Impact of Physical Activity on Psychological Distress: A Prospective Analysis of an Australian National Sample

Objectives. We analyzed the individual-level associations between participation in moderate to vigorous physical activity (MVPA) and psychological distress levels using a large, nationally representative, longitudinal sample and multivariable panel regression models.Methods. We used 3 waves of panel data from the Household, Income and Labour Dynamics in Australia Survey, consisting of 34 000 observations from 17 000 individuals and covering 2007, 2009, and 2011. We used fixed-effects panel regression models accounting for observable and unobservable confounders to examine the relationships between the weekly frequency of MVPA and summary measures of psychological distress based on the Kessler Psychological Distress Scale.Results. We found substantial and highly statistically significant associations between the frequency of MVPA and different indicators of psychological distress. Frequent participation in MVPA reduces psychological distress and decreases the likelihood of falling into a high-risk category.Conclusions. Our findings underscore the importance of placing physical activity at the core of health promotion initiatives aimed at preventing and remedying psychological discomfort.Moderate to vigorous physical activity (MVPA) is important to people’s lives, with the World Health Organization as well as national and international bodies recommending frequent participation in it.1,2 Recent analyses of Australian population-level data have endorsed this by showing that MVPA is independently associated not only with general and physical health but also with overall levels of mental health and self-reported life satisfaction.3 However, the relationships between MVPA and other facets of mental health, including levels of psychological distress, have not yet been well established. Psychological distress, understood as the experience of unpleasant feelings or emotions that affect day-to-day functioning, affects a sizable share of the population in developed countries such the United States, the United Kingdom, and Australia4–7 and is known to lead to more severe mental disorders and physical health issues.8,9 Consequently, the financial and human costs of psychological distress are non-negligible, and gaining a deeper understanding of the factors that influence individuals’ distress levels is important for the development of efficient public health policies and the devising of effective palliative interventions.Emerging evidence of an association between MVPA and overall levels of mental health has suggested that associations between MVPA and psychological distress are also likely. Potential effects may run through known physiological, psychological, and social processes. From a physiological point of view, we know that MVPA enhances fitness levels, which in turn regulate physiological stress responses, such as reduced secretion of hormones and lowered blood pressure.10 From a psychological perspective, MVPA has been linked to reduced arousal and mood enhancement through cognitive distraction and biochemical changes, and to positive health behaviors during periods of high stress (e.g., a lower likelihood to smoke and eat unhealthily).11 Additionally, participation in MVPA tends to increase time spent outdoors, as well as the frequency and quality of social interactions and interpersonal relationships.12–14 As a result, we would expect MVPA to have the potential to enhance well-being by reducing psychological distress.Consistent with these theories, results from the limited body of existing empirical research have suggested that there are indeed negative associations between the frequency of MVPA and psychological distress levels. However, these findings have emerged almost exclusively from analyses of small nonprobability samples,15–21 and the few available studies based on nationally representative samples are cross-sectional (e.g., Scotland22 and Singapore23). The small, nonprobability nature of the samples used in these studies means that findings are tentative and cannot be generalized to the population as a whole. Their cross-sectional nature means that longitudinal regression techniques that enable more precise estimation of the associations of interest by examining within-individual change over time and minimizing omitted variable bias attributable to unobservable factors cannot be implemented. In fact, undertaking large-scale prospective analyses is often regarded as a necessary step forward in enhancing current knowledge of the associations between MVPA and psychological distress.6,23In this article, we fill this gap and add to the literature by establishing the population-level associations between the weekly frequency of MVPA and self-reported levels of psychological distress with a nationally representative Australian panel data set and fixed-effect (FE) panel regression models.     

A randomized,phase 1/2 trial of the safety,tolerability, and immunogenicity of bivalent rLP2086 meningococcal B vaccine in healthy infants

Background

Neisseria meningitidis serogroup B (MnB) is a major cause of invasive meningococcal disease in infants. A conserved, surface-exposed lipoprotein, LP2086 (a factor H-binding protein [fHBP]), is a promising MnB vaccine target. A bivalent, recombinant vaccine targeting the fHBP (rLP2086) of MnB was developed.

Methods

This phase 1/2 clinical study was designed to assess the immunogenicity, safety, and tolerability of a 4-dose series of the rLP2086 vaccine at 20-, 60-, 120-, or 200-μg dose levels in vaccine-naive infants when given with routine childhood vaccines. The study was to consist of two phases: a single-blind sentinel phase and an open-label full enrollment phase. During the sentinel phase, randomization of subjects to the next higher dose was delayed pending a 14-day safety review of dose 1 of the preceding dose cohort. The full enrollment phase was to occur after completion of the sentinel phase.

Results

Local reactions were generally mild and adverse events infrequent; however, after only 46 infants were randomized into the study, fever rates were 64% and 90% in subjects receiving one 20- or 60-μg rLP2086 dose, respectively. Most fevers were <39.0 °C. Only 2 subjects in the 20-μg group and 1 subject in the 60-μg group experienced fevers >39.0 °C; no fevers were >40.0 °C. Due to these high fever rates, the study was terminated early. No immunogenicity data were collected. This report discusses the safety and acceptability of rLP2086 in infants after one 20- or 60-μg dose.

Conclusion

Due to the high fever rate experienced in the 20- and 60-μg groups, rLP2086 in the current formulation may not be acceptable for infants.     

Task difficulty in mental arithmetic affects microsaccadic rates and magnitudes

Microsaccades are involuntary, small‐magnitude saccadic eye movements that occur during attempted visual fixation. Recent research has found that attention can modulate microsaccade dynamics, but few studies have addressed the effects of task difficulty on microsaccade parameters, and those have obtained contradictory results. Further, no study to date has investigated the influence of task difficulty on microsaccade production during the performance of non‐visual tasks. Thus, the effects of task difficulty on microsaccades, isolated from sensory modality, remain unclear. Here we investigated the effects of task difficulty on microsaccades during the performance of a non‐visual, mental arithmetic task with two levels of complexity. We found that microsaccade rates decreased and microsaccade magnitudes increased with increased task difficulty. We propose that changes in microsaccade rates and magnitudes with task difficulty are mediated by the effects of varying attentional inputs on the rostral superior colliculus activity map.     

Do patient and ward-related characteristics influence the use of coercive measures? Results from the EUNOMIA international study

Purpose

This study aims to identify whether selected patient and ward-related factors are associated with the use of coercive measures. Data were collected as part of the EUNOMIA international collaborative study on the use of coercive measures in ten European countries.

Methods

Involuntarily admitted patients (N = 2,027) were divided into two groups. The first group (N = 770) included patients that had been subject to at least one of these coercive measures during hospitalization: restraint, and/or seclusion, and/or forced medication; the other group (N = 1,257) included patients who had not received any coercive measure during hospitalization. To identify predictors of use of coercive measures, both patients’ sociodemographic and clinical characteristics and centre-related characteristics were tested in a multivariate logistic regression model, controlled for countries’ effect.

Results

The frequency of the use of coercive measures varied significantly across countries, being higher in Poland, Italy and Greece. Patients who received coercive measures were more frequently male and with a diagnosis of psychotic disorder (F20–F29). According to the regression model, patients with higher levels of psychotic and hostility symptoms, and of perceived coercion had a higher risk to be coerced at admission. Controlling for countries’ effect, the risk of being coerced was higher in Poland. Patients’ sociodemographic characteristics and ward-related factors were not identifying as possible predictors because they did not enter the model.

Conclusions

The use of coercive measures varied significantly in the participating countries. Clinical factors, such as high levels of psychotic symptoms and high levels of perceived coercion at admission were associated with the use of coercive measures, when controlling for countries’ effect. These factors should be taken into consideration by programs aimed at reducing the use of coercive measures in psychiatric wards.     

Protective Effects of Cannabidiol Against Hippocampal Cell Death and Cognitive Impairment Induced by Bilateral Common Carotid Artery Occlusion in Mice

The present study investigated whether cannabidiol (CBD), a major non-psychoactive constituent of marijuana, protects against hippocampal neurodegeneration and cognitive deficits induced by brain ischemia in adult mice. Male Swiss mice were subjected to a 17 min of bilateral common carotid artery occlusion (BCCAO) and tested in the Morris water maze 7 days later. CBD (3, 10, and 30 mg/kg) was administered 30 min before and 3, 24, and 48 h after BCCAO. After behavioral testing, the brains were removed and processed to evaluate hippocampal cell survival and degeneration using Nissl staining and FluoroJade C histochemistry, respectively. Astroglial response was examined using immunohistochemistry for glial fibrillary acidic protein (GFAP). CBD (3–30 mg/kg) improved spatial learning performance in BCCAO mice. The Nissl and FJC staining results showed a decrease in hippocampal neurodegeneration after CBD (10 and 30 mg/kg) treatment. GFAP immunoreactivity was also decreased in ischemic mice treated with CBD (30 mg/kg). These findings suggest a protective effect of CBD on neuronal death induced by ischemia and indicate that CBD might exert beneficial therapeutic effects in brain ischemia. The mechanisms that underlie the neuroprotective effects of CBD in BCCAO mice might involve the inhibition of reactive astrogliosis.     

Diagnostic accuracy of the Phototest for cognitive impairment and dementia in Argentina

Phototest is a simple, easy and very brief test with theoretical advantages over available dementia screening tests in Spain. The objective of this study was to estimate the diagnostic accuracy of the Phototest for cognitive impairment and dementia and to compare it with that of the MMSE and the Clock Drawing Test (CDT) in an Argentine population. A phase II cross-sectional study of diagnostic tests evaluation was performed in a sample of 30 controls, 61 with amnestic mild cognitive impairment (a-MCI), and 56 with mild Alzheimer type dementia (DAT). The diagnostic accuracy (DA) was assessed in relation to the clinical diagnosis by calculating the area under the ROC curve (UAC), Sensitivity (Sn), and Specificity (Sp).The DA of the Phototest for a-MCI and DAT (0.93 and 0.97 [UAC]) was higher than that of the MMSE and the CDT. The cut-off points of 27/28 for DAT (Sn = 89.29 [78.1–96.0], Sp = 96.67 [82.8–99.9]) and 30/31 for a-MCI (Sn = 85.25 [73.8–93.0], Sp = 90.00 [73.5–97.9]) maximized the sum of Sn and Sp. Phototest correlates significantly with MMSE and CDT. The Phototest is an efficient instrument for the detection of mild dementia or MCI, with good accuracy and good correlation with tests measuring overall cognitive impairment.     

Theiler’s virus infection provokes the overexpression of genes coding for the chemokine Ip10 (CXCL10) in SJL/J murine astrocytes,which can be inhibited by modulators of estrogen receptors

Theiler’s murine encephalomyelitis virus (TMEV) induces demyelination in susceptible strains of mice (SJL/J) through an immunopathological process that is mediated by CD4⁺ Th1 T cell. These T cells are chemoattracted to the central nervous system by chemokines. Hence, in this study, we focused on the production of the chemokine “interferon-gamma-inducible protein 10 kDa,” or IP-10/CXCL10, by cultured SJL/J mouse astrocytes infected with the BeAn strain of TMEV and its capacity to attract activated T cells. The analysis of the whole murine genome by DNA hybridization with cRNAs from mock- and TMEV-infected cultures revealed the upregulation of six sequences that potentially encode for CXCL10. This increased CXCL10 expression was validated by PCR and qPCR. The presence of this chemokine was further demonstrated by enzyme-linked immunoassay (ELISA). Significantly, astrocytes from BALB/c mice, a strain resistant to demyelination, did not produce CXCL10. The secreted CXCL10 was biologically active, inducing chemoattraction of activated lymphocytes. The inflammatory cytokines, IL-1α, IFN-γ, and TNF-α, were strong inducers of CXCL10 in astrocytes. Serum from TMEV-infected SJL/J but not BALB/c mice contains CXCL10, the levels of which peak at the onset of the clinical disease. Finally, this in vitro inflammation model was fully inhibited by 17β-estradiol and four selective estrogen receptor modulators, as demonstrated by ELISA and qPCR.     

Type I Tympanoplasty: surgical success and prognostic factors

ObjectivesTo evaluate success rate of type I tympanoplasty in adults and to investigate the importance of selected prognostic factors on graft uptake.Material and methodsRetrospective medical chart review of 155 patients who underwent Type I Tympanoplasty, in our department, from January 2013 to December 2017. Graft uptake rate was evaluated and the effects of prognostic factors on surgical outcome such as sex, smoking and otological surgery history, status of the contralateral ear, size and location of the perforation, middle ear mucosa status, surgical approach and graft material. Preoperative and postoperative audiometric data were collected, and the functional success was determined.ResultsThe overall surgical anatomical success rate was 75%. Analysis of the selected variables, identified as independent prognostic factors of anatomical unsuccess (95% CI): smoking (OR = 3.29, p < .01), middle ear tympanosclerosis (OR = 2.96; p = .04). Perforations above 50% of the tympanic membrane area had a borderline effect on graft uptake (p = .05). There was a significative improvement in the average air conduction thresholds of 7.44 dB and an ABG closure rate at 10 dB and 20 dB was achieved in 47% and 84.5%, respectively. Patients who received temporalis fascia graft had similar hearing gain compared to patients who underwent cartilage tympanoplasty (7.7 vs. 7.3 dB, p = .79).ConclusionType I tympanoplasty is an effective and safe procedure with a high anatomical success rate in the treatment of mucosal COM. Poorer outcomes were found in patients with smoking habits, in those with tympanosclerosis of middle ear mucosa and in larger perforations. These prognostic factors should be considered in surgical planning and patients should be advised to quit smoking. Tympanoplasty with cartilage graft had a hearing outcome comparable to temporalis fascia graft and should be considered in high-risk patients.