41 results on '"Markus J. Duncan"'
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2. Towards precision 24-hour movement behavior recommendations—The next new paradigm?
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Mark S. Tremblay, Markus J. Duncan, Nicholas Kuzik, Diego Augusto Santos Silva, and Valerie Carson
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Sports ,GV557-1198.995 ,Sports medicine ,RC1200-1245 - Published
- 2024
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3. Inequities in sleep duration and quality among adolescents in Canada
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Jessica Mitchell, Megan J. Magier, Markus J. Duncan, Jean-Philippe Chaput, Valerie Carson, Guy Faulkner, Emily Belita, Leigh M. Vanderloo, Negin A. Riazi, Rachel E. Laxer, Sarah Carsley, Scott T. Leatherdale, and Karen A. Patte
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Sleep ,Equity ,Adolescents ,Youth ,COVID-19 ,Gender ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Several recent global events may have impacted adolescent sleep and exacerbated pre-existing disparities by social positions (i.e., social roles, identity or sociodemographic factors, and/or group memberships that are associated with power and oppression due to the structures and processes in a given society at given time). Current understanding of sleep among adolescents is critical to inform interventions for a more equitable future, given the short and long-term consequences of inadequate sleep on health and well-being. This study aimed to provide contemporary evidence on sleep disparities by key social positions among adolescents in Canada. Methods Cross-sectional analyses were conducted using self-reported data collected during 2020–2021 (the first full school year after the COVID-19 pandemic onset) from 52,138 students (mean [SD] age = 14.9 [1.5]) attending 133 Canadian secondary schools. Multiple regression models were used to test whether sleep quality (how well students slept during past week), duration (weekday, weekend, weighted daily average), and guideline adherence (8–10 h/day) differed by sex and gender, race and ethnicity, and socioeconomic status (SES). Results Females reported a mean [95% CI] difference of -1.7 [-3.7, 0.4] min/day less sleep on weekdays than males, but 7.1 [4.5, 9.6] min/day more sleep on weekends, resulting in no difference in average daily sleep between males and females. Females were less likely to report good quality sleep compared to males (AOR = 0.57 [0.54, 0.60]). SES followed a generally monotonic trend where higher scores were associated with more sleep on weekdays (Δhighest: lowest = -28.6 [-39.5, -17.6]) and weekends (Δhighest: lowest = -17.5 [-3.8, -31.2]) and greater likelihood of higher sleep quality (AORhighest: lowest = 3.04 [2.35, 3.92]). Relative to White adolescents, weekday and average daily sleep duration were lower among all other racial identities; mean differences ranged from ∼ 5–15 min/day, with Black students reporting the least sleep. Conclusions Differences in sleep duration and quality were most profound among adolescents from the lowest and highest SES. Racial disparities were more evident on weekdays. Compensatory weekend sleep appears more pronounced in females than males. Addressing sleep inequities is critical, as a robust predictor of multiple health outcomes.
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- 2024
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4. A prospective study of financial worry, mental health changes and the moderating effect of social support among Canadian adolescents during the COVID-19 pandemic
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Jessica A. Goddard, Valerie F. Pagnotta, Markus J. Duncan, Matthew Sudiyono, William Pickett, Scott T. Leatherdale, and Karen A. Patte
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Medicine (General) ,R5-920 - Abstract
IntroductionThe COVID-19 pandemic intensified the impact of risk factors for adolescent mental health, including financial worry. Social support has shown to protect from negative mental health during times of stress. We examined the effect of financial worry on changes in anxiety and depression symptoms among Canadian adolescents prior to and during the pandemic, and assessed whether social support from family and friends moderated any changes. MethodsWe analyzed 2-year linked data from the 2018/19 (pre-pandemic) and 2020/21 (during-pandemic) waves of the COMPASS study, with reports from 12 995 Canadian secondary school students. A series of multilevel linear regressions were conducted to examine the main hypotheses under study. ResultsStudents scored an average (SD) of 7.2 (5.8) on the anxiety (GAD-7) and 10.0 (6.5) on the depression (CESD-10) scales; 16.1% reported they experienced financial worry during the pandemic. Financial worry was a strong and significant predictor of increased anxiety scores (+1.7 score between those reporting “true/mostly true” versus “false/mostly false”) during the pandemic, but not for depression scores. Low family and friend support were associated with anxiety, and low family support was associated with depression. No significant interactions were detected between social support and financial worry. ConclusionPandemic-related financial worry was significantly associated with anxiety in our large sample of Canadian adolescents. Clinical and public health initiatives should be aware of adolescents’ financial worry and its associations with anxiety during times of crisis.
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- 2024
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5. Étude prospective des préoccupations financières, des changements de l’état de santé mentale et de l’effet modérateur du soutien social chez les adolescents canadiens pendant la pandémie de COVID-19
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Jessica A. Goddard, Valerie F. Pagnotta, Markus J. Duncan, Matthew Sudiyono, William Pickett, Scott T. Leatherdale, and Karen A. Patte
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Medicine (General) ,R5-920 - Abstract
IntroductionLa pandémie de COVID-19 a intensifié les effets des facteurs de risque associés à la santé mentale des adolescents, en particulier les préoccupations financières. Par ailleurs, on sait que le soutien social offre une protection contre les problèmes de santé mentale pendant les périodes de stress. C’est dans ce cadre que nous avons exploré l’effet des préoccupations financières sur les variations des symptômes d’anxiété et de dépression chez les adolescents canadiens avant et pendant la pandémie, pour déterminer si le soutien social apporté par la famille et les amis modérait ces variations. MéthodologieNous avons analysé des données couplées sur deux ans provenant des vagues 2018-2019 (avant la pandémie) et 2020-2021 (pendant la pandémie) de l’étude COMPASS pour 12 995 élèves canadiens du secondaire. Nous avons réalisé une série de régressions linéaires multiniveaux pour explorer les principales hypothèses à l’étude. RésultatsLes élèves ont obtenu un score moyen de 7,2 (écart-type : 5,8) pour l’anxiété (échelle GAD-7) et de 10,0 (6,5) pour la dépression (échelle CESD-10), et 16,1 % des élèves ont déclaré avoir eu des préoccupations financières pendant la pandémie. Les préoccupations financières ont constitué un facteur de prédiction important et statistiquement significatif de scores d’anxiété plus élevés (+1,7 entre ceux qui ont répondu « vrai/le plus souvent vrai » et ceux qui ont répondu « faux/le plus souvent faux ») pendant la pandémie, mais non en ce qui concerne les scores de dépression. Il existe un lien entre un faible soutien de la part de la famille et des amis et l’anxiété ainsi qu’entre un faible soutien de la part de la famille et la dépression. Aucune interaction importante n’a été observée entre le soutien social et les préoccupations financières. ConclusionLes préoccupations financières liées à la pandémie ont été fortement associées à l’anxiété dans notre large échantillon d’adolescents canadiens. Les initiatives cliniques et sanitaires doivent tenir compte des préoccupations financières des adolescents et de leurs liens avec l’anxiété en période de crise.
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- 2024
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6. Changes in breakfast and water consumption among adolescents in Canada: examining the impact of COVID-19 in worsening inequity
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Markus J. Duncan, Emily Belita, Angelica Amores, Negin A. Riazi, Sarah Carsley, Leigh M. Vanderloo, Valerie Carson, Jean-Philippe Chaput, Guy Faulkner, Scott T. Leatherdale, and Karen A. Patte
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Healthy eating ,Breakfast ,Water consumption ,COVID-19 ,Equity ,Longitudinal ,Nutrition. Foods and food supply ,TX341-641 ,Food processing and manufacture ,TP368-456 ,Medicine (General) ,R5-920 - Abstract
Abstract Background To assess whether changes in breakfast and water consumption during the first full school year after the emergence of the COVID-19 pandemic varied based on sex/gender, race/ethnicity, and socioeconomic status among Canadian adolescents. Methods Prospective annual survey data collected pre- (October 2019-March 2020) and post-COVID-19 onset (November 2020-June 2021) the Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, and Sedentary behaviour (COMPASS) study. The sample consisted of 8,128 students; mean (SD) age = 14.2 (1.3) years from a convenience sample of 41 Canadian secondary schools. At both timepoints self-reported breakfast and water consumption were dichotomized as daily or not. Multivariable logistic generalized estimating equations with school clustering were used to estimate differences in maintenance/adoption of daily consumption post-COVID-19 based on demographic factors, while controlling for pre-COVID-19 behaviour. Results Adjusted odds ratios (AOR) with 95% confidence intervals are reported. Females (AOR = 0.71 [0.63, 0.79]) and lower socioeconomic status individuals (AORLowest:Highest=0.41 [0.16, 1.00]) were less likely to maintain/adopt daily breakfast consumption than male and higher socioeconomic status peers in the 2020–2021 school year. Black identifying individuals were less likely than all other racial/ethnic identities to maintain/adopt plain water consumption every day of the week (AOR = 0.33 [0.15, 0.75], p
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- 2024
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7. Stronger together: Coping behaviours and mental health changes of Canadian adolescents in early phases of the COVID-19 pandemic
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Negin A. Riazi, Katelyn Battista, Markus J. Duncan, Terrance J. Wade, William Pickett, Mark A. Ferro, Scott T. Leatherdale, and Karen A. Patte
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Coping ,Youth ,Adolescent ,Mental health ,COVID-19 ,Pandemic ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background The impact of the COVID-19 pandemic and consequent public health restrictions on the mental health of adolescents is of global concern. The purpose of this study was to examine how Canadian adolescents coped during the early pandemic and whether different coping methods were associated with changes in mental health from before the pandemic to the early lockdown response. Methods Using two-year linked survey data (2018–2020) from a prospective cohort of secondary school students (n = 3,577), linear regression models were used to examine whether changes in mental health (anxiety [Generalized Anxiety Disorder-7 scale], depression [Center for Epidemiologic Studies Depression 10-item scale Revised], emotion regulation [Difficulties in Emotion Regulation Scale], psychosocial well-being [Flourishing scale]) were related to each coping behaviour. Results The most common reported coping behaviours included staying connected with friends online (78.8%), playing video games, watching TV/movies, and/or surfing the internet/social media (76.2%), studying or working on schoolwork (71.0%), and getting exercise (65.2%). The use of positive coping mechanisms during the early pandemic period (e.g., keeping a regular schedule, time with family, time with friends online) was associated with less adverse mental health changes from before to during the early lockdown; whereas, negative coping mechanisms (e.g., spending time alone, eating junk food) were consistently associated with more adverse mental health changes. Conclusion This study demonstrates the importance of social support and connections with both friends and family, as well as keeping and maintaining a routine, over the pandemic. Interventions supporting positive relationships and engagement in these coping behaviours may be protective for adolescent mental health during disruptive events.
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- 2023
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8. Sleep duration change among adolescents in Canada: Examining the impact of COVID-19 in worsening inequity
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Markus J. Duncan, Jessica Mitchell, Negin A. Riazi, Emily Belita, Leigh M. Vanderloo, Sarah Carsley, Valerie Carson, Jean-Philippe Chaput, Guy Faulkner, Scott T. Leatherdale, and Karen A. Patte
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Public aspects of medicine ,RA1-1270 ,Social sciences (General) ,H1-99 - Abstract
Purpose: The purpose of this study was to assess if adolescent sub-populations in Canada (i.e., based on race/ethnicity, sex/gender, socioeconomic status, and urbanicity groups) experienced a larger change in sleep duration and guideline adherence between 2019 and 2020 (pre-pandemic) and the 2020–2021 (mid-pandemic) school years. Methods: Longitudinally linked data from 2019 to 2020 (pre-pandemic) and 2020–2021 (mid-pandemic) of a prospective cohort study of secondary school students (M = 14.2, SD = 1.3 years, N = 8209) in Canada were used for analyses. Regression modelling tested the main effects of race/ethnicity, sex/gender, socioeconomic status, and urbanicity on changes in sleep duration as well as adherence to Canada's 24-h Movement Guidelines for sleep (8–10 h/night). Interactions between identity variables (race/ethnicity or sex/gender) and other main effect variables were subsequently tested. Results: Females gained more sleep (4.5 [1.5, 7.5] min/day more) and increased guideline adherence (AOR = 1.16 [1.04, 1.30] than males on average. Asian race/ethnic identity was associated with less sleep gain than White identity −10.1 [-19.4, −0.8], but not guideline adherence. Individuals in large urban areas gained less sleep and adhered less to guidelines than individuals from any other level of urbanicity (−21.4 [-38.5, −4.2] to −15.5 [-30.7, −0.2] min/day). Higher individual SES scores were associated with greater sleep gain (linear trend: 11.16 [1.2–21.1]). The discrepancies in sleep gain and guideline adherence between males and females were significantly modified by race/ethnicity and urbanicity. Discussion: Increases in sleep duration may be one of the few benefits to adolescents during the COVID-19 pandemic but were not equally distributed across sub-populations. Efforts to promote better sleep adherence may need to account for sex/gender differences, especially in less urbanized areas and certain racial/ethnic groups.
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- 2023
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9. Support for mask use as a COVID-19 public health measure among a large sample of Canadian secondary school students
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Karen A. Patte, Terrance J. Wade, Adam J. MacNeil, Richard E. Bélanger, Markus J. Duncan, Negin Riazi, and Scott T. Leatherdale
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COVID-19 ,Pandemic ,Masks ,School ,Policy ,Adolescent ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Youth voice has been largely absent from deliberations regarding public health measures intended to prevent SARS-CoV-2 transmission, despite being one of the populations most impacted by school-based policies. To inform public health strategies and messages, we examined the level of student support of mask use in public spaces and school mask requirements, as well as factors associated with students’ perspectives. Methods We used cross-sectional survey data from 42,767 adolescents attending 133 Canadian secondary schools that participated in the COMPASS study during the 2020/2021 school year. Multinomial regression models assessed support for i) wearing a mask in indoor public spaces and ii) schools requiring students to wear masks, in association with COVID-19 knowledge, concerns, and perceived risk. Results Wearing masks in indoor public spaces was supported by 81.9% of students; 8.7% were unsupportive and 9.4% were neutral/undecided. School mask requirements were supported by 67.8%, with 23.1% neutral and 9.1% unsupportive. More females supported mask wearing in public spaces (83.9% vs. 79.1%) and school mask requirements (70.8% vs. 63.5%) than males. Students had increased odds of supporting mask use in public spaces and school mask requirements if they reported concerns about their own or their family’s health, had discussions regarding ways to prevent infection, perceived COVID-19 to be a risk to young people, and knew that signs are not always present in COVID-19 cases and that masks prevent SARS-CoV-2 transmission if someone coughs. Conclusions During the year following the beginning of the pandemic, most students supported the required use of masks in schools and wearing masks in indoor public spaces. Improving knowledge around the effectiveness of masks appears likely to have the largest impact on mask support in adolescent populations among the factors studied.
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- 2022
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10. Physical activity and substance use among Canadian adolescents: Examining the moderating role of school connectedness
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Matthew James Fagan, Markus J. Duncan, Robinder P. Bedi, Eli Puterman, Scott T. Leatherdale, and Guy Faulkner
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physical activity ,sport participation ,substance use (drugs ,alcohol ,smoking) ,school connectedness ,Public aspects of medicine ,RA1-1270 - Abstract
Physical activity may play a role in promoting or preventing substance use among youth. The purpose of this study was to examine the association between different types of physical activity [i.e., non-competitive school sport, competitive school sport, outside of school sport and minutes of moderate to vigorous physical activity (MVPA) per day] and substance use (i.e., current smoking, e-cigarette, cannabis, binge drinking) among Canadian youth. Interaction effects between physical activity and school connectedness were also examined. Using data from the COMPASS study (2018–19; n = 73,672), four multi-level logistic regression models were developed to investigate whether physical activity lessened or worsened the odds of (1) smoking; (2) e-cigarette use; (3) cannabis use; and (4) binge drinking. Models were stratified by gender to reflect the inherent differences between genders. Models were adjusted for demographic factors and other covariates. Sport participation was consistently associated with substance use, whereas less evidence was found for meeting MVPA guidelines. Non-competitive school sport lessened the odds of cannabis use for males and females. However, non-competitive school sport only lessened the odds of e-cigarette use for females but increased the odds of binge drinking for males. Participation in competitive school sport lessened the odds of cigarette smoking but increased the odds of e-cigarette use and binge drinking for males and females. Outside of school sport lessened the odds of cigarette smoking and cannabis use but increased the odds of e-cigarette use and binge drinking for males and females. A significant moderation effect was found for males participating in sport outside of school and meeting MVPA guidelines who were at a lower risk of e-cigarette use in the presence of high levels of school connectedness. Our study provides evidence for further consideration and provision of extracurricular activities, specifically non-competitive sport, in protecting against substance use. Caution is required in claiming that sport participation or physical activity, in general, is negatively associated with substance use among youth.
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- 2022
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11. Are weight status and weight perception associated with academic performance among youth?
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Maram Livermore, Markus J. Duncan, Scott T. Leatherdale, and Karen A. Patte
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Obesity ,Overweight ,Academic achievement ,Weight perception ,Education ,Youth ,Psychiatry ,RC435-571 - Abstract
Abstract Background Emerging evidence suggests perceptions of being overweight account for many of the psychosocial consequences commonly associated with obesity. Previous research suggests an obesity achievement gap, yet limited research has explored weight perception in association with academic performance. Moreover, underweight perceptions have typically been excluded from research. The current study examined how BMI classification and weight perception relate to academic performance in a large cohort of youth. Methods We used cross-sectional survey data from 61,866 grade 9–12 students attending the 122 Canadian schools that participated in Year 6 (2017/2018) of the COMPASS study. Mixed effect regression models were used to examine associations between students’ BMI classification and weight perceptions and their math and English/French course grades. All models were stratified by sex and adjusted for sociodemographic covariates and school clustering. Results For English/French grades, males and females with overweight or underweight perceptions were less likely to achieve higher grades than their peers with perceptions of being at “about the right weight”, controlling for BMI and covariates. For math grades, females with overweight perceptions, and all students with underweight perceptions, were less likely to achieve higher grades than their peers with “about the right weight” perceptions. All students with BMIs in the obesity range were less likely to report grades of 60% or higher than their peers with “normal-weight” BMIs, controlling for weight perception and covariates. Overweight BMIs were predictive of lower achievement in females for English/French grades, and in males for math grades, relative to “normal-weight” BMIs. Results for students that did not respond to the weight and weight perception items resembled those for obesity BMI and overweight/underweight perceptions, respectively. Conclusions Overall, this study demonstrates that an obesity achievement gap remains when controlling for students’ perceptions of their weight, and that both underweight and overweight perceptions predict lower academic performance, regardless of BMI classification. Results suggest barriers to academic success exist among youth with larger body sizes, and those with perceptions of deviating from “about the right weight”.
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- 2020
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12. Changes in Body Mass, Physical Activity, and Dietary Intake during the COVID-19 Pandemic Lockdowns in Canadian University Students
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Madison Bell, Markus J. Duncan, Karen A. Patte, Brian D. Roy, David S. Ditor, and Panagiota Klentrou
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COVID-19 ,university students ,body mass index ,physical activity ,caloric intake ,macronutrient intake ,Biology (General) ,QH301-705.5 - Abstract
This study examined changes in body mass and body mass index (BMI), physical activity, and dietary intake in Canadian university students during the first year of the COVID-19 pandemic. Two self-reported recall surveys were conducted: after the first lockdown in September 2020 (T1) and following the second lockdown in March 2021 (T2). Eligible participants were full-time undergraduate students attending a Canadian university and residing in Canada during the first year of the pandemic. At T1, 510 students (99 male, 411 female) completed the survey, and of those, 135 (32 males, 103 females) completed the survey at T2 (73% attrition). At both T1 and T2, most participants were 18–24 years of age (93% and 90%, respectively), Caucasian (73% and 78%, respectively), and resided in the province of Ontario (79% and 80%, respectively). Body mass increased from T1 to T2 (+0.91 ± 3.89 kg t(132) = −2.7, p = 0.008). BMI also increased from T1 to T2 (+0.30 ± 1.33 kg/m2 [t(130) = −2.5, p = 0.012), with a greater number of participants within the overweight range (19.8% versus 24.4%, respectively). At T1, 38% of the participants reported a decrease in physical activity, while the number of students reporting a decrease in activity increased to 56% at T2. Dietary energy intake decreased from 1678 ± 958 kcal/day at T1 to 1565 ± 842 kcal/day at T2 [c2(1) = 7.2, p = 0.007]. Diet quality also decreased, with participants not meeting the recommended daily allowance for essential macro and micronutrients. A decrease was observed in daily servings of fruits (−27%, p < 0.001), vegetables (−72%, p < 0.001), and grains (−68%, p < 0.001). In conclusion, despite a small decrease in dietary energy intake, a modest weight gain occurred during the first year of the COVID-19 pandemic in this cohort of Canadian university students, which was potentially related to decreased physical activity and diet quality.
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- 2023
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13. The Utility of the Health Action Process Approach Model for Predicting Physical Activity Intentions and Behavior in Schizophrenia
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Kelly P. Arbour-Nicitopoulos, Markus J. Duncan, Gary Remington, John Cairney, and Guy E. Faulkner
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schizophrenia ,physical activity ,determinants ,theory based ,accelerometry ,Psychiatry ,RC435-571 - Abstract
Research is needed to develop evidence-based behavioral interventions for preventing and treating obesity that are specific to the schizophrenia population. This study is the precursor to such intervention research where we examined the utility of the social cognitions outlined within the Health Action Process Approach (HAPA) model for predicting moderate to vigorous physical activity (MVPA) intentions and behavior among individuals with schizophrenia or schizoaffective disorder. A prospective cohort design [baseline (T1), week 2 (T2), and week 4 (T3)] was used to examine the HAPA constructs and MVPA across a sample of 101 adults (Mage = 41.5 ± 11.7 years; MBMI = 31.2 ± 7.8 kg/m2; 59% male). Two hierarchical regression analyses were conducted controlling for age, gender, BMI, and previous self-reported MVPA. In the first regression, intentions at T1 were regressed onto the T1 motivational HAPA constructs (risk perception, affective attitudes, task self-efficacy) and social support; MVPA status (meeting vs. not meeting the MVPA guidelines) assessed via accelerometry at T3 was regressed onto T1 social support and intentions followed by T2 action and coping planning, and maintenance self-efficacy in the second analysis. Overall, the motivational and social support variables accounted for 28% of the variance in intentions, with affective attitudes (β = 0.33, p
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- 2017
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14. Exploring Work-Time Affective States Through Ecological Momentary Assessment in an Office-Based Intervention to Reduce Occupational Sitting
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Guy Faulkner, Katie A. Weatherson, Markus J. Duncan, Kelly B. Wunderlich, and Eli Puterman
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Orthopedics and Sports Medicine - Abstract
Background: The aim of this study was to examine whether a low-cost standing desk intervention that reduced occupational sitting was associated with changes in work-time cognitive–affective states in real time using ecological momentary assessments at the start and end of the trial. Methods: Forty-one office employees (91.7% female, mean age = 39.8 [10.1] y) were randomized to receive a low-cost standing desk or a waitlist control. Participants received 5 surveys each day for 5 workdays via smartphone application prior to randomization and at trial’s end. Ecological momentary assessment assessed current work-time psychological states (valence and arousal, stress, fatigue, and perceived productivity). Multilevel models assessed whether changes in work-time outcomes over the course of the intervention were significantly different between treatment groups. Results: There were no significant differences in outcomes between the groups except for fatigue, with the control group reporting a significant decrease in daily fatigue following the intervention (P P > .05). Conclusions: A low-cost standing desk intervention to reduce occupational sedentary behavior did not negatively impact work-time outcomes such as productivity and fatigue in the short term.
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- 2023
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15. Pharmacological interventions for prevention of weight gain in people with schizophrenia
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Sri Mahavir Agarwal, Nicolette Stogios, Zohra A Ahsan, Jonathan T Lockwood, Markus J Duncan, Hiroyoshi Takeuchi, Tony Cohn, Valerie H Taylor, Gary Remington, Guy E J Faulkner, and Margaret Hahn
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Nausea ,Famotidine ,Ranitidine ,Weight Gain ,Metformin ,Reboxetine ,Topiramate ,Fluoxetine ,Schizophrenia ,Humans ,Pharmacology (medical) ,Nizatidine ,Antipsychotic Agents ,Betahistine ,Melatonin - Abstract
Antipsychotic-induced weight gain is an extremely common problem in people with schizophrenia and is associated with increased morbidity and mortality. Adjunctive pharmacological interventions may be necessary to help manage antipsychotic-induced weight gain. This review splits and updates a previous Cochrane Review that focused on both pharmacological and behavioural approaches to this problem.To determine the effectiveness of pharmacological interventions for preventing antipsychotic-induced weight gain in people with schizophrenia.The Cochrane Schizophrenia Information Specialist searched Cochrane Schizophrenia's Register of Trials on 10 February 2021. There are no language, date, document type, or publication status limitations for inclusion of records in the register.We included all randomised controlled trials (RCTs) that examined any adjunctive pharmacological intervention for preventing weight gain in people with schizophrenia or schizophrenia-like illnesses who use antipsychotic medications.At least two review authors independently extracted data and assessed the quality of included studies. For continuous outcomes, we combined mean differences (MD) in endpoint and change data in the analysis. For dichotomous outcomes, we calculated risk ratios (RR). We assessed risk of bias for included studies and used GRADE to judge certainty of evidence and create summary of findings tables. The primary outcomes for this review were clinically important change in weight, clinically important change in body mass index (BMI), leaving the study early, compliance with treatment, and frequency of nausea. The included studies rarely reported these outcomes, so, post hoc, we added two new outcomes, average endpoint/change in weight and average endpoint/change in BMI.Seventeen RCTs, with a total of 1388 participants, met the inclusion criteria for the review. Five studies investigated metformin, three topiramate, three H2 antagonists, three monoamine modulators, and one each investigated monoamine modulators plus betahistine, melatonin and samidorphan. The comparator in all studies was placebo or no treatment (i.e. standard care alone). We synthesised all studies in a quantitative meta-analysis. Most studies inadequately reported their methods of allocation concealment and blinding of participants and personnel. The resulting risk of bias and often small sample sizes limited the overall certainty of the evidence. Only one reboxetine study reported the primary outcome, number of participants with clinically important change in weight. Fewer people in the treatment condition experienced weight gains of more than 5% and more than 7% of their bodyweight than those in the placebo group (5% weight gain RR 0.27, 95% confidence interval (CI) 0.11 to 0.65; 1 study, 43 participants;7% weight gain RR 0.24, 95% CI 0.07 to 0.83; 1 study, 43 participants; very low-certainty evidence). No studies reported the primary outcomes, 'clinically important change in BMI', or 'compliance with treatment'. However, several studies reported 'average endpoint/change in body weight' or 'average endpoint/change in BMI'. Metformin may be effective in preventing weight gain (MD -4.03 kg, 95% CI -5.78 to -2.28; 4 studies, 131 participants; low-certainty evidence); and BMI increase (MD -1.63 kg/m2, 95% CI -2.96 to -0.29; 5 studies, 227 participants; low-certainty evidence). Other agents that may be slightly effective in preventing weight gain include H2 antagonists such as nizatidine, famotidine and ranitidine (MD -1.32 kg, 95% CI -2.09 to -0.56; 3 studies, 248 participants; low-certainty evidence) and monoamine modulators such as reboxetine and fluoxetine (weight: MD -1.89 kg, 95% CI -3.31 to -0.47; 3 studies, 103 participants; low-certainty evidence; BMI: MD -0.66 kg/m2, 95% CI -1.05 to -0.26; 3 studies, 103 participants; low-certainty evidence). Topiramate did not appear effective in preventing weight gain (MD -4.82 kg, 95% CI -9.99 to 0.35; 3 studies, 168 participants; very low-certainty evidence). For all agents, there was no difference between groups in terms of individuals leaving the study or reports of nausea. However, the results of these outcomes are uncertain given the very low-certainty evidence.There is low-certainty evidence to suggest that metformin may be effective in preventing weight gain. Interpretation of this result and those for other agents, is limited by the small number of studies, small sample size, and short study duration. In future, we need studies that are adequately powered and with longer treatment durations to further evaluate the efficacy and safety of interventions for managing weight gain.
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- 2023
16. Mental Health Associations with Academic Performance and Education Behaviors in Canadian Secondary School Students
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Scott T. Leatherdale, Markus J. Duncan, and Karen A. Patte
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education ,05 social sciences ,Developmental and Educational Psychology ,050301 education ,0501 psychology and cognitive sciences ,School level ,Psychology ,0503 education ,Mental health ,Depression (differential diagnoses) ,050104 developmental & child psychology ,Clinical psychology - Abstract
Course grades, as an indicator of academic performance, are a primary academic concern at the secondary school level and have been associated with various aspects of mental health status. The purpose of this study is to simultaneously assess whether symptoms of mental illness (depression and anxiety) and mental well-being (psychosocial well-being) are associated with self-reported grades (in their primary language [English or French] and math courses) and education behaviors (school days missed due to health, truancy, and frequency of incomplete homework) in a sample of secondary school students across Canada ( n = 57,394). Multivariate imputation by chained equations and multilevel proportional odds logistic regressions were used to assess associations between mental health scores, academic performance and education behaviors. Lower depression and higher psychosocial well-being scores were associated with better grade levels in both math and language courses, as well as better education behaviors. In turn, better education behaviors were associated with higher course grades. Depression scores and psychosocial well-being scores remained associated with higher grades after controlling for education behaviors, however the magnitude of association was diminished. Results indicate that the effects of mental health factors were partially attenuated by education behaviors, suggesting while reduced class attendance and poor homework adherence were associated with both academic outcomes and mental health, they do not account entirely for the association between lower grades and worse mental health.
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- 2021
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17. Support for mask use as a COVID-19 public health prevention measure among a large sample of Canadian secondary school students
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Karen A. Patte, Terrance J Wade, Adam J MacNeil, Richard E. Bélanger, Markus J Duncan, Negin Riazi, and Scott T. Leatherdale
- Abstract
Objectives: We examined the level of student support of mask use in public spaces and school mask requirements intended to prevent SARS-CoV-2 transmission, as well as factors associated with students’ perspectives. Methods: We used cross-sectional survey data from 42,767 adolescents attending 133 Canadian secondary schools that participated in the COMPASS study during the 2020/2021 school year. Multinomial regression models assessed support for i) wearing a mask in indoor public spaces and ii) schools requiring students to wear masks, in association with COVID-19 knowledge, concerns, and perceived risk. Results : Wearing masks in indoor public spaces was supported by 81.9% of students; 8.7% were unsupportive and 9.4% were neutral/undecided. School mask requirements were supported by 67.8%, with 23.1% neutral and 9.1% unsupportive. More females supported mask wearing in public spaces (83.9% vs. 79.1%) and school mask requirements (70.8% vs. 63.5%) than males. Students had increased odds of supporting mask use in public spaces and school mask requirements if they reported concerns about their own or their family’s health, had discussions regarding ways to prevent infection, perceived COVID-19 to be a risk to young people, and knew that signs are not always present in COVID-19 cases and that masks prevent SARS-CoV-2 transmission if someone coughs. Conclusions : During the year following the beginning of the pandemic, most students supported wearing masks in indoor public spaces and the required use of masks in schools. Improving knowledge around the effectiveness of masks appears likely to have the largest impact on mask support among adolescent populations.
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- 2022
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18. Hit the chronic… physical activity: are cannabis associated mental health changes in adolescents attenuated by remaining active?
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Karen A. Patte, Markus J. Duncan, and Scott T. Leatherdale
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medicine.medical_specialty ,Health (social science) ,Social Psychology ,Epidemiology ,Physical fitness ,Psychological intervention ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,030212 general & internal medicine ,Psychiatry ,biology ,business.industry ,biology.organism_classification ,Mental illness ,medicine.disease ,Mental health ,3. Good health ,030227 psychiatry ,Psychiatry and Mental health ,Cohort ,Anxiety ,Cannabis ,medicine.symptom ,business ,Psychosocial - Abstract
High-frequency cannabis use in adolescents has been associated with adult mental illness. In contrast, physical activity has been demonstrated to benefit mental health status. The purpose of this study was to examine whether, within a 1-year prospective study design, changes in cannabis use frequency are associated with changes in mental health, and whether meeting physical activity guidelines moderates these associations. COMPASS (2012–2021) is a hierarchical longitudinal health data survey from a rolling cohort of secondary school students across Canada; student-level mental health data linked from Years 5 (2016/17) and 6 (2017/18) were analysed (n = 3173, 12 schools). Multilevel conditional change regression models were used to assess associations between mental health scores change, cannabis use change and physical activity guideline adherence change after adjusting for covariates. Adopting at least weekly cannabis use was associated with increases in depressive and anxiety symptoms and decreases in psychosocial well-being. Maintaining physical activity guidelines across both years improved psychosocial well-being regardless of cannabis use frequency, and offset increases in depressive symptoms among individuals who adopted high frequency cannabis use. Physical activity adherence had no apparent relationship with anxiety symptoms. Regardless of the sequence of events, adopting high frequency cannabis use may be a useful behavioural marker of current or future emotional distress, and the need for interventions to address mental health. Physical activity adherence may be one approach to minimizing potential changes in mental health associated with increasing cannabis use.
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- 2020
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19. The prospective association between physical activity and initiation of current substance use among adolescents: Examining the role of school connectedness
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Matthew James Fagan, Markus J. Duncan, Robinder P. Bedi, Eli Puterman, Scott T. Leatherdale, and Guy Faulkner
- Subjects
Psychiatry and Mental health ,Applied Psychology - Published
- 2023
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20. Moving away from depression: Physical activity changes in patients undergoing r-TMS for major depressive disorder
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Daniel M. Blumberger, Fidel Vila-Rodriguez, Zafiris J. Daskalakis, Jonathan Downar, Markus J. Duncan, Matthew James Fagan, Lira Yun, and Guy Faulkner
- Subjects
medicine.medical_specialty ,business.industry ,Physical activity ,Stimulation ,030229 sport sciences ,medicine.disease ,030227 psychiatry ,03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,Internal medicine ,medicine ,Major depressive disorder ,In patient ,Treatment effect ,business ,Applied Psychology ,Depression (differential diagnoses) - Abstract
Background Physical activity (PA) may predict or mark successful treatment from major depressive disorder after repeated-transcranial magnetic stimulation (r-TMS). Objectives To explore if r-TMS treatment responders were more physically active than non-responders at baseline, and to determine if treatment responders increased PA compared to non-responders post-treatment. Methods Thirty subjects were included in the study. PA was measured through Actical accelerometers. Baseline PA levels were compared through separate independent t-tests, whereas post-treatment changes were compared through separate ANCOVAs. Results There were no differences in PA at baseline between groups. Controlling for baseline PA levels, ANCOVAs identified a non-significant treatment effect between moderate-to-vigorous physical activity levels post-treatment between groups [p = 0.276, η2 = 0.044]. A significant treatment effect was found between groups for light physical activity favouring responders [p = 0.009, η2 = 0.226]. Conclusion Responders’ LPA significantly increased in comparison to non-responders receiving r-TMS for major depressive disorder.
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- 2019
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21. Do You Really Want to Be Forever Young? Emotional Health and Psychosocial Well-being by Relative Birth Quarter in Canadian Adolescents
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Markus J. Duncan, Scott T. Leatherdale, and Karen A. Patte
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Psychiatry and Mental health ,Canada ,Mental Health ,Adolescent ,Adolescent Behavior ,Pediatrics, Perinatology and Child Health ,Emotions ,Public Health, Environmental and Occupational Health ,Humans ,Female ,Anxiety ,Child ,Aged - Abstract
Those born earlier within cohorts of similarly aged children tend to outperform peers in athletic and academic pursuits. Subsequent evidence suggests relatively younger children may also experience worse emotional and psychosocial health; however, evidence from middle adolescents is limited. This study assessed whether depression, anxiety, and psychosocial well-being differed by the relative birth quarter (RBQ) within a cohort of grades 9-12 in secondary schools across Canada.Data from the 2018-19 student self-report surveys of the cannabis use, obesity, mental health, physical activity, alcohol use, smoking, and sedentary behavior study were analyzed. Students having made normative progress were categorized into RBQs by the provincial enrollment cutoff date (n = 49,921). Hierarchical modeling approaches assessed whether self-reported depression, anxiety, psychosocial well-being, and positive controls differed by RBQ after controlling for covariates.Despite relative age effects for positive control outcomes, no significant difference was detected for anxiety and depression scores or likelihood of meeting thresholds for having clinically relevant symptoms. However, a significant difference emerged between RBQs for psychosocial well-being scores; post hoc tests found that psychosocial well-being scores were lower in the fourth RBQ than those in all prior quarters.Results agree with limited findings that relative age differences in emotional health are not significant in older cohorts. Nonetheless, relatively older individuals reported very small (d = .04-.05) advantages in psychosocial well-being than their youngest peers, which aligns with previous data. Longitudinal approaches to assess relative age effects on mental health during and throughout the transition into middle adolescence are warranted.
- Published
- 2021
22. Are weight status and weight perception associated with academic performance among youth?
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Scott T. Leatherdale, Maram Livermore, Karen A. Patte, and Markus J. Duncan
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Youth ,genetic structures ,lcsh:RC435-571 ,media_common.quotation_subject ,education ,Weight Perception ,Academic achievement ,Overweight ,behavioral disciplines and activities ,Education ,03 medical and health sciences ,Behavioral Neuroscience ,0302 clinical medicine ,lcsh:Psychiatry ,030225 pediatrics ,Perception ,medicine ,030212 general & internal medicine ,Obesity ,media_common ,2. Zero hunger ,Nutrition and Dietetics ,4. Education ,nutritional and metabolic diseases ,medicine.disease ,Weight perception ,Psychiatry and Mental health ,Eating disorders ,medicine.symptom ,Underweight ,Psychosocial ,psychological phenomena and processes ,Demography ,Research Article - Abstract
Background: Emerging evidence suggests perceptions of being overweight account for many of the psychosocial consequences commonly associated with obesity, yet limited research has explored weight perception in associations between body mass index (BMI) and academic performance. The current study examined how BMI classification and weight perception relate to academic performance in a large cohort of youth.Methods: We used cross-sectional survey data from 61,866 grade 9-12 students attending the 122 Canadian schools that participated in Year 6 (2017/2018) of the COMPASS study. Mixed effect regression models were used to examine associations between students’ BMI classification and weight perceptions and their math and English/French course grades, stratified by sex.Results: For English/French grades, males and females with overweight or underweight perceptions were less likely to achieve higher grades than their peers with perceptions of being at “about the right weight”, controlling for BMI and covariates. For math grades, females with overweight perceptions, and all students with underweight perceptions, were less likely to achieve higher grades than their peers with “about the right weight” perceptions. All students with BMIs in the obesity range were less likely to report grades of 60% or higher than their peers with “normal-weight” BMIs. Overweight BMIs were predictive of lower achievement in females for English/French grades, and in males for math grades, relative to “normal-weight” BMIs. Results for students that did not respond to weight and weight perception items resembled those for obesity BMI and overweight/underweight perceptions, respectively.Conclusions: Overall, this study demonstrates that an obesity achievement gap remains when controlling for students’ perceptions of their weight, and that both underweight and overweight perceptions predict lower academic performance, regardless of BMI classification. Results suggest barriers to academic success exist among youth with larger body sizes, and those with perceptions of deviating from “about the right weight”.Plain Language Summary: An obesity achievement gap has been suggested as an early contributor to later socioeconomic disparities found by weight status. To date, limited research has examined how sociocultural weight norms contribute to potential links between weight status and academic performance. Emerging evidence suggests weight perception—individual’s subjective appraisal of their body weight—accounts for many of the psychosocial consequences commonly associated with obesity. We sought to determine if body weight and weight perceptions predicted grades in a large sample of Canadian secondary school students. It was hypothesized that perceptions of being at “about the right weight” would provide a protective effect. Overall, this study demonstrates that an obesity achievement gap remains when controlling for students’ perceptions of their weight, and that weight perceptions—both underweight and overweight—predict academic performance, regardless of BMI classification. Results contribute to a body of research that encourages the consideration of both overweight and underweight perceptions and their potential impact on adolescent emotional and physical health. Further research is needed to determine the mechanisms underlying these relationships, in order to remove barriers to academic success among youth with larger body sizes, and those with perceptions of deviating from “about the right weight”.
- Published
- 2020
23. Are one-year changes in adherence to the 24-hour movement guidelines associated with depressive symptoms among youth?
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Scott T. Leatherdale, Guy Faulkner, Wei Qian, Markus J. Duncan, and Karen A. Patte
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Male ,medicine.medical_specialty ,Adolescent ,Poison control ,030209 endocrinology & metabolism ,Adolescents ,Suicide prevention ,Young Adult ,Screen time ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Injury prevention ,medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,Students ,Psychiatry ,Exercise ,Depression (differential diagnoses) ,Ontario ,Internet ,British Columbia ,Depression ,Physical activity ,business.industry ,lcsh:Public aspects of medicine ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,Sedentary behaviour ,Mental illness ,medicine.disease ,Mental health ,Female ,Guideline Adherence ,Self Report ,Sedentary Behavior ,Biostatistics ,Sleep ,business ,030217 neurology & neurosurgery ,Research Article - Abstract
BackgroundThere remains a need for prospective research examining movement behaviours in the prevention and management of mental illness. This study examined whether changes in adherence to the 24-h Movement Guidelines (moderate-to-vigorous physical activity [MVPA], sleep duration, screen time) were associated with depression symptoms among youth.MethodsConditional change models were used to analyze two waves of longitudinal questionnaire data (2016/17, 2017/18) from students in grades 9–12 (N = 2292) attending 12 schools in Ontario and British Columbia, Canada, as part of the COMPASS study. One-year change in adherence to the MVPA, screen time, and sleep duration guidelines were modeled as predictors of depressive symptoms, adjusting for covariates and prior year depressive symptoms. Models were stratified by sex.ResultsContinued adherence to sleep guidelines and transitioning from inadequate to sufficient sleep were associated with lower depressive symptoms than continued nonadherence, and continued adherence was associated with lower depression than transitioning from sufficient to short sleep. For screen time, transitioning from exceeding guidelines to guideline adherence was associated with lower depressive symptoms than continued nonadherence. MVPA guideline adherence was not associated with depression scores, when controlling for sleep and screen time guideline adherence change and covariates. When combined, meeting additional guidelines than the year prior was associated with lower depressive symptoms among females only.ConclusionsAdherence to the sleep guidelines emerged as the most consistent predictor of depression symptoms. Promoting adherence to the Movement Guidelines, particularly sleep, should be considered priorities for youth mental health at a population level.
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- 2020
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24. Walk this way: validity evidence of iphone health application step count in laboratory and free-living conditions
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Guy Faulkner, Kelly Wunderlich, Yingying Zhao, and Markus J. Duncan
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Adult ,Male ,Adolescent ,Computer science ,Monitoring, Ambulatory ,Physical Therapy, Sports Therapy and Rehabilitation ,Fitness Trackers ,Walking ,Accelerometer ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Activities of Daily Living ,Statistics ,Humans ,Step count ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,Treadmill ,Simulation ,Heterogeneous sample ,030229 sport sciences ,Actigraphy ,Mobile Applications ,Test (assessment) ,Laboratory test ,Convergent validity ,Pedometer ,Female ,Smartphone - Abstract
Several attempts have been made to demonstrate the accuracy of the iPhone pedometer function in laboratory test conditions. However, no studies have attempted to evaluate evidence of convergent validity of the iPhone step counts as a surveillance tool in the field. This study takes a pragmatic approach to evaluating Health application derived iPhone step counts by measuring accuracy of a standardized criterion iPhone SE and a heterogeneous sample of participant owned iPhones (6 or newer) in a laboratory condition, as well as comparing personal iPhones to accelerometer derived steps in a free-living test. During lab tests, criterion and personal iPhones differed from manually counted steps by a mean bias of less than ±5% when walking at 5km/h, 7.5km/h and 10km/h on a treadmill, which is generally considered acceptable for pedometers. In the free-living condition steps differed by a mean bias of 21.5% or 1340 steps/day when averaged across observation days. Researchers should be cautioned in considering the use of iPhone models as a research grade pedometer for physical activity surveillance or evaluation, likely due to the iPhone not being continually carried by participants; if compliance can be maximized then the iPhone might be suitable.
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- 2017
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25. Barriers and facilitators to physical activity and exercise among adults with depression: A scoping review
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Guy Faulkner, Krista Glowacki, Markus J. Duncan, and Heather L. Gainforth
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education.field_of_study ,Population ,Context (language use) ,medicine.disease ,030227 psychiatry ,03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,Mood ,Mood disorders ,medicine ,030212 general & internal medicine ,Social determinants of health ,Psychology ,education ,Applied Psychology ,Depression (differential diagnoses) ,Qualitative research ,Social influence ,Clinical psychology - Abstract
Background Exercise is now recommended as a treatment for depression in Canada. What remains less clear is how best to encourage exercise uptake by individuals with mood disorders. The purpose of this scoping review is to identify barriers and facilitators to exercise and physical activity participation among individuals with depression. Method A scoping review with systematic searches was conducted. Eligible studies required samples >50% diagnosed with depression or a mood disorder, and reported empirical data on barriers and/or facilitators to physical activity using quantitative and/or qualitative methods. Extracted barriers and facilitators were classified into the fourteen domains of the Theoretical Domains Framework (TDF). Results Thirteen studies were included (seven quantitative, six qualitative). The most common barriers were classified under the TDF domains of Emotion, Environmental Context & Resources, Beliefs about Capabilities, and Intentions. The most common facilitators were classified under the domains of Beliefs about Consequences, Social Influences, Emotion and Behavioural Regulation. Conclusions Most identified domains are all common determinants of health behaviours in various models and theories applied to physical activity participation. However, the Emotion domain appears to be particularly important to individuals with depression, and yet is not covered by these traditional theories of behaviour change, and may be overlooked when trying to promote physical activity among this population. Future research should investigate the effectiveness of behaviour change interventions that specifically target the Emotion domain, and clearly report the behaviour change techniques employed to do so.
- Published
- 2017
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26. Pharmacological interventions for prevention of weight gain in people with schizophrenia
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Margaret Hahn, Hiroyoshi Takeuchi, Markus J. Duncan, Jonathan Lockwood, Guy Faulkner, Zohra Ahsan, Gary Remington, Valerie H. Taylor, Tony Cohn, and Sri Mahavir Agarwal
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Medicine General & Introductory Medical Sciences ,medicine.medical_specialty ,business.industry ,Schizophrenia (object-oriented programming) ,education ,behavioral disciplines and activities ,Pharmacological interventions ,mental disorders ,Medicine ,Pharmacology (medical) ,medicine.symptom ,business ,Psychiatry ,Weight gain - Abstract
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To determine the effects of pharmacological interventions for preventing weight gain in people with schizophrenia.
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- 2019
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27. A Systematic Review and Meta-Analysis of Pharmacological Interventions for Reduction of Weight Gain in People With Schizophrenia: 2019 Update
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Hiroyoshi Takeuchi, Guy Faulkner, Sri Mahavir Agarwal, Nicolette Stogios, Tony Cohn, Gary Remington, Jonathan Lockwood, Markus J. Duncan, Margaret Hahn, Valerie H. Taylor, and Zohra Ahsan
- Subjects
Reduction (complexity) ,medicine.medical_specialty ,Pharmacological interventions ,business.industry ,Meta-analysis ,Schizophrenia (object-oriented programming) ,medicine ,medicine.symptom ,Psychiatry ,business ,Weight gain ,Biological Psychiatry - Published
- 2020
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28. S90. A SYSTEMATIC REVIEW AND META-ANALYSIS OF PHARMACOLOGICAL INTERVENTIONS FOR REDUCTION OF WEIGHT GAIN IN PEOPLE WITH SCHIZOPHRENIA: 2019 UPDATE
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Sri Mahavir Agarwal, Nicolette Stogios, Margaret Hahn, Tony Cohn, Markus J. Duncan, Zohra Ahsan, Valerie H. Taylor, Gary Remington, Hiroyoshi Takeuchi, Guy Faulkner, and Jonathan Lockwood
- Subjects
medicine.medical_specialty ,Poster Session I ,AcademicSubjects/MED00810 ,business.industry ,Schizophrenia (object-oriented programming) ,Reduction (complexity) ,Psychiatry and Mental health ,Pharmacological interventions ,Meta-analysis ,medicine ,medicine.symptom ,Psychiatry ,business ,Weight gain - Abstract
Background Weight gain and obesity are common problems encountered by patients with schizophrenia. This is partially attributable to use of second-generation antipsychotics that are associated with weight gain and other metabolic disturbances. The significance of this prevalence and its impact on premature mortality and morbidity requires better consensus on its management. The objective of this review is to determine the effects of adjunctive pharmacological interventions aimed at reducing weight gain in schizophrenia. Methods We searched the Cochrane Schizophrenia Group’s Trials Register which is based on regular searches of CINAHL, BIOSIS, AMED, EMBASE, PubMed, MEDLINE, PsycINFO, and registries of clinical trials. Inclusion criteria consisted of all randomized controlled trials examining any adjunctive pharmacological intervention for weight loss in patients with schizophrenia or schizophrenia-like illnesses. The primary outcome of each study had to be body weight or a weight related measure. We reliably selected, quality assessed, and extracted data from studies. As endpoint and change data was combined in the analysis, mean differences (MD) of the change from baseline were calculated using Review Manager 5.3. Results Sixty-one randomized controlled trials met inclusion criteria for this review (pooled n = 3328). Metformin is effective in bringing about modest weight loss (Weight: MD -3.40 kg, 95% CI -4.63 to -2.16; participants = 731; studies = 12; BMI: MD -1.39, 95% CI -1.94 to -0.85; participants = 879; studies = 13). Heterogeneity was reduced by dividing populations into first episode psychosis (FEP) and chronic populations, where FEP patients appeared to benefit most from early metformin intervention (Weight: MD -5.18 kg, 95% CI -6.22 to -4.14; BMI: MD -1.87 kg/m2, 95% CI -2.19 to -1.56; participants = 214; studies = 3) as compared to chronic patients (Weight: MD -2.22 kg, 95% CI -3.07 to -1.37; participants = 517; studies = 9; BMI: MD -1.18 kg/m2, 95% CI -1.89 to -0.48; participants = 665; studies = 10). However, ethnicity could be a confounder for the apparent effect of illness stage, as all first episode metformin intervention studies were conducted in patients with Chinese ethnicity. Metformin as a treatment for weight gain may be associated with additional adaptive changes in fasting insulin levels and insulin resistance. The frequency of adverse effects did not differ between metformin and placebo groups. Moreover, glucagon-like peptide agonists (GLP-1RAs), such as liraglutide and exenatide, were also effective in reducing weight (Weight: MD -3.95 kg, 95% CI -7.08 to -0.83; participants = 165; studies = 3; BMI -1.26 kg/m2, 95% CI -2.21 to -0.30; participants = 165; studies = 3; waist circumference: MD -3.25, 95% CI -5.93 to -0.57; participants = 165, studies = 3). The frequency of adverse effects did not differ between GLP-1RA and placebo groups. Topiramate 200 mg was also effective for weight reduction (Weight: MD=-6.61 kg, 95% CI -9.62 to -3.61; BMI: MD=-2.72, 95% CI -3.25 to -2.20; participants = 181, studies = 3). Discussion This review highlights the promise of pharmacological interventions for decreasing weight gain associated with antipsychotic use. Of the drugs studied, metformin has the most evidence and was most effective in bringing about modest weight loss. Topiramate and GLP-1RA also have accumulating evidence supporting efficacy in reducing weight. Interpretation for other agents is limited by the small number of studies, sample size, and short study duration. Future studies that are adequately powered, with longer treatment duration, will be needed in evaluating the efficacy and safety of interventions for managing weight gain further.
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- 2020
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29. Revisiting the International Physical Activity Questionnaire (IPAQ): Assessing sitting time among individuals with schizophrenia
- Author
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Markus J. Duncan, Gary Remington, Mehala Subramaniapillai, Guy Faulkner, and Kelly P. Arbour-Nicitopoulos
- Subjects
Adult ,Male ,medicine.medical_specialty ,Population level ,Intraclass correlation ,Physical activity ,Validity ,Sitting ,Health outcomes ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Medicine ,Humans ,Exercise ,Biological Psychiatry ,Sitting Position ,business.industry ,Reproducibility of Results ,Middle Aged ,medicine.disease ,Sitting time ,030227 psychiatry ,Psychiatry and Mental health ,Schizophrenia ,Physical therapy ,Female ,Sedentary Behavior ,business ,030217 neurology & neurosurgery - Abstract
While moderate to vigorous physical activity may be one method of addressing common physical morbidities in schizophrenia, reducing sedentary time may be a low intensity adjunct. In order to determine whether sedentary behaviour is associated with health outcomes, valid and reliable tools for assessing sedentary time are necessary. In order to characterize the validity and reliability of the International Physical Activity Questionnaire (IPAQ) for assessing sitting (sedentary) time, participants completed the IPAQ at baseline and 4 weeks later and wore accelerometers for 7 days before the final assessment. Bland-Altman analyses and intraclass correlation coefficients (ICC) were used to compare agreement between measurements. One-hundred thirteen individuals completed the study. Mean difference between the IPAQ and accelerometer was 26.8 min (95% Limits of Agreement: −458.7–512.3) and ICCA,1 was 0.23 (95% CI: 0.06–0.39). Week 1 and Week 4 administrations of the IPAQ differed by an average of 26.6 min, (95% Limits of Agreement: −510.9–564.2) and ICCA,1 was 0.41 (95% CI: 0.21–0.59). The “minutes” of sitting reported by the IPAQ do not reflect objective sedentary behaviour measurements and this current measure may be unsuitable for the population level assessment of sitting time among individuals with schizophrenia.
- Published
- 2018
30. Physical activity and mental health
- Author
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Guy Faulkner and Markus J. Duncan
- Subjects
Psychotherapist ,Exercise intervention ,Referral ,Physical activity ,Physical health ,Research findings ,Psychology ,Mental health ,Depression (differential diagnoses) ,Depressive symptoms - Abstract
The purpose of this chapter is to focus on the evidence for physical activity as a strategy to prevent and treat depression. There is a consistent body of literature that indicates being physically active prevents depression and that exercise can alleviate depressive symptoms. There is a range of plausible mechanisms that explain why physical activity may have an antidepressant effect. Challenges and implications for policy and practice are presented. Both physical activity and mental health professionals have important roles to play in establishing inter-professional dialogue and collaborating in developing structures of referral to supervised and structured exercise interventions. There is a compelling and extensive body of literature supporting the role of physical activity in enhancing and maintaining physical health. Over the last decade there has been rapid growth in research findings concerning the mental health benefits of physical activity. The journal Mental Health and Physical Activity is dedicated to the topic while 2013 saw the publication of the most comprehensive synthesis to date on the subject (Ekkekakis 2013a). The collective body of evidence presents a strong case that physical activity similarly helps enhance and maintain many dimensions of mental health. As Boreham and Riddoch (2003, p. 24) neatly encapsulated, ‘from the cradle to the grave, regular physical activity appears to be an essential ingredient for human well-being’.
- Published
- 2017
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31. The Utility of the Health Action Process Approach Model for Predicting Physical Activity Intentions and Behavior in Schizophrenia
- Author
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Markus J. Duncan, Gary Remington, Guy Faulkner, Kelly P. Arbour-Nicitopoulos, and John Cairney
- Subjects
lcsh:RC435-571 ,Population ,Psychological intervention ,physical activity ,Schizoaffective disorder ,Developmental psychology ,03 medical and health sciences ,Social support ,0302 clinical medicine ,lcsh:Psychiatry ,accelerometry ,medicine ,education ,Original Research ,Psychiatry ,education.field_of_study ,theory based ,Health action process approach ,Multilevel model ,determinants ,Cognition ,medicine.disease ,030227 psychiatry ,schizophrenia ,Psychiatry and Mental health ,Schizophrenia ,Psychology ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
Research is needed to develop evidence-based behavioral interventions for preventing and treating obesity that are specific to the schizophrenia population. This study is the precursor to such intervention research where we examined the utility of the social cognitions outlined within the Health Action Process Approach (HAPA) model for predicting moderate to vigorous physical activity (MVPA) intentions and behavior among individuals with schizophrenia or schizoaffective disorder. A prospective cohort design [baseline (T1), week 2 (T2), and week 4 (T3)] was used to examine the HAPA constructs and MVPA across a sample of 101 adults (Mage = 41.5 ± 11.7 years; MBMI = 31.2 ± 7.8 kg/m2; 59% male). Two hierarchical regression analyses were conducted controlling for age, gender, BMI, and previous self-reported MVPA. In the first regression, intentions at T1 were regressed onto the T1 motivational HAPA constructs (risk perception, affective attitudes, task self-efficacy) and social support; MVPA status (meeting vs. not meeting the MVPA guidelines) assessed via accelerometry at T3 was regressed onto T1 social support and intentions followed by T2 action and coping planning, and maintenance self-efficacy in the second analysis. Overall, the motivational and social support variables accounted for 28% of the variance in intentions, with affective attitudes (β = 0.33, p
- Published
- 2017
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32. Behavioural Interventions for Weight Management Among Patients with Schizophrenia
- Author
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Guy Faulkner, Gary Remington, Karen M. Davison, and Markus J. Duncan
- Subjects
medicine.medical_specialty ,Binge eating ,business.industry ,Schizophrenia (object-oriented programming) ,Physical activity ,Case vignette ,Behavioural intervention ,behavioral disciplines and activities ,humanities ,030227 psychiatry ,03 medical and health sciences ,surgical procedures, operative ,0302 clinical medicine ,mental disorders ,Weight management ,medicine ,In patient ,medicine.symptom ,Psychiatry ,business ,health care economics and organizations ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
This chapter will focus on behavioural interventions for patients with schizophrenia and obesity. Building on previous chapters focused on assessment of obesity, this chapter will use a case vignette to apply an approach to assessing and treating obesity in patients with schizophrenia. We will summarize the evidence for behavioural interventions for weight management among patients with schizophrenia and specific components of behavioural approaches will be discussed.
- Published
- 2016
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33. Revisiting the International Physical Activity Questionnaire (IPAQ): Assessing physical activity among individuals with schizophrenia
- Author
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Kelly P. Arbour-Nicitopoulos, Gary Remington, Guy Faulkner, Mehala Subramanieapillai, and Markus J. Duncan
- Subjects
Adult ,Male ,medicine.medical_specialty ,Waist ,Psychometrics ,Population ,Physical activity ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,medicine ,Criterion validity ,Humans ,education ,Exercise ,Biological Psychiatry ,Reliability (statistics) ,education.field_of_study ,Recall ,Reproducibility of Results ,Middle Aged ,medicine.disease ,3. Good health ,030227 psychiatry ,Psychiatry and Mental health ,Schizophrenia ,Physical therapy ,Female ,Psychology ,030217 neurology & neurosurgery - Abstract
Individuals with schizophrenia tend to have low levels of physical activity (PA) which contributes to high rates of physical comorbidities. Valid and reliable methods of assessing PA are essential for advancing health research. Ten years after initial validation of the Short-Form International Physical Activity Questionnaire (IPAQ), this study expands on the initial validation study by examining retest reliability over a 4-week period, assessing validity with a larger sample, and comparing validity of the IPAQ to a 24-hour recall alternative.Participants completed the IPAQ at baseline and 4weeks later, along with a 24-hour PA recall at week 4. At week 3 participants wore waist accelerometers for 7days. Spearman's correlation coefficients and Bland-Altman plots were calculated based on weekly minutes of moderate to vigorous PA (MVPA).Test-retest reliability for the self-administered IPAQ was ρ=0.47, p0.001 for MVPA. Correlation between IPAQ assessment and accelerometer-determined MVPA was ρ=0.30, p=0.003. The 24-hour recall correlated significantly with MVPA on the previous day ρ=0.27, p=0.012. A Bland-Altman plot indicated the IPAQ-SF underreported by -119.2min (-72%) on average compared to accelerometry (95% limits of agreement -1017.1 to 778.7min, -292% to 147%).Compared to previous IPAQ validation work in this population, criterion validity was similar, but reliability was lower over a 4-week period. MVPA criterion validity of the 24-hour recall was comparable to the 7-day self-report IPAQ. Findings further support that the IPAQ is a suitable assessment tool for epidemiological studies. Objective measures of physical activity are recommended for intervention assessment.
- Published
- 2016
34. Physical activity preferences of individuals diagnosed with schizophrenia or bipolar disorder
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Rodrigo B. Mansur, Mehala Subramaniapillai, Gary Remington, Markus J. Duncan, Kelly P. Arbour-Nicitopoulos, Guy Faulkner, and Roger S. McIntyre
- Subjects
Adult ,Male ,medicine.medical_specialty ,Bipolar Disorder ,Population ,Physical activity ,Walking ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,0302 clinical medicine ,Intervention (counseling) ,Preferences ,mental disorders ,Severe mental illness ,medicine ,Humans ,Bipolar disorder ,Psychiatry ,education ,Exercise ,Monitoring, Physiologic ,Medicine(all) ,education.field_of_study ,business.industry ,Biochemistry, Genetics and Molecular Biology(all) ,Resistance Training ,General Medicine ,Middle Aged ,Mental illness ,medicine.disease ,Mental health ,030227 psychiatry ,Self Care ,Premature death ,Schizophrenia ,Female ,Schizophrenic Psychology ,Health perceptions ,Sedentary Behavior ,business ,030217 neurology & neurosurgery ,Research Article - Abstract
Background Individuals with a severe mental illness (SMI) are at least two times more likely to suffer from metabolic co-morbidities, leading to excessive and premature deaths. In spite of the many physical and mental health benefits of physical activity (PA), individuals with SMI are less physically active and more sedentary than the general population. One key component towards increasing the acceptability, adoption, and long-term adherence to PA is to understand, tailor and incorporate the PA preferences of individuals. Therefore, the objective of this study was to determine if there are differences in PA preferences among individuals diagnosed with different psychiatric disorders, in particular schizophrenia or bipolar disorder (BD), and to identify PA design features that participants would prefer. Methods Participants with schizophrenia (n = 113) or BD (n = 60) completed a survey assessing their PA preferences. Results There were no statistical between-group differences on any preferred PA program design feature between those diagnosed with schizophrenia or BD. As such, participants with either diagnosis were collapsed into one group in order to report PA preferences. Walking (59.5 %) at moderate intensity (61.3 %) was the most popular activity and participants were receptive to using self-monitoring tools (59.0 %). Participants were also interested in incorporating strength and resistance training (58.5 %) into their PA program and preferred some level of regular contact with a fitness specialist (66.0 %). Conclusions These findings can be used to tailor a physical activity intervention for adults with schizophrenia or BD. Since participants with schizophrenia or BD do not differ in PA program preferences, the preferred features may have broad applicability for individuals with any SMI.
- Published
- 2016
35. M58. Sedentary Behavior Profiles and Obesity Among People With Schizophrenia
- Author
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Markus J. Duncan, Guy Faulkner, Gary Remington, Kelly P. Arbour-Nicitopoulos, and Mehala Subramaniapillai
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Abstracts ,Psychiatry and Mental health ,Schizophrenia (object-oriented programming) ,medicine ,Sedentary behavior ,medicine.disease ,Psychology ,Obesity ,Clinical psychology - Abstract
Background: Sedentary behavior has been identified as a risk factor for cardiovascular disease and mortality independent of physical activity; the purpose of this study was to profile sedentary behavior in a sample of people with schizophrenia and identify relationships between patterns of sedentary behavior and measures of adiposity.
- Published
- 2017
- Full Text
- View/download PDF
36. Exercise and cognition
- Author
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Mehala Subramaniapillai, Danielle S. Cha, Guy Faulkner, Markus J. Duncan, and Roger S. McIntyre
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Cognition ,Psychology ,Cognitive psychology - Published
- 2015
- Full Text
- View/download PDF
37. Characterizing the affective responses to an acute bout of moderate-intensity exercise among outpatients with schizophrenia
- Author
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Kelly P. Arbour-Nicitopoulos, Markus J. Duncan, Guy Faulkner, and Gary Remington
- Subjects
Adult ,Male ,Pleasure ,medicine.medical_specialty ,media_common.quotation_subject ,Population ,Sitting ,Affect (psychology) ,behavioral disciplines and activities ,Arousal ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Psychiatry ,education ,Exercise ,Biological Psychiatry ,media_common ,education.field_of_study ,Middle Aged ,medicine.disease ,Mental health ,030227 psychiatry ,Psychiatry and Mental health ,Affect ,Schizophrenia ,Well-being ,Female ,Psychology ,030217 neurology & neurosurgery - Abstract
In addition to offering many physical health benefits, exercise may help improve mental health among individuals with schizophrenia through regulating affect. Therefore, the purpose of this study is to characterize affective responses experienced before, during and after a 10-min bout of exercise versus passive sitting among individuals with schizophrenia. A randomized crossover design compared affect related to feelings of pleasure and arousal at baseline, 6-min into the task, immediately post-task, and 10min post-task to sitting. Thirty participants enroled in the study; 28 participants completed the study. Separate mixed model analyses of variance were conducted for pleasure and arousal, with test order as the between-subject factor, and time and task as within-subject factors. For pleasure, a significant main effect for time and a time x task interaction effect emerged. Post-hoc Bonferroni corrected t-tests (α=.0125) revealed significant differences between pleasure at baseline and both immediately post-task and 10min post-task. No other main effects or interactions emerged. Individuals with schizophrenia derive acute feelings of pleasure from exercise. Thus, exercise may provide a method of regulating affect to improve mental health. Future studies should examine the links between affective responses to health behaviours such as long-term adherence to exercise within this population.
- Published
- 2015
38. Pharmacological interventions for reducing weight gain in schizophrenia
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Tony Cohn, Markus J. Duncan, Guy Faulkner, Margaret Hahn, and Gary Remington
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medicine.medical_specialty ,Pharmacological interventions ,business.industry ,Schizophrenia (object-oriented programming) ,medicine ,Pharmacology (medical) ,medicine.symptom ,Psychiatry ,business ,Weight gain - Published
- 2014
- Full Text
- View/download PDF
39. Behavioural interventions for reducing weight gain in schizophrenia
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Markus J. Duncan, Gary Remington, Tony Cohn, Guy Faulkner, and Margaret Hahn
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medicine.medical_specialty ,business.industry ,Schizophrenia (object-oriented programming) ,medicine ,Behavioural intervention ,Pharmacology (medical) ,medicine.symptom ,business ,Psychiatry ,Weight gain - Published
- 2013
- Full Text
- View/download PDF
40. Comparative Validity of Physical Activity Assessment Methods for Individuals with Schizophrenia
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Markus J. Duncan, Gary Remington, Kelly P. Arbour-Nicitopoulos, Mehala Subramanieapillai, and Guy Faulkner
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medicine.medical_specialty ,Schizophrenia (object-oriented programming) ,Assessment methods ,Physical activity ,Alternative medicine ,medicine ,Physical Therapy, Sports Therapy and Rehabilitation ,Orthopedics and Sports Medicine ,Psychology ,Psychiatry - Published
- 2016
- Full Text
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41. The Relationship Between Moderate-to-Vigorous Physical Activity and Executive Function Among Individuals with Schizophrenia
- Author
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Kelly P. Arbour-Nicitopoulos, Fervaha G, Grassmann, Subramaniapillai M, Gary Remington, Markus J. Duncan, and Guy Faulkner
- Subjects
business.industry ,Schizophrenia (object-oriented programming) ,Physical activity ,Medicine ,Physical Therapy, Sports Therapy and Rehabilitation ,Orthopedics and Sports Medicine ,business ,Clinical psychology - Published
- 2016
- Full Text
- View/download PDF
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