RESUMEN
A large portion of the U.S. population desires to lose weight, but only a small portion maintains a desirable body weight. We examined weight loss success and the psychological benefits of exercise among men and women who were obese and initially sedentary (N = 33). These participants completed anthropometric assessments and psychological inventories before and after graded exercise tests (GXTs) at the beginning and end of their enrollment in a 6-month behavioral weight loss program (BWLP). Participants significantly decreased their body weight, body mass index (BMI), and % body fat; they also increased their aerobic capacity and exercise time. They reported long-term increases in their stage of change, self-efficacy, exercise enjoyment and processes of change. They also reported immediate changes toward more positive affect, as measured with pre-to post-GXTs on both the Profile of Mood States (POMS) and State Anxiety Subscale (A-State) at the beginning and again at end of the BWLP. Mood benefits were reported on the POMS subscales of Tension, Depression, Anger, Vigor, and Confusion. At the end of the BWLP, Fatigue and Confusion continued to improve after a 20-min post-GXT recovery period. Finally, reductions in Depression and Fatigue after the first GXT were correlated with program success, as indicated by decreases in BMI, percent body fat, and body weight. Initial scores on trait enjoyment were associated with decreased BMI and body weight. Psychological benefits of exercise may help individuals who are obese and sedentary change their behavior and exercise perceptions from something they "should do" to something they "want to do." Feeling good during weight loss efforts is an important pathway to change and should be an explicit component goal of BWLPs.
Asunto(s)
Emociones , Ejercicio Físico , Masculino , Humanos , Femenino , Afecto , Obesidad/terapia , Obesidad/psicología , Fatiga , Pérdida de PesoRESUMEN
BACKGROUND: Chronic pain and mood disorders share common neuroanatomical substrates involving disruption of the reward system. Although increase in negative affect (NA) and decrease in positive affect (PA) are well-known factors complicating the clinical presentation of chronic pain patients, our understanding of the mechanisms underlying the interaction between pain and PA/NA remains limited. Here, we used a validated task probing behavioral and neural responses to monetary rewards and losses in conjunction with functional magnetic resonance imaging (fMRI) to test the hypothesis that dysfunction of the striatum, a key mesolimbic structure involved in the encoding of motivational salience, relates to mood alterations comorbid with chronic pain. METHODS: Twenty-eight chronic musculoskeletal pain patients (chronic low back pain, n=15; fibromyalgia, n=13) and 18 healthy controls underwent fMRI while performing the Monetary Incentive Delay (MID) task. Behavioral and neural responses were compared across groups and correlated against measures of depression (Beck Depression Inventory) and hedonic capacity (Snaith-Hamilton Pleasure Scale). RESULTS: Compared to controls, patients demonstrated higher anhedonia and depression scores, and a dampening of striatal activation and incentive-related behavioral facilitation (reduction in reaction times) during reward and loss trials of the MID task (ps â< â0.05). In all participants, lower activation of the right striatum during reward trials was correlated with lower incentive-related behavioral facilitation and higher anhedonia scores (ps â< â0.05). Finally, among patients, lower bilateral striatal activation during loss trials was correlated with higher depression scores (ps â< â0.05). CONCLUSIONS: In chronic pain, PA reduction and NA increase are accompanied by striatal hypofunction as measured by the MID task.
Asunto(s)
Anhedonia/fisiología , Mapeo Encefálico , Dolor Crónico/fisiopatología , Cuerpo Estriado/fisiología , Descuento por Demora/fisiología , Depresión/fisiopatología , Fibromialgia/fisiopatología , Dolor de la Región Lumbar/fisiopatología , Adulto , Dolor Crónico/diagnóstico por imagen , Cuerpo Estriado/diagnóstico por imagen , Depresión/diagnóstico por imagen , Femenino , Fibromialgia/diagnóstico por imagen , Humanos , Dolor de la Región Lumbar/diagnóstico por imagen , Imagen por Resonancia Magnética , Masculino , Castigo , RecompensaRESUMEN
OBJECTIVES: To provide an overview of the symptoms commonly experienced by patients with malignant glioma, and discuss the pathophysiology and interventions associated with those. DATA SOURCES: A review of published scientific literature and clinical literature, and online information from National Comprehensive Cancer Network, Oncology Nursing Society, Epilepsy Foundation of America, and the American Brain Tumor Association. CONCLUSION: The unique symptom burden associated with a malignant glioma diagnosis often disrupts the lives of patients and their caregivers. Clinical support and interventions addressing malignant glioma-related focal deficits, seizures, headaches, venous thromboembolism, mood disturbances, fatigue, and sleep-wake disturbance can positively impact patient and caregiver experiences while living with malignant glioma. IMPLICATIONS FOR NURSING PRACTICE: Understanding the pathophysiology of these symptoms and reviewing nursing-led and supported interventions will empower the nurse in providing comprehensive care to patients with malignant glioma and their caregivers.
Asunto(s)
Epilepsia/enfermería , Fatiga/enfermería , Glioma/enfermería , Glioma/fisiopatología , Enfermería Oncológica/normas , Guías de Práctica Clínica como Asunto , Trastornos del Sueño-Vigilia/enfermería , Tromboembolia/enfermería , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Social isolation stress and its effect on mood have been well reported, but the effect of monotony (a state of repetition of events for a considerable period of time without variation) on mood and hippocampal synaptic plasticity needs to be addressed. Present study was conducted on male Sprague-Dawley rats. Singly housed (SH) rats were subjected to monotony stress by physical, visual and pheromonal separation in specially designed animal segregation chamber. Fluoxetine (a selective serotonin reuptake inhibitor) was administered orally. Behavioral assessment showed anxiety and depression like traits in SH group. Monotony stress exposure to SH group resulted in increased pyknosis, decreased apical dendritic arborization and increased asymmetric (excitatory) synapses with the corresponding decrease in the symmetric (inhibitory) synapses in the hippocampal CA3 region. Monotonous environment during isolation stress also decreased the serotonin level and reduced the expression of synaptophysin and pCREB in the hippocampus. Fluoxetine administration to singly housed rats resulted in amelioration of altered mood along with improvement in serotonin and decrease in excitatory synaptic density but no change in altered inhibitory synaptic density in the hippocampus. These findings suggest that monotony during isolation contributes to early impairment in mood state by altering hippocampal synaptic density and neuronal morphology.