There is currently considerable discussion about the relative influences of evolutionary and cultural factors in the development of early numerical skills. In particular, there has been substantial debate and study of the relationship between approximate, nonverbal (approximate magnitude system, AMS) and exact, symbolic (symbolic number system, SNS) representations of number. Here we examined several hypotheses concerning whether, in the earliest stages of formal education, AMS abilities predict growth in SNS abilities, or the other way around. In addition to tasks involving symbolic (Arabic numerals) and non-symbolic (dot arrays) number comparisons, we also tested children's ability to translate between the two systems (i.e., mixed-format comparison). Our data included a sample of 539 Kindergarten children (mean=5.17yrs, SD=0.29yrs), with AMS, SNS and mixed comparison skills assessed at the beginning and end of the academic year. In this way, we provide, to the best of our knowledge, the most comprehensive test to date of the direction of influence between the AMS and SNS in early formal schooling. Results were more consistent with the view that SNS abilities at the beginning of Kindergarten lay the foundation for improvement in both AMS abilities and the ability to translate between the two systems. Importantly, we found no evidence to support the reverse. We conclude that, once one acquires a very basic grasp of exact number symbols, it is this understanding of exact number (and perhaps repeated practice therewith) that facilitates growth in the AMS. Though the precise mechanism remains to be understood, these data challenge the widely held view that the AMS scaffolds the acquisition of the SNS.

An exercise-aided NRT smoking cessation program with built-in maintenance components enhances post-intervention cessation rates at week 14 but not at weeks 26 and 56.

Objective. To assess a comprehensive, intensive lifestyle intervention in combination with metformin extended release (MXR) or placebo on body mass index (BMI) and risk factors for type 2 diabetes and cardiovascular disease in obese adolescents. Study Design. Sixty-nineobese adolescents (mean BMI 32.5) received a comprehensive lifestyle intervention with structured dietary, physical activity, and behavioral components for 24 months. Subjects were randomized to 1 of 4 groups: MXR (33) 2,000 mg daily or placebo, with either moderate or vigorous intensity exercise for the first 3 months. Subsequently the exercise intervention was the same for all 4 groups. Results. Anthropometry measurements did not differ with initial exercise intensity at any time. At 3 months % body fat decreased in all 4 groups (P < 0.006). BMI and % body fat decreased in the MXR groups, but not the placebo groups, at 6 (−0.88, −3.16) and 12 months (−0.56, −2.34) (P < 0.05). Insulin resistance, fasting blood glucose, and leptin improved in all groups at 6 and 12 months. A high subject attrition rate (58%) occurred by 24 months. Conclusion. A comprehensive, intensive lifestyle intervention combined with MXR led to a decline in BMI and % body fat at 1 year independent of initial exercise intensity. This trial is registered with ClinicalTrials.gov NCT00934570 .

Introduction-Smoking during pregnancy is common, and quitting at any point during pregnancy can yield benefits to both the fetus and mother. Smoking cessation is typically followed by withdrawal symptoms and a strong desire to smoke, both of which are likely to contribute to relapse. Research has shown that a bout of exercise minimizes cravings and tobacco withdrawal symptoms (TWS) after temporary abstinence in smokers, but these findings have not been replicated in pregnant smokers. This study examined the effect of 20 min of exercise on cravings (primary outcome) and TWS (secondary outcomes) among temporary abstinent, inactive pregnant smokers.Methods-Thirty female smokers (Mean(M) age = 25.7 years, Standard Deviation(SD) = 5.5; M weeks pregnant = 18.2, SD = 5.3; Fagerstrom Test for Cigarette Dependence = 3.3, SD = 2.2; M 9.3 cigarettes/day, SD = 4.7; M hours abstained = 17.2, SD = 2.8) were randomized to 20 min of mild-to-moderate intensity exercise (EC; n = 14) or passive (PC; n = 16) condition. Cravings and TWS were assessed immediately before, during (at 10 min), immediately post, and at 10, 20, and 30 min post-condition.Results-A 2 (condition) × 6 (time) repeated measures ANOVA revealed that the EC significantly (p < 0.05) reduced cravings (ή 2 = 0.46) compared with the PC, across time. Nonsignificant, but nevertheless, large effects were evident favouring the EC over time for TWS ☆ Editorial board for Addictive Behaviors. *Corresponding author at: University of Western Ontario, Faculty of Health Sciences, School of Kinesiology, Thames Hall/3M Centre, London, Ontario, Canada, N6A 3K7. Tel.: +1 519 661 2111x80173. hprapave@uwo.ca (H. Prapavessis). Contributors HP, GF, PS, MM, and MU conceived the study. SDJ, AC, TH and LF recruited participants and conducted the study in London, ON. MU recruited participants and collected the study in London, England. HP and SDJ ran the statistical analyses and prepared the first draft of the manuscript, which were jointly interpreted and edited by the authors, respectively. All authors contributed to and approved the final version of the manuscript. Conflict of interestMy coauthors and I do not have any personal or financial conflicts of interest related to the research, nor do the authors have other relationships with other people or organizations within three years of beginning the submitted work that could inappropriately influence, or be perceived to influence, this work. CIHR Author ManuscriptCIHR Author Manuscript CIHR Author Manuscript restlessness (ή 2 = 0.34), stress (ή 2 = 0.24), irritability (ή 2 = 0.21), tension (ή 2 = 0.15), and depression (ή 2 = 0.14).Conclusions-Consistent with previous research, this study reveals that in pregnant smokers, a bout of exercise is associated with a reduction in cravings and similar patterns exist for TWS. Therefore, exercise may have the potential to assist in the initial stages of smoking cessation attempts during pregnancy.

Although immediate results are good to excellent in great majority of patients who undergo biofeedback treatment (BFT) for chronic constipation and fecal incontinence, they tend to loose the benefit over a period of time. The purpose of this study was to evaluate the long-term sustainability of results after successful biofeedback treatment. Two groups of patients who successfully completed BFT at our institution from 1995 to 1997 were created based on the date of completion. The first had a mean follow-up of 35 months and the second group was followed for an average of 12 months. Both groups were questioned as to the presence of constipation and incontinence. The questioning was focused depending on the patient's diagnosis. This information was then compared with the initial BFT results. Overall, all patients were satisfied by the initial BFT results. All patients initially had an excellent or good response to BFT. However, after a mean of 35 months, in the first group, 19 of 22 patients had a near complete regression back to their pre-biofeedback status. In the 14 patients in the second group with mean follow-up of 12 months, 11 had a significant decay in benefits. Only time was a significant factor in the decay of BFT benefits. In conclusion, BFT is highly effective in the treatment of selected patients with complex defecation disorders. Although there is a high initial success rate, there is a clear loss of the immediate benefits over time. Other factors such as dietary habits, pelvic floor exercises, manometry, invasive EMG, and rectal sensation did not correlate with long-term outcomes. The comparison between the two groups reveals a linear model describing the time decay of the benefits of BFT. Based on the linear model, patients may need reevaluation after one year and may benefit from additional BFT.