Affective Response to Exercise, Affective Style, Perceived Competence, and Physical Activity Behavior in Adolescents

The present study tests the hypothesis (derived from Competence Motivation Theory (CMT)) that affective response to exercise mediates the link between perceived competence for exercise and Physical Activity (PA). The relationship between affect and PA behavior likely depends on affective style, a trait that determines individuals' affective responsivity to emotion-eliciting stimuli. Therefore, the link between affect and PA was hypothesized to be moderated by affective style. Healthy sixth grade students completed a perceived competence and an affective style (BIS/BAS scale) questionnaire, wore an Actigraph accelerometer to measure MVPA, and performed 30-minute exercise tasks on a cycle ergometer: (a) a moderate-intensity exercise task, and (b) a "feels-good" task during which they were encouraged to maintain an intensity that felt good (30 min). Outcome variables were (a) work rate, heart rate and rating of perceived exertion (RPE) as indicators of exercise intensity during the feels-good task, and (b) MVPA throughout the day and during PE. Affect was measured every three minutes during the moderate exercise task; mean and lowest affect were used in analyses. Partial support for CMT was found. Affect mediated the association between competence and self-selected intensity. Competence was positively associated with MVPA, but affect did not mediate this relationship. The behavioral activation system (BAS) moderated the association between affect and RPE such that the link between affect and RPE was strongly attenuated in individuals with less sensitive BAS. The BAS also moderated the association between affect and MVPA such that individuals with less sensitive BAS had a positive association between affect and MVPA whereas those with more sensitive BAS had a negative association between affect and MVPA. The results suggest that the link between competence, affect, and exercise may be more complex than proposed. Interventions that are tailored to maximize competence may result in greater enjoyment and PA engagement. The differential association of affect and exercise across levels of BAS suggests that further investigation into the dynamics of affective style in relation to exercise may yield personalized approaches to promote PA. Integrating ecological assessment into research may lead to discoveries that will improve personalized interventions for PA promotion

Affective Response to Exercise and Preferred Exercise Intensity among Adolescents

BACKGROUND: Little information exists as to the exercise intensity that adolescents enjoy and whether identifiable subgroups of adolescents will choose higher-intensity exercise. METHODS: Healthy adolescents (N = 74; mean age = 11.09) completed a cardiorespiratory fitness test, a moderate-intensity exercise task, and an exercise task at an intensity that felt “good”. Heart rate (HR), work rate (WR) and ratings of perceived exertion (RPE) were assessed every 3 minutes. RESULTS: During the “feels good” task, adolescents exercised at a HR recognized as beneficial for cardiovascular health (Mean HR = 66-72% of HR at VO(2)peak). Adolescents who experienced a positive affective shift during the moderate-intensity task engaged in higher-intensity exercise during the “feels-good” task as compared to those whose affective response to moderate-intensity exercise was neutral or negative (76% of peak HR vs. 70% of peak HR, p < .01).There was no difference between groups in RPE. CONCLUSIONS: Adolescents tend to select an exercise intensity associated with fitness benefits when afforded the opportunity to choose an intensity that feels good. An identified subgroup engaged in higher-intensity exercise without a commensurate perception of working harder. Encouraging adolescents to exercise at an intensity that feels “good” may increase future exercise without sacrificing fitness

Impact of a personalized versus moderate-intensity exercise prescription: a randomized controlled trial.

Effective approaches to promote adolescent physical activity are needed. Moreover, a one-size-fits-all approach has been minimally successful to date. This randomized controlled trial evaluates a theory-based personalized exercise prescription to enhance motivation for being active and physical activity participation among adolescent reluctant exercisers. Adolescents were characterized by affective style as reluctant (predisposed to negative affect during exercise) or latent (predisposed to positive affect during exercise) exercisers based on their affective response to an acute exercise task, and then randomly assigned to an exercise prescription of either a personalized or a moderate intensity. Assignment was double-blind. Assessments were pre- and post- the 8-week intervention. Participants were an ethnically diverse group of adolescents (19&nbsp;% non-Latino White) in a public middle-school. The exercise intensity manipulation and assessments took place at the school site during regular Physical Education. Participants were assigned to either a moderate-intensity exercise prescription [target heart rate (HR) range 60-80&nbsp;% of HR max] or a personalized exercise prescription corresponding to an intensity that "feels good" to the individual for 8&nbsp;weeks during daily Physical Education. Outcome measures included exercise-related intrinsic motivation (via questionnaire), and daily moderate-to-vigorous physical activity (MVPA; via accelerometer). The exercise intensity manipulation did not yield actual differences in exercise intensity during PE, and had no effect on either Intrinsic Motivation or MVPA. There was no significant interaction between affective style and group assignment in predicting Intrinsic Motivation or MVPA. This study did not find support for a link between affective experiences during exercise and physical activity participation. Providing adolescents with a personalized exercise intensity prescription and asking them to follow the prescription during PE was not an effective strategy to manipulate their affective experience of exercise. A more rigorous test of affective manipulation may require supervised exercise sessions during which exercise intensity can be directly observed and controlled

Understanding disparities in lipid management among patients with type 2 diabetes: gender differences in medication nonadherence after treatment intensification.

BackgroundGender differences in dyslipidemia are widely documented, but the contributors to these differences are not well understood. This study examines whether differences in quality of care, intensity of lipid-lowering medication regimen, and medication adherence can explain this disparity.MethodsSecondary analysis of medical records data and questionnaires collected from adult patients with type 2 diabetes (n&nbsp;=&nbsp;1,369) from seven outpatient clinics affiliated with an academic medical center as part of the Reducing Racial Disparities in Diabetes: Coached Care (R2D2C2) study. Primary outcome was low-density lipoprotein (LDL) cholesterol.FindingsWomen had higher LDL cholesterol levels than men (mean [SD], 101.2 [35.2] vs. 92.3 [33.0] mg/dL; p&nbsp;&lt;&nbsp;.001), but were no less likely to receive recommended processes of diabetes care, to attain targets for glycemic control and blood pressure, or to be on intensive medication regimens. More women than men reported medication nonadherence related to cost (32.7% vs. 24.2%; p&nbsp;=&nbsp;.040) and related to side effects (47.2% vs. 36.8%; p&nbsp;=&nbsp;.024). For all patients, regimen intensity (p&nbsp;&lt;&nbsp;.05) and nonadherence related to side effects (p&nbsp;&lt;&nbsp;.01) were each associated with higher LDL cholesterol levels. The addition of a new lipid-lowering agent was associated with subsequent nonadherence related to side effects for women (p&nbsp;&lt;&nbsp;.001), but not for men (p&nbsp;=&nbsp;.45; test for interaction p&nbsp;=&nbsp;.048).ConclusionsDespite comparable quality of diabetes care and regimen intensity for lipid management, women with diabetes experienced poorer lipid control than men. Medication nonadherence seemed to be a major contributor to dyslipidemia, particularly for women because of side effects associated with intensifying the lipid-lowering regimen

Understanding Disparities in Lipid Management Among Patients with Type 2 Diabetes: Gender Differences in Medication Nonadherence after Treatment Intensification

BackgroundGender differences in dyslipidemia are widely documented, but the contributors to these differences are not well understood. This study examines whether differences in quality of care, intensity of lipid-lowering medication regimen, and medication adherence can explain this disparity.MethodsSecondary analysis of medical records data and questionnaires collected from adult patients with type 2 diabetes (n&nbsp;=&nbsp;1,369) from seven outpatient clinics affiliated with an academic medical center as part of the Reducing Racial Disparities in Diabetes: Coached Care (R2D2C2) study. Primary outcome was low-density lipoprotein (LDL) cholesterol.FindingsWomen had higher LDL cholesterol levels than men (mean [SD], 101.2 [35.2] vs. 92.3 [33.0] mg/dL; p&nbsp;&lt;&nbsp;.001), but were no less likely to receive recommended processes of diabetes care, to attain targets for glycemic control and blood pressure, or to be on intensive medication regimens. More women than men reported medication nonadherence related to cost (32.7% vs. 24.2%; p&nbsp;=&nbsp;.040) and related to side effects (47.2% vs. 36.8%; p&nbsp;=&nbsp;.024). For all patients, regimen intensity (p&nbsp;&lt;&nbsp;.05) and nonadherence related to side effects (p&nbsp;&lt;&nbsp;.01) were each associated with higher LDL cholesterol levels. The addition of a new lipid-lowering agent was associated with subsequent nonadherence related to side effects for women (p&nbsp;&lt;&nbsp;.001), but not for men (p&nbsp;=&nbsp;.45; test for interaction p&nbsp;=&nbsp;.048).ConclusionsDespite comparable quality of diabetes care and regimen intensity for lipid management, women with diabetes experienced poorer lipid control than men. Medication nonadherence seemed to be a major contributor to dyslipidemia, particularly for women because of side effects associated with intensifying the lipid-lowering regimen

Prospective evaluation of point-of-care ultrasound for pre-procedure identification of landmarks versus traditional palpation for lumbar puncture.

BackgroundThe objective of this study is to determine if point-of-care ultrasound (POCUS) pre-procedure identification of landmarks can decrease failure rate, reduce procedural time, and decrease the number of needle redirections and reinsertions when performing a lumbar puncture (LP).MethodsThis was a prospective, randomized controlled trial comparing POCUS pre-procedure identification of landmarks versus traditional palpation for LP in a cohort of patients in the emergency department and intensive care unit.ResultsA total of 158 patients were enrolled. No significant difference was found in time to completion, needle re-direction, or needle re-insertion when using POCUS when compared to the traditional method of palpation.ConclusionConsistent with findings of previous studies, our data indicate that there was no observed benefit of using POCUS to identify pre-procedure landmarks when performing an LP

Prospective evaluation of point-of-care ultrasound for pre-procedure identification of landmarks versus traditional palpation for lumbar puncture

BACKGROUND: The objective of this study is to determine if point-of-care ultrasound (POCUS) pre-procedure identification of landmarks can decrease failure rate, reduce procedural time, and decrease the number of needle redirections and reinsertions when performing a lumbar puncture (LP). METHODS: This was a prospective, randomized controlled trial comparing POCUS pre-procedure identification of landmarks versus traditional palpation for LP in a cohort of patients in the emergency department and intensive care unit. RESULTS: A total of 158 patients were enrolled. No significant difference was found in time to completion, needle re-direction, or needle re-insertion when using POCUS when compared to the traditional method of palpation. CONCLUSION: Consistent with findings of previous studies, our data indicate that there was no observed benefit of using POCUS to identify pre-procedure landmarks when performing an LP

Prospective evaluation of point-of-care ultrasound for pre-procedure identification of landmarks versus traditional palpation for lumbar puncture.

BackgroundThe objective of this study is to determine if point-of-care ultrasound (POCUS) pre-procedure identification of landmarks can decrease failure rate, reduce procedural time, and decrease the number of needle redirections and reinsertions when performing a lumbar puncture (LP).MethodsThis was a prospective, randomized controlled trial comparing POCUS pre-procedure identification of landmarks versus traditional palpation for LP in a cohort of patients in the emergency department and intensive care unit.ResultsA total of 158 patients were enrolled. No significant difference was found in time to completion, needle re-direction, or needle re-insertion when using POCUS when compared to the traditional method of palpation.ConclusionConsistent with findings of previous studies, our data indicate that there was no observed benefit of using POCUS to identify pre-procedure landmarks when performing an LP

Plexus 2010

Editors-in-Chief:&nbsp; Virginia Liu, Nupoor NarulaMarketing and Outreach:&nbsp; Philip Ngai, Ann ShueSelection: Justin Tilan, Connie Lin, David ChengCreative Writing: Nupoor Narula, Tommy Hand, Coutham GanesanVisual Arts: Philip Ngai, Sue WangAudio: Matt Fradkin, Micheal StoneLayout and Design: Chase Warren, Stephanie LeSponsors: SOM Dean’s Office, Office of Educational Affairs, Office of AdmissionsSpecial ThanksFaculty Advisor:&nbsp; Dr. Johanna Shapiro, Dr. Ellena PetersonPast Plexus Editors:&nbsp; Rod Mortazavi, Charitha Reddy, Maheen Hassan, Neera SodhiPublished works were contributed by UCI School of Medicine students, physicians, faculty, staff, alumni, and patients.&nbsp; © 2010 Plexu