Correlates of physical activity and sedentary behavior in adults living with overweight and obesity: A systematic review

Overweight and obesity are consistently associated with lower physical activity (PA) levels and greater sedentary behavior (SB) in population studies. To date, no review has evaluated the factors associated with these behaviors in the specific population who have developed obesity/overweight. The aim of this systematic review was to identify the correlates/determinants of SB and PA in adults with overweight and obesity. Five databases were searched for studies, which reported factors or outcomes relating to PA or SB in adults living with overweight/obesity, published from 1980 to 2021. The factors were categorized using a socioecological model, strength, and direction of association. Of 34,058 articles retrieved, 45 studies were included, and 155 factors were identified. Self-efficacy, intrinsic motivation, exercise enjoyment, self-perceived good health, and social support were consistently associated with higher levels of PA. Consistent negative correlations were married females, increased BMI, obesity severity, pain, number of comorbidities, lack of time, energy, and willpower, and hilly terrain. Few studies (n = 12) examined SB, and no evidence for consistent associations were found. This review identified several correlates specific to PA in this population. Further studies are required to identify directionality and distal correlates for PA and all correlate levels of SB.     

The link between reversible cerebral vasoconstriction syndrome and transient global amnesia

Reversible cerebral vasoconstriction syndrome (RCVS) and transient global amnesia (TGA) are acute and self-limiting intra-cerebral conditions. Although previously studied as independent phenomena, there are increasing reports of co-occurrence of these two pathologies. We report a 55-year-old male who presented to the hospital with recurrent thunderclap headaches over the course of 1 week with sudden onset of anterograde memory loss. His medications included a selective serotonin reuptake inhibitor and intermittent use of pseudoephedrine. On examination he was amnestic to recent events and notably perseverating. Magnetic resonance imaging of the brain without contrast showed a small, punctate focus of restricted diffusion in the left hippocampus. He was diagnosed with TGA based on his clinical presentation. His headaches and amnesia resolved over the next 12 h throughout the course of his stay with acetaminophen and oral verapamil and he was discharged. Repeat computed tomography angiogram at 2 weeks revealed diffuse and segmental narrowing of the anterior and posterior intracranial circulation, which resolved on follow-up imaging at 3 months, confirming RCVS. The acute and reversible nature of these conditions and increasing reports of co-occurrence suggests a common pathophysiologic link. We review the literature highlighting similar cases and the presumed pathophysiology.     

Site-specific thigh muscle loss as an independent phenomenon for age-related muscle loss in middle-aged and older men and women

The purpose of this study was to examine the relationships between dual-energy X-ray absorptiometry (DXA)-determined appendicular lean mass (aLM) and ultrasound-measured thigh muscle thickness (MTH) ratio and between aLM or thigh MTH ratio and zigzag walking performance. Eighty-one middle-aged and older adults (41 men and 40 women) aged 50 to 74 years volunteered for the study. Approximately two thirds of the subjects (34 men and 17 women) carried out regular sports activity (at least >2 times a week) including running and cycling exercise. MTH was measured using B-mode ultrasound at two sites on the anterior (A50) and posterior (P50) aspects of the mid-thigh. A50:P50 MTH ratio was calculated to evaluate site-specific thigh muscle loss. aLM and percent body fat were also determined using a DXA. Men had lower body fat and higher aLM than women. Anterior and posterior thigh MTH as well as A50:P50 MTH ratio was higher in men than in women. Zigzag walking time was faster in men than in women. Anterior and posterior thigh MTH was positively (p < 0.001) correlated to aLM and aLM index in men and women. However, A50:P50 MTH ratio was not significantly correlated with aLM and aLM index in both sexes. There was no significant correlation between aLM index and zigzag walking time in men and women. A50:P50 MTH ratio was inversely (p < 0.05) correlated to zigzag walking time in both men and women. Our results suggest that thigh MTH ratio is independent of age-related muscle mass loss detected by aLM.     

Diagnostic Features of Nonverbal Synchrony in Psychotherapy: Comparing Depression and Anxiety

It has repeatedly been shown that interacting persons synchronize their affective, physiological, verbal and nonverbal responses, especially when they are engaged in positive interaction. Nonverbal synchrony (assessed by automated measurement of videotaped movements) is a new concept in psychotherapy research, which has been associated with alliance, self-efficacy and outcome. However, there is a lack of knowledge regarding diagnostic differences in nonverbal synchrony. In this study, we investigated diagnosis and movement quantity as predictors of nonverbal synchrony. The naturalistic analysis sample consisted of 173 videotaped sessions of patients with a depressive disorder (N = 68) or an anxiety disorder (N = 25), who were treated with cognitive behavioral therapy at an outpatient clinic in southwest Germany. Therapy videos were routinely collected and nonverbal synchrony was computed using motion energy analysis (MEA). Using multilevel modeling, we first investigated the influence of diagnosis and time of assessment on patient and therapist movement quantity. Second, we predicted nonverbal synchrony by diagnosis and time of assessment, while controlling for patient movement quantity. We found a lower quantity of movement in depressive than in anxious patients. At the beginning of therapy, nonverbal synchrony was lower in dyads with depressive patients, even when controlling for patient movement quantity. At the end of therapy, patients with depression and anxiety no longer differed as nonverbal synchrony increased in depression and decreased in anxiety during the course of therapy. Nonverbal synchrony provides information beyond psychomotor retardation and is discussed with regard to patients' range of affect and attention focus.