Acute effects of outdoor and indoor walking on cigarette cravings, withdrawal symptoms and affective response during temporary smoking abstinence

RATIONALE

Cigarette smoking is one of the leading preventable causes of premature death worldwide. There is evidence in the literature that brief exercise units indoors can improve well-being in temporarily abstinent smokers and reduce cigarette cravings and withdrawal symptoms.

OBJECTIVE

Because exercise in natural environments showed enhanced psychological effects, the aim of our study was to examine the acute effects of outdoor exercise compared with indoor exercise on craving, withdrawal symptoms and affective response in temporarily abstinent smokers.

METHODS

In a randomized controlled within-subject-design, temporarily abstinent smokers (N = 16) participated in three interventions lasting 10 min: outdoor walking (OUT-EX), indoor walking (IN-EX) and a sedentary control condition (CC). Self-reported cigarette craving, withdrawal symptoms and affective response were assessed pre-, mid-, post-interventions and at follow-up.

RESULTS

In contrast to CC, OUT-EX and IN-EX significantly reduced cigarette cravings during and at the end of the intervention compared to pre-intervention, but not at 20 min follow-up. Cigarette withdrawal symptoms decreased significantly over time in all three groups, but no significant group differences were found. OUT-EX and IN-EX, but not CC, showed significantly improved affective valence at the end of the intervention and at follow-ups. Outdoor walking resulted in significantly lower cigarette cravings than indoor walking at the end of the intervention.

CONCLUSION

The study adds to existing evidence that short bouts of indoor or outdoor exercise can help reduce cigarette cravings and increase well-being in abstinent smokers. Further studies are needed to address the potential additional effect of outdoor exercise on craving, affective states and smoking cessation.

Facilitators and barriers to TB care during the COVID-19 pandemic

BACKGROUND

Knowledge about factors influencing access and adherence to TB care, and on the impact of the COVID-19 pandemic on TB care in resource-restricted settings is scarce. We conducted this study in Atsimo-Andrefana, a rural region in southern Madagascar where TB prevalence, poverty and food insecurity rates are high. We aimed to determine facilitators and barriers to access to and provision of TB care in rural Madagascar during the COVID-19 pandemic.

METHODS

We conducted qualitative focus group discussions (FGDs) and in-depth interviews (IDIs) with patients with TB, community health workers, facility-based health workers, public health officials and non-governmental organisation staff. We analysed interviews using thematic analysis.

RESULTS

We conducted 11 FGDs and 23 IDIs. We identified three main barriers to access and adherence to TB care: 1) stigma, 2) indirect treatment costs, and 3) food insecurity. The facilitator perceived as most influential was high health worker motivation. The effects of the COVID-19 pandemic on TB care varied between stake-holders; some health workers described delays in TB diagnosis and increased workload.

CONCLUSIONS

To improve access and adherence to TB care, both indirect treatment costs and stigma need to be reduced; undernourished patients with TB should receive food support.

Risk Factors for Accidents and Close Calls in Junior Freeriders, Adolescent Alpine Skiers and Adult Freeriders-A Comparison

Understanding factors associated with risk-taking behavior, accidents and close calls could enhance prevention strategies and thus contribute to preventing serious injury or death in the long term. The following study aims to assess these factors in junior freeride athletes in comparison with competitive alpine skiers of similar age and adult freeriders. A cross-sectional questionnaire design was used to assess risk-related variables and potential associated factors. Accident and close call involvement did not significantly differ between the groups (p > 0.080). No significant relationships between gender and risk-related variables were found (|r| < 0.26). Precautionary behavior was higher in freeride adults and freeride juniors compared to alpine skiers (p < 0.001) and deliberate risk-taking was lower in freeride adults compared to junior freeriders and alpine skiers (p < 0.001). Regression analyses revealed that the association between self-objectification and accidents was stronger in freeride juniors compared to alpine skiers of similar age and freeride adults (p < 0.049). Although accidents and close calls were similar between groups, age seems to be an associated variable to deliberate risk-taking and precautionary behavior. The relationship between accidents and self-objectification in freeride juniors implicates a need for risk education in freeriders in the sensitive phase of adolescence beyond the mere presentation of environmental dangers.

Better Together? Analyzing Experiences from Male and Female Students and Teachers from Single-Sex and Coeducational Physical Education Classes

Purpose: Since personal, environmental and behavioral factors influence students’ and teachers’ actions and experiences, the present study aimed to assess gender-related experiences of students and teachers from single-sex and coeducational physical education (PE) settings. Method: In total, 64 students (mean age: 13.8 ± 0.5 years) and 12 PE teachers from single-sex and coeducational PE settings from higher education schools (6th to 13th grade) in Germany and Austria were interviewed. Interviews were analyzed using a thematic content approach. Results: Students from coeducational PE settings described more gender-unrelated behavior and a higher variety of activities including various non-gender conforming activities. Male students from single-sex PE settings reported performing only gender conform and some gender-neutral activities. Teachers from coeducational settings stated that they purposefully formed mixed-gender groups to foster social processes. A lack of time and lack of knowledge were named by PE teachers as reasons for not addressing gender issues in PE by teachers. Conclusion: Performed activities and teachers’ behavior differed between PE settings, eventually influencing reported differences in terms of behavior and gender perception by students. Further studies should evaluate the influence of specific physical activity interventions on gender perceptions and students’ behavior in order to give practical recommendations for PE classes.

Intention to Engage in Mountain Sport During the Summer Season in Climate Change Affected Environments

Natural environments can make it easier to engage in regular physical activity, including mountain sport activities. However, global warming is expected to change natural environments, especially in mountainous regions with potential impacts on physical activity behavior. While there is some evidence of a reduced intention to engage in winter sport in climate change affected environments, little is known on the impact of climate change in mountain sports conducted in the summer season. Therefore, the present study aimed at comparing the effect of being exposed to a climate change affected scenario (CCA) to being exposed to a climate change unaffected scenario (CCU) on the intention to engage in summer mountain sport activities. Furthermore, we aimed to analyze the role of anticipated affective responses in the context of the Theory of Planned Behavior (TPB). Using a web-based experimental cross-sectional study design, participants were randomly allocated to scenarios of either CCA or CCU pictures. Participants were asked to complete questions about TPB variables and about affective responses referring to the displayed scenarios. Statistical analyses included tests on group differences and hierarchical linear regression analyses. TPB variables (intention to engage in summer mountain sport, attitude, and perceived behavioral control) did not show significant group differences between CCA (n = 155) and CCU (n = 156), p > 0.131; r < −0.10. Significantly lower anticipated affective valence was found in CCA compared to CCU, p < 0.001, r = −0.43. Affective valence did not significantly improve the TPB model, change in R² = 0.7%, p = 0.096. However, a higher affective valence was significantly associated with a higher attitude toward summer mountain sport, beta = 0.19, p < 0.001. Intention to engage in summer mountain sport was similar in the groups. Therefore, an immediate reduced engagement in mountain sport activities due to climate change seems unlikely in the summer season, although differentiated findings across various activities of summer mountain sport cannot be excluded. A reduced affective valence during summer mountain sport activities might occur in the presence of signs of climate change in the environment, which may lead to longer-term behavior changes in climate change affected scenarios also in the summer by repeated experiences of reduced valence.

Add-on exercise interventions for smoking cessation in people with mental illness: a systematic review and meta-analysis

BACKGROUND

Smoking is the most common substance use disorder among people with mental illness. In contrast to people without mental illness, among whom the proportion of smokers has declined in recent decades, the proportion of smokers among people with mental illness remains high. There is a growing body of literature suggesting the use of exercise interventions in combination with smoking cessation in people without mental illness, but to our knowledge the available studies on this treatment option in people with mental illness have not been systematically reviewed. Therefore, this systematic review and meta-analysis aims to assess the effectiveness of exercise interventions as an adjunctive treatment for smoking cessation in people with mental illness.

METHODS

Electronic databases (PubMed, Web of Science, PsycInfo, Sport Discus and Base) were searched for randomised controlled trials and prospective single-group studies that investigated exercise interventions in combination with smoking cessation programmes alone or in comparison with a control group in people with mental illness. A meta-analysis using the Mantel-Haenszel fixed-effect model was conducted to estimate the overall effect of treatment on smoking cessation (abstinence rate at the end of the intervention and at 6-month follow-up).

RESULTS

Six studies, five randomised controlled trials and one study with a prospective single-group design, were included in the systematic review and four randomised controlled trials were included in the meta-analysis. The meta-analysis found a significantly higher abstinence rate after additional exercise at the end of the intervention [risk ratio (RR) 1.48, 95% confidence interval (CI) 1.13-1.94], but not at the 6-month follow-up (RR 1.34, 95% CI 0.89-2.04).

CONCLUSIONS

Exercise appears to be an effective adjunctive therapy to temporarily increase abstinence rates in individuals with mental illness at the end of the intervention. However, due to the small number of included studies and some risk of bias in the included studies, the results should be treated with caution. Therefore, future studies with larger samples are needed to provide a more accurate estimate of the effect in people with mental illness. Registration The systematic review and meta-analysis were registered in the International Prospective Register of Systematic Reviews (PROSPERO) (registration number: CRD42020178630).

A Comparison of Acute Effects of Climbing Therapy with Nordic Walking for Inpatient Adults with Mental Health Disorder: A Clinical Pilot Trial

As climbing therapy is increasingly used for mental health disorders, the present study aimed to compare acute effects of a therapeutic climbing intervention (CT) on affective responses, anxiety, and self-efficacy with those of Nordic walking (NW) and a sedentary control condition (SC) in an inpatient setting with persons with depression, anxiety, or obsessive−compulsive disorders. A total of 21 inpatients (32 ± 12.2 years) participated in a clinical trial in all interventions using an experimental within-subject design. Anxiety and self-efficacy were assessed preintervention (t0) and postintervention (t2) using the State-Trait Anxiety Inventory and the General Self-Efficacy Scale, and affective responses were additionally evaluated during (t1) and 180 min after the intervention (t3) using the Feeling Scale, Felt Arousal Scale, and Positive and Negative Affect Schedule. Statistical evaluation was performed with a 3 × 2 or 3 × 4 repeated measures ANOVA. Significant interaction effects were found for affective responses regarding positive affect, affective valence, and perceived activation (p < 0.015) favoring CT over NW and SC. For anxiety, a significant interaction effect was found (F(2.40) = 6.603; p = 0.003; η2 = 0.248), and also perceived self-efficacy increased significantly (F(2.40) = 6.046; p = 0.005; η2 = 0.232). Single CT sessions may enhance affective responses and self-efficacy and reduce anxiety in inpatients with mental health disorders to a higher extent than NW. CT as part of an inpatient therapy program may help to improve key affective mechanisms and should be further studied in comparison with other exercise interventions with comparable intensity.

Expert Views on Therapeutic Climbing-A Multi-Perspective, Qualitative Study

Therapeutic climbing (TC) is regularly used as an add-on treatment option for a variety of disorders. However, evidence on the assessment of professionals deciding on the treatment options or assessing the appropriateness of treatment options is lacking. Therefore, the aim of the present study was to assess the potential of TC as an exercise intervention from different expert perspectives. The study was designed as a qualitative, problem-centered interview experiment to assess the perspectives of pedagogues, physicians, and psychologists on exercise therapy in general and the potential of TC. The sample consisted of 30 experts (10 pedagogues, 10 physicians, and 10 psychologists) with different levels of experience in TC (ᴓage: 41.7 years, ♀ = 43%). Overall, the potential of TC as an add-on treatment option for various disorders was rated by the respondents as positive and useful. The interviewed experts believed that TC can have a decisive effect on the social, psychological, and physiological domain as a sensibly used add-on therapy. However, considering the reported potential adverse effects and the costs connected with TC, it should not be considered as a panacea. Although research in this area is still much in its infancy, the positive perspective of the professional representatives surveyed could facilitate access to TC for patients and may foster more research in this field.

Intention to Engage in Winter Sport in Climate Change Affected Environments

Exercise, including winter sport activities, shows positive effects on physical and mental health, with additional benefits when participating in natural environments. Winter sport activities are particularly vulnerable to climate change, since global warming will decrease the duration and amount of snow. In the context of climate change in alpine environments, little is known on the determinants of winter sport behavior. Thus, the following study primarily aimed at comparing the effect of being exposed to a climate change affected scenario (CCA) or to a climate change unaffected scenario (CCU) on the intention to engage in recreational winter sport activities. Secondly, we aimed to analyze the role of anticipated affective responses during exercising based on the Theory of Planned Behavior (TPB). An experimental cross-sectional web-based study design was used. Participants were randomly allocated to pictures of either CCA or CCU. TPB variables and affective responses with regard to the displayed scenarios were assessed. Statistical analyses included Mann-Whitney-U Tests, linear regression, and mediation analyses. Significant group differences were seen in all TPB variables, p < 0.038; −0.13 < r < −0.30, as well as in affective responses, p < 0.001; −0.24 < r < −0.85. Lower intention to engage in winter sport activities and lower anticipated affective valence during exercising was found in CCA compared to CCU. Attitude toward winter sport was significantly positively associated with intention to engage in winter sport, beta = 0.66, p < 0.001. The effect of group allocation on attitude was mediated by anticipated affective valence, indirect effect = 0.37, p < 0.001. Intention to engage in recreational winter sport activities was lower in participants exposed to the climate change affected winter sport scenario. Since affective valence seems to influence attitude and consequently intention to exercise, the role of non-cognitive variables with regard to climate change related exposure should be considered in future studies. Therefore, winter sport resorts may consider altered winter sport behaviors due to the consequences of climate change as well as the importance of providing an optimal framework to enhance affective valence of their guests in order to mitigate potential changes in winter sports behavior.

Psychological Variables Related to Developmental Changes during Adolescence-A Comparison between Alpine and Non-Alpine Sport Participants

Alpine sport is a popular form of exercise and provides several skills that are potentially relevant for positive development during adolescence. However, empirical data on differences between alpine and non-alpine sport participants in variables related to developmental changes are lacking. Therefore, the primary aim of the present study was to analyze differences in self-esteem and additional variables between adolescent alpine and non-alpine sport participants. A comparison to non-regular exercisers was conducted for self-esteem. In a cross-sectional design, information on self-esteem, sensation seeking, agency, and emotion regulation was collected in 183 adolescents [(mean age: 15.4 (SD: 2.3) years, 71.0% female)]. Alpine sport participants reported significantly higher self-esteem compared to non-regular exercisers, p = 0.003, d = 0.95, but not compared to non-alpine sport participants, p = 0.774, d = 0.06. When controlling for sex and high-risk sport engagement, alpine sport participants showed a significantly higher experience of agency compared to non-alpine sport participants, p = 0.016, d = 0.46. We conclude that alpine sport participation is less relevant with regard to self-esteem compared to regular exercise. However, the characteristics of alpine sport might provide a trigger for higher experience of agency during sport participation, potentially helping to satisfy the increased need for autonomy and independence in adolescence.

Affective responses to climbing exercises in children and adolescents during in-patient treatment for mental health disorders a pilot study on acute effects of different exercise interventions

The aim of the present study was to compare acute effects of a climbing intervention (CI) on affective responses with a different exercise intervention (swimming, SI) and an occupational therapy intervention (OTI) in children and adolescents during in-patient treatment for mental health disorders. The following study was designed as a cross-over study. Participants completed three single 60 min interventions of CI, SI and OTI. Affective responses were assessed pre and post intervention and at 20 and 40 min during intervention. The sample consisted of 33 children and adolescents in mental-health inpatient care (ᴓage: 13.3 ± 2.2 years, ♀=39.4%). A significant time effect was seen in all interventions in increasing positive and reducing negative affect, p<.028, eta²>0.144. Repeated measures ANOVAs revealed a significant time by intervention effect for affective valence (p=.011, eta²=0.09), but not for perceived activation, favouring CI over SI and OCT between pre-test and the first 20 or 40 min, respectively. All interventions showed similar effects on affective responses pre to post interventions. CI seems to increase affective valence more strongly during intervention compared to SI and OTI. The present results may have implications for therapy adherence and acute emotion regulation in children and adolescent in-patients with mental health disorders.

Does Age Matter? A Qualitative Comparison of Motives and Aspects of Risk in Adolescent and Adult Freeriders

Recent research has shown multiple motives for high-risk sport participation derived from research on adult participants. The aim of this study was to provide insights into motives and risk-related aspects in adolescent high-risk sport participants and to compare those findings with adults performing the same activity. Semi-structured interviews were conducted with 24 adolescent (14-20 years) freeriders (skiers/snowboarders who ski outside the protected areas of a ski resort) and 24 adult freeriders (26-41 years). A content analyses was done using MAXQDA software. Both cohorts reported the motives Challenge (adolescents: 92%, adults: 88%), Freedom/Pleasure (adolescents: 88%, adults: 75%), Friends (adolescents: 88%, adults: 79%) and Balance (adolescents: 63%, adults: 63%). However, the description of friends differed between adults and adolescents. Whereas adolescents mostly referred to a community and shared interests, adults described the importance of trust and the development of deep friendships through the activity more often. Nature was a major motive in adults (83%) but not in adolescents (29%). Most of the adults have already experienced a major accident or close call (n = 19; 79%), contrary to adolescents (n = 7; 29%). Adolescents learned about the risks in freeriding primarily through their families (n = 10) and the ski club (n = 9). Some adults reported to have realized the risks involved in freeriding after starting with the activity due to experienced negative outcomes. Both cohorts were largely motivated by the same motives. As the new generation of freeriders seems to receive more instructions about risk reduction, it might be interesting to see if this educational approach results into less accidents or close calls in this group.

Mortality in Different Mountain Sports Activities Primarily Practiced in the Winter Season-A Narrative Review

Annually, millions of people engage in mountain sports activities all over the world. These activities are associated with health benefits, but concurrently with a risk for injury and death. Knowledge on death rates is considered important for the categorization of high-risk sports in literature and for the development of effective preventive measures. The death risk has been reported to vary across different mountain sports primarily practiced in the summer season. To complete the spectrum, the aim of the present review is to compare mortality rates across different mountain sports activities primarily practiced in winter. A comprehensive literature search was performed on the death risk (mortality) during such activities, i.e., alpine (downhill) skiing, snowboarding, cross-country skiing, ski touring, and sledging. With the exception of ski touring (4.4 deaths per 1 million exposure days), the mortality risk was low across different winter sports, with small activity-specific variation (0.3–0.8 deaths per 1 million exposure days). Traumatic (e.g., falls) and non-traumatic (e.g., cardiac death) incidents and avalanche burial in ski tourers were the predominant causes of death. Preventive measures include the improvement of sport-specific skills and fitness, the use of protective gear, well-targeted and intensive training programs concerning avalanche hazards, and sports-medical counseling for elderly and those with pre-existing diseases.

[German Language Version and Validation of the Risk-Taking Behaviour Scale (RBS-K) for High-Risk Sports]

BACKGROUND

 High-risk sports, particularly climbing, kayaking and extreme skiing, have become increasingly popular. The most widely used psychological survey instrument with regard to risk behaviour in sports is the Sensation Seeking Model, mostly assessed by the Sensation Seeking Scale (SSS-V). Until recently, the literature discussed risk behaviour solely through this model. However, this scale does not measure risk-taking behaviours. In contrast, the Risk-Taking Behaviour Scale (RBS-K) is a three-item scale that measures risk behaviour in high-risk sports. This study aimed to validate a German language version of the RBS-K.

METHODS

 The RBS-K was translated and back-translated between English and German. High-risk sports participants (n = 2399) completed the German version of the RBS-K. Of those participants, 820 completed the RBS-K in person as part of a field survey and 1579 participated in an online survey. To validate the questionnaire, the SSS-V, accident involvement, age and sex were evaluated. The RBS-K divides the sample into deliberate risk takers (mean + standard deviation) and risk-averse persons (mean - standard deviation). We tested for internal consistency and correlations with SSS-V, age, sex and accident involvement. Group differences were calculated between deliberate risk takers and risk-averse persons.

RESULTS

 For internal consistency, we obtained a Cronbach's alpha of 0.56 and a McDonald's omega of 0.63. Significant correlations were shown between RBS-K and SSS-V as well as age and sex. Compared to risk-averse persons (n = 643, 26.8 %), deliberate risk takers (n = 319, 13.3 %) scored significantly higher in sensation seeking, were significantly younger and primarily male and had a significantly higher accident involvement.

CONCLUSION

 The RBS-K discriminates well for age, sex and accident involvement. Also, correlations between the RBS-K and the well-established SSS-V are acceptable. With regard to the results and its compact design, the scale seems to be well suited for field surveys. We discuss the relatively modest internal consistency in the context of the small number of items and the different dimensions of risk-taking.

[Current state of the scientific literature on effects of therapeutic climbing on mental health - conclusion: a lot to do]

BACKGROUND

Therapeutic Climbing is applied in physiological as well as in psychological rehabilitation programs. Systematic reviews have been conducted, evaluating the physiological effects of therapeutic climbing. The aim of the following article is a review on existing literature about the psychological effects of climbing therapy.

METHODS

We searched the databases of PubMed, Scholar and ScienceDirect up to December 2017 in German and English language. Trials were included if they assessed psychological variables in climbing interventions.

RESULTS

Seven articles were included in the following review. Effectiveness of climbing therapy was studied in a) adult inpatients with mental disorders (n = 3), b) adult outpatients with mental disorders (n = 1), c) children with motoric deficits and disabilities (n = 2), d) healthy adults (n = 1). All trials had major methodological limitations. Control groups if present, were defined differently. Three trials assessed self-efficacy and revealed enhanced self-efficacy after the climbing intervention. No psychological differences were seen between aerobic exercise and climbing therapy in healthy adults. Acute positive affective changes were seen in in-patients with major depressive disorders after a climbing session compared to a relaxation session.

CONCLUSION

The effectiveness of climbing therapy on psychological outcomes remains unclear. Limited evidence with varying age groups (children and adults) and a high risk of bias shows enhanced self-efficacy through climbing therapy. There is a need for further studies in children and adults on psychological outcomes through climbing therapy, especially in comparison with aerobic activity interventions.

Freeriding-Only a need for thrill?: Comparing different motives and behavioural aspects between slope skiers and freeride skiers

OBJECTIVES

To compare professional freeride skiers (an experienced high-risk cohort) with recreational freeride skiers (a less experienced high risk cohort) and slope skiers (a low-risk sport cohort) in regard to their motives and their reported accident involvement.

DESIGN

Case-control study.

METHODS

In an online survey, skiers completed the German Sensation Seeking, Emotion Regulation and Agency Scale and the German Accident and Close Calls in Sport Inventory. Freeriders were further asked about their risk-management strategies and their use of safety equipment. For every professional freerider (total 31; 29% female) within the sample, two matched controls (age, gender) were allocated (slope skier and recreational freerider). Univariate analyses of variance (ANOVAs) and Chi-square differences were calculated.

RESULTS

Freeriders showed significantly higher sensation seeking scores than slope skiers. No differences were found in the experience of agency while participating; however freeriders experienced higher agency transfers after the activity than slope skiers. No further motivational disparities between recreational or professional freeriders were shown. Both freeride samples reported a significantly higher accident and close call involvement than slope skiers. Accident and close call involvement was not predicted by motives of participation.

CONCLUSIONS

Freeriding might provide beneficial transfer effects as shown through a higher agency transfer, for participants into aspects of everyday life. Nevertheless it should not be ignored that the potential behavioural gain of freeriding is at the cost of a higher risk which is underlined by the higher involvement in accidents and experienced close calls of freeriders compared to slope skiers.

Alcohol Consumption and Physical Activity in Austrian College Students-A Cross-Sectional Study

BACKGROUND

The age of college students is considered as crucial for developing health-related behaviors, e.g., alcohol consumption or a physically active lifestyle. Previous research reported a positive relationship between alcohol consumption and physical activity (PA) in college students. However, the main body of research was done in students from the United States who might differ from European students.

OBJECTIVES

Thus the aim of this study was to analyze the relationship between alcohol consumption and PA in a sample of Austrian college students.

METHODS

In a cross-sectional design, 861 Austrian students from various study fields responded to a web-based questionnaire. Self-reported alcohol consumption, PA, and relevant sociodemographic variables were assessed. Multiple regression analyses were used to study the relationship between alcohol consumption and PA.

RESULTS

In none of the regression models, a significant relationship between alcohol consumption and PA was found. There was a significant influence of sex, age, relationship status, education level, and study field on alcohol consumption. Male, older, and undergraduate students studying social sciences without a relationship reported higher alcohol consumption. Conclusions/Importance: The results do not support a general relationship between alcohol consumption and PA among urban Austrian college students of various study fields. Compared to other variables (e.g., sex, relationship status), PA seems to be less important in relation to the consumption of alcohol. This study challenges a global perspective on a positive relationship between alcohol consumption and PA and highlights the need for more cross-cultural investigations.

Development of physical fitness in Austrian primary school children : A longitudinal study among overweight and non-overweight children over 2.5 years

Background

Physical activity and physical fitness play an important role in the prevention of overweight and obesity in childhood and adolescence and reduce the risk of becoming overweight or obese in adulthood.

Aim

To evaluate the development of physical fitness in overweight and non-overweight primary school children from the first to third grades.

Methods

Using a longitudinal study design, body height and weight as well as physical fitness of primary school children from Tyrol, Austria were measured five times during a period of 2.5 years using the German motor performance test (DMT 6–18).

Results

In total, 266 children (55% boys) with a mean age of 6.4 ± 0.5 years at baseline participated. The proportion of overweight children was 11% at baseline and 22% at the fifth time point. Overweight children showed a significantly lower physical fitness level (mean total z‑score of DMT6–18) at all 5 time points (Hedges g: 0.64–1.09). Repeated measurement analyses of variances showed a significant increase of physical fitness over time among overweight (partial η²: 0.12) and non-overweight (partial η²: 0.29) children. With respect to gender, physical fitness significantly increased over time among overweight (partial η²: 0.20) and non-overweight (partial η²: 0.28) girls, as well as among non-overweight boys (partial η²: 0.31) but not among overweight boys (partial η²: 0.07).

Conclusion

Overweight and non-overweight primary school children significantly increased their physical fitness over the study period; however, overweight children showed a significantly lower physical fitness level at all test time points and did not even achieve the mean baseline fitness level of non-overweight children. With respect to the increasing percentage of overweight children over the study period, evidence-based preventive measures to reduce overweight and increase physical fitness should be implemented at the earliest in primary schools with a special focus on overweight boys.

A Qualitative Approach on Motives and Aspects of Risks in Freeriding

Recent research has shown that there are multiple motives for participation in high-risk sport; however these results have come from studies that consider a number of different sports. Therefore, the aim of the present study was to better understand the motives and risk-related aspects of freeriding, using a qualitative approach. Semi-structured interviews were conducted with 40 professional and semi-professional freeride skiers and snowboarders. All freeriders were highly experienced, of different age (19–44 years; 27.5 ± 4.5 years), gender (female = 13), and profession (professional athletes = 11). Analyses were done using MAXQDA software following a code theme approach. Mixed methods analyses using χ²-tests were computed for age (<25 years ≥) and gender (female/male) on motives and risk factors. Five emerging themes were found, namely Challenge (n = 36), Friends (n = 31), Nature (n = 27), Balance (n = 26), and Freedom (n = 26). A sixth theme Habit (n = 13) was allocated as a subtheme due to minor responses. With regard to risk management, participants decided upon a risk calculation strategy which included multiple factors (e.g., planning, conditions, current situation, knowledge, and experience). Trusting in one's own abilities, avoiding negative fear and having trusted partners were among the risk factors. Deliberately seeking out dangerous situations was not a motive. χ²-tests revealed no gender or age differences regarding aspects of risk (range of p-scores: p = 0.17–1.00) or motives (p = 0.16–1.00). Freeriding was shown to provide positive effects through participation. Some important factors seem to be motivational drivers for freeriders: challenging oneself, experiencing nature, contributing to deep friendships, freeriding as a counterbalance to everyday life and escape from restrictions. Contrary to prior research reports on sensation seeking, experienced freeriders do not search the risk; they seem to minimize it based on knowledge and experience. Analyses of the present data did not show any gender or age differences, which may suggest that experience plays a more important role in high-risk sports than age or gender. Future research should qualitatively investigate further terrain based activities and implement motives and risk-related factors in quantitative research.

Is decision making in hypoxia affected by pre-acclimatisation? A randomized controlled trial

INTRODUCTION

Decision making is impaired in hypoxic environments, which may have serious or even lethal consequences for mountaineers. An acclimatisation period prior to high altitude exposures may help to overcome adverse effects of hypoxia. Thus, we investigated possible effects of short-term pre-acclimatisation on decision making in hypoxia.

METHODS

In a randomized controlled study design, 52 healthy participants were allocated to a hypoxia group (HG: short-term pre-acclimatisation by the use of intermittent hypoxia 7×1h at F_iO₂=12.6%, equivalent to 4500m) or a control group (CG: sham pre-acclimatisation 7×1h at F_iO₂=20.9%, equivalent to 600m). The number of risky decisions was assessed using the Game of Dice Task at four time points during a 12-hours stay in hypoxia (F_iO₂=12.6%).

RESULTS

42 (HG: 27, CG: 25) participants completed the study. The number of risky decisions was significantly (p=0.048 as determined by 4×2 ANCOVA) reduced in the hypoxia group compared to the control group, partial η²=0.11, when the age-effect on decision making was controlled. Self-reported positive affective valence prior to decision making was negatively related to the number of risky decisions, r<-0.38.

CONCLUSION

Short-term pre-acclimatisation might influence decision making in hypoxia in a positive way and might be considered as a risk-reducing preparation method prior to exposures to hypoxic environments. Positive affective states seem to have a medium-sized protective effect against risky decision making.

Subjective assessment of acute mountain sickness: investigating the relationship between the Lake Louise Self-Report, a visual analogue scale and psychological well-being scales

Purpose

There is an ongoing discussion how to assess acute mountain sickness (AMS) in real life conditions. Next to more-item scales with a cut off like the Lake Louise Self-Report (LLS), some authors suggested to use visual analog scales (VAS) to assess AMS. This study tried to contribute to this question using VAS items used for the Subjective Ratings of Drug Effects, including an additional single item for AMS. Furthermore, we investigated if instruments developed to assess psychological well-being might predict AMS assessed via LLS or VAS.

Methods

32 (19 Female) adult persons with known AMS susceptibility filled in questionnaires (Feeling Scale, Felt Arousal Scale, Activation Deactivation Check List, LLS, VAS) at a height of 3650 m above sea level.

Results

Correlation and regression analysis suggest a moderate to high relationship between the LLS score and the VAS items, including one VAS item asking for the severity of AMS, as well as psychological well-being.

Conclusion

In conclusion, using VAS items to assess AMS can be a more precise alternative to questionnaires like LLS, for people knowledgeable with AMS. Furthermore, researchers should be aware that psychological well-being might be an important parameter influencing the assessment of AMS.

[Sympathetic ophthalmia 50 years after penetrating injury. A case report]

BACKGROUND

Sympathetic ophthalmia is a rare form of autoimmune uveitis and manifests in 90% of cases within the first year after penetrating injuries or surgical interventions.

PATIENTS AND METHODS

In the present case the sympathetic ophthalmia started 50 years after a penetrating injury by a shell splinter. The injured eye was amaurotic and phthitic and the sympathizing eye showed an anterior uveitis. After an initial treatment with local and systemic corticosteroids the uveitis improved. The clinical diagnosis of sympathetic ophthalmia was made after a second inflammation course with substantial visual loss and subtotal chorioidal detachment. After enucleation of the exciting eye the diagnosis was confirmed by histological examination. An immunosuppressive therapy including azathioprine and cyclosporine became necessary to control the uveitis.

RESULTS

After enucleation the corticosteroid treatment was not sufficient. Additional therapy with azathioprine resulted in a recovery of the symptoms but had to be stopped because of adverse reactions. The alternative therapy by means of cyclosporine was tolerated well, but dose reduction was difficult because of recurrences. After a 30 month lasting cyclosporine therapy the patient shows stabile results since 6 months with visual acuity of 20/30.

CONCLUSIONS

The present case report demonstrates that a delayed onset of sympathetic ophthalmia 50 years after initial trauma may occur but can be controlled by an immediate, high dose immunotherapy.

[Thiobarbituric acid positive substances as indicators of lipid peroxidation]

Polyenic acids of particularly membrane-bound lipids can be disintegrated non-enzymatically by oxygen radicals or enzymatically by peroxidation. Final products of the lipid peroxidation are malon dialdehyde, n-alcanes, n-alcanales, hydroxyalcanales, 2-alcenales. Alca-2,4-dienales. Hydroxyalcenales and ketones. Products of lipid peroxidation can react with proteins and glycosaminoglycans. Thus receptor binding of the LDL, enzyme activities, DNA- and protein synthesis can be inhibited. Of the peroxidation products malon dialdehyde is relatively specifically recognizable by the reaction of the thiobarbituric acid. Size and clinical significance of processes of lipid peroxidation are up to now only little known in several diseases, but they might be of great importance for numerous pathological processes.