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PubMed1982

Scanning laser ophthalmoscopy. Clinical applications.

The scanning laser ophthalmoscope (SLO) provides a high-quality television image of the retina using less than 1/1000 of the light required for conventional indirect ophthalmoscopy. The SLO employs a new ophthalmoscopic principle in which a dim laser beam scans across the fundus, and light is collected only from one retinal point at a time. Since the instrument is highly light efficient, illumination levels are comfortable for the patient, and fluorescein angiography can be performed with one tenth of the usual fluorescein dose. Since a continuous, large depth of field view is displayed on the SLO screen and stored on video tape, repeated dynamic inspection of the vitreous, retina and vitreoretinal interface is afforded. In addition, any graphical material that can be displayed on a microcomputer monitor (such as text of video games) can also be impressed on the retinal pattern formed by the sweeping laser beam. The graphical material is thus observed directly by the patient and on the patient's retina by the clinician. Since the exact retinal locus of each point in the graphical material is viewed directly, it is possible to perform perimetry directly on the retina, to measure acuity at arbitrary retinal loci, to study how patients with macular disease use residual functional retina for reading, and to perform distortometry with a retinal (Amsler-type) grid.

Fluorescein Angiography↗
PubMed2001

Cardiovascular (CV) responsivity and recovery to acute stress and future CV functioning in youth with family histories of CV disease: a 4-year longitudinal study.

Blood pressure (BP) and heart rate (HR) data obtained during supine rest, in response to and recovery from four laboratory stressors in a baseline year were used to predict supine resting BP and HR values obtained during each of four consecutive annual follow-up evaluations. Subjects were 385 normotensive youth [95 African American (AA) males, 106 AA females, 92 European American (EA) males, 92 EA females] (mean age 12.7+/-2.6 at baseline year) with a positive family history of cardiovascular disease (CVD). During the baseline evaluation subjects were presented with four laboratory stressors (namely, postural change, video game challenge, social competence interview, and parent--child conflict discussion). The BP and HR values taken during each of the laboratory stressors and during the post stressor recovery periods were converted to z-scores which were averaged to yield aggregate measures for systolic and diastolic BP and HR responsivity and recovery. The data obtained during the baseline evaluation were subsequently used to predict the follow-up values of supine resting BP and HR. The prediction models were fairly consistent across each of the 4 follow-up years. Responsivity or recovery accounted for up to 6% of the total variance after accounting for baseline values. Within the prediction models responsivity or recovery accounted for 4--56% of the variance. The predictive value of the derived models did not decline from one annual evaluation to the next over the length of the study. CV recovery may supplement resting and responsivity in the prediction of future development of CVD

Adolescent↗
PubMed1999

Effects of race, sex, and socioeconomic status upon cardiovascular stress responsivity and recovery in youth.

Cardiovascular (CV) responsivity to and recovery from acute laboratory stressors, as derived from aggregate scores of CV functioning during and after postural change, video game challenge, social competence interview, and parent-child conflict discussion, were evaluated in 272 youths [mean age 13.5 +/- 2.6 years; 162 Blacks (77 males, 85 females), 110 Whites (60 males, 50 females)], all with a positive family history of essential hypertension. Blacks demonstrated greater systolic and diastolic blood pressure (SBP, DBP) and lower heart rate responsivity compared to Whites (all P values < 0.05). A race by neighborhood socioeconomic status (SES) interaction for SBP responsivity was also observed where low SES Whites and high SES Blacks had the greatest responsivity compared to their same race cohorts. Additionally, upper SES Whites had the lowest total peripheral resistance responsivity. For recovery, Blacks and males exhibited higher SBP during recovery compared to Whites and females, respectively. These findings extend previous studies and provide further support for the hypothesis that recovery from stress is a potentially informative component of the contribution of stress responsivity to cardiovascular disease.

Adolescent↗
PubMed2002

The effectiveness of interventions to increase physical activity. A systematic review.

The Guide to Community Preventive Service's methods for systematic reviews were used to evaluate the effectiveness of various approaches to increasing physical activity: informational, behavioral and social, and environmental and policy approaches. Changes in physical activity behavior and aerobic capacity were used to assess effectiveness. Two informational interventions ("point-of-decision" prompts to encourage stair use and community-wide campaigns) were effective, as were three behavioral and social interventions (school-based physical education, social support in community settings, and individually-adapted health behavior change) and one environmental and policy intervention (creation of or enhanced access to places for physical activity combined with informational outreach activities). Additional information about applicability, other effects, and barriers to implementation are provided for these interventions. Evidence is insufficient to assess a number of interventions: classroom-based health education focused on information provision, and family-based social support (because of inconsistent findings); mass media campaigns and college-based health education and physical education (because of an insufficient number of studies); and classroom-based health education focused on reducing television viewing and video game playing (because of insufficient evidence of an increase in physical activity). These recommendations should serve the needs of researchers, planners, and other public health decision makers.

Evidence-Based Medicine↗
PubMed1999

Correlates of objectively measured physical activity in preadolescent youth.

OBJECTIVE: The purpose of this study was to identify the psychosocial and environmental correlates of objectively measured physical activity behavior in a diverse sample of sixth-grade students. DESIGN: Cross-sectional. PARTICIPANTS AND SETTINGS: One hundred ninety-eight sixth-grade students from 4 public middle schools in Columbia, South Carolina. The study group was 52.0% female, 55.1% African-American, with a mean age of 11.4 +/- 0.6 years. MAIN OUTCOME MEASURES: Time spent in moderate physical activity (MPA) and vigorous physical activity (VPA) was assessed using a uniaxial accelerometer (CSA WAM 7164) (Computer Science and Applications Inc., Shalimar, FL). Determinant variables included: age, gender, race/ethnicity (demographic); physical activity self-efficacy, social norms related to physical activity, and beliefs regarding physical activity outcomes (psychosocial); and perceived physical activity habits of parents and peers, involvement in community physical activity organizations, involvement in community-based sports programs, access to fitness/sporting equipment at home, and self-reported hours spent watching television or playing video games (environmental). RESULTS: For boys, physical activity self-efficacy, social norms related to physical activity, and involvement in community physical activity organizations were salient predictors of MPA and VPA. Among girls, only physical activity self-efficacy emerged as a clear predictor of objectively measured physical activity. CONCLUSIONS: These findings are consistent with previous studies using self-reported physical activity and suggest that interventions to increase physical activity in preadolescent youth should endeavor to boost physical activity self-efficacy by offering a wide selection of enjoyable, developmentally-appropriate physical activity options.

Child↗
PubMed1997

Active vision therapy for pseudophakic amblyopia.

PURPOSE: To study the benefit of active vision therapy using various pleoptic methods in pseudophakic amblyopic children and young adults. SETTING: Daljit Singh Eye Hospital, Amritsar, India. METHODS: This study comprised 160 consecutive pseudophakic amblyopic patients who had had iris-claw lens implantation for congenital or traumatic cataract. Their ages ranged from 3.5 to 25.0 years. Before active vision treatment, visual acuity was worse than 20/200 in 63 patients (39.3%), 20/200 in 77 (48.1%), 20/120 to 20/80 in 14 (8.7%), and 20/60 in 6 (3.7%). The methods included Haidinger brushes on the synoptophore, after images, CAM stimulator, drawings on the cheiroscope, Pigeon-Cantonnet stereoscope, video games with the amblyopic eye, and exercises for promoting eye-hand coordination. Mean duration of therapy was 6 months. RESULTS: After therapy, visual acuity was worse than 20/200 in 31 patients (19.4%), 20/200 in 38 (23.7%), 20/120 to 20/80 in 41 (25.6%), 20/60 to 20/40 in 36 (22.5%), and 20/20 in 14 (8.7%). In 20 patients (12.5%), all younger than 15 years, visual acuity decreased within 1 month after treatment stopped. However, vision was rapidly restored after another session of active vision therapy. CONCLUSIONS: Active vision therapy helped improve visual acuity in the majority of young pseudophakic amblyopes.

Adolescent↗
PubMedDate not supplied

Neurobehavioral test performance in the third National Health and Nutrition Examination Survey.

The third National Health and Nutrition Examination Survey (NHANES III) contained three computerized neurobehavioral tests from the Neurobehavioral Evaluation System (NES): simple reaction time, symbol-digit substitution and serial digit learning. The neurobehavioral data that were collected came from a nationally representative sample of adults 20-59 years old. Performance on the tests was related to sex, age, education level, family income and race-ethnicity. Performance decreased as age increased, and increased as education level and family income increased. Differences in performance between sexes, levels of education and racial-ethnic groups tended to decrease as family income increased. The relationship between age and performance on the symbol-digit substitution test varied by education level and by racial-ethnic group. The relationship between age and performance on the serial digit learning test varied by racial-ethnic group. Questionnaire variables that were related to performance on one or more of the tests included the reported amount of last night's sleep, energy level, computer or video game familiarity, alcoholic beverages within the last 3 h and effort. Persons who took the tests in English or Spanish performed differently on the symbol-digit substitution and serial digit learning tests. Performance on all the tests decreased as test room temperature increased.

Adult↗
PubMed2002

Relation of self-rated measures of physical activity to multiple risk factors of insulin resistance syndrome in young adults: the Bogalusa Heart Study.

The relation of self-rated measures of physical activity to multiple risk factors of insulin resistance syndrome (IRS) was examined in African American (n = 409) and white (n = 1,011) young adults aged 20 to 38 years enrolled in the Bogalusa Heart Study. Physical activity was assessed in terms of work activity, leisure-time activity, television watching, and video game playing by a questionnaire. Waist circumference, blood pressure, total to high-density lipoprotein cholesterol ratio, and insulin resistance index showed a consistent inverse trend with leisure-time activity (P < 0.01) and a positive trend with hours of inactivity (P < 0.01) after adjusting for age, race, and sex. An inverse relationship was seen between leisure-time activity and mean number of risk factors (>75th percentile for age, race, and sex) (P < 0.001), whereas a positive relationship was seen with hours of inactivity (P < 0.001). Moderately to very active individuals versus inactive individuals had a reduced relative risk of having > or =3 risk factors (P < 0.05); conversely, excess hours of inactivity increased the relative risk (P < 0.05). Thus, leisure-time activity and hours of inactivity are important predictors of multiple cardiovascular risk variables of IRS in young adults.

Abdomen↗
PubMed2002

Impaired stress-induced pressure natriuresis increases cardiovascularload in African American youths.

BACKGROUND: We hypothesized that impaired stress-induced pressure natriuresis increases blood pressure (BP) load. METHODS: The 118 African American youths were brought into similar levels of sodium balance. The protocol consisted of a 2-h baseline period, a 1-h stress period (competitive video games), and a 2-h recovery period. RESULTS: Normal pressure natriuresis (n = 80) resulted from a resistance-mediated (r = 0.23; P <.03) increase in BP (P <.001). In contrast, impaired pressure natriuresis (n = 38), leading to an extended period of elevated BP (P <.05), resulted from a volume-mediated (r = 0.55; P <.002) increase in BP (P <.001). CONCLUSIONS: Impaired stress-induced pressure natriuresis may contribute to the development of essential hypertension, particularly in African Americans.

Adolescent↗
PubMed2003

Apathy in schizophrenia: clinical correlates and association with functional outcome.

Apathy is considered one of the negative symptoms of schizophrenia, but its natural history and relationship to other clinical characteristics have not been systematically studied. The purpose of this cross-sectional study was to measure the level of apathy in schizophrenia and its relation to other symptoms and functional outcome. Twenty-eight patients with schizophrenia, and receiving antipsychotic treatment, were assessed with the Apathy Evaluation Scale (AES). The mean level of apathy of patients with schizophrenia, as rated by the AES, was significantly higher than that of matched healthy control subjects. In the patients, apathy was not significantly correlated with positive symptoms or depressive symptoms. It was significantly correlated with the item "emotional withdrawal" on the negative subscale of the Positive and Negative Syndrome Scale (PANSS), but was not correlated with the overall negative subscale score. Apathy was more highly associated with functional outcome than were other symptom measures, and it was independently associated with functional outcome above and beyond other negative symptoms. It was not associated with observed interest in playing a video game or performance on a simulated clerical task.

Activities of Daily Living↗
PubMed2000

Neurophysiological and behavioral indices of time pressure effects on visuomotor task performance.

Using a video game format, this study examined the effects of time pressure (TP) on behavioral and electrocortical indices. The behavioral results were consistent with previous time pressure research in that TP reduced time to perform a task and increases behavioral errors. In addition, electroencephalogram (EEG) measures showed distinctive patterns associated with TP in the theta, mu, and gamma bands along the midline. Site specific changes in the success vs. failure trials were also seen in midline theta at Fz, gamma at Fz, and mu at Cz. Right parietal alpha also differentiated TP and success vs. failure trials. In specific TP (1) increased frontal midline theta activity and (2) increased gamma at midline (frontal, central, and partietal) and in right frontal areas. The results of these findings are discussed in terms of the formation of specific neurocognitive strategies as evidenced by the topographic distribution of task-related modulation of the EEG within certain frequency bands. It is suggested that the effect of TP on visuomotor performance is mediated by adopting either task-relevant or task-irrelevant neurocognitive strategies as evidenced by successful or failed trials, respectively. Whether these strategies are formulated prior to performance or appear spontaneously during task performance remains unclear and is awaiting further experimentation.

Adult↗
PubMed2001

"If you do not gamble, check this box": perceptions of gambling behaviors.

Most adults in the U.S. have participated in one or more gambling activities. However, many people engage in gambling activities without considering themselves as gamblers. Four hundred and forty-nine university students returned surveys about their participation in gambling activities. After completing a questionnaire recording the style and frequency of gambling participated in, respondents were asked to indicate whether or not they gambled. Results indicated that gamblers participated in twice as many forms of gambling activities as those who classified themselves as non-gamblers. Scratch tickets and lottery tickets were not generally considered gambling unless purchased frequently. Casino visits, bingo, dog races, football pools, golf matches, local poker games, and other card games were more likely to be viewed as gambling, especially when engaged in frequently. Subjects who had gambled on at least one occasion with bookies, dice games, video poker in a bar, dog or cock fights, or off track betting almost always identified themselves as gamblers. It is recommended that further research be conducted to clarify the gambling activities, and frequency of those activities, that influence a person's perceptions of gambling.

Adolescent↗
PubMed1999

How young children spend their time: television and other activities.

Time-use diaries were collected over a 3-year period for 2 cohorts of 2- and 4-year-old children. TV viewing declined with age. Time spent in reading and educational activities increased with age on weekdays but declined on weekends. Time-use patterns were sex-stereotyped, and sex differences increased with age. As individuals' time in educational activities, social interaction, and video games increased, their time watching entertainment TV declined, but time spent playing covaried positively with entertainment TV. Educational TV viewing was not related to time spent in non-TV activities. Maternal education and home environment quality predicted frequent viewing of educational TV programs and infrequent viewing of entertainment TV. The results do not support a simple displacement hypothesis; the relations of TV viewing to other activities depend on the program content, the nature of the competing activity, and the environmental context.

Activities of Daily Living↗
PubMed1985

Effects of load stressors, cognitive complexity and type A coronary prone behavior on visual-motor task performance.

In two separate experiments, 25 and 42 adult working males participated in a visual-motor task modeled on a video game. The game was designed to permit measurement of strategy, risk taking, errors committed, and overall task performance. Predictions of complexity theory for task performance were supported. In the second experiment, participants were divided into four subgroups on the basis of Type A versus Type B coronary-prone behavior (measured on the structured interview) and on the basis of unidimensional versus multidimensional responding (measured by a complexity interview with stems of the sentence completion test). Type A coronary-prone behavior did not contribute to differences in visual-motor performance. More multidimensional persons exceeded their unidimensional counterparts, especially in the application of strategy. The extension of complexity theory approaches to simpler tasks is discussed. It is noted that the frequently voiced assumptions of Type A individuals-that their behavior style tends to lead to higher performance levels-is not supported.

Adult↗
PubMed1990

Aerobic fitness, psychological characteristics, and cardiovascular reactivity to stress.

Examined the relations among aerobic fitness (AF), psychological characteristics, and cardiovascular reactivity using 62 men divided into highly fit and less fit groups based on a maximal treadmill exercise test. Several psychological and physiological variables were measured, and subjects' cardiovascular reactivity was assessed during a mental arithmetic task and during a video game task. Highly fit subjects showed a significantly smaller increase in both diastolic blood pressure (DBP) and heart rate (HR) and reported themselves to be less anxious and less angry than less fit subjects. Furthermore, controlling for subjects' scores on a scale assessing angry temperament reduced the relationship between AF and DBP reactivity to nonsignificant levels. These results suggest that degree of dispositional anger, which covaries with increased fitness, may contribute to the apparent relationship between AF and DBP--but not HR--reactivity.

Adaptation, Psychological↗
PubMed1997

Motivation, sustained attention, and autonomic regulation in school-age boys exposed in utero to opiates and alcohol.

The effects of incentive on sustained attention and autonomic regulation among boys exposed in utero to opiates were studied. Respiratory sinus arrhythmia (RSA), an indicator of autonomic regulation, was quantified during sustained attention in 3 groups of 7- to 12-year-old boys. RSA is a component of heart rate variability controlled by cortical influences and affected by changes in demand for attention. The Gordon Diagnostic System-Distractibility Task was performed with and without monetary reward. A cartoon task and a video game were used as measures of interest. Although opiate-exposed boys did not differ in performance as a function of incentive or interest, they had a tendency to perform more poorly overall across tasks. Alcohol exposure rather than opiate exposure covaried with autonomic regulation, with greater RSA decreases being associated with more alcohol exposure. Post hoc analyses revealed that the alcohol- and opiate-exposed boys responded with these hyperreactive RSA changes along with poorer performance.

Adult↗
PubMed2003

Frontolimbic response to negative feedback in clinical depression.

Functional neuroimaging suggests that limbic regions of the medial frontal cortex may be abnormally active in individuals with depression. These regions, including the anterior cingulate cortex, are engaged in both action regulation, such as monitoring errors and conflict, and affect regulation, such as responding to pain. The authors examined whether clinically depressed subjects would show abnormal sensitivity of frontolimbic networks as they evaluated negative feedback. Depressed subjects and matched control subjects performed a video game in the laboratory as a 256-channel EEG was recorded. Speed of performance on each trial was graded with a feedback signal of A, C, or F. By 350 ms after the feedback signal, depressed subjects showed a larger medial frontal negativity for all feedback compared with control subjects with a particularly striking response to the F grade. This response was strongest for moderately depressed subjects and was attenuated for subjects who were more severely depressed. Localization analyses suggested that negative feedback engaged sources in the anterior cingulate and insular cortices. These results suggest that moderate depression may sensitize limbic networks to respond strongly to aversive events.

Adult↗
PubMed2001

Knowledge structures and the acquisition of a complex skill.

The purpose of this study was to examine the viability of knowledge structures as an operationalization of learning in the context of a task that required a high degree of skill. Over the course of 3 days, 86 men participated in 9 training sessions and learned a complex video game. At the end of acquisition, participants' knowledge structures were assessed. After a 4-day nonpractice interval, trainees completed tests of skill retention and skill transfer. Findings indicated that the similarity of trainees' knowledge structures to an expert structure was correlated with skill acquisition and was predictive of skill retention and skill transfer. However, the magnitude of these effects was dependent on the method used to derive the expert referent structure. Moreover, knowledge structures mediated the relationship between general cognitive ability and skill-based performance.

Adolescent↗