Investigating the autonomic nervous system and cognitive functions as potential mediators of an association between cardiovascular disease and driving performance

Abstract: Cardiovascular disease (CVD) impacts the autonomic nervous system and cognitive functions related to activities of daily living, including driving an automobile. Although CVD has been linked to unsafe driving, mechanisms underlying this relationship remain elusive. The aim of this study was to examine the role of cognitive functions and the autonomic nervous system as potential mediators of driving performance. Nineteen individuals having recently suffered a cardiac event and sixteen individuals with no history of CVD completed a simulated drive using a STISIM simulator to assess driving performance. Heart rate was recorded throughout testing using a Polar RS800CX heart rate monitor and measures of executive, orienting and alerting functions were obtained through the Attention Network Test. We used the Baron and Kenny analysis method to assess potential mediating effects of the relationship between CVD and driving performance. Executive function was the only potential mediator investigated to be associated with driving (p < 0.01) and CVD (p < 0.05), however, it did not appear to play a mediating role (p = 0.28). These results suggest that individuals with CVD exhibit decrements in complex cognitive tasks such as driving and that further research is needed to better understand the mechanisms underlying this relationship

Convergent validity and inter-rater reliability of a lower-limb multimodal physical function assessment in community-dwelling older adults

Introduction: Lower-limb physical function declines with age and contributes to a greater difficulty in performing activities of daily living. Existing assessments of lower-limb function assess one dimension of movement in isolation or are not time-efficient, which discourages their use in community and clinical settings. We aimed to address these limitations by assessing the inter-rater reliability and convergent validity of a new multimodal functional lower-limb assessment (FLA).Methods: FLA consists of five major functional movement tasks (rising from a chair, walking gait, stair ascending/descending, obstacle avoidance, and descending to a chair) performed consecutively. A total of 48 community-dwelling older adults (32 female participants; age: 71 ± 6 years) completed the FLA as well as timed up-and-go, 30-s sit-to-stand, and 6-min walk tests.Results: Slower FLA time was correlated with a slower timed up-and-go test (ρ = 0.70), less sit-to-stand repetitions (ρ = −0.65), and a shorter distance in the 6-min walk test (ρ = −0.69; all, p &lt; 0.001). Assessments by two raters were not different (12.28 ± 3.86 s versus 12.29 ± 3.83 s, p = 0.98; inter-rater reliability ρ = 0.993, p &lt; 0.001) and were statistically equivalent (via equivalence testing). Multiple regression and relative weights analyses demonstrated that FLA times were most predicted by the timed up-and-go performance [adjusted R2 = 0.75; p &lt; 0.001; raw weight 0.42 (95% CI: 0.27, 0.53)].Discussion: Our findings document the high inter-rater reliability and moderate-strong convergent validity of the FLA. These findings warrant further investigation into the predictive validity of the FLA for its use as an assessment of lower-limb physical function among community-dwelling older adults

Physical activity mediates the relationship between outdoor time and mental health

Both spending time outdoors and participating in physical activity improve mental health. Given that the outdoor environment provides an ideal location for physical activity, better understanding of the relationships among time spent outdoors, physical activity and positive mental health is needed to help guide interventions. The aim was to examine if physical activity moderates or mediates the relationship between outdoor time and positive mental health. Two-hundred-forty-two participants (15 ± 1 years old, 59% girls) from New Brunswick, Canada were included in the current analysis. Youth self-reported time spent outdoors and moderate-to-vigorous physical activity (MVPA) three times between October 2016 and June 2017. Data on their mental health were collected in October 2017. Values of outdoor time and MVPA were averaged across the three time points to represent the exposure and mediator variables, respectively. Mental health, dichotomized as flourishing/not flourishing, was the outcome in the mediation analysis. An interaction term tested if the mediation effect depended on outdoor time. Analyses were undertaken in 2019 using the mediation package in R. In univariate analyses, both MVPA (p < 0.001) and outdoor time (p = 0.05) were positive predictors of flourishing mental health. In mediation analyses, a small indirect mediation (OR: 1.02, 95% CI: 1.01–1.04) and no direct (1.00, 0.98–1.05) effect were noted, suggesting that MVPA mediates the effect of outdoor time on positive mental health. This effect did not vary as a function of outdoor time (interaction: 1.00, 0.99–1.01). Physical activity mediates the relationship between outdoor time and positive mental health. Outdoor time could promote positive mental health among youth through increases in physical activity

Relationship between eating behaviors and physical activity of preschoolers and their peers: a systematic review

Abstract: Objectives: Children learn by observing and imitating others, meaning that their eating behaviors and physical activity may be influenced by their peers. This paper systematically reviews how preschoolers’ eating behaviors and physical activity relate to their peers’ behaviors, and discusses avenues for future research. Methods: Six databases were searched for quantitative, peer-reviewed studies published up to July 2015 reporting on the correlates, predictors or effectiveness of peers on eating behaviors and physical activity in preschoolers. Risk of bias was independently assessed by two evaluators using the Quality Assessment Tool for Quantitative Studies. Results: Thirteen articles were included: six measured physical activity, and seven assessed eating behaviors. Four of the six physical activity studies reported that children were more active when peers were present, while large peer group size was negatively associated with physical activity in two cross-sectional studies. All nutrition interventions reported that children’s eating behaviors may be influenced by their peers. Conclusions: Although supported by weak evidence, peers appear to influence children’s eating behaviors and physical activity. However, this influence may be moderated by the number of peers, gender, age and the perceived status of the role models. Future obesity prevention interventions should consider involving peers as agents for positive eating behaviors and physical activity in preschoolers

Induction of Selective Blood-Tumor Barrier Permeability and Macromolecular Transport by a Biostable Kinin B1 Receptor Agonist in a Glioma Rat Model

Treatment of malignant glioma with chemotherapy is limited mostly because of delivery impediment related to the blood-brain tumor barrier (BTB). B1 receptors (B1R), inducible prototypical G-protein coupled receptors (GPCR) can regulate permeability of vessels including possibly that of brain tumors. Here, we determine the extent of BTB permeability induced by the natural and synthetic peptide B1R agonists, LysdesArg9BK (LDBK) and SarLys[dPhe8]desArg9BK (NG29), in syngeneic F98 glioma-implanted Fischer rats. Ten days after tumor inoculation, we detected the presence of B1R on tumor cells and associated vasculature. NG29 infusion increased brain distribution volume and uptake profiles of paramagnetic probes (Magnevist and Gadomer) at tumoral sites (T1-weighted imaging). These effects were blocked by B1R antagonist and non-selective cyclooxygenase inhibitors, but not by B2R antagonist and non-selective nitric oxide synthase inhibitors. Consistent with MRI data, systemic co-administration of NG29 improved brain tumor delivery of Carboplatin chemotherapy (ICP-Mass spectrometry). We also detected elevated B1R expression in clinical samples of high-grade glioma. Our results documented a novel GPCR-signaling mechanism for promoting transient BTB disruption, involving activation of B1R and ensuing production of COX metabolites. They also underlined the potential value of synthetic biostable B1R agonists as selective BTB modulators for local delivery of different sized-therapeutics at (peri)tumoral sites

Number of years of participation in some, but not all, types of physical activity during adolescence predicts level of physical activity in adulthood: Results from a 13-year study

Abstract: Background: Adolescent physical activity (PA) levels track into adulthood. However it is not known if type of PA participated in during adolescence is associated with PA levels later in life. We aimed to identify natural groupings of types of PA and to assess whether number of years participating in these different groupings during adolescence is related to PA level in early adulthood. Methods: 673 adolescents in Montreal, Canada, age 12–13 years at baseline (54 % female), reported participation in 29 physical activities every 3 months over 5 years (1999–2005). They also reported their PA level at age 24 years (2011–12). PA groupings among the 29 physical activities were identified using factor analysis. The association between number of years participating in each grouping during adolescence and PA level at age 24 was estimated using linear regression within a general estimating equation framework. Results: Three PA groupings were identified: “sports”, “fitness and dance”, and “running”. There was a positive linear relationship between number of years participating in sports and running in adolescence and PA level at age 24 years (β (95 % confidence interval) = 0.09 (0.04-0.15); 0.08 (0.01-0.15), respectively). There was no relationship between fitness and dance in adolescence and PA level at age 24. Conclusions: The association between PA participation in adolescence and PA levels in young adulthood may be specific to certain PA types and to consistency of participation during adolescence. Results suggest that efforts to establish the habit of participation in sports and running in adolescence may promote higher PA levels in adulthood

Factors that could explain the increasing prevalence of type 2 diabetes among adults in a Canadian province: a critical review and analysis

Abstract: Background: The prevalence of diabetes has increased since the last decade in New Brunswick. Identifying factors contributing to the increase in diabetes prevalence will help inform an action plan to manage the condition. The objective was to describe factors that could explain the increasing prevalence of type 2 diabetes in New Brunswick since 2001. Methods: A critical literature review was conducted to identify factors potentially responsible for an increase in prevalence of diabetes. Data from various sources were obtained to draw a repeated cross-sectional (2001–2014) description of these factors concurrently with changes in the prevalence of type 2 diabetes in New Brunswick. Linear regressions, Poisson regressions and Cochran Armitage analysis were used to describe relationships between these factors and time. Results: Factors identified in the review were summarized in five categories: individual-level risk factors, environmental risk factors, evolution of the disease, detection effect and global changes. The prevalence of type 2 diabetes has increased by 120% between 2001 and 2014. The prevalence of obesity, hypertension, prediabetes, alcohol consumption, immigration and urbanization increased during the study period and the consumption of fruits and vegetables decreased which could represent potential factors of the increasing prevalence of type 2 diabetes. Physical activity, smoking, socioeconomic status and education did not present trends that could explain the increasing prevalence of type 2 diabetes. During the study period, the mortality rate and the conversion rate from prediabetes to diabetes decreased and the incidence rate increased. Suggestion of a detection effect was also present as the number of people tested increased while the HbA1c and the age at detection decreased. Period and birth cohort effect were also noted through a rise in the prevalence of type 2 diabetes across all age groups, but greater increases were observed among the younger cohorts. Conclusions: This study presents a comprehensive overview of factors potentially responsible for population level changes in prevalence of type 2 diabetes. Recent increases in type 2 diabetes in New Brunswick may be attributable to a combination of some individual-level and environmental risk factors, the detection effect, the evolution of the disease and global changes

The prospective and concurrent effect of exercise on health related quality of life in older adults over a 3 year period

Abstract Background It is not clear whether socioeconomic status influences health outcomes among older adults through its effect on physical activity. The aim of this study was to assess the effect of sex and neighborhood socio-economic status on the change in health related quality of life (HR-QOL) as a function of physical activity over a three-year period. Methods This cohort study included French-speaking community-dwelling older adults recruited in primary care practices in the province of Quebec and participating in the ‘Étude sur la Santé des Ainés’ (ESA)-Services study on the health of the elderly. Primary care practices were recruited through participating general practitioners (GPs) working full-time in the health administrative region. A stratified sample was comprised of various types of primary care practices (family medicine group, local community health services centers, primary care practices with less than 3 GPs, and with at least 3 GPs). In this study sample, 967 participants with scores ≥26 on the Mini Mental State Examination (MMSE) were included and followed for 3 years to study HR-QOL as a function of reported exercise at baseline and follow-up, controlling for study variables. Analyses were also carried out to study the effect of change in reported exercise at follow-up with respect to baseline and categorised as follows: no change, decrease in exercise and increase in exercise. The interaction terms area of residence socio-economic status*exercise and sex*exercise, were tested. Results Exercise at baseline did not significantly predict HR-QOL at follow-up when adjusting for all other study variables. Exercise at follow-up was cross-sectionally associated with follow-up HR-QOL. Participants reporting never exercising and those reporting a decrease in exercise reported a lower HR-QOL at follow-up, when controlling for all other study variables. There was no interaction between exercise and sex and socioeconomic status. Conclusions For healthy ageing, maintaining and increasing physical activity throughout the years is necessary for improved HR-QOL. Past physical activity does not confer protection against future decline of HR-QOL. Future research should focus on potential moderating and mediating psycho-social barriers associated with exercising in older age populations