Control Session Research Articles

Benefit of human moderate running boosting mood and executive function coinciding with bilateral prefrontal activation

Running, compared to pedaling is a whole-body locomotive movement that may confer more mental health via strongly stimulating brains, although running impacts on mental health but their underlying brain mechanisms have yet to be determined; since almost the mechanistic studies have been done with pedaling. We thus aimed at determining the acute effect of a single bout of running at moderate-intensity, the most popular condition, on mood and executive function as well as their neural substrates in the prefrontal cortex (PFC). Twenty-six healthy participants completed both a 10-min running session on a treadmill at 50%{dot{text{V}}text{O}}_{{{text{2peak}}}} and a resting control session in randomized order. Executive function was assessed using the Stroop interference time from the color-word matching Stroop task (CWST) and mood was assessed using the Two-Dimensional Mood Scale, before and after both sessions. Prefrontal hemodynamic changes while performing the CWST were investigated using functional near-infrared spectroscopy. Running resulted in significant enhanced arousal and pleasure level compared to control. Running also caused significant greater reduction of Stroop interference time and increase in Oxy-Hb signals in bilateral PFCs. Besides, we found a significant association among pleasure level, Stroop interference reaction time, and the left dorsolateral PFCs: important brain loci for inhibitory control and mood regulation. To our knowledge, an acute moderate-intensity running has the beneficial of inducing a positive mood and enhancing executive function coinciding with cortical activation in the prefrontal subregions involved in inhibitory control and mood regulation. These results together with previous findings with pedaling imply the specificity of moderate running benefits promoting both cognition and pleasant mood.

Abstract 12775: Supervised Exercise Therapy Adherence and Six-Minute Walk Improvement in Peripheral Artery Disease. Findings From Two Randomized Clinical Trials

Introduction: Supervised exercise therapy (SET) is first line therapy for improving walking ability in people with peripheral artery disease (PAD), but adherence to SET is poor. The association of SET adherence with change in six-minute walk distance in PAD is unclear. Methods: Data were combined from two randomized clinical trials of SET for PAD. In both trials, participants with PAD were randomized to exercise or a control group for six months. Those randomized to SET were asked to attend 72 exercise treadmill exercise sessions over six months in the presence of an exercise physiologist. Those randomized to attention control were asked to attend up to 24 educational sessions once weekly for six months. Adherence rates were defined as the number of attended intervention or control sessions divided by the number of expected sessions. Participants randomized to SET were categorized into tertiles of adherence, according to the proportion of exercise sessions attended. Six-minute walk was measured at baseline and at 6-month follow-up. Results: 281 randomized participants (mean age: 68±9 years; 43% female; 61% African American) were included. The mean adherence rate was 75±18 % in the SET group. The adherence rates for the three SET tertiles were: ≤ 69%, 69 – 85%, and ≥ 85% respectively. Baseline characteristics, within group 6-month changes in six-minute walk distance by intervention group, and pairwise comparisons results are shown in table. Conclusion: While greater adherence to SET was associated with greater six-minute walk distance improvement, even participants with PAD in the lowest tertile of adherence had significantly greater six-minute walk improvement, compared to control. These data suggest that even intermittent exercise activity significantly improves six-minute walk in people with PAD.

Blood Pressure and Heart Rate Variability Responses to High-intensity Interval Training in Untrained Postmenopausal Women

ABSTRACT Purpose: The aim of this study was to analyze the blood pressure (BP) and heart rate variability (HRV) responses in untrained postmenopausal women submitted to acute single sessions of high-intensity interval training (HIT). Method: Sixteen postmenopausal women (59.9 ± 5.6 years, 26.7 ± 3.0 kg/m2) participated in a random order of two acute sessions in a balanced crossover format: control without exercise in sitting position or HIT session. BP and heart rate (HR) were recorded before and during 60 min following the sessions. Results: Diastolic (DBP), mean BP (MBP), and double product (DPO) showed interaction (p < .01). DBP, MBP, and DPO increased (p < .01) after HIT but not after the control session. The area under the curve (AUC) of DBP (p = .02) and DPO (p < .01) were different between conditions. Time and frequency indices of HRV presented interaction (p < .05) which impaired these indices post-HIT, but not post-control. The AUC of time and frequency HRV indices were different between conditions. Conclusions: A single session of HIT may increase BP and cardiac stress and cause perturbation of the autonomic function in untrained postmenopausal women.

Electrically Induced Blink for the Prevention of Ocular Symptoms and Blurred Vision in Patients With Acute Facial Nerve Palsy.

Objectives: Facial nerve palsy causes blurred vision and ocular discomfort due to deficits in blinking and eye closure. The objective of this study was to determine whether eye-blinks could be elicited by electrical stimulation and whether electrically induced blink would have an effect on the visual acuity and ocular symptoms in patients with acute facial nerve palsy. Methods: The zygomatic branch of the facial nerve of fifteen participants with acute facial nerve palsy was electrically stimulated in order to elicit a blink. In successful cases, the participant proceeded with a two-hour TV watching session in which an electrically induced blink was delivered every 5seconds. The control condition consisted of an otherwise similar TV watching session without electrically induced blinking. Subjective ocular symptoms were evaluated with a Dry Eye Questionnaire and visual acuity was assessed with a Logarithm of the Minimum Angle of Resolution (LogMAR) chart before and after both sessions. Results: The stimulation produced a blink in 8 participants (53%). The visual acuity in the affected eye decreased during the control session, whereas no significant change occurred during the stimulation session. The ocular symptoms were significantly reduced during the stimulation session. Conclusions: Electrically elicited blink is a promising method for reducing the eye symptoms in individuals with acute facial nerve palsy.

Choline-Based Multi-Ingredient Supplementation Can Improve Explosive Strength during a Fatiguing Task.

Various choline-based multi-ingredient supplementations (CMS) have been suggested in the current market, but the research is limited. The purpose of this study was to investigate the acute effect of a CMS on physical performance. Fourteen male college football players (20.4 ± 1.0 years) participated in a randomized double-blind crossover experiment separated by 7 days. Subjects were given a CMS or a placebo 60 min before physical performance testing measures, including maximum vertical jumps, maximum voluntary isometric contractions (MVIC), maximal voluntary concentric contractions (MVCC), and fatiguing contractions. Four MVICs and seven sets of two MVCCs at various loads (1 N·m to 60% MVIC torque) were performed with the knee extensor muscles while seated on a dynamometer before and after the fatiguing tasks. During the fatiguing tasks, 120 MVCCs (4 sets × 30 reps) were performed with a load equivalent to 20% MVIC. Twitch interpolation technique was used to assess muscle contractile properties and voluntary activation. No significant differences were seen at baseline between sessions for all testing measures including vertical jump height, strength, power, muscle contractile properties and voluntary activation. Rate of torque development and impulse was higher in supplemental session compared to control session throughout the fatiguing contractions (p = 0.018, p < 0.001, respectively). Acute CMS can improve explosive strength by delaying the onset of fatigue.

Outcomes of a Cluster Randomized Controlled Trial of the SoMe Social Media Literacy Program for Improving Body Image-Related Outcomes in Adolescent Boys and Girls.

Although the negative effect of social media use among youth on body image and eating concerns has been established, few classroom-based resources that can decrease these effects through targeting social media literacy skills have been developed. This study aimed to test the efficacy of SoMe, a social media literacy body image, dieting, and wellbeing program for adolescents, through a cluster randomized controlled trial. Participants (n = 892; Mage = 12.77, SD = 0.74; range 11–15; 49.5% male) were randomized by school (n = 8) to receive either weekly SoMe (n = 483) or control sessions (lessons as usual; n = 409) over 4 weeks in their classroom. Participants completed surveys at four timepoints (baseline, 1-week post-intervention, and 6- and 12-month follow-up) assessing body dissatisfaction, dietary restraint, strategies to increase muscles (primary outcomes), self-esteem and depressive symptoms (secondary outcomes), and internalization of appearance ideals and appearance comparison (exploratory outcomes). Modest positive intervention effects were found in dietary restraint and depressive symptoms at 6-month follow-up in girls but few positive effects emerged for boys. The findings provide only preliminary support for a social media literacy intervention, but suggest the usefulness of both identifying those who benefit most from a universally delivered intervention and the need to refine the intervention to maximize intervention effects.

Singing and music making: physiological responses across early to later stages of dementia.

Background: Music based interventions have been found to improve the wellbeing of people living with dementia. More recently there has been interest in physiological measures to provide additional information about how music and singing impact this population. Methods: This multiple-case study design explored physiological responses (heart rate-HR, electrodermal activity-EDA, movement, and skin temperature-ST) of nine people with mild-to-moderate dementia during a singing group, and six people in the later stages of dementia during an interactive music group. The interactive music group was also video recorded to provide information about engagement. Data were analysed using simulation modelling analysis. Results: The singing group showed an increase in EDA (p < 0.01 for 8/9 participants) and HR (p < 0.01 for 5/9 participants) as the session began. HR (p < 0.0001 for 5/9 participants) and ST (p < 0.0001 for 6/9 participants) increased during faster paced songs. EDA (p < 0.01 all), movement (p < 0.01 for 8/9 participants) and engagement were higher during an interactive music group compared to a control session (music listening). EDA (p < 0.0001 for 14/18 participants) and ST (p < 0.001 for 10/18 participants) increased and in contrast to the responses during singing, HR decreased as the sessions began (p < 0.002 for 9/18 participants). EDA was higher during slower music (p < 0.0001 for 13/18 participants), however this was less consistent in more interactive sessions than the control. There were no consistent changes in HR and movement responses during different styles of music. Conclusions: Physiological measures may provide valuable information about the experiences of people with dementia participating in arts and other activities, particularly for those with verbal communication difficulties. Future research should consider using physiological measures with video-analysis and observational measures to explore further how engagement in specific activities, wellbeing and physiology interact.

When it\u2019s needed most: a blueprint for resident creative writing workshops during inpatient rotations

BackgroundNarrative Medicine may mitigate physician burnout by increasing empathy and self-compassion, and by encouraging physicians to deeply connect with patient stories/experiences. However, Narrative Medicine has been difficult to implement on hectic inpatient teaching services that are often the most emotionally taxing for residents.ObjectiveTo evaluate programmatic and learner outcomes of a novel narrative medicine curriculum implementation during inpatient medicine rotations for medical residents. Programmatic outcomes included implementation lessons. Learner outcomes included preliminary understanding of impact on feelings of burnout. Additionally, we developed a generalizable narrative medicine framework for program implementation across institutions.MethodsWe developed and implemented a monthly 45-min Narrative Medicine workshop on Stanford’s busiest and emotionally-demanding inpatient rotation (medical oncology). Using the Physician Wellbeing Inventory (PWBI, range 1–7; 3–4 = high burnout risk; ≥4, high burnout), we anonymously assessed resident burnout during pre-implementation control year (2017–2018, weeks 1 and 4), and implementation year (2018–2019, weeks 1 and 4). We interviewed program directors and facilitators regarding curriculum implementation challenges/facilitators.ResultsResidents highly rated the narrative medicine curriculum, and the residency program renewed the course for 3 additional years. We identified success factors for programmatic success including time neutrality, control of session, learning climate, building trust, staff partnership, and facilitators training. During control year, resident burnout was initially high (n = 16; mean PBWI = 3.0, SD: 1.1) and increased by the final week (n = 15; PBWI = 3.4, SD: 1.6). During implementation year, resident burnout was initially similar (n = 13; PBWI = 3.1, SD: 1.9) but did not rise as much by rotation end (n = 24; PBWI = 3.3, SD: 1.6). Implementation was underpowered to detect small effect sizes. Based on our our experience and literature review, we propose an educational competency framework potentially helpful to facilitate inpatient narrative medicine workshops, as a blueprint for other institutions.ConclusionsInpatient Narrative Medicine is feasible to implement during a challenging inpatient rotation and may have important short-term effects in mitigating burnout rise, with more study needed. We share teaching tools and propose a competency framework which may be useful to support development of inpatient narrative medicine curricula across institutions.

Efeito agudo do Mat Pilates sobre a variabilidade da pressão arterial ambulatorial em mulheres após a menopausa

Introdução: Após a menopausa mulheres tem maior risco de desenvolver doenças cardiovasculares. A prática de exercício físico é um dos tratamentos para e redução da incidência dessas doenças, e o método Pilates consiste em um programa completo de condicionamento físico. Objetivos: Verificar as respostas da Monitorização Ambulatorial da Pressão Arterial (MAPA) e da Variabilidade da Pressão Arterial após uma única sessão de Mat Pilates em mulheres após a menopausa não obesas. Métodos: Este é um estudo cruzado randomizado com 15 mulheres pós-menopáusicas normotensas, que participaram de uma única sessão de Mat Pilates e de uma sessão de controle. A sessão de Pilates durou 50 minutos, com 5 minutos de aquecimento. Em cada exercício, houve 1 série de 10 repetições com 45 segundos de descanso entre as séries. A sessão controle teve a mesma duração, mas as voluntárias permaneciam sentadas. A MAPA foi avaliada durante 24 horas após a intervenção. Estatística: Utilizou-se ANOVA de dois fatores com post hoc de Newman-Keuls para análise das variáveis da MAPA e teste t de Student para análise da variabilidade de pressão arterial. Resultados: Não houve diferença significativa (p &lt;0,05) nas respostas da pressão arterial sistólica e diastólica durante 24h, vigília e sono ou em sua variabilidade entre as sessões de Pilates e Controle. Conclusão: O Mat Pilates não reduziu os valores pressóricos da MAPA ou sua variabilidade em mulheres após a menopausa não obesas.

Singing and music making: physiological responses across early to later stages of dementia

Background: Music based interventions have been found to improve the wellbeing of people living with dementia. More recently there has been interest in physiological measures to provide additional information about how music and singing impact this population. Methods: This multiple-case study design explored physiological responses (heart rate-HR, electrodermal activity-EDA, movement, and skin temperature-ST) of nine people with mild-to-moderate dementia during a singing group, and six people in the later stages of dementia during an interactive music group. The interactive music group was also video recorded to provide information about engagement. Data were analysed using simulation modelling analysis. Results: The singing group showed an increase in EDA (p < 0.01 for 8/9 participants) and HR (p < 0.01 for 5/9 participants) as the session began. HR (p < 0.0001 for 5/9 participants) and ST (p < 0.0001 for 6/9 participants) increased during faster paced songs. EDA (p < 0.01 all), movement (p < 0.01 for 8/9 participants) and engagement were higher during an interactive music group compared to a control session (music listening). EDA (p < 0.0001 for 14/18 participants) and ST (p < 0.001 for 10/18 participants) increased and in contrast to the responses during singing, HR decreased as the sessions began (p < 0.002 for 9/18 participants). EDA was higher during slower music (p < 0.0001 for 13/18 participants), however this was less consistent in more interactive sessions than the control. There were no consistent changes in HR and movement responses during different styles of music. Conclusions: Physiological measures may provide valuable information about the experiences of people with dementia participating in arts and other activities, particularly for those with verbal communication difficulties. Future research should consider using physiological measures with video-analysis and observational measures to explore further how engagement in specific activities, wellbeing and physiology interact.

Acute effects of different types of exercise on the blood pressure of hypertensive older women: a randomized study.

The magnitude and duration of the hypotensive effect of exercise may be influence by the type of exercise performed. The aim of the present study was to compare systolic (SBP) and diastolic (DBP) blood pressure for 24 hours after a single session of continuous aerobic (CA), interval aerobic (IA), resistance (RE) exercise and control (C), among hypertensive older women under treatment. The study was conducted on 30 women aged 67.5±5.2 years participating in all sessions applied in random order. After each session, blood pressure was obtained by an oscillometric device and they were submitted to 24-hour ambulatory blood pressure monitoring. Immediately after the sessions, a lower SBP value was observed in groups CA and IA compared to groups C and RE. During the 24 hours after sessions, there was a greater reduction of SBP after IA than after other types of exercise, with the reduction after RE being greater than after CA and C (P<0.01). In wakefulness period, the reduction of SBP after IA was more intensive, and, during sleep, IA and RE promoted greater reductions of SBP, with reduction of DBP only after RE (P<0.01). Immediately after the exercise sessions there was a fall in SBP only after aerobic exercises. However, aerobic exercise in the interval mode and RE were more effective in reducing BP over a period of 24 hours.

Investigating Cortical Buffering Effects of Acute Moderate Intensity Exercise: A cTBS Study Targeting the Left Dorsolateral Prefrontal Cortex.

Background: The beneficial effects of both single-session bouts of aerobic exercise and therapeutic exercise interventions on the cortical regions associated with top-down attentional control [i.e., prefrontal cortex (PFC)] have been well documented. However, it remains unclear whether aerobic exercise can be used to buffer against suppressive influences on the dorsolateral PFC (dlPFC).Objective: The current study sought to determine whether a single session of moderate intensity aerobic exercise can offset the expected suppressive effects of continuous theta burst stimulation (cTBS) targeting the dorsolateral prefrontal cortex (dlPFC).Methods: Twenty-two right-handed participants (aged 19–30) completed a 20-minute movement-only control session [10% heart rate reserve (HRR)] and moderate intensity (50% HRR) exercise in a counterbalanced order. Following each exercise session, participants received active cTBS to the left dlPFC. Changes in executive functions were quantified using a Flanker paradigm employed at baseline, post-exercise and post-cTBS time points. Additionally, EEG was used to measure changes in event-related potential components related to inhibitory control (i.e., N2) and attentional control (i.e., P3) during the flanker task.Results: Behavioral results from the flanker task revealed a significant improvement in task performance following an acute bout of moderate intensity exercise. Furthermore, the effect of cTBS in both the movement-only control and moderate intensity conditions were non-significant. Similarly, EEG data from P3b and N2 ERP components revealed no changes to amplitude across time and condition. P3b latency data revealed a significant effect of time in both the moderate intensity and movement-only conditions, such that P3b latencies were significantly shorter across time points. Latency data within the N2 ERP component revealed no significant interactions or main effects.Conclusion: The findings of the current study provide tentative support for the hypothesis that both moderate and light intensity exercise promote cortical buffering against the suppressive effects of cTBS targeting the dlPFC. However, in the absence of a no-movement control, a lack of expected suppressive effects of cTBS cannot be ruled out.

Passive stretching decreases muscle efficiency in balance tasks.

The current study aimed to verify whether or not passive static stretching affects balance control capacity. Thirty-eight participants (19 women and 19 men) underwent a passive static stretching session, involving the knee extensor/flexor and dorsi/plantarflexor muscles, and a control session (no stretching, CTRL). Before (PRE), immediately after (POST), after 15 (POST15) and 30 min (POST30) from stretching (or rest in CTRL), balance control was evaluated under static and dynamic conditions, with open/closed eyes, and with/without somatosensory perturbation (foam under the feet). During tests, centre of pressure (CoP) sway area and perimeter and antero-posterior and medio-lateral sway mean speed were computed. Surface electromyography root mean square (sEMG RMS) was calculated from the vastus lateralis, biceps femoris, gastrocnemius medialis, and tibialis anterior muscles during MVC and during the balance tests. Hip flexion/extension and dorsi/plantarflexion range of motion (ROM), maximum voluntary contraction (MVC) and sEMG RMS during MVC were measured at the same time points. After stretching, ROM increased (≈6.5%; P<0.05), while MVC and sEMG RMS decreased (≈9% and ≈7.5%, respectively; P<0.05). Regardless of the testing condition, CoP sway area and the perimeter remained similar, while antero-posterior and medio-lateral sway mean speed decreased by ≈8% and ≈12%, respectively (P<0.05). sEMG RMS during the balance tests increased in all muscles in POST (≈7%, P<0.05). All variables recovered in POST30. No changes occurred in CTRL. Passive static stretching did not affect the overall balance control ability. However, greater muscle activation was required to maintain similar CoP sway, thus suggesting a decrease in muscle efficiency.

Effect of warm-up and muscle fatiguing exercise on knee joint sounds in motion by vibroarthrography: A randomized crossover trial.

Vibroarthrography measures joint sounds caused by sliding of the joint surfaces over each other. and can be affected by joint health, load and type of movement. Since both warm-up and muscle fatigue lead to local changes in the knee joint (e.g., temperature increase, lubrication of the joint, muscle activation), these may impact knee joint sounds. Therefore, this study investigates the effects of warm-up and muscle fatiguing exercise on knee joint sounds during an activity of daily living. Seventeen healthy, physically active volunteers (25.7 ± 2 years, 7 males) performed a control and an intervention session with a wash-out phase of one week. The control session consisted of sitting on a chair, while the intervention session contained a warm-up (walking on a treadmill) followed by a fatiguing exercise (modified sit-to-stand) protocol. Knee sounds were recorded by vibroarthrography (at the medial tibia plateau and at the patella) at three time points in each session during a sit-to-stand movement. The primary outcome was the mean signal amplitude (MSA, dB). Differences between sessions were determined by repeated measures ANOVA with intra-individual pre-post differences for the warm-up and for the muscle fatigue effect. We found a significant difference for MSA at the medial tibia plateau (intervention: mean 1.51 dB, standard deviation 2.51 dB; control: mean -1.28 dB, SD 2.61 dB; F = 9.5; p = .007; η2 = .37) during extension (from sit to stand) after the warm-up. There was no significant difference for any parameter after the muscle fatiguing exercise (p > .05). The increase in MSA may mostly be explained by an increase in internal knee load and joint friction. However, neuromuscular changes may also have played a role. It appears that the muscle fatiguing exercise has no impact on knee joint sounds in young, active, symptom-free participants during sit to stand.

Comparison of the Sustainability Effects of High-Intensity Interval Exercise and Moderate-Intensity Continuous Exercise on Cognitive Flexibility.

This study examined the immediate and sustained effects of high-intensity interval exercise (HIIE) and moderate-intensity continuous exercise (MICE) on cognitive flexibility in young adults. Participants (n = 56) engaged in (1) a session of HIIE, involving 10 sets of one-minute treadmill running at an intensity targeting 90% heart rate reserve (HRR) interspersed with self-paced walking at 50% HRR; (2) a session of MICE, involving a 20 min treadmill running at an intensity of 40–59% HRR; and (3) a control session, involving 24 min of resting on separate days in a counterbalanced order. Using a more-odd shifting task, cognitive flexibility was assessed before the intervention (t0), immediately after the session (t1), and then at 30 min (t2) after the session. During the more-odd shifting task, the switch cost of response time (RT) immediately after the HIIE was significantly reduced compared to that before exercise, suggesting beneficial effects on cognitive flexibility. Additionally, the impacts of HIIE were maintained for 30 min post-exercise. However, improved cognitive flexibility was not observed until 30 min after the MICE intervention. HIIE might represent a time-efficient approach for enhancing cognitive flexibility.

Metabolomics reveals biomarkers in human urine and plasma to predict cytochrome P450 2D6 (CYP2D6) activity.

Background and PurposeIndividualized assessment of cytochrome P450 2D6 (CYP2D6) activity is usually performed through phenotyping following administration of a probe drug to measure the enzyme's activity. To avoid any iatrogenic harm (allergic drug reaction, dosing error) related to the probe drug, the development of non‐burdensome tools for real‐time phenotyping of CYP2D6 could significantly contribute to precision medicine. This study focuses on the identification of markers of the CYP2D6 enzyme in human biofluids using an LC‐high‐resolution mass spectrometry‐based metabolomic approach.Experimental ApproachPlasma and urine samples from healthy volunteers were analysed before and after intake of a daily dose of paroxetine 20 mg over 7 days. CYP2D6 genotyping and phenotyping, using single oral dose of dextromethorphan 5 mg, were also performed in all participants.Key ResultsWe report four metabolites of solanidine and two unknown compounds as possible novel CYP2D6 markers. Mean relative intensities of these features were significantly reduced during the inhibition session compared with the control session (n = 37). Semi‐quantitative analysis showed that the largest decrease (−85%) was observed for the ion m/z 432.3108 normalized to solanidine (m/z 398.3417). Mean relative intensities of these ions were significantly higher in the CYP2D6 normal–ultrarapid metabolizer group (n = 37) compared with the poor metabolizer group (n = 6). Solanidine intensity was more than 15 times higher in CYP2D6‐deficient individuals compared with other volunteers.Conclusion and ImplicationsThe applied untargeted metabolomic strategy identified potential novel markers capable of semi‐quantitatively predicting CYP2D6 activity, a promising discovery for personalized medicine.

Short-Term Effects of Forest Therapy on Mood States: A Pilot Study.

Immersion in forest environments was shown to produce beneficial effects to human health, in particular psychophysical relaxation, leading to its growing recognition as a form of integrative medicine. However, limited evidence exists about the statistical significance of the effects and their association with external and environmental variables and personal characteristics. This experimental study aimed to substantiate the very concept of forest therapy by means of the analysis of the significance of its effects on the mood states of anxiety, depression, anger and confusion. Seven forest therapy sessions were performed in remote areas and a control one in an urban park, with participants allowed to attend only one session, resulting in 162 psychological self-assessment questionnaires administered before and after each session. Meteorological comfort, the concentration of volatile organic compounds in the forest atmosphere and environmental coherence were identified as likely important external and environmental variables. Under certain conditions, forest therapy sessions performed in remote sites were shown to outperform the control session, at least for anxiety, anger and confusion. A quantitative analysis of the association of the outcomes with personal sociodemographic characteristics revealed that only sporting habits and age were significantly associated with the outcomes for certain psychological domains.

Mental fatigue correlates with depression of task-related network and augmented DMN activity but spares the reward circuit

Long-lasting and demanding cognitive activity typically leads to mental fatigue (MF). Indirect evidence suggests that MF may be caused by altered motivational processes. Here, we hypothesized that if MF consists in an alteration of motivational states, brain functional changes induced by MF could specifically affect the brain motivation circuit. In order to test this hypothesis, we devised a functional neuroimaging protocol to detect altered brain activity in reward-related brain regions in relation to cognitively induced mental fatigue.Twenty-five healthy participants underwent a FATIGUE and a CONTROL session on different days. In the FATIGUE session, MF was induced by performing a demanding cognitive task (adapted Stroop task) during 90 min, whereas in the CONTROL session, participants were asked to read magazines for the same period of time. We measured the neural consequences of the MF induction during a working memory task (Missing Number task) while modulating extrinsic motivation with block-wise variations in monetary reward. We also tracked participants’ momentary fatigue, anxiety state and intrinsic motivation prior to and following the MF inducement and measurement.Accuracy on the Missing Number Task was lower in the FATIGUE than in the CONTROL condition. Furthermore, subjective MF, but not its behavioral manifestations, was associated with hypoactivity of the task-evoked neural responses. Importantly, activity in regions modulated by reward showed no differences between FATIGUE and CONTROL sessions. In parallel, subjective MF correlated with increased on-task activity and resting-state functional connectivity in the default mode network.These results indicate that subjective mental fatigue is not associated with altered activity in the brain motivation circuit but rather with hypoactivity in task-specific brain regions as well as relative increases of activity and connectivity in the default mode network during and after the task.

Impact of Personal Cooling on Performance, Comfort and Heat Strain of Healthcare Workers in PPE, a Study From West Africa.

Background: Personal protective equipment (PPE) is an essential component of safely treating suspected or confirmed SARS-CoV-2 patients. PPE acts as a barrier to heat loss, therefore increasing the risk of thermal strain which may impact on cognitive function. Healthcare workers (HCWs) need to be able to prioritize and execute complex tasks effectively to ensure patient safety. This study evaluated pre-cooling and per-cooling methods on thermal strain, thermal comfort and cognitive function during simulated emergency management of an acutely unwell patient.Methods: This randomized controlled crossover trial was run at the Clinical Services Department of the Medical Research Unit The Gambia. Each participant attended two sessions (Cool and Control) in standard PPE. Cool involved pre-cooling with an ice slurry ingestion and per-cooling by wearing an ice-vest external to PPE.Results: Twelve participants completed both sessions. There was a significant increase in tympanic temperature in Control sessions at both 1 and 2 h in PPE (p = 0.01). No significant increase was seen during Cool. Effect estimate of Cool was −0.2°C (95% CI −0.43; 0.01, p = 0.06) post 1 h and −0.28°C (95% CI −0.57; 0.02, p = 0.06) post 2 h on tympanic temperature. Cool improved thermal comfort (p < 0.001), thermal sensation (p < 0.001), and thirst (p = 0.04). No difference on cognitive function was demonstrated using multilevel modeling.Discussion: Thermal strain in HCWs wearing PPE can be safely reduced using pre- and per-cooling methods external to PPE.

Patients’ and therapists’ actions on the precipice of change: Session processes before sudden gains and sudden losses.

In the present study, sessions prior to sudden gains, sudden losses, and neutral control sessions were examined regarding the processes of change resource activation, problem actuation and therapeutic alliance. With respect to these change processes, we examined whether pregain, preloss, and neutral sessions are distinguishable by particular patterns. For the current project, videos of 30 pregain, 29 preloss, and 30 neutral control sessions from n = 89 patients receiving integrative cognitive–behavioral therapy were rated minute-by-minute using Resource-Oriented Microprocess Analysis. The sample was drawn from a total of N = 365 patients, who had completed treatment or who had attended at least 20 sessions of therapy between the years of 2007 and 2011. Discriminant function and survival analyses as well as a binary logistic regression analysis were performed to identify patterns and timing of change processes associated with session types (gains, losses, and neutral sessions). The three session types differed with regard to patterns of resource activation and problem actuation. No difference concerning therapeutic alliance was found. The findings may help future studies to generate new hypotheses regarding processes that are involved in the occurrence of sudden changes. (PsycInfo Database Record (c) 2020 APA, all rights reserved)