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INTRODUCTION: The relationship between physical activity (PA) intensity and executive functions in older adolescents remains poorly understood. This study aimed to examine the associations between PA intensity, volume, attentional control, and working memory and the moderating effects of sex in older adolescents. METHOD: We analyzed baseline data from 418 participants (211 females, Mage = 16.5 ± 0.40 years) from the Burn 2 Learn trial. Adolescents wore GT9X Link accelerometers on a non-dominant wrist for 7 days, 24-h·d-1 . PA intensity was expressed as intensity gradient (IG) and moderate-to-vigorous PA (MVPA, Hildebrand cut-points); PA volume was expressed as average acceleration (AvACC). Attentional control was measured with a standard deviation (SDRT) and a coefficient of variation (CVRT) of the reaction time on the incongruent trials of a flanker task. Working memory was expressed as a d prime (a signal discrimination index) on the 2-back task. The moderating effects of sex on the PA-executive functions associations, adjusting for age, BMI z-score, and cardiorespiratory fitness, were tested using multilevel random intercept models. RESULTS: After controlling for AvACC, sex moderated the relationships between IG and incongruent SDRT (B = 0.53, 95% CI: 0.12, 0.94) and CVRT (B = 0.63, 95% CI: 0.22, 1.05; ps ≤ 0.002). Only girls with higher IG showed smaller incongruent SDRT and CVRT (Bs ≤ -0.26, ps ≤ 0.01). IG was not related to working memory. AvACC and MVPA were not associated with attentional control or working memory. CONCLUSION: Our findings reveal a novel association between higher-intensity PA and superior attentional control among adolescent girls.
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Acelerometria , Aptidão Cardiorrespiratória , Feminino , Humanos , Adolescente , Exercício Físico , Função Executiva , Memória de Curto PrazoRESUMO
BACKGROUND/OBJECTIVES: To assess the relationships between daily sedentary time (ST), prolonged ST, moderate-to-vigorous physical activity (MVPA), and behavioral and neuroelectric indices of cognitive control in adults with overweight and obesity (OW/OB). SUBJECTS/METHODS: A cross-sectional design was used. Overall, 89 adults (BMI = 31.9 ± 4.9 kg/m2) provided measures of ST, prolonged ST (i.e., ST accumulated in ≥20 min), and MVPA from a hip-worn accelerometer worn over 7 days. Inhibitory control was measured with a modified Eriksen flanker task and cognitive flexibility with task switching. The amplitude and the latency of the P3 component of event-related potentials during each task were used as measures of attentional resource allocation and information processing speed, respectively. RESULTS: After adjusting for ST and MVPA, prolonged ST was related to greater interference (i.e., a larger decrement in accuracy between congruent and incongruent trials of the flanker task) indicative of a specific relationship between prolonged ST and poorer inhibitory control. Before adjusting for ST, MVPA was related to a smaller Global Switch Cost expressed as larger (more positive) amplitude of the P3 difference wave (mixed-task minus single-task condition of the switch task). Adjustment for ST attenuated this association to non-significance. CONCLUSIONS: Our findings suggest that future interventions focused on improving inhibitory control in adults with OW/OB should target restructuring ST in addition to current efforts to increase MVPA.
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Cognição , Exercício Físico , Obesidade/psicologia , Sobrepeso/psicologia , Comportamento Sedentário , Adulto , Estudos Transversais , Eletroencefalografia , Potenciais Evocados , Feminino , Humanos , Illinois , Masculino , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
OBJECTIVE: To assess whether preadolescents' objectively measured moderate-to-vigorous physical activity (MVPA) is associated with cognitive control and academic achievement, independent of aerobic fitness. STUDY DESIGN: A sample of 74 children (Meanage = 8.64 years, SD = .58, 46% girls) were included in the analyses. Daily MVPA (min/d) was measured over 7 days using ActiGraph wGT3X+ accelerometer. Aerobic fitness was measured using a maximal graded exercise test and expressed as maximal oxygen uptake (mL*kg(-1)*min(-1)). Inhibitory control was measured with a modified Eriksen flanker task (reaction time and accuracy), and working memory with an Operation Span Task (accuracy scores). Academic achievement (in reading, mathematics, and spelling) was expressed as standardized scores on the Kaufman Test of Educational Achievement. The relationships were assessed using hierarchical regression models adjusting for aerobic fitness and other covariates. RESULTS: No significant associations were found between MVPA and inhibition, working memory, or academic achievement. Aerobic fitness was positively associated with inhibitory control (P = .02) and spelling (P = .04) but not with other cognitive or academic variables (all P > .05). CONCLUSIONS: Aerobic fitness, rather than daily MVPA, is positively associated with childhood ability to manage perceptual interference and spelling. Further research into the associations between objectively measured MVPA and cognitive and academic outcomes in children while controlling for important covariates is needed.
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Cognição , Escolaridade , Exercício Físico , Acelerometria/instrumentação , Criança , Teste de Esforço , Feminino , Humanos , Inteligência , Masculino , Memória de Curto Prazo , Consumo de Oxigênio , Aptidão Física , Tempo de ReaçãoRESUMO
The aim of this study was to assess the relations of daily moderate-to-vigorous physical activity (MVPA) to cognitive functions in 15-year-old adolescents from the Avon Longitudinal Study of Parents and Children while controlling for aerobic fitness. A sub-sample of 667 adolescents (M(age) = 15.4 ± 0.16 years; 55% females) who provided valid data on variables of interest, were used in the analyses. MVPA was objectively assessed using an Actigraph GT1M accelerometer and aerobic fitness was expressed as physical work capacity at the heart rate of 170 beats per minute from a cycle ergometer test. A computerized stop-signal task was used to measure mean reaction time (RT) and standard deviation of RT, as indicators of cognitive processing speed and variability during an attention and inhibitory control task. MVPA was not significantly related to cognitive processing speed or variability of cognitive performance in hierarchical linear regression models. In simple regression models, aerobic fitness was negatively related to mean RT on the simple go condition. Our results suggest that aerobic fitness, but not MVPA, was associated with cognitive processing speed under less cognitively demanding task conditions. The results thus indicate a potential global effect of aerobic fitness on cognitive functions in adolescents but this may differ depending on the specific task characteristics.
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Cognição/fisiologia , Exercício Físico/psicologia , Actigrafia , Adolescente , Feminino , Humanos , Estudos Longitudinais , Masculino , Testes Neuropsicológicos , Aptidão Física/psicologia , Tempo de Reação/fisiologiaRESUMO
BACKGROUND: Using a Biocultural Model of Maturity-Associated Variance in physical activity (PA) as a conceptual framework, the main and interactive effects of biological maturity status and perceived peer acceptance on PA and health-related quality of life (HRQoL) in adolescent girls were examined. METHODS: Three hundred forty-two female British students in years 7 to 9 (13.2±0.83 years) participated in the study. All participants completed the PA Questionnaire for Adolescents and KIDSCREEN-10, a measure of HRQoL. Self-reported perceptions of peer acceptance were measured by items from the National Longitudinal Study of Adolescent Health.Maturity status was estimated as the percentage of predicted adult (mature) height attained at the time of observation. RESULTS: Analysis of covariance suggested an influence of peer acceptance on maturity-associated differences in PA, but not on HRQoL. Girls early and "on time" in maturation with higher perceptions of peer acceptance reported greater involvement in PA than girls early and "on time" in maturation with lower perceptions of peer acceptance. A reverse association was observed for late-maturing girls. CONCLUSIONS: Peer acceptance is an important moderator of maturity-associated variation in PA.
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Desenvolvimento do Adolescente , Exercício Físico , Nível de Saúde , Distância Psicológica , Qualidade de Vida , Adolescente , Criança , Feminino , Humanos , Estudos Longitudinais , Atividade Motora , Grupo Associado , Autorrelato , Estudantes , Inquéritos e QuestionáriosRESUMO
The study examined resting state functional connectivity (rs-FC) associated with moderate-to-vigorous physical activity (MV-PA), sedentary time (ST), TV viewing, computer use, and their relationship to cognitive performance in older adults. We used pre-intervention data from 119 participants from the Fit & Active Seniors trial. Multivariate pattern analysis revealed two seeds associated with MV-PA: right superior frontal gyrus (SFG; spanning frontoparietal [FPN] and ventral attention networks [VAN]) and right precentral (PrG) and postcentral gyri (PoG) of the somatosensory network (SN). A positive correlation between the right SFG seed and a cluster spanning default mode (DMN), dorsal attention (DAN), FPN, and visual networks (VIS) was linked to higher fluid intelligence, as was FC between the right PrG/PoG seed and a cluster in VIS. No significant rs-FC patterns associated with ST, TV viewing, or computer use were found. Our findings suggest that greater functional integration within networks implementing top-down control and within those supporting visuospatial abilities, paired with segregation between networks critical and those not critical to top-down control, may help promote cognitive reserve in more physically active seniors.
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Conectoma , Humanos , Idoso , Individualidade , Córtex Pré-Frontal , Imageamento por Ressonância Magnética , Encéfalo/diagnóstico por imagemRESUMO
While the dopaminergic system is important for cognitive processes, it is also sensitive to the influence of physical activity (PA). We summarize current evidence on whether PA-related changes in the human dopaminergic system are associated with alterations in cognitive performance, discuss recent advances, and highlight challenges and opportunities for future research.
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Cognição , Dopamina , Exercício Físico , Humanos , Cognição/fisiologia , Exercício Físico/fisiologia , Dopamina/metabolismo , AnimaisRESUMO
Higher levels of physical activity are known to benefit aspects of brain health across the lifespan. However, the role of sedentary behavior (SB) is less well understood. In this review we summarize and discuss evidence on the role of SB on brain health (including cognitive performance, structural or functional brain measures, and dementia risk) for different age groups, critically compare assessment approaches to capture SB, and offer insights into emerging opportunities to assess SB via digital technologies. Across the lifespan, specific characteristics of SB (particularly whether they are cognitively active or cognitively passive) potentially act as moderators influencing the associations between SB and specific brain health outcomes. We outline challenges and opportunities for future research aiming to provide more robust empirical evidence on these observations.
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Longevidade , Comportamento Sedentário , Humanos , Exercício Físico , EncéfaloRESUMO
PURPOSE: We aimed to assess whether total daily physical activity (PA), PA intensities, sedentary time (ST), and prolonged ST are associated with differences in the gut microbiota composition or short-chain fatty acid (SCFA) profile of adults with overweight or obesity. METHODS: Cross-sectional associations between total daily PA (counts per minute), PA intensities (light and moderate-to-vigorous (MVPA)), ST, prolonged ST, and fecal microbiota composition were assessed in adults ( n = 124) between 25 and 45 yr of age with body mass index ≥25 kg·m -2 . Fecal microbiota composition was assessed with 16S rRNA gene sequencing. Daily PA and ST were measured with a hip-worn ActiGraph wGT3X-BT accelerometer. RESULTS: Daily PA volume and intensity were positively associated with relative abundance of Faecalibacterium ( P = 0.04) and negatively associated with the abundances of Alistipes , Parabacteroides , and Gemmiger ( P = 0.003-0.04) as well as the concentrations of acetate, butyrate, and total SCFA (all P = 0.04). Conversely, ST was negatively associated with abundance of Faecalibacterium but positively associated with the abundances of taxa, including Ruminococcaceae, Parabacteroides , Alistipes , and Gemmiger . Clustering of participants based on whether they met PA recommendations suggested that SCFA profiles differed between individuals who did and did not meet PA recommendations. K-means clustering based on percent of time spent in MVPA and ST also identified differences in fecal microbiota composition between cluster 1 (lower MVPA, higher ST) and cluster 2 (higher MVPA, lower ST), including a higher abundance of Alistipes in cluster 1. CONCLUSIONS: The current analysis suggests a beneficial association of daily PA on the fecal microbiota and a negative association of ST, particularly with respect to the associations of these variables with the genera Faecalibacterium , a butyrate-producing taxon.
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Microbioma Gastrointestinal , Sobrepeso , Humanos , Adulto , Estudos Transversais , RNA Ribossômico 16S , Exercício Físico , Obesidade , Ácidos Graxos Voláteis , Butiratos , AcelerometriaRESUMO
INTRODUCTION: Greater engagement in sedentary behaviours has been related to poorer cognitive functions in epidemiological research. However, the effects of reducing sedentary behaviour duration on cognitive function, brain function, and structure remain poorly understood. This systematic review aims to synthesise the evidence on the effects of reducing sedentary behaviour duration by increasing time spent in physical activity on cognitive function, brain structure and function in apparently healthy children, adolescents and adults. METHODS AND ANALYSIS: The protocol follows Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The literature search will be conducted (search dates: August-September 2022) across six databases: PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (via EBSCO Host), PsycINFO (via ProQuest), SPORTDiscus and Web of Science (Science and Social Science Citation Index). The inclusion criteria are as follows: randomised and non-randomised experimental studies as defined by the Cochrane Handbook, published in English, in peer-reviewed journals, and as theses or dissertations. References of included papers will be screened for additional studies. Acute and chronic interventions targeting children (≥ 4 years), adolescents, younger adults (≥ 18-40 years), middle-aged (40-64 years) and older adults (65+ years) will be eligible. Methodological quality will be assessed with the Effective Public Health Practice Project quality assessment tool for quantitative studies. Qualitative synthesis will be stratified by intervention type (acute vs chronic), intervention content (reducing sedentary time or interrupting prolonged sitting) and outcome (cognitive, brain structure and function). ETHICS AND DISSEMINATION: No primary data collection will be conducted as part of this systematic review. Study findings will be disseminated through peer-reviewed publications, conference presentations and social media. PROSPERO REGISTRATION NUMBER: CRD42020200998.
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Longevidade , Comportamento Sedentário , Adolescente , Criança , Humanos , Idoso , Pessoa de Meia-Idade , Exercício Físico , Cognição , Encéfalo , Revisões Sistemáticas como AssuntoRESUMO
Transient epileptic amnesia is a form of temporal lobe epilepsy in which sufferers often complain of irretrievable loss of remote memories. We used a broad range of memory tests to clarify the extent and nature of the remote memory deficits in patients with transient epileptic amnesia. Performance on standard tests of anterograde memory was normal. In contrast, there was a severe impairment of memory for autobiographical events extending across the entire lifespan, providing evidence for the occurrence of 'focal retrograde amnesia' in transient epileptic amnesia. There was a milder impairment of personal semantic memory, most pronounced for midlife years. There were limited deficits of public semantic memory for recent decades. These results may reflect subtle structural pathology in the medial temporal lobes or the effects of the propagation of epileptiform activity through the network of brain regions responsible for long-term memory, or a combination of these two mechanisms.
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Amnésia Retrógrada/etiologia , Amnésia Retrógrada/psicologia , Epilepsia do Lobo Temporal/psicologia , Memória , Idoso , Autobiografias como Assunto , Feminino , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Fatores de TempoRESUMO
Excessive sedentariness has been related to poorer cognitive control in adults. Sedentariness may compound obesity-related impairments in response inhibition, but its relationship to response inhibition remains poorly understood. This study investigated the relationship between accelerometer-measured sedentary time (ST, min/day), performance on the Oddball and NoGo tasks, N2 and P3-ERP indices of response inhibition and attentional control in 80 adults with overweight and obesity (55 females, Mage = 35.2 ± 5.8 years, BMI = 32.8 ± 5.3 kg/m2 ). ST was not related to performance on the Oddball task. However, more sedentary adults had larger P3b amplitude to targets. Higher ST was also related to increased attentional resource allocation during NoGo target and nontarget trials as indicated by higher P3b amplitudes across centroparietal sites (C1, Cz, C2, CP1, CPz, CP2; ps ≤ .03). ST was negatively indirectly related to target accuracy on NoGo trials through its association with faster response times to nontargets (95% percentile bootstrap CI for a standardized effect: -0.182, -0.014). ST was not related to N2 amplitude on either Oddball or NoGo target trials. Adjustment for moderate-to-vigorous physical activity (MVPA; all models), age (models with P3b NoGo target amplitude, N2 NoGo target amplitude and latency), and % fat mass (models with target NoGo accuracy and N2 NoGo target amplitude) did not modulate behavioral findings. MVPA did not significantly predict P3b amplitude. Our results suggest suboptimal response inhibition due to trading accuracy for speed and despite the upregulation of attentional resources among more sedentary adults with overweight and obesity.
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Atenção/fisiologia , Disfunção Cognitiva/fisiopatologia , Potenciais Evocados/fisiologia , Função Executiva/fisiologia , Inibição Psicológica , Sobrepeso/fisiopatologia , Desempenho Psicomotor/fisiologia , Comportamento Sedentário , Acelerometria , Adulto , Disfunção Cognitiva/etiologia , Eletroencefalografia , Potenciais Evocados P300/fisiologia , Feminino , Humanos , Masculino , Obesidade/complicações , Obesidade/fisiopatologia , Sobrepeso/complicaçõesRESUMO
Sedentary behavior increases the risk for multiple chronic diseases, early mortality, and accelerated cognitive decline in older adults. Interventions to reduce sedentary behavior among older adults are needed to improve health outcomes and reduce the burden on healthcare systems. We designed a randomized controlled trial that uses a self-affirmation manipulation and gain-framed health messaging to effectively reduce sedentary behavior in older adults. This message-based intervention lasts 6 weeks, recruiting 80 healthy but sedentary older adults from the community, between the ages of 60 and 95 years. Participants are randomly assigned to one of two groups: 1) an intervention group, which receives self-affirmation followed by gain-framed health messages daily or 2) a control group, which receives daily loss-framed health messages only. Objective physical activity engagement is measured by accelerometers. Accelerometers are deployed a week before, during, and the last week of intervention to examine potential changes in sedentary time and physical activity engagement. Participants undertake structural and functional (resting and task-based) MRI scans, neuropsychological tests, computerized behavioral measures, and neurobehavioral inventories at baseline and after the intervention. A 3-month follow-up assesses the long-term maintenance of any engendered behaviors from the intervention period. This study will assess the effectiveness of a novel behavioral intervention at reducing sedentarism in older adults and examine the neurobehavioral mechanisms underlying any such changes.
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Exercício Físico , Comportamento Sedentário , Idoso , Idoso de 80 Anos ou mais , Terapia Comportamental , Humanos , Pessoa de Meia-Idade , Projetos PilotoRESUMO
Individual differences in brain network modularity at baseline can predict improvements in cognitive performance after cognitive and physical interventions. This study is the first to explore whether brain network modularity predicts changes in cortical brain structure in 8- to 9-year-old children involved in an after-school physical activity intervention (N = 62), relative to children randomized to a wait-list control group (N = 53). For children involved in the physical activity intervention, brain network modularity at baseline predicted greater decreases in cortical thickness in the anterior frontal cortex and parahippocampus. Further, for children involved in the physical activity intervention, greater decrease in cortical thickness was associated with improvements in cognitive efficiency. The relationships among baseline modularity, changes in cortical thickness, and changes in cognitive performance were not present in the wait-list control group. Our exploratory study has promising implications for the understanding of brain network modularity as a biomarker of intervention-related improvements with physical activity.
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Córtex Cerebral/anatomia & histologia , Córtex Cerebral/fisiologia , Desenvolvimento Infantil/fisiologia , Terapia por Exercício , Exercício Físico/fisiologia , Rede Nervosa/anatomia & histologia , Rede Nervosa/fisiologia , Córtex Cerebral/diagnóstico por imagem , Criança , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Rede Nervosa/diagnóstico por imagemRESUMO
How daily physical activity and sedentary time relate to human judgement and functional connectivity (FC) patterns that support them remains underexplored. We investigated the relationships between accelerometer-measured moderate-to-vigorous physical activity (MVPA) and sedentary time to decision-making competence (DMC) in young adults using a comprehensive Adult-Decision Making Competence battery. We applied graph theory measures of global and local efficiency to test the mediating effects of FC in cognitively salient brain networks (fronto-parietal; dorsal attention, DAN; ventral attention; and default mode), assessed from the resting-state fMRI. Sedentary time was related to lower susceptibility to a framing bias. However, once global and local efficiency of the DAN were considered we observed (1) higher susceptibility to framing with more sedentary time, mediated through lower local and global efficiency in the DAN, and (2) lower susceptibility to framing with more sedentary time. MVPA was not related to DMC or graph theory measures. These results suggest that remaining sedentary may reduce neurofunctional readiness for top-down control and decrease engagement of deliberate thought, required to ignore irrelevant aspects of a problem. The positive effect suggests that the relationship between sedentary time and DMC may be moderated by unmeasured factors such as the type of sedentary behavior.
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Atenção/fisiologia , Tomada de Decisões/fisiologia , Exercício Físico/fisiologia , Rede Nervosa/fisiologia , Vias Neurais/fisiologia , Comportamento Sedentário , Adolescente , Adulto , Algoritmos , Encéfalo/fisiologia , Mapeamento Encefálico/métodos , Humanos , Imageamento por Ressonância Magnética/métodos , Modelos Neurológicos , Adulto JovemRESUMO
BACKGROUND: Structured vigorous physical activity (VPA) can improve cognitive control in children, but studies relating daily physical activity (PA) to cognitive control have yielded conflicting findings. While objectively measured daily PA summarizes all occurrences of PA within a registered period, a minimum duration of continuous PA is required for registration of a PA bout. Because brief bouts of high-intensity PA can account for a large proportion of children's daily activity-related energy expenditure, this study assessed whether daily and bouted VPA were selectively related to cognitive control in preadolescents relative to other PA intensities. METHODS: A total of 75 children between the ages of 8 and 10 years (49% girls) wore an ActiGraph wGT3X+ on the hip for 7 days. The acceleration signal from the vertical axis was summarized over 1 s, 5 s, and 15 s epochs. Daily and bouted moderate PA, moderate-to-vigorous PA, and VPA were measured. PA bouts were expressed as the frequency and time spent in 2 different continuous PA bouts, one lasting ≥10 s and the other lasting ≥30 s at a given intensity. Inhibitory control was assessed using behavioral responses to a modified flanker task (mean reaction time (RTmean) and accuracy). Attentional resource allocation and cognitive processing speed were measured using the amplitude and latency of the P3 component of event-related brain potentials, respectively. Associations between PA, behavioral indices of inhibitory control, P3 amplitude, and latency were assessed using hierarchical regression models. RESULTS: Daily VPA was not related to RTmean or accuracy on either congruent or incongruent trials. In contrast, more time spent in VPA bouts lasting ≥30 s predicted shorter P3 latency across epochs and flanker congruencies (all ß ≤ -0.24, all p ≤ 0.04). The associations between shorter P3 latency and the time spent in moderate-to-vigorous PA bouts lasting ≥30 s were less consistent and largely limited to congruent trials (congruent: ß (-0.31, -0.34)). No significant associations were observed upon correction for false discovery rate. CONCLUSION: The pattern of uncorrected associations aligns with the dose-response literature and suggests that brief VPA bouts may yield the greatest benefits to cognitive processing speed in preadolescents. Future studies using measures of brain structure and function are needed to understand the mechanisms linking bouted VPA to neurocognitive function during childhood.
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[This corrects the article DOI: 10.1371/journal.pone.0192533.].
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OBJECTIVE: To describe and explain stroke survivors and informal caregivers' experiences of primary care and community healthcare services. To offer potential solutions for how negative experiences could be addressed by healthcare services. DESIGN: Systematic review and meta-ethnography. DATA SOURCES: Medline, CINAHL, Embase and PsycINFO databases (literature searched until May 2015, published studies ranged from 1996 to 2015). ELIGIBILITY CRITERIA: Primary qualitative studies focused on adult community-dwelling stroke survivors' and/or informal caregivers' experiences of primary care and/or community healthcare services. DATA SYNTHESIS: A set of common second order constructs (original authors' interpretations of participants' experiences) were identified across the studies and used to develop a novel integrative account of the data (third order constructs). Study quality was assessed using the Critical Appraisal Skills Programme checklist. Relevance was assessed using Dixon-Woods' criteria. RESULTS: 51 studies (including 168 stroke survivors and 328 caregivers) were synthesised. We developed three inter-dependent third order constructs: (1) marginalisation of stroke survivors and caregivers by healthcare services, (2) passivity versus proactivity in the relationship between health services and the patient/caregiver dyad, and (3) fluidity of stroke related needs for both patient and caregiver. Issues of continuity of care, limitations in access to services and inadequate information provision drove perceptions of marginalisation and passivity of services for both patients and caregivers. Fluidity was apparent through changing information needs and psychological adaptation to living with long-term consequences of stroke. LIMITATIONS: Potential limitations of qualitative research such as limited generalisability and inability to provide firm answers are offset by the consistency of the findings across a range of countries and healthcare systems. CONCLUSIONS: Stroke survivors and caregivers feel abandoned because they have become marginalised by services and they do not have the knowledge or skills to re-engage. This can be addressed by: (1) increasing stroke specific health literacy by targeted and timely information provision, and (2) improving continuity of care between specialist and generalist services. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO 2015:CRD42015026602.
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Atitude , Cuidadores/psicologia , Serviços de Saúde Comunitária , Atenção Primária à Saúde , Acidente Vascular Cerebral/enfermagem , Acidente Vascular Cerebral/psicologia , Sobreviventes , Antropologia Cultural , HumanosRESUMO
INTRODUCTION: Interventions delivered by primary and/or community care have the potential to reach the majority of stroke survivors and carers and offer ongoing support. However, an integrative account emerging from the reviews of interventions addressing specific long-term outcomes after stroke is lacking. The aims of the proposed scoping review are to provide an overview of: (1) primary care and community healthcare interventions by generalist healthcare professionals to stroke survivors and/or their informal carers to address long-term outcomes after stroke, (2) the scope and characteristics of interventions which were successful in addressing long-term outcomes, and (3) developments in current clinical practice. METHODS AND ANALYSIS: Studies that focused on adult community dwelling stroke survivors and informal carers were included. Academic electronic databases will be searched to identify reviews of randomised controlled trials (RCTs) and controlled trials, trials from the past 5â years; reviews of observational studies. Practice exemplars from grey literature will be identified through advanced Google search. Reports, guidelines and other documents of major health organisations, clinical professional bodies, and stroke charities in the UK and internationally will be included. Two reviewers will independently screen titles, abstracts and full texts for inclusion of published literature. One reviewer will screen search results from the grey literature and identify relevant documents for inclusion. Data synthesis will include analysis of the number, type of studies, year and country of publication, a summary of intervention components/service or practice, outcomes addressed, main results (an indicator of effectiveness) and a description of included interventions. ETHICS AND DISSEMINATION: The review will help identify components of care and care pathways for primary care services for stroke. By comparing the results with stroke survivors' and carers' needs identified in the literature, the review will highlight potential gaps in research and practice relevant to long-term care after stroke.
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Serviços de Saúde Comunitária , Atenção à Saúde , Atenção Primária à Saúde , Acidente Vascular Cerebral/terapia , Cuidadores , Humanos , Assistência de Longa Duração , Sobreviventes , Reino UnidoRESUMO
The aim of this investigation was to examine the influence of pediatric sport-related concussion on brain and cognitive function. To do so, we used a between-participants design, measures of executive control, and event-related potentials (ERPs). The findings demonstrate that children with a history of concussion exhibit behavioral deficits in attention, working memory and impulse control, as well as neuroelectric alterations in ERP indices of visual attention (N1), conflict resolution (N2) and attentional resource allocation (P3). Furthermore, the age at injury related to the magnitude of several concussion-related deficits. Accordingly, a single sports-related concussive incident during childhood (m=2.1years prior to testing) may lead to subtle, yet pervasive alterations in the behavioral and neural indices of attention and executive control, and age at injury may moderate injury outcomes.