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Research on weight-loss interventions in emerging adulthood is warranted. Therefore, a cognitive-behavioral group treatment (CBT), including development-specific topics for adolescents and young adults with obesity (YOUTH), was developed. In a controlled study, we compared the efficacy of this age-specific CBT group intervention to an age-unspecific CBT group delivered across ages in an inpatient setting. The primary outcome was body mass index standard deviation score (BMI-SDS) over the course of one year; secondary outcomes were health-related and disease-specific quality of life (QoL). 266 participants aged 16 to 21 years (65% females) were randomized. Intention-to-treat (ITT) and per-protocol analyses (PPA) were performed. For both group interventions, we observed significant and clinically relevant improvements in BMI-SDS and QoL over the course of time with small to large effect sizes. Contrary to our hypothesis, the age-specific intervention was not superior to the age-unspecific CBT-approach.
Numerical cognitions such as spatial-numerical associations have been observed to be influenced by grounded, embodied and situated factors. For the case of finger counting, grounded and embodied influences have been reported. However, situated influences, e.g., that reported counting habits change with perception and action within a given situation, have not been systematically examined. To pursue the issue of situatedness of reported finger-counting habits, 458 participants were tested in three separate groups: (1) spontaneous condition: counting with both hands available, (2) perceptual condition: counting with horizontal (left-to-right) perceptual arrangement of fingers (3) perceptual and proprioceptive condition: counting with horizontal (left-to-right) perceptual arrangement of fingers and with busy dominant hand. Report of typical counting habits differed strongly between the three conditions. 28 % reported to start counting with the left hand in the spontaneous counting condition (1), 54 % in the perceptual condition (2) and 62 % in the perceptual and proprioceptive condition (3). Additionally, all participants in the spontaneous counting group showed a symmetry-based counting pattern (with the thumb as number 6), while in the two other groups, a considerable number of participants exhibited a spatially continuous counting pattern (with the pinkie as number 6). Taken together, the study shows that reported finger-counting habits depend on the perceptual and proprioceptive situation and thus are strongly influenced by situated cognition. We suggest that this account reconciles apparently contradictory previous findings of different counting preferences regarding the starting hand in different examination situations.
Finger-based numerical representations have gained increasing research interest. However, their description and assessment often refer to different numerical principles of ordinality, cardinality and 1-to-1 correspondence. Our aim was to investigate similarities and differences between these principles in finger-based numerical representations. Sixty-eight healthy adults performed ordinal finger counting, cardinal finger montring (showing the number of gestures) and finger-to-number mapping with twisted arms and fingers. We found that counting gestures and montring postures were identical for Number 10 but differed to varying degrees for other numbers. Interestingly, there was no systematic relation between finger-to-number mapping and ordinal finger counting habits. These data question the assumption of a unitary embodied finger-based numerical representation, but suggest that different finger-based representations co-exist and can be recruited flexibly depending on the numerical aspects to be conveyed.
Background: High-intensity muscle actions have the potential to temporarily improve the performance which has been denoted as postactivation performance enhancement.
Objectives: This study determined the acute effects of different stretch-shortening (fast vs. low) and strength (dynamic vs. isometric) exercises executed during one training session on subsequent balance performance in youth weightlifters.
Materials and Methods: Sixteen male and female young weightlifters, aged 11.3±0.6years, performed four strength exercise conditions in randomized order, including dynamic strength (DYN; 3 sets of 3 repetitions of 10 RM) and isometric strength exercises (ISOM; 3 sets of maintaining 3s of 10 RM of back-squat), as well as fast (FSSC; 3 sets of 3 repetitions of 20-cm drop-jumps) and slow (SSSC; 3 sets of 3 hurdle jumps over a 20-cm obstacle) stretch-shortening cycle protocols. Balance performance was tested before and after each of the four exercise conditions in bipedal stance on an unstable surface (i.e., BOSU ball with flat side facing up) using two dependent variables, i.e., center of pressure surface area (CoP SA) and velocity (CoP V).
Results: There was a significant effect of time on CoP SA and CoP V [F(1,60)=54.37, d=1.88, p<0.0001; F(1,60)=9.07, d=0.77, p=0.003]. In addition, a statistically significant effect of condition on CoP SA and CoP V [F(3,60)=11.81, d=1.53, p<0.0001; F(3,60)=7.36, d=1.21, p=0.0003] was observed. Statistically significant condition-by-time interactions were found for the balance parameters CoP SA (p<0.003, d=0.54) and CoP V (p<0.002, d=0.70). Specific to contrast analysis, all specified hypotheses were tested and demonstrated that FSSC yielded significantly greater improvements than all other conditions in CoP SA and CoP V [p<0.0001 (d=1.55); p=0.0004 (d=1.19), respectively]. In addition, FSSC yielded significantly greater improvements compared with the two conditions for both balance parameters [p<0.0001 (d=2.03); p<0.0001 (d=1.45)].
Conclusion: Fast stretch-shortening cycle exercises appear to be more effective to improve short-term balance performance in young weightlifters. Due to the importance of balance for overall competitive achievement in weightlifting, it is recommended that young weightlifters implement dynamic plyometric exercises in the fast stretch-shortening cycle during the warm-up to improve their balance performance.
In daily life, we automatically form impressions of other individuals on basis of subtle facial features that convey trustworthiness. Because these face-based judgements influence current and future social interactions, we investigated how perceived trustworthiness of faces affects long-term memory using event-related potentials (ERPs). In the current study, participants incidentally viewed 60 neutral faces differing in trustworthiness, and one week later, performed a surprise recognition memory task, in which the same old faces were presented intermixed with novel ones. We found that after one week untrustworthy faces were better recognized than trustworthy faces and that untrustworthy faces prompted early (350–550 ms) enhanced frontal ERP old/new differences (larger positivity for correctly remembered old faces, compared to novel ones) during recognition. Our findings point toward an enhanced long-lasting, likely familiarity-based, memory for untrustworthy faces. Even when trust judgments about a person do not necessarily need to be accurate, a fast access to memories predicting potential harm may be important to guide social behaviour in daily life.
Background: Interoceptive awareness (iA), the awareness of stimuli originating inside the body, plays an important role in human emotions and psychopathology. The insula is particularly involved in neural processes underlying iA. However, iA-related neural activity in the insula during the acute state of major depressive disorder (MDD) and in remission from depression has not been explored.
Methods: A well-established fMRI paradigm for studying (iA; heartbeat counting) and exteroceptive awareness (eA; tone counting) was used. Study participants formed three independent groups: patients suffering from MDD, patients in remission from MDD or healthy controls. Task-induced neural activity in three functional subdivisions of the insula was compared between these groups.
Results: Depressed participants showed neural hypo-responses during iA in anterior insula regions, as compared to both healthy and remitted participants. The right dorsal anterior insula showed the strongest response to iA across all participant groups. In depressed participants there was no differentiation between different stimuli types in this region (i.e., between iA, eA and noTask). Healthy and remitted participants in contrast showed clear activity differences.
Conclusions: This is the first study comparing iA and eA-related activity in the insula in depressed participants to that in healthy and remitted individuals. The preliminary results suggest that these groups differ in there being hypo-responses across insula regions in the depressed participants, whilst non-psychiatric participants and patients in remission from MDD show the same neural activity during iA in insula subregions implying a possible state marker for MDD. The lack of activity differences between different stimulus types in the depressed group may account for their symptoms of altered external and internal focus.
Background: Interoceptive awareness, the awareness of stimuli originating inside the body, plays an important role in human emotions and psychopathology. The insula is particularly involved in neural processes underlying iA. However, iA-related neural activity in the insula during the acute state of major depressive disorder (MDD) and in remission from depression has not been explored.
Methods: A well-established fMRI paradigm for studying interoceptive awareness (iA; heartbeat counting) and exteroceptive awareness (eA; tone counting) was used. Study participants formed three independent groups: patients suffering from MDD, patients in remission from MDD or healthy controls. Task-induced neural activity in three functional subdivisions of the insula was compared between these groups.
Results: Depressed participants showed neural hypo-responses during iA in anterior insula regions, as compared to both healthy and remitted participants. The right dorsal anterior insula showed the strongest response to iA across all participant groups. In depressed participants there was no differentiation between different stimuli types in this region (i.e., between iA, eA and noTask). Healthy and remitted participants in contrast showed clear activity differences.
Conclusions: This is the first study comparing iA and eA-related activity in the insula in depressed participants to that in healthy and remitted individuals. The preliminary results suggest that these groups differ in there being hypo-responses across insula regions in the depressed participants, whilst healthy participants and patients in remission from MDD show the same neural activity during iA in insula subregions implying a possible state marker for MDD. The lack of activity differences between different stimulus types in the depressed group may account for their symptoms of altered external and internal focus.
Objective: Alexithymia relates to difficulties recognizing and describing emotions. It has been linked to subjectively increased interoceptive awareness (IA) and to psychiatric illnesses such as major depressive disorder (MDD) and somatization. MDD in turn is characterized by aberrant emotion processing and IA on the subjective as well as on the neural level. However, a link between neural activity in response to IA and alexithymic traits in health and depression remains unclear.
Methods: A well-established fMRI task was used to investigate neural activity during IA (heartbeat counting) and exteroceptive awareness (tone counting) in non-psychiatric controls (NC) and MDD. Firstly, comparing MDD and NC, a linear relationship between IA-related activity and scores of the Toronto Alexithymia Scale (TAS) was investigated through whole-brain regression. Secondly, NC were divided by median-split of TAS scores into groups showing low (NC-low) or high (NC-high) alexithymia. MDD and NC-high showed equally high TAS scores. Subsequently, IA-related neural activity was compared on a whole-brain level between the three independent samples (MDD, NC-low, NC-high).
Results: Whole-brain regressions between MDD and NC revealed neural differences during IA as a function of TAS-DD (subscale difficulty describing feelings) in the supragenual anterior cingulate cortex (sACC; BA 24/32), which were due to negative associations between TAS-DD and IA-related activity in NC. Contrasting NC subgroups after median-split on a whole-brain level, high TAS scores were associated with decreased neural activity during IA in the sACC and increased insula activity. Though having equally high alexithymia scores, NC-high showed increased insula activity during IA compared to MDD, whilst both groups showed decreased activity in the sACC.
Conclusions: Within the context of decreased sACC activity during IA in alexithymia (NC-high and MDD), increased insula activity might mirror a compensatory mechanism in NC-high, which is disrupted in MDD.
This study compares the duration and first two formants (F1 and F2) of 11 nominal monophthongs and five nominal diphthongs in Standard Southern British English (SSBE) and a Northern English dialect. F1 and F2 trajectories were fitted with parametric curves using the discrete cosine transform (DCT) and the zeroth DCT coefficient represented formant trajectory means and the first DCT coefficient represented the magnitude and direction of formant trajectory change to characterize vowel inherent spectral change (VISC). Cross-dialectal comparisons involving these measures revealed significant differences for the phonologically back monophthongs /D, , , u:/ and also /3z:/ and the diphthongs /eI, e, aI, I/. Most cross-dialectal differences are in zeroth DCT coefficients, suggesting formant trajectory means tend to characterize such differences, while first DCT coefficient differences were more numerous for diphthongs. With respect to VISC, the most striking differences are that /u:/is considerably more diphthongized in the Northern dialect and that the F2 trajectory of /e/proceeds in opposite directions in the two dialects. Cross-dialectal differences were found to be largely unaffected by the consonantal context in which the vowels were produced. The implications of the results are discussed in relation to VISC, consonantal context effects and speech perception. (c) 2014 Acoustical Society of America.
Background
Doping presents a potential health risk for young athletes. Prevention programs are intended to prevent doping by educating athletes about banned substances. However, such programs have their limitations in practice. This led Germany to introduce the National Doping Prevention Plan (NDPP), in hopes of ameliorating the situation among young elite athletes. Two studies examined 1) the degree to which the NDPP led to improved prevention efforts in elite sport schools, and 2) the extent to which newly developed prevention activities of the national anti-doping agency (NADA) based on the NDPP have improved knowledge among young athletes within elite sports schools.
Methods
The first objective was investigated in a longitudinal study (Study I: t0 = baseline, t1 = follow-up 4 years after NDPP introduction) with N = 22 teachers engaged in doping prevention in elite sports schools. The second objective was evaluated in a cross-sectional comparison study (Study II) in N = 213 elite sports school students (54.5 % male, 45.5 % female, age M = 16.7 ± 1.3 years (all students had received the improved NDDP measure in school; one student group had received additionally NADA anti-doping activities and a control group did not). Descriptive statistics were calculated, followed by McNemar tests, Wilcoxon tests and Analysis of Covariance (ANCOVA).
Results
Results indicate that 4 years after the introduction of the NDPP there have been limited structural changes with regard to the frequency, type, and scope of doping prevention in elite sport schools. On the other hand, in study II, elite sport school students who received further NADA anti-doping activities performed better on an anti-doping knowledge test than students who did not take part (F(1, 207) = 33.99, p <0.001), although this difference was small.
Conclusion
The integration of doping-prevention in elite sport schools as part of the NDPP was only partially successful. The results of the evaluation indicate that the introduction of the NDPP has contributed more to a change in the content of doping prevention activities than to a structural transformation in anti-doping education in elite sport schools. Moreover, while students who did receive additional education in the form of the NDPP“booster sessions” had significantly more knowledge about doping than students who did not receive such education, this difference was only small and may not translate to actual behavior.
Objectives: Chronic back pain (CBP) can lead to disability and burden. In addition to its medical causes, its development is influenced by psychosocial risk factors, the so-called flag factors, which are categorized and integrated into many treatment guidelines. Currently, most studies investigate single flag factors, which limit the estimation of individual factor significance in the development of chronic pain. Furthermore, factors concerning patients’ lifestyle, biography and treatment history are often neglected. Therefore, the objectives of the present study are to identify commonly neglected factors of CBP and integrate them into an analysis model comparing their significance with established flag factors.
Methods: A total of 24 patients and therapists were cross-sectionally interviewed to identify commonly neglected factors of CBP. Subsequently, the impact of these factors was surveyed in a longitudinal study. In two rehabilitation clinics, CBP patients (n = 145) were examined before and 6 months after a 3-week inpatient rehabilitation. Outcome variables, chronification factor pain experience (CF-PE) and chronification factor disability (CF-D), were ascertained with confirmatory factor analysis (CFA) of standardized questionnaires. Predictors were evaluated using stepwise calculations of simple and multiple regression models.
Results: Through interviews, medical history, iatrogenic factors, poor compliance, critical life events (LEs), social support (SS) type and effort–reward were identified as commonly neglected factors. However, only the final three held significance in comparison to established factors such as depression and pain-related cognitions. Longitudinally, lifestyle factors found to influence future pain were initial pain, physically demanding work, nicotine consumption, gender and rehabilitation clinic. LEs were unexpectedly found to be a strong predictor of future pain, as were the protective factors, reward at work and perceived SS.
Discussion: These findings shed insight regarding often overlooked factors in the development of CBP, suggesting that more detailed operationalization and superordinate frameworks would be beneficial to further research.
Conclusion: In particular, LEs should be taken into account in future research. Protective factors should be integrated in therapeutic settings.
Introduction: Chronic low back pain (LBP) is a major cause of disability; early diagnosis and stratification of care remain challenges.
Objectives: This article describes the development of a screening tool for the 1-year prognosis of patients with high chronic LBP risk (risk stratification index) and for treatment allocation according to treatment-modifiable yellow flag indicators (risk prevention indices, RPI-S).
Methods: Screening tools were derived from a multicentre longitudinal study (n = 1071, age >18, intermittent LBP). The greatest prognostic predictors of 4 flag domains ("pain," "distress," "social-environment," "medical care-environment") were determined using least absolute shrinkage and selection operator regression analysis. Internal validity and prognosis error were evaluated after 1-year follow-up. Receiver operating characteristic curves for discrimination (area under the curve) and cutoff values were determined.
Results: The risk stratification index identified persons with increased risk of chronic LBP and accurately estimated expected pain intensity and disability on the Pain Grade Questionnaire (0-100 points) up to 1 year later with an average prognosis error of 15 points. In addition, 3-risk classes were discerned with an accuracy of area under the curve = 0.74 (95% confidence interval 0.63-0.85). The RPI-S also distinguished persons with potentially modifiable prognostic indicators from 4 flag domains and stratified allocation to biopsychosocial treatments accordingly.
Conclusion: The screening tools, developed in compliance with the PROGRESS and TRIPOD statements, revealed good validation and prognostic strength. These tools improve on existing screening tools because of their utility for secondary preventions, incorporation of exercise effect modifiers, exact pain estimations, and personalized allocation to multimodal treatments.
Decades of research have demonstrated that physical stress (PS) stimulates bone remodeling and affects bone structure and function through complex mechanotransduction mechanisms. Recent research has laid ground to the hypothesis that mental stress (MS) also influences bone biology, eventually leading to osteoporosis and increased bone fracture risk. These effects are likely exerted by modulation of hypothalamic–pituitary–adrenal axis activity, resulting in an altered release of growth hormones, glucocorticoids and cytokines, as demonstrated in human and animal studies. Furthermore, molecular cross talk between mental and PS is thought to exist, with either synergistic or preventative effects on bone disease progression depending on the characteristics of the applied stressor. This mini review will explain the emerging concept of MS as an important player in bone adaptation and its potential cross talk with PS by summarizing the current state of knowledge, highlighting newly evolving notions (such as intergenerational transmission of stress and its epigenetic modifications affecting bone) and proposing new research directions.
Physical activity and exercise are effective approaches in prevention and therapy of multiple diseases. Although the specific characteristics of lengthening contractions have the potential to be beneficial in many clinical conditions, eccentric training is not commonly used in clinical populations with metabolic, orthopaedic, or neurologic conditions. The purpose of this pilot study is to investigate the feasibility, functional benefits, and systemic responses of an eccentric exercise program focused on the trunk and lower extremities in people with low back pain (LBP) and multiple sclerosis (MS). A six-week eccentric training program with three weekly sessions is performed by people with LBP and MS. The program consists of ten exercises addressing strength of the trunk and lower extremities. The study follows a four-group design (N = 12 per group) in two study centers (Israel and Germany): three groups perform the eccentric training program: A) control group (healthy, asymptomatic); B) people with LBP; C) people with MS; group D (people with MS) receives standard care physiotherapy. Baseline measurements are conducted before first training, post-measurement takes place after the last session both comprise blood sampling, self-reported questionnaires, mobility, balance, and strength testing. The feasibility of the eccentric training program will be evaluated using quantitative and qualitative measures related to the study process, compliance and adherence, safety, and overall program assessment. For preliminary assessment of potential intervention effects, surrogate parameters related to mobility, postural control, muscle strength and systemic effects are assessed. The presented study will add knowledge regarding safety, feasibility, and initial effects of eccentric training in people with orthopaedic and neurological conditions. The simple exercises, that are easily modifiable in complexity and intensity, are likely beneficial to other populations. Thus, multiple applications and implementation pathways for the herein presented training program are conceivable.
Poor dietary quality is a major cause of morbidity, making the promotion of healthy eating a societal priority. Older adults are a critical target group for promoting healthy eating to enable healthy aging. One factor suggested to promote healthy eating is the willingness to try unfamiliar foods, referred to as food neophilia. This two-wave longitudinal study explored the stability of food neophilia and dietary quality and their prospective relationship over three years, analyzing self-reported data from N = 960 older adults (MT1 = 63.4, range = 50–84) participating in the NutriAct Family Study (NFS) in a cross-lagged panel design. Dietary quality was rated using the NutriAct diet score, based on the current evidence for chronic disease prevention. Food neophilia was measured using the Variety Seeking Tendency Scale. The analyses revealed high a longitudinal stability of both constructs and a small positive cross-sectional correlation between them. Food neophilia had no prospective effect on dietary quality, whereas a very small positive prospective effect of dietary quality on food neophilia was found. Our findings give initial insights into the positive relation of food neophilia and a health-promoting diet in aging and underscore the need for more in-depth research, e.g., on the constructs’ developmental trajectories and potential critical windows of opportunity for promoting food neophilia.
Bone pathology is frequent in stressed individuals. A comprehensive examination of mechanisms linking life stress, depression and disturbed bone homeostasis is missing. In this translational study, mice exposed to early life stress (MSUS) were examined for bone microarchitecture (μCT), metabolism (qPCR/ELISA), and neuronal stress mediator expression (qPCR) and compared with a sample of depressive patients with or without early life stress by analyzing bone mineral density (BMD) (DXA) and metabolic changes in serum (osteocalcin, PINP, CTX-I). MSUS mice showed a significant decrease in NGF, NPYR1, VIPR1 and TACR1 expression, higher innervation density in bone, and increased serum levels of CTX-I, suggesting a milieu in favor of catabolic bone turnover. MSUS mice had a significantly lower body weight compared to control mice, and this caused minor effects on bone microarchitecture. Depressive patients with experiences of childhood neglect also showed a catabolic pattern. A significant reduction in BMD was observed in depressive patients with childhood abuse and stressful life events during childhood. Therefore, future studies on prevention and treatment strategies for both mental and bone disease should consider early life stress as a risk factor for bone pathologies.
This study examined the spoken narrative skills of a group of bilingual Mandarin–English speaking 3–6-year-olds (N = 25) in Australia, using a remote online story-retell task. Bilingual preschoolers are an understudied population, especially those who are speaking typologically distinct languages such as Mandarin and English which have fewer structural overlaps compared to language pairs that are typologically closer, reducing cross-linguistic positive transfer. We examined these preschoolers’ spoken narrative skills as measured by macrostructures (the global organization of a story) and microstructures (linguistic structures, e.g., total number of utterances, nouns, verbs, phrases, and modifiers) across and within each language, and how various factors such as age and language experiences contribute to individual variability. The results indicate that our bilingual preschoolers acquired spoken narrative skills similarly across their two languages, i.e., showing similar patterns of productivity for macrostructure and microstructure elements in both of their two languages. While chronological age was positively correlated with macrostructures in both languages (showing developmental effects), there were no significant correlations between measures of language experiences and the measures of spoken narrative skills (no effects for language input/output). The findings suggest that although these preschoolers acquire two typologically diverse languages in different learning environments, Mandarin at home with highly educated parents, and English at preschool, they displayed similar levels of oral narrative skills as far as these macro−/micro-structure measures are concerned. This study provides further evidence for the feasibility of remote online assessment of preschoolers’ narrative skills.
In canoe sprint, the trunk muscles play an important role in stabilizing the body in an unstable environment (boat) and in generating forces that are transmitted through the shoulders and arms to the paddle for propulsion of the boat. Isokinetic training is well suited for sports in which propulsion is generated through water resistance due to similarities in the resistive mode. Thus, the purpose of this study was to determine the effects of isokinetic training in addition to regular sport-specific training on trunk muscular fitness and body composition in world-class canoeists and to evaluate associations between trunk muscular fitness and canoe-specific performance. Nine world-class canoeists (age: 25.6 ± 3.3 years; three females; four world champions; three Olympic gold medalists) participated in an 8-week progressive isokinetic training with a 6-week block “muscle hypertrophy” and a 2-week block “muscle power.” Pre- and post-tests included the assessment of peak isokinetic torque at different velocities in concentric (30 and 140∘s-1) and eccentric (30 and 90∘s-1) mode, trunk muscle endurance, and body composition (e.g., body fat, segmental lean mass). Additionally, peak paddle force was assessed in the flume at a water current of 3.4 m/s. Significant pre-to-post increases were found for peak torque of the trunk rotators at 30∘s-1 (p = 0.047; d = 0.4) and 140∘s-1 (p = 0.014; d = 0.7) in concentric mode. No significant pre-to-post changes were detected for eccentric trunk rotator torque, trunk muscle endurance, and body composition (p > 0.148). Significant medium-to-large correlations were observed between concentric trunk rotator torque but not trunk muscle endurance and peak paddle force, irrespective of the isokinetic movement velocity (all r ≥ 0.886; p ≤ 0.008). Isokinetic trunk rotator training is effective in improving concentric trunk rotator strength in world-class canoe sprinters. It is recommended to progressively increase angular velocity from 30∘s-1 to 140∘s-1 over the course of the training period.