The therapeutic potential of exercise to improve mood, cognition, and sleep in Parkinson's disease

Published in final edited form as: Mov Disord. 2016 January ; 31(1): 23–38. doi:10.1002/mds.26484.In addition to the classic motor symptoms, Parkinson's disease (PD) is associated with a variety of nonmotor symptoms that significantly reduce quality of life, even in the early stages of the disease. There is an urgent need to develop evidence‐based treatments for these symptoms, which include mood disturbances, cognitive dysfunction, and sleep disruption. We focus here on exercise interventions, which have been used to improve mood, cognition, and sleep in healthy older adults and clinical populations, but to date have primarily targeted motor symptoms in PD. We synthesize the existing literature on the benefits of aerobic exercise and strength training on mood, sleep, and cognition as demonstrated in healthy older adults and adults with PD, and suggest that these types of exercise offer a feasible and promising adjunct treatment for mood, cognition, and sleep difficulties in PD. Across stages of the disease, exercise interventions represent a treatment strategy with the unique ability to improve a range of nonmotor symptoms while also alleviating the classic motor symptoms of the disease. Future research in PD should include nonmotor outcomes in exercise trials with the goal of developing evidence‐based exercise interventions as a safe, broad‐spectrum treatment approach to improve mood, cognition, and sleep for individuals with PD.This work was supported by the National Institute of Mental Health (F31MH102961 to G.O.R.)

Electoral system design: The new international IDEA handbook

The Choice of Electoral System is one of the most important institutional decisions for any democracy. In almost all cases the choice of a particular electoral system has a profound effect on the future political life of the country concerned, and electoral systems, once chosen, often remain fairly constant as political interests solidify around and respond to the incentives presented by them. However, while conscious design has become far more prevalent recently, traditionally it has been rare for electoral systems to be consciously and deliberately selected. Often the choice was essentially accidental, the result of an unusual combination of circumstances, of a passing trend, or of a quirk of history, with the impact of colonialism and the effects of influential neighbours often being especially strong

A test of the CaR-FA-X mechanisms and depression in adolescents

People who have depression have difficulty recalling specific autobiographical information (Sumner, 2011). This is called overgeneral autobiographical memory (OGM) and is associated with the development and persistence of depression. Williams and colleagues (2007) proposed that OGM is maintained by three mechanisms: capture and rumination (CaR), functional avoidance (FA), and impaired executive control (X), and integrated these into the CaR-FA-X model. The aim of this study was to assess OGM and test the CaR-FA-X model in adolescents with low mood. We recruited 29 young people aged 12-17 with elevated symptoms of depression and 29 with minimal symptoms of depression, matched for gender and age. After controlling for IQ, adolescents with elevated depression retrieved fewer specific memories, ruminated more, and had poorer working memory and verbal fluency than adolescents with minimal depression. The groups did not differ on measures of inhibition or functional avoidance. The CaR-FA-X model was therefore partially supported. These results confirm that there is a relationship between low mood and OGM in young people and that OGM may arise as consequence of impaired working memory and verbal fluency and cognitive interference due to rumination

An evaluation of the efficacy of the exercise on referral scheme in Northumberland, UK: association with physical activity and predictors of engagement. A naturalistic observation study

Objectives Exercise on referral schemes (ERS) are widely commissioned in the UK but there is little evidence of their association with physical activity levels. We sought to assess the Northumberland exercise on referral scheme in terms of increased levels of physical activity and identify predictors of engagement. Design A naturalistic observational study. Setting 9 local authority leisure sites in Northumberland. Participants 2233 patients referred from primary and secondary care between July 2009 and September 2010. Intervention A 24-week programme including motivational consultations and supervised exercise sessions for participants. Outcome measures Uptake, 12-week adherence, 24-week completion, changes in Godin Leisure-Time Exercise Questionnaire scores after 24-weeks and attendance levels at supervised exercise sessions during the scheme. Three binary logistic regressions were used to examine demographic and referral factors associated with initial uptake, 12-week adherence and 24-week completion. Results Uptake was 81% (n=1811), 12-week adherence was 53.5% (n=968) and 24-week completion was 42.9% (n=777). Participants who completed significantly increased their self-reported physical activity levels at 24-weeks t (638)=−11.55, p<0.001. Completers attended a mean of 22.87 (12.47 SD) of a target 48 supervised sessions. Increasing age, being female and leisure site were associated with uptake, increasing age, Index of Multiple Deprivation and leisure site were associated with 12-week adherence and Body Mass Index and leisure site were associated with 24-week completion. Each regression significantly increased the prediction accuracy of stage of exit (non-starters vs starters 81.5%, dropouts before 12 weeks vs 12-week adherers 66.9%, and dropouts between 13 and 24 weeks 82.2%). Conclusions Completers of the Northumberland ERS increased physical activity at 24 weeks, although the levels achieved were below the current UK guidelines of 150 min of moderate exercise per week. Leisure site was associated with uptake, adherence and completion

Confessin\u27

Illustration of pairs or squirrels, birds, and caterpillars under and on trees; Photograph of Rudy Valleehttps://scholarsjunction.msstate.edu/cht-sheet-music/9087/thumbnail.jp

Because I\u27m Yours Sincerely

Photograph of man; Illustration of two birds in treehttps://scholarsjunction.msstate.edu/cht-sheet-music/8996/thumbnail.jp

'HeART of Stroke (HoS)', a community-based Arts for Health group intervention to support self-confidence and psychological well-being following a stroke: protocol for a randomised controlled feasibility study

Introduction Over 152 000 people in the UK have strokes annually and a third experience residual disability. Low mood also affects a third of stroke survivors; yet psychological support is poor. While Arts for Health interventions have been shown to improve well-being in people with mild-to-moderate depression post-stroke, their role in helping people regain sense of self, well-being and confidence has yet to be evaluated. The main aim of this study is to explore the feasibility of conducting a pragmatic multicentre randomised controlled trial to assess the effectiveness and cost-effectiveness of an Arts for Health group intervention (‘HeART of Stroke’ (HoS)) for stroke survivors. HoS is a 10-session artist-facilitated group intervention held in the community over 14 weeks. It offers a non-judgemental, supportive environment for people to explore sense of self, potentially enhancing well-being and confidence. Methods and analysis Sixty-four people, up to 2 years post-stroke, recruited via secondary care research staff or community stroke/rehabilitation teams in two UK centres will be randomised to either HoS plus usual care or usual care only. Self-reported outcomes, measured at baseline and approximately 5 months postrandomisation, will include stroke-related, well-being, mood, self-esteem, quality of life and process measures. Analyses will focus on estimating key feasibility parameters (eg, rates of recruitment, retention, intervention attendance). We will develop outcome and resource use data collection methods to inform an effectiveness and cost-effectiveness analysis in the future trial. Interviews, with a sample of participants, will explore the acceptability of the intervention and study processes, as well as experiences of the HoS group. Ethics and dissemination National Health Service (NHS), Research and Development and University ethical approvals have been obtained. Two peer-reviewed journal publications are planned plus one service user led publication. Findings will be disseminated at key national conferences, local stakeholder events and via institutional websites.This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0212-27054)

An isotope dilution model for partitioning of phenylalanine and tyrosine uptake by the liver of lactating dairy cows

An isotope dilution model to describe the partitioning of phenylalanine (PHE) and tyrosine (TYR) in the bovine liver was developed. The model comprises four intracellular and six extracellular pools and various flows connecting these pools and external blood. Conservation of mass principles were applied to generate the fundamental equations describing the behaviour of the system in the steady state. The model was applied to datasets from multi-catheterised dairy cattle during a constant infusion of [1-13C] phenylalanine and [2,3,5,6-2H] tyrosine tracers. Model solutions described the extraction of PHE and TYR from the liver via the portal vein and hepatic artery. In addition, the exchange of free PHE and TYR between extracellular and intracellular pools was explained and the hydroxylation of PHE to TYR was estimated. The model was effective in providing information about the fates of PHE and TYR in the liver and could be used as part of a more complex system describing amino acid metabolism in the whole animal

Applicative Bidirectional Programming with Lenses

A bidirectional transformation is a pair of mappings between source and view data objects, one in each direction. When the view is modified, the source is updated accordingly with respect to some laws. One way to reduce the development and maintenance effort of bidirectional transformations is to have specialized languages in which the resulting programs are bidirectional by construction---giving rise to the paradigm of bidirectional programming. In this paper, we develop a framework for applicative-style and higher-order bidirectional programming, in which we can write bidirectional transformations as unidirectional programs in standard functional languages, opening up access to the bundle of language features previously only available to conventional unidirectional languages. Our framework essentially bridges two very different approaches of bidirectional programming, namely the lens framework and Voigtlander’s semantic bidirectionalization, creating a new programming style that is able to bag benefits from both

Art therapy after stroke: Evidence and a need for further research

This is the post-print version of the final paper published in The Arts in Psychotherapy. The published article is available from the link below. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. Copyright @ 2012 Elsevier B.V.This review presents available evidence regarding the benefits of art therapy and therapeutic arts interventions for stroke survivors. Whilst available evidence is very limited, it suggests that art therapy may address many of the diverse cognitive, emotional and functional needs of people disabled by stroke. Attention, spatial processing, sequencing and planning seem to improve among those who persist with art therapy. Use of the stroke-affected limb may increase. Several studies report improvements in social interaction, and emotional expression. Most published reports offer single case examples, which are idiographic and illuminating. Nonetheless, the brevity of these reports, the reliance on therapist's own accounts, and uncertainties surrounding case selection make generalization of the findings uncertain. There is a pressing need for multi-method research studies. These could use quantitative standardized scales to explore changes in stroke survivors’ physical and emotional functioning, and qualitative enquiry to gain the insights of stroke survivors concerning the art therapy process. Such research designs might help to establish a better recognized role for art therapy within multidisciplinary stroke rehabilitation programs