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A modern assessment of Freud's conceptualization of the creative process focusing on drives, ego psychology, and object relation theory is presented. 40 artists and musicians were interviewed employing 13 open-ended questions to provoke responses historically associated with the theoretical conceptualizations of Freud and post-Freudian theory related to the creative process. Creative process was defined as internal object relations that motivate the external connection between artist and the creative work. Measured responses concerning purpose and understanding; motivation before, during, and after performance; obstacles in performance; and needs through the creative process were assessed. Cluster analysis segregated the participants into high, medium, and low agreement groups based on similarity of responses. A multivariate stepwise regression revealed four questions (enlightenment, drives, obstacles, and ought self discrepancies) accounted for 83.9% of the variance. A post hoc discriminant function analysis identified 82.5% of the population to their correct groups. The findings support Spitz's (2005) suggestion that we regard “drives, ego psychology, and object relation theory not as separate approaches but as parts of a whole with varying stresses or accents” (p. 503).

The Lifestyle Interventions and Independence for Elders (LIFE) Study is a Phase III randomized controlled clinical trial (Clinicaltrials.gov identifier: NCT01072500) that will provide definitive evidence regarding the effect of physical activity (PA) on major mobility disability in older adults (70-89 years old) who have compromised physical function. This paper describes the methods employed in the delivery of the LIFE Study PA intervention, providing insight into how we promoted adherence and monitored the fidelity of treatment. Data are presented on participants' motives and self-perceptions at the onset of the trial along with accelerometry data on patterns of PA during exercise training. Prior to the onset of training, 31.4% of participants noted slight conflict with being able to meet the demands of the program and 6.4% indicated that the degree of conflict would be moderate. Accelerometry data collected during PA training revealed that the average intensity - 1,555 counts/minute for men and 1,237 counts/minute for women - was well below the cutoff point used to classify exercise as being of moderate intensity or higher for adults. Also, a sizable subgroup required one or more rest stops. These data illustrate that it is not feasible to have a single exercise prescription for older adults with compromised function. Moreover, the concept of what constitutes “moderate” exercise or an appropriate volume of work is dictated by the physical capacities of each individual and the level of comfort/stability in actually executing a specific prescription.

A methodological discrepancy exists in the hydration assessment literature regarding the establishment of euhydration, as some investigations utilize a prehydration technique, while others do not (overnight fluid/food fast). However, the degree that plasma osmolality (Posm) dilutes when using the pre-hydration method and how body mass/composition might influence the results is not known. Thirty subjects (22 M, 8 F; 20 ± 2 years (mean ± SD); 1.8 ± 0.1 m; 75.8 ± 13.5 kg) had P osm measured after an 8-h food and fluid fast (overnight fast) and 90 min after a 500-mL (4-9 mL/kg) water bolus (prehydration). From pre- to post-bolus, participants' P osm declined from 297 ± 3.5 to 295 ± 3.8 mmol/kg (p<0.05; Δ -1.7 ± 3.5 mmol/kg). One-third of the sample diluted to more than -3 mmol/kg. The effect of body mass on P osm dilution was investigated by comparing dilution in the ten lightest (62.8 ± 3.4 kg) and heaviest (92.0 ± 9.8 kg) participants; however, the change between the light (Δ -1.9 ± 3.8 mmol/kg) versus heavy groups (Δ -1.1 ± 3.0 mmol/kg) was not different (p>0.05). The correlation between body mass or total body water and change in P osm was weak (p>0.05), as was the correlation between relative fluid intake based on mass and change in P osm (p>0.05). The two methodologies appear to produce similar P osm values when measured in most individuals. However, the potential for significant dilution (>3 mmol/kg) should be considered when choosing the pre-hydration methodology. © Springer-Verlag (outside the USA) 2011.

Purpose To evaluate baroreflex sensitivity and autonomic control in a cohort of normotensive obese (OB) children. Method A cross-sectional investigation, in which, baroreflex sensitivity and autonomic control were evaluated using transfer function and power spectral density analysis (PSDA) of the electrocardiogram and beat-to-beat blood pressures in normotensive OB children and normal weight normotensive controls. All methods used were noninvasive and data were captured while seated and at rest. Results The OB and control subjects non-obese (NO) were of similar age (OB 9.1 ± 1.9 years vs.NO9.2 ± 1.4 years). The OB group was classified as having a BMI greater than the 95th percentile adjusted for age and gender, and a NO group with a BMI at or less than the 95th percentile (BMI percentile OB. 97.5 ± 1.3 vs. NO 58.5 ± 24.1). Both groups had similar normotensive blood pressures. T tests revealed that baroreflex sensitivity and HFRR were significantly reduced in the OB 9.2 ± 2.7 vs. 15.2 ± 4.7 (ms/mmHg) and 6.7 ± 1.1 vs. 8.2 ± 1.1 ms 2, respectively, while LF SBP and LF/HF ratio were significantly increased in the OB 11.9 ± 5.6 vs. 8.2 ± 4.7 mmHg 2 and 1.2 ± 0.7 vs. 0.54 ± 0.3, respectively. Conclusions Normotensive OB children exhibited significantly reduced baroreflex sensitivity, parasympathetic control as well as increased sympathetic control when compared with healthy, NO controls. Findings in this investigation raise the awareness that autonomic dysfunction is present in young OB normotensive children. © Springer-Verlag 2011.

Using eye-tracking methodology, gaze to a speaking face was compared in a group of children with autism spectrum disorders (ASD) and a group with typical development (TD). Patterns of gaze were observed under three conditions: audiovisual (AV) speech in auditory noise, visual only speech and an AV non-face, non-speech control. Children with ASD looked less to the face of the speaker and fixated less on the speakers' mouth than TD controls. No differences in gaze were reported for the non-face, non-speech control task. Since the mouth holds much of the articulatory information available on the face, these findings suggest that children with ASD may have reduced access to critical linguistic information. This reduced access to visible articulatory information could be a contributor to the communication and language problems exhibited by children with ASD.

Purpose: High central blood pressure is more predictive of cardiovascular disease (CVD) versus high peripheral blood pressure. Measures of central pressures (CPs) include, central systolic blood pressure (CSBP) and central diastolic blood pressure. Measures of central pressures augmentation (CPsA) include augmentation pressure (AP) and the augmentation index @ 75 beats$min-1 (AIx@75). Increased sympathetic tone (ST) is also associated with CVD. The low to high frequency ratio (LF/HF) is often used to determine sympatho-vagal balance. Given the association between ST, CPs, CPsA and CVD there is a need to understand the association between these predictors of CVD. The aims of this study were to examine the association between the LF/HF ratio, CPs, and CPsA in men and women collectively and based on gender. Methods: We measured the LF/HF ratio, CSBP, AP, and AIx@75 in 102 participants (41F/61M). The LF/ HF ratio was determined via power spectral density analysis. CSBP, AP, and AIx@75 were determined via applanation tonometry. Results: The LF/HF ratio was inversely associated with AP (r 5 -0.26) and AIx @75 (r 5 -0.29) in the combined group of men and women. The LF/HF ratio was inversely associated with CSBP (r 5 -0.27), AP (r 5 -0.28), and AIx@75 (r 5 -0.32) in men, but not in women. Conclusion: There is an inverse association between the LF/HF ratio, AP, and AIx@75 in men and women combined. The association between the LF/HF ratio, CSBP, AP, and AIx@75, differs based on gender. © 2020 Akademiai Kiado, Budapest.

OBJECTIVE: Guided by the Transactional Model of Stress and Coping, this study seeks to (1) examine the independent relationships between the level of distress among burn survivors, pre-morbid psychiatric history, and burn severity on length of hospital stay, and (2) to examine the relationship between having a premorbid psychiatric history and level of distress following a burn injury., METHODS: Data collected by the National Institute on Disability, Independent Living, Rehabilitation Research funded Burn Model System (N = 846) was used to theoretically link psychological distress with the length of hospital stay for survivors of burn injuries. Structural Equation Modeling was used to evaluate the aims of this study., RESULTS: Although counterintuitive, and while significant, burn severity was found to have a rather modest association with a burn survivor's level of distress, indicating that one's ability to cope may be a better predictor of distress rather than burn severity alone. Premorbid psychiatric history was significantly associated with increased levels of distress. While burn severity was associated with length of stay, level of distress did not act as a partial mediator. Length of stay was, however, significantly related to having a premorbid-psychiatric history. Of notable interest, a significant racial, ethnic, and gender difference exists in level of distress. Women and people of color experience higher levels of distress holding constant burn severity and psychiatric history., CONCLUSION: A need exists to assess for and address premorbid and current mental health challenges of burn survivors, specifically the ability to cope, especially among people of color and women, regardless of the burn size or severity. Copyright © 2019 Elsevier Ltd and ISBI. All rights reserved.

Lunn, WR and Axtell, RS. Validity and reliability of the Lode Excalibur Sport cycle ergometer for the Wingate Anaerobic Test. J Strength Cond Res XX(X): 000–000, 2019—Although multiple testing devices advertise Wingate Anaerobic Test (WAnT), capability, reliability, and validity data are sparse. The purpose was to determine whether the Lode Excalibur Sport cycle ergometer is a reliable and valid instrument to conduct the 30-second WAnT when compared with the Monark 894e Peak Bike ergometer. Recreationally active men (n = 49; 20.6 ± 2.5 years; 1.75 ± 0.07 m; and 79.1 ± 9.8 kg) completed four 30-second WAnTs: 2 each on the Lode and the Monark ergometers for peak power (PP), mean power (MP), minimum power (MinP), fatigue index (FI), and peak cadence (vmax) measurement. Interday and interunit correlation, multivariate analysis of variance, regression, and Bland-Altman analysis determined reliability and validity. Cohen's d was used to determine effect size. Relative reliability (intraclass correlation coefficient) with 95% confidence interval for Monark and Lode was very high for PP, MP, MinP, and vmax and high for FI (r > 0.83; coefficient of variation ≤ 27.0%; p < 0.01). Interunit correlation was strong for PP, MP, MinP, and vmax (r > 0.75; p < 0.001) and moderate for FI (p = 0.001). Lode PP and FI values were significantly less (p < 0.001; d > 1.18) and MinP, MP, and vmax significantly greater (p ≤ 0.001; d > 0.51) than Monark. Proportional bias was demonstrated for all variables (p < 0.04; d > 2.68) except vmax. The Lode ergometer reliably provides WAnT outcomes and correlates well to the Monark ergometer. However, differences in power values and proportional bias between differently braked instruments prevent use of the Lode ergometer for comparison of WAnT data with normative data generated by the Monark ergometer.

Background/ObjectiveMany adolescents with type 1 diabetes do not achieve 60 minutes of daily moderate-to-vigorous intensity physical activity (MVPA). Recognizing the importance of peer influence during adolescence, we evaluated the feasibility and safety of a group MVPA intervention for this population. MethodsEighteen adolescents with type 1 diabetes (age 14.12 .3 years, female 67%, black or Latino 67%, median body mass index 92%ile, A1c 79.925.1 mmol/mol, 9.5 +/- 2.3%). Intervention sessions (35minutes MVPA and 45minutes discussion) occurred 1x/week for 12weeks. Feasibility and safety metrics were enrollment, completion of intervention and assessments, cost, and hypoglycemia rates. Participants completed MVPA (accelerometry), and exploratory nutritional, psychosocial, clinical, and fitness variable assessments at baseline, 3 months, and 7 months. Hedges' effect sizes were calculated. ResultsEnrollment was 16%, and intervention completion was 56%. Assessment completion at 7 months was 67% for MVPA, nutrition, and fitness, 83% for psychosocial assessments, and 94% for clinical assessments. Cost was $1241 per completing participant. One episode of mild hypoglycemia occurred during the sessions (0.6%). Self-reported daily fruit/vegetable servings (d=-0.72) and diabetes self-management behaviors decreased over time (d=-0.40). In the 10 completers, endurance run score improved (d=0.49) from low baseline levels, while systolic blood pressure decreased (d=-0.75) and low-density lipoprotein increased (d=0.49) but stayed within normal ranges. ConclusionsThe protocol for the group MVPA intervention was safe and had some feasibility metrics meriting further investigation. MVPA levels and glycemic control remained suboptimal, suggesting the need for more intensive interventions for this population.