kin 1070 Flashcards

Question

Research and Applications of Modeling in Rehab Psychology

Answer 1

Settings Modeling Interventions Outcomes

Answer 2

Performance - adherence, outcome, errors, form Cognitive and Affective Psychological Responses - anxiety, self-efficacy, mood, RPE

Answer 3

Mastery vs Coping Models Imagery vs Modeling as a Vicarious Experience Self-Modeling

Answer 4

Demonstrate errorless perfromance Verbalize Confidence Demonstrate positive attitude Verbalize low task difficulty

Answer 5

Display decreasing distress as they struggle with difficulties or threats Demonstate strategies for dealing with different situations voice progressively self-efficacious beliefs Approach or achieve mastery

Answer 6

The exposure to postoperative sensations and events through a coping model better prepares the observer by providing accurate information on which cognitive appraisal of the situation can be made

Answer 7

Powerful instructional tool for the acquisition of motor skills, psychological responses, and behavior change in physical activity contexts Modeling combined with instruction in coping strategies is highly effective in producing positive outcomes for adults undergoing surgery or invasive medical procedures

Answer 8

An area that has received limited attention in the realm of injury rehabilitation is modeling

Answer 9

Examined the role of coping models compared to no models on psychological factors and functional outcomes following a rehabilitation program for ACL among ten female basketball players. Players were assigned to watch a coping model video of peers participating in rehabilitation from ACL surger. The coping model video showed female athletes similar in age, basketball position, and type of injury progressing through the rehabilitation process to full recovery.

Answer 10

At 3 weeks post-srugery athletes who watched the modelling video had greater self-efficacy than the control gorup At 2 months post surgery the intervention group had higher perceived athletic competence

Answer 11

Flint study had a modest sample size and hence was underpowered. Modeling intervention was introduced postoperatively and did not provide an indication of its benefit preoperatively.

Answer 12

To extend the work of Flint (1991) by investigating the effectiveness of a coping model intervention to improve psychological processes and fucntional outcomes pre- and post- ACLR

Answer 13

Population suitable for continued research, because ACL disruption is one of the more common sport-related injury and is associated with an extensive period of rehabilitation (6-9 months) Opportunity to augment traditional programmes

Answer 14

Athletes who received the coping modeling video intervention would report lower preoperative anxiety and perceptions of pain and would report reater elf-efficacy for rehabilitation compared to the non-intervention group Participants in the intervention group would show greater improvements in functional milestones (ex. range of motion, and crutch use) than those in the non-intervention group.

Answer 15

72 partcipants scheduled for ACLR recruited 30 intervention, 28 control 15-53 years of age 68% were male

Answer 16

Perceptions of expected pain - baseline, pre operative Perceptions of actual pain - baseline, predischarge and 2 weeks Anxiety- participants rated levels of state anxiety, baseline, pre-operatively and pre-discharge Self-efficacy- Partcipants rated their confidence to perform specific tasks over increasing duration and frequency Walk with crutches (post-op) Walk without crutches (post-op, 2 weeks) Perform rehabilitation exercises (post-op, 2 and 6 weeks)

Answer 17

International Knee Documentation Committee Form (IKDC) Objective component (surgeon)- knee laxity, swelling ROM Subjective component (patient)- symptoms, difficulty performing tasks) Basline and 6-weeks Range of Motion - baseline, 2 and 6 weeks using a goniometer, time walking without crutches (in days)

Answer 18

A DVD was developed Presented interviews of individuals who had undergone ACL repair Demonstrated and verbalised increasing confidence in dealing with the operation and rehabilitation programme Detailed various stages of the post-operative rehabilitation process It was expected that watching the video would permit individuals to pick up relevent cues and information particular to their own stage of progression (pre-op/post op) This information would be processed, retained, and result in decreased anxiety, perceptions of pain and increased confidence to perform rehabilitation.

Answer 19

Intervention group - better walking self efficacy pre discharge, confidence in exercise pre discharge, expected pain lowered, crutch efficacy higher, less days walking with a crutch Objective: IKDC score was a closer to 0 (better function) Subjective: IKDC score was higher

Answer 20

Preoperative anxiety, no effect Perceptions of expected pain, positive effect Perceptions of actual pain, no effect Self-efficacy measures, early effect

Answer 21

Crutch walking, positive effect IKDC, positive effect ROM, no effect

Answer 22

The use of interactive modeling techniques in specific rehabilitation exercsies. Non-pharmacological pain-management techniques used during pain focusing (association and disassociation) and pain reduction (relaxation training, meditation) might be presented using a modeling format Use of modelling techniques could be employed to alter psychological variables previously shown to affect adherence behavior (ex. motivation, intention and perceived behavioral control)

Answer 23

The measurable, observable, or felt improvment in health not attributable to treatment Psychological theory- belief in the treatment or a subjective feeling of improvement

Answer 24

Placebos caue the release endogenous opiods, or endorphins, that reduce pain showing attention, care, affection etc. to the pateint/subject triggers phsyical rreactions in the boyd which reduce stresss and promote healing

Answer 25

The placebo effect has been measure in thousands of medical experiment and many doctors regulary prescribe placebos, drug companeis must show that their new drug work better than a placebo before the drugs are approved Placebos have been shown to affect a range of health conditions The color and of a talbet can alter the strength of its placebo affect

Answer 26

Compared rehab outcomes from real surgery vs. sham surgery. No difference between knee surgery and sham surgery, no notable difference in regards to the ability to walk

Answer 27

Breakdown of cartilage in joints and arthroscopic surgery damaged cartilage is scraped or flushed out

Answer 28

What are the true effects of a placebo after sugery ( internal validity was measure qualitatively by curcial appraisal) Risk assumed omplicationw ere not lower in placebo than the intervention group No complications following sham sugery compared to actual surgery

Answer 29

Followed PRISMA Statement guidelines PRISM- document that structures and guidees how people report these kind of systematic review with meta analsysi component

Answer 30

Placebo can be feasible and is valid methodological instrument for evaluation of the fficiency of surgical inerventions Risk with placebo which should only be used if there is a necssity Placebos are proven beneifical and very powerful

Answer 31

Affects about 121 million people 13% of Americans experience major depression over the course of their lifetime Approximately 7% suffer a major depressive disorder in any given year Fewere than 25% of those affected have access to effective treatment Women experience depression more than men Leading cause of disability as measured by eyars living with disability (YLD) and the fourth leading contributor to the global burden of disease

Answer 32

Specific short term feeling states or emotional tones which can be either postiive or negative

Answer 33

Unpleasant feeling state and physiological reaction that occurs when fear is provoked Affective, physiological, cognitive, behavioural aspects, AROUSAL is key trait vs state.

Answer 34

State that eventuates from a perception of an important loss or the threat of such a loss Affective, phsyiological, cognitive, behavioural aspects, characterised by avoidance, withdrawal, diminished activity

Answer 35

No biological test currently available Established 2 core and 9 other symptoms for depression (4 psychological and 5 physical) A person must have at least 1 core symptom and 5 or more of the other symptoms present in the same two week period within the last month

Answer 36

Depressed mood most of the day, nearly every day Markedly diminished interested in pelasure in all, or almost all, activities most of the day, nearly every day

Answer 37

Feeling guilty, hopeless, and worthless Recurring suicidal thoughts Having trouble sleeping, either too much or too little Experiencing appetite/weight changes Trouble concentrating Feeling little energy or unexplained tiredness Agitation or slowing down of body movement

Answer 38

Bipolar disorder-alternating episodes of emotional highs (mania) and lows (depression) Dysthmia - mild depression symptoms that last two years or longer Postpartum depression - a type of depression that occurs in the mother after her baby is born Season affective disorder (SAD) - amajor depression that occurs during season with low sunlight

Answer 39

Anxiety disorders Alcohol and/or substance abuse Heart disease Stroke Cancer HIV/AIDS Diabetes Parkinson's disease

Answer 40

Used to asses presence and intensity of depressive symptoms in psychiatric populations Self report 21 items Symtpoms & attitudes common to depression Scored 0-3 for intensity Summed to give total score <10 none/minimal depression 10-18 mild/moderate depression 19-29 moderate/severe depression 30-63 severe depression

Answer 41

Used to asess presnece and intesity of depressive symtpoms in the general population Self report 20 items 6 domains of symptoms Scored 0-3 Summed to give total socre >= 16 =depression

Answer 42

Self Report 21 items Scored 0-4 Depressed mood, feelings of guilt, suicide, insomnia, work and activites, psychomotor retardation, agitation, anxiety, libido, hypochrondiasis, loss of weight, insight, diurnal, paranoid, obsessional and compulsive symptoms

Answer 43

not fully known combination of genetics, biolgoic, and environmental, and personal factors at work

Answer 44

In some people who are severely depressed, receptors may be insensitive to seroonin, causing their response to its release to be inadequate. Message mgiht be weakend if the originating cell pumps out too little of the serotonin neurotransmitter or if an overly efficient reuptake mops up too much before the molecules have the chance to bind to the receptors on other neuros Any of these system faults could signifcantly affect mood

Answer 45

Keeping serotonin at levels that allow communication between nerve cells strengthen circuits to the brain which regulate mood

Answer 46

Inflmmation is the body's immune response to infection and trauma One theory is that depressed patients may have been exposed to an infection or trauma, and their brain has yet to cool off from the experience

Answer 47

Depression can be associated with the loss of volumen in parts of the brain, namely the hippocampus, which belongs to the limbic system, and is important in the consolidation of information from short-term memory to long-term memory. The most severe the depression, the greater the loss of brain volume

Answer 48

Using MRI, reaeraches presented 16 formerly depressed patinets with sad movie clips while taking pictures of their brain activity. Over the next year and 9 of the 16 patients relapsed into depression. The researchers compared the brain activity of relapsing patients against those who remained healthy and against another gorup of people who had never been depressed. Relapsing patients showed more activity in a rontal region of the brain known as the medial prefrontal gyrus. Responses in this front region were also linked to higher rumination scores, and the tendency to think obsessively about negative events

Answer 49

For a person with ahistory of epression, using the frontal brain's ability to analyze and interpret sadness may actually be an unhealthy reaction that can perpetuate the chronic cycle of depression

Answer 50

PET scans use a radiopharmaceutical that binds (high or mixed affinity binding) to the translocator protein (TSPO) in microglia cells. Level of protein is increased in activated microglia cells = elevated translocator protein density

Answer 51

Type of glial cell that are the residnet macrophages of the brain and spinal cord, and thus act as the first and main form of active immune defense in the central nervous system (CNS)

Answer 52

Type of white blood cell that engulfs and digests cellular debris, foreign substances, microbes

Answer 53

Design: case-control Participants: 20 patients with a major depressive episode (MDE) secondary to major depressive disorder and 20 healthy controls

Answer 54

Brain inflmmation, and more specifically microglia activation is implication in major depressive episode Unable to determine whether the neuroinflammation occurs before depression or because of it Suggests that treatments should be designed to reduce microglia activation in depressive patients

Answer 55

The CNS has two kinds of tissue: grey matter and white matter, grey matter, which has a pinkish-grey color in the living brain, contains the cell bodies, dendrites and axon terminals of neurons, so it is where all synapses are. White matter is made of axons connecting different parts of grey matter to each other Depression has been shown to alter the strucutre of the brain's white matter, and underpins brain function

Answer 56

Depression tends to run in families, so researches believe that certain genes may be associated with developing it If someone has a parent or sibling with major depression, that person probably has a 2 or 3 times greater risk o developing depression compared with the average persion

Answer 57

Researchers at Wisconsin and Otago anayzed the type of 5-HTT gene carried by 847 adults (5-HTT gene helps regulat serotonin) 2 forms of the 5-HTT gene, the long and the short. An individual can inherit two copies of the long form, two fo the short, or one of each Short version of 5-HTT is not as effective in controlling the serotonin flow as the long version Researchers focused on subjects who had traumatic life events over a 5 year period Patients with at least one copy of the short form of 5-HTT were moer at risk of depression

Answer 58

Psychological consequences of treatment (exercsie) Using treatment (exercise) to change other health behaviours

Answer 59

Relates to the frequency and patterns of disease occurrence in a population

Answer 60

How often the disease occurs

Answer 61

Rate of new disease or health events

Answer 62

Observational not experimental

Answer 63

Virtually the only way in which a quantitative understanding of the exposure-disease relationship can be obtained

Answer 64

Analytical, case control, cohort

Answer 65

Designed to test specific hypotheses regarding casual links between various exposures and mortality and incidence outcomes using purely observational methods

Answer 66

Whatever the topic, a group of individuals is identified and watched to see what events befall them

Answer 67

Disease rates in cohort studies are often expressed relative to "person years" of follow up Person year represents 1 year of observation for one person during the follow up period

Answer 68

At follow-up assessment 6-10 years later, it was determined that 572 men had experienced their first heart attack Rates of fatal, non fatal, and all first heart attack were compared in each of the baseline physical activity exposure categories.

Answer 69

Often the gorup of individuals will have some disease, in which case the question will be directed at the causes of their diease. Select a set of patients with a defining characteristic: a diagnosed disease Characteristics of theses are compared with a control group similar in age, sex and background who do not have the disease Sometimes called a retrospective study These types of studies typically look for treatments which reduce event rates

Answer 70

metabolic equivalent, a unit used to estimate the metabolic cost of physical activity. The value of 1 MET is approxiamtely equal to a person's resting energy ependiture

Answer 71

Investigated effect of physical activity exposure from adolescence through adulthood on the risk of breast cancer Compared women with breast cancer to those without Looked physical activity exposure retrospectively Looked for treatment that reduced event rates Women who exercise more than 3.8 hours a week were 58% reduced risk to breast cancer

Answer 72

Meta analysis and review on dosage associations between physical activity and chronic diseases However, they mainly focused on leisure time physical activity Total physical activity and chronic diseases relation was not well characterized

Answer 73

no matter what diseases all lines are quite different with how physical activity affects diseases Each one of these diseases has its own unique and distinct pattern Only similarity is that for ischaemic heart diseases and diabetes, the protective benefit seem to dissipate at 4000 MET mins per week Most to Least Profound Benefits: 1.Ischaemic stroke and ischaemic heart disease (3000-2. 4000 MET mins a week) 3. Diabetes (4000 MET mins a week) 4. Colon cancer (3000 MET mins per week) 5.Breast cancer (some benefit throughout MET min per week the risk benefits are much greater for the others then breast cancers)

Answer 74

Risks of these disease decrease with increasing level of total activity Most health gains occur at relatviely lower levels of activity Dose response focused on total physical activity

Answer 75

Injury-relevant processing - information about pain, extent of injury, how it happened, negative consequences Emotional upheaval & reactive behaviour - agitation, emotional depletion, isolation, shock, disbelief, denial, self-pity Positive outlook & coping - acceptance, coping efforts, optimism, relief with progress Identity Loss Fear & anxiety Lack of Confidence Performance decrements

Answer 76

Substantial imbalance between demand and response capability Under conditions where failure to meet demand has important consequences Injry is a stressor Rehab can be a stressor as well

Answer 77

Most salient when recover < expectations Period immediately post-injury characterized by greatest negative emotion High stress may = poor adjustment

Answer 78

Training/treatment in preparation for an anticipated stressor CAn be physical, psychological, or both

Answer 79

Prehab patients have a boost before surgery Boost is beneficial because they will be a drop post of minimum level of functional ability surgery but it won't be as dramatic with prehab Spend less time postoperative below minimum level of function

Answer 80

Train specific systems that will be affected by the stressor build up a functional reserve to compensate for depletion by the stressor

Answer 81

Elective surgery or longer wait times for necessary surgery = larger prehab window

Answer 82

Condition continues to get worse Patients become more sedentary Treatment options have been exhausted

Answer 83

Get mobile ASAP Wound closure, prevent infection Strength, independence, range of motion

Answer 84

Acute Injury Shorter surgical wait time Performance goals Return to play timeline

Answer 85

Gradual onset Longer wait time Daily living/health goals No defined recovery timeline

Answer 86

Does prehab for patients undergoing joint replacement surgery improve outcomes Joint replacement surgery is one of the most successful medical interventions Significant pain relief and improvement Recovery is difficult and prolonged

Answer 87

Randomized control trials Prehab vs Non-Prehab before surgery Prehab --- Physio supervised exercise Non-Prehab --- Normal Care

Answer 88

Function scores Pain Quality of life Cost Length of hospital stay

Answer 89

Strength - Converted outcomes into standardized measurement of WOMAC Limitation - Compliance wasn't reported and no physical measure of function

Answer 90

Prehab slightly improve post-operative pain and function Effects are too small andshort term to be clinically reliable Did not influence outcomes of interest

Answer 91

A refusal to maintain body weight at or above a minimally normal weight for age and height Intense fear of gaining weight or becoming fat, even though underweight. distrubance in thew ay in which one's body weight or shape is expereinced undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.

Answer 92

severe weight loss insomnia dehydration constipation weakness and fatigue dizziness and fainting thinning and breaking hair bluish tinge to the fingers dry, yellowish skin inability to tolerate cold absense of menstruation downy hair on the boyd, arms and face arrhythmia

Answer 93

skipping melas lying about how much food they've eaten eating only low calorie foods talking badly about their body trying to hide their body with baggy clothes avoiding situation that can involve eating in front of other people extreme exercising

Answer 94

Two different types of bulimia. The attempts to purge are used to differentiate them. The new edition of DSM-5 now refers to attempts to purge as "inappropriate compensatory behaviors" Purging bullmia: vomitting after binge eating Non-purging bulimia: fast or engage in extreeme exercise to prevent weight gain after a binge

Answer 95

Weight that increases and decrease in signficant amounts between 5-20 pounds in a week chapped or cracked lips bloodshot eyes callouses, sores, or scares on the knuckles mouth sensitivity swollen lymph nodes

Answer 96

constantly worrying about weight or appearance eating to the point of discomfort going to the bathroom immediately after eating exercising too much, especially after they've eaten a lot restricitng calories or avoiding certain foods not wanting to eat in front of others

Answer 97

Poor self esteem and body image irritability agitation, or other mod changes social isolation depression anxiety

Answer 98

Psychotherapy Family approaches Nutritional management Medication

Answer 99

Eating Disorder patients have abnormally high levels of serotonin Controllling food intake lowers serotonin levels to make patients feel better

Answer 100

High levels of competitevenss, high emphasis on control, and perfectionist tendencies. Athletes may also represent a high-risk population for eating disroders becaue it is assumed they are exposed to body shape and weight pressures unique to sport.

Answer 101

A 2 step study including self-reported questionnaire and clinical interview

Answer 102

The entire population of Norwegian male and female elite athletes was evaluated

Answer 103

Followed DSM criteria for eating disorders

Answer 104

More athletes had subclinical or clinical EDs. Females competing in aesthetic sports were at high risk. Males in antigrativation sports were a more risk

Answer 105

Prevalence of ED is higher in athletes than the controls, higher in females than males More common in lean-dependant and weight-dependant sports

Answer 106

496 New Zealand and Australian national rowers

Answer 107

Positive and Negative Perfectionism Scale Eating Attitudes Test BMI

Answer 108

As perfectionism socres go up so do eating attitude scores Rowers who have a lower GMI ahve a lower strength of that relationship

Answer 109

Negative Perfectionism is positviely related to EDs Positive Perfectionism is unrelate to EDs Body mass, weight classification and gender moderate relations between negative perfectionism and disturbed eating attitudes Negative Perfectionsim- ED's are maximised for lightweight female rowers with greater body mass

Answer 110

Underlying mechanism for ocnjunctive moderator effect- need for control Lack of relations between Positive Perfectionism and ED Translation into psychopathology

Answer 111

As a person begins to fall asleep, his/her heart rate, respiration rate and body temperature decrease and alpha waves ( 8-13 cps) appear on an electreoncephalography EEG profile

Answer 112

Semi conscious state characterised by further reduction in HR, irregularity in respiration, and muscle relaxation tha my atrigger involuntary twitching

Answer 113

As body temperature continues to decrease the person enters stage 2 where EEG profile exhibits short bursts of rhytmical activity in the 13-16 cps range known as sleep spindles. Theses spindles mark the boundary between perceptions of semi-consciousness and sleep, because most people awaked after the appearance of spinkldes report that they have been asleep

Answer 114

with further loss of consciousness and the intial appearance of very slow brain waves (5-3 cps). No cosscious awarenss. slow wave sleep

Answer 115

Low voltage, mixed fequency EEG in conjunction with episodic REMs and low amplitude electromyography (EMG) The most memorable and vivid dreams occur during REM sleep REM sleep occurs in cycles of about 90-120 minutes through the night, and it accounts for up to 20-25% of total sleep time

Answer 116

How much benefit does exercise have on sleep patterns vs no exercise Strength association with IV and DV How much total variability of the grouping or factor variable --- how much exercise affects sleep variable

Answer 117

Effect size were small 0.2 to moderate 0.5 favouring exercise Observed effect size may be somewhat conservative since exercise/sleep studies generally examine individuals without sleep difficulty Exercise has the biggest impact on sleep when exercise has a longer duration and is completed earlier in the day

Answer 118

Dynamic/Aerobic exercise increase time to fall asleep and may result in less SWS if undertaken late in the day Static exercise performed close to bedtime appears to decrease sleep latency and may increase SWS Exercise may increase SWS only for already trailed (fit) individuals Evidence that the time of day and the type of exercise are important moderators of the relationship between exercise and sleep patterns

Answer 119

Sleep disorders are on eof the most common difficulties facing older people Conceptualized as a geritatric syndrome and include insomnai and other conditions Common symptoms: difficulty falling asleep, noncturnal awakenings, etc. Higher prevalence of sleep disorders,with rates of 25%-60% in elderly people, than in the general adult population Sleep disorders can have a significant negative impact on mental and physical health

Answer 120

As people age, sleep wake circadian rhythm and hormone secretions become less robust Decreased health status Psychiatric illness Cognitive diorder status Medication side effects Psychological factors

Answer 121

Involve pharmacologic and psychological interventions Pharmacological agents Cognitive behavior therapy

Answer 122

Evidenced based complementary and alternative mediceine (CAM) approaches are of interest and increasing popularity MMIs: combine meditative focuse with movement Defined as some form of movement or body positioning as well as focus on breathing with a cleared or calm state of mind Ex. yoga, tai chi

Answer 123

14 studies examined Types of MMIs varied Duration ranged form 12-24 weeks Most studies included interventions lasting 60 minutes/session Performed 3x a week

Answer 124

MMIs can be beneficial for sleep quality in elderly people with sleep complaints Effects were clinically relevant Similar effects as seen with conventional interventions Effectiveness is influenced by frequency

Answer 125

Obstructive sleep apnea (OSA) is commonly characterized by recurring upper airway obstruction during sleep Common predisposing factors: gender (male), craniofacial anomalies and obesity Treatment options: continuous positive airway pressure (CPAP)

Answer 126

Number of events per hour of sleep as measure of severity of OSA

Answer 127

To study the use of exercise as a management treatment for OSA in adults

Answer 128

8 studies included Supervised exercise programs were used in the majority of studies 2-6 monhs with a frequency of 2-7 days/week Exercise was associated with a reduciton in API after treatment

Answer 129

Exercise has an effect on reducing AHI and the underlying causes of OSA in patients with OSA Consistent findings independent of different types, durations, and frequency of exercise ssions; CPAP usage; supervised vs. unsupervised

Answer 130

Sleep distrubance is quite frequent in the general population 40-55% of middle aged womenmay show some degree of sleep disturbance Insomnia is under recognized and undertreated Exercise has been proposed as a non-pharmacological alternative

Answer 131

To assess the effets of short term programmed exercsie on sleep quality and insomnia in middle-aged women

Answer 132

5 publications reported data from four RCTs on PE effects during 12-16 weeks on sleep quality and/or insomnia Moderate PE = positive effect on sleep quality as compared to controls Low levels of PE = no significant improvement on sleep quality Low-moderate PE = no significant reduction in severity of insomnia

Answer 133

Porgrammed exercise improved sleep quality but had no signifcant effect on the severity of insomnia current evidence should be interpreted with caution due to small # of studies

Answer 134

Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obsturctive pulmonary disease (COPD), which includes emphysema and chronic bronchitis Smoking is directly related for approximatey 90% of lung deaths and approximately 80-90% of COPD (emphysema and bronchitis) deaths

Answer 135

Smoking damages your lungs' natural cleaning and repair system and traps cancer-causing chemicals in your lungs Smoking chemicals mix together to form a sticky tar that lines the inside of your lungs If the cilia are covered in tar, they can't do their job properly, and germs, chemicals and dirt can stay in your lungs and cause disease-cancer.

Answer 136

Smoking permanently damages the alveoli in the lungs making it harder to breathe Smoking damages the structure of the alveoli by making it less stretchy harder for lungs to take in oxygen and get rid of carbon dioxide Leads to shortness of breath and feeling tired Heart has to work harder to give your body the oxygen it needs Over time this damage leades to COPD

Answer 137

It is recognized in all Canadian health strategy documents that stopping smoking at any age is associate with clear health beneftis

Answer 138

Failure rates amongst self-quitters have consistently been shown to be as high as 95-98% Relapse after quitting is fast and common Up to 70% of current smokers wish to quit or have made at least 1 quit attempt

Answer 139

Within several seconds, about 1/4 of the nicotine has gone through the bloodstream straight to the brain causes a rise in heart rate and in the rate of breathing Nicotine stimulates nicotine acetylcholine receptors located in the ventral tegmental area Leads to the release of dopamine in the nucleus accumbens, plays an important role

Answer 140

Weight management, nicotine regulates metabolism Psychological- helps control mood and stress Habit and sensory - risky situations that trigger the urge to smoke Risk factors - depression, history of alcohol or drug abuse, low SES, co morbidity

Answer 141

NIcotine is metabolized to cotinine and cotinine is metabolized to 3-hydroxycotine by the lizer enzyme cyctochrome P450 2AG. The rate of nictoine metabolism has been found to predict smoking behavior.

Answer 142

Exercise has positive effects on mood Exercise increase self-efficacy/coping Exercise may be a competitive behavior o smoking and hence incompatible Promotes healthy weight and may reduced post cessation weight concerns Favorable effect on CVD risk profile

Answer 143

Only one piece of exercise equipment, heart rate monitor, carbon monoxide monitor Data in a missivle control is consisten for a treatment phase Those in exercise condition show a drop in desire to smoke during exercise rises a bit after but remains lower than the control Can help women with acute craving

Answer 144

A more realistic situation for a smoker attempting to quit: stressors are presented concurrently 1. temporary abstinence 2. demanding cognitive tasks and/r cue-elicited smoking stimuli Unknown how exercise will affect cravings and time to first cigarette in this situation

Answer 145

Collected data and asked participants to retain from smoking Follow up- stress them again with a cognitive task Gave money and would lose money every time they lit a cigarette

Answer 146

First study to examine the effects of acute exercise following concurrent stressors Reflects a more ecologically valid scenario when a smoker is attempting to quit Exercise significantly decreased cravings following concurrent stressors Exercise had no effect on ad lib smoking

Answer 147

Included temporarily abstinent smokers rather than quitters Severity of desire sy potoms may not correspond entirely with those felt when an individual is fully invested in a quit attempt The effect of acute exercise on cravings and withdrawal during a pharacological based products is unknown

Answer 148

Exercise seems to work Different from a fact acting losing or spray Comibing the two could be worth while

Answer 149

Nicotine Replacement Therapy: All of the NRT products rely on systemic venous absorption and therefore do not achieve the rapid systemic arterial delivery as cigarettes

Answer 150

Cigarette Cravings: 7 poin tlikert scale Withdrawal Symptoms: 5 single items that are believed to be part of the nictone withdrawel syndrome, including depressed mood, irritability, restlessness, and poor concentration 5 point scale

Answer 151

Engaging in an acute bout of moderate intensity exercise while consuming a nicotine lozenge yields additive cigarette craving relief for recently quit smokers When feasible one should use both treatments

Answer 152

Exercise serves as a distraction, idea that if a smoker redirects thier attention toward something else, the urge will pass, possible that it may play a small role early on in the exercise bout, but it sunlikely to have any effecs once the exercise stops Alleviates affect/mood/feeling disturbances Some evidence that exercise can reduce negative affect and enhance positive mood which in turn can reduce cravings

Answer 153

Physiological explanations Exercise mimics the effects of nicotine Cortisol regulation

Answer 154

Shown to drop during the first 2 weeks of abstinence, and low cortisol on the first day of abstinence has been associated with increased tobacco cravings and withdrawel symptoms Acute exercise has been show to elevate corisol levels

Answer 155

Acute exercise produces craving reduction in temporary abstinent smokers

Answer 156

Half the group attended a cessation program combined with a three times a week wellness program, and the other half attended a cessation program with supervised vigorous exercise three times a week Asked to stop smoking at the end of week 4 Abstinence from smoking was bsed on self report which was verified by saliva cotinie and CO cut off points Abstinence was measure 1 week after quit day (week 5), end of treatment (week 12), and 3 and 12 months later

Answer 157

People in exercise had a higher continuous abstinence Exerecise gained significantly less weight than control subjects among quitters Quitters gained more weight than non quitters

Answer 158

adding exercise to a CBT cessation program has value Marginal benefits of adding pharmacological agents, such as nicotine replacement therapy, deserves exploration

Answer 159

Female smokers, one year exercise + nicoerm quit smoking program to prevent smoking relapse and to maintain exercise

Answer 160

Cigarette Consumption Smoking topography- a thorough representation of the physical characterisitics of smoking behaviour

Answer 161

Smoking sensation Smoking satisfaction psychological reward Enjoyment of respiratory tract sensation Craving reduction Smoking Reduction

Answer 162

Hardly any reductions in topography Psychological - satisfaction of cigarettes that are being smoked are gradually declining

Answer 163

Female smokers who exercise prior to quit attempt are favourable to achieve cessation People are putting themselves int he right place to do the right thing behaviourally and psychologically to properly quit

Answer 164

Stem from how they affect certain brain circuits and the chemicals that pass along signals from one nerve cell to another in the brain

Answer 165

Serotonin Dopamine Norephinephrine

Answer 166

Process in which neurotransmitters are naturally absorbed back into the nerve cells in the brain Reuptake inhibitors prevents this from happening- neurotransmitter tays at least temporarily in the gap between nerves (synapse)

Answer 167

Prozac Zoloft Celexa Lexapro

Answer 168

Meta-analyses of antidepressant medications have reported only modest benefits over placebo treatment, and when unpublished trial data are included, the benefit falls below accpted criteria for clinical significance The efficacy of the antidepressants may also be depend on the severity of initial depression

Answer 169

Psychological theory - belief in the treatment or to a subjective feeling of improvement The critical factor "is our beliefs about what's going to happen to us"

Answer 170

To establish the relationof baseline severity and antidepressant efficacy using a relevant dataset of published and unpublished clinical trials

Answer 171

Obtained data on all clinical trials submitted to the FDA for the licensing of the four new generation antidepressants for which full datasets were available Meta analytic techniques to assess linear and quadratic effects of initial severity on improvement socres for drug and placebo groups and on drug-placebo difference scores.

Answer 172

Hamilton Rating Scale 9.6 Improvement in receiving the drug 7.8 Improvement in receiving the drug Difference of 1.8 favouring drug over placebo National institute for health and clinical excellence criteria of clinically relevant/significant a point difference should be ----- At least a 3 point difference 1.8 Falls below the 3 point criteria that signifies there is a clinical significance Standardized mean difference (0.5 to meet statistical significance) --- Difference between drug and placebo is 0.32 (1.24 for drug & 0.92 for placebo) Mean difference/Standardized difference ---- How far ahead the treatment group is over the placebo

Answer 173

Drug placebo differences increased as a function of initial severity, rising from virtually no difference at moderate levels of initial depression to a relatively small difference for patients with very severe depression, reaching conventional criteria for clinical significance only for patients at the upper end of the very seerely depression category. The relationship between initial severity and antidepressant efficacy is attributable to decreased responsiveness to placebo among very severely depressed patients, rather than to increased responsiveness to medication

Answer 174

All antidepressants were more efficacious than placebo in adults with MDD Lingering questions: is it because of the active ingredient in the drug or that the placebo stops working as effectively? All-cause attrition is only a crude proxy for tolerability can not determine the benefits and harms, especially harms that matter most to patiens

Answer 175

The role of psychotherapy in treating clinical depression is to help the person develop good coping strategies for dealing with everyday stressors. In addition, it can encourange you to use your medications properly

Answer 176

Depression occurs within an interpersonal context and affects relationships and the roles of people within those relationships. by addressing interpersonal issues, interpersonal therapy for depression puts emphasis on the way symptoms are related to a person's relationships, including family and peers

Answer 177

Designed to help patients explore the full range of their emotions, including feelings they may not be aware of. By making the unconscious elements of their life a part of their present experience, psychodynamic therapy helps people understand how their behavior and mood are affected by unresolved issues and unconscious feelings

Answer 178

At the heart of CBT is an assumption that a person's mood is directly related to his or her patterns of htought. Negative, dysfunctional thinking affects a person's mood, sense of self, behavior, and even physical state. The goal of cognitive behavioral therapy is to help a person learn to recognize negatie patterns of thought, evaluate their validity, and replace them with healthier ways of thinking

Answer 179

Brain stimulation techniques such as electroconvulsive therapy (ECT), for example, can be used to treat major depression that hasn't responded to standard treatments

Answer 180

CAMH-Toronto Ketamien is a fact acting anesthetic and pain killer Has antidepressant properties

Answer 181

different from other types of medications because theses types of treatments only last when the drugs in the system Ketamine causes reaction in the cortex of the brain and enables brain connects to regrow Gives patients the opportunity to create more positive thoughts and behaviour

Answer 182

showed that daily step count and daily duration of moderate intensity PA were signifcantly and inversely correlated with depression

Answer 183

People with the highest energy profile were 28% less likely to develop depression

Answer 184

The extent to which exercise training may reduce depressive symptoms in older patients with MDD has not been systematically evaluated

Answer 185

To assess the effectiveness of an aerobic exercise program compared to standard medication

Answer 186

156 men and women with MDD randonmly assigned to : exercise, antidepressant medication Treatment period: 16 weeks Primary outcome: HAM-D and BDI

Answer 187

Intervention group with exercise reduced CSD post inervention scores from baseline those in ctonrol also reduced CES-D scores but not as much

Answer 188

an exercise training program may be considered an alternative to antidepressants for treatment of depression in older persons. After 16 weeks of treatment exercise was equally effective in reducing dperession among patients with MDD

Answer 189

Affects up to 20% of all pregnancies 19% will continue to have depressive symptoms postpartum Can negatively impact growing fetus: preterm birth, intrauterine growth restriction, early cessation of breastfeeding

Answer 190

Pharmacological treatment options are often avoided Most women go untreated Recent literature has shown that exercise may prevent prenatal depression

Answer 191

focus on statistical significance to discuss effectiveness of an intervntion This means the change we are seeing is likely not due to chance Not necessarily mean that it is clinically important

Answer 192

To determine if prenatal exercise during pregnancy can treat depression among women who enter pregnancy at risk for dperession To determine if exercise can have a clinically reliable change on depression risk during pregnancy

Answer 193

Randomized Controlled Trial: Exercise Group and Standard Care Control Group Group fitness class 3 times a week Aerobic training and resistance exerecises Baseline 9-12 weeks Completion 36-38 weeks At baseline and at the ened, completed the CES-D

Answer 194

The original study includes all CES-D scores For the current study, only women with baseline CES-D scores >= 16 were included Compared baseline and post-intervention CES-D scores

Answer 195

Population and tool specific Equation accounts for the internal consistency and standard deviation for the current population Standard error of difference = 3.6 Therefore the clinically reliable change criteria was 7.09

Answer 196

Prenantal exercise is both a statistical and clinically reliable treatment effect on depression risk Prenatal exercise may be prescribed to treat women who enter pregnancy with depression risk Exercise can increase the likelihood of achieving the clinically reliable threshold

Answer 197

first study to calculate and apply clinically reliable change criteria for this population; calculation can be used for other outcomes Included women with a CES-D score >= 16

Answer 198

Convenience sample used Group dynamis not assessed

Answer 199

Participants who satisfied all criteria were randomized into a 12 week aerobic exercise or stretching intervention Attended session 3x per week for 30-40 minutes Exercise group = moderate-intensity aerobic exercise at 40-70% of Heart Rate Reserve Stretching group= mild-intensity stretching

Answer 200

Depression Coping efficacy Episodic memory Cortisol Cardiovascular fitness Flexibility

Answer 201

BDII --- Decrease in depression in both groups, more pronounced in aerobic group (Exercise) MADRAS --- Decreased depression in both, more in the aerobic group (exercise) Coping efficacy --- Increased in both groups, coping efficacy is more in the stretching group Un-cued recall (Memory retrieval) --- Both groups improving but more in the aerobic (Exercise) Cortisol --- Decreasing in both groups at week 6, but stretching increases at week 12

Answer 202

Participants in the aerobic exercise group showed significant reductions in depression and significant improvements in coping efficacy and episodic memory However, these benefits also occurred, albeit to a lesser extent in the stretching gorup

Answer 203

Both aerobic exercise and stretching seem to be good reatments for depression with associated positive changes to coping efficacy, episodic emmory. Stress was only positively influenced by aerobic exercise