Short-term effects of a multi-disciplinary cardiac rehabilitation programme on psychological well-being, exercise capacity and weight in a sample of obese in-patients with coronary heart disease: a practice-level study

Given that many patients referred to cardiac rehabilitation (CR) are obese, diet therapy, exercise training, nutritional and psychological counselling for both obesity and psychological distress should be included as important components in all CR programmes. In this practice-level, observational study we evaluated the short-term within-group effects of a four-week multi-factorial inpatient CR programme specifically addressed to weight loss, fitness improvement and psychological health increase on 176 obese in-patients with coronary heart disease (CHD). Outcome measures were exercise capacity measured with estimated metabolic equivalents (METs), body mass index (BMI) and psychological well-being (PGWBI). Results show statistically significant improvements in all the PGWBI sub-scales and total score, except in general health (p = 0.393). No moderation effects were found for BMI class, age, diabetes and ejection fraction (EF). METs significantly increased by 30.3% (p < 0.001) and BMI decreased by 1.37 points (p < 0.001). Significant correlations were found between BMI and weight reductions with PGWBI anxiety and total score improvements. This multi-disciplinary CR programme including diet therapy, exercise training and psychological counselling provides indication for short-term within-group effectiveness on functional exercise capacity, BMI and PGWBI in a sample of obese in-patients with CHD. However, controlled studies are needed to corroborate the results we found.     

Motor excitability is reduced prior to voluntary movements in children and adolescents with Tourette syndrome

Tourette syndrome (TS) is a neuro‐developmental disorder characterized by the occurrence of motor and vocal tics: involuntary, repetitive, stereotyped behaviours that occur with a limited duration, often typically many times in a single day. Previous studies suggest that children and adolescents with TS may undergo compensatory, neuroplastic changes in brain structure and function that help them gain control over their tics. In the current study we used single‐pulse and dual‐site paired‐pulse transcranial magnetic stimulation (TMS), in conjunction with a manual choice reaction time task that induces high levels of inter‐manual conflict, to investigate this conjecture in a group of children and adolescents with TS, but without co‐morbid Attention Deficit Hyperactivity Disorder (ADHD). We found that performance on the behavioural response‐conflict task did not differ between the adolescents with TS and a group of age‐matched typically developing individuals. By contrast, our study demonstrated that cortical excitability, as measured by TMS‐induced motor‐evoked potentials (MEPs), was significantly reduced in the TS group in the period immediately preceding a finger movement. This effect is interpreted as consistent with previous suggestions that the cortical hyper‐excitability that may give rise to tics in TS is actively suppressed by cognitive control mechanisms. Finally, we found no reliable evidence for altered patterns of functional inter‐hemispheric connectivity in TS. These results provide evidence for compensatory brain reorganization that may underlie the increased self‐regulation mechanisms that have been hypothesized to bring about the control of tics during adolescence.     

Third Men: The Logic of the Sophisms at Arist. SE 22, 178b36–170a10

This article aims at elucidating the logic of Arist. SE 22, 178b36–179a10 and, in particular, of the sophism labelled "Third Man" discussed in it. I suggest that neither the sophistic Walking Man argument, proposed by ancient commentators, nor the Aristotelian Third Man of the , suggested by modern interpreters, can be identified with the fallacious argument Aristotle presents and solves in the passage. I propose an alternative reconstruction of the Third Man sophism and argue that an explanation of the lines regarding the identity of Coriscus and Coriscus the musician (178b39–179a3) is indispensable for its correct understanding, since they hint at another sophism in some important aspects analogous. Finally, I show that two contradictions concerning spotted by scholars in the passage are only apparent and can be dissolved once the assumption that the anti-Platonic Third Man argument is at stake here is discarded, and once the passage is read in the light of its agonistic context.     

Self-Efficacy,Decision-Making,and Stages of Change: An Integrative Model of Physical Exercise1

Exercise has important health benefits but a large proportion of the population is physically inactive. We examined the stages of readiness to exercise and their relationship to self-efficacy, the costs and benefits of exercising, and self-report of physical activity in a sample of Rhode Island worksites. Using a three-step model-building approach, exploratory principal components analyses were followed by an examination of the stages of change model with confirmatory structural equation modeling procedures. The model was then examined with longitudinal data. Confirmatory and longitudinal analyses showed an excellent tit between the model and the data. Results indicated that the costs and benefits of exercise and self-efficacy for exercise were related to physical activity only indirectly, through the mediation of stage of readiness to exercise. Structural modeling fit indices revealed that much of the variation and covariation in physical activity was explained by the model. There is the potential to enhance the impact of exercise interventions, by targeting them so as to address factors related to these different stages of readiness.     

Pain appraisal and quality of life in 108 outpatients with rheumatoid arthritis

Individual differences in emotional functioning, pain appraisal processing, and perceived social support may play a relevant role in the subjective experience of pain. Due to the paucity of data regarding individuals with Rheumatoid Arthritis (RA), the present study aimed to examine pain intensity, emotional functioning (psychological distress and alexithymia), pain appraisal (pain beliefs, pain catastrophizing, and pain-related coping strategies) and social support, and their relationships with the health-related quality of life (HRQoL) in patients with RA. Data were collected from 108 female patients diagnosed with RA. Clinically relevant levels of depressive and anxiety symptoms assessed by the HADS subscales were present in 34% and 41% of the patients, respectively, and about 24% of them exhibited the presence of alexithymia. The results of hierarchical multiple regression analyses showed that pain intensity, alexithymia, the maladaptive beliefs regarding the stability of pain and the coping strategy of guarding explained 54% of the variance in the physical component of HRQoL (p < 0.001). Depression subscale of the HADS, alexithymia, the coping strategy of resting, and the rumination factor of pain catastrophizing significantly explained 40% of the variance in the mental component of HRQoL (p < 0.001). The present findings provide evidence regarding the importance of emotional functioning and pain appraisal in the negative impact of RA on patients’ quality of life. These findings provide additional evidence for the biopsychosocial model of chronic pain, further supporting the complex interaction between emotional, cognitive, and behavioral processes in patients with chronic pain.     

Autobiographical recall training in elderly adults with subjective memory complaint: a pilot study

Subjective memory complaint is a self-reported memory impairment which affects elderly people. This problem does not interfere with daily living activities but could decrease quality of life. This study's purpose was to verify whether a specific, newly developed, autobiographical recall training could modify self-perception of memory of subjects with subjective memory complaint. Seven elderly subjects (4 women and 3 men; mean age 65.5 yr., SD=11) with such complaint, evidenced through a specific questionnaire, attended the training course and were prospectively assessed on standard neuropsychological tests, depressive symptomatology, and self-perception of memory. Self-perception of memory, as assessed by scores on a formalized questionnaire, improved significantly after the training, while depressive symptoms did not change. Neuropsychological performances were normal before and after the training, but a statistically significant improvement was observed only on the phonological fluency test. Thus the present pilot study suggested that the training may be effective in improving self-perception of memory and metamnestic capacity in elderly people with subjective memory complaints but not in changing subjects' depressive symptoms. This requires replication of this work with a much larger sample so statistical power is adequate.     

Church Attendance,Problems of Measurement,and Interpreting Indicators: A Study of Religious Practice in the United States, 1975–2010

Church attendance is usually measured in surveys by asking a direct question about frequency of churchgoing over a preset period of time, which is typically a year. Different studies have cast doubt over the validity of this indicator as it tends to overestimate actual attendance to a significant degree. The aim of this article is to compare data on church attendance provided by two different types of research conducted in the United States between 1975 and 2010: survey data (GSS) and data obtained from time use surveys (ATUS). This comparison has three main objectives: (1) to confirm the hypothesis that survey data tend to overestimate actual attendance; (2) to show that this overestimation is not constant over time and space, but tends to vary in an erratic and unpredictable way; and (3) to demonstrate that data provided by time use surveys are more reliable than the frequencies of churchgoing provided by traditional surveys when the objective is to identify trends in religiosity in a population.