People With Dementia: A Randomized Controlled Trial

ObjectivesPeople with dementia are known to be physically frailer, more sedentary, and participate less in regular physical exercise compared to their healthy peers. Physical activity interventions have the potential to reduce the level of frailty in community-dwelling older adults. Exergaming combines physical exercise with cognitive stimulation in a virtual environment. It is an innovative and fun way of exercising, which may aid people with dementia to be more physically active. The primary aim of this study was to investigate the efficacy of a 12-week exergame training and equally long aerobic training, both compared to an active control group, on frailty in people with dementia.DesignA 3-armed randomized controlled trial compared exergame training, aerobic training, and an active control intervention.Participants115 people with dementia [mean (standard deviation [SD]) age = 79.2 (6.9) years; mean (SD) Mini-Mental State Examination score = 22.9 (3.4)].MethodsParticipants were randomized and individually trained 3 times a week during 12 weeks. The Evaluative Frailty Index for Physical activity (EFIP) was used to assess the level of frailty at baseline and after the 12-week intervention period. Between-group differences were analyzed with analysis of covariance.ResultsThe exergame group showed a trend toward higher adherence compared to the aerobic group (87.3% vs 81.1%, P = .05). A significant reduction on the EFIP was found in the exergame group (EG) compared to the active control group (CG) [mean difference (95% confidence interval) between EG and CG: −0.034 [–0.062, −0.007], P = .012], with a small-to-moderate effect size (partial η² = 0.055).Conclusions and implicationsThis is the first study to show that a 12-week exergame intervention reduces the level of frailty in people with dementia. This is an important and promising result, because frailty is a powerful predictor for adverse health outcomes, and its reduction may have positive effects on health status. Moreover, exergaming resulted in high adherence rates of physical exercise, which makes it an effective strategy to engage people with dementia in physical activity.     

Trajectories of Depressive Symptoms Over 2 Years Postpartum Among Overweight or Obese Women

BackgroundAlthough depressive symptoms are common postpartum, few studies have followed women beyond 12 months postpartum to investigate changes in the number and severity of these symptoms over time, especially in overweight and obese women. Using two complementary analytical methods, this study aims to identify trajectories of depressive symptoms over 2 years postpartum among overweight or obese mothers, and assess the demographic, socioeconomic, and health covariates for these trajectories.MethodsUsing longitudinal data from two behavioral intervention studies (Kids and Adults Now!-Defeat Obesity [KAN-DO] and Active Mothers Postpartum (AMP); n = 844), we used latent growth modeling to identify the overall trajectory of depressive symptoms and how it was related to key covariates. Next, we used latent class growth analysis to assess the heterogeneity in the depressive symptom trajectories over time, and thereby, identify subgroups of women with distinct trajectories.FindingsThe overall trajectory of depressive symptoms over 2 years postpartum was relatively stable in our sample. However, the presence of three distinct latent class trajectories (stable-low [82.5%], decreasing symptoms [7.3%], and increasing symptoms [10.2%]), identified based on trajectory shape and mean depressive symptom score, supported heterogeneity in depressive symptom trajectories over time. Lower maternal education was related to a higher symptom score, and poorer subjective health status at baseline predicted inclusion in the increasing symptoms trajectory.ConclusionsIn some overweight or obese mothers, postpartum depressive symptoms do not resolve quickly. Practitioners should be aware of this phenomenon and continue to screen for depression for longer periods of time postpartum.     

Disparities in mental health,social support and coping among individuals with mobility impairment

BackgroundCDC estimated that 19.4 million (7.8%) US adults are living with mobility impairment, who are unable to walk a quarter mile. Individuals with physical disability reported greater depression and, in some cases, insufficient social support.ObjectivesThis study explores the extent of disparities in psychological health, social support, and coping mechanisms among those with mobility impairment as compared to those without such impairment, and the longitudinal effect of onset of mobility impairment on subsequent psychosocial health and coping.MethodsIndividuals with mobility impairment were matched to controls from a nationally representative sample, using the propensity score method. The final sample included 345 matched pairs. Regression models with robust standard errors were used to assess disparities in outcomes by mobility status. Autoregressive models were used to assess the longitudinal effect of the onset of mobility limitation on these outcomes.ResultsThose with impaired mobility fared significantly higher on negative affect (p < .05) and pessimism (p < .05), and significantly lower on life satisfaction (p < .05) and positive affect (p = .001). In terms of coping, they showed disparities in health locus of control (self) (p < .05), planning (p < .05), active coping (p < .05), and problem-focused coping (p < .05), as compared to those without mobility limitation. The onset of mobility impairment had significant effects in similar psychological and coping domains.ConclusionOur work revealed a piece of reality of individuals living with mobility impairment and will inform designing effective interventions to mitigate psychosocial health disparities in this population.     

Depressed Adolescents Treated with Exercise (DATE): A pilot randomized controlled trial to test feasibility and establish preliminary effect sizes

The Depressed Adolescents Treated with Exercise (DATE) study evaluated a standardized aerobic exercise protocol to treat nonmedicated adolescents that met DSM-IV-TR criteria for major depressive disorder. From an initial screen of 90 individuals, 30 adolescents aged 12–18 years were randomized to either vigorous exercise (EXER) (>12 kg/kcal/week [KKW]) or a control stretching (STRETCH) activity (<4 KKW) for 12 weeks. The primary outcome measure was the blinded clinician rating of the Children's Depression Rating Scale – Revised (CDRS-R) to assess depression severity and Actical (KKW) accelerometry 24hr/7days a week to assess energy expenditure and adherence. Follow-up evaluations occurred at weeks 26 and 52. The EXER group averaged 77% adherence and the STRETCH group 81% for meeting weekly target goals for the 12 week intervention based on weekly sessions completed and meeting KKW requirements. There was a significant increase in overall weekly KKW expenditures (p < .001) for both groups with the EXER group doubling the STRETCH group in weekly energy expenditure. Depressive symptoms were significantly reduced from baseline for both groups with the EXER group improving more rapidly than STRETCH after six weeks (p < .016) and nine weeks (p < .001). Both groups continued to improve such that there were no group differences after 12 weeks (p = .07). By week 12, the exercise group had a 100% response rate (86% remission), whereas the stretch group response rate was 67% (50% remission) (p = .02). Both groups had improvements in multiple areas of psychosocial functioning related to school and relationships with parents and peers. Anthropometry reflected decreased waist, hip and thigh measurements (p = .02), more so for females than males (p = .05), but there were no weight changes for either gender. The EXER group sustained 100% remission at week 26 and 52. The STRETCH group had 80% response and 70% remission rates at week 26 and by week 52 only one had not fully responded. The study provides support for the use of exercise as a non-medication intervention for adolescents with major depressive disorders when good adherence and energy expenditure (KKW) are achieved.     

Dropout from physical activity interventions in children and adolescents with attention deficit hyperactivity disorder: A systematic review and meta-analysis

Physical activity (PA) interventions have shown promising in improving core symptoms of children and adolescents with ADHD, yet treatment dropout may pose a challenge to routine implementation in clinical practice. We conducted a meta-analysis to investigate the prevalence and predictors of treatment dropout from PA interventions in children and adolescents with ADHD. Electronic databases were searched from inception until 06/2016. Randomized control trials of PA interventions in children and adolescents with ADHD reporting dropout rates were included. A random effects meta-analysis and meta-regression analyses were performed. In 8 studies involving 9 PA intervention arms, 148 children or adolescents assigned to a PA intervention (mean age range = 8.2–15.8 years, 87.8% male) were included. The trim and fill adjusted treatment dropout rate was 17.5% (95%CI = 9.8%–29.4%). The prevalence of dropouts in exercisers was not significantly different from the dropouts in control conditions (odds ratio, OR = 1.12; 95%CI = 0.48–2.65; I² = 0). Lower dropout was observed in sports interventions compared with structured aerobic exercise or yoga (p = 0.049). A higher proportion of male participants (β = 0.05; 95%CI = 0.001 to 0.10; p = 0.045, R² = 1.0) appeared to moderate higher dropout rates from PA interventions. Our findings suggest that in order to maximize PA participation, and therefore health benefits, sports-related interventions should be offered in the multidisciplinary treatment of children and adolescents with ADHD. Our data also suggest that males with ADHD may be more likely to dropout. Dropout rates are comparable to control conditions, suggesting that PA interventions are feasible in adolescents with ADHD.     

Associations between changes in physical fitness and psychological difficulties status among Norwegian adolescents

ObjectivesTo investigate the associations for one-year changes in cardiorespiratory fitness, muscular strength and body mass index, with psychological difficulties status in adolescents.MethodsNorwegian 14-15-year-olds (n = 925) participated in data collection at two time points separated by one year. Psychological difficulties were assessed via the Strengths and Difficulties questionnaire and data from follow-up serve as the dependent variable. Cardiorespiratory fitness (the Andersen-test), muscular strength (Eurofit) and body mass index were measured. Change scores were calculated from the physical fitness variables and serve as independent variables in linear mixed effects models.ResultsThere was no association between change in body mass index and psychological difficulties. Sex and socioeconomic status moderated the association between cardiorespiratory fitness and psychological difficulties. Immigrant status moderated the association between muscular strength and psychological difficulties. Subgroup results indicated inverse associations between change in cardiorespiratory fitness and psychological difficulties among boys (b = −0.009; 95% CI = −0.015 to −0.003; p = .006); change in muscular strength and psychological difficulties among immigrants (b = −1.97; 95% CI = −4.03 to 0.09; p = .061). Subgroup results also indicated an association between change in cardiorespiratory fitness and psychological difficulties among girls in the highest socioeconomic group (b = 0.014; 95% CI = 0.003 to 0.025; p = .014).ConclusionsThe associations for different fitness components were dependent on different moderators. Possibly, this indicates that associations in different subgroups are mediated by different mechanisms. Moderated associations should be addressed in future investigations.     

Risk factors of ICU or high dependency requirements amongst hospitalized pediatric pertussis cases: A 10 year retrospective series,Singapore

IntroductionPertussis causes the highest complication rates and deaths in the infant group. Our study explored risk factors for ICU/high dependency (HD) admissions and intubation/non-invasive ventilation (NIV).MethodsA retrospective review of pertussis admissions over 10 years from 2007 to 2016 was done at KK Women's and Children's Hospital, Singapore. To understand risk factors for severe pertussis infection, we compared cases requiring ICU/HD care with controls admitted to the general ward. Risk factors for intubation/NIV were also studied. Vaccine efficacy for protection against ICU/HD admission or intubation/NIV was also calculated.ResultsThere were 200 pertussis patients with a median age of 2.75 months. Sixty-one % were ≤3 months and 14.5% were <6 weeks old. Majority of patients (77%) had no prior pertussis vaccination. After removing 3 patients with missing vaccination records, 20 cases were compared with 177 controls. On univariate analysis, risk factors for ICU/HD admission comprised: Age ≤3 months, contact history, underlying co-morbidity, prematurity, absent DTaP vaccination, lymphocytosis, hyperleukocytosis (wbc ≥50 × 10⁹/L), thrombocytosis (platelet ≥500 × 10⁹/L), and pneumonia. Multivariate analysis revealed that age ≤3 months (OR 40, 95% CI 4.57–1111.11, p = .007), co-morbidity (OR 8.46 (95% CI 1.47–56.89, p = .019), pneumonia (OR 18.08, 95% CI 3.22–132.15, p = .002), white cell count (OR 1.07, 95% CI 1.01–1.14, p = .023) and cyanosis (OR 5.09, 95% CI 1.31–24.71, p = .026) were risk factors for ICU/HD admission. Prior DTaP vaccination had a vaccine effectiveness of 86.5% in preventing ICU/HD admission and 82.1% in preventing intubation/NIV.ConclusionsAs the majority of pertussis patients were infants ≤3 months old who are at high risk for ICU/HD admission and intubation/NIV, prevention is key to reducing pertussis morbidity. Even though not statistically significant, DTaP vaccination had a role in preventing ICU/HD admission and intubation/NIV.     

Effects of acute exercise on drug craving in adults with poly-substance use disorder. A randomized controlled trial

ObjectivesTo examine the short-term effects of exercise on drug craving in poly-drug-dependent inpatients, duration of effects, differences between exercise types, explore the relationship between craving and mood, and possible moderators.DesignMulticenter randomized control trial (RCT) with a crossover design.Methods38 (25 completed) inpatients (37.3 ± 6.4 years; 84 % male) from three treatment centers participated in soccer, circuit training and control condition in random order for 45-min. Craving was assessed with a self-rated visual analog scale (VAS), mood with Feeling scale (FS), immediately before and after each condition and 1, 2, and 4 h post interventions. Ratings of perceived exertion (RPE) and heart rate were assessed. Intervention effects were assessed using linear mixed effects model, including moderator analyses.ResultsExercise sessions were perceived as “somewhat hard” to “hard”. Compared to control, there was an immediate reduction in craving after soccer and circuit training (β = −1.35, 95 %CI: 1.96, −0.75, p = 0.000; β = -1.44, 95 %CI: 2.06, −0.83, p = 0.000) that persisted for 4 h (β = −1.11, 95 %CI: 1.72, −0.49, p = 0.000; β = -0.85, 95 %CI: 1.49, −0.22, p = 0.008). Elevations in mood after soccer (β = 1.08, 95 %CI: 0.41, 1.76, p = 0.002) and circuit training (β = 0.99, 95 %CI: 0.32, 1.67, p = 0.004) were significantly larger than control. Depressive disorder and primary drug of use might moderate the effect.ConclusionReduced drug cravings and elevated mood following soccer and circuit training were observed in people with poly-SUDs. Single exercise sessions can be an effective strategy to alleviate craving and potentially prevent relapse and treatment drop-out.     

Project MOVE: A randomized controlled trial of interventions for initiating and maintaining physical activity in depressed individuals

ObjectiveTo test interventions for increasing aerobic exercise in depressed individuals.MethodsWe conducted a 3-arm randomized controlled trial aimed at increasing minutes of moderate-to-vigorous physical activity (MVPA) in depressed adults (N = 242). Each successive arm included an added component that might serve to increase and maintain physical activity. Arms were: 1) Brief advice (BA) to aerobic exercise; 2) BA + supervised and home-based aerobic exercise (SHE) + health education (HE); and 3) BA + SHE + cognitive-behavioral sessions focused on increasing and maintaining aerobic exercise (CBEX). HE was intended to serve as a control for CBEX. Assessments were conducted at baseline, Month 1.5, end of intervention (Month 3), Month 6, and Month 9. The primary outcome of MVPA was assessed via accelerometry. Secondary outcomes included self-reported MVPA, depression severity, and other aspects of mood and affect.ResultsAt 3 months (the pre-designated primary outcome timepoint), the simple effect of treatment was statistically significant (F_{2, 569.0} = 4.17, p = .016), with BA + SHE + CBEX being superior to BA. We did not observe differences between BA + SHE + HE and either of the other arms. There were no statistically significant differences between treatment groups at 6- or 9-months. Treatment effects were not statistically significant for secondary outcomes.ConclusionsSupervised and home-based exercise, when combined with a cognitive-behavioral exercise intervention, is effective in increasing aerobic exercise in depressed adults in the short-term, although the impact diminishes post-intervention period.Trial registrationclinicaltrials.gov NCT02691845.     

Corrigendum to “Validation of the Yale Food Addiction Scale among a weight-loss surgery population” [Eating Behaviors 14(2013) 216–219]

The Yale Food Addiction Scale (YFAS), recently validated in college students and binge eaters, is a means to assess “food addiction” in accordance with DSM-IV criteria for substance dependence. Using online survey methodology, we aimed to validate the use of the YFAS among weight loss surgery (WLS) patients. Participants completed measures about pre-WLS food addiction (YFAS), emotional and binge eating, behavioral avoidance and inhibition, and pre- and post-WLS substance use. A sample of 67 WLS patients (59.7% Roux-en-Y) was recruited; participants were 62.7% female, 86.6% Caucasian, had a mean age of 42.7; and 53.7% met criteria for pre-WLS food addiction. Convergent validity was found between the YFAS and measures of emotional eating (r = .368, p < .05) and binge eating (r = .469, p < .05). Discriminant validity was supported in that problematic substance use, behavioral avoidance, and behavioral inhibition were not associated with YFAS scores. Incremental validity was supported in that the YFAS explained a significant proportion of additional variance in binge eating scores, beyond that predicted by emotional eating (EES) and disordered eating behavior (EAT-26). There was a nonsignificant trend towards those with higher food addiction being more likely to admit to post-WLS problematic substance use (i.e., potential “addiction transfer”; 53% vs. 39%). Results support the use of the YFAS as a valid measure of food addiction among WLS patients. Future research with a larger sample may shed light on potentially important relationships between pre-surgical food addiction and both weight and substance use outcomes.

Results

There was a significant relationship between the YFAS symptom count and emotional eating (EES), r = .368, p < .05, and between the YFAS symptom count and binge eating (BES), r = .469, p < .05. The relationship between the YFAS symptom count and behavioral inhibition (BIS) trended towards significance, r = − .262, p = .051. There was no significant relationship between the YFAS symptom count and behavioral avoidance (BAS), r = .098, p = .471, or between the YFAS symptom count and eating disorder severity (EAT-26, r = .148, p = .253. No association was observed between food addiction and problematic substance use.With respect to meeting diagnostic criteria for food addiction (yes/no), there was a significant relationship between food addiction and emotional eating, r = .468, p < .05, binge eating r = .254, p < .05, and symptoms of eating disorders, r = .327, p < .05. There was no significant relationship between food addiction classification and behavioral inhibition or behavioral avoidance. Table 1 displays the correlations between the YFAS and measures of both eating behaviors and substance use.Eating pathology; including symptoms of eating disorders and emotional eating, were significant predictors of binge eating, accounting for 42% of the variance. After controlling for eating pathology in step one, the YFAS explained a significant proportion of additional variance in binge eating scores, R² = .421 for Step 1, ∆R² = .060 for Step 2, F(2,1) = 17.018, p = < .001. Table 2 reports the outcomes of the linear regression conducted to confirm incremental validity of the YFAS over other measure known to predict problematic eating behaviors.Additionally, those meeting criteria for food addiction had poorer total percent weight loss outcomes (32% vs. 27%; p = .220) and were more likely to admit to post-WLS problematic substance use (i.e., potential “addiction transfer”; 53% vs. 39%; p = .126), but neither of these comparisons attained statistical significance.The authors would like to apologize for any inconvenience caused.     

Efectividad de un programa de estiramientos sobre los niveles de ansiedad de los trabajadores de una plataforma logística: un estudio controlado aleatorizado

ObjectiveTo study the influence of a short programme of stretching exercises on anxiety levels of workers in a Spanish logistic company.MethodA controlled clinical trial was carried out by means of an inter-subject design of random homogeneous blocks. Participants were assigned to the experimental group (n = 67), treated with a programme of stretching exercises of 10-minute duration after working hours for a period of 3 months, or to the untreated control group (n = 67). The primary result variable was anxiety, and the secondary variables were burnout syndrome, quality of life and flexibility. An analysis of covariance (ANCOVA) by intention to treat was performed on each of the result variables by controlling the baseline scores, the age and the practice of introjective activities outside the program, with the size effect calculated by means of the partial eta-squared value (η²).ResultsThe results of the ANCOVA showed a moderate effect of the stretching exercise programme on the levels of anxiety (η² = 0,06; P = .004). Other effects found were substantial for flexibility (η² = 0,13; P < .001); moderately high for bodily pain (η² = 0,08; P = .001), and moderate for vitality (η² = 0,05; P = .016); mental health (η² = 0,05; P = .017); general health (η² = 0,04; P = .028) and exhaustion (η² = 0,04; P = .025).ConclusionsThe implementation of a short programme of stretching exercises in the work place was effective for reducing levels of anxiety, bodily pain and exhaustion, and for raising levels of vitality, mental health, general health and flexibility. This type of intervention could be seen as a low-cost strategy for improving the well-being of workers.     

Sex difference in the immunogenicity of the quadrivalent Human Papilloma Virus vaccine: Systematic review and meta-analysis

BackgroundImmunological differences between males and females in response to viral vaccines are well known. This the first review to examine them for the Human Papilloma Virus.MethodsWe conducted a systematic review and meta-analysis of the immunogenicity of the Quadrivalent Human Papilloma Virus Vaccine qHPVV. We searched Medline, Embase, and CENTRAL for trials published until September 17, 2019. Inclusion criteria were 3-doses and reporting geometric mean titers (GMTs). We performed random-effects meta-analyses and meta-regression separated by age group and sex.ResultsOur search yielded 1809 unique studies. 334 full texts were screened and data from 18 studies were extracted. Females had higher pooled geometric mean titers than males in all age groups. Log transformed GMTs in male children (<16) years were: against HPV6: 6·62 (95% CI 6·29–6·94; I² = 86·0%), against HPV11: 7·07 (95% CI 6·90–7·23; I² = 63.1%), against HPV16: 8·53 (95% CI 8·28–8·78; I² = 73·0%), and against HPV18 7·21 (95% CI 7·08–7·34; I² = 26·4%). In females: against HPV6 7·10 (95% CI 6·79–7·41; I² = 96·6%), HPV11: 7·32 (95% CI 7·15–7·50; I² = 90·6%), HPV16: 8·71 (95% CI 8·52–8·91; I² = 90·2%), and HPV18 7·35 (95% CI 7·11–7·58; I² = 92·7%). In the meta-regression, the sexual difference was significant for HPV6 (p = 0·022) with a similar tendency for HPV11 (p = 0·066) and HPV18 (p = 0·079). Immunogenicity was significantly higher in children (<16) than in adults (p < 0·001).ConclusionFemales have higher antibody titers against HPV after receiving the qHPVV than do males. The difference is bigger in low-risk HPV strains. Adjusting the doses and schedules for each sex should be explored further.     

Psychotherapy for the Treatment of Anxiety and Depression in Patients with Parkinson Disease: A Meta-Analysis of Randomized Controlled Trials

ObjectiveAnxiety and depression are major psychiatric nonmotor symptoms (NMSs) of Parkinson disease (PD). Although several studies have investigated the effects of psychotherapeutic interventions, particularly cognitive-behavioral therapy (CBT), for alleviating anxiety and depression in patients with PD, the findings have been inconclusive because of the small sample size and the lack of a unified protocol for such treatments. Thus, the present meta-analysis of randomized controlled trials (RCTs) was conducted to assess the effect of psychotherapy on PD-related anxiety and depression.DesignSystematic review and meta-analysis.Setting and ParticipantsRelevant RCTs were extracted from PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library databases. This study was registered in PROSPERO under the number CRD 42020165052.MeasuresThe primary and secondary outcomes were changes in the anxiety score and depressive symptoms, respectively.ResultsFourteen RCTs including 507 patients with PD were analyzed. The interventions were classified as CBT and non-CBT. CBT significantly reduced anxiety at the end of the study (standardized mean difference = −0.85, 95% confidence interval = −1.12 to −0.58, P < .001, I² = 0%), whereas non-CBT did not. Greater heterogeneity in the effects of non-CBT treatment was observed. CBT was significantly beneficial for depression (standardized mean difference = −0.83, 95% confidence interval = −1.26 to −0.40, P < .001, I² = 55%). Despite the greater heterogeneity in the effects, non-CBT interventions were also effective in alleviating depressive symptoms.Conclusion and ImplicationsCBT is effective for the management of anxiety and depression in patients with PD. Routine treatment for patients with this condition is strongly recommended.