Exercise or physical activity and cognitive function in adults with type 2 diabetes,insulin resistance or impaired glucose tolerance: a systematic review

Background

Diabetes is an important risk factor for cognitive impairment. Although some studies suggest that physical exercise can minimize age-related cognitive declines or improve brain morphology or function, benefits in diabetes or impaired glucose tolerance are unclear. Therefore, our aim was to evaluate the efficacy of exercise or physical activity on cognition in adults with type 2 diabetes, insulin resistance or impaired glucose tolerance.

Methods

An electronic search for studies published from the earliest record until February 2017 was conducted using Medline, EMBASE, SPORTDiscus, CINAHL, and PsycINFO. Any experimental or observational study designs were included, as long as they were conducted in individuals of any age with type 2 diabetes, insulin resistance or impaired glucose tolerance, and they directly examined exercise/physical activity effects on cognitive outcomes or the relationship between changes in cognition and changes in either insulin resistance and glucose homeostasis. Study quality was assessed using the PEDro scale; data on participant and intervention characteristics and outcomes were extracted.

Results

Six studies enrolling 2289 participants met the eligibility criteria. Quality was modest and effect sizes variable and mostly small or negligible. Overall, four of the six studies (67%) reported significant benefits of greater exercise/physical activity participation for some aspects of cognition, but only 26% of cognitive outcomes were significant across all trials. Clinical improvements in insulin resistance/glucose homeostasis were related to improvements in cognitive function in three studies. Overall results were inconsistent, with benefits varying across exercise types and cognitive domains.

Conclusions

Literature does not provide evidence that physical activity or exercise interventions contribute to a better cognitive function in patients with type 2 diabetes or impaired glucose tolerance. Large-scale, long-term, robust randomized controlled trials are required to determine if exercise improves cognition in this high-risk cohort, and to investigate putative mechanistic links between cognition, body composition, metabolism, and inflammation in diabetes and related metabolic syndromes.

     

The 1988 Nigerian population policy

The population of Nigeria is one of the fastest growing rates in the world at 2.5-3.5%/ year. The estimated population was 101.11 million in 1987 and by 2015 is projected to be 280 million. Nigeria was the 10th most populous country in 1985 and by 2025 it would be 4th. The average number of children for each woman is 6-7 and the death rate is 16/1000. A recent government policy has restricted women to 4 children. 47% of the population is under 15 years of age. Goals of the government include reducing the growth rate, improving the standard of living, and balancing the population distribution between urban and rural areas. To do this they will need to promote awareness of their population situation to all citizens, educate young people on family planning, and to enhance development in rural and urban areas by slowing the migration to the cities. Most Nigerians view this policy as discriminatory against women, and ineffective in curbing present growth in population. Religions including Catholicism, Islam and some Christian groups do not promote birth control. Although many groups oppose this policy, most realize that the country is over populated and that with the present economic situation, a reduction in growth is needed. A more acceptable policy would restrict Christians, who marry only 1 wife, to 4 children and Moslems, who can have up to 4 wives, could have only 1 child/wife or 4 children for the man, in each family. A better method would be to encourage 3 children/family because of the young age structure in the population. Even if the fertility would decline to 2 children/family there would be substantial growth for many years to come.     

Preventing Credit-Card Fraud: A Goal-Setting and Prompting Intervention to Increase Cashiers’ ID-Checking Behavior

A goal-setting and prompting intervention was promoted by a restaurant manager to increase the frequency of cashiers’ ID-checking behavior. An A-B-A (Baseline-Intervention-Withdrawal) reversal design at one of two restaurants showed that the socially-valid intervention increased the percentage of ID-checked purchases significantly from 2.4% at Baseline to 35.8% during the Intervention phase. ID checking decreased slightly to 30.6% during the Withdrawal phase, showing maintenance of the target behavior. The percentage of ID-checked purchases at the control restaurant was almost nonexistent throughout the 18-week study.     

Non-Muslim Australians’ Knowledge of Islam: Identifying and Rectifying Knowledge Deficiencies

It is more than a decade since social geographer Kevin Dunn first described non-Muslim Australians’ ignorance about Islam and its adherents and outlined a series of recommendations about how Australian governments could address this as a pressing social policy issue. Recently researchers have re-assessed non-Muslim Australians’ perceptions of their knowledge of Islam and Muslims identifying while it has improved since 2003, 70% acknowledge they know little to nothing about either. Using data from Australia’s 2016 National Social Survey, this study examines the correlation between non-Muslim Australians’ perceptions of their knowledge of Islam and Muslims and their actual knowledge. We find that perception of knowledge is a reasonable indicator of actual knowledge. Further, we find that tertiary education is the single significant demographic factor impacting actual knowledge. By examining geographical patterns of knowledge, we also find that ignorance of Islam and Muslims is consistent across Australia.     

Religious Social Support,Discrimination, and Psychiatric Disorders Among Black Adolescents

Discrimination is a common experience for black adolescents that can jeopardize their mental health. However, research suggests that various dimensions of religion have positive effects on their mental health and well-being. Additionally, exposure to discrimination may vary by youths’ socio-demographic factors, such as gender and ethnicity. Numerous studies identify the protective effects of emotional and tangible religious social support on the mental health of black adults reporting discrimination. Conversely, fewer studies address the influence of emotional and tangible religious social support on mental health for black adolescents experiencing discrimination, while also accounting for socio-demographic heterogeneity among black adolescents. Historically, religion has played an instrumental role in the diverse narratives of the black Diaspora in the United States. It is important to account for its potential protective effects for black youth. Examining these factors using a compensatory risk and resilience model, our study finds that black adolescents who experience discrimination are also more likely to meet criteria for a psychiatric disorder. Additionally, those who report experiencing religious social support are less likely to meet criteria for a psychiatric disorder. These findings were not moderated by the socio-demographic factors of gender or ethnicity. To date, this investigation is one of the first to examine the effect of different types of religious social support in the presence of discrimination on psychiatric illness among African American and Caribbean black adolescents.     

Behavioral Perspectives on Variability in Human Behavior as Part of Process Safety

ABSTRACT

Process safety involves worker decisions at various points in an extended process, and much remains unknown regarding sources of variability in worker behavior at these decision points. This paper seeks to explain why some workers may be deviating from sanctioned policies and procedures. Risky choice is analyzed through discussion of positive and negative reinforcement, habituation in terms of respondent and operant behavior, risk discounting, and consequence dimensions that include a review of prospect theory, heuristics, and behavioral decision theory. Recommendations are made for improving our understanding of sources of variability in process safety by conducting systematic research on the perspectives reviewed.     

Wealth Accumulation Inequality: Does Investment Risk Tolerance and Equity Ownership Drive Wealth Accumulation?

This study examined the savings aspect of wealth accumulation by estimating differences in financial risk tolerance and equity ownership among individual investors. Data were obtained from a proprietary dataset that collected over 15,000 risk-tolerance attitude responses between late 2007 and early 2013. Two research methodologies were utilized: cluster analysis and ANCOVA. The cluster analysis identified four investor profiles: (a) young lower-income women, (b) young unmarried men, (c) young college-educated men, and (d) older men with high income and education. Results from the ANCOVA test indicated that each cluster had significantly different levels of equity ownership, controlling for financial risk tolerance. Results provide a framework and methodology for future research on issues related to wealth inequality, investment behavior, and risk attitudes. The ability to group individuals similarly can be an important tool for researchers, policy makers, social activists, financial advisers, financial counselors, and educators when analyzing the household and macroeconomic wealth profile of United States residents.     

Maximum flows in generalized processing networks

Processing networks (cf. Koene in Minimal cost flow in processing networks: a primal approach, 1982) and manufacturing networks (cf. Fang and Qi in Optim Methods Softw 18:143–165, 2003) are well-studied extensions of traditional network flow problems that allow to model the decomposition or distillation of products in a manufacturing process. In these models, so called flow ratios \(\alpha _e \in [0,1]\) are assigned to all outgoing edges of special processing nodes. For each such special node, these flow ratios, which are required to sum up to one, determine the fraction of the total outgoing flow that flows through the respective edges. In this paper, we generalize processing networks to the case that these flow ratios only impose an upper bound on the respective fractions and, in particular, may sum up to more than one at each node. We show that a flow decomposition similar to the one for traditional network flows is possible and can be computed in strongly polynomial time. Moreover, we show that there exists a fully polynomial-time approximation scheme (FPTAS) for the maximum flow problem in these generalized processing networks if the underlying graph is acyclic and we provide two exact algorithms with strongly polynomial running-time for the problem on series–parallel graphs. Finally, we study the case of integral flows and show that the problem becomes \({\mathcal {NP}}\)-hard to solve and approximate in this case.