Effects of Early Clozapine Treatment on Remission Rates in Acute Schizophrenia (The EARLY Trial): Protocol of a Randomized-Controlled Multicentric Trial.

BACKGROUND: Quick symptomatic remission after the onset of psychotic symptoms is critical in schizophrenia treatment, determining the subsequent disease course and recovery. In this context, only every second patient with acute schizophrenia achieves symptomatic remission within three months of initiating antipsychotic treatment. The potential indication extension of clozapine-the most effective antipsychotic-to be introduced at an earlier stage (before treatment-resistance) is supported by several lines of evidence, but respective clinical trials are lacking. METHODS: Two hundred-twenty patients with acute non-treatment-resistant schizophrenia will be randomized in this double-blind, 8-week parallel-group multicentric trial to either clozapine or olanzapine. The primary endpoint is the number of patients in symptomatic remission at the end of week 8 according to international consensus criteria ('Andreasen criteria'). Secondary endpoints and other assessments comprise a comprehensive safety assessment (i. e., myocarditis screening), changes in psychopathology, global functioning, cognition, affective symptoms and quality of life, and patients' and relatives' views on treatment. DISCUSSION: This multicentre trial aims to examine whether clozapine is more effective than a highly effective second-generation antipsychotics (SGAs), olanzapine, in acute schizophrenia patients who do not meet the criteria for treatment-naïve or treatment-resistant schizophrenia. Increasing the likelihood to achieve symptomatic remission in acute schizophrenia can improve the overall outcome, reduce disease-associated burden and potentially prevent mid- and long-term disease chronicity.

Effects of media-assisted therapeutic approaches on physical activity of obese adults: a systematic review.

BACKGROUND: The number of patients with obesity continues to increase in our society. At the same time, digitalization defines our everyday life. Therefore, the question arises whether to use digital media for effective treatments against obesity. Aim of this review is a concise presentation of effects of media-assisted therapeutic approaches. METHODS: A systematic literature research in multiple scientific databases, PubMed, Web of Science and Cochrane Library, was performed for literature published in the last 10 years (cut-off date 12.07.2017). Only randomized controlled trials using digital support for treatment and/or aftercare of obese adults aged between 18 to 70 years were included into the analysis. RESULTS: Overall, 14 trials with data on a total of 4979 participants were included in this review. Generally, there are positive trends for increased moderate to vigorous physical activity by the use of digital media. A simultaneous usage of various digital media, which focus on important aspects of activity behavior, has proven to be effective. A combination of various digital media shows the greatest positive effect and could significantly increase physical activity. However, the biggest potential was found in mixed approaches combining digital devices and personal face-to-face support. CONCLUSIONS: Therapeutic approaches using digital media for supporting obesity treatment did not show superior benefit over traditional personal therapeutic methods. Nevertheless, using both methods together offered the greatest potential for successful obesity therapy. However, there is a backlog of transparency concerning information about the content of treatment. Furthermore, there is a lack of valid data about aftercare and follow-up.

Association of psychosocial and perceived environmental factors with park-based physical activity among elderly in two cities in China and Germany.

BACKGROUND: Urban parks play an important role in promoting physical activity (PA) among adults and especially among older city residents. According to the socioecological approach the association of physical environments and psychosocial factors in the context of park-based PA of elderly have not been systematically examined until now, let alone the relevance of the city (urban area) on a cross-cultural level. This study investigated selected aspects of (1) the association of psychosocial and park environmental factors with park-based physical activity (PBPA) of older people; and (2) the moderating effect of city on the association of these factors with PBPA. METHODS: A face-to-face survey was conducted of a mixed-culture sample from different urban surroundings in Hong Kong (HK) and Leipzig (L). In six parks of each city physically active elderly (> = 60 years; HK: n = 306; L: n = 311) were recruited. Multiple linear regressions were used to analyse the association between psychosocial factors and perceived environmental factors with PBPA and the moderating effect of city. RESULTS: Controlled for demographic variables, all other psychosocial factors were significantly related to PBPA, except social support. In terms of environmental factors, PBPA was positively associated with safety, attractiveness, features and negatively associated with park time distance. Controlled for demographic variables, psychosocial and environmental factors, the moderating effect of city on the associations of park features and park time distance with PBPA was not significant in HK. In contrast, there was a significant positive relationship for park features and a negative relationship for park time distance with PBPA in L. CONCLUSIONS: Psychosocial and perceived environmental factors significantly influence PBPA of older people. City moderates the associations of these factors and independently contributes to park-based PA of the elderly. The different interactions of environmental factors and urban area for PBPA of elderly can support policy makers on the municipal level in choosing adequate strategies for promoting PA of older people in parks.

[The Use of Social Networks and Physical Activity Patterns of Adolescents in Obesity Therapy - A Sociodemographic Stratified Analysis]. / Soziodemografisch stratifizierte Analyse der Nutzung sozialer Netzwerke und des Bewegungsverhaltens von juvenilen Adipositastherapieteilnehmern.

The improvement of existing obesity treatment for children and adolescents requires knowledge about social and personal conditions, individual needs, and life style. From particular importance are information about physical activity and media use, in order to target and adjust content and methods of therapy interventions. In 2013, 510 adolescents aged 11 to 17 years participated in a survey on above named factors. Physical activities were conducted with friends (64%) and in sport clubs (43%). Girls (OR 0.55) and children of unemployed parents (OR 0.28) had reduced chances to participate in sports clubs. Through social media social networks, primarily Facebook, were widely used. The use of the network functions differed among socio-demographic groups. Participants who completed obesity treatments expressed their desire to share their experience with other treatment participants (79%) and with the therapy team (37%). The results indicate the need for individualised treatment approaches.

[German Translation of the COPD Self-Efficacy Scale: Development and Validation of a Short Form]. / Deutsche Übersetzung der COPD Self-Efficacy Scale: Entwicklung und Validierung einer Kurzform.

Illness-specific self-efficacy is important in the disease-management of patients with COPD (Chronic Obstructive Pulmonary Disease). Nevertheless, there is no instrument to measure the illness-specific self-efficacy in the German speaking countries. The purposes of the study were to translate the COPD Self-Efficacy Scale (CSES) into German (CSES-D) and to determine the psychometric criteria. Another objective was to construct a short form of the CSES-D. A total of 199 participants with COPD were recruited. The factorial structure of the CSES including 5 dimensions could not be confirmed with exploratory and confirmatory factor analyses. However, the short form of the CSES-D indicated acceptable fit indices. The internal consistencies of the subscales psychological stress (α=0.95) and physical exertion (α=0.92) were good. The correlations between the CSES-Dkurz and convergent and discriminant questionnaires confirmed the validity of the instrument. The results indicate that the CSES-Dkurz is a valid and reliable instrument to assess illness-specific self-efficacy of COPD-patients. Further, studies are needed to verify the factorial construct validity of the CSES-Dkurz.

Perspectives on Speech Timing: Coupled Oscillator Modeling of Polish and Finnish.

This stud y was ai med at analyzing empirical duration data for Polish spoken at different tempos using an updated version of the Coupled Oscillator Model of speech timing and rhythm variability (O'Dell and Nieminen, 1999, 2009). We use Bayesian inference on parameters relating to speech rate to investigate how tempo affects timing in Polish. The model parameters found are then compared with parameters obtained for equivalent material in Finnish to shed light on which of the effects represent general speech rate mechanisms and which are specific to Polish. We discuss the model and its predictions in the context of current perspectives on speech timing.

[Media use and physical activity patterns of adolescent participants in obesity therapy: Analysis of the impact of selected sociodemographic factors]. / Mediennutzungs- und Aktivitätsverhalten jugendlicher Teilnehmer einer Adipositastherapie : Analyse zum Einfluss soziodemographischer Faktoren.

To meet the challenge of obesity, effective therapeutic concepts for adolescents focusing on lifestyle changes are necessary. Particularly relevant are nutrition and physical activity patterns associated with media use, which can be influenced by sociodemographic factors. For the optimization of obesity therapy approaches, it is essential to analyze these sociodemographic factors to adjust the aims, content, and methods of interventions, and to use the potential of media in treatment concepts. Thus, the research question is: what are the media and physical activity patterns of 11- to 17-year-old participants in obesity therapy, depending on sociodemographic factors? The national multicenter study was conducted from 2012 to 2013. A questionnaire was administered to 564 participants aged 13.4 ± 1.6 (mean ± standard deviation) years. Standardized instruments were used to assess the variables physical activity, media use, and sociodemographic factors. Participants were physically active for 1 h on 3.3 ± 1.8 days per week, 8.5 % daily. Televisions, mobile phones, and computers were available in all sociodemographic groups and were used for 2 h per day. Sociodemographic differences can be seen in the extent of media usage (h/day). These differences can be found between girls and boys concerning their usage of mobile phones (2.49 vs. 1.90; p < 0.001), between 11- to 13- and 14- to 17-year-old children concerning their usage of game consoles (0.55 vs. 1.65; p = 0.007), and in the correlation analysis of media usage and physical activity. Compared with existing literature, the survey results reveal reduced activity and increased media use, which vary among the groups. Thus, differentiated therapy approaches appear to be reasonable. Future research needs to evaluate to what extent media, despite the risks, can contribute to the methodological support of therapy, training, and aftercare concepts.

Early-life determinants of asthma from birth to age 20 years: a German birth cohort study.

BACKGROUND: The lack of longitudinal data analyses from birth to adulthood is hampering long-term asthma prevention strategies. OBJECTIVE: We aimed to determine early-life predictors of asthma incidence up to age 20 years in a birth cohort study by applying time-to-event analysis. METHODS: In 1990, the Multicenter Allergy Study included 1314 newborns in 5 German cities. Children were evaluated from birth to age 20 years at 19 time points. Using a Cox regression model, we examined the associations between 36 early-life factors and onset of asthma based on a doctor's diagnosis or asthma medication (primary outcome), typical asthma symptoms, or allergic asthma (including positive IgE measurements). RESULTS: Response at 20 years was 71.6%. Two hundred eighteen subjects met the primary outcome criteria within 16,257 person years observed. Asthma incidence was lower in participants who were vaccinated (measles, mumps, and rubella vaccine/tick-borne encephalitis vaccine/BCG vaccine: adjusted hazard ratio [HR], 0.66 [95% CI, 0.47-0.93]). Up to age 20 years, asthma incidence was higher in subjects who had parents with allergic rhinitis (adjusted HR, 2.24 [95% CI, 1.67-3.02]), started day care early or late (before 18 months: adjusted HR, 1.79 [95% CI, 1.03-3.10]; after 3 years: adjusted HR, 1.64 [95% CI, 0.96-2.79]), had mothers who smoked during pregnancy (adjusted HR, 1.79 [95% CI, 1.20-2.67]), had poor parents (adjusted HR, 1.55 [95% CI, 1.09-2.22]), and had parents with asthma (adjusted HR, 1.65 [95% CI, 1.17-2.31]). Not associated with asthma were aspects of diet and breast-feeding, pet ownership, presence of older siblings, and passive smoking. CONCLUSION: Parental asthma and nasal allergy increase asthma incidence in offspring up to adulthood. Avoiding tobacco smoke exposure during pregnancy, receiving vaccinations in early childhood, and starting day care between 1.5 and 3 years of age might prevent or delay the development of asthma.

Barriers to and facilitators of interventions to counter publication bias: thematic analysis of scholarly articles and stakeholder interviews.

BACKGROUND: When the nature and direction of research results affect their chances of publication, a distortion of the evidence base - termed publication bias - results. Despite considerable recent efforts to implement measures to reduce the non-publication of trials, publication bias is still a major problem in medical research. The objective of our study was to identify barriers to and facilitators of interventions to prevent or reduce publication bias. METHODS: We systematically reviewed the scholarly literature and extracted data from articles. Further, we performed semi-structured interviews with stakeholders. We performed an inductive thematic analysis to identify barriers to and facilitators of interventions to counter publication bias. RESULTS: The systematic review identified 39 articles. Thirty-four of 89 invited interview partners agreed to be interviewed. We clustered interventions into four categories: prospective trial registration, incentives for reporting in peer-reviewed journals or research reports, public availability of individual patient-level data, and peer-review/editorial processes. Barriers we identified included economic and personal interests, lack of financial resources for a global comprehensive trial registry, and different legal systems. Facilitators identified included: raising awareness of the effects of publication bias, providing incentives to make data publically available, and implementing laws to enforce prospective registration and reporting of clinical trial results. CONCLUSIONS: Publication bias is a complex problem that reflects the complex system in which it occurs. The cooperation amongst stakeholders to increase public awareness of the problem, better tailoring of incentives to publish, and ultimately legislative regulations have the greatest potential for reducing publication bias.

The Role of Sports Club Participation on Stability of Motor Performance and Body Composition: A Longitudinal Study in Primary School Children.

Methods: MP and BC of 295 children (161 girls) with a mean age of 8.42 ± 0.36 years were measured annually with the German Motor Test 6-18. Based on self-reports, children were divided into three groups according to consistent (CON), partial (PAR), and nonparticipation (NO) in SC. NO and PAR were then combined into NO-PAR. The stability of MP and BC was determined using Pearson's correlation coefficient (r). Associations of SC participation, MP, and BC were examined using robust mixed-model ANOVA (mmANOVA) additionally with first grade as covariate (ANCOVA). Results: More girls (39%) than boys (25%) were classified in PAR. The stability of MP (r = .755) and BMI (r = .889) was moderately high. Children in CON (r = .847) showed lower stability in BMI than NO-PAR (r = .923). mmANOVA revealed better overall MP for both sexes in CON except for balance and BMI. Boys in CON showed better performance in flexibility, endurance, and speed than NO-PAR. ANCOVA confirmed unadjusted results for boys. Conclusion: Lower stability of BMI due to CON indicates a greater variance in ranking and thus the chance to adjust weight management in childhood. Girls' MP benefited less from SC participation, which may be due to their more frequent rates in PAR. Therefore, interventions to increase engagement in SC should focus on a stepwise approach from none to partial and finally to long-term participation.

Oral application of bacterial lysate in infancy decreases the risk of atopic dermatitis in children with 1 atopic parent in a randomized, placebo-controlled trial.

BACKGROUND: Lower prevalence of atopy was found in children with continuous exposure to livestock and thus to microbial compounds. In animal models exposure to endotoxin (LPS) decreases allergic sensitization and airway inflammation. OBJECTIVE: We sought to evaluate the effect of orally applied bacterial lysate in infancy on the prevalence of atopic dermatitis (AD) after the treatment phase at 7 months of age. METHODS: This randomized, placebo-controlled trial included 606 newborns with at least single heredity for atopy. From week 5 until the end of month 7, infants were treated orally with bacterial lysate containing heat-killed gram-negative Escherichia coli Symbio and gram-positive Enterococcus faecalis Symbio or its placebo. Children were followed until 3 years of age. RESULTS: There was no difference in the primary outcome between the active and placebo groups in the total study group. AD prevalence was significantly reduced at the end of the intervention phase (31 weeks of age) in the subgroup of infants with single heredity for atopy (relative risk, 0.52; 95% CI, 0.3-0.9). Ten percent (15/154) of infants in the active group had AD compared with 19% (27/145, P = .030) in the placebo group. This was more pronounced in the group of infants with paternal heredity for atopy (11% vs 32%, P = .004; relative risk, 0.34; 95% CI, 0.2-0.7). CONCLUSION: Feeding of bacterial lysate might have prevented the development of AD, especially in children with paternal atopy, possibly indicating a preventive property only in subjects with a limited risk for atopy.

Molecular spreading and predictive value of preclinical IgE response to Phleum pratense in children with hay fever.

BACKGROUND: IgE sensitization against grass pollen is a cause of seasonal allergic rhinitis. OBJECTIVE: We sought to investigate the evolution at the molecular level and the preclinical predictive value of IgE responses against grass pollen. METHODS: The German Multicentre Allergy Study examined a birth cohort born in 1990. A questionnaire was administered yearly, and blood samples were collected at 1, 2, 3, 5, 6, 7, 10, and 13 years of age. Grass pollen-related seasonal allergic rhinitis (SARg) was diagnosed according to nasal symptoms in June/July. Serum IgE antibodies to Phleum pratense extract and 8 P pratense molecules were tested with immune-enzymatic singleplex and multiplex assays, respectively. RESULTS: One hundred seventy-seven of the 820 examined children had SARg. A weak monomolecular/oligomolecular IgE response to P pratense was observed very frequently before SARg onset. These initial IgE responses increased in concentration and molecular complexity during the preclinical and clinical process. A typical progression of IgE sensitization was observed: Phl p 1 (initiator in >75% of cases); then Phl p 4 and Phl p 5; then Phl p 2, Phl p 6, and Phl p 11; and then Phl p 12 and Phl p 7. At age 3 years, IgE sensitization predicted SARg by age 12 years (positive predictive value, 68% [95% CI, 50% to 82%]; negative predictive value, 84% [95% CI, 80% to 87%]). At this preclinical prediction time, the number of recognized molecules and the serum levels of IgE to P pratense were significantly lower than at 3 or more years after SARg onset. CONCLUSIONS: The IgE response against grass pollen molecules can start years before disease onset as a weak monosensitization or oligosensitization phenomenon. It can increase in serum concentration and complexity through a "molecular spreading" process during preclinical and early clinical disease stages. Testing IgE sensitization at a preclinical stage facilitates prediction of seasonal allergic rhinitis at its molecular monosensitization or oligosensitization stage.

Association of Social-Cognitive Factors with Individual Preventive Behaviors of COVID-19 among a Mixed-Sample of Older Adults from China and Germany.

Identifying modifiable correlates of older adults' preventive behaviors is contributable to the prevention of the COVID-19 and future pandemics. This study aimed to examine the associations of social-cognitive factors (motivational and volitional factors) with three preventive behaviors (hand washing, facemask wearing, and physical distancing) in a mixed sample of older adults from China and Germany and to evaluate the moderating effects of countries. A total of 578 older adults (356 Chinese and 222 German) completed the online cross-sectional study. The questionnaire included demographics, three preventive behaviors before and during the pandemic, motivational factors (health knowledge, attitude, subjective norm, risk perception, motivational self-efficacy (MSE), intention), and volitional factors (volitional self-efficacy (VSE), planning, and self-monitoring) of preventive behaviors. Results showed that most social-cognitive factors were associated with three behaviors with small-to-moderate effect sizes (f2 = 0.02 to 0.17), controlled for demographics and past behaviors. Country moderated five associations, including VSE and hand washing, self-monitoring and facemask wearing, MSE and physical distancing, VSE and physical distancing, and planning and physical distancing. Findings underline the generic importance of modifiable factors and give new insights to future intervention and policymaking. Country-related mechanisms should be considered when aiming to learn from other countries about the promotion of preventive behaviors.

The perception of sentence stress in cochlear implant recipients.

OBJECTIVES: Sentence stress is a vital attribute of speech since it indicates the importance of specific words within an utterance. Basic acoustic correlates of stress are syllable duration, intensity, and fundamental frequency (F0). Objectives of the study were to determine cochlear implant (CI) users' perception of the acoustic correlates and to uncover which cues are used for stress identification. DESIGN: Several experiments addressed the discrimination of changes in syllable duration, intensity, and F0 as well as stress identification based on these cues. Moreover, the discrimination of combined cues and identification of stress in conversational speech was examined. Both natural utterances and artificial manipulations of the acoustic cues were used as stimuli. RESULTS: Discrimination of syllable duration did not differ significantly between CI recipients and a control group of normal-hearing listeners. In contrast, CI users performed significantly worse on tasks of discrimination and stress identification based on F0 as well as on intensity. Results from these measurements were significantly correlated with the ability to identify stress in conversational speech. Discrimination performance for covarying F0 and intensity changes was more strongly correlated to identification performance than was found for discrimination of either F0 or intensity alone. Syllable duration was not related to stress identification in natural utterances. CONCLUSIONS: The outcome emphasizes the importance of both F0 and intensity for CI users' identification of sentence-based stress. Both cues were used separately for stress perception, but combining the cues provided extra benefit for most of the subjects.

Physical Activity and Social Network Use of Adolescents in Overweight and Obesity Treatment.

Tackling obesity among adolescents requires the optimization of existing obesity treatment strategies. For this purpose, social and personal circumstances, individual needs and behavior of therapy participants need to be analyzed to tailor aims, content and methods of therapy interventions to the target groups. A total of 432 obesity therapy participants between 11 and 17 years completed a written survey in a national multi-center study conducted in 2015. The data collection on behavior, in terms of physical activity, media use and sociodemographic variables, was based on questionnaires from the KiGGS, HBSC and JIM studies. The results show that participants were found to be physically active together with friends (75.5%), alone (41.4%) and in sports clubs (34.9%). Girls (OR 1.55) were less likely to participate in sports clubs. Social networks, especially YouTube, WhatsApp, Instagram and Facebook, were widely used. However, differences emerged among sociodemographic groups (e.g., boys vs. girls) regarding the use of social network features. A third of participants reported that smartphone apps regularly encouraged them to exercise. The findings imply that obesity therapy approaches need to be adapted and more differentiated according to the specific needs of the target groups.

Can the use of HEPA cleaners in homes of asthmatic children and adolescents sensitized to cat and dog allergens decrease bronchial hyperresponsiveness and allergen contents in solid dust?

BACKGROUND: Exposure and sensitization to pet allergens are associated with allergic asthma in children. Conflicting data have emerged regarding the potential benefit of air cleaners with respect to a reduction of indoor pet allergens and bronchial hyperresponsiveness (BHR). METHODS: In a randomized controlled trial 36 asthmatic children with sensitization to cat and/or dog and significant exposure to cat and/or dog allergen (Fel d 1 and/or Can f 1 >500 ng/g of carpet dust) were included in order to study the effect of high-efficiency particulate arresting (HEPA) air cleaners placed in the living room and bedroom compared with the effect of sham air cleaners. Patients were allocated to two groups: group 1 exposed to active filters and group 2 exposed to sham filters. At month 0, after 6 months and after 12 months, pulmonary function testing and cold air challenge were performed, serum eosinophil cationic protein (ECP) and specific IgE to seven aeroallergens were determined, and carpet dust samples and filters were collected. Major pet allergen concentrations (Fel d 1, Can f 1) were determined in filters and bulk dust samples. RESULTS: Thirty patients completed the study. After 6 and 12 months, there was no significant change in delta FEV(1) after cold air challenge, or in the use of medication and serum ECP levels. However, there was a trend in the active group towards an improvement of bronchial hyperresponsiveness, whereas the sham filter group showed a deterioration of BHR. CONCLUSION: Although HEPA air cleaners retained airborne pet allergens, no effect on disease activity or allergen concentrations in bulk dust samples was observed in this study.

Associations between the physical environment and park-based physical activity: A systematic review.

BACKGROUND: With an increase in the evidence for the associations between park-based physical activity (PA) and physical environments (especially park and neighborhood environments), researchers face an important challenge in interpreting and summarizing the evidence to develop environmental change interventions. An updated review is needed to better inform policymaking and environmental interventions. The current study aimed to systematically review the research on the associations of park-based PA with park and neighborhood environmental characteristics. METHODS: We targeted English peer-reviewed articles from 5 electronic databases using keywords related to park-based PA, park environments, and neighborhood environments. Of the 4071 identified papers, 25 studies published between 2008 and 2016 met all the eligibility criteria and were included in this review. RESULTS: The characteristics of physical environment that received consistent support included paths/trails, lighting, and incivilities (e.g., broken glasses and litter). Mixed findings were revealed for 6 park environmental factors (unspecified active facilities, playgrounds and skating areas, fitness stations, picnic areas, greenness, and park size) and 2 neighborhood environmental factors (park density and park proximity). CONCLUSION: It can be concluded that paths/trails, lighting, and incivilities are 3 key physical environmental attributes of park-based PA. Given the inconsistent findings on park and neighborhood environmental factors, more robust designs such as prospective investigation are required.

Socioecological Correlates of Park-based Physical Activity in Older Adults: A Comparison of Hong Kong and Leipzig Parks.

AIMS: The present study aimed to examine and compare the socioecological correlates of park-based physical activity (PA) among Hong Kong and Leipzig older adults in terms of types of activity areas, perceived park environment, psychosocial factors, and the interactions between the perceived park environmental and psychosocial factors. METHODS: Based on the SOPARC, systematic observations were conducted in six randomly selected urban parks in each city. A total of 317 Hong Kong (Mage = 69.96; SD = 6.81) and 311 Leipzig (Mage = 72.06; SD = 6.78) older adults from these six parks completed an interviewer-delivered survey measuring their perceived park environment, psychosocial variables, and park-based PA. RESULTS: In both cities, the types of activity areas were positively associated with the number of older adults observed being active in parks. Psychosocial factors, especially self-efficacy and perceived barriers, had larger associations with park-based PA compared with the perceived park environment. The interaction between perceived park features and self-efficacy in the association with park-based PA was found in Leipzig, but not in Hong Kong. CONCLUSION: Findings of the current study contribute to the cross-cultural understanding of the socioecological correlates of park-based PA among older adults.

Media Use and Physical Activity Behaviour of Adolescent Participants in Obesity Therapy: Impact Analysis of Selected Socio-Demographic Factors.

BACKGROUND: To address the challenge of juvenile obesity, effective therapeutic concepts focusing on lifestyle changes are necessary. A relevant aspect is the media use, which is associated with nutrition and physical activity patterns and is influenced by socio-demographic factors. To optimise obesity therapy, the use of media depending on these socio-demographic factors needs to be analysed to adjust the aims, content and methods of interventions as well as to harness the potential of media use in obesity therapy. The question considered in this research is: What media and physical activity patterns show 11- to 17-year-old obesity therapy participants in dependence on socio-demographic factors? METHODS: A national multicentre study was conducted in 2015. A questionnaire was used to survey 432 participants' aged 13.75 ± 1.4 years. Standardised instruments were used to assess the variables: physical activity, media use and socio-demographic factors. RESULTS: The participants were 1-hour physically active for 3.9 ± 1.9 days/week, 14.1% daily. Televisions, mobile phones and computers were available in all socio-demographic groups and used for 2 h/day. Socio-demographic differences emerged in the duration of media use (h/day). Girls were found to use mobile phones for longer (2.49 vs. 1.90; p < 0.01) and spend less time on game consoles than boys (0.55 vs. 1.65; p < 0.01). CONCLUSION: Compared to current recommendations, the sample shows reduced physical activity and increased media use, which vary between the groups. Hence, differentiated therapy approaches appear recommendable. Future research needs to evaluate, how media (despite its risks) can facilitate therapy, training and aftercare concepts.

Maternal bonding behavior, adult intimate relationship, and quality of life.

Continuity and discontinuity in the development of social relationships have been investigated by reviewing the course of social bonds and by analyzing the effects of a sound intimate relationship in adulthood in conjunction with recalled maternal bonding on the quality of life among students.A questionnaire-based study of 207 students was conducted. Perceptions of maternal bonding were designated as being representative of one of the two contrasting bonding types "optimal maternal bonding" and "affectionless maternal control" assessed by the Parental Bonding Instrument (PBI) and combined with perceptions of a sound intimate adult relationship measured by the Family Assessment Measure III Dyadic Relationships Scale (FAM-III-D). Quality of life and general health data were determined by using the World Health Organization Quality of Life (WHOQOL-BREF) instrument.Students who reported "optimal maternal bonding" had intimate relationships in adulthood that were of significantly higher quality than those who recalled "affectionless maternal control". Students who recalled "optimal maternal bonding" and described their intimate relationship as sound showed significantly higher scores in all domains of quality of life and indicated having better general health than those who reported "affectionless maternal control" and a sound intimate relationship.A sound intimate relationship in adulthood does not appear to compensate the impact of a recalled maternal bonding behavior in terms of affectionless control, on quality of life. Furthermore, results seem to support the hypothesis of continuity of the development of social relationships among psychologically well individuals based on the association between maternal bonding and later intimate relationships.