Supporting early-career dementia researchers: Identifying support needs and ways forward via a European study.

INTRODUCTION: Early-career researchers contribute significantly to dementia research and clinical practice. However, a growing group of early-career dementia researchers (ECDRs) lack appropriate support throughout their careers. Thus, we aim to (i) explore support needs, (ii) determine recommendations, and (iii) set the agenda for organizations to better support ECDRs. METHODS: An iterative, explanatory sequential mixed-methods design was applied. First ECDRs' needs were identified using an online survey informed by the Vitae Researcher Development Framework. Next, priority areas were selected and explored qualitatively with ECDRs in two workshops, utilizing the World Café methodology. RESULTS: Sixty-five ECDRs throughout Europe completed the survey, with the majority reporting that greater support is needed in terms of funding and career opportunities, social support and well-being, and "wide-reaching" dissemination. DISCUSSION: Based on the findings, six recommendations for support organizations, funding bodies, and universities to better support ECDRs are formulated, each intended for specific target audiences. HIGHLIGHTS: This article reports on focal points of career-related support needed in doctoral education and postdoctoral employment to foster a healthier academic environment, including finance, work-life balance, dissemination of research findings, and supervision, both in general and in dementia fields specifically. Funding and resources were identified as a significant challenge, and there was a call for more long-term positions and transition funding for postdoctoral researchers. Early-career dementia researchers addressed the need for support in producing outputs for non-academic audiences, including people living with dementia. The importance of disseminating research to diverse audiences has long been recognized; thus, it is critical that early-career dementia researchers be supported in this effort. Recommendations were formulated for researcher support (organizations), funding bodies, and universities. These recommendations include providing support for disseminating research to non-academic audiences, offering training in supervision skills, and promoting peer-to-peer mentoring and social activities for early-career dementia researchers.

The Integration of Psychosocial Care into National Dementia Strategies across Europe: Evidence from the Skills in DEmentia Care (SiDECar) Project.

There is evidence supporting the use of psychosocial interventions in dementia care. Due to the role of policy in clinical practice, the present study investigates whether and how the issue of psychosocial care and interventions has been addressed in the national dementia plans and strategies across Europe. A total of 26 national documents were found. They were analyzed by content analysis to identify the main pillars associated with the topic of psychosocial care and interventions. Specifically, three categories emerged: (1) Treatment, (2) Education, and (3) Research. The first one was further divided into three subcategories: (1) Person-centred conceptual framework, (2) Psychosocial interventions, and (3) Health and social services networks. Overall, the topic of psychosocial care and interventions has been addressed in all the country policies. However, the amount of information provided differs across the documents, with only the category of 'Treatment' covering all of them. Furthermore, on the basis of the existing policies, how the provision of psychosocial care and interventions would be enabled, and how it would be assessed are not fully apparent yet. Findings highlight the importance of policies based on a comprehensive and well-integrated system of care, where the issue of psychosocial care and interventions is fully embedded.

A narrative synthesis systematic review of digital self-monitoring interventions for middle-aged and older adults.

OBJECTIVE: Self-monitoring is crucial to raise awareness for own behaviors and emotions, and thus facilitate self-management. The composition of self-monitoring within interventions, however, varies and guidelines are currently unavailable. This review aimed to provide a comprehensive overview of technology-based self-monitoring interventions that intend to improve health in middle-aged and older adults (>45 years). METHODS: Five online databases were systematically searched and articles were independently screened. A narrative synthesis of 26 studies with 21 unique interventions was conducted. Primary focus lay on the composition of self-monitoring within interventions, including technology used, health-aspects monitored, and type of feedback provided. Secondly, the usability of/adherence to the self-monitoring treatment, intervention effects, and their sustainability were examined. FINDINGS: Studies concentrated on middle-aged adults (mean of 51 years). Mobile technologies seem necessary to ensure flexible self-monitoring in everyday life. Social health aspects were rarely monitored. Mechanisms and the sustainability of intervention effect are understudied. CONCLUSION: Digital self-monitoring technologies hold promise for future trials as they seem suitable to understand and support health-related self-management. Key elements including automatic and personal feedback following the blended care principle were highlighted and may guide study designs. Prospectively, research is especially needed to study sustained self-monitoring to support disease prevention and lasting lifestyle changes.

Self-regulation and obesity: the role of executive function and delay discounting in the prediction of weight loss.

Obesity rates are rising worldwide. Executive function and delay discounting have been hypothesized to play important roles in the self-regulation of behavior, and may explain variance in weight loss treatment success. First, we compared individuals with obesity (n = 82) to healthy weight controls (n = 71) on behavioral and self-report measures of executive function (working memory, inhibition and shifting) and delay discounting. Secondly, the individuals with obesity took part in a multidisciplinary weight loss program and we examined whether executive function and delay discounting predicted weight change. Individuals with obesity displayed weaker general and food-specific inhibition, and weaker self-reported executive function. Better behavioral working memory and better self-reported inhibition skills in daily life were predictive of greater weight loss. As findings are correlational, future studies should investigate the causal relationship between executive function and weight loss, and test whether intervening on executive function will lead to better prevention and treatment of obesity.

Gamified working memory training in overweight individuals reduces food intake but not body weight.

Working Memory (WM) plays a crucial role in successful self-regulation of behavior, including weight regulation. Improving WM might therefore be a promising strategy to support weight loss. In the present study, overweight individuals with a desire to lose weight (N = 91) received an online lifestyle intervention, in conjunction with either 25 sessions of gamified WM training (experimental condition) or a sham training (control). Primary outcomes were Body Mass Index (BMI) and food intake at posttest. Secondary outcomes were executive functioning, self-control, eating style, eating psychopathology and healthy eating. Data were analyzed with mixed regression analyses with condition as between-subjects factor (experimental versus control) and time as within-subjects factor (baseline, posttest, FU1 after one month and FU2 after six months). Results revealed that the experimental condition increased their WM span more than control from pretest to posttest, and these gains were retained at FU1, though lost at FU2. No transfer effects of WM training to other executive functioning measures were found. During the bogus taste test at posttest, participants in the experimental condition consumed significantly less than participants in the control condition. However, both conditions showed a small reduction in BMI, improved eating style, reduced eating disorder pathology, and reported more self-control and a healthier eating pattern. In conclusion, the current results provide some evidence that WM training can improve eating behavior at the short term. However, the WM gains were short-lived, and the added value of WM training as an intervention to promote weight loss could not be established. Future studies should test the added value of WM training booster sessions to promote weight loss over a prolonged period of time.

Taking control: Working memory training in overweight individuals increases self-regulation of food intake.

Working memory (WM) plays a critical role in cognitive control by shielding self-regulatory goals from distraction by desire-related thoughts and emotions. This study examined whether training WM increases self-regulation in overweight participants. It was hypothesized that WM training would decrease psychopathological eating-related thoughts, (over)consumption of food in response to emotions and external cues, food intake and body weight. Overweight participants (n = 50) performed 20-25 sessions of WM training or control/sham training. The dependent measures were self-reported eating-related psychopathology, self-reported emotional/external eating behavior, food intake during a bogus taste test, and body weight, assessed before training, immediately following training, and at one-month follow-up. Relative to control, WM training reduced psychopathological eating-related thoughts and emotional eating (but not external eating). These effects were still present at follow-up, one month later. Food intake and body weight did not show an overall effect of training, though WM training did reduce food intake among highly restrained participants. WM training effectively reduced eating-related thoughts, overeating in response to negative emotions, and food intake among participants with strong dietary restraint goals. Hence, these findings indicate that WM training may strengthen self-regulation by shielding dieting goals from distraction by unwanted eating-related thoughts and emotions.

Focus on the future: Episodic future thinking reduces discount rate and snacking.

Obesity seems related to a preference for immediate gratification. By changing this focus on short term benefits to a more future-oriented outlook, delay discounting (impulsive decision making) can be changed by a manipulation of episodic future thinking (EFT). EFT comprises a vivid mental simulation of general future experiences. EFT may also affect consumption of unhealthy foods, which can be seen as a choice for immediate gratification. Recent research shows that future orientation should be tailored to the behavior at outcome. We therefore hypothesize that the effectiveness of EFT on food intake could be enhanced by making the content food-related. We conducted a 2 (future vs past thinking) by 2 (food vs non-food related thoughts) between-subject design experiment in female undergraduates (N = 94), to compare the efficacy of EFT versus the recalling of episodic past events in reducing discount rate and caloric intake. Content of imagery was either unrestricted or food-related. Participants engaged in EFT or control episodic imagery while snacks were offered to freely consume, and next the Monetary Choice Questionnaire was completed as a measure of delay discounting, while again being engaged in EFT or control imagery. Both types of EFT reduced delay discounting, however, only food-related EFT lead to more restricted caloric consumption. Thus, we found evidence that EFT reduced discount rate during decision making. However, in order to restrict caloric intake, EFT should entail food-related imagery. As discount rate and caloric intake were not related in the current sample, the underlying mechanism remains to be discovered. Results however suggest that EFT is a promising technique to resist immediate gratification.

Impulsivity and overeating in children in the absence and presence of hunger.

Overweight children appear to be more responsive to environmental, hedonic cues and easily overeat in the current obesogenic environment. They are also found to overeat in the absence of hunger, and this overeating seems related to impulsivity: impulsive participants are more prone to external eating. However, some studies showed that impulsive adults are also more prone to hunger cues: impulsive participants overate especially when feeling hungry. This would mean impulsive people are more reactive to both external and internal cues. The overeating was limited to palatable high energy-dense foods: hunger made them fancy a snack. In the current study, we wanted to test the interaction between impulsivity, hunger and consumption of food type in children. Impulsivity was measured in 88 children between the ages of 7 and 9. Next, half of the participants performed a taste test before their own regular lunch and half of the participants immediately after their lunch. During the taste test, low, medium and high energy-dense food items were presented. Results showed that impulsive children ate more high energy-dense foods than low impulsive children, both before and after their lunch. No differences were found on low or medium energy-dense foods. Impulsive children therefore showed normal sensitivity for internal hunger and satiety cues, but abnormal response to high energy-dense foods. This might render them vulnerable to tasty temptation in the environment and to weight gain in their future.

Time orientation and eating behavior: Unhealthy eaters consider immediate consequences, while healthy eaters focus on future health.

Time orientation could play an important role in eating behavior. The current study investigated whether eating behavior is associated with the Consideration of Future Consequences scale (CFC). Specifically, it was examined whether unhealthy eaters consider the future less and are more concerned with immediate gratification. A related measure of time orientation is delay discounting, a process by which a reinforcer becomes less valuable when considered later in time. Recent research argues that the relation between time orientation and health behaviors is measured best at a behavior-specific level. In the current study, we explored the relationships between CFC and discount rate - both general and food-specific - and their influence on healthy eating. Participants with ages 18 to 60 (N = 152; final sample N = 146) filled in an online questionnaire consisting of the CFC, a food-specific version of the CFC (CFC-food), the Monetary Choice Questionnaire (MCQ) and an adapted MCQ version with snack food as a reinforcer. Self-reported healthy eating was positively related to the future subscale (r = .48, p < .001) and negatively to the immediate subscale of the CFC-food (r = -.43, p < .001). The general CFC and discount rate (MCQ and MCQ-snack) were not related to healthy eating (all p > .05). In order to predict behavior, measurements of time orientation should thus be tailored to the behavior of interest. Based on current results, shifting one's concern from the immediate consequences of eating to a more future-oriented perspective may present an interesting target for future interventions aimed at promoting healthy eating and reducing overweight.