Abstract Purpose To evaluate the DSM-5 diagnosis of Avoidant/Restrictive Food Intake Disorder (ARFID) in children and adolescents with poor eating not associated with body image concerns. Methods A ...retrospective case-control study of 8–18-year-olds, using a diagnostic algorithm, compared all cases with ARFID presenting to seven adolescent-medicine eating disorder programs in 2010 to a randomly selected sample with anorexia nervosa (AN) and bulimia nervosa (BN). Demographic and clinical information were recorded. Results Of 712 individuals studied, 98 (13.8%) met ARFID criteria. Patients with ARFID were younger than those with AN (n = 98) or BN (n = 66), (12.9 vs. 15.6 vs. 16.5 years), had longer durations of illness (33.3 vs. 14.5 vs. 23.5 months), were more likely to be male (29% vs. 15% vs. 6%), and had a percent median body weight intermediate between those with AN or BN (86.5 vs. 81.0 and 107.5). Patients with ARFID included those with selective (picky) eating since early childhood (28.7%); generalized anxiety (21.4%); gastrointestinal symptoms (19.4%); a history of vomiting/choking (13.2%); and food allergies (4.1%). Patients with ARFID were more likely to have a comorbid medical condition (55% vs. 10% vs. 11%) or anxiety disorder (58% vs. 35% vs. 33%) and were less likely to have a mood disorder (19% vs. 31% vs. 58%). Conclusions Patients with ARFID were demographically and clinically distinct from those with AN or BN. They were significantly underweight with a longer duration of illness and had a greater likelihood of comorbid medical and/or psychiatric symptoms.
To synthesize and appraise research testing the effects of exercise interventions on fitness, cardiometabolic health, and bone health among adults with spinal cord injury (SCI).
Electronic databases ...were searched (1980-2016). Included studies employed exercise interventions for a period ≥2 weeks, involved adults with acute or chronic SCI, and measured fitness (cardiorespiratory fitness, power output, or muscle strength), cardiometabolic health (body composition or cardiovascular risk factors), or bone health outcomes. Evidence was synthesized and appraised using Grading of Recommendations Assessment, Development, and Evaluation (GRADE).
A total of 211 studies met the inclusion criteria (22 acute, 189 chronic). For chronic SCI, GRADE confidence ratings were moderate to high for evidence showing exercise can improve all of the reviewed outcomes except bone health. For acute SCI, GRADE ratings were very low for all outcomes. For chronic SCI, there was low to moderate confidence in the evidence showing that 2-3 sessions/week of upper body aerobic exercise at a moderate to vigorous intensity for 20-40 minutes, plus upper body strength exercise (3 sets of 10 repetitions at 50%-80% 1-repetition maximum for all large muscle groups), can improve cardiorespiratory fitness, power output, and muscle strength. For chronic SCI, there was low to moderate confidence in the evidence showing that 3-5 sessions per week of upper body aerobic exercise at a moderate to vigorous intensity for 20-44 minutes can improve cardiorespiratory fitness, muscle strength, body composition, and cardiovascular risk.
Exercise improves fitness and cardiometabolic health of adults with chronic SCI. The evidence on effective exercise types, frequencies, intensities, and durations should be used to formulate exercise guidelines for adults with SCI.
The objective of this review was to summarize the literature supporting narrative interventions that target health-promoting behaviours. Eligible articles were English-language peer-reviewed studies ...that quantitatively reported the results of a narrative intervention targeting health-promoting behaviours or theoretical determinants of behaviour. Five public health and psychology databases were searched. A total of 52 studies met inclusion criteria. In all, 14 studies found positive changes in health-promoting behaviours after exposure to a narrative intervention. The results for the changes in theoretical determinants were mixed. While narrative appears to be a promising intervention strategy, more research is needed to determine how and when to use these interventions.
Phenotypic plasticity in vascular smooth muscle cells (VSMC) is necessary for vessel maintenance, repair and adaptation to vascular changes associated with aging. De-differentiated VSMC contribute to ...pathologies including atherosclerosis and intimal hyperplasia. As resveratrol has been reported to have cardio- protective effects, we investigated its role in VSMC phenotypic modulation. We demonstrated the novel finding that resveratrol promoted VSMC differentiation as measured by contractile protein expression, contractile morphology and contraction in collagen gels. Resveratrol induced VSMC differentiation through stimulation of SirT1 and AMPK. We made the novel finding that low or high dose resveratrol had an initially different mechanism on induction of differentiation. We found that low dose resveratrol stimulated differentiation through SirT1-mediated activation of AKT, whereas high dose resveratrol stimulated differentiation through AMPK-mediated inhibition of the mTORC1 pathway, allowing activation of AKT. The health effects of resveratrol in cardiovascular diseases, cancer and longevity are an area of active research. We have demonstrated a supplemental avenue where-by resveratrol may promote health by maintaining and enhancing plasticity of the vasculature.
Most adults with multiple sclerosis (MS) are physically inactive. Physical activity guidelines are an important tool for exercise prescription, promotion, and monitoring. This article describes the ...application of international standards for guideline development in the creation of evidence-based physical activity guidelines for people with MS. The development process was informed by the Appraisal of Guidelines Research and Evaluation II instrument. The evidence base for the guidelines consisted of a systematic review of research examining the effects of exercise on fitness, fatigue, mobility, and health-related quality of life among people with MS. A multidisciplinary consensus panel deliberated the evidence and generated the guidelines and a preamble. Expert and stakeholder reviews of the materials led to refinement of the wording of both components of the guidelines. The resulting guidelines state that to achieve important fitness benefits, adults with MS who have mild to moderate disability need at least 30 minutes of moderate intensity aerobic activity 2 times per week and strength training exercises for major muscle groups 2 times per week. Meeting these guidelines may also reduce fatigue, improve mobility, and enhance elements of health-related quality of life. People with MS and health professionals are encouraged to adopt these rigorously developed guidelines.
Martin Ginis et al argue that there are insufficient research evaluating physical activity for preventing chronic diseases in people living with disabilities. Without data, evidence-based physical ...activity policies, programs and guidelines cannot be developed to address health differences and disparities experienced by these vulnerable populations. They stress that coordinated efforts are needed to collect population-level data on physical activity and chronic disease among people living with disabilities. Currently, no existing international, population-level surveillance system monitors and assesses physical activity and chronic disease in people living with disabilities, unlike for the general population. In most national health surveillance systems, disability is either an exclusion criterion or is not measured. This limitation can be overcome by implementing standardized, valid measures of disability into ongoing population-level data collection systems and disaggregating data on disability status.
Objective: Theoretically informed by narrative inquiry, this article examines the utility of stories as a possible tool for disseminating synthesized physical activity knowledge to adults with spinal ...cord injury (SCI) and health care professionals (HCPs) working with this population. It is the first research to systematically examine in this context the use of narratives as a knowledge translation tool. Method: Forty-three participants (15 adults with SCI; 13 peer mentors with SCI; and 15 HCPs) individually listened to an evidence-based story set in a rehabilitation hospital about the process of becoming physically active following SCI. Individual telephone interviews were conducted to examine participants' perceptions of the story. Qualitative data were analyzed using a thematic analysis. Results: Five themes were inductively identified: (a) effective communication, (b) narrative authenticity, (c) credible messengers, (d) narrative format, and (e) narrative as a form of action. Together, the themes reveal that the story had utility, the various attributes that help explain why this is case, how the utility might be maximized, what the stories could do on and for people, and how the narratives can be used to support behavior change. Conclusions: The article advances knowledge by revealing the value of narrative as a means for disseminating evidence-based information to people with SCI and to HCPs. It also reveals that stories can be used to facilitate dialogue, teach, remind, reassure, and reinvigorate people. This article is a resource for enabling knowledge to be more effectively shared to different audiences and applying what we know in practice to help people live meaningful lives.
Dozens of published papers cite factors related to leisure-time physical activity (LTPA) participation among people with physical disabilities. Unfortunately, there has been little effort to ...synthesise this literature in a manner that is accessible and useful to the sectors (e.g., health care, recreation) responsible for LTPA promotion in disability populations. In this systematic review, over 200 factors were extracted from 22 review articles addressing barriers and facilitators to LTPA in children and adults with physical disabilities. Factors were grouped according to common themes, classified into five levels of a social ecological model, and coded according to whether they could be affected by the health-care and/or recreation sectors. Findings are discussed with regard to key factors to target in LTPA-enhancing interventions, relevant theories and models in which to frame interventions, the levels at which the interventions can be implemented, and intervention priorities. The synthesis provides a blueprint and a catalyst for researchers and practitioners to shift focus from conducting studies that merely describe LTPA barriers and facilitators, to developing and delivering strategies to increase LTPA among persons with physical disabilities.
To estimate the number of minutes a day of leisure time physical activity (LTPA) performed by people with chronic spinal cord injury (SCI) and to identify the demographic and injury-related ...characteristics associated with LTPA in a population-based sample of people with chronic SCI.
Cross-sectional telephone survey.
General community.
Men and women with SCI (N=695).
Not applicable.
The number of minutes/day of LTPA performed at a mild intensity or greater.
Respondents reported mean minutes +/- SD of 27.14+/-49.36 of LTPA/d; however, 50% reported no LTPA whatsoever. In a multiple regression analysis, sex, age, years postinjury, injury severity, and primary mode of mobility each emerged as a unique predictor of LTPA. Multiple correspondence analysis indicated that being a man over the age of 34 years and greater than 11 years postinjury was associated with inactivity, while being a manual wheelchair user and having motor complete paraplegia were associated with the highest level of daily LTPA.
Daily LTPA levels are generally low in people with SCI. Women, older adults, people with less recent injuries, people with more severe injuries, and users of power wheelchairs and gait aids are general subgroups that may require special attention and resources to overcome unique barriers to LTPA. Specific subgroups may also require targeted interventions.
While considerable evidence suggests that interval exercise confers numerous physiological adaptations linked to improved health, its psychological consequences and behavioural implications are less ...clear and the subject of intense debate. The purpose of this scoping review was to catalogue studies investigating the psychological responses to interval exercise in order to identify what psychological outcomes have been assessed, the research methods used, and the results. A secondary objective was to identify research issues and gaps. Forty-two published articles met the review inclusion/exclusion criteria. These studies involved 1258 participants drawn from various active/inactive and healthy/unhealthy populations, and 55 interval exercise protocols (69% high-intensity interval training HIIT, 27% sprint interval training SIT, and 4% body-weight interval training BWIT). Affect and enjoyment were the most frequently studied psychological outcomes. Post-exercise assessments indicate that overall, enjoyment of, and preferences for interval exercise are equal or greater than for continuous exercise, and participants can hold relatively positive social cognitions regarding interval exercise. Although several methodological issues (e.g., inconsistent use of terminology, measures and protocols) and gaps (e.g., data on adherence and real-world protocols) require attention, from a psychological perspective, the emerging data support the viability of interval exercise as an alternative to continuous exercise.
PDF
