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Psychosocial factors related to physical activity and weight loss in overweight women.

PURPOSE: This study examined whether psychosocial factors related to physical activity in overweight, previously sedentary women were affected by a 6-month behavioral weight loss program. In addition, these psychosocial factors were examined across levels of weight loss and self-reported physical activity in response to a weight loss intervention. METHODS: Data from 165 overweight (body mass index (BMI) = 32.7 +/- 4.2 kg.m(-2)) women (age = 37.6 +/- 5.5 yr) who participated in a comprehensive behavioral weight loss program that included behavioral education, moderate caloric restriction, and progressive home-based exercise were examined. Body weight was assessed at 0 and 6 months. Perceived benefits and barriers, physical activity self-efficacy, and physical activity processes of change were assessed at 0 and 6 months. Physical activity (minutes per week of at least moderate-intensity activity) was assessed using the 7-Day Physical Activity Recall at 0 and 6 months. RESULTS: The intervention resulted in increases in physical activity self-efficacy, behavioral processes of change, and several cognitive processes of change(P < 0.05). There was a reduction in expected barriers for physical activity (P < 0.05). Individuals with > or = 10% weight loss reported higher levels of physical activity self-efficacy, greater use of behavioral strategies to elicit social support, and fewer barriers to physical activity than those with lower levels of physical activity and less weight loss (P < 0.05). Individuals reporting higher levels of exercise also reported higher levels of physical activity self-efficacy, greater use of behavioral strategies, and fewer barriers to physical activity than those individuals with lower levels of physical activity (P < 0.05). CONCLUSION: Targeting self-efficacy, behavioral strategies, and barriers in weight management programs may improve physical activity, which may result in improved weight loss in overweight adults.

Adult↗

Physical contact experience and depression.

Out of a consideration of the relevance of interpersonal physical contact to mental health is developed the hypothesis that unsatisfactory physical contact experience predisposes to depression. This hypothesis is then systematically explored using self-ratings of depression and physical contact (and love) experience obtained on admission and at discharge from 254 unselected psychiatric in-patients. Following the demonstration of a strong association between unsatisfactory physical contact experience and depression a significant relationship is also found between depression and the experience of being not loved. These two relationships are shown to exist independently of one another and when direction of causation is investigated both unsatisfactory physical contact experience and the experience of being not loved are seen to be causal of depression rather than vice versa. Unsatisfactory physical contact experience, however, clearly has the greater utility as an indicator of depression-proneness. Different categories and different kinds of physical contact experience are explored, first in relation to depression generally and then to each of the three major forms of depressive illness. Considered too is the patterning of physical contact experience and love experience for each of these latter. The results suggest that depression generally tends to be more closely linked with stable than unstable unsatisfactory physical contact experience and with present rather than childhood such experience. In addition endogenous depression is seen to be characterised by an absence of any physical contact experience in the present, while manic-depressive psychosis combines unsatisfactory physical contact experience with the experience of being loved and shows a relative lack of exclusively bad physical contact experience in childhood. Reactive depression, however, emerges with no distinguishing features of this kind. There follows an examination of the relationships between unsatisfactory physical contact experience and those psychiatric conditions other than depression represented in the subject sample. This raises the possibility that unsatisfactory physical contact experience could also be closely linked with schizophreniform disorder and adjustment disorder. Finally it is suggested that, above all, physical contact experience may be a major determinant of the capacity to cope with stress. Unsatisfactory such experience might then be predisposing to a wide range of psychiatric disorders, with depression seen as a commonly occurring symptom of inadequate coping.

Adaptation, Psychological↗

Continuous-scale physical functional performance in healthy older adults: a validation study.

OBJECTIVE: The continuous-scale physical functional performance test (CS-PFP) is an original instrument designed to provide a comprehensive, in-depth measure of physical function that reflects abilities in several separate physical domains. It is based on a concept of physical function as the integration of physiological capacity, physical performance, and psychosocial factors. SETTING: The test was administered under standard conditions in a hospital facility with a neighborhood setting. The CS-PFP consists of a battery of 15 everyday tasks, ranging from easy to demanding, that sample the physical domains of upper and lower body strength, upper body flexibility, balance and coordination, and endurance. Participants are told to work safely but at maximal effort, and physical functional performance was measured as weight, time, or distance. Scores were standardized and scaled 0 to 12. The test yields a total score and separate physical domain scores. DESIGN: The CS-PFP was evaluated using 148 older adults-78 community dwellers, 31 long-term care facility residents living independently, and 39 residents with some dependence. MAIN OUTCOME MEASURES: Maximal physical performance assessment included measures of maximal oxygen consumption (VO2max), isokinetic strength, range of motion, gait, and balance. Psychosocial factors were measured as self-defined health status using the Sickness Impact Profile (SIP), self-perceived function using the Health Survey (SF36), and Instrumental Activities of Daily Living (IADL). RESULTS: IADL scores were not significantly different among the groups. Test-retest correlations ranged from .84 to .97 and inter-rater reliability from .92 to .99 for the CS-PFP total and 5 domains. Internal consistency was high (Cronbach's alpha, .74 to .97). Both total and individual domain CS-PFP scores were significantly different for the three groups of study participants, increasing with higher levels of independence, supporting construct validity. CS-PFP domain scores were significantly correlated with measures of maximal physical performance (VO2max, strength, etc) and with physical but not emotional aspects of self-perceived function. CONCLUSION: The CS-PFP is a valid, reliable measure of physical function, applicable to a wide range of functional levels, and having minimal floor and ceiling effect. The total and physical domains may be used to evaluate, discriminate, and predict physical functional performance for both research and clinical purposes.

Activities of Daily Living↗

The meaning of "physical fitness".

The understanding of the term "physical fitness" was determined for a randomly selected sample (n = 94) of a population using a self-administered mailed questionnaire. Subjects were asked to state and give a reason for their perceived level of physical fitness, to state their perceived performance level in a number of physical fitness tests (muscular strength, daily physical work capacity, fatness, level of regular physical exercise, exercise speed, and body flexibility), and to rate how well these tests measure physical fitness. The reason most frequently stated for perceived level of physical fitness was the level of habitual physical activity (43%); significantly less frequently (P less than 0.01-0.0001) cited were reasons related to health (23%), physical performance (12%), and obesity (3%). The variation in perceived level of physical fitness was best explained by the variation in imagined regular exercise and fatness (r2 = 0.66, P less than 0.0001) with no significant additional contribution from imagined performance in remaining fitness tests. The measurement of regular exercise was most favored as a test of physical fitness. These results, taken together with evidence of the physical and psychological health benefits of regular exercise, imply that the most appropriate measure of physical fitness for the average person is an assessment of the habitual physical activity level.

Attitude to Health↗

The importance of the social environment for physically active lifestyle--results from an international study.

Physically active lifestyles are regularly associated with improved health and quality of life. Differences in lifestyles in society can partly be understood through the differences in the social and physical environment. This study examines the relationships between reported physical activity, and the extent of perceived support for physical activity in the physical and policy environment (e.g. facilities, programmes and other opportunities), and in the social environment. The data for the study come from a cross-cultural health policy study called MAREPS. In total, 3342 adults, 18 years or older, from six countries (Belgium, Finland, Germany, The Netherlands, Spain, Switzerland) were interviewed via telephone. Respondents were categorised as active or inactive according to self-reported physical activity. Social environmental factors and physical and policy environmental factors were also assessed. The analysis of the data was informed by social cognitive theory, although the study was not originally designed for this purpose. Sixty-eight percent of females and 70% of males were active. The proportions of active and inactive varied by countries to a great extent. The strongest independent predictor of being physically active was social environment. Those who perceived low social support from their personal environment (i.e. family, friends, school and workplace) were more than twice as likely to be sedentary compared to those who reported high social support from their personal environment. Specific knowledge of the programmes and actions for physical activity and sport was also a strong predictor of being active. A supportive physical and policy environment was not associated with participation in physical activity as strongly as had been anticipated. The variation between countries was stronger predictor of being active than the physical and policy environment variables. This study generates the hypotheses and raises the questions that in a preliminary way, there appears to be some relationships between aspects of physical and social environment and physical activity participation. However, future research is needed to refine and clarify this.

Adolescent↗

Physical activity, body weight, and adiposity: an epidemiologic perspective.

Overweight is a common problem in the United States, especially among minority women and persons of lower socioeconomic status and lower educational attainment. Moreover, the prevalence of reported inactivity may be highest in these same population subgroups. Both overweight and sedentary behavior are important risk factors for chronic disease morbidity and mortality; however, there is encouraging evidence that moderate to higher levels of physical activity may provide protection from certain chronic diseases, even among persons with established risk factors. Several methodological issues preclude the ability to determine accurately the impact of physical activity on body weight and adiposity. These issues include (a) a low prevalence of higher-intensity physical activity in the general population, (b) measurement error with regard to self-reported activity, especially that of lower-intensity, (c) inappropriate time frame of the physical activity assessment, (d) effect modification by age and gender, and (e) failure to adjust for important statistical confounders. Despite these methodological issues, the inverse association between physical activity and weight has been reported in several cross-sectional epidemiologic studies, which consistently report lower body weight, or more favorable distribution of body fat, with higher categorical levels of self-reported physical activity. Directionality of the physical activity and weight relation cannot be determined from these studies, however, and the few longitudinal epidemiologic studies that have assessed the influence of physical activity on the risk of weight gain report inconclusive results. This is possibly because a one-time assessment of physical activity if not adequate in describing the contribution of habitual physical activity on long-term weight maintenance. Therefore, longitudinal population-based studies with multiple assessments of physical activity over long follow-up periods are necessary to determine this relationship. In any case, the evidence suggests that persons concerned with overweight, or especially the prevention of overweight and obesity, should increase their physical activity. Sociodemographic characteristics such as age, gender, educational level, and weight are associated with physical activity patterns and choices. Therefore, these characteristics should be considered by professionals when implementing physical activity interventions for weight control. Walking is accessible to all segments of the U.S. population. Because walking is convenient, low cost, and safe, and can result in weight loss if done regularly for durations of at least 20-30 min, its relative merits should be stressed in weight reduction and maintenance programs. Furthermore, to reduce the morbidity and mortality associated with overweight, obesity, and sedentary behavior, priority for intervention programs should be directed at persons in the most vulnerable sectors of the population.

Adipose Tissue↗

The promotion of physical activity in the United States population: the status of programs in medical, worksite, community, and school settings.

While the medical care encounter is considered an ideal situation in which patients are encouraged to increase their physical activity levels, very little research has been conducted in this setting. In fact, with the exception of the physical activity components of cardiac rehabilitation programs, few formal physical activity programs are available in medical care settings. Although the workplace is currently the focus of the greatest interest by those persons who implement physical activity programs, there is little precision in defining what constitutes a worksite physical activity program. A number of researchers and authors, using program experience rather than empirical findings, have described what they believe to be the important components of successful worksites health promotion and physical education programs. The greatest variety of physical activity programs are found in community settings. They are offered by a number of nonprofit private organizations, nonprofit public agencies, and for-profit organizations. While relatively little research has been done concerning changes in the community environment, it is clear that such changes can effect community participation. Community campaigns to increase physical activity have been studied, and it appears that they clearly affect residents' interest and awareness in physical activity, but they do not have a major effect on behavioral changes in the short term. It appears that a major opportunity to influence favorable physical activity in the United States is being missed in schools. A large majority of students are enrolled in physical education classes, but the classes appear to have little effect on the current physical fitness levels of children and, furthermore, have little impact on developing life-long physical activity skills.

Adolescent↗

Antidepressants for depression in people with physical illness.

OBJECTIVES: To determine whether antidepressants are clinically effective and acceptable for the treatment of depression in people who also have a physical illness. SEARCH STRATEGY: Medline, Cochrane Library Trials Register and Cochrane Depression and Neurosis Group Trials Register were all systematically searched, supplemented by hand searches of two journals and reference searching. SELECTION CRITERIA: All relevant randomised trials comparing any antidepressant drug (as defined in the British National Formulary) with placebo or no treatment, in patients of either sex over 16, who have been diagnosed as depressed by any criterion, and have a specified physical disorder (for example cancer, myocardial infarction). "Functional" disorders where there is no generally agreed physical pathology (e.g. irritable bowel syndrome) were excluded. The main outcome measures are numbers of individuals who recover/improve at the end of the trial and, as a proxy for treatment acceptability, numbers who complete treatment. DATA COLLECTION AND ANALYSIS: Data was extracted independently by the reviewers onto data collection forms and differences settled by discussion. MAIN RESULTS: 18 studies were included, covering 838 patients with a range of physical diseases (cancer 2, diabetes 1, head injury 1, heart 1, HIV 5, lung 1, multiple sclerosis 1, renal 1, stroke 3, mixed 2). Depression was diagnosed clinically in 3 studies, otherwise by structured interview or checklist. Only 5 studies described how they performed randomisation. 1 study compared drug with no treatment, and the rest with placebo: all of the latter said they were double blind. 6 studies used SSRIs, 3 atypical antidepressants, and the remainder tricyclics. Patients treated with antidepressants were significantly more likely to improve than those given placebo (13 studies, OR 0.37, 95% CI 0.27-0.51) or no treatment (1 study, OR 3.45, 95% CI 11.1-1.10). About 4 patients would need to be treated with antidepressants to produce one recovery from depression which would not have occurred had they been given placebo (NNT 4.2, 95% CI 3.2-6.4). Most antidepressants (tricyclics and SSRIs together, 15 trials ) produced a small but significant increase in dropout (OR 1.66, 95% CI 1.14-2.40. NNH 9.8, 95% CI 5.4-42.9). The "atypical" antidepressant mianserinproduced significantly less dropout than placebo. Only 2 studies used numerical scales designed to measure effects on function and quality of life; in HIV (Karnofsky scale), drug was better than no treatment; in lung disease (Sickness Impact Profile), drug was not significantly different from placebo. Only 7 studies reported looking for changes in the physical disease. Antidepressants produced no change in immune function in HIV relative to placebo (2 studies) or no treatment (1 study). Relative to placebo, antidepressants produced no change in cardiovascular function in heart disease, in respiratory function in lung disease, or in vital signs or laboratory tests in cancer (1 study each). Nortriptyline produced worse control in diabetes. Trends towards tricyclics being more effective than SSRIs, but also more likely to produce dropout were noted, but these are based on non-randomised comparisons between trials. REVIEWER'S CONCLUSIONS: The review provides evidence that antidepressants, significantly more frequently than either placebo or no treatment, cause improvement in depression in patients with a wide range of physical diseases. About 4 patients would need to be treated with antidepressants to produce one recovery from depression which would not have occurred had they been given placebo (NNT 4.2, 95% CI 3.2-6.4). Antidepressants seem reasonably acceptable to patients, in that about 10 patients would need to be treated with antidepressants to produce one dropout from treatment which would not have occurred had they been given placebo (NNH 9.8, 95% CI 5.4-42.9). (ABSTRACT TRUNCATED)

Antidepressive Agents↗

Impact of the interaction of depression and physical illness on a psychiatric unit's length of stay.

Prior literature suggests that length of stay (LOS) on medical inpatient units is increased by the coexistence of depression and physical illness. The present study examined 532 psychiatric inpatient admissions to determine if physical illness increased LOS for patients grouped by diagnostic categories of psychosis, depression, personality disorder, anxiety disorder, adjustment disorder, bipolar disorder (not depressed), and other psychiatric disorders. LOS for depressed patients was significantly longer for those with any physical final diagnosis (mean = 20.08 days) than for depressed patients with no physical diagnosis (mean = 11.48 days). LOS was also longer for all patients with physical diagnoses (mean = 19.31 days) than all patients with no physical diagnosis (mean = 13.13 days). No other specific diagnostic group (psychosis, personality disorder, and so forth) showed significant differences in LOS for any associated physical illness vs no physical illness. The study results tend to indicate that physical illness is associated with increased LOS for depressed psychiatric patients but not for other specific diagnostic groups. Depressed patients may 1) mask physical illness by depression-generated physical complaints; 2) prioritize mood symptoms over physical symptoms; and/or 3) may suffer from feelings of hopelessness or be pessimistic that their physical symptoms will be effectively treated and, therefore, not report their physical symptoms.

Adult↗

The role of physical activity in the prevention and management of obesity.

The United States is facing 2 major lifestyle-related epidemics that are intricately linked: an epidemic of obesity and an epidemic of inactivity. Multiple interactions exist between lack of physical activity and obesity. Increased physical activity lowers the risk of obesity, may favorably influence distribution of body weight, and confers a variety of health-related benefits even in the absence of weight loss. Physical activity is important for achieving proper energy balance, which is needed to prevent or reverse obesity. Not only is energy expended during physical activity, physical activity also has a positive effect on resting metabolic rate. Regular physical activity can improve body composition. Properly designed programs of physical activity may preserve or even increase lean muscle mass during weight loss. Physical activity has also been strongly associated with maintenance of weight loss. Physical activity that expends 1,500 to 2,000 kcal/week appears necessary to maintain weight loss. Numerous studies have shown that the combination of proper nutrition and regular physical activity is the most effective intervention for weight loss and maintenance of weight loss. Walking is the most convenient and logical way most obese persons can increase their physical activity. Physical activity plays multiple roles in the prevention and treatment of obesity. Dietitians and other health care workers who treat obese patients should understand the role physical activity plays in comprehensive obesity treatment as well as how to incorporate a physical activity prescription in treatment plans for obese clients.

Adolescent↗

The validity of self-reported leisure time physical activity, and its relationship to serum cholesterol, blood pressure and body mass index. A population based study of 332,182 men and women aged 40-42 years.

The importance of leisure time physical activity as a health indicator became more obvious after the results of large prospective studies were published. The validity of these results depends upon both the selection of the active individuals and to what extent self-reported physical activity reflects the individual's true activity. The purpose of this paper is to describe the changes in self-reported physical activity, and to assess the relation between this variable and other biological risk factors such as blood lipids, blood pressure and body mass index (BMI). This report also aims at corroborating the validity of self-reported physical activity by assessing the consistency of the associations between these biological risk factors and physical activity during a 25-years period. The basis for this analysis is a long lasting observational study with a questionnaire as the most important research instrument, in addition to physiological and biological factors such as BMI, blood pressure and blood lipids. The study population consists of 332,182 individuals, aged 40-42 from different counties in Norway who were invited to participate in health survey during 1974-1999. The objectives of this study are (1) to describe changes in self-reported physical activity from 1974 to 1999; (2) to assess the relation between physical activity and the biological variables; and (3) to corroborate the validity of the variable physical activity by assessing the consistency of the above analysis. The results of the analyses of association between decade of birth and self-reported physical activity show that physical activity among 40-aged individuals decreased during 1974-1999. This trend is stronger among the men. Multivariate analyses revealed differences in BMI and serum cholesterol between levels of self-reported physical activity, gender, smoking habits and decade of birth. The explained percentage of the total variance ranged from 6% for BMI to 7% for serum cholesterol. The similar shape of serum cholesterol and BMI according to physical activity indicates that the validity of self-reported physical activity has remained stable over these 25 years. Furthermore, the analysis of covariance showed that the slopes relating year of birth and serum cholesterol and BMI are parallel for self-reported physical activity thus the validity of the variable is confirmed.

Adult↗

Cardiovascular health and physical activity in older adults: an integrative review of research methodology and results.

UNLABELLED: PURPOSE OF THE PAPER: The purpose of this article is to review the literature on physical activity and its relationship to cardiovascular risk factors and mortality in older adults, in an effort to clarify the specific benefits and optimal level of physical activity for cardiovascular health in the older adult population. BACKGROUND/RATIONALE: Despite physical activity being recognized as an important factor in the quality of life of older adults, there is a lack of clarity about the optimal level of physical activity that results in positive cardiovascular health benefits. DESIGN/METHODS: An integrative review of the literature using the MEDLINE and CINAHL databases from 1990 through August 2000 was conducted identifying articles related to physical activity and cardiac risk factors, cardiovascular health, or mortality in the older adult. RESULTS/FINDINGS: Forty-four research articles were reviewed. The intervention studies generally provided support for positive cardiovascular changes with exercise, but the results were inconsistent, sample sizes were small, and the outcomes, interventions, and measures of physical activity differed between studies. There was wide variation in the method of measurement of physical activity in the studies. Studies showed an increase in mortality in those who had a sedentary lifestyle compared to those who were more physically active. Results were mixed related to plasma lipids levels. Three studies showed a positive effect of physical activity on blood pressure (BP), while three studies showed no relationship. Each of the studies that evaluated the relationship between physical activity and pulse rate showed a decreased rate with increased physical activity. CONCLUSIONS: The quantity and type of physical activity that should be recommended to bring about positive effects on cardiovascular health and mortality is unclear. There is support, however, that an active lifestyle decreases mortality. There is conflicting evidence to support positive effects of physical activity on cardiac risk factors. Further research is needed with larger sample sizes, better control of extraneous variables, and using measurements of physical activity that have undergone adequate psychometric testing.

Aged↗

Physical activity patterns in heart transplant women.

Maintaining regular, long-term physical activity is critical to achieve favorable effects of heart transplantation. Yet, at present, little is known about the physical activity patterns of transplant recipients, especially women. The study was conducted to (1) describe levels and types of physical activity using actigraphy and self-report, (2) determine the association between physical activity and sociodemographic variables, and (3) assess the relationship between physical activity, quality of life (QOL), and relevant health indicators (hypertension, hyperlipidemia, and obesity) among female heart transplant recipients. Twenty-seven women (average age, 57 +/- 13 years, primarily Caucasian [82%], retired [89%], married [67%], average time since transplant 2.1 +/- 1.3 years) from a single heart transplant facility were asked to report amount and types of physical activity and overall QOL and wear an actigraph for 1 week to measure physical activity level. Physical activity levels by actigraphy averaged 280,320 +/- 52,416 counts for the week (range, 206,784-354,144); self-reported physical activity level on a 0 to 10 scale was 4.3 +/- 0.37 (range, 0-7). The actigraph and self-reported measures were significantly correlated (r = 0.661, P = .000). It was found that women were more likely to engage in household tasks and family activities than occupational activities or sports. Significant differences in physical activity (F = 6.319, P = .006) were observed in participants who reported fair (n = 13), good (n = 9), and very good (n = 5) overall QOL. The only demographic factor associated with physical activity was age; younger women were more active than older women (r = -0.472, P = .013). A negative correlation was found between levels of physical activity and presence of hypertension, hyperlipidemia, and obesity. It was found that a majority of female transplant recipients remains sedentary. Given the association between physical activity and overall QOL and relevant health indicators, measures to enhance physical activity need to be developed and tested; these strategies may be beneficial in improving overall outcomes.

Activities of Daily Living↗

Physical activity and related factors among nursing home residents.

OBJECTIVE: The purpose of this study was to examine physical activity and the predictors of physical activity and exercise among nursing home residents. DESIGN: Population study. PARTICIPANTS: The sample (n = 190) was obtained by selecting every man and every second women from the entire nursing home population (n = 346) in the city of Jyväskylä, central Finland, in autumn 1989. Information was eventually collected by interview from 158 persons (49 men and 109 women). SETTING: An in-home interview carried out among nursing home populations. MEASUREMENTS: Independent variables were the questions describing physical activity among nursing home populations. Dependent variables were the predictors of physical activity: depression, contentment with nursing home living, activities outside the nursing home, and self-rated functioning. MAIN RESULTS: Walking and home gymnastics were the most common forms of physical exercise. The intensity of overall exercise was rather low, and the men carried out physical exercise more intensively than the women. More than 30% of the respondents reported decreased physical activity during their stay in the nursing home. However, attitudes toward physical exercise among the residents were largely positive. The primary factor limiting physical exercise was poor health status. Among the men, physical exercise was significantly associated with self-rated functioning, depressive symptoms, and contentment with life in the nursing home. Among the women, higher contentment with the nursing home and less depression were associated with a physically active life. CONCLUSIONS: The results suggest that living conditions and factors related to health and functional capacity affect the level of physical activity among nursing home residents. In order to encourage this population to be physically active, attention should be paid not only to physical exercise but also to associated factors, such as satisfaction with everyday life and health.

Activities of Daily Living↗

Minor physical anomalies in schizophrenic patients and their siblings.

OBJECTIVE: The aim of this study was to assess the frequency and type of minor physical anomalies in schizophrenic patients and their normal siblings. METHOD: Sixty adult patients with schizophrenia, 21 siblings of these patients, and 75 normal comparison subjects were assessed through use of an extended scale consisting of the Waldrop scale and 23 other minor physical anomalies. RESULTS: Patients had significantly more minor physical anomalies than comparison subjects in all body areas tested and also more minor physical anomalies in total than their siblings. Hand, eye, and mouth minor physical anomalies best discriminated patients from comparison subjects. Siblings had significantly more minor physical anomalies than normal comparison subjects. Sixty percent of the patients and 38% of the siblings, but only 5% of the comparison subjects, had a higher rate of minor physical anomalies (i.e., six or more). With the exception of ear minor physical anomalies, no association was found between minor physical anomalies in the patient and sibling in the same family. CONCLUSIONS: Higher levels of minor physical anomalies (especially in the eye, mouth, and hand/foot regions) characterize both schizophrenic patients and their normal siblings, but there is little similarity in these anomalies between patients and siblings in the same family. Thus, one or more genetic or shared environmental factors may increase the risk for development of both minor physical anomalies and schizophrenia in these families at large. Minor physical anomalies associated with schizophrenia are frequently found in, but are clearly not limited to, the head or facial region. The Waldrop scale identifies minor physical anomalies strongly associated with schizophrenia. Nevertheless, assessment of the new items clearly indicates that many additional minor physical anomalies are found in schizophrenic patients.

Adult↗

Physical activity is related to quality of life in older adults.

BACKGROUND: Physical activity is associated with health-related quality of life (HRQL) in clinical populations, but less is known whether this relationship exists in older men and women who are healthy. Thus, this study determined if physical activity was related to HRQL in apparently healthy, older subjects. METHODS: Measures were obtained from 112 male and female volunteers (70 +/- 8 years, mean +/- SD) recruited from media advertisements and flyers around the Norman, Oklahoma area. Data was collected using a medical history questionnaire, HRQL from the Medical Outcomes Survey short form-36 questionnaire, and physical activity level from the Johnson Space Center physical activity scale. Subjects were separated into either a higher physically active group (n = 62) or a lower physically active group (n = 50) according to the physical activity scale. RESULTS: The HRQL scores in all eight domains were significantly higher (p < 0.05) in the group reporting higher physical activity. Additionally, the more active group had fewer females (44% vs. 72%, p = 0.033), and lower prevalence of hypertension (39% vs. 60%, p = 0.041) than the low active group. After adjusting for gender and hypertension, the more active group had higher values in the following five HRQL domains: physical function (82 +/- 20 vs. 68 +/- 21, p = 0.029), role-physical (83 +/- 34 vs. 61 +/- 36, p = 0.022), bodily pain (83 +/- 22 vs. 66 +/- 23, p = 0.001), vitality (74 +/- 15 vs. 59 +/- 16, p = 0.001), and social functioning (92 +/- 18 vs. 83 +/- 19, p = 0.040). General health, role-emotional, and mental health were not significantly different (p > 0.05) between the two groups. CONCLUSION: Healthy older adults who regularly participated in physical activity of at least moderate intensity for more than one hour per week had higher HRQL measures in both physical and mental domains than those who were less physically active. Therefore, incorporating more physical activity into the lifestyles of sedentary or slightly active older individuals may improve their HRQL.

Age Factors↗

Social support, physical activity and sedentary behavior among 6th-grade girls: a cross-sectional study.

BACKGROUND: Despite the importance of social support in promoting physical activity, little is known about the relative influence of the type or source of social support on adolescent girls' physical activity and sedentary behaviors. This study examined the associations of two types of social support (social participation in and social encouragement for physical activity) and two social support sources (family and friends) with self-reported daily minutes of physical activity and sedentary behavior among sixth-grade girls in Texas. METHODS: A secondary analysis of 718 sixth-grade girls between the ages of 10 to 14 was performed using cross-sectional baseline data from an osteoporosis prevention intervention study. Physical activity and sedentary behaviors (television-video viewing and computer-video game playing) were assessed using 3 administrations of the Self-Administered Physical Activity Checklist; social support indicators were assessed with Likert-type items from a psychosocial questionnaire. RESULTS: In multiple linear regression analyses, friend physical activity participation (partial correlation coefficient (r) = 0.10, p = .009) and friend (r = 0.12) and family encouragement (r = 0.11) (p < .01, respectively) were positively related to moderate-to-vigorous physical activity in the full model with other support variables, BMI and ethnicity; friend encouragement was the only variable positively related to vigorous physical activity (r = 0.11, p = .005). Family participation in physical activity had the strongest negative correlation with total minutes of television-video viewing and computer-video playing (r = -0.08, p < .05). CONCLUSION: Findings lend support to the importance of social support for physical activity among adolescent girls but suggest that the source and type of social support may differ for physical activity and sedentary behaviors. Further research is needed to assess the causal or reciprocal relation between the roles of friends and family in promoting physical activity and of family physical activity in decreasing sedentary behaviors among early adolescent girls.

Journal Article↗

A review of physical activity patterns in pregnant women and their relationship to psychological health.

Regular physical activity contributes positively to physical and psychological health. Adverse consequences of inactivity may be an especially important problem among pregnant women. Up to 60% are inactive during pregnancy. This review found consistent evidence that physical activity is reduced during pregnancy; however, few investigators have sought to quantify physical activity patterns among pregnant women using well validated measures. Some of the barriers to physical activity during pregnancy, such as depression, anxiety and fatigue, have been shown to be attenuated by regular exercise performed by non-pregnant samples. There is a need to better understand the relationships between these factors and physical activity during pregnancy. Available retrospective and prospective results suggest that both leisure time and work-related physical activities are decreased across pregnancy. Intensity and duration decrease both during pregnancy compared with pre-pregnancy and in the third trimester compared with the first. There is a need for well designed longitudinal investigations that document pregnancy-related changes in physical activity at frequent intervals during pregnancy using validated and more precise measures of physical activity. Reductions in physical activity and a worsening mood are common during pregnancy. If the relationship between physical inactivity and mood disturbances is indeed observed and maintained during pregnancy, then decreases in physical activity in the third trimester would be expected to result in a worsening mood. In recent years, increased attention has been paid to antenatal mood disturbances, and this research has yielded a host of important findings. Prior correlational and experimental research with non-pregnant samples has demonstrated a consistent relationship between physical inactivity and mood disturbances. Whether this relationship occurs among pregnant women and/or is maintained as women progress during pregnancy is uncertain. Prior investigations have revealed that there is higher rate of mood disturbance during pregnancy than following pregnancy but little is known about the mechanisms that cause these mood disturbances. It is important to better understand changes in mood with pregnancy because mood disturbances can have major negative consequences for a pregnant woman. The major adverse consequences of depression among pregnant women are largely the same as those of non-pregnant individuals. Only six investigations have quantified the relationship between changes in physical activity and changes in mood during pregnancy. The available evidence suggests that inactivity is associated with worse mood. Additional research into this topic is warranted due to the limited number of published papers and the design and methodology limitations of these investigations.

Affect↗