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Risk maps facilitate discussion among different stakeholders and provide a tool for spatial targeting of health interventions. We present maps documenting shrinking risk profiles after deworming with respect to soil-transmitted helminthiasis among schoolchildren from disadvantaged neighbourhoods in Port Elizabeth, South Africa. Children were examined for soil-transmitted helminth infections using duplicate Kato-Katz thick smears in March 2015, October 2015 and May 2016, and subsequently treated with albendazole after each survey. The mean infection intensities for Ascaris lumbricoides were 9,554 eggs per gram of stool (EPG) in March 2015, 4,317 EPG in October 2015 and 1,684 EPG in March 2016. The corresponding figures for Trichuris trichiura were 664 EPG, 331 EPG and 87 EPG. Repeated deworming shrank the risk of soil-transmitted helminthiasis, but should be complemented by other public health measures.

People from low- and middle-income countries still face challenges stemming from parasitic infections. Additionally, non-communicable diseases (NCDs) and their risk factors are rapidly increasing, which puts South African children at an elevated risk of a dual disease burden, with negative consequences for child development and wellbeing. Contrastingly, regular physical activity (PA) is associated with decreased cardiovascular disease (CVD) risk. Therefore, the objective of this study was to examine whether PA is associated with the double infection-CVD phenotype burden in South African schoolchildren. 801 children (402 boys, 399 girls; mean age 9.5 years) from eight schools from disadvantaged neighbourhoods were included. Data assessment took place between February and March 2015 in Port Elizabeth, South Africa. Children who achieved PA recommendations (physically active on 6-7 days/week for at least 60 min), who were active, but below recommended standards (2-5 physically active days/week), or who were insufficiently active on almost all days (0-1 physically active days/week) were compared with regard to systolic and diastolic blood pressure, body mass index (BMI), percent body fat, and infection with soil-transmitted helminths. Moderate and high self-reported PA levels were associated with lower BMI, lower body fat, and lower risk of being hypertensive. Conversely, children with high self-reported PA were more likely to be infected with soil-transmitted helminths than peers with low PA levels. Promoting PA in disadvantaged areas is worthwhile to prevent NCD later in life, but should be combined with regular anthelminthic treatment to comprehensively improve children's health and wellbeing.

The relationship between health-related quality of life (HRQoL), physical activity (PA), and cardiorespiratory fitness (CRF) among disadvantaged communities in low- and middle-income countries is poorly understood. In South Africa, children from socioeconomically deprived households are at an elevated risk of sedentary lifestyles and poor HRQoL. We examined whether higher self-reported PA and higher CRF levels are associated with better HRQoL in South African schoolchildren from disadvantaged neighbourhoods. Overall, 832 children aged 8–12 years participated in this cross-sectional study. HRQoL was assessed through five dimensions of the KIDSCREEN-27 tool. Self-reported PA was measured using a single item of the Health-Behaviour of School-Aged Children test, and CRF with the 20-m shuttle run test. Higher self-reported PA was significantly and positively related to HRQoL. Significant, but small group differences existed across all dimensions of HRQoL between low and high self-reported PA. No significant associations were observed between CRF levels and HRQoL. Schoolchildren reporting PA of at least 60 min on at least 6 days a week (the recommended minimum) report higher HRQoL than their peers with lower PA levels.

To examine the effects of a structured exercise program implemented during school break-time on working memory maintenance and neurophysiological indices of task preparation processes in adolescents.Using class-wise random allocation, participants from four classes were divided into an exercise (n=20) and a wait-list control group (n=16). Over a period of eight weeks, the exercise group engaged in 20min of combined aerobic and coordinative exercise on each school day.Prior to and after the intervention period, participants performed a computer-based Sternberg task for the assessment of working memory performance. Simultaneously, the contingent negative variation (CNV) of event-related potentials was measured.The exercise group demonstrated a larger decrease in reaction time from pre- to post-test relative to the control group, F(1, 31)=13.5, p0.001. No changes were found for accuracy on the Sternberg task across groups. Using cluster-based permutation testing, the analysis of event-related potentials revealed a significant increase of the initial CNV from pre- to post-test in the exercise group, cluster value=-2376.2, p=0.006, which was most pronounced for the fronto-central region, with no such effect observed for the control group.Daily engagement in a short combined aerobic and coordinative exercise program following the school lunch time break elicits benefits for working memory in adolescents. These changes are accompanied by improvements of task preparation processes, which allow the selection of a more appropriate cognitive control strategy.

Varying levels of inattention, impulsivity and hyperactivity characterize children and adolescents with attention-deficit hyperactivity disorder (ADHD). These symptoms are accompanied by deficits in different cognitive domains, which in turn have a negative impact on educational achievement. Commonly, pharmacological treatments and behavioral therapy are used to normalize cognition and social behavior in ADHD. Interestingly, exercise in healthy children has been found to elicit neurobiological effects similar to neuro-enhancing pharmacological treatment in ADHD, but without serious adverse effects. Although evidence for exercise benefits in children and adolescents with ADHD is scarce, the number of studies investigating effects of acute and chronic physical activity on cognitive and behavioral outcomes is steadily growing. After presenting neurophysiological evidence for the differences between children and adolescents with ADHD and their healthy peers, the chapter reviews the impact of exercise interventions on cognitive functioning and ADHD-related behavior. Attention will be paid to neurobiological mechanisms underlying exercise effects on cognitive performance. After reviewing the literature, the authors discuss whether or not evidence on the dose-response-relationship is sufficient to recommend a systematic implementation of exercise interventions.

This study investigated the interrelatedness of physical disability, physical activity and depression among patients with Multiple Sclerosis (MS). We hypothesized that self-reported physical activity would mediate the effect of disability on depressive symptoms. Twenty-seven patients with MS (mean age: 49 years; 44.5% females) completed self-rating scales covering socio-demographic variables, intake of antidepressants, physical activity, and symptoms of depression; disability was measured by the Expanded Disability Status Scale (EDSS). We found a higher level of disability to be significantly associated with more symptoms of depression. While higher reported physical activity was descriptively associated with lower depression scores and unrelated to EDSS, physical activity levels did not mediate the effect of disability on depressive symptoms. We concluded that increased disability was associated with more symptoms of depression and that self-reported physical activity did not mediate this association even though higher physical activity was separately related to fewer depression symptoms.

Background: Following an aneurysmal subarachnoid haemorrhage (aSAH), many patients report persistent deficits in psychological functioning, characterised by high levels of stress and symptoms of depression, low life satisfaction, along with poor sleep. Such deficits have been associated with altered saliva and serum cortisol levels due to a dysregulation of hypothalamic-pituitary-adrenal axis activity (HPA-AA). However, hair cortisol concentrations (HCCs) have not been assessed in this population, although this method allows a long-term insight into cortisol values. Therefore, the objective of this study was to compare HCCs in aSAH patients and healthy controls and to examine how HCCs are associated with perceived stress, psychological functioning, and sleep complaints. Methods: In this cross-sectional study, data on depressive symptoms, hypochondriacal beliefs, life satisfaction, and sleep complaints were gathered in 15 aSAH patients and 17 healthy controls. HCCs of the previous 3 months were assessed. Results: aSAH patients had significantly higher HCCs than healthy controls. In aSAH patients, higher HCCs were significantly associated with increased depressive symptoms, hypochondriacal beliefs, lower life satisfaction, and increased sleep complaints. Such significant associations were not found in healthy controls. Conclusions: Our findings indicate that a dysregulation of HPA-AA is associated with some of the long-term impairments in psychological functioning and sleep in aSAH survivors. While the direction of association remained unclear, a dysregulated HPA-AA may be causally linked with the maintenance of poor psychological functioning and poor sleep. The overall findings should be considered in the planning of long-term treatment aimed at improving psychological functioning and sleep in aSAH patients.

Although overtly racist political discourse in Switzerland has receded, culturalist discourses continue to construct ideal immigrants. Policies define immigrants in terms of “cultural proximity” and contain an implicit distinction between “distant” and “proximal” foreigners. Culturally, distant immigrants have been stereotyped as aggressive and/or lacking interest in education and professional success and while scholars have examined immigrants from Switzerland’s “culturally-near” regions, the experiences of second generation immigrant populations from perceived culturally distant countries have largely escaped attention. Knowledge about girls and women is particularly scarce. Against this backdrop, this paper provides an examination of how six teenage girls living in a German-speaking Swiss city negotiate their perceived cultural distance. By combining interview material with elements of Foucauldian theory, the paper provides insight into (1) the diasporic experiences of girls with second generation immigration backgrounds and (2) the operation and influence of culturalist discourses. Foucault’s notion of dispositive—the discourses, institutions, laws, and scientific findings that, through various means of distribution (e.g., media texts, policies, education curricula), act as an apparatus that constructs and supports normative ideals—provides a generative analytic tool for this task. The analysis suggests that the ways girls learn to understand their social worlds is a collective process of discipline that places mechanisms of social control within each individual. This process involves the homogenisation and marginalisation of the immigrant population and is circular in nature in that the girls strengthen and maintain the power of existing culturalist knowledge that works negatively on them. The paper concludes with a consideration of how this situation might be challenged.

Background Albendazole is one of two standard drugs for the control of soil-transmitted helminthiasis. Methods A total of 149 schoolchildren from Port Elizabeth, South Africa, were examined for soil-transmitted helminth infections using duplicate Kato-Katz thick smears before and 2 weeks after administration of albendazole (400 mg). Results Trichuris trichiura was the predominant soil-transmitted helminth species (prevalence 60.4%), followed by Ascaris lumbricoides (47.7%). While albendazole was highly efficacious against A. lumbricoides (cure rate [CR] 97.2%; egg reduction rate [ERR] 94.3%), it lacked efficacy against T. trichiura (CR 1.1%; ERR 46.0%). Conclusions Our study confirms low efficacy of single dose albendazole against T. trichiura. There is a need for safe and efficacious drugs against T. trichiura.

Background: The burden of poverty-related infectious diseases remains high in low- and middle-income countries, while noncommunicable diseases (NCDs) are rapidly gaining importance. To address this dual disease burden, the KaziBantu project aims at improving and promoting health literacy as a means for a healthy and active lifestyle. The project implements a school-based health intervention package consisting of physical education, moving-to-music, and specific health and nutrition education lessons from the KaziKidz toolkit. It is complemented by the KaziHealth workplace health intervention program for teachers. Objectives: The aim of the KaziBantu project is to assess the effect of a school-based health intervention package on risk factors for NCDs, health behaviors, and psychosocial health in primary school children in disadvantaged communities in Port Elizabeth, South Africa. In addition, we aim to test a workplace health intervention for teachers. Methods: A randomized controlled trial (RCT) will be conducted in 8 schools. Approximately 1000 grade 4 to grade 6 school children, aged 9 to 13 years, and approximately 60 teachers will be recruited during a baseline survey in early 2019. For school children, the study is designed as a 36-week, cluster RCT (KaziKidz intervention), whereas for teachers, a 24-week intervention phase (KaziHealth intervention) is planned. The intervention program consists of 3 main components; namely, (1) KaziKidz and KaziHealth teaching material, (2) workshops, and (3) teacher coaches. After randomization, 4 of the 8 schools will receive the education program, whereas the other schools will serve as the control group. Intervention schools will be further randomized to the different combinations of 2 additional intervention components: teacher workshops and teacher coaching. Results: This study builds on previous experience and will generate new evidence on health intervention responses to NCD risk factors in school settings as a decision tool for future controlled studies that will enable comparisons among marginalized communities between South African and other African settings. Conclusions: The KaziKidz teaching material is a holistic educational and instructional tool designed for primary school teachers in low-resource settings, which is in line with South Africa’s Curriculum and Assessment Policy Statement. The ready-to-use lessons and assessments within KaziKidz should facilitate the use and implementation of the teaching material. Furthermore, the KaziHealth interventions should empower teachers to take care of their health through knowledge gains regarding disease risk factors, physical activity, fitness, psychosocial health, and nutrition indicators. Teachers as role models will be able to promote better health behaviors and encourage a healthy and active lifestyle for children at school. We conjecture that improved health and well-being increase teachers’ productivity with trickle-down effects on the children they teach and train. Trial Registration: International Standard Randomized Controlled Trial Number (ISRCTN): 18485542; http://www.isrctn.com/ISRCTN18485542 International Registered Report Identifier (IRRID): DERR1-10.2196/14097

Obesity-related conditions impose a considerable and growing burden on low- and middle-income countries, including South Africa. We aimed to assess the effect of twice a 10-week multidimensional, school-based physical activity intervention on children&rsquo, s health in Port Elizabeth, South Africa. A cluster-randomised controlled trial was implemented from February 2015 to May 2016 in grade 4 classes in eight disadvantaged primary schools. Interventions consisted of physical education lessons, moving-to-music classes, in-class activity breaks and school infrastructure enhancement to promote physical activity. Primary outcomes included cardiorespiratory fitness, body mass index (BMI) and skinfold thickness. Explanatory variables were socioeconomic status, self-reported physical activity, stunting, anaemia and parasite infections. Complete data were available from 746 children. A significantly lower increase in the mean BMI Z-score (estimate of difference in mean change: &minus, 0.17, 95% confidence interval (CI): &minus, 0.24 to &minus, 0.09, p &lt, 0.001) and reduced increase in the mean skinfold thickness (difference in mean change: &minus, 1.06, 95% CI: &minus, 1.83 to &minus, 0.29, p = 0.007) was observed in intervention schools. No significant group difference occurred in the mean change of cardiorespiratory fitness (p &gt, 0.05). These findings show that a multidimensional, school-based physical activity intervention can reduce the increase in specific cardiovascular risk factors. However, a longer and more intensive intervention might be necessary to improve cardiorespiratory fitness.

Few studies have focused on burnout among vocational students. This study examined the association between burnout and mental health among 56 Swiss vocational students (29 males, 27 females, M = 18.1, SD = 1.2 years) and tested whether recommended levels of moderate-to-vigorous physical activity (MVPA) attenuate this relationship. Burnout was strongly associated with increased depressive symptoms and decreased levels of life satisfaction, mental toughness, and quality of sleep. Students above recommended levels of MVPA reported lower burnout and higher mental health. No significant moderator effects were observed. Symptoms of burnout were associated with increased mental health problems. Physical activity should be promoted to prevent burnout, because nearly half of the students did not meet MVPA recommendations. Language: en

Background Burnout is a work-related syndrome that comprises physical fatigue, emotional exhaustion and cognitive weariness and is considered to be a risk factor for the development of major depression. While cognitive impairments in major depression persist even after remission of mood symptoms, the role of cognitive impairments in burnout is less clear. The hypothesis tested in the present study submits that executive function performance is reduced during burnout compared to healthy subjects but can recover to normal levels. Methods 12 male subjects (mean age 45.8 ± 6.8 years) suffering from occupational burnout took part in the study. They completed questionnaires related to burnout severity and underwent testing of executive functions twice at baseline and at follow-up 12 weeks later. Between baseline and follow-up burnout participants performed regular aerobic exercise training. Executive function performance at baseline and follow-up was compared to 12 matched healthy controls. Results Executive functioning was significantly reduced during acute burnout compared to healthy controls. At follow-up, both burnout severity and executive functioning were improved. Changes in burnout severity and executive function performance were not related. Conclusions Data suggest that executive function performance is impaired during acute burnout but can recover to the level of healthy controls. This finding is at odds with the finding of persistent deficits in the same tests found in major depression even after remission of depressive mood. Results may indicate that the pathophysiological changes underlying the impaired executive functioning during burnout are less pronounced compared to those in major depression.

Both scientists and the general public assume that physical activity (PA) is an effective, non-pharmacological approach to improvement in sleep quality. However, objective and reliable data on this relationship are scarce, particularly for adolescents. Therefore, the aims of the present study were to test the relationship by assessing both PA and sleep subjectively and objectively. A total of 56 adolescent vocational school students (Mean age=17.98, SD=1.36; 28 males, 28 females) participated in the study. Sleep and PA were subjectively assessed via questionnaires. Accelerometers objectively assessed PA, while sleep-EEG devices objectively assessed sleep. The data supported our prediction that adolescents with high PA levels would have longer TST, fewer wakening at night (WASO), fewer symptoms of insomnia, and higher sleep quality. However, gender influenced this pattern of results in that significant findings were only found between high self-reported PA levels and shorter perceived sleep onset latency (SOL). Though self-reported PA levels were a better predictor of good sleep than objectively assessed PA levels, gender was associated with sleep complaints; females reported more sleep complaints. Results indicate that among a non-clinical sample of adolescents increased PA is favorably associated with restoring sleep. Therefore, PA seems beneficial not only for physical and mental health, but also for sleep restoration.

In this paper we illustrate how ways of thinking about ethics are tied up with sport and physical education practice and introduce an alternative approach that can help to develop ethical pedagogies. We begin by locating socio-moral education in physical education within historical and contemporary pedagogical scholarship. Our argument is that the work of today's physical educators is still shaped by claims that were made about school sport in the nineteenth century and that sport scholars have long had difficulties proving these claims empirically. Rather than search for data that can confirm or refute claims of moral learning, we examine how incidents related to moral behaviour occur during physical education lessons. To do this we draw on data from an ethnographic investigation of a school in North Western Switzerland. Specifically, we present three episodes of interaction in three different physical education lessons. To make sense of these episodes, we introduce a social constructionist perspective. ...

Die Ressourcen der exekutiven Funktionen von Menschen sind begrenzt, weshalb nicht unbeschränkt Energie in die Selbstkontrollfunktion investiert werden kann. Aus sport- und gesundheitspsychologischer Perspektive bedeutet dies, dass chronischer Stress möglicherweise die Kapazität von Personen herabsetzt, die kognitive Kontrolle über ihr Sportverhalten aufrechtzuerhalten. Aufbauend auf den Postulaten des Strength Model of Self-Control wird in der vorliegenden Studie geprüft, ob der häufige Gebrauch spontaner Selbstkontrollstrategien bei 300 Polizeiangestellten (30 % Frauen, M = 41.8 Jahre) mit mehr Sportaktivität einhergeht, wenn sich diese hohem Stress ausgesetzt fühlen oder ein hohes Mass an sportbezogenen Barrieren wahrnehmen. Die Befunde zeigen, dass der spontane Gebrauch von Implementierungsintentionen und Strategien der Intentionsabschirmung mit erhöhter Sportaktivität assoziiert ist. Dieser Zusammenhang scheint jedoch unabhängig vom Stressniveau und den wahrgenommenen Bewegungsbarrieren zu sein. Die Studie unterstützt die Annahme, dass volitionale Selbstkontrollstrategien wie das Formulieren von Handlungsplänen und das Antizipieren von Bewegungsbarrieren und Bewältigungsstrategien bei Polizeiangestellten zur verbesserten Umsetzung gesundheitsbezogener Verhaltensziele beiträgt.

A mindset of mental toughness enables an individual to cope successfully with the pressures and demands of life. This 10-month study prospectively examined the association between mental toughness and stress resilience in 865 students (M = 17.86 years, 42.7% girls) from two vocational schools. Within each school, separate cluster analyses identified groups with different profiles of risk (assessed with perceived stress) and adaptation (operationalized with depressive symptoms and life satisfaction). Four clusters emerged characterizing students with well-adjusted (low risk, good adaptation), maladjusted (elevated risk, bad adaptation), deteriorated (low initial risk, worsening adaptation) and resilient profiles (elevated initial risk, improving adaptation). The latter two clusters reported similar levels of mental toughness at baseline, but resilient adolescents scored significantly higher on mental toughness at follow-up. After controlling for possible confounds, baseline toughness levels predicted depressive symptoms and life satisfaction over time. This study shows that mental toughness operates as a stress resilience resource. Mental toughness is, therefore a topic of interest for health specialists working with adolescent populations.

This paper critically interrogates widespread assumptions pertaining to the integrative function of sporting involvement in Switzerland. It focuses specifically on young people living in a culturally diverse area and how they make use of discursive variations of the integrative sport text. Interview material draws attention to four main sub-texts that frame sport as: a pedagogical tool, a site of interpersonal exchange, a method of catharsis, and as an apolitical activity without relevance to ethnicity. It is argued that these sub-texts: (1) are embedded within broader culturalist discourse and, (2) either support divisive social relations or do little to challenge them. Both instances suggest that changes are necessary to the way sport is ‘produced’ in discourse if it is to positively influence ethnic relations.

In children, the pathways by which physical activity and fitness are associated with physical and psychological wellbeing are still not fully understood. The present study examines for the first time in young children whether high levels of cardiorespiratory fitness and physical activity moderate the relationship between severity of life events and health-related quality of life. Three hundred and seventy-eight children (188 girls, 190 boys, M age = 7.27 years) participated in this cross-sectional study. Parental education, gender, age, severity of life events, health-related quality of life and physical activity were assessed via parental questionnaires. Cardiorespiratory fitness was assessed with the 20 m shuttle run test. Hierarchical regression analyses were used to test whether physical activity and fitness interacted with critical life events to explain health-related quality of life. When exposed to critical life events, children with higher fitness levels experienced higher levels of psychological wellbeing, relative to their less fit peers. On the other hand, children with higher fitness levels experienced higher physical wellbeing and more positive friendship relationships when severity of life events was low. A similar moderation effect was found for physical activity with overall quality of life as outcome. Recent stressful experiences alone were not sufficient to explain negative health outcomes in young children. Children with low cardiorespiratory fitness levels experienced lower psychological wellbeing when they were exposed to critical life events. More research is needed to find out whether similar findings emerge with objective physical activity measurements and when critical life events are assessed over longer periods of time.

The pathways by which physical activity impacts on participants' health are still not fully understood. The purpose of the present study was to go beyond existing research by combining methods from survey-based and experimental stress research, and by examining whether the potential of vigorous physical activity (VPA) to attenuate physiological and psychological stress responses is moderated by participants' subjective stress perception.The sample consisted of 42 undergraduate students (M=21.2±2.2 years, 52% women). Participants self-reported their stress and wore an accelerometer device for seven consecutive days. To examine differences in the adrenocortical, autonomic and psychological stress reactivity, salivary free cortisol, heart rate, state anxiety, mood and calmness were assessed prior to, during and after the Trier Social Stress Test (TSST). The cut-offs of the American College of Sports Medicine (ACSM) were used to distinguish between students below/above current VPA recommendations.High levels of perceived stress combined with VPA levels below the ACSM's standards (3×20min/week) were associated with an increased salivary cortisol response to the TSST (p.05). No significant group differences existed for heart rate. However, students with high stress/low VPA experienced less favourable affect throughout the entire testing session (p.05).Our study suggests that VPA has a high stress-protective potential among undergraduate students with high stress levels. Our findings highlight that promoting VPA in young adults seems to be a promising strategy to increase physiological and psychological stress resilience.

A better understanding of how social and environmental contexts affect childhood overweight/obesity is needed to develop more effective prevention strategies. Because the relationship between physical activity, stress, and obesity measures has received limited attention, this study examined for the first time in first-grade schoolchildren whether physical activity and fitness moderate the relationship between psychosocial stress and obesity-related measures.A total of 325 children (51% girls, Mage = 7.3 yr) took part in this cross-sectional study. Stress (critical life events, family, peer, and school-related stress) and vigorous physical activity were assessed via parental reports. Fitness was assessed with the 20-m shuttle run test. Body mass index, sum of skinfolds, and waist circumference were used as obesity-related outcomes. Hierarchical regression analyses were calculated to test whether fitness and physical activity act as stress buffers, using sex, age, and parental education as covariates.Children experiencing elevated school-related stress had lower body mass index, body fat, and waist circumferences if they had high fitness and physical activity levels, as compared with their less active and fit peers. Few significant interaction effects occurred for the other stress measures, although the findings trended in a similar direction for peer stress.This study shows that high fitness is associated with less unfavorable body composition among children with elevated school stress. Our findings indicate that policies aimed at reducing overweight and obesity should include the promotion of physical activity both inside and outside the school context. Moreover, our findings highlight the importance of strengthening children's capacities to cope successfully with school-related pressures.

Major depressive disorders (MDDs) are a widespread and burdensome mental illness associated with a high comorbidity with other conditions and a significantly reduced life expectancy compared to the general population. Therefore, targeted actions are needed to improve physical health in people with MDDs, in addition to ongoing efforts to enhance psychological well-being. Meanwhile, the positive effects of exercise training on the treatment of MDDs are well documented, while compelling evidence exists that exercise interventions can improve cardiorespiratory fitness in clinically meaningful ways. On the flipside, the long-term effects of exercise therapy are still not well documented, and recent studies suggest that initial improvements in MDDs dissipate if regular exercise participation is discontinued after the end of interventions. A recent survey among Swiss psychiatric hospitals further shows that all institutions provide some form of physical activity and exercise program. However, only a limited number of patients participate in these programs, mainly because participation is voluntary and no particular efforts are undertaken to engage patients with the lowest physical activity levels. We argue that more systematic efforts are needed to fully exploit the potential of physical activity and exercise programs in psychiatric care. We also emphasize that initiating and maintaining regular physical activity among psychiatric patients is a major challenge because specific dysfunctional cognitive–emotional processes might interfere with their capacity to self-regulate health-related behaviors. Specifically, we claim that behavioral skill training should be used to support patients with MDDs in overcoming barriers to initiating and maintaining physical activity. Moreover, we suggest that the assessment of physical activity and cardiorespiratory fitness should become routine in psychiatric practice.

Objectives Hair cortisol measurement has become an increasingly accepted approach in endocrinology and biopsychology. However, while in adult research hair cortisol has been proposed as a relevant biomarker for chronic stress (and its adverse consequences), studies with children are scarce. Therefore, the goal of the present exploratory study was to examine the associations between hair cortisol concentrations (HCCs), stress, and a series of health-related outcomes in a sample of Swiss first grade schoolchildren. Methods The sample consisted of 318 children (53% girls, M age = 7.26, SD = 0.35). Hair strands were taken near the scalp from a posterior vertex position, and HCCs were tested for the first 3-cm hair segment. Parents provided information about their children’s age, gender, parental education, children’s stress (recent critical life events, daily hassles), health-related quality of life, and psychosomatic complaints. Body composition, blood pressure, retinal vessel diameters, and cardiorespiratory fitness were measured with established methods. Results In multiple regression analyses, higher HCCs were weakly associated with increased BMI in girls (β = 0.22, p p Conclusions Although small significant relationships were found between HCCs, BMI and somatic complaints, the findings of this exploratory study challenge the view that HCCs can be used as a reliable biomarker of recent critical life events, daily hassles, health-related quality of life, and cardiovascular health indicators in non-clinical young children.

Background: Physical activity and exercise programs (PAEPs) are an important factor in increasing and maintaining physical and mental health. This holds particularly true for patients with psychiatric disorders undergoing treatment in a psychiatric hospital. To understand whether the benefits reported in the literature are mirrored in current treatment modalities, the aim of the present study was to assess the current state of PAEPs in psychiatric hospitals in the German-speaking part of Switzerland. Methods: All psychiatric hospitals (N=55) in the German-speaking part of Switzerland were contacted in spring 2014. Staff responsible for PAEPs were asked to complete an online questionnaire covering questions related to PAEPs such as type, frequency, staff training, treatment rationale, importance of PAEPs within the treatment strategy, and possible avenues to increase PAEPs. Results: Staff members of 48 different psychiatric hospitals completed the survey. Hospitals provided the following therapeutic treatments: relaxation techniques (100%), sports therapy (97%), activity-related psychotherapeutic interventions (95%), physiotherapy (85%), body therapies (59%), far-east techniques (57%), and hippotherapy (22%). Frequencies ranged from once/week to five times/week. Approximately 25% of patients participated in the PAEPs. Interventions were offered irrespective of psychiatric disorders. PAEP providers wanted and needed more vocational training. Conclusion: All participating psychiatric hospitals offer a broad variety of PAEPs in their treatment curricula. However, the majority of inpatients do not participate in PAEPs. Furthermore, those who do participate cannot continue to do so following discharge. PAEP providers need specific extended vocational trainings and believe that the potential of PA should be improved., Neuropsychiatric Disease and Treatment, 12, ISSN:1178-2021, ISSN:1176-6328

Dena Sadeghi Bahmani,1 Markus Gerber,2 Nadeem Kalak,1 Sakari Lemola,3 Peter J Clough,4 Pasquale Calabrese,5 Vahid Shaygannejad,6 Uwe Pühse,2 Edith Holsboer-Trachsler,1 Serge Brand1,2 1Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders, 2Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland; 3Department of Psychology, University of Warwick, Coventry, 4Department of Psychology, Manchester Metropolitan University, Manchester, UK; 5Division of Molecular and Cognitive Neuroscience, University of Basel, Basel, Switzerland; 6Department of Neurology and Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Background: Multiple sclerosis (MS) is the most common chronic autoimmune demyelinating and inflammatory disease of the central nervous system, afflicting both the body and mind. The risk of suffering from MS is 2.5–3.5 times greater in females than in males. While there is extant research on fatigue, depression, and cognitive impairment in patients with MS during its clinical course, there is a lack of research focusing on sleep, psychological functioning, and physical activity (PA) at the point of disease onset. The aims of the present study were therefore, to assess the markers of mental toughness (MT) as a dimension of psychological functioning, sleep disturbances (SD), and PA among patients at the moment of disease onset and to compare these with the corresponding values for healthy adolescents and young adults. Methods: A total of 23 patients with MS at disease onset (mean age =32.31 years; 91% females), 23 healthy adolescents (mean age =17.43 years; 82% females), and 25 healthy young adults (mean age =20.72 years; 80% females) took part in the study. They completed questionnaires covering sociodemographic data, MT, SD, and PA. Results: Patients with MS had similar scores for MT traits as those in healthy adolescents and healthy young adults, and equivalent levels of moderate-intensity PA and SD as young adults. MS patients reported lower levels of vigorous PA compared to both healthy adolescents and young adults. Conclusion: The pattern of the results of the present study suggests that the onset of MS is not associated with poor MT, poor sleep, or reduced moderate-intensity PA. Lower levels of vigorous PA were observed in MS patients. Low levels of vigorous PA may lead to decreased cardiorespiratory fitness in patients with MS and, in the long run, to reduced cardiovascular health and degraded psychological functioning. Keywords: multiple sclerosis, illness onset, mental toughness, sleep disturbances, physical activity, healthy controls

Background A variety of objective and subjective methods exist to assess insomnia. The Insomnia Severity Index (ISI) was developed to provide a brief self-report instrument useful to assess people’s perception of sleep complaints. The ISI was developed in English, and has been translated into several languages including German. Surprisingly, the psychometric properties of the German version have not been evaluated, although the ISI is often used with German-speaking populations. Methods The psychometric properties of the ISI are tested in three independent samples: 1475 adolescents, 862 university students, and 533 police and emergency response service officers. In all three studies, participants provide information about insomnia (ISI), sleep quality (Pittsburgh Sleep Quality Index), and psychological functioning (diverse instruments). Descriptive statistics, gender differences, homogeneity and internal consistency, convergent validity, and factorial validity (including measurement invariance across genders) are examined in each sample. Results The findings show that the German version of the ISI has generally acceptable psychometric properties and sufficient concurrent validity. Confirmatory factor analyses show that a 1-factor solution achieves good model fit. Furthermore, measurement invariance across gender is supported in all three samples. Conclusions While the ISI has been widely used in German-speaking countries, this study is the first to provide empirical evidence that the German version of this instrument has good psychometric properties and satisfactory convergent and factorial validity across various age groups and both men and women. Thus, the German version of the ISI can be recommended as a brief screening measure in German-speaking populations. Electronic supplementary material The online version of this article (doi:10.1186/s12888-016-0876-8) contains supplementary material, which is available to authorized users.

Numerous studies showed that regular physical activity (PA) is associated with both favourable and restorative sleep and improved psychological functioning (PF). However, there is little research on the topic covering the early to mid-adolescence period. Moreover, curiosity and exploratory behaviour (CEB) and mental toughness (MT) as a result of PA remains thus far uninvestigated, as do possible gender differences. The aim of the present study was to explore the associations between PA, subjective sleep (sS), PF, CEB, and MT during early to mid-adolescence. A total of 1361 participants (mean age = 13.37 years; range: 11–16 years; 51.2% female) took part in the study. They completed questionnaires covering PA, sS, PF, CEB, and MT. Greater PA was related to improved PF, better sS, and increased CEB and MT. Compared to male participants, females reported less PA, poorer sS, and had lower PF and MT scores. The present pattern of results suggests that during early and mid-adolescence greater PA was associated with more favourable sS and better PF, including CEB and MT, and that female participants reported lower scores in PA, sS, and PF. Accordingly, if PA has a favourable impact on sleep and psychological functioning, then data suggest that sports participation should be more tailored to increase motivation among female adolescents.

To assess the quality of public physical activity resources (PARs) in a low socio-economic community in the Olympic city of Rio de Janeiro. The Physical Activity Resource Assessment (PARA) instrument was used to assess all 29 public PARs located in this community. A quality indicator (QI) was developed based on PARA results. The average QI of the areas assessed was 1.3 ± 6.40 and the median 1 point, a considerably low score if compared to scores of public PARs across the city (13.6 ± 4.91 and 13 points). The urban regeneration necessary for hosting mega-sport events is frequently promoted as an opportunity to enhance PARs and therefore to improve health through physical activity (PA) participation. Findings indicate that the high number of elements that can discourage the use of these spaces may help explain the low level of PA during leisure time that has been previously reported of residents of the same neighborhood. Whether using the Olympic Games as catalyst or not, policies designed to encourage PA should focus also on the built environment.

Background As traditional lifestyle and diets change with social and economic development, disadvantaged communities in low- and middle-income countries increasingly face a double burden of communicable and non-communicable diseases. We studied the relationship between physical fitness and infections with soil-transmitted helminths (STHs), intestinal protozoa and Helicobacter pylori among schoolchildren in Port Elizabeth, South Africa. Methods We conducted a cross-sectional survey among 1009 children, aged 9 to 12 years, from eight primary schools in socioeconomically disadvantaged neighbourhoods of Port Elizabeth. Physical fitness was determined using field-deployable tests of the Eurofit fitness test battery. Stool samples were analysed with the Kato-Katz thick smear technique to diagnose STHs and with rapid diagnostic tests (RDTs) to detect intestinal protozoa and H. pylori infections. Haemoglobin (Hb) levels were assessed and anthropometric indicators determined. Results Complete data were available for 934 children (92 %). In two schools, high STH prevalences were found (Ascaris lumbricoides 60 and 72 %; Trichuris trichiura 65 % each). For boys and girls co-infected with A. lumbricoides and T. trichiura (n = 155) the maximal oxygen uptake (VO2 max) was estimated to be 50.1 and 47.2 ml kg-1 min-1, compared to 51.5 and 47.4 ml kg-1 min-1 for their non-infected peers (n = 278), respectively. On average, children without helminth infections had greater body mass (P = 0.011), height (P = 0.009) and a higher body mass index (P = 0.024) and were less often stunted (P = 0.006), but not significantly less wasted compared to their peers with a single or dual species infection. Among 9-year-old boys, a negative correlation between helminth infections and VO2 max, grip strength and standing broad jump distance was observed (P = 0.038). The overall mean Hb level was 122.2 g l-1. In the two schools with the highest prevalence of STHs the Hb means were 119.7 and 120.5 g l-1, respectively. Conclusions Intestinal parasite infections appear to have a small but significant negative effect on the physical fitness of infected children, as expressed by their maximal oxygen uptake. We observed a clear impact on anthropometric indicators. Electronic supplementary material The online version of this article (doi:10.1186/s13071-016-1761-5) contains supplementary material, which is available to authorized users.

Objectives Numerous studies have shown that the sleep and well-being of children and their parents are closely related. Previous studies have relied on subjective sleep data and have focused mostly on younger preadolescent children. The aim of the present study was therefore to investigate the relationship between the sleep patterns of adolescents and those of their parents using objective assessment of sleep. Methods Forty-seven families took part in this study. The sample comprised 80 adolescents (age: 16.3 ± 2.0 years; 44 males/36 females), 47 mothers (age: 49.5 ± 4.0 years), and 39 fathers (age: 50.8 ± 5.1 years). All participants individually completed questionnaires related to psychological functioning and sleep. Sleep-EEGs were assessed for all family members in their homes. Results Adolescents' and parents' objective sleep patterns were associated. In particular, the sleep continuity and architecture of adolescents and their mothers were strongly related. Additionally, significant relationships between objectively assessed sleep patterns, subjective sleep disturbances, depression scores and family climate held true for equally adolescents and mothers. Also, substantial links were found between adolescents' and parents' subjective sleep disturbances, depressive symptoms, and perceived family climate. Conclusion The present findings document objectively for the first time the existence of relationships between adolescents' sleep and well-being and parents' sleep and well-being. These relationships were apparent regardless of whether subjective or objective sleep data were considered. The overall pattern of results strongly indicates that adolescents' sleep and well-being and family functioning are related.

Mental toughness has been explored predominantly within sport contexts. Nevertheless, it is difficult to conceive mental toughness as only applicable to athletes. This study examines whether mentally tough participants exhibit resilience against stress. This is a cross-sectional study based on two different samples: Sample 1 consisted of 284 high school students (99 males, 185 females, M = 18.3 years). Sample 2 consisted of 140 first through fifth semester undergraduate students (53 males, 87 females, M = 20.0 years). Participants provided information about their level of perceived stress (10-item Perceived Stress Scale), mental toughness (48-item Mental Toughness Questionnaire) and depressive symptoms (Beck Depression Inventory). Consistent across the two samples, mental toughness mitigated the relationship between high stress and depressive symptoms. The interaction between stress and mental toughness explained 2% of variance in the adolescent sample and 10% of variance among young adults. The promotion of protective factors that foster resilient adaptation is a relevant issue. Mental toughness may appeal to individuals that are typically difficult to be reached with health interventions. Because mental toughness is part of young people's daily speech, it may serve as a less academic resource than other health psychology concepts.

Whereas a wealth of studies have investigated acute effects of moderate aerobic exercise on executive function, the roles of age, fitness, and the component of executive function in this relationship still remain unclear. Therefore, the present meta-analysis investigates exercise-induced benefits on specific aspects of executive function in different age and aerobic fitness subgroups. Based on data from 40 experimental studies, a small effect of aerobic exercise on time-dependent measures (g = .35) and accuracy (g = .22) in executive function tasks was confirmed. The results further suggest that preadolescent children (g = .54) and older adults (g = .67) compared to other age groups benefit more from aerobic exercise when reaction time is considered as dependent variable. In contrast to age, aerobic fitness and the executive function component had no influence on the obtained effect sizes. Consequently, high aerobic fitness is no prerequisite for temporary improvements of the executive control system, and low- as well as high-fit individuals seem to benefit from exercise in a similar way. However, a higher sensitivity of executive function to acute aerobic exercise was found in individuals undergoing developmental changes. Therefore, preadolescent children and older adults in particular might strategically use a single aerobic exercise session to prepare for a situation demanding high executive control.

Past research has shown that higher stress is associated with increased burnout symptoms. The purpose of this study was to test whether mental toughness protects against symptoms of burnout and whether mental toughness moderates the relationship between perceived stress and burnout over time. Fifty-four vocational students (M age = 18.1 yr., SD = 1.2; 27 males, 27 females) completed self-report questionnaires twice, 10 mo. apart. Perceived stress, mental toughness, and burnout were measured using the Adolescent Stress Questionnaire (ASQ), the Mental Toughness Questionnaire (MTQ), and the Shirom-Melamed Burnout Measure (SMBM). Students who perceived higher stress and lower mental toughness scores reported higher burnout symptoms. Although no significant interaction effects were found between stress and mental toughness in the prediction of burnout, the graphical inspection of the interactions indicated that among students with high stress, those with high mental toughness remained below the cutoff for mild burnout, whereas an increase in burnout symptoms was observable among peers with low mental toughness.

While understanding young people has never been easy, migration trends make it increasingly difficult. Many classrooms have become culturally heterogeneous and teachers are often faced with pupils with diverse linguistic and cultural heritages. Current scholarship suggests that as a discipline, physical education has not adapted to this diversity. In fact, commentators have suggested that physical education alienates pupils from minority groups and that traditional practices work to maintain cultural difference. The broad objective of this paper is to provide insights into how physical education intersects with biographies shaped by migration. Drawing from a case study investigation, this paper presents interview data from three youths with migration backgrounds living in a German-speaking region of Switzerland. The cases were selected because they highlight various ways in which physical education (PE) comes to make sense for adolescents. The key arguments that we develop are that ethnicity often works a...

Purpose: To explore associations between dream recall, gender, sleep, perceived stress, and creativity in a large sample of adolescents. In adults, women report a higher frequency of dream recall than men. Moreover, increased awakenings seem to increase dream recall, whereas low sleep quality is associated with low dream recall. In addition, there is some evidence that dream recall is associated with personality traits such as creativity. For adolescents, comparable data from larger samples are missing to date. Method: A total of 5,580 adolescents (mean age: 18.23 years; 3,711 females and 1,869 males) participated in the present study. Participants completed an Internet-administered questionnaire related to dreaming, sleep, perceived stress, and creativity. Results: As compared with males, female adolescents reported a higher dream recall rate and felt a stronger impact of dreams on the subsequent day. Female adolescents also described themselves as more creative, and reported suffering more from sleep complaints and perceived stress. Multiple regression analyses further revealed that increased dream recall was independently predicted by factors such as female gender, sleep quality, and creativity, whereas perceived stress, awakenings during the night, and sleep duration had no predictive value. Conclusions: Similar to the findings of studies conducted on adults, dream recall was also associated with female gender in a large sample of adolescents. Additionally, it seemed that several different factors such as good mood, increased sleep quality, and creativity influenced dream recall. These results can provide a basis for better understanding the psychology of dreams in adolescence. In contrast to nightmares, recalling dreaming is associated with health and well-being. 2011 Society for Adolescent Health and Medicine. All rights reserved.

Aim: The acculturation process presents numerous challenges that could benefit or adversely affect immigrants' health practices. The goal of this review was to present a systematic summary of studies examining the relationship between acculturation and physical activity among immigrants and ethnic minority populations. Subjects and methods: Systematic review based on 44 original studies found in electronic databases (Psychinfo/Psyndex, Eric, Pubmed/Medline, Web of Science, SportDiscus). Studies were eligible if they were written in English, German or French, incorporated a measure of acculturation and physical activity, exercise, or sport as independent and dependent variables, and provided statistical information to judge the level of significance. The 44 studies found included 760,242 participants. A narrative synthesis was performed. Causality of effects was examined based on seven criteria: consistency, strength of associations, specificity of effects, temporality, gradient, plausibility and experimental evidence. Results: Acculturation was associated with higher leisure time physical activity in 57% of all studies (even after controlling for potential confounds), independent of participants' gender, age and ethnic background. The main limitations of this review are that findings were not weighted for sample size and that publication biases might have contributed to an overestimation of the relationships. Conclusion: Prevention programs aimed at stimulating participation in physical activity among immigrants should give priority to individuals with low acculturation levels and it should consider culturally specific beliefs and constraints. Additionally, prevention programs could make an effort to promote acculturation among immigrants. Future studies should use longitudinal designs which include objective assessments of physical activity and which use multidimensional and bidirectional definitions of acculturation

The purpose of this study was to examine the extent to which action planning, coping planning and the interaction with past behaviour explain additional variance over and above that predicted by behavioural intention in a sample of 210 Swiss high school students (160 boys, 150 girls, mean age = 17.43 years). Participants filled in a questionnaire designed to assess exercise intention, action planning coping planning, past and current exercise behaviour at baseline and after three months. The findings show that adolescents’ exercise participation was predominantly regulated by exercise intention. Stronger exercise intentions were found among adolescents with positive outcome expectancies, high self-efficacy and self-determination scores. Spontaneous implementation intentions had no substantial influence on exercise participation. No significant interactions occurred between intention × Action Planning and Intention × Coping Planning. The effects of exercise intentions were stronger among students with high...

Purpose This study examined how a specific shift system was associated with stress, sleep and health among police officers. Moreover, this study investigated whether gender moderated the association between shift work and stress, sleep and health. Additional analyses were performed to find out how stress and shift work interact in explaining sleep and health. Methods The findings are based on a cross-sectional survey. A written questionnaire was sent to all employees of a local police force. 460 police officers (M = 40.67 years, SD = 9.66; 25.2% females) volunteered to take part in the study. 251 subjects were shift workers (54.6%). Police officers filled in a series of validated instruments assessing stress (TICS), perceived health (SF-12, somatic complaints, health care use) and sleep (ISI, PSQI). Results Shift work was associated with increased social stress, work discontent and sleep complaints. In turn, shift workers reported decreased use of primary health care. Moreover, stress was associated with increased sleep complaints and lower scores in perceived health. The interplay between stress and shift work did not produce any significant effects. Conclusions Workforce health promotion should make attempts to reduce chronic stress, while occupational health physicians should emphasize the diagnosis of undetected sleep disorders.

Zusammenfassung. Körperliche Inaktivität ist eine wichtige Ursache von Adipositas. Die Förderung eines körperlich-aktiven Lebensstils ist deshalb aus präventivmedizinischer Sicht ein wünschenswertes Ziel. Bisherige Interventionsprogramme konzentrierten sich vorwiegend auf die Verbesserung der Motivation. Programme für übergewichtige und adipöse Personen sollten jedoch verstärkt auch volitionale Faktoren in den Blick nehmen. Um herauszufinden, ob durch die Stärkung volitionaler Kompetenzen die Alltags- und Sportaktivität sowie die Determinanten körperlich-sportlicher Aktivität beeinflusst werden können, wurde in der vorliegenden Studie mit N = 50 übergewichtigen und adipösen Personen das Kurz-Bewegungsberatungsprogramm MoVo-LISA durchgeführt. Dazu wurden über einen Zeitraum von vier Monaten eine Experimental- (n = 21) und eine Wartegruppe (n = 29) dreimal befragt. Die Resultate zeigen signifikante Verbesserungen hinsichtlich der Sportaktivität, der Konsequenzerwartungen, der Zielintention, der Implementierungsintentionen und der volitionalen Selbstregulations-Fertigkeiten. Insgesamt liefern die Befunde überzeugende Belege für die kurz- und mittelfristige Wirksamkeit und die praktische Durchführbarkeit des MoVo-LISA Bewegungsberatungsprogramms in einem nicht medizinischen Setting.

Background Accurate assessment of physical activity is essential to determine the magnitude of the health-related benefits of regular physical activity. While physical activity questionnaires are easy to use, their accuracy in comparison to objective measures has been questioned. The purpose of the present study was to examine the utility of two interview-based questionnaires; a recently-developed instrument, the Simple Physical Activity Questionnaire (SIMPAQ), and the Seven Day-Physical Activity Recall (7DPAR). Methods Accelerometer data was collected in 72 university students (50% females). Telephone interviews were conducted to complete the SIMPAQ and the 7DPAR. Results Significant correlations (p < .001) were found between accelerometer-based moderate-to-vigorous physical activity (MVPA), the amount of self-reported moderate-to-vigorous exercise assessed via the SIMPAQ (rho = .49), and vigorous physical activity assessed via the 7DPAR (rho = .50). Exercise assessed via the SIMPAQ was significantly correlated with the vigorous physical activity score of the 7DPAR (rho = .56, p < .001). While participants needed three minutes less to complete the SIMPAQ (p < .001), participants tended to be more confident about the accuracy of the answers they provided on the 7DPAR (p < .01). Conclusions These two questionnaire measures of physical activity performed similarly in a healthy young adult sample. The SIMPAQ can be completed in 15 minutes, which could be an advantage in settings where time for physical activity assessment is limited.

Objectives During the past three decades, researchers from many disciplines have been interested in whether exercise can help people to cope better with stress. Past research examining the stress buffering effects of exercise, however, is limited by small sample sizes, poorly validated measures of stress, exercise and health, and the exclusion of samples that are at-risk for chronic stress exposure. The purpose of the present study, therefore, was to address these limitations by exploring the stress buffering effects of exercise and fitness in a sample of police and emergency response service officers. Design The design of the current study is cross-sectional. Method The current study recruited 533 employees of the police force and emergency response service corps in an urban area of German-speaking, North-Western Switzerland (22.9% females). All respondents filled in a self-administered battery of validated questionnaires assessing stress, exercise, perceived fitness and health. Results The data showed that increased stress was associated with poorer health. There was no significant relationship between exercise and stress; however, increased fitness was associated with reduced stress. Exercise and fitness were associated with enhanced health. Hierarchical regression analyses revealed significant interactions, suggesting that exercise protects against stress-related health problems. Exercise was a more powerful stress buffer than perceived physical fitness. Moreover, moderate exercise was more suited to counteract stress than vigorous exercise activities. Conclusions The findings indicate that exercise and fitness can help foster a healthy and thriving workforce that takes less sick leaves and feels better prepared to cope with chronic stress.

A cognitive mediation model was examined to find out how stress, depression, and hypomania precipitate the occurrence of dysfunctional sleep-related cognitions, which in turn lead to insomnia. A total of 862 participants (639 women, 223 men; M age: 24.67 years, SD = 5.91) completed a series of self-report questionnaires assessing perceived stress, depression, hypomania, dysfunctional sleep-related cognitions, and insomnia. Compared to men, women reported higher levels of stress, depression, and insomnia. Women also suffered from more dysfunctional sleep-related cognitions. All variables were intercorrelated. Structural equation analyses showed that the relationship between stress and insomnia was largely mediated by dysfunctional sleep-related cognitions. Links between depression and insomnia were found to be weak when controlled for stress and dysfunctional sleep-related cognitions. The findings support a cognitive model of insomnia. Stress must be seen as a precipitating factor in the onset and maintenance of insomnia. Consequently, competencies to deal with dysfunctional sleep-related cognitions should be fostered in stress management programs. In turn, stress management should be a primary focus in the treatment of insomnia.

Fear of negative evaluation (FNE) is regarded as being the core feature of social anxiety. The present study examined how FNE is associated with physical activity (PA), body mass index (BMI) and perceived physical health (PPH) in children. Data were collected in a sample of 502 primary school children in first and fifth grades taking part in a randomized-controlled trial ('Kinder-Sportstudie KISS') aimed at increasing PA and health. PA was assessed by accelerometry over 7 days, PPH by the Child Health Questionnaire and FNE by the Social Anxiety Scale for Children - Revised. BMI z-scores were calculated based on Swiss norms. Cross-sectional analyses indicated that children high in FNE exercised less, reported lower levels of PPH and had higher BMI z-scores (P>0.01). Using mixed linear models, the school-based PA intervention did not manage to reduce FNE scores. Overweight children demonstrated a greater increase in FNE (P>0.05) indicating that enhanced weight may be a risk factor for FNE. In conclusion, the associations among high FNE, low PA and increased BMI should be considered when promoting an active lifestyle in children

Background: Understanding how exercise influences health is important in designing public health interventions. At present, evidence suggests that there is a positive relationship between exercise and health. However, whether this relationship is partly due to the stress-moderating impact of exercise has been less frequently investigated although more and more people are taxed by stressful life circumstances. Methods: A comprehensive review of studies testing the potential of exercise as a stress-buffer was conducted (including literature from 1982 to 2008). The findings are based on a narrative review method. Specific criteria were taken into account to evaluate causality of the evidence. Results: About half of the studies reported at least partly supportive results in the sense that people with high exercise levels exhibit less health problems when they encounter stress. The causality analyses show that stress-moderation effects were consistently found in different samples and with different methodological approaches. Although more support results from cross-sectional studies, exercise-based stress-buffer effects were also found in prospective, longitudinal and quasi-experimental investigations. Conclusions: This review underscores the relevance of exercise as a public health resource. Recommendations are provided for future research. More prospective and experimental studies are needed to provide insight into how much exercise is necessary to trigger stress-buffer effects. Furthermore, more information is warranted to conclude which sort of exercise has the strongest impact on the stress-illness-relationship.

Background Prevalence rates of autism spectrum disorder (ASD) have increased dramatically in the last two decades. In addition to the core symptoms such as impaired communication, difficulties in social interaction, and restricted and stereotypical patterns of behavior and interests, poor sleep and motor skill (MS) deficits have also been observed in children with ASD. On the other hand, there is evidence that aerobic exercise training (AET) has a positive impact on sleep, and that specific training improves MSs. Accordingly, the aim of the present pilot study was to investigate to what extent a combination of AET and MS training (MST) would improve sleep and physical performance in a small sample of children with ASD. Methods Ten children with ASD (mean age: 10 years) took part in the study. After a thorough medical examination and psychiatric assessment, children participated in thrice-weekly 60-minute sessions of AET and MST lasting for 3 consecutive weeks. Sleep was assessed both objectively (sleep-encephalography [sleep-EEG]) and subjectively (parents’ questionnaire). MSs were assessed via standardized test batteries. Parents completed sleep and mood logs, and ratings of mood. Results Mild-to-moderate insomnia was reported in 70% of children. Compared to nights without previous AET and MS, on nights following AET and MS, sleep efficiency increased (d=1.07), sleep onset latency shortened (d=0.38), and wake time after sleep onset decreased for 63% of the sample (d=1.09), as assessed via sleep-EEG. Mood in the morning, as rated by parents, improved after three weeks (d=0.90), as did MSs (ball playing, balance exercise: ds>0.6). Conclusion The pattern of results of this pilot study suggests that regular AET and MST impact positively on sleep, MSs, and mood among children with ASD.

Serge Brand,1,2,* Stefanie Jossen,2,* Edith Holsboer-Trachsler,1 Uwe Pühse,2 Markus Gerber21Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders (ZASS), 2Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland*These authors contributed equally to this work and share the first authorshipBackground: Prevalence rates of autism spectrum disorder (ASD) have increased dramatically in the last two decades. In addition to the core symptoms such as impaired communication, difficulties in social interaction, and restricted and stereotypical patterns of behavior and interests, poor sleep and motor skill (MS) deficits have also been observed in children with ASD. On the other hand, there is evidence that aerobic exercise training (AET) has a positive impact on sleep, and that specific training improves MSs. Accordingly, the aim of the present pilot study was to investigate to what extent a combination of AET and MS training (MST) would improve sleep and physical performance in a small sample of children with ASD. Method: Ten children with ASD (mean age: 10 years) took part in the study. After a thorough medical examination and psychiatric assessment, children participated in thrice-weekly 60-minute sessions of AET and MST lasting for 3 consecutive weeks. Sleep was assessed both objectively (sleep-encephalography [sleep-EEG]) and subjectively (parents’ questionnaire). MSs were assessed via standardized test batteries. Parents completed sleep and mood logs, and ratings of mood. Results: Mild-to-moderate insomnia was reported in 70% of children. Compared to nights without previous AET and MS, on nights following AET and MS, sleep efficiency increased (d=1.07), sleep onset latency shortened (d=0.38), and wake time after sleep onset decreased for 63% of the sample (d=1.09), as assessed via sleep-EEG. Mood in the morning, as rated by parents, improved after three weeks (d=0.90), as did MSs (ball playing, balance exercise: ds>0.6).Conclusion: The pattern of results of this pilot study suggests that regular AET and MST impact positively on sleep, MSs, and mood among children with ASD.Keywords: physical activity, ball playing, balancing, insomnia, sleep efficiency, autism spectrum disorder, sleep-EEG