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Background: Research investigating the psychological determinants of physical activity (PA) tends to conceptualize determinants as stable, trait-like factors. Growing evidence suggests that people and the processes that regulate people's behavior fluctuate over short timescales (eg, hours and days). This study explores the extent to which subject-level variability (vs stability) in determinants of PA, as well as the interaction between subject-level mean and variability in those determinants, is associated with moderate- to vigorous-intensity PA (MVPA) in older adults., Methods: Older adults (N = 202) enrolled in a measurement burst design study with 3 data collection waves occurring over a 1-year period. Each data collection wave consisted of accelerometers and ecological momentary assessment to capture MVPA and psychological determinants of MVPA, respectively. Mixed-effects location scale modeling was first used to estimate subject-level means and variability in psychological determinants. These estimates were then used as predictors of daily MVPA using multilevel modeling., Results: Subject-level variability in PA intentions (β = 0.199, SE = 0.062, P = .001), self-efficacy (β = 0.133, SE = 0.064, P = .037), and planning (β = 0.154, SE = 0.062, P = .014) were positively associated with daily MVPA. Associations between subject-level variability in PA intentions and self-efficacy decreased in strength, becoming nonsignificant at higher mean levels of PA intentions (β = -0.147, SE = 0.062, P = .018) and self-efficacy (β = -0.116, SE = 0.063, P = .062)., Conclusions: Greater subject-level variability in psychological determinants may be adaptive for PA engagement, especially among older adults experiencing low levels of those determinants. Moving beyond mean levels to include subject-level variability in psychological determinants of PA may help to improve our understanding of the processes that drive PA engagement.

Background/objectives: Few studies have investigated associations between the motivational outcome based on physical activity (PA) affective experiences (i.e., attraction vs. antipathy toward PA) and behavior. This study investigated cross-sectional and longitudinal associations between attraction (vs. antipathy) toward PA and device-based PA in older adults., Methods: Older adults (n = 139; 71% female, Mage = 70.5) completed assessments of attraction (vs. antipathy) toward PA and 14 days of device-based accelerometry at Times 1 and 2., Results: Greater attraction toward PA at Time 1 was associated with greater steps (β = 5.31, p < .01) and moderate to vigorous intensity PA (β = 3.08, p < .05) at Time 1. Greater attraction toward PA at Time 1 was not significantly associated with steps or moderate to vigorous intensity PA at Time 2., Conclusion: Greater emphasis on resultant motivation from PA affective experiences may be useful in promoting PA in older adults. Significance/Implications: In spite of mixed findings in the present study, there is strong evidence that positive affective responses during a single bout of PA play an important role in predicting future engagement. Yet, affective experiences during PA can be individualistic and often influenced by contextual factors. Interventions designed to increase PA should focus on factors that may create positive affective experiences for participants.

Objective: Assess the acceptability of a digital grocery shopping assistant among rural women with low income., Design: Simulated shopping experience, semistructured interviews, and a choice experiment., Setting: Rural central North Carolina Special Supplemental Nutrition Program for Women, Infants, and Children clinic., Participants: Thirty adults (aged ≥18 years) recruited from a Special Supplemental Nutrition Program for Women, Infants, and Children clinic., Phenomenon of Interest: A simulated grocery shopping experience with the Retail Online Shopping Assistant (ROSA) and mixed-methods feedback on the experience., Analysis: Deductive and inductive qualitative content analysis to independently code and identify themes and patterns among interview responses and quantitative analysis of simulated shopping experience and choice experiment., Results: Most participants liked ROSA (28/30, 93%) and found it helpful and likely to change their purchase across various food categories and at checkout. Retail Online Shopping Assistant's reminders and suggestions could reduce less healthy shopping habits and diversify food options. Participants desired dynamic suggestions and help with various health conditions. Participants preferred a racially inclusive, approachable, cartoon-like, and clinically dressed character., Conclusions and Implications: This formative study suggests ROSA could be a beneficial tool for facilitating healthy online grocery shopping among rural shoppers. Future research should investigate the impact of ROSA on dietary behaviors further., (Copyright © 2024 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Background: Low-income households often experience a cyclic pattern in food availability, with acute food shortages at month end. Variations in the monthly feeding of infant formula are understudied., Objectives: This study aimed to compare the amount and frequency of formula consumed at the beginning and end of the monthly Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) assistance cycle and test associations with total energy intake and other feeding practices among infants aged 7-11 mo., Methods: This study was conducted between May 2020 and April 2021 in the southeastern United States and involved mothers of infants participating in WIC's fully formula package. Mothers were interviewed and 24-h feeding recalls were conducted at the beginning and end of the month. We defined month beginning as 5 d following the first WIC formula purchase and month end as 5 d before the next monthly cycle. Fifty mother-infant dyads participated in single or multiple monthly cycles, totaling 98 monthly cycles. Generalized linear mixed-effects modeling was used to test differences in formula feeding at month beginning and end., Results: Most participants (84%) were African American or Latino and >90% purchased all formula within 2-3 d of the WIC issuance. The energy intake from formula at month beginning was significantly higher than at month end (67.63% and 57.85%, respectively; P = 0.002), with no differences in total energy intake. The odds of infants being fed cow milk and fruit juices/drinks increased from month beginning to end (P < 0.05)., Conclusions: Infants in low-income households are at risk of experiencing a cyclic feeding pattern characterized by higher formula feeding at month beginning and an increase in feeding of nonrecommended drinks at month end. The WIC program policy could review educational and distribution options to reduce cyclic formula feeding and clarify caregivers' understanding of infants' formula needs. Household-level investigations into formula management and determinants of cyclic feeding are warranted., (Copyright © 2024 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

Background: Assessing postural control is important for the assessment of motor function after concussion. Data used for postural control assessment typically do not take the sport played, age, or sex of the athlete into consideration. It is plausible these variables may be significant when making return-to-play decisions., Research Question: This study used the BTrackS database to examine differences in postural control in athletes playing different types of sports and across sex and age., Methods: BTrackS data from 9093 high school to college-aged athletes (aged 14-22 years) were examined employing a One-way ANOVA with a post-hoc test to compare CoP path length between sport types. A moderation analysis was used to test interaction effects of sex and age on a CoP/BMI ratio., Results: Significant differences were observed between sport types, F(3,9089) = 42.4, p <.001, η2 = 0.014. Post hoc tests indicated that collision (M = 25.0, SD = 7.6) sport athletes exhibited significantly higher CoP measures compared to the contact (M = 23.4, SD = 7.4), limited contact (M = 22.9, SD = 6.9), and non-contact (M = 23.0, SD = 7.4) athletes. There was no difference between other sport types (p >.20). A significant mean sex difference (Mmale = 0.924, Mfemale = 0.898, p <.001) and a quadratic association with age, (β = -0.042, p <.001) was observed. Further, magnitude of those age differences decreased with age (β = 0.011, p <.001). An interaction of age and sex was significant for linear (β = 0.020, p <.001) and quadratic terms (β = -0.006, p <.001)., Significance: Athletes exhibited different postural control when the type of sport, age, and sex was taken into consideration. This data possess clinical significance as this suggests that normative postural control data for collision sport athletes should be derived from data based upon type of sport played, age, and sex of the athlete., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Daniel J. Goble reports financial support was provided by Balance Tracking Systems, Inc. Daniel J. Goble reports a relationship with Balance Tracking Systems, Inc. that includes: equity or stocks. Daniel J. Goble has patent #10,660,558,2020 issued to Daniel J. Goble. DJG is eligible for royalties from a patent (US Patent 10,660,558,2020) related to the technology used in this study. In addition, he has an equity stake (stock options) in Balance Tracking Systems, Inc. This financial conflict of interest is mitigated by a management plan put in place by his academic institution to ensure the integrity of his research.The other authors of this manuscript report no conflicts of interest in this work. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper, (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Obesity prevalence is significantly higher among Latino boys than girls. Weight status at 12 mo, a significant predictor of childhood obesity, is associated with feeding practices during infancy., Objectives: The objectives were to examine breastfeeding and formula-feeding practices overall and by infant gender and to examine relations among infant gender, milk-feeding practices, and obesity risk among Latino infants over the first year of life., Methods: Latino mother-infant dyads ( n = 90) were recruited from a pediatric clinic. Mothers were interviewed at regular intervals (infants aged 2, 4, 6, and 9 mo), and 24-h feeding recalls were conducted when infants were aged 6 and 9 mo. Infants' lengths and weights were retrieved from clinic records to calculate weight-for-length percentiles. A bivariate analysis was conducted to compare feeding practices by gender and mediation analysis to test whether feeding practices mediated the relation between gender and obesity risk., Results: The majority (80%) of mothers were born outside the United States. In early infancy, mixed feeding of formula and breastfeeding was common. At 6 and 9 mo of age, milk-feeding practices differed, with formula feeding more common for boys than girls. At 12 mo, 38% of infants experienced obesity risk (≥85th weight-for-length percentile). Infants' obesity risk increased by 18% per 1 oz increase in powdered formula intake. Formula intake among boys was on average 1.42 oz (in dry weight) higher than that among girls, which, in turn, mediated their increased obesity risk (IE RR = 1.27, 95% confidence interval: 1.02, 1.90)., Conclusions: The increased obesity risk among Latino boys compared with girls at 12 mo was explained by higher rates of formula feeding at 6 and 9 mo of age. Future investigations of cultural values and beliefs in gender-related feeding practices are warranted to understand the differences in obesity risk between Latino boys and girls., (© 2024 The Author(s).)

The present study sought to identify differences in the rates and predictors of risky sexual behavior among college students with and without attention-deficit hyperactivity disorder (ADHD). Current ADHD diagnosis, medication status among those with ADHD, executive functioning, substance use, comorbid anxiety, comorbid depression, and gender were identified as potential predictors of increased risky sexual behavior. Multiple group latent growth curve modeling was used to estimate trajectories of risky sexual behavior across four years of college among college students with ADHD (n medicated  = 99, n unmedicated  = 105) and a comparison group (n = 217) recruited from colleges throughout the eastern United States (M age = 18.23 years, 53% female, 70% White). First-year college students with ADHD reported significantly higher rates of sexual risk behavior than their peers without ADHD, with no significant differences found based on medication status. Students with ADHD who were taking medication for ADHD reported significant decreases in risky sexual behavior over time. Among college students with ADHD, anxiety was related to increased current risky sexual behavior in the medicated group, while depression was predictive of decreased future risky sexual behavior in the unmedicated group. Alcohol and cannabis use were significantly associated with increased mean levels of risky sexual behavior across all three groups, and cannabis use was associated with decreased future risky sexual behavior within the comparison group. Executive functioning deficits and male gender were predictive of risky sexual behavior within the comparison group. The results demonstrate that college students with ADHD, regardless of medication status, are at an increased likelihood of engaging in risky sexual behavior., (© 2023. The Author(s).)

Background: Older adults struggle to maintain newly initiated levels of physical activity (PA) or sedentary behavior (SB) and often regress to baseline levels over time. This is partly because health behavior theories that inform interventions rarely address how the changing contexts of daily life influence the processes regulating PA and SB or how those processes differ across the behavior change continuum. Few studies have focused on motivational processes that regulate the dynamic nature of PA and SB adoption and maintenance on microtimescales (ie, across minutes, hours, or days)., Objective: The overarching goal of Project Studying Maintenance and Adoption in Real Time (SMART) is to determine the motivational processes that regulate behavioral adoption versus maintenance over microtimescales, using a dual process framework combined with ecological momentary assessment and sensor-based monitoring of behavior. This paper describes the recruitment, enrollment, data collection, and analytics protocols for Project SMART., Methods: In Project SMART, older adults engaging in at least 30 minutes of moderate-to-vigorous intensity PA per week complete 3 data collection periods over 1 year, with each data collection period lasting 14 days. Across each data collection period, participants wear an ActiGraph GT3X accelerometer (ActiGraph, LLC) on their nondominant waist and an ActivPAL micro4 accelerometer (PAL Technologies, Ltd) on their anterior thigh to measure PA and SB, respectively. Ecological momentary assessment questionnaires are randomly delivered via smartphone 10 times per day on 4 selected days in each data collection period and assess reflective processes (eg, evaluating one's efficacy and exerting self-control) and reactive processes (eg, contextual cues) within the dual process framework. At the beginning and end of each data collection period, participants complete a computer-based questionnaire to learn more about their typical motivation for PA and SB, physical and mental health, and life events over the course of the study., Results: Recruitment and enrollment began in January 2021; enrollment in the first data collection period was completed by February 2022; and all participants completed their second and third data collection by July 2022 and December 2022, respectively. Data were collected from 202 older adults during the first data collection period, with approximate retention rates of 90.1% (n=182) during the second data collection period and 88.1% (n=178) during the third data collection period. Multilevel models and mixed-effects location scale modeling will be used to evaluate the study aims., Conclusions: Project SMART seeks to predict and model the adoption and maintenance of optimal levels of PA and SB among older adults. In turn, this will inform the future delivery of personalized intervention content under conditions where the content will be most effective to promote sustained behavior change among older adults., International Registered Report Identifier (irrid): DERR1-10.2196/47320., (©Jaclyn P Maher, Derek J Hevel, Kelsey M Bittel, Brynn L Hudgins, Jeffery D Labban, Laurie Kennedy-Malone. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 28.07.2023.)

Introducing complementary foods early during infancy has been associated with an increased risk of overweight later in life, but the pathway is an understudied topic. Hence the study was conducted with low-income and primarily minority mother-infant dyads to: 1) understand how the introduction of complementary foods prior to 4 months was associated with socio-demographic characteristics and food security status; 2) determine the association between early introduction to complementary foods and breastfeeding and adding cereal into the bottle in later infancy (i.e., at 6 and 9 months), and; 3) examine how adding infant cereal into the bottle was related to daily calorie and macronutrient intake in infancy. We conducted interviews with mothers (n = 201) at 4 months of age and 24-h feeding recalls at age 6 and 9 months. Results indicated that 29% of the infants were fed complementary foods before 4 months of age. Introducing complementary foods early was negatively associated with breastfeeding and positively associated with adding cereal into the bottle at 6-months. This practice was more common among those who experienced marginal to very low levels of food security. Comparing by race/ethnicity, Latinx mothers were significantly less likely to introduce solids early. After controlling for sex, infants fed cereal in the bottle were consuming significantly more calories compared to their counterparts. Specifically, adding cereal into the bottle resulted in approximately 10% additional daily calorie intake among infants. Understanding how these feeding practices affect appetite development and weight status during infancy is warranted., Competing Interests: Declaration of competing interest None., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Online grocery shopping is a rapidly growing food procurement approach in the United States with the potential to improve food access. Limited research has focused on understanding differential access to online grocery shopping that provides healthier items such as fresh or frozen fruits and vegetables., Objective: The study aim was to understand geospatial, socioeconomic, and racial disparities in the availability of healthy online grocery shopping and online Supplemental Nutrition Assistance Program (SNAP) acceptance in North Carolina., Design: A cross-sectional study was conducted during spring 2021., Participants/setting: A listing of grocery stores with online shopping was generated using a systematic search strategy. Stores were geocoded and spatially joined to relevant contextual (rural/urban [based on US Department of Agriculture Rural Urban Continuum codes]), broadband Internet availability, socioeconomic variables (ie, percent poverty and Social Vulnerability Index), and demographic variables (ie, percent racial minority) in geographic information systems software., Main Outcome Measures: Prevalence rate ratios (PRRs) of healthy online grocery shopping (availability of curbside pickup or home delivery of fresh and frozen produce), and online SNAP acceptance (ie, availability of online SNAP), at the census tract level (n = 2,162)., Statistical Analyses Performed: PRRs for availability of healthy online grocery shopping and SNAP online acceptance at the census tract level (n = 2,162) were modeled using Poisson regression with robust standard errors., Results: This study found disparities in access to healthy online grocery shopping and SNAP online shopping availability in North Carolina. Healthy online shopping availability rates were higher in urban census tracts (PRR 1.68, 95% CI 1.47 to 1.92), areas with lower Social Vulnerability Index scores (PRR 0.99, 95% CI 0.98 to 0.99), higher Internet Availability Index scores (PRR 1.21, 95% CI 1.17 to 1.25), and lower percent poverty (PRR 0.94, 95% CI 0.90 to 0.98). SNAP online shopping availability rates were higher in urban census tracts (PRR 1.41, 95% CI 1.16 to 1.65), areas with higher Social Vulnerability Index scores (PRR 1.02, 95% CI 1.01 to 1.04), higher Internet Availability Index scores (PRR 1.15, 95% CI 1.10 to 1.20), and higher percent minority (PRR 1.02, 95% CI 1.0001 to 1.03). SNAP online shopping availability rates were lower in areas with higher percent poverty (PRR 0.90, 95% CI 0.85 to 0.95)., Conclusions: This study found disparities in access to healthy online grocery shopping and SNAP online shopping for rural areas, and areas with higher poverty, and lower broadband Internet access in North Carolina. Further research is needed to identify effective strategies for addressing these disparities., (Copyright © 2022 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Females have smaller anterior cruciate ligaments (ACLs) than males and smaller ACLs have been associated with a greater risk of ACL injury. Overall body dimensions do not adequately explain these sex differences. This study examined the extent to which quadriceps muscle volume (VOL QUAD ) positively predicts ACL volume (VOL ACL ) once sex and other body dimensions were accounted for. Physically active males (N = 10) and females (N = 10) were measured for height, weight, and body mass index (BMI). Three-Tesla magnetic resonance images of their dominant and nondominant thigh and knee were then obtained to measure VOL ACL , quadriceps, and hamstring muscle volumes, femoral notch width, and femoral notch width index. Separate three-step regressions estimated associations between VOL QUAD and VOL ACL (third step), after controlling for sex (first step) and one body dimension (second step). When controlling for sex and sex plus BMI, VOL HAM , notch width, or notch width index, VOL QUAD consistently exhibited a positive association with VOL ACL in the dominant leg, nondominant leg, and leg-averaged models (p < 0.05). Findings were inconsistent when controlling for sex and height (p = 0.038-0.102). Once VOL QUAD was included, only notch width and notch width index retained a statistically significant individual association with VOL ACL (p < 0.01). Statement of Clinical Significance: The positive association between VOL QUAD and VOL ACL suggests ACL size may in part be modifiable. Future studies are needed to determine the extent to which an appropriate training stimulus (focused on optimizing overall lower extremity muscle mass development) can positively impact ACL size and structure in young females., (© 2021 Orthopaedic Research Society. Published by Wiley Periodicals LLC.)

Undernutrition among children is a significant issue in rural areas in Cameroon, with diarrhea being one of the major contributing risk factors. To gain a better understanding of the risk factors of diarrhea, the main objective of this epidemiological study was to examine associations between water access and sanitation service with diarrhea, diet diversity, and anemia among infants and toddlers in rural households in Cameroon. The study involved household- and individual-level data of 2,129 rural-dwelling infants and toddlers from the Demographic and Health Survey database. About one-third of infants and toddlers were experiencing diarrhea, with higher odds among those who lived in households with limited water service (p = 0.028). The odds of having diarrhea were 50% higher among infants and toddlers when households did not have sanitation facilities (p = 0.007). The lack of improved water and sanitation was also associated with a low intake of various food groups among older infants and toddlers. The prevalence of anemia was high, but no significant differences were seen by water and sanitation services. The achievement of SDG #6 will help address undernutrition and achieve other SDGs, including improving health and wellbeing.

Objective : The current study reports functional outcomes from a multi-site randomized trial of a cognitive-behavioral treatment program for college students diagnosed with ADHD. Methods : A sample of emerging adults ( N = 250; ages 18 to 30) currently attending college were comprehensively evaluated and diagnosed with ADHD ( M age  = 19.7; 66% female, 6.8% Latino, 66.3% Caucasian). Participants were randomized to either a two-semester intervention (Accessing Campus Connections and Empowering Student Success (ACCESS)) or a delayed treatment condition. Participants were assessed with measures of academic, daily life, and relationship functioning prior to treatment, at the end of the first semester, and after the second semester of treatment. Results : Multi-group latent growth curve models revealed moderate effect size improvements on self-report measures of study skills and strategies, as well as on self-report measures of time management, daily functioning, and overall well-being for participants in ACCESS. Importantly, treatment effects were maintained or increased in some cases from the end of the first semester to the end of the second semester. Improvements in self-reported interpersonal functioning were not significantly different across condition and neither condition demonstrated significant change over time in educational record outcomes (GPA and number of credits earned). Conclusions : ACCESS appears to promote improvements in self-reported general well-being and functioning, time management, and study skills and strategies. However, improvements in interpersonal relationships and objective academic outcomes such as GPA were not observed. Clinical implications and future directions for treating ADHD on university and college campuses are discussed.

Objective: College students with attention deficit/hyperactivity disorder (ADHD) are at increased risk for numerous educational and psychosocial difficulties. This study reports findings from a large, multisite randomized controlled trial examining the efficacy of a treatment for this population, known as ACCESS-Accessing Campus Connections and Empowering Student Success., Method: ACCESS is a cognitive-behavioral therapy program delivered via group treatment and individual mentoring across two semesters. A total of 250 students (18-30 years of age, 66% female, 6.8% Latino, 66.3% Caucasian) with rigorously defined ADHD and comorbidity status were recruited from two public universities and randomly assigned to receive ACCESS immediately or on a 1-year delayed basis. Treatment response was assessed on three occasions, addressing primary (i.e., ADHD, executive functioning, depression, anxiety) and secondary (i.e., clinical change mechanisms, service utilization) outcomes., Results: Latent growth curve modeling (LGCM) revealed significantly greater improvements among immediate ACCESS participants in terms of ADHD symptoms, executive functioning, clinical change mechanisms, and use of disability accommodations, representing medium to large effects (Cohen's d, .39-1.21). Across these same outcomes, clinical significance analyses using reliable change indices (RCI; Jacobson & Truax, 1992) revealed significantly higher percentages of ACCESS participants showing improvement. Although treatment-induced improvements in depression and anxiety were not evident from LGCM, RCI analyses indicated that immediate ACCESS participants were less likely to report a worsening in depression/anxiety symptoms., Conclusions: Findings from this RCT provide strong evidence in support of the efficacy and feasibility of ACCESS as a treatment for young adults with ADHD attending college. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Acute exercise benefits memory, and the temporal placement of exercise relative to exposure can affect the magnitude of benefits observed. Although the temporal placement appears to be important, there is a limited understanding as to how cognitive benefits in response to acute exercise are achieved. Hence, we conducted a two-part study including a behavioral study and a follow-up functional magnetic resonance imaging (fMRI) study to advance our understanding of the potential role of the effects of exercise on memory and neural activation. For Study One, we assessed the effect of acute exercise on memory in young adults. Participants were randomized to exercise before exposure for 20 min (before only, BO), after exposure for 20 min (After Only, AO), before and after exposure for 10 min at each time (before and after, BA), or to receive no exercise (No-exercise Control, NC). Similar to previous findings, any exercise prior to exposure (BO, BA) benefited some aspects of memory performance. Interestingly, the more consistent and larger benefits were seen with a shorter duration of exercise both before and after exposure (BA). Study Two replicated the methods of Study One comparing the BA condition (which had the most robust benefits) to the NC condition while collecting fMRI data during the memory task. Analyses assessed condition differences of activation during encoding and recall. There were no condition differences during memory encoding, however there was a condition effect on activation in occipito-temporal regions during the memory recall trials. Consistent with previous research, exercise appears to benefit memory with some exercise prior to exposure being important for the benefits achieved. Further, exercise affects neural activation and the results appear complementary to the behavior findings. Future research should use a within-subjects design to control for heterogeneity in behavior and neural activation., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Meta-analytic evidence supports that exercise has benefits for short-term memory (STM) and long-term memory (LTM). However, only three studies with children have tested the differential effects of exercise on STM and LTM. The purpose of this study was to examine the effects of an aerobic fitness test on STM and LTM and to consider the moderating effects of grade level. Children (7-13 years of age) were randomly assigned to either perform an aerobic fitness test before (exercise prior) or after (exercise post) performing the Rey Auditory Verbal Learning Test (RAVLT) to assess memory. Memory was tested again after approximately 24 hours. There were significant differences in memory performance as a function of grade with 4 th and 6 th graders consistently outperforming 2 nd graders. For learning, Day 1 Retention, 24-hr recall, and Day 2 Retention, the exercise prior group performed better than the exercise post group. It is concluded that an aerobic fitness test performed prior to a declarative memory test benefits LTM as compared to when the aerobic fitness test is performed after the memory test.

Background: By 2050, the prevalence of Alzheimer's disease (AD) in the United States is predicted to reach 13.8 million. Despite worldwide research efforts, a cure for AD has not been identified. Thus, it is critical to identify preventive strategies that can reduce the risk of or delay the onset of AD. Physical activity (PA) has potential in this regard. This randomized clinical trial aims to (a) test the causal relationship between PA and AD-associated cognitive function for persons with a family history of AD (FH+), (b) determine the moderating role of apolipoprotein epsilon 4 (APOE4) carrier status on cognition, and (c) assess cerebral structure, cerebral function, and putative biomarkers as mediators of the effects of PA on cognition., Methods: We are recruiting cognitively normal, middle aged (40-65 years) sedentary adults with FH+. Participants are randomly assigned to a 12-month PA intervention for 3 days/week or to a control group maintaining their normal lifestyle. Saliva samples are taken at pre-test to determine APOE genotype. At pre-, mid-, and post-tests, participants complete a series of cognitive tests to assess information-processing speed, verbal and visual episodic memory, constructional praxis, mnemonic discrimination, and higher-order executive functions. At pre- and post-tests, brain imaging and blood biomarkers are assessed., Discussion: We hypothesize that 1) the PA group will demonstrate improved cognition compared with controls; 2) PA-derived cognitive changes will be moderated by APOE4 status; and 3) PA-induced changes in neural and blood biomarkers will contribute to cognitive changes and differ as a function of APOE4 status. Our results may provide important insights into the potential of PA to preserve neurocognitive function in people with a heightened risk of AD due to FH+ and as moderated by APOE4 status. By using sophisticated analytic techniques to assess APOE as a moderator and neurobiological mechanisms as mediators across trajectories of cognitive change in response to PA, we will advance our understanding of the potential of PA in protecting against AD., Trial Registration: ClinicalTrials.gov NCT03876314. Registered March 15, 2019.

Evidence supports that acute exercise benefits long-term memory. However, it is unclear whether these effects are due to benefits to encoding or consolidation. The purpose of this study was to more effectively isolate encoding and consolidation to advance our understanding of the specific nature of the effects of exercise on long-term memory. Using a within-subject design, participants completed a control session (no exercise), an encoding and consolidation condition (exercise prior to exposure to the memory task, E + C), and a consolidation condition (exercise following exposure). The exercise was 30 min of moderate-intensity cycling. Memory was assessed using the Rey Auditory Verbal Learning Test with recall assessed at 60 min and recall and recognition assessed at 24 hr. Results showed that the E + C condition had significantly better recall at 60 min and 24 hr than the no-exercise condition. This provides additional evidence that acute exercise benefits encoding more than consolidation.

Objective: To (i) determine differences in the availability of variety of fruits and vegetables (F&V) at home by food security status; and (ii) examine the inter-associations between food security status, availability of variety of F&V at home and frequency of F&V intake, among low-income pregnant women. Design/Setting Participants were interviewed to collect food security status, home availability of variety of F&V and frequency of F&V intake. Bivariate analyses, multivariate regression and exploratory mediation analyses were conducted using IBM SPSS Statistics version 23.0 and the PROCESS macro., Subjects: Low-income pregnant women (n 198) were interviewed if they were ≥18 years of age, in the second trimester of pregnancy, and spoke English or Spanish., Results: Low/very low food security was found among 43 % of participants. Compared with fully food-secure participants, very low food-secure participants reported a lower variety of fruits (P=0·028) and vegetables (P=0·058) available at home. Mediation analyses indicated that through home availability of variety of fresh F&V, food security status was associated with the daily intake of F&V (indirect effect (95 % CI): fresh fruits, -0·039 (-0·074, -0·013); fresh vegetables, -0·048 (-0·083, -0·023)). As food security worsened, the available variety of fresh F&V decreased, which was associated with lower intake., Conclusions: The study highlights the interlink between food security, home food environment and diet quality, and the importance of nutrition education intervention to promote a healthy home food environment and improved pregnancy outcomes among low-income women.

Background: Alzheimer's disease is a progressive disease that degrades cognitive functioning and ultimately results in death. Currently, there is no cure for Alzheimer's disease and, hence, the identification of preventative strategies is important. Physical activity (PA) is a behavioral intervention that holds promise with respect to delaying the onset of Alzheimer's disease., Purpose: The purpose of this study was to explore the differential cognitive benefits achieved in response to PA as a function of a person's genetic risk for AD., Methods: Older cognitively normal adults (50-65 years) with a family history of AD (FHxAD) participated in an 8-month PA program. Cognitive performance was measured at baseline, pretest, midtest, and posttest and changes over time were assessed as a function of apolipoprotein E (APOE) status (carriers: 1-2 copies of the ɛ4 allele; noncarriers: 0 copies of the ɛ4 allele)., Results: Improvements in memory were associated with PA participation irrespective of APOE ɛ4 carrier status., Conclusions: Future experimental studies are needed to confirm that PA causes improvements to cognitive performance in older cognitively normal adults with a FHxAD and that these improvements are equivalent for cognitively normal APOE ɛ4 carriers and noncarriers.

Background: The influence of prolonged and repeated water immersions on heart rate variability (HRV) and complexity was examined in 10 U.S. Navy divers who completed six-hour resting dives on five consecutive days. Pre-dive and during-dive measures were recorded daily., Methods: Dependent variables of interest were average heart rate (HR), time-domain measures of HRV [root mean square of successive differences of the normal RR (NN) interval (RMSSD), standard deviation of the NN interval (SDNN)], frequency-domain measures of HRV [low-frequency power spectral density (psd) (LFpsd), low-frequency normalized (LFnu), high-frequency psd (HFpsd), high-frequency normalized (HFnu), low-frequency/ high-frequency ratio (LF/HF)], and non-linear dynamics of HRV [approximate entropy (ApEn)]. A repeated-measures ANOVA was performed to examine pre-dive measure differences among baseline measures. Hierarchical linear modeling (HLM) was performed to test the effects of prolonged and repeated water immersion on the dependent variables., Results: Pre-dive HR (P=0.005) and RMSSD (P⟨0.001) varied significantly with dive day while changes in SDNN approached significance (P=0.055). HLM indicated that HR decreased during daily dives (P=0.001), but increased across dive days (P=0.011); RMSSD increased during daily dives (P=0.018) but decreased across dive days (P⟨0.001); SDNN increased during daily dives (P⟨0.001); LF measures increased across dive days (LFpsd P⟨0.001; LFnu P⟨0.001), while HF measures decreased across dive days (HFpsd P⟨0.001; HFnu P⟨0.001); LF/HF increased across dive days (P⟨0.001); ApEn decreased during daily dives (P⟨0.02) and across dive days (P⟨0.001)., Conclusions: These data suggest that the cumulative effect of repeated dives across five days results in decreased vagal tone and a less responsive cardiovascular system., Competing Interests: The authors of this paper declare no conflicts of interest exist with this submission.

Acute exercise benefits cognition, and some evidence suggests that brain-derived neurotrophic factor (BDNF) plays a role in this effect. The purpose of this study was to explore the dose-response relationship between exercise intensity, memory, and BDNF. Young adults completed 3 exercise sessions at different intensities relative to ventilator threshold (Vt) (VO 2max , Vt - 20%, Vt + 20%). For each session, participants exercised for approximately 30 min. Following exercise, they performed the Rey Auditory Verbal Learning Test (RAVLT) to assess short-term memory, learning, and long-term memory recall. Twenty-four hours later, they completed the RAVLT recognition trial, which provided another measure of long-term memory. Blood was drawn before exercise, immediately postexercise, and after the 30-min recall test. Results indicated that long-term memory as assessed after the 24-hr delay differed as a function of exercise intensity with the largest benefits observed following maximal intensity exercise. BDNF data showed a significant increase in response to exercise; however, there were no differences relative to exercise intensity and there were no significant associations between BDNF and memory. Future research is warranted so that we can better understand how to use exercise to benefit cognitive performance.

Children with autism spectrum disorders (ASD) may be impaired in their ability to detect audiovisual synchrony and their ability may be influenced by the nature of the stimuli. We investigated the possibility that synchrony detection is disrupted by the presence of human faces by testing children with ASD using a preferential looking language-based paradigm. Children with low language abilities were significantly worse at detecting synchrony when the stimuli include an unobscured face than when the face was obscured. Findings suggest that the presence of faces may make multisensory processing more difficult. Implications for interventions are discussed, particularly those targeting attention to faces.

Physical activity is predictive of better cognitive performance and lower risk of Alzheimer's disease (AD). The apolipoprotein E gene (APOE) is a susceptibility gene for AD with the e4 allele being associated with a greater risk of AD. Cross-sectional and prospective research shows that physical activity is predictive of better cognitive performance for those at greater genetic risk for AD. However, the moderating role of APOE on the effects of a physical activity intervention on cognitive performance has not been examined. The purpose of this manuscript is to justify the need for such research and to describe the design, methods, and recruitment tactics used in the conductance of a study designed to provide insight as to the extent to which cognitive benefits resulting from an 8-month physical activity program are differentiated by APOE e4 status. The effectiveness of the recruitment strategies and the feasibility of recruiting APOE e4 carriers are discussed.

We examined variation in the use of evidence-based decision-making (EBDM) practices across local health departments (LHDs) in the United States and the extent to which this variation was predicted by resources, personnel, and governance. We analyzed data from the National Association of County and City Health Officials Profile of Local Health Departments, the Association of State and Territorial Health Officials State Health Departments Profile, and the US Census using 2-level multilevel regression models. We found more workforce predictors than resource predictors. Thus, although resources are related to LHDs' use of EBDM practices, the way resources are used (e.g., the types and qualifications of personnel hired) may be more important.

Background: Many US women fall short of meeting the recommendations on breastfeeding. Whereas prenatal demographic factors have been well researched in relation to breastfeeding, psychosocial maternal characteristics are less understood but could be important predictors of breastfeeding initiation and duration., Objective: This study examined primiparous maternal psychosocial characteristics and temperamentally based negative infant affect as predictors of breastfeeding initiation and duration while accounting for depression and sociodemographic covariates., Methods: Prenatally, 237 primiparous women were administered the Adult Attachment Interview and completed a measure of beliefs related to infant crying. At 6 months postpartum, negative infant affect was assessed via mother report. Breastfeeding was assessed at 6 months and 1 year postpartum via mother report., Results: Results indicated that younger, low income, less educated, single, ethnic minority mothers and mothers with elevated depressive symptoms were less likely to initiate breastfeeding and breastfed for a shorter period than other women. Women who initiated breastfeeding tended to have higher adult attachment coherence scores (more secure attachment) than those who did not initiate breastfeeding (median score of 6.00 vs 4.00). An interaction was observed between negative infant affect and beliefs about crying related to spoiling, such that earlier cessation of breastfeeding was observed among mothers who reported high levels of negative infant affect and strongly endorsed the belief that responding to cries spoils infants (hazard ratio = 1.71, P < .01)., Conclusion: Although these psychosocial variables predicted relatively little variation in breastfeeding over and above covariates, the results suggest some novel approaches to promote breastfeeding., Competing Interests: There are no conflicts of interest., (© The Author(s) 2014.)

Canonical babbling is a critical milestone for speech development and is usually well in place by 10 months. The possibility that infants with autism spectrum disorder (ASD) show late onset of canonical babbling has so far eluded evaluation. Rate of vocalization or "volubility" has also been suggested as possibly aberrant in infants with ASD. We conducted a retrospective video study examining vocalizations of 37 infants at 9-12 and 15-18 months. Twenty-three of the 37 infants were later diagnosed with ASD and indeed produced low rates of canonical babbling and low volubility by comparison with the 14 typically developing infants. The study thus supports suggestions that very early vocal patterns may prove to be a useful component of early screening and diagnosis of ASD.

Research supports the positive effects of exercise on cognitive performance by children. However, a limited number of studies have explored the effects specifically on memory. The purpose of this study was to compare the effects of an acute bout of exercise on learning, short-term memory, and long-term memory in a sample of children. Children were randomly assigned to an exercise condition or to a no-treatment control condition and then performed repeated trials on an auditory verbal learning task. In the exercise condition, participants performed the PACER task, an aerobic fitness assessment, in their physical education class before performing the memory task. In the control condition, participants performed the memory task at the beginning of their physical education class. Results showed that participants in the exercise condition demonstrated significantly better learning of the word lists and significantly better recall of the words after a brief delay. There were not significant differences in recognition of the words after an approximately 24-hr delay. These results provide evidence in a school setting that an acute bout of exercise provides benefits for verbal learning and long-term memory. Future research should be designed to identify the extent to which these findings translate to academic measures.

The present study aimed to determine the day to day variability and reliability of several blood oxidative stress markers at rest in a healthy young cohort over a four-week period. Twelve apparently healthy resistance trained males (24.6 ± 3.0 yrs) were tested over 7 visits within 4 weeks with at least 72 hrs between visits at the same time of day. Subjects rested 30 minutes prior to blood being obtained by vacutainer. Results. The highest IntraClass correlations (ICC's) were obtained for protein carbonyls (PC) and oxygen radical absorbance capacity (ORAC) (PC = 0.785 and ORAC = 0.780). Cronbach's α reliability score for PC was 0.967 and for ORAC was 0.961. The ICC's for GSH, GSSG, and the GSSG/TGH ratio ICC were 0.600, 0.573, and 0.570, respectively, with Cronbach's α being 0.913, 0.904, and 0.903, respectively. Xanthine oxidase ICC was 0.163 and Cronbach's α was 0.538. Conclusions. PC and ORAC demonstrated good to excellent reliability while glutathione factors had poor to excellent reliability. Xanthine oxidase showed poor reliability and high variability. These results suggest that the PC and ORAC markers were the most stable and reliable oxidative stress markers in blood and that daily changes across visits should be considered when interpreting resting blood oxidative stress markers.

We used a treatment group-only design to pilot test a newly developed intervention to increase condom use among higher risk heterosexually active African American/black male college students. A community-based participatory research partnership developed the intervention called Brothers Leading Healthy Lives. Following an initial screening of 245 men, 81 eligible men were contacted for participation. Of the 64 men who agreed to participate, 57 completed the intervention and 54 of those completed the 3-month follow-up assessment, for a 93% completion rate. Results show significant changes between the baseline and 3-month follow-up assessments in behavioral outcomes, including reductions in unprotected sex, increase in protection during last intercourse, and fewer condom use errors. Most potential mediators (knowledge, attitudes, intentions, and condom use self-efficacy) also changed significantly in the expected direction. These demonstrated changes provide good evidence that men exposed to this intervention will see changes that reduce their risk for HIV.

There is a substantial body of literature related to the effects of a single session of exercise on cognitive performance. The premise underlying this research is that physiological changes in response to exercise have implications for cognitive function. This literature has been reviewed both narratively and meta-analytically and, although the research findings are mixed, researchers have generally concluded that there is a small positive effect. The purpose of this meta-analysis was to provide an updated comprehensive analysis of the extant literature on acute exercise and cognitive performance and to explore the effects of moderators that have implications for mechanisms of the effects. Searches of electronic databases and examinations of reference lists from relevant studies resulted in 79 studies meeting inclusion criteria. Consistent with past findings, analyses indicated that the overall effect was positive and small (g=0.097 n=1034). Positive and small effects were also found in all three acute exercise paradigms: during exercise (g=0.101; 95% confidence interval [CI]; 0.041-0.160), immediately following exercise (g=0.108; 95% CI; 0.069-0.147), and after a delay (g=0.103; 95% CI; 0.035-0.170). Examination of potential moderators indicated that exercise duration, exercise intensity, type of cognitive performance assessed, and participant fitness were significant moderators. In conclusion, the effects of acute exercise on cognitive performance are generally small; however, larger effects are possible for particular cognitive outcomes and when specific exercise parameters are used., (Copyright © 2012 Elsevier B.V. All rights reserved.)

In this study, we tested the effect of acute exercise on long-term memory, specifically the timing of exercise relative to the memory challenge. We assessed memory via paragraph recall, in which participants listened to two paragraphs (exposure) and recounted them following a 35-min delay. Participants (n = 48) were randomly assigned to one of three groups: exercise prior to exposure, exercise after exposure, or no-exercise. Exercise consisted of 30 min on a cycle ergometer including 20 min at moderate intensity. Only the exercise prior group recalled significantly more than the control group (p < .05). Differences among the exercise groups failed to reach significance (p = .09). Results indicated that acute exercise positively influenced recall and that exercise timing relative to memory task may have an impact on this effect.

Unlabelled: Evidence supports the beneficial effects of physical activity (PA) on cognitive performance and suggests that effects might be particularly large for children. However, limited research has explored PA as a means of managing behavioral symptoms and improving cognitive performance of children with attention deficit hyperactivity disorder (ADHD). The etiology of ADHD and the putative mechanisms for the effects of PA on cognitive performance suggest that PA might be especially important for this population., Objective: The purpose of this paper is to review the literature regarding the potential of PA for ADHD symptom management, particularly in regard to behavioral and cognitive symptoms., Methods: Literature was reviewed for published and unpublished research specifically examining the effects of PA on cognitive and/or behavioral symptoms of ADHD. Additionally, potential mechanisms were addressed., Results: Albeit limited, current research generally supports the potential for acute and chronic PA to mitigate ADHD symptoms., Conclusion: Given the generally supportive extant literature and the challenges that face children with ADHD, future research exploring the potential of PA with this population is advocated., (Copyright © 2011 Elsevier Inc. All rights reserved.)