Comparison of fetal and maternal heart rate measures using electrocardiographic and cardiotocographic methods

PurposeTo determine the reliability at term of: (1) two methods of measuring fetal heart rate (HR), electrocardiographic (ECG, the ‘gold standard’) and cardiotocographic (CTG) and (2) two ECG methods of measuring maternal HR variability over relatively brief periods of time (s–min).MethodsDuring 20 min of rest (N = 39) and during 2 min of auditory stimulation (mother's recorded voice, n = 19), fetal HR data were collected using an ECG (Monica AN24) and a Hewlett-Packard Model 1351A CTG. Simultaneously, maternal HR data (n = 37) were collected using the same ECG device (Monica AN24) and a second stand-alone cardiac monitor (Spacelab 514T cardiac monitor with a QRS detector).ResultsDuring 20 min of maternal rest, correlations of individual fetal CTG with ECG measures of HR at each second were moderate to high (r = .57–.97) for 77% of fetuses. Correlations of HR averaged over fetuses and over each of the 20 min were high (r = .93–.97); fetal HR averaged over 20 min varied between devices from 0.0 to 0.8 bpm. During 2 min of maternal voice presentation, correlations of fetal HR over each second were moderate to high (r = .54–.99) for 95% of fetuses and high (all rs = .99) when averaged across fetuses in 30 s or 2 min epochs. Average fetal HR between devices over the 2 min voice varied from 0.0 to 0.6 bpm. Correlations and/or % agreement between the two ECG methods of measuring maternal HR were high. Average maternal HR over 10 min showed 81% of pairs with a difference of ≤1 bpm; correlations for HR variability measures varied from r = .89 to .97.ConclusionsGood reliability was demonstrated between individual spontaneous and auditory induced fetal CTG and ECG with high correlations when HR data were averaged over fetuses or in 30–120 s epochs. High reliability of maternal HR measures was obtained using two ECG devices.     

“The effects of family-centered physiotherapy on the cognitive and motor performance in premature infants”

ObjectiveThe aim of this study is to investigate the effects of family centered physiotherapy according to the neurodevelopmental treatment (NDT) principles on mental and motor performance in premature infants.MethodsA total of 156 infant, ≥24/36 week + 6 days gestational age included in the study. All the infants were diagnosed by a child neurologist and referred to psychology and physiotherapy department for their neurodevelopmental assessment and treatment. Bayley Scale of Infant II (BSI-II) was used for neurodevelopmental assessment and Alberta Infant Motor Scale (AIMS) was used for assessing their motor performance. Seventy-eight of the infants were in the study group and 76 were recruited as age matched controls according to the classification of their gestational age. Family centered physiotherapy according to the neurodevelopmental treatment principles was used as an intervention and all the mothers are trained accordingly.ResultsCognitive Development Scores and Motor Development Scores of Bayley II were recorded for the 3., 6., 9., and 12 months respectively. Between the 3. and 12. month of gestational age, within-groups measurements in both Cognitive Development Scores (p < 0.001) and Motor Development Scores (p<0.001) were significantly increased. However, the improvements in both Cognitive Development Scores (p = 0.059) and Motor Development Scores (p = 0.334) between the groups was not different.ConclusionFamily centered physiotherapy with NDT principles may not be enough to improve motor and cognitive performance in preterm infants at the first year of age. For supporting the motor and cognitive development of the preterm infants other intervention modalities also should be considered. Keywords: infants; premature; early intervention     

Perceiving red decreases motor performance over time: A pilot study

IntroductionColors may influence motor performance.ObjectiveThe present study aimed to compare the effects of perception of red and green environments on physical (performance and heart rate) and psychological (perceived effort, anxiety and enjoyment) parameters during cycling trials.MethodTen cyclists achieved two identical series of three randomized 7-minute trials on home trainers, during which they were continuously exposed to red, green, and gray environments. Covered distance and heart rate were recorded during each trial, after which participants answered items intended to assess perceived effort, anxiety, and enjoyment experienced during the trial.ResultsResults showed that covered distance (ps ≤ .02) and heart rate (ps ≤ .03) were lower in the red environment than in the gray and green environments. Enjoyment was higher in the green environment than in the red environment (p = .006). The colored environments did not influence perceived effort and anxiety (ps > .05).ConclusionThis study is the first to show that perceiving red is detrimental for motor performance over an extended period of time.     

Is sensory processing an issue for infants with colic?

ObjectivesTo determine the association between sensory functioning, sleep, cry/fuss, and feeding behaviors of infants with colic younger than 4 months of age.MethodsDunn’s Infant/Toddler Sensory Profile™ and a modified Barr Baby Day Diary^© were used to assess 44 breastfed infants with colic under four months of age. Colic was defined according to Wessel’s criteria.ResultsThirty-four of the 44 infants with colic (77%) scored as atypical for sensory processing. Of these, 56% scored atypical for sensory processing on quadrant one (Q1) (Low Registration), with 24%, 65%, and 18% scoring as atypical for sensory processing on Q2 (Sensory seeking), Q3 (Sensory sensitivity), and Q4 (Sensation avoiding), respectively. All infants demonstrating sensation avoiding also scored as Low Threshold. A moderate statistically significant correlation was found between sensation seeking and time spent sleeping (r = 0.31; p = 0.04). No other statistically significant associations between infant behaviors and their sensory functioning were demonstrated. Overall, infants demonstrating atypical sensory responses (in any quadrant) slept significantly more than infants demonstrating typical sensory responses (mean difference = −67.8 min/day; 95% CI = −133.6 to −2.1; p = 0.04).ConclusionVery limited associations between infant behaviors and sensory functioning were demonstrated, suggesting that sensory functioning may not be a significant factor in the multifactorial nature of infant colic. Further well-designed studies using validated tools for infants with colic are required to determine whether associations between infant behaviors and sensory functioning exist.     

The lowering of bilirubin levels in patients with neonatal jaundice using massage therapy: A randomized,double-blind clinical trial

ObjectiveDue to the effects of massage on various laboratory parameters (including those related to jaundice) in infants and the expansion of existing studies to achieve effective and safe therapy in the treatment of neonatal jaundice, this study aimed to investigate the effect of massage on bilirubin levels in cases of neonatal jaundice.MethodsIn this study, 134 patients were randomly assigned to either an intervention group (massage combined with phototherapy, n = 67) or a control group (phototherapy only, n = 67). In both groups, serum total bilirubin level and frequency of daily bowel movements were measured and compared during each of the first four days of treatment.ResultsBaseline levels of bilirubin were similar between the two groups (P > 0.05). During the measurements obtained post-intervention, significant differences surfaces between the two groups in bilirubin levels and frequency of daily bowel movements (P < 0.05 for both). No significant relationship was observed during days 1 and 2 of massage therapy between daily frequency of bowel movements and serum bilirubin level (P > 0.05); this relationship became significant during the third and fourth days (P < 0.05).ConclusionMassage therapy combined with phototherapy is an effective method for reducing serum total bilirubin in infants with neonatal jaundice.     

Correlation between maternal and infant cortisol varies by breastfeeding status

ObjectiveThe objective of this study was to examine associations of mother and infant salivary cortisol, measured three times over the course of a day, and assess whether these varied by breastfeeding status.MethodsWe conducted a cross-sectional study of 54 mothers and their infants aged 4–11 months. Mothers collected their own saliva and that of their infants upon awakening, 30 min after waking and at bedtime. Breastfeeding status was reported by mothers and cortisol level was measured in saliva in μg/dl using standard techniques. We used generalized linear models to evaluate relationships between maternal and infant cortisol levels, and assessed whether the relationship differed by breastfeeding status: formula only compared to partial and full breastfeeding, adjusting for infant sex, race, age, maternal education, and family income.ResultsThirty-four infants received formula only and 20 were either partially or fully breastfed. Breastfeeding was associated with higher household income, higher maternal education, and white race. Cortisol levels were higher among breastfed infants at all three time points. After adjustment, maternal cortisol levels were related with infant cortisol at bedtime only (regression estimate 0.06; 95% CI: 0.10, 1.1; p = 0.02). The adjusted association between bedtime maternal and infant cortisol was stronger among breastfeeding dyads than among formula-feeding dyads (regression estimate 1.0; 95% CI: 0.1, 2.0; p = 0.04 vs. 0.6; CI: −0.1, 1.3; p = 0.10). In addition, we assessed the influence of maternal education and household income in our adjusted model; income strengthened the observed association, whereas maternal education did not change the estimate.ConclusionsBreastfeeding mothers and infants had significant correlations for cortisol at bedtime, while formula-feeding dyads did not. These data suggest that several factors may contribute to cortisol synchrony observed in mother/infant dyads, including the transfer of cortisol in human milk, physical interaction such as skin-to-skin contact, and shared environment. In addition, our findings support household income as a possible contributor.     

Screening Solid Foods Infants 1 (SSFI-1) development of a screening tool to detect problems in the transition from milk to solid food in infants from six to nine months of age

AimTo establish the psychometric properties of a newly developed screening tool Screening Solid Foods Infants 1 (SSFI-1) used by early childhood professionals, to detect problems in the transition from milk to solid food of smooth consistency in infants 6–9 months of age.MethodsThe SSFI-1 score was filled out by the parents of a subgroup with term infants (n = 35); healthy preterm infants (n = 26); infants with comorbidity (n = 17); infants with feeding problems (n = 13). Internal consistency, reproducibility, construct, criterion and related validity was evaluated.ResultsThe preterm subgroup differed significantly in age when starting with fruits/vegetables and period of experience (p < 0.01). The SSFI-1 was sufficiently reliable for the total group and term subgroup (α = 0.78 and 0.76), but not for the preterm and comorbidity/feeding problem subgroup (α = 0.51 and 0.69). Inter-rater reliability was high for the total score (n = 25, ICC r = 0.93), and moderate to good for individual items (weighted kappa range 0.55–0.95). Validity was confirmed by significantly higher scores for the comorbidity/feeding problem subgroups and clinically distinguishable subgroups (p < 0.05) and area under the curve values > 0.78. The initial 10-item screening tool was modified to a seven item screening tool. A SSFI-1 score of 4, +2 SD of the term subgroup, had 76.9% sensitivity and 82.1% specificity, for detecting the presence of a feeding problem.ConclusionThe seven-item screening tool Screening Solid Foods 1 may be used as a screening tool for term infants. Further testing of the SSFI-1 in new infants is needed, to confirm reliability and validity both for term, preterm and (risk for) feeding problem infants.     

Infant sleep-wake behaviors at two weeks,three and six months

Although infant sleep-wake behavior presents several developmental changes during the first six months, literature lacks on reference values and few studies have explored the role of individual change and stability on infant sleep-wake behavior during the first six months. This study aimed (1) to describe infant sleep-wake behaviors during the 24-h period, day and night, at two weeks, three, and six months, (2) and to explore developmental changes and the role of individual change and stability on infant sleep-wake behaviors from two weeks to six months. Ninety-four primiparous mothers completed measures on infant sleep-wake behaviors at two weeks, three and six months. Significant developmental changes were found on infant sleep-wake behaviors from two weeks to six months. Two-week-old infants sleep 13.3 h, spend 8.7 h awake, awake 6.1 times, have 0.4 h of latency to sleep, and 3.2 h of longest sleep period. Three-month-old infants sleep 13.0 h, spend 9.2 h awake, awake 5.5 times, have 0.4 h of latency to sleep, and 5.2 h of longest sleep period. Six-month-old infants sleep 12.2 h, spend 10.0 h awake, awake 5.2 times, have 0.4 h of latency to sleep, and 5.6 h of longest sleep period. Significant individual change and stability were also found on infant sleep-wake behaviors from two weeks to six months. Despite significant developmental and individual changes, individual stability explains a significant amount of the variance on infant sleep-wake behaviors over the first six months of life.     

Exposing Clinicians to Exposure: A Randomized Controlled Dissemination Trial of Exposure Therapy for Anxiety Disorders

ObjectiveThe present study evaluated three technology-based methods of training mental health providers in exposure therapy (ET) for anxiety disorders. Training methods were designed to address common barriers to the dissemination of ET, including limited access to training, negative clinician attitudes toward ET, and lack of support during and following training.MethodClinicians naïve to ET (N = 181, M_age = 37.4, 71.3% female, 72.1% Caucasian) were randomly assigned to (a) an interactive, multimedia online training (OLT), (b) OLT plus a brief, computerized motivational enhancement intervention (OLT + ME), or (c) OLT + ME plus a Web-based learning community (OLT + ME + LC). Assessments were completed at baseline, posttraining, and 6 and 12 weeks following training. Outcomes include satisfaction, knowledge, self-efficacy, attitudes, self-reported clinical use, and observer-rated clinical proficiency.ResultsAll three training methods led to large and comparable improvements in self-efficacy and clinical use of ET, indicating that OLT alone was sufficient for improving these outcomes. The addition of the ME intervention did not significantly improve outcomes in comparison to OLT alone. Supplementing the OLT with both the ME intervention and the LC significantly improved attitudes and clinical proficiency in comparison to OLT alone. The OLT + ME + LC condition was superior to both other conditions in increasing knowledge of ET.ConclusionsMulticomponent trainings that address multiple potential barriers to dissemination appear to be most effective in improving clinician outcomes. Technology-based training methods offer a satisfactory, effective, and scalable way to train mental health providers in evidence-based treatments such as ET.     

Child care centre adherence to infant physical activity and screen time recommendations in Australia,Canada and the United States: An observational study

ObjectiveThe aim of this study was to compare adherence to physical activity and sedentary behaviour recommendations within the 2011 Institute of Medicine Early Childhood Obesity Prevention Policies as well as screen time recommendations from the 2013 American Academy of Pediatrics for samples of infants in child care centres in Australia, Canada, and the United States (US).MethodsThis cross-sectional study used data from: the Australian 2013 Standing Preschools (N = 9) and the 2014–2017 Early Start Baseline (N = 22) studies; the 2011 Canadian Healthy Living Habits in Pre-School Children study (N = 14); and the American 2008 (N = 31) and 2013–2017 (N = 31) Baby Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) trials. Data were compared on the above infant recommendations. Percentages were used to describe compliance to the recommendations and chi-square tests to determine whether compliance differed by country.ResultsChild care centres were most compliant (74%–95%) with recommendations to: provide daily indoor opportunities for infants to move freely under adult supervision, daily tummy time for infants less than 6 months of age, indoor and outdoor recreation areas that encourage infants to be physically active, and discourage screen time. Centres were least compliant (38%-41%) with adhering to recommendations to: limit the use of equipment that restricts an infant’s movement and provide education about physical activity to families. Compared with Canadian and US centres, Australian centres were less compliant (46%) with the recommendation to engage with infants on the ground each day, to optimize adult-infant interactions and to limit the use of equipment that restricts the infant’s movement. Canadian centres were less compliant (39%) with the recommendation to provide training to staff and education to parents about children’s physical activity. US centres were less compliant (25%–41%) with the recommendations to provide daily opportunities for infants to explore their outdoor environment, limit the use of equipment that restricts the infant’s movement and provide education to families about children’s physical activity.ConclusionsAssisting child care centres on limiting the use of equipment that restricts an infant’s movement, and providing education about children’s physical activity to families may be important targets for future interventions.     

Effect of developmental care for very premature infants on neurodevelopmental outcome at 2 years of age

BackgroundTo determine the effect of developmental care on neurodevelopmental outcome in formerly preterm infants at a corrected age of 2 years.MethodsA prospective phase-lag study was performed at an Austrian neonatal intensive care unit (NICU). From January 2003 to December 2005 (study period of conventional care) and January 2007 to December 2009 (study period of developmental care), we enrolled all infants born in Tyrol at less than 32 weeks of gestation. During this period a total of 261 of 359 preterm infants (participation rate 72.7%) completed the follow-up visit at 2 years of age; there were 124 children in the conventional and 137 in the developmental care group. The association between developmental care and delayed motor or mental development (Bayley Scales of Infant Development II; psychomotor or mental developmental index <85) was analyzed by means of logistic regression analysis at a corrected age of 24 months.ResultsChildren in the developmental care group showed less psychomotor delay than did those in the control group (developmental care group: 16.1%, conventional care group 27.4%; adjusted odds ratio 0.37 [95% confidence interval: 0.19–0.74], P = 0.005). Not smoking in pregnancy and higher gestational age were also significant predictors for a better psychomotor outcome at 2 years of age. Regarding cognitive outcome, no significant difference was observed between these two groups.ConclusionOur data implicate that developmental care may result in an improved 2-year psychomotor outcome in formerly preterm infants.     

Partial body weight support treadmill training speed influences paretic and non-paretic leg muscle activation,stride characteristics,and ratings of perceived exertion during acute stroke rehabilitation

BackgroundIntensive task-specific training is promoted as one approach for facilitating neural plastic brain changes and associated motor behavior gains following neurologic injury. Partial body weight support treadmill training (PBWSTT), is one task-specific approach frequently used to improve walking during the acute period of stroke recovery (<1 month post infarct). However, only limited data have been published regarding the relationship between training parameters and physiologic demands during this early recovery phase.ObjectiveTo examine the impact of four walking speeds on stride characteristics, lower extremity muscle demands (both paretic and non-paretic), Borg ratings of perceived exertion (RPE), and blood pressure.DesignA prospective, repeated measures design was used.MethodsTen inpatients post unilateral stroke participated. Following three familiarization sessions, participants engaged in PBWSTT at four predetermined speeds (0.5, 1.0, 1.5 and 2.0 mph) while bilateral electromyographic and stride characteristic data were recorded. RPE was evaluated immediately following each trial.ResultsStride length, cadence, and paretic single limb support increased with faster walking speeds (p ⩽ 0.001), while non-paretic single limb support remained nearly constant. Faster walking resulted in greater peak and mean muscle activation in the paretic medial hamstrings, vastus lateralis and medial gastrocnemius, and non-paretic medial gastrocnemius (p ⩽ 0.001). RPE also was greatest at the fastest compared to two slowest speeds (p < 0.05).ConclusionsDuring the acute phase of stroke recovery, PBWSTT at the fastest speed (2.0 mph) promoted practice of a more optimal gait pattern with greater intensity of effort as evidenced by the longer stride length, increased between-limb symmetry, greater muscle activation, and higher RPE compared to training at the slowest speeds.     

Through babies’ eyes: Practical and theoretical considerations of using wearable technology to measure parent–infant behaviour from the mothers’ and infants’ view points

AimsTo explore the utility of first-person viewpoint cameras at home, for recording mother and infant behaviour, and for reducing problems associated with participant reactivity, which represent a fundamental bias in observational research.MethodsWe compared footage recording the same play interactions from a traditional third-person point of view (3rd PC) and using cameras worn on headbands (first-person cameras [1st PCs]) to record first-person points of view of mother and infant simultaneously. In addition, we left the dyads alone with the 1st PCs for a number of days to record natural mother–child behaviour at home. Fifteen mothers with infants (3–12 months of age) provided a total of 14 h of footage at home alone with the 1st PCs.ResultsCodings of maternal behaviour from footage of the same scenario captured from 1st PCs and 3rd PCs showed high concordance (kappa >0.8). Footage captured by the 1st PCs also showed strong inter-rater reliability (kappa = 0.9). Data from 1st PCs during sessions recorded alone at home captured more ‘negative’ maternal behaviours per min than observations using 1st PCs whilst a researcher was present (mean difference = 0.90 (95% CI 0.5–1.2, p < 0.001 representing 1.5 SDs).Conclusion1st PCs offer a number of practical advantages and can reliably record maternal and infant behaviour. This approach can also record a higher frequency of less socially desirable maternal behaviours. It is unclear whether this difference is due to lack of need of the presence of researcher or the increased duration of recordings. This finding is potentially important for research questions aiming to capture more ecologically valid behaviours and reduce demand characteristics.     

Effect of an intensified training period on well-being indices,recovery and psychological aspects in professional soccer players

IntroductionIntensified training periods (IT) are associated with fatigue increase and psychological variations.ObjectiveThis investigation aimed to examine the perceived well-being, recovery quality and psychological responses during an IT.MethodsFifteen professional soccer players (mean ± SD: age: 24 ± 1 years, body mass: 71.3 ± 15.1 kg, height: 178.0 ± 6.1 cm) completed a 6-week training program consisting of 2 weeks of basic training (BT) and 4 weeks of IT. They were tested before (T1) and after (T2) the IT. Training load (TL) perception, strain and monotony were measured by the session-RPE method. Well-being indices (sleep quality, fatigue level, stress and delayed-onset muscular soreness [DOMS]) and total quality recovery (TQR) were recorded before each training session. The profile of mood states (POMS) and the Ottowa mental skills assessment tool (OMSAT)-3 were conducted before and after IT.ResultsNo significant difference was found after IT in OMSAT-3 scores (p > 0.05). TL, monotony and strain increased during IT (p < 0.001). Moreover, well-being indices (stress, sleep quality, fatigue level and DOMS) increased (p < 0.001) and TQR decreased (p < 0.001) during IT. The IT increased total mood disturbance (TMD, p < 0.001), tension (p < 0.05) and fatigue (p < 0.01) and decreased vigor (p < 0.001). Significant relationships were found between TL and Hooper Index (HI), TQR and TMD (r = 0.58, 0.65, −0.57, respectively; all p < 0.05).ConclusionThe findings of this investigation suggested that mental ability was not sensitive to fatigue caused by training load intensification. However, perceived well-being, recovery state and mood were found to be sensitive measures and may provide coaches with information about wellness and psychological state of soccer players during IT.     

Massage therapy improves the development of HIV-exposed infants living in a low socio-economic,peri-urban community of South Africa

The aim of this study was to assess the effect of massage therapy on the growth and development of infants of HIV-infected mothers in a low socio-economic community in Cape Town. It was a prospective, randomised, controlled intervention trial that included massage therapy and control groups of HIV-infected mothers and their normal birth weight infants who were enrolled in the prevention of mother-to-child transmission (PMTCT) programme. Participants were recruited at the 6-week clinic visit and followed up every 2 weeks until their infants were 9 months of age. Mother–infant pairs in the massage therapy and control groups included 73 and 88 at 6 weeks and 55 and 58 at 9 months, respectively. Mothers in the intervention group were trained to massage their infants for 15 min daily. The socioeconomic status, immunity, relationship with the partner and mental pain of mothers; the infants’ dietary intake, anthropometry and development (Griffiths Mental Development Scales); and haematological and iron status of mothers and infants were assessed at baseline and follow-up. Nine infants (5.3%) were HIV-infected on the HIV DNA PCR test at 6 weeks. Despite significantly higher levels of maternal mental pain, infants in the massage therapy compared to control group scored higher in all five of the Griffiths Scales of Mental Development and significantly higher in the mean quotient (p = 0.002) and mean percentile (p = 0.004) for the hearing and speech scale at 9 months. Based on the mean difference in scores, the massage therapy group showed greater improvement for all five scales compared to the control group. The mean difference in scores was significantly greater for the hearing and speech quotient (21.9 vs. 11.2) (p < 0.03) and the general quotient percentile (19.3 vs. 7.7) (p = 0.03) in the massage therapy compared to the control group. These scales remained significant when adjusting for the relationship with the partner and maternal mental pain. Both groups had lower scores in the performance scale at 9 months although this was significantly worse in the control compared to the massage therapy group when adjusting for maternal CD4 count, anaemia, relationship with the partner and mental pain. There were no significant differences in the anthropometric measurements between the two groups. In conclusion, based on the Griffiths Scales, massage therapy improved the overall development and had a significant effect on the hearing and speech and general quotient of HIV-exposed infants in this study.     

A crossover randomised and controlled trial of the impact of active video games on motor coordination and perceptions of physical ability in children at risk of Developmental Coordination Disorder

BackgroundImpaired motor development can significantly affect a child’s life and may result in an increased risk of a range of physical and psychological disorders. Active video game (AVG) interventions have been demonstrated to enhance motor skills in children with Developmental Coordination Disorder (DCD); however a home-based intervention has not been assessed.ObjectivesThe primary aim of this study was to compare the changes in motor coordination between a 16 week period of AVG use, with 16 weeks of normal activities (NAG). The secondary aim was to compare the child and parent perceptions of their physical performance between the AVG and NAG conditions.MethodsTwenty-one 9–12 year olds (10 males) were confirmed to be at risk of DCD (⩽16th percentile Movement Assessment Battery for Children-2nd edition (MABC-2) and ⩽15th percentile Developmental Coordination Disorder Questionnaire (DCDQ)) and participated in this crossover randomised and controlled trial. Data was collected at study entry, after the first 16 week condition and following the final 16 week condition, including; (1) the MABC-2, (2) three-dimensional motion analysis of single leg balance and finger–nose tasks, and (3) parent perception of physical skills. Participant perception of physical skills was collected only after the first and second conditions.ResultsThere was no significant difference between AVG and NAG for any of the primary variables including the MABC-2, balance centre-of-mass path distance and finger–nose path distance. There was no significant intervention effect for secondary measures of motor coordination; however the children perceived their motor skills to be significantly enhanced as a result of the AVG intervention in comparison to the period of no intervention.ConclusionA 16 week home based AVG intervention did not enhance motor skills in children with DCD, although they perceived their physical skills to be significantly improved.Trial Registration: Australia and New Zealand Clinical trials Registry (ACTRN 12611000400965).     

Randomized Controlled Trial of an Internet-Based Cognitive-Behavioral Treatment Program for Binge-Eating Disorder

Binge-eating disorder (BED) is a prevalent health condition associated with obesity. Few people with BED receive appropriate treatment. Personal barriers include shame, fear of stigma, geographic distance to mental health services, and long wait-lists. The aims of this study were to examine the efficacy of an Internet-based cognitive-behavioral intervention for adults with threshold BED (DSM-IV) and to examine the stability of treatment effects over 12 months. Participants were randomly assigned to a 16-week Internet-based cognitive-behavioral intervention (n = 69) or a wait-list condition (n = 70). Binge-eating frequency and eating disorder psychopathology were measured with the Eating Disorder Examination–Questionnaire and the Eating Disorder Examination administered over the telephone. Additionally, body weight and body mass index, depression, and anxiety were assessed before and immediately after treatment. Three-, 6-, and 12-month follow-up data were recorded in the treatment group. Immediately after the treatment the number of binge-eating episodes showed significant improvement (d = 1.02, between group) in the treatment group relative to the wait-list condition. The treatment group had also significantly reduced symptoms of all eating psychopathology outcomes relative to the wait-list condition (0.82 ≤ d ≤ 1.11). In the treatment group significant improvement was still observed for all measures 1 year after the intervention relative to pretreatment levels. The Internet-based intervention proved to be efficacious, significantly reducing the number of binge-eating episodes and eating disorder pathology long term. Low-threshold e-health interventions should be further evaluated to improve treatment access for patients suffering from BED.     

The psychosocial purpose of driving and its relationship with the risky driving behaviour of young novice drivers

BackgroundThe overrepresentation of young drivers in road crashes, injuries and fatalities around the world has resulted in a breadth of injury prevention efforts including education, enforcement, engineering, and exposure control. Despite multifaceted intervention, the young driver problem remains a challenge for injury prevention researchers, practitioners and policy-makers. The intractable nature of young driver crash risks suggests that a deeper understanding of their car use – that is, the purpose of their driving – is required to inform the design of more effective young driver countermeasures.AimsThis research examined the driving purpose reported by young drivers, including the relationship with self-reported risky driving behaviours including offences.MethodsYoung drivers with a Learner or Provisional licence participated in three online surveys (N1 = 656, 17–20 years; N2 = 1051, 17–20 years; N3 = 351, 17–21 years) as part of a larger state-wide project in Queensland, Australia.ResultsA driving purpose scale was developed (the PsychoSocial Purpose Driving Scale, PSPDS), revealing that young drivers drove for psychosocial reasons such as for a sense of freedom and to feel independent. Drivers who reported the greatest psychosocial purpose for driving were more likely to be male and to report more risky driving behaviours such as speeding. Drivers who deliberately avoided on-road police presence and reported a prior driving-related offence had significantly greater PSPDS scores, and higher reporting of psychosocial driving purposes was found over time as drivers transitioned from the supervised Learner licence phase to the independent Provisional (intermediate) licence phase.Discussion and conclusionsThe psychosocial needs met by driving suggest that effective intervention to prevent young driver injury requires further consideration of their driving purpose. Enforcement, education, and engineering efforts which consider the psychosocial purpose of the driving are likely to be more efficacious than those which presently do not. Road safety countermeasures could reduce the young driver’s exposure to risk through such mechanisms as encouraging the use of public transport.     

Trait anxiety and trait anger measured by ecological momentary assessment and their correspondence with traditional trait questionnaires

Ecological momentary assessments (EMA) of anxiety and anger/hostility were obtained every 25–30 min over two 24-h periods, separated by a median of 6 months, from 165 employees at a university in the Northeast. We used a multilevel trait-state-error structural equation model to estimate: (1) the proportion of variance in EMA anxiety and anger/hostility attributable to stable trait-like individual differences; (2) the correspondence between these trait-like components of EMA anxiety and anger/hostility and traditional questionnaire measures of each construct; and (3) the test–retest correlation between two 24-h averages obtained several months apart. After adjustment for measurement error, more than half the total variance in EMA reports of anxiety and anger/hostility is attributable to stable trait-like individual differences; however, the trait-like component of each construct is only modestly correlated with questionnaire measures of that construct. The 6-month “test–retest” correlations of latent variables representing the true 24-h EMA average anxiety and average anger are quite high (r ? 0.83). This study represents the longest follow-up period over which EMA-based estimates of traits have been examined. The results suggest that although the trait component (individual differences) of EMA momentary ratings of anxiety and anger is larger than the state component, traditional self-report questionnaires of trait anxiety and anger correspond only weakly with EMA-defined traits.