Associations between patients' risk attitude and their adherence to statin treatment - a population based questionnaire and register study

Background: Poor adherence to medical treatment may have considerable consequences for the patients’ health and for healthcare costs to society. The need to understand the determinants for poor adherence has motivated several studies on socio-demographics and comorbidity. Few studies focus on the association between risk attitude and adherence. The aim of the present study was to estimate associations between patients’ adherence to statin treatment and different dimensions of risk attitude, and to identify subgroups of patients with poor adherence. Methods: Population-based questionnaire and register-based study on a sample of 6393 persons of the general. Danish population aged 20–79. Data on risk attitude were based on 4 items uncovering health-related as well as financial dimensions of risk attitude. They were collected through a web-based questionnaire and combined with register data on redeemed statin prescriptions, sociodemographics and comorbidity. Adherence was estimated by proportion of days covered using a cut-off point at 80 %. Results: For the dimension of health-related risk attitude, “Preference for GP visit when having symptoms”, riskneutral and risk-seeking patients had poorer adherence than the risk-averse patients, OR 0.80 (95 %-CI 0.68–0.95)and OR 0.83 (95 %-CI 0.71–0.98), respectively. No significant association was found between adherence and financial risk attitude. Further, patients in the youngest age group and patients with no CVD were less adherent to statin treatment. Conclusion: We find some indication that risk attitude is associated with adherence to statin treatment, and that risk-neutral and risk-seeking patients may have poorer adherence than risk-averse patients. This is important for clinicians to consider when discussing optimal treatment decisions with their patients. The identified subgroups with the poorest adherence may deserve special attention from their GP regarding statin treatment

Motor-enriched learning activities can improve mathematical performance in preadolescent children

Objective: An emerging field of research indicates that physical activity can benefit cognitive functions and academic achievements in children. However, less is known about how academic achievements can benefit from specific types of motor activities (e.g., fine and gross) integrated into learning activities. Thus, the aim of this study was to investigate whether fine or gross motor activity integrated into math lessons (i.e., motor-enrichment) could improve children's mathematical performance. Methods: A 6-week within school cluster-randomized intervention study investigated the effects of motor-enriched mathematical teaching in Danish preadolescent children (n = 165, age = 7.5 ± 0.02 years). Three groups were included: a control group (CON), which received non-motor enriched conventional mathematical teaching, a fine motor math group (FMM) and a gross motor math group (GMM), which received mathematical teaching enriched with fine and gross motor activity, respectively. The children were tested before (T0), immediately after (T1) and 8 weeks after the intervention (T2). A standardized mathematical test (50 tasks) was used to evaluate mathematical performance. Furthermore, it was investigated whether motor-enriched math was accompanied by different effects in low and normal math performers. Additionally, the study investigated the potential contribution of cognitive functions and motor skills on mathematical performance. Results: All groups improved their mathematical performance from T0 to T1. However, from T0 to T1, the improvement was significantly greater in GMM compared to FMM (1.87 ± 0.71 correct answers) (p = 0.02). At T2 no significant differences in mathematical performance were observed. A subgroup analysis revealed that normal math-performers benefitted from GMM compared to both CON 1.78 ± 0.73 correct answers (p = 0.04) and FMM 2.14 ± 0.72 correct answers (p = 0.008). These effects were not observed in low math-performers. The effects were partly accounted for by visuo-spatial short-term memory and gross motor skills. Conclusion: The study demonstrates that motor enriched learning activities can improve mathematical performance. In normal math performers GMM led to larger improvements than FMM and CON. This was not the case for the low math performers. Future studies should further elucidate the neurophysiological mechanisms underlying the observed behavioral effects

Influence of Second-Generation Oral Contraceptives on Muscle Recovery after Repeated Resistance Exercise in Trained Females

Purpose: Oral contraceptives (OCs) are commonly used by female athletes, but their effects on skeletal muscle are still poorly understood. We investigated if physically trained females using second-generation OCs differed from nonusers of OCs in the recovery of muscle function and muscle damage markers after repeated resistance exercise sessions. Methods: We recruited 20 trained second-generation OC users and 20 trained nonusers to perform three strenuous resistance exercise sessions. Before, and 3, 24, and 48 h after exercise, blood samples were collected, and participants were evaluated for muscle soreness, maximal isometric and isokinetic muscle strength, vertical jump height, Wingate power performance, leg press strength, and intermittent recovery capacity (yo-yo test). All participants were provided with an energy-macronutrient–balanced diet during the experimental period. Results: After resistance exercise, maximal isometric and isokinetic muscle strength, rate of force development, vertical jump height, and Wingate peak and average power were reduced, whereas markers of muscle damage were increased in both groups ( P &lt; 0.05). OC users experienced a greater reduction in isokinetic strength 3, 24, and 48 h after exercise compared with nonusers of OCs (interaction: P &lt; 0.05). No other interactions were observed. Conclusions: We demonstrate that measures of muscle strength recovery after three strenuous resistance exercise sessions are comparable between trained females using second-generation OCs and nonusers of OCs. However, group differences were observed for isolated dynamic (isokinetic) muscle strength, suggesting a marginal benefit of not using OCs when accelerated recovery is needed.<br/

Whole grain-rich diet reduces body weight and systemic low-grade inflammation without inducing major changes of the gut microbiome: a randomised cross-over trial

Objective To investigate whether a whole grain diet alters the gut microbiome and insulin sensitivity, as well as biomarkers of metabolic health and gut functionality. Design 60 Danish adults at risk of developing metabolic syndrome were included in a randomised cross-over trial with two 8-week dietary intervention periods comprising whole grain diet and refined grain diet, separated by a washout period of ≥6 weeks. The response to the interventions on the gut microbiome composition and insulin sensitivity as well on measures of glucose and lipid metabolism, gut functionality, inflammatory markers, anthropometry and urine metabolomics were assessed. Results 50 participants completed both periods with a whole grain intake of 179±50 g/day and 13±10 g/day in the whole grain and refined grain period, respectively. Compliance was confirmed by a difference in plasma alkylresorcinols (p&lt;0.0001). Compared with refined grain, whole grain did not significantly alter glucose homeostasis and did not induce major changes in the faecal microbiome. Also, breath hydrogen levels, plasma short-chain fatty acids, intestinal integrity and intestinal transit time were not affected. The whole grain diet did, however, compared with the refined grain diet, decrease body weight (p&lt;0.0001), serum inflammatory markers, interleukin (IL)-6 (p=0.009) and C-reactive protein (p=0.003). The reduction in body weight was consistent with a reduction in energy intake, and IL-6 reduction was associated with the amount of whole grain consumed, in particular with intake of rye. Conclusion Compared with refined grain diet, whole grain diet did not alter insulin sensitivity and gut microbiome but reduced body weight and systemic low-grade inflammation

Acute high-intensity football games can improve children's inhibitory control and neurophysiological measures of attention

Recent studies suggest that a single bout of exercise can lead to transient performance improvements in specific cognitive domains in children. However, more knowledge is needed to determine the key exercise characteristics for obtaining these effects and how they translate into real-world settings. In the present study, we investigate how small-sided football games of either high-or moderate-intensity affect measures of inhibitory control in a school setting. Eighty-one children (mean age 11.8, 48 boys) were randomly allocated to three groups performing 20-minute of high-intensity small-sided real football games (SRF), moderate-intensity small-sided walking football games (SWF) or resting (RF). Behavioral measures of inhibitory control and neurophysiological measures of attention (P300 latency and amplitude) were obtained during a flanker task performed at baseline and 20 minutes following the intervention. Retention of declarative memory was assessed in a visual memory task 7 days after the intervention. Measures of inhibitory control improved more in children performing SRF compared to SWF 19 ms, 95% CI [7, 31 ms] (P = 0.041). This was paralleled by larger increases in P300 amplitudes at Fz in children performing SRF compared both to RF in congruent (3.54 mu V, 95% CI [0.85, 6.23 mu V], P = 0.039) and incongruent trials (5.56 mu V, 95% CI [2.87, 8.25 mu V], P &lt; 0.001) and compared to SWF in incongruent trials (4.10 mu V, 95% CI [1.41, 6.68 mu V], P = 0.010). No effects were found in measures of declarative memory. Together this indicates that acute high-intensity small-sided football games can transiently improve measures of inhibitory control and neurophysiological correlates of attention. Intense small-sided football games are easily implementable and can be employed by practitioners, for example, during breaks throughout the school day. © 2019 The Authors. Scandinavian Journal of Medicine &amp; Science In Sports Published by John Wiley &amp; Sons Ltd.</p

Acute exercise and motor memory consolidation:The role of exercise timing

High intensity aerobic exercise amplifies offline gains in procedural memory acquired during motor practice. This effect seems to be evident when exercise is placed immediately after acquisition, during the first stages of memory consolidation, but the importance of temporal proximity of the exercise bout used to stimulate improvements in procedural memory is unknown. The effects of three different temporal placements of high intensity exercise were investigated following visuomotor skill acquisition on the retention of motor memory in 48 young (24.0 ± 2.5 yrs), healthy male subjects randomly assigned to one of four groups either performing a high intensity (90% Maximal Power Output) exercise bout at 20 min (EX90), 1 h (EX90+1), 2 h (EX90+2) after acquisition or rested (CON). Retention tests were performed at 1 d (R1) and 7 d (R7). At R1 changes in performance scores after acquisition were greater for EX90 than CON (p<0.001) and EX90+2 (p=0.001). At R7 changes in performance scores for EX90, EX90+1, and EX90+2 were higher than CON (p<0.001, p=0.008, and p=0.008, resp.). Changes for EX90 at R7 were greater than EX90+2 (p=0.049). Exercise-induced improvements in procedural memory diminish as the temporal proximity of exercise from acquisition is increased. Timing of exercise following motor practice is important for motor memory consolidation

The influence of physical, psychological and sociocultural factors on cognitive performance:A nationwide cross-sectional analysis in 10–12-year-old Danish children

Objective: To assess the associations between exercise capacity, body composition, demographic characteristics, well-being dimensions, and leisure-time sports background with cognitive performance in children aged 10–12 years. Methods: A cross-sectional study was conducted with 2470 Danish schoolchildren aged 10–12. Cognitive performance was assessed using the Cogstate Brief Battery, measuring psychomotor function, attention, working memory, and visual learning. Exercise capacity was evaluated using the Yo-Yo Intermittent Recovery Level 1 Children's Test (YYIR1C). Body composition, including BMI, fat percentage, and muscle mass percentage, was assessed with bioelectrical impedance analysis. Well-being was measured using a modified KIDSCREEN-27 questionnaire, and demographic characteristics and leisure-time sports background data were collected via self-reports. Linear mixed regression models were applied, adjusting for school-class as a random effect. Results: Higher exercise capacity was significantly associated with better cognitive performance across all domains (p &lt; 0.05). Boys exhibited faster reaction times in psychomotor function, attention, and working memory tasks (p &lt; 0.001), while no sex differences were observed in visual learning (p = 0.684). School well-being positively correlated with attention and working memory performance, but no associations were found with other well-being dimensions. Body composition (BMI, fat percentage, muscle mass) and leisure-time sports background were not associated with cognitive performance. Conclusions: Exercise capacity, but not body composition or sports participation, emerged as a key predictor of cognitive performance. These findings suggest that cardiorespiratory fitness, rather than body composition or sports background, is a general predictor of cognitive performance in children. School well-being and sex also influenced cognitive test performance, highlighting the importance of considering both physical and psychological factors.</p