Physical activity and mental health: the association between exercise and mood

OUP accepted manuscript

Aims

The European Association of Cardiovascular Imaging Scientific Initiatives Committee conducted a global survey to evaluate the impact of the 2019 coronavirus disease (COVID-19) pandemic on the mental well-being of cardiac imaging specialists.

Methods and results

In a prospective international survey performed between 23 July 2021 and 31 August 2021, we assessed the mental well-being of cardiac imaging specialists ∼18 months into the COVID-19 pandemic. One-hundred-and-twenty-five cardiac imaging specialists from 34 countries responded to the survey. More than half described feeling anxious during the pandemic, 34% felt melancholic, 27% felt fearful, and 23% respondents felt lonely. A quarter of respondents had increased their alcohol intake and more than half reported difficulties in sleeping. Two-thirds of respondents described worsening features of burnout during the past 18 months, 44% considered quitting their job. One in twenty respondents had experienced suicidal ideation during the pandemic. Despite these important issues, the majority of participants (57%) reported having no access to any formal mental health support at work.

Conclusion

The survey has highlighted important issues regarding the mental well-being of cardiac imaging specialists during the COVID-19 pandemic. This is a major issue in our sub-specialty, which requires urgent action and prioritization so that we can improve the mental health of cardiovascular imaging specialists.

Physical Activity and Physical Fitness among University Students-A Systematic Review

The aim of this systematic review was to examine the scientific evidence regarding physical activity and physical fitness among university students. The search and analysis of the studies were done in accordance with the PRISMA guidelines. An electronic databases search (Google Scholar, PubMed, Science Direct, and Scopus) yielded 11,839 studies. Subsequently, the identified studies had to be published in English between 2011 and 2021, the experimental study had to have included males and females attending a faculty, and the participants had to have been evaluated for physical activity and fitness. A total of 21 studies were included in the quantitative synthesis, with a total of 7306 participants, both male and female. After analyzing the obtained results, it could be concluded that university students show a satisfactory level of physical activity and physical fitness. However, the results vary due to different factors involved, mostly related to the cultural differences and educational systems in different countries. As this study observes mediocre results of physical activity and physical fitness among university students, it is crucial to get their attention and awareness, to at least maintain a satisfactory level of physical activity and physical fitness.

Comparison of General-Social Health and Corona-Induced Anxiety Between Active and Inactive Students in the COVID-19 Pandemic

Background: General health includes physical and mental health and their interactions, and physical activity can improve people's mental and social health. The present study has compared general-social health and COVID-19-induced anxiety between active and inactive students during the COVID-19 pandemic. Methods: A causal-comparative research design was used in this study. The statistical population consisted of all students of the Farhangian University of Mashhad (2,500 students) in 2020, out of whom 752 students were randomly selected (323 men and 429 women). Subjects were assessed for general health, social health, and COVID-19-induced anxiety. Data normality was investigated by the Kolmogorov-Smirnov test and data were analyzed statistically using independent t-test and Pearson correlation coefficient test. Results: The results of the present study showed that there was a significant difference between general health and COVID-19-induced anxiety of active and inactive students (p = 0.001), but no significant difference was observed between these two groups in social health (p ≥ 0.05). Results obtained regarding the correlation indicated that there was a significant correlation between general and social health in both active and inactive students (p = 0.001). However, there was no significant correlation between COVID-19-induced anxiety and general-social health (p ≥ 0.05). Conclusion: According to the results of the present study, it can be said that an active lifestyle and physical activity are important factors to improve general health and reduce anxiety, especially in specific conditions of the COVID-19 outbreak. Therefore, it is recommended that students have a regular exercise program to reduce their anxiety and increase the level of their physical health.

Self-reported neurocognitive symptoms during COVID-19 lockdown and its associated factors in a sample of psychiatric patients. Results from the BRIS-MHC study

Lockdown caused by COVID-19 pandemic has a negative impact on mental health. The aim was to assess self-reported neurocognitive symptoms during the lockdown and identify associated vulnerable and protective factors in a sample of psychiatric patients in a Spanish population. These results are part of the Barcelona ResIlience Survey for Mental Health COVID-19 (BRIS-MHC) project. Neurocognitive symptoms were assessed through an online survey considering the five items that represented self-reported neurocognitive complaints. We split the sample into two groups based on the severity of the self-reported neurocognitive complaints: intact cognitive function/mild cognitive impairment (CI-) and moderate/severe cognitive impairment (CI+). Univariate analyses were used to compare both groups in terms of sociodemographic and clinical variables. Multiple logistic regression models were carried out to identify clinical variables and coping strategies associated with neurocognitive symptoms. 198 patients with different psychiatric diagnoses were included in this study. One hundred seventeen patients were classified in the CI- group and 81 in the CI+ group. Depressive symptoms and negative psychotic-like symptoms were vulnerable factors for neurocognitive impairment. Coping strategies of performing physical activity, carrying out relaxing activities and maintaining a routine were protective factors against cognitive impairment. Lockdown situation negatively impact on neurocognitive function. Psychopathological symptoms and coping strategies were associated with neurocognitive symptoms during lockdown in subjects with psychiatric illness. The early treatment of psychopathological symptoms in psychiatric patients and promoting coping strategies during lockdown should be considered an intervention strategy against cognitive impairment.

Physical Exercise and Mental Health: The Routes of a Reciprocal Relation

Sport participation and exercise practice are considered to be beneficial for mental status, yielding an improved mood and better quality of life. On the other hand, good mental fitness is thought to lead to better physical status and sport performance. The key aim of this narrative review is to provide an unstructured overview on the topic with special considerations on the role of mental and physical health to summarize the evidence on their reciprocal influence. While very few papers describe the role of mental health measures in affecting physical performance, more evidence is available concerning the effect of exercise and sport in improving mental health outcomes. Furthermore, there is a consistent role of depressive and anxiety symptoms in influencing the risk of sport injury in either recreational or elite athletes. Moreover, the importance of investigating mental health issues in elite and retired athletes is highlighted. On the basis of the available literature, several biases were found to affect the provided evidence mainly because of the complexity of a proper study design in this field.

Measuring Exercise-Induced Secreted Protein Acidic and Rich in Cysteine Expression as a Molecular Tool to Optimize Personalized Medicine

The numerous exercise benefits for health as well as applications for diseases has lead to exercise being prescribed in many pathological conditions. Secreted protein acidic and rich in cysteine (SPARC) gene expression is stimulated by exercise and SPARC has been suggested as a molecular mediator of exercise. Therefore, we suggest using this property for personalized medicine. This can be achieved by prescribing the exercise with a pattern (duration, intensity, etc.) that corresponds to the optimum SPARC/Sparc expression. We expect this approach to optimize the exercise therapy in both the preventive and curative contexts. In the research field, measuring exercise -dependent expression of Sparc would represent a molecular tool to further optimize the selection of exercise animal models as well.

Physical Activity, Mental Health and Wellbeing during the First COVID-19 Containment in New Zealand: A Cross-Sectional Study

Strategies implemented worldwide to contain COVID-19 outbreaks varied in severity across different countries, and established a new normal for work and school life (i.e., from home) for many people, reducing opportunities for physical activity. Positive relationships of physical activity with both mental and physical health are well recognised, and therefore the aim was to ascertain how New Zealand's lockdown restrictions impacted physical activity, mental health and wellbeing. Participants (n = 4007; mean ± SD: age 46.5 ± 14.7 years, 72% female, 80.7% New Zealand European) completed (10-26 April 2020) an online amalgamated survey (Qualtrics): International Physical Activity Questionnaire: Short Form; Depression, Anxiety and Stress Scale-9; World Health Organisation-Five Well-Being Index; Stages of Change Scale. Positive dose-response relationships between physical activity levels and wellbeing scores were demonstrated for estimates that were unadjusted (moderate activity OR 3.79, CI 2.88-4.92; high activity OR 8.04, CI 6.07-10.7) and adjusted (confounding variables: age, gender, socioeconomic status, time sitting and co-morbidities) (moderate activity 1.57, CI 1.11-2.52; high activity 2.85, CI 1.97-4.14). The study results support previous research demonstrating beneficial effects of regular physical activity on mental health and wellbeing. Governments may use these results to promote meeting physical activity guidelines in order to protect mental health and wellbeing during the ongoing COVID-19 restrictions and future pandemics.

Associations between screen time, physical activity, and depressive symptoms during the 2019 coronavirus disease (COVID-19) outbreak among Chinese college students

BACKGROUND

The 2019 novel coronavirus disease (COVID-19) emerges in China, which spreads rapidly and becomes a public health emergency of international concern. Chinese government has promptly taken quarantine measures to block the transmission of the COVID-19, which may cause deleterious consequences on everyone's behaviors and psychological health. Few studies have examined the associations between behavioral and mental health in different endemic areas. This study aimed to describe screen time (ST), physical activity (PA), and depressive symptoms, as well as their associations among Chinese college students according to different epidemic areas.

METHODS

The study design is cross-sectional using online survey, from 4 to 12 February 2020, 14,789 college students accomplished this online study, participants who did not complete the questionnaire were excluded, and finally this study included 11,787 college students from China.

RESULTS

The average age of participants was 20.51 ± 1.88 years. 57.1% of the college students were male. In total, 25.9% of college students reported depression symptoms. ST > 4 h/day was positively correlated with depressive symptoms (β = 0.48, 95%CI 0.37-0.59). COVID-19ST > 1 h/day was positively correlated with depressive symptoms (β = 0.54, 95%CI 0.43-0.65), compared with COVID-19ST ≤ 0.5 h/day. Compared with PA ≥ 3 day/week, PA < 3 day/week was positively associated with depression symptoms (β = 0.01, 95%CI 0.008-0.012). Compared with low ST and high PA, there was an interaction association between high ST and low PA on depression (β = 0.31, 95%CI 0.26-0.36). Compared with low COVID-19ST and high PA, there was an interaction association between high COVID-19ST and low PA on depression (β = 0.37, 95%CI 0.32-0.43). There were also current residence areas differences.

CONCLUSIONS

Our findings identified that high ST or low PA was positively associated with depressive symptoms independently, and there was also an interactive effect between ST and PA on depressive symptoms.

Leisure but Not Occupational Physical Activity and Sedentary Behavior Associated With Better Health

OBJECTIVE

This study explores relations between occupational and leisure-time physical activity (OPA, LTPA) and sedentary behavior (OSB, LTSB) and several health outcomes.

METHODS

A total 114 full-time workers had their body composition, waist circumference, height, weight, resting heart rate, and resting blood pressure measured. ActivPal monitor measured physical activity behaviors. Stress, mood, and pain were measured with ecological momentary assessment. General linear models were used to examine the relationship between high and low OPA, LTPA, OSB, and LTSB with each health outcome while controlling for covariates.

RESULTS

The high LTPA group had lower body mass index (BMI) (P = 0.04) and better mood (P = 0.007) than the low LTPA group. The high LTSB group had higher systolic blood pressure (P = 0.001), higher diastolic blood pressure (P = 0.01), higher BMI (P = 0.027), higher body fat percentage (P = 0.003), higher waist circumference (P = 0.01), and worse mood (P = 0.032) than the low LTSB group. No differences were found between OPA and OSB groups.

CONCLUSIONS

These findings suggest there may be differential relations between PA and SB accumulated during leisure versus occupational time.

Physical activity on mental wellbeing in senior English Premier League soccer players during the COVID-19 pandemic and the lockdown

The COVID-19 pandemic and the subsequent lockdown created new stressors that could potentially attenuate mental wellbeing (MW) in athletes, who are already susceptible to poor MW. This study aims to describe fluctuations to MW during "lockdown" and subsequent "return to sport" protocols, in comparison to the normal "in-season" in professional soccer. Twenty-five English Premier League (EPL) soccer players completed the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) every two weeks, during the 2019/2020 season, and every week during "lockdown" and "return to training" for 28 weeks. The duration of each physical activity (PA) session completed was recorded. No significant differences were found for MW between time points (In-season, lockdown, return to training and the restart) (51.5 ± 5.6 vs. 50.7 ± 4.8 vs. 50.8 ± 5.7 vs. 50.7 ± 5.6 (p > 0.05)) respectively. Individually, differences were identified; in-season weekly session duration (243 ± 38 min) was higher than during lockdown (180 ± 62 min) (p < 0.05). During lockdown, weekly MW scores were related to the previous 7-day number of sessions (r = 0.151) and active min (r = 0.142) (p < 0.05). Furthermore, participants that exercised >250 min in lockdown, had higher MW scores (52.46 ± 4.65) than <250 min (50.35 ± 6.55) (p < 0.05). MW responses to lockdown were best understood on an individual basis. Additionally, PA only had a measurable effect on MW when >250 min. Further, stressors imposed upon players during an EPL season, are potentially greater than those inflicted by the lockdown. Implications for monitoring MW in EPL soccer players and the potential inclusion of an in-season break are discussed.Highlights Mental Wellbeing Responses, as measured by the Warwick-Edinburgh Mental Wellbeing scale did not change significantly at a group level across the four phases of the season. However, on an individual level changes were evident.There was a decline in the trend of wellbeing scores during in-season, return to training and the restart, but an increase in wellbeing scores during lockdown.Physical Activity had a measurable effect on wellbeing, when physical activity was >250 min during lockdown.These findings highlight the need for individual monitoring of wellbeing and longitudinal monitoring in sport to identify decline in wellbeing and implement intervention. In addition, the prescription of physical activity >250 min per week during lockdown in trained athletes may promote positive mental health.

Predictors of depression, anxiety and stress among remote workers during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has had a massive impact on work and home life, changing all daily routines of remote workers. It is extremely important to figure out some changes in home and work life that may affect the mental health of remote workers more.

OBJECTIVES

The first aim of the study was to investigate the predictors of depression, anxiety, and stress among first-time remote workers during the COVID-19 pandemic. The second aim was to explore sex differences regarding work and home life during the COVID-19 pandemic.

METHODS

The sample consisted of 459 participants who have been working from home for the first time during the COVID-19 pandemic. An online survey used included questions relating to sociodemographic characteristics, changes in work and home life, Depression Anxiety Stress Questionnaire-Short Form, Jenkins Sleep Scale, and Leisure-Time Exercise Questionnaire.

RESULTS

The prevalence of depression, anxiety, and stress was 17.9%, 19.6%, and 19.6% of the participants, respectively. Poor sleep quality, trouble focusing at work, being female, workplace loneliness, low levels of control over working hours, and low levels of physical activity were predictors of depression. Poor sleep quality, increased workload, and being female were predictors of anxiety. Poor sleep quality, trouble focusing at work, being female, financial concern, and workplace loneliness were predictors of stress. It was observed a higher increase in both housework and working hours during the COVID-19 pandemic in women.

CONCLUSION

Determining the variables that can affect the mental health of remote workers is highly important for timely psychological intervention.

Physical Activity Among People With Lower Limb Amputation in Brazil

BACKGROUND

Limb loss affects quality of life, well-being, and autonomy. The World Health Organization has launched a global action plan to reduce physical inactivity and presented recommendations of physical activity for people living with disability. Knowledge of the characteristics of people with lower limb amputation regarding physical activity is important. Thus, the aim of this study was to identify the quantity and type of physical activity done by people with lower limb amputation.

METHODS

The sample (N = 149) included adults aged 53.08 (17.24) years old with lower limb loss. Data collection was performed through the application of a sociodemographic, behavioral, and clinical data sheet and the Brazilian version of the Physical Activity Scale for Individuals with Physical Disabilities.

RESULTS

The total Physical Activity Scale for Individuals with Physical Disabilities score was between 0 and 65.79 metabolic equivalents of task per hour per day, which suggests low practice of physical activities. The most frequently practiced activities (79.9%) were those that involved stationary behavior. Women carried out more domestic activities, and subjects who used lower limb prosthesis and those with traumatic amputation reported higher practice of physical activity.

CONCLUSIONS

People living with lower limb amputation, from different regions of Brazil, have low levels of physical activity and mainly carry out activities of stationary behavior.

Relationship of childhood maltreatment, exercise, and emotion regulation to self-esteem, PTSD, and depression symptoms among college students

Because physical exercise improves psychological functioning, it may be beneficial to college students with maltreatment histories. Thus, we tested the hypotheses that cumulative maltreatment would negatively affect psychological functioning, physical exercise would positively affect psychological functioning, and emotion regulation difficulties would negatively contribute to the prediction of psychological functioning. Participants: Participants were 90 undergraduate students (71.1% female, 65.6% white). Methods: Participants completed questionnaires regarding their maltreatment and physical exercise history, emotion regulation difficulties, and psychological functioning. Results: Cumulative maltreatment was negatively correlated with self-esteem and positively correlated with PTSD/depression and frequent exercise was negatively correlated with PTSD/depression. Emotion regulation difficulties impacted the relationships between maltreatment history and psychological functioning, and accounted for much of the variability in psychological functioning. Cumulative maltreatment and exercise impacted different domains of emotion regulation which in turn uniquely affect psychological functioning. Conclusions: Therapeutic interventions should aim to improve these specific emotion regulation abilities.

Relationships between Depression, Daily Physical Activity, Physical Fitness, and Daytime Sleepiness among Japanese University Students

In Japan and other developed countries, the lifestyles of many—particularly the younger generation—have been disrupted in recent years. This disruption may manifest as a decrease in physical activity and deterioration in the quality and quantity of sleep. Depressive tendencies are also increasing among university students. This study examined the relationship between mental health, physical activity, physical fitness, and daytime sleepiness. Eighty-five undergraduate students participated in this study (52 men and 33 women, aged 18.9 (±1.4) years). Physical activity levels were measured using an accelerometer (Lifecorder, Kenz, Nagoya, Japan) for two weeks. To evaluate their level of physical fitness, maximal oxygen uptake (V˙O₂max) was calculated by an indirect method using a cycle ergometer. Depressive tendencies and daytime sleepiness were evaluated using the Patient Health Questionnaire (PHQ-9). The PHQ-9 score was positively correlated with sleepiness (r = 0.35, p = 0.001) and total steps per day (r = 0.39, p < 0.001). Moreover, the PHQ-9 score was positively correlated with V˙O₂max (r = 0.25, p = 0.019). The PHQ-9 score was higher in students with good exercise habits or part-time jobs. An important finding was the positive correlation between depression and variables related to physical activity levels. These results suggest that vigorous physical activity, such as exercise and part-time jobs, might be positively associated with depressive tendencies among university students.

Physical activity patterns among adults population during the coronavirus pandemic: consideration of the role of resilience

BACKGROUND

This study aims to characterize patterns of physical activity (PA) and resilience levels, and to examine whether resilience contributes to PA participation among adults during COVID-19 pandemic.

METHODS

This cross-sectional study was conducted during the quarantine period. The International Physical Activity Questionnaire-Short Form (IPAQ-SF) and the Brief Resilience Scale (BRS) questionnaires were used to assess the study's outcomes. The Kruskal-Wallis test was used to examine the difference in PA across resilience levels. Spearman's correlation coefficient was used to assess the relationship between resilience and PA. Data were reported as medians and interquartile ranges.

RESULTS

A sample of 1859 were included in the study (40% aged 26-35 yrs). The findings show that 85% of the respondents engaged in PA and 15% were physically inactive. The majority participated in moderate-intensity PA (71%). The median score was 3.50(0.85), which indicates a medium level of resilience. The positive correlation coefficient was shown between the average score of resilience and both walking (rs =0.01, p<0.001) and vigorous- intensity PA (rs =0.08, p=.007). Data did not show a significant correlation between moderate-intensity PA and resilience score.

CONCLUSIONS

Greater emphasis on PA engagement after the period of quarantine is needed. Resilience may play an important role in buffering the deleterious impact of quarantine on PA. Key words: Exercise; Physical Activity; Rehabilitation; Mental Health; COVID-19.

The association between core job components, physical activity, and mental health in African academics in a post-COVID-19 context

This study examined the association between core job components (i.e. teaching, research, and student assessment), physical activity (PA), and mental health in a post-COVID-19 context. An online questionnaire administered via Google Forms was used to gather data from 1064 African academics in four countries. A sensitivity analysis was applied to adjust for covariates. Data were analyzed with the hierarchical linear regression analysis. The average age of participants was 44 years. The study found that PA was positively associated with research but negatively associated with student assessment. Mental health was positively associated with onsite teaching but negatively associated with online teaching and research. PA did not predict mental health and mediate the relationship between the job components and mental health. It is concluded that PA may not increase mental health in African academics in a post-COVID-19 situation that required the resumption of work while observing social distancing protocols.

Mental Health and Physical Activity in Health-Related University Students during the COVID-19 Pandemic

The coronavirus disease 2019 (COVID-19) pandemic led to increased negative emotional states among students. Physical activity is known to have positive impacts on mental health and well-being. However, due to the closure of gyms and other recreational facilities as a restrictive measure, students' physical activity levels may decrease. This cross-sectional study aimed to determine the prevalence of depression, anxiety, and stress symptoms and physical activity among health-related students during the second partial COVID-19 lockdown. The study included 823 students from the Faculty of Dental Medicine and Health of the University of Osijek in Croatia. The Depression Anxiety Stress Scale-21 (DASS-21) and the Godin-Shephard Leisure Time Questionnaire for Physical Activity (GSLTPAQ) questionnaires were used to assess the prevalence of depression, anxiety, and stress symptoms as well as physical activity. Two-thirds (59.2%) of students in health-related fields were insufficiently active, while the prevalence of depression (50.8%), anxiety (50.9%), and stress (49.9%) symptoms were high. Also, female respondents had significantly higher levels of depression, anxiety, and stress than their male counterparts. Graduate students had higher levels of all three negative emotional states, but only anxiety levels were significant. This study shows that students in health-related fields had reduced physical activity and a high prevalence of negative emotional conditions (depression, anxiety, and stress) during the second partial lockdown. The resulting symptoms were mostly of mild intensity; however, we consider this a significant mental health issue during the COVID-19 pandemic. Hence, it is crucial to control and support students' mental health, especially in more affected female individuals, in order to reduce the pandemic's negative impact.

The Differential Impact of Acute Exercise and Mindfulness Meditation on Executive Functioning and Psycho-Emotional Well-Being in Children and Youth With ADHD

This study investigated how acute exercise and mindfulness meditation impacts executive functioning and psycho-emotional well-being in 16 children and youth with ADHD aged 10-14 (male = 11; White = 80%). Participants completed three interventions: 10 min of exercise, 10 min of mindfulness meditation, and 10 min of reading (control). Before and after each intervention, executive functioning (inhibitory control, working memory, task-switching) and psycho-emotional well-being (mood, self-efficacy) were assessed. Mindfulness meditation increased performance on all executive functioning tasks whereas the other interventions did not (d = 0.55-0.86). Exercise enhanced positive mood and self-efficacy whereas the other interventions did not (d = 0.22-0.35). This work provides preliminary evidence for how acute exercise and mindfulness meditation can support differential aspects of executive and psycho-emotional functioning among children and youth with ADHD.

Psychological Impact of the COVID-19 Outbreak on Mental Health Outcomes among Youth: A Rapid Narrative Review

The coronavirus disease (COVID-19) outbreak has affected not only physical health but also mental health and psychological wellbeing. This narrative review aimed to map the literature on the psychological impact on the young generation of the COVID-19 pandemic, social restrictions, and extraordinary measures to curb the spread of coronavirus. We performed a systematic search of MEDLINE through PubMed and Web of Science [Science Citation Index Expanded, SCI-EXPANDED), Social Sciences Citation Index (SSCI), and Emerging Sources Citation Index (ESCI)] of all scientific literature published from May 2020 until 15 March 2021. Based on inclusion and exclusion criteria, a total of 15 articles were included. We conducted a narrative review. The reviewed articles suggested the impact of the pandemic and lockdown measures on young persons for several mental symptoms as well as anxiety, stress, depression, event-specific distress, decrease in psychological wellbeing, and changes in sleep habits. Psychological symptoms were related to the experience of several stressors, such as risk for reduction of academic perspectives, massive e-learning adoption, economic issues, social restrictions, and implications for daily life related to the COVID-19 outbreak. This narrative review points out the negative psychological impact of the pandemic outbreak and the high vulnerability of the young in the development of psychological distress, highlighting the relevant focus on the mental health of young people during the pandemic and the need for structured and tailored psychological support and interventions focused to the improvement of Quality of Life of university students after the pandemic experience.

Effects of Physical Activity and Training Routine on Mental Health During the COVID-19 Pandemic and Curfew

This research aimed to explore the effects of physical activity and training routine on mental health during the COVID-19 pandemic and the proclaimed emergency state and curfew. To measure the mental health components of psychological distress and subjective well-being, two studies were conducted on different samples: Study 1 during the beginning of curfew in Serbia (N = 678) and Study 2 during the ending phase (N = 398). The results of Study 1 showed that elite athletes as well as those with high level of physical activity experienced the lowest distress. Furthermore, effects of the changes in the training routine on distress among physically active individuals depended on the level of sports participation with elite athletes who reduced trainings showing lower anxiety compared to recreational athletes who reduced trainings as well or kept the same training routine. Thus, we could conclude that in the early stage of the pandemic, elite athletes showed better mental health and adaptability to the crisis situation. Results of Study 2 showed that although all the participants had decreased well-being during the curfew, compared to the period before the pandemic and the curfew, there were no differences in well-being between elite and recreational athletes, who had higher well-being compared to non-athletes. However, this effect held both before and during the curfew showing that physically active individuals did not additionally benefit from this decrease compared to the non-active. Furthermore, athletes who became physically inactive showed lower well-being compared to those who kept the same training routine. Thus, in the later stage of the pandemic, prolonged physical inactivity had negative effects on mental health.

Feasibility, Acceptability, and Preliminary Target Engagement of a Healthy Physical Activity Promotion Intervention for Bulimia Nervosa: Development and Evaluation via Case Series Design

Bulimia nervosa (BN) is characterized by a pattern of binge eating and compensatory behaviors as well as an overemphasis on body weight and shape in self-evaluation. Although cognitive behavioral therapy (CBT) is efficacious, recent reviews suggest that only 30% of patients reach abstinence at posttreatment. One potential reason for these poor outcomes is that CBT fails to adequately reduce elevated negative affect (NA) and shape and weight concern, which have been shown to be correlated with poorer treatment outcomes in BN. Therefore, novel treatment components that focus on improving NA and shape and weight concern are needed in order to enhance outcomes. Promoting physical activity (PA) is a promising avenue through which to reduce NA and improve body image in healthy individuals, other clinical populations (e.g., individuals with depression or anxiety), and individuals with eating disorders. While prescribing PA for individuals with BN has been controversial (due to concerns that exercise maybe be used to compensate for binge episodes or become driven or compulsive), this approach may have many benefits, including promoting healthy lifetime exercise habits that reduce likelihood of relapse through the improvement of emotion regulation skills and weight regulation. Given the promise of PA for targeting key maintenance factors of BN, we developed a 12-session healthy PA promotion intervention for BN and tested initial feasibility, acceptability, and preliminary target engagement in an iterative case series design (n = 3). The treatment provided cognitive-behavioral skills designed to identify, practice, and achieve behavioral goals while asking patients to engage in up to 150 minutes of moderate-to-vigorous PA per week, which was preplanned during each session with the client's therapist. Results suggested that the healthy PA promotion intervention was both feasible and acceptable to deliver. In addition, the intervention resulted in a clinically significant decrease in BN symptom frequency in each participant. Further, participants showed clinically significant decreases in NA and shape and weight concern. The current study demonstrates that healthy PA interventions can have beneficial effects on BN symptoms, NA, and shape and weight concern. However, due to the small sample size, conclusions must be treated with caution. Future research should investigate additional approaches for promoting healthy PA and include a larger sample in order to further test initial efficacy of this treatment approach.

Depression, anxiety and stress during the COVID-19 pandemic: results from a New Zealand cohort study on mental well-being

OBJECTIVES

The COVID-19 pandemic has caused unprecedented disruption to daily life. This study investigated depression, anxiety and stress in New Zealand (NZ) during the first 10 weeks of the COVID-19 pandemic, and associated psychological and behavioural factors. It also compares the results with a similar cross-sectional study in the UK.

DESIGN

Cross-sectional study.

SETTING

NZ community cohort.

PARTICIPANTS

N=681 adults (≥18 years) in NZ. The cohort was predominantly female (89%) with a mean age of 42 years (range 18-87). Most (74%) identified as NZ European and almost half (46%) were keyworkers. Most were non-smokers (95%) and 20% identified themselves as having clinical risk factors which would put them at increased or greatest risk of COVID-19.

MAIN OUTCOME MEASURES

Depression, anxiety, stress, positive mood and engagement in health behaviours (smoking, exercise, alcohol consumption).

RESULTS

Depression and anxiety significantly exceeded population norms (p<0.0001). Being younger (p<0.0001) and most at risk of COVID-19 (p<0.05) were associated with greater depression, anxiety and stress. Greater positive mood, lower loneliness and greater exercise were protective factors for all outcomes (p<0.0001). Smoking (p=0.037) and alcohol consumption (p<0.05) were associated with increased anxiety. Pet ownership was associated with lower depression (p=0.006) and anxiety (p=0.008). When adjusting for age and gender differences, anxiety (p=0.002) and stress (p=0.007) were significantly lower in NZ than in the UK. The NZ sample reported lower perceived risk (p<0.0001) and worry about COVID-19 (p<0.0001) than the UK sample.

CONCLUSIONS

The NZ population had higher depression and anxiety compared with population norms. Younger people and those most at risk of COVID-19 reported poorer mental health. Interventions should promote frequent exercise, and reduce loneliness and unhealthy behaviours.

Impact of Coronavirus Disease 2019 (COVID-19) Outbreak Quarantine, Isolation, and Lockdown Policies on Mental Health and Suicide

The novel coronavirus disease (COVID-19) pandemic has made a huge impact on people's physical and mental health, and it remains a cause of death for many all over the world. To prevent the spread of coronavirus infection, different types of public health measures (social isolation, quarantine, lockdowns, and curfews) have been imposed by governments. However, mental health experts warn that the prolonged lockdown, quarantine, or isolation will create a "second pandemic" with severe mental health issues and suicides. The quarantined or isolated people may suffer from various issues such as physical inactivity, mental health, economic and social problems. As with the SARS outbreak in 2003, many suicide cases have been reported in connection with this current COVID-19 pandemic lockdown due to various factors such as social stigma, alcohol withdrawal syndrome, fear of COVID infection, loneliness, and other mental health issues. This paper provides an overview of risk factors that can cause suicide and outlines possible solutions to prevent suicide in this current COVID-19 pandemic.

Health and Well-Being of Athletes During the Coronavirus Pandemic: A Scoping Review

Background: The ongoing global pandemic has become the world's leading health problem, causing massive public fear and concern. Reports suggest that athletes are seeking mental health support, showing the pressures of boredom, and tension associated with their anticipated social isolation. The current study seeks to evaluate the evidence regarding the effects of the coronavirus pandemic on occupational stress in professional athletes. Method: A scoping review was conducted. A comprehensive search involving Embase and PubMed databases was conducted using a combination of the following key words: COVID-19, SARS-CoV-2, coronavirus, and athletes. In this study, articles were retained if they were original studies reporting on the impact of the pandemic on professional athletes. Results: Nine studies were identified as they investigated the impact of the pandemic on athletes. Most were observational and cross-sectional, and one was longitudinal. Outcome measures mainly investigated were level of depression, anxiety, and stress. Dependent variables were physical activity, nutrition, mental state, sleep quality, individual well-being, social identity, exclusivity, negative affectivity, alcohol consumption, psychological distress, and gambling habits. Conclusions: This review highlights the need for proactive engagement with professional athletes, coaches, trainers, and sports councils to facilitate understanding and awareness-raising, process optimization, and delivery of consistent training and psychosocial aid and occupational therapy programs that maintain the health and well-being of athletes while minimizing occupational stress during a pandemic.

The Effect of Progressive Dynamic Balance Training on Physical Function, The Ability to Balance and Quality of Life Among Elderly Women Who Underwent a Total Knee Arthroplasty: A Double-Blind Randomized Control Trial

Total knee arthroplasty (TKA) is used to treat end-stage osteoarthritis. However, this surgical procedure affects the mechanical receptor function and impairs the ability to balance. Dynamic balance training has been reported to improve stability and self-confidence and safely yield increased physical activity. This study aimed to investigate the effect of dynamic balance training on physical function, the ability to balance and quality of life among patients who underwent TKA. Thirty-eight participants were assigned to either the progressive dynamic balance training (PDBT) with physical therapy group (n = 19) or the control group (n = 19). The experimental group undertook a dynamic balance program with physical therapy for 30 minutes per day, five times per week for six weeks, while the control group undertook physical therapy only. A continuous passive motion exercise was performed for 20 minutes after training by both groups. The outcomes were evaluated using the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index, pain pressure threshold (PPT), range of motion (ROM), Knee Outcome Survey-Activities of Daily Living (KOS-ADLS), Multifunction Force Measuring Plate, timed up and go (TUG) test and Short-Form Health Survey 36 (SF-36). Physical function (WOMAC Osteoarthritis Index, ROM and KOS-ADLS score) and the ability to balance (TUG test score, confidence ellipse area, path length and average velocity) significantly improved (p < 0.05) in the experimental group compared with the control group. In contrast, the physical component summary score for the SF-36 regarding quality of life significantly improved (p < 0.05); however, the mental component summary score for the SF-36 and PPT did not significantly differ between the groups. Therefore, we suggest that PDBT with physical therapy has positive effects on physical function, the ability to balance and quality of life among patients who underwent TKA.

What Lies Beneath: Exploring Different Depressive Symptoms Across Selected Risk Factors in Icelandic Team Sport Athletes

The aim of the study was to explore the prevalence of specific symptoms of depression in athletes and to test differences in the likelihood of athletes exhibiting these symptoms across age, sex, type of team sport, and level of competition. A sample of Icelandic male and female team sport athletes (N = 894, 18–42 years) was included in the study. Of the athletes exhibiting clinically significant depressive symptoms on the Patient Health Questionnaire-9, 37.5% did not exhibit core symptoms of depression. Compared with males, females were significantly more likely to exhibit depressed mood, feelings of worthlessness/guilt, and problems with sleep, fatigue, appetite, and concentration. Within males, differences were mostly related to neurovegetative aspects of depression (sleep and appetite), whereas in females, differences were related to cognitive/emotional aspects (e.g., depressed mood, guilt/worthlessness). The findings underline the importance of exploring specific symptoms of depression to provide a richer understanding of depressive symptomology in athletes.

Prevalence and Risk Factors Associated With Self-reported Psychological Distress Among Children and Adolescents During the COVID-19 Pandemic in China

IMPORTANCE

Schools have been suspended nationwide in 188 countries, and classes have shifted to home-based distance learning models to control the spread of the coronavirus disease 2019 (COVID-19) pandemic. Additional information is needed to determine mental health status among school-aged children and adolescents during this public health crisis and the risk factors associated with psychological distress during the pandemic.

OBJECTIVE

To assess self-reported psychological distress among school-aged children and adolescents associated with the COVID-19 pandemic.

DESIGN, SETTING, AND PARTICIPANTS

This cross-sectional study using data from a survey on the mental health of school-aged children and adolescents in Guangdong province, China, conducted by using a stratified cluster random sampling method between March 8 to 30, 2020. To estimate outcomes associated with location of districts, only data from students with internet protocol addresses and current addresses in Guangdong were included. Data were analyzed from April 5 to July 20, 2020.

EXPOSURE

Home-based distance learning during the COVID-19 pandemic.

MAIN OUTCOME AND MEASURES

The main outcome was self-reported psychological distress, measured using the total score on the 12-item General Health Questionnaire of 3 or greater. Multivariate logistic regression was used to analyze risk factors associated with mental health status. Odds ratios (ORs) were used to analyze the associations of factors with psychological distress.

RESULTS

Among 1 310 600 students who completed the survey, 1 199 320 students (mean [SD] age, 12.04 [3.01] years; 619 144 [51.6%] boys) were included in the final analysis. A total of 126 355 students (10.5%) self-reported psychological distress. Compared with students in primary school, high school students had increased risk of psychological distress (OR, 1.19 [95% CI, 1.15-1.23]). Compared with students who wore a face mask frequently, students who never wore a face mask had increased risk of psychological distress (OR, 2.59 [95% CI, 2.41-2.79]). Additionally, students who spent less than 0.5 hours exercising had increased odds of self-reported psychological distress compared with students who spent more than 1 hour exercising (OR, 1.64 [95% CI, 1.61-1.67]).

CONCLUSIONS AND RELEVANCE

These findings suggest that the prevalence of self-reported psychological distress among students during the COVID-19 pandemic was relatively high. Frequency of wearing a face mask and time spent exercising were factors associated with mental health. Therefore, it may be necessary for governments, schools, and families to pay attention to the mental health of school-aged children and adolescents during the COVID-19 pandemic and take corresponding countermeasures to reduce the impact of the COVID-19 pandemic on students' mental health.

Self care practices and psychological distress among diabetic patients in Manipur during COVID-19: A scenario from the North East

BACKGROUND AND AIM

Uncontrolled diabetes has emerged as one of the major risk factors for mortality in patients with coronavirus disease (COVID-19). Physical inactivity, alterations in dietary habits, and inability to seek guidance from the physician are some of the contributing factors. This study aims to assess the self-care practices and psychological distress during the pandemic among diabetic patients visiting the institute's out patient department.

METHOD

A convenient sampling method was used to recruit subjects from a representative clinical sample using validated scales like the Summary of Diabetes Self-Care Activities (SDSCA) and Kessler Psychological Distress Scale (K10).

RESULT

The study enrolled a total of 108 subjects with the mean age being 56.3 years. The everyday healthy eating plan was followed by 76.85% (N = 83) subjects and daily physical activity for at least 30 min performed by 50% (54) subjects. Only 12.04% (13) subjects tested their blood sugar and 6.48% (7) respondents checked their feet daily. There was no significant difference found between the SDSCA and psychological distress based on socio-demographic variables.

CONCLUSION

Participants in this study typically reported a good level of self-care behavior particularly for diet followed by exercise whereas the self-care behavior was not adequate for foot care and blood-glucose testing. People were not too anxious about COVID-19. This study highlighted the fact that people with diabetes should monitor their blood sugar levels more often along with their foot care.

Effect of physical activity on mental wellbeing among teachers of secondary school in Almadina city, Saudi Arabia

Background:

Physical activity has many beneficial effects on mental health. Benefit of physical activity appears proportional to the amount of activity rather than the intensity of physical activity.

Objectives:

The aim of this study was to assess the effect of physical activity on mental wellbeing of teachers of secondary school in Almadina city- 2019.

Subjects and Methods:

A descriptive cross sectional study was applied among a representative multi-stage random sample of secondary school teachers in Almadina. Two validated questionnaires, in addition to personal data were utilized to collect data; Short-form International Physical Activity Questionnaire (IPAQ) version 2.0 to evaluate physical activity and the Warwick-Edinburg Mental Wellbeing Scale (WEMWBS) to assess mental wellbeing both in Arabic language.

Results:

The study included 230 teachers. Their age ranged between 27 and 59 years with a mean ± (SD) of 39.4 (±7.6) years. Almost half of them were males (50.4%). Most of the teachers were either overweight (30%) or obese (40.9%). Almost half of teachers (48.3%) reported moderate level of physical activity whereas only 9.1% reported high level. Low level of physical activity was mentioned by 42.6% of the respondents. There was no significant difference between male and female teachers regarding physical activity level. The association between level of physical activity and body mass index was statistically significant, P < 0.001. Majority of the teachers expressed high mental wellbeing level while only 3.5% of them had low level of mental wellbeing. High level of mental well-being was observed among 95.6% of females compared to 85.3% of males, P = 0.008. There was a statistically significant positive association between levels of physical activity and mental well-being among teachers (P = 0.002).

Conclusion:

Level of practicing physical activities among secondary school teachers in Almadina is suboptimal, with no gender difference. Majority of the teachers have high mental well-being, particularly females. There is a positive association between levels of physical activity and mental wellbeing among teachers.

Insights Gained in the Aftermath of the COVID-19 Pandemic: A Follow-Up Survey of a Recreational Training Program, Focusing on Sense of Coherence and Sleep Quality

The original aim of this study was a follow-up assessment of a recreational program running for six months (September 2019-February 2020) within controlled conditions. Following the arrival of the COVID-19 pandemic, the survey acquired a new goal: how do the subjects of the follow-up sampling experience this severe stress situation, and in this experience, what role does physical activity and a salutogenetic sense of coherence play. Austrian women (N = 53) took part in the training program, whose physical condition was assessed before the start of the program, then reassessed after three months and after six months; the organizers also had them fill out the sense of coherence questionnaire (SOC) as well as the Regensburger insomnia scale. After the lifting of the lockdown introduced due to the pandemic, participants completed an online survey relating to their changed life conditions, physical activities, sense of coherence and sleep quality. Results: After the first three months of the training, no significant changes were detected. After six months, the participants SOC and sleep quality improved (Friedman test: p = 0.005 and p < 0.001). During the lockdown, sleep quality generally deteriorated (W-rank test: p = 0.001), while SOC did not change. The women in possession of a relatively stronger SOC continued the training (OR = 3.6, CI 95% = 1.2-12.2), and their sleep quality deteriorated to a lesser degree. (OR = 1.7, CI 95% = 1.1-2.8). Conclusion: The data reinforce the interdependency between physical exercise (PE) and SOC; furthermore, the personal training that the authors formulated for middle-aged women proved to be successful in strengthening their sense of coherence, and it also reduced the deterioration in sleep quality due to stress.

Effects of kettlebell training and detraining on mood status and sleep and life quality of healthy women

BACKGROUND AND PURPOSE

Kettlebell exercise have become popular because of its ability to simultaneously train aerobic/anaerobic systems, low cost and easy access, and the great potential for physical fitness programs with a focus on public health. However, little is known about its effects on mood status, sleep, and quality of life (QOL) parameters. The aim of the present study was to examine the effects of kettlebell training/detraining on the prevention of depressive and anxiety symptoms and QOL and sleep quality.

METHODS

The sample was composed of 17 healthy women (age: 26.0 ± 5.0 years; body mass: 60.9 ± 12.5 kg; height: 164.6 ± 5.5 cm). The study was organized into four consecutive phases: pre-intervention (PRE), intervention (kettlebell training, 12 weeks, three times/week), post-intervention (POST) and detraining (D, four weeks). The questionnaires SF-36 (QOL), Beck (depressive symptoms), State-Anxiety Inventory (acute anxiety symptoms), POMS (mood state) and the Pittsburgh Sleep Quality Index (sleep quality) were administered at PRE/POST/D phases.

RESULTS

QOL, anxiety, sleep quality, and mood state exhibited no differences between PRE/POST/D. Levels of depressive symptoms significantly decreased (22.0%, p = 0.003) between PRE and POST phases, and remained low and similar to POST levels after D.

CONCLUSION

Twelve weeks of kettlebell training was able to reduce and prevent depressive/anxiety symptoms in healthy women and these results were maintained after short-term detraining. Thus, kettlebell training might be considered an alternative method on the promotion of mental health and prevention of mood disorders and consequently can improve QOL even in health people.

Sleep Duration, Sleep Quality and Physical Activity, but Not Sedentary Behaviour, Are Associated with Positive Mental Health in a Multi-Ethnic Asian Population: A Cross-Sectional Evaluation

BACKGROUND

We assessed the associations of sleep, physical activity and sedentary behaviour with positive mental health (PMH) in the multi-ethnic population of Singapore.

METHODS

The Singapore Health 2 study is a nationally representative cross-sectional survey among residents aged 18-79 years. A PMH instrument was administered to 1925 participants to obtain total PMH and six sub-component scores. Self-rated sleep duration, sleep quality, sedentary behaviour and physical activity were assessed. Multivariable linear regression analyses were conducted.

RESULTS

The mean age of the participants was 40.1 (SD 14.3) years. Sleep duration (≥8 h/night: β = 0.17,95% CI: 0.02-0.32; 7-< 8 h/night: β = 0.17,95% CI: 0.03-0.30 versus <6 h/night, p = 0.002), sleep quality (very good: β = 0.45,95% CI: 0.29-0.60; fairly good: β = 0.20,95% CI: 0.06-0.33 versus very/fairly bad; ptrend < 0.001) and physical activity (high: β = 0.19,95% CI: 0.05-0.32; moderate: β = 0.15, 95% CI: 0.03-0.27 versus low; ptrend < 0.001) were directly associated with total PMH. Sedentary behaviour was not significantly associated with PMH. Sleep duration, sleep quality and physical activity were directly associated with the PMH sub-components 'emotional support' and 'personal growth and autonomy'.

CONCLUSIONS

Duration and quality of sleep and physical activity were directly associated with PMH in an urban Asian population. These findings support incorporating sleep and physical activity interventions to improve population mental health.

A systematic review of the effectiveness of group-based exercise interventions for individuals with first episode psychosis

BACKGROUND

Treating first episode psychosis represents a critical time to improve the trajectory of people's physical health, mental health, functioning, and quality of life. Individuals should be offered a variety of evidence-based interventions to promote physical activity and social connectedness. This review aimed to establish the effectiveness of group-based exercise interventions for improving outcomes in people with first episode psychosis.

METHOD

We undertook a systematic review of the following databases; Medline (Ovid), PsycINFO (Ovid), Embase (Ovid) and CINAHL, to identify studies in first episode psychosis populations that implemented a group-based exercise intervention and examined outcomes in physical health, mental health or functioning and quality of life.

RESULTS

From 1431 studies screened, five met our inclusion criteria. Whilst group-based exercise interventions did not have a significant impact on physical health, there was a significant effect on psychiatric symptomatology, quality of life and functioning (including cognition). The overall risk of bias was high.

CONCLUSIONS

Group-based exercise interventions may be feasible and acceptable in first episode psychosis populations. However, more, high quality research is required to understand the best mode of delivery of exercise interventions to maximise patient outcomes and optimise patient contact with services using an engaging and cost-effective approach.

Evaluation of Psychophysical Factors in Individuals with Frailty Syndrome Following a 3-Month Controlled Physical Activity Program

Background: The aim of the study was to compare the emotional state and strength-velocity parameters of patients with frailty and pre-frailty syndrome undertaking a 12-week training programme. Methods: The study was completed by 36 individuals, including 17 with frailty syndrome (FS) and 19 with pre-frailty syndrome (PFS). The age of the subjects ranged from 63 to 89 years, with a mean 69.2 years (±5.0). The Beck Depression Inventory (BDI), Spielberg’s State-Trait Anxiety Inventory (STAI), and Satisfaction with Life Scale (SWLS) were used. The strength of knee muscles was evaluated. The above tests were conducted at two time points: before the training sessions (T1); and after 12 weeks of regular training sessions (T2). Results: After completion of the training programme, statistically significant differences in BDI were observed between the PFS and FS groups (especially in somatic symptoms). Following the training, BDI values in the PFS group were significantly lower (fewer depressive symptoms) than in the FS group. The parameter values describing strength capacities of the lower limbs, both at T1 and T2, proved to be higher in the PFS group. Conclusions: In individuals with pre-frailty and frailty syndrome, the 3-month physical training programme improved the strength parameters of lower limb muscles. An improvement in mood and reduction in depressive symptoms were only observed in the group of subjects with pre-frailty syndrome. Rehabilitation programmes for people with frailty syndrome should include psychotherapeutic activities in addition to physical training in order to improve the psychophysical condition of patients.

Association between Physical Activity and Mood States of Children and Adolescents in Social Isolation during the COVID-19 Epidemic

The COVID-19 epidemic adversely affects the lifestyle of people. This study aimed to examine the impacts of social isolation on physical activity (PA) levels and mood states of children and adolescents and to explore the correlation between them during the COVID-19 epidemic. A total of 9979 children and adolescents (11.63 ± 1.23 years old) from Yan’an, China volunteered to participate in this study and completed online questionnaires. PA and mood states were measured by International Physical Activity Questionnaire Short Form (IPAQ-SF) and Profile of Mood States (POMS), respectively. The results showed that the mean of students’ moderate-to-vigorous PA (MVPA) was 23.19 min per day. The total mood disturbance in the moderate and high-level PA groups were significantly lower than those in the low-level PA group (p < 0.05). Additionally, boys and girls had significant differences in PA levels (p < 0.01), and the PA levels of students in different grades were also significantly different (p < 0.01). Meanwhile, boys’ mood states were worse than girls’. The Grade 4 in primary schools had the worst mood states while Grade 5 had the best mood states. The results suggested that the MVPA of students has dropped badly, compared with the results of previous studies investigated in normal times. In addition, the PA level had a significantly positive impact on the mood states of children and adolescents during the COVID-19 epidemic. Sex and grades were factors which affected the PA levels and mood states. This study can help policymakers and healthcare professionals understand PA and mood states of Chinese children and adolescents during the epidemic. We should pay attention to the changes in PA levels and mood states of children and adolescents.

Association Pathways Between Neighborhood Greenspaces and the Physical and Mental Health of Older Adults-A Cross-Sectional Study in Guangzhou, China

According to the United Nations, the proportion of the older population is increasing at a faster rate than all other age groups. Hence, the well-being of older adults is a mounting concern worldwide in the current century. Using a single greenery metric, previous studies linked greenness to residents' well-being. This study aims to extend this field by focusing on the mental and physical well-being of older adults by using remote sensing and streetscape metrics in evaluating neighborhood greenness. We selected 20 residential neighborhoods in Guangzhou City, China as the cross-sectional case study areas. We investigated neighborhood normalized difference vegetation index (NDVI) collected using remote sensing images, streetscape greenery, and PM2.5 via field surveys. We assessed the health condition of 972 senior residents selected by multi-stage stratified probability proportionate to population size sampling technique (PPS) using a questionnaire survey. We adopted the structural equation model (SEM) in analyzing the pathways that link neighborhood greenness and the mental and physical health of older adults. We found that neighborhood greenness has a positive association with the physical activity by older adults that is positively linked to their physical health. Moreover, neighborhood greenness is positively related to regular social interactions among older adults that is positively linked to their mental health. These findings are consistent with those of previous studies. However, we obtained new results that were unique to China. We found that neighborhood greenness has no significant direct relationship with the physical and mental health of older adults and that social interactions of low-income senior groups are more substantially related to neighborhood greenness than the other groups. Therefore, community planning should emphasize the development of neighborhood greenness, such as parks and street trees, to provide natural spaces for social interactions and places for physical activities among older residents.

Brain and muscle adaptation to high-fat diets and exercise: Metabolic transporters, enzymes and substrates in the rat cortex and muscle

There is evidence suggesting that the effects of diet and physical activity on physical and mental well-being are the result of altered metabolic profiles. Though the central and peripheral systems work in tandem, the interactions between peripheral and central changes that lead to these altered states of well-being remains elusive. We measured changes in the metabolic profile of brain (cortex) and muscle (soleus and plantaris) tissue in rats following 5-weeks of treadmill exercise and/or a high-fat diet to evaluate peripheral and central interactions as well as identify any common adaptive mechanisms. To characterize changes in metabolic profiles, we measured relative changes in key metabolic enzymes (COX IV, hexokinase, LDHB, PFK), substrates (BHB, FFA, glucose, lactate, insulin, glycogen, BDNF) and transporters (MCT1, MCT2, MCT4, GLUT1, GLUT3). In the cortex, there was an increase in MCT1 and a decrease in glycogen following the high-fat diet, suggesting an increased reliance on monocarboxylates. Muscle changes were dependent muscle type. Within the plantaris, a high-fat diet increased the oxidative capacity of the muscle likely supported by increased glycolysis, whereas exercise increased the oxidative capacity of the muscle likely supported via increased glycogen synthesis. There was no effect of diet on soleus measurements, but exercise increased its oxidative capacity likely fueled by endogenous and exogenous monocarboxylates. For both the plantaris and soleus, combining exercise training and high-fat diet mediated results, resulting in a middling effect. Together, these results indicate the variable adaptions of two main metabolic pathways: glycolysis and oxidative phosphorylation. The results also suggest a dynamic relationship between the brain and body.

COVID-19 and Type 1 Diabetes: Concerns and Challenges

Due to the current COVID-19 pandemic, worldwide population's lifestyle has changed dramatically, causing psychosocial consequences.  Patients presenting a preexisting chronic condition, as Type 1 Diabetes (T1D), are the ones suffering the most from this situation. Moreover, people affected by diabetes are the ones with the worst prognosis, if infected by SARS-CoV-2.  We analyzed why patients with T1D were poorly represented between the subjects hospitalized for COVID-19 and why the cases of diabetic ketoacidosis (DKA) were fewer and more severe compared with the past years. Furthermore, literature has showed how patients of all ages with T1D did not experience a deterioration in their glucose control throughout the lockdown. Among other causes, this is also due to the surging use of telemedicine. Finally, we tried to understand how the coronavirus tropism for endocrine tissues could influence the future epidemiology of T1D, focusing on the effects they have on pancreatic β-cells.

Me, Myself, and My Thoughts: The Influence of Brooding and Reflective Rumination on Depressive Symptoms in Athletes in the United Kingdom

Individual differences in vulnerability to depression are still underexplored in athletes. We tested the influence of different brooding and reflective rumination profiles (i.e., repetitive thought processes in response to low/depressed mood) on the odds of experiencing clinically relevant depressive symptoms in competitive athletes (N = 286). The Patient Health Questionnaire–9 and the Ruminative Responses Scale–short form were utilized to measure depression and rumination, respectively. Compared to athletes with a low brooding/reflection profile, athletes with a high brooding/reflection profile had significantly higher odds of experiencing clinical levels of depressive symptoms (OR = 13.40, 95% CI = 3.81–47.11). A high reflection/low brooding profile was not, however, related to increased odds of depressive symptoms. Future research could extend our findings by exploring determinants of ruminative tendencies, especially brooding, in athletes. Furthermore, psychological interventions targeting rumination could be examined as a potential prevention and treatment approach to tackling depressive symptoms in athletes.

COVID-19 and type 1 diabetes: dealing with the difficult duo

Background

Coronavirus disease 2019 (COVID-19) has aroused global health concerns, particularly in relation to diabetes where it has been associated with poorer outcomes. The bulk of the evolving evidence in diabetes and COVID-19 relates to type 2 diabetes (T2D). Since there are a significant number of patients with type 1 diabetes (T1D) with unique concerns and challenges during the ongoing COVID-19 pandemic, we reviewed existing literature, relevant websites, and related guidelines to form this narrative review to help address key questions in this area.

Methods

We systematically searched the PubMed database up to May 31, 2020, and retrieved all the articles published on T1D and COVID-19.

Results

We found 18 relevant articles, each of which carried a part of the evidence regarding the risk of contracting COVID-19 in patients with T1D, effect of COVID-19 on development of T1D, outcomes in T1D with COVID-19, and special management issues in T1D in the light of COVID-19. These have been documented in the present review.

Conclusion

COVID-19 with T1D presents special challenges. While the available evidence does shed some light, we need more evidence to deal with this difficult duo.

COVID-19 Outbreak and Physical Activity in the Italian Population: A Cross-Sectional Analysis of the Underlying Psychosocial Mechanisms

Italy is one of the first European epicenters of the COVID-19 pandemic. In attempts to hinder the spread of the novel coronavirus disease, Italian government hardened protective measures, from quarantine to lockdown, impacting millions of lives dramatically. Amongst the enacted restrictions, all non-essential activities were prohibited as well as all outdoor activities banned. However, at the first spur of the outbreak, for about a dozen of days, physical and sports activities were permitted, while maintaining social distancing. In this timeframe, by administering measures coming from self-determination theory and theory of planned behavior and anxiety state, in an integrated approach, we investigated the prevalence of these activities by testing, via a Structural Equation Model, the influence of such psychosocial variables on the intention to preserve physical fitness during the healthcare emergency. Through an adequate fit of the hypothesized model and a multi-group analysis, we compared the most COVID-19 hit Italian region - Lombardy - to the rest of Italy, finding that anxiety was significantly higher in the Lombardy region than the rest of the country. In addition, anxiety negatively influenced the intention to do physical activity. Giving the potential deleterious effects of physical inactivity due to personal restrictions, these data may increase preparedness of public health measures and attractiveness of recommendations, including on the beneficial effects of exercise, under circumstances of social distancing to control an outbreak of a novel infectious disease.

Making 'us' better: High-quality athlete leadership relates to health and burnout in professional Australian football teams

Overtraining, exhaustion, and burnout are widely recognized problems amongst elite athletes. The present research addresses this issue by exploring the extent to which high-quality athlete leadership is associated with elite athletes' health and burnout. Participants (120 male athletes from three top-division Australian football teams) were asked to rate the quality of each of their teammates in four different leadership roles (i.e. as task and motivational leaders on the field and as social and external leaders off the field), and also to indicate their identification with their team as well as their self-reported health and burnout. Findings indicated that (a) being seen to be a good athlete leader by other members of the team and (b) having a good athlete leader on the team were both positively associated with better team member health and lower burnout. This relationship was mediated by athletes' identification with their team, suggesting that leaders enhance athletes' health and reduce athlete burnout by creating and maintaining a sense of shared identity in their team. This, in turn, suggests that coaches can foster an optimal team environment by developing the leadership potential of their athlete leaders - in particular, their skills that foster a sense of shared team identification. This is in the interests not only of team performance but also of team members' health and burnout.

Association Between Current Physical Activity and Current Perceived Anxiety and Mood in the Initial Phase of COVID-19 Confinement

The World Health Organization (WHO) has declared a world pandemic due to COVID-19, and several enacted measures such as compulsory confinement may have collateral consequences on both physical and mental health. We aimed to investigate associations between current physical activity (PA) and current perceived anxiety and mood among a sample of Spanish adults confined due to COVID-19 restrictions of movement. Using an online survey, we collected data on the Spanish adult population regarding health habits during the first days of enacted confinement. A total of 2250 participants (54.8% women) aged 35.3 (SD 13.6) completed the survey, which included questions about sociodemographic characteristics (i.e. age, gender, civil status, education, and occupation), health habits (i.e. prior PA, alcohol consumption, smoking, screen exposure, and sleep hours) and COVID-19 confinement context (i.e. number of isolation days, solitude, and exposure to COVID-19). Physical Activity Vital Sign (PAVS) short form was used to estimate weekly minutes of PA, whereas a single-item question was used to assess both current perceived anxiety and mood. We conducted weighted binomial logistic regressions to check associations between current adherence to WHO guidelines of PA and current perceived anxiety and mood of confined adults. Significant inverse associations between overall adherence to PA and current perceived anxiety in the final adjusted model (OR, 0.66; 95% CI, 0.54-0.79) as well as in several subgroup analyses such as younger women were observed. In addition, a borderline significant inverse association was found between current PA and current perceived worse mood when fully adjusted (OR, 0.82; 95% CI, 0.68-1.00); this association was significantly stronger in women than men. The results of the present study indicate that current PA adherence to WHO guidelines in the initial phase of COVID-19 confinement associates with both lower current perceived anxiety and lower current perceived worse mood among a sample of Spanish adults.

Everyday bodily movement is associated with creativity independently from active positive affect: a Bayesian mediation analysis approach

Previous (predominantly) laboratory studies reported positive relations of physical activity (or everyday bodily movement) with executive functioning, some even showed effects on creative thinking. Furthermore, positive-activated affect was found to be positively associated with everyday bodily movements and creativity. The mechanisms, however, underlying these relationships are poorly understood. The aim of this study was twofold: Firstly, we investigated whether everyday bodily movement was associated with creative performance. Secondly, we examined if positive-activated affect may mediate the association between bodily movement and creative performance. In a sample of 79 participants everyday bodily movement was recorded during five consecutive days using accelerometers. Creativity in the figural and verbal domain was assessed with performance tests, along with self-reported positive-activated affect as a trait. Findings revealed that creativity, positive-activated affect, and everyday bodily movement were associated with each other. However, positive-activated affect did not mediate the association between everyday bodily movement and creative performance. The pattern of findings argues for shared variance between bodily movement and creativity (fluency and originality) that is largely independent from variations in positive-activated affect.

Relationship between different domains of physical activity and positive mental health among young adult men

Background

There is growing evidence on positive effects of physical activity (PA) on mental health. However, the focus of previous research on this relationship has typically been on mental health from the perspective of mental health problems rather than from the perspective of mental wellbeing. Further, previous research has commonly focused rather on leisure time PA without evidence on the role of other domains of PA. The aim of the present cross-sectional study was to investigate the relationship between positive mental health (PMH) and different domains of PA in young Finnish men. The secondary aim was to examine the reasons for physical inactivity among individuals with a low level of PMH.

Methods

Positive mental health (measured with Short Warwick-Edinburgh Mental Wellbeing Scale, SWEMWBS), self-reported leisure time, occupational and commuting PA as well as reasons for physical inactivity were measured using questionnaires (n = 456, mean age 29 years) among young Finnish males. Logistic regression modelling was used to generate odds for low and high levels of positive mental health for different levels of PA and sociodemographic variables.

Results

A weak positive association between leisure time PA and PMH was found in men with a low level of PMH (OR = 0.33, 95% CI 0.13–0.86). No association was found in the domains of commuting and occupational PA. Multivariate logistic regression analysis showed lower level of leisure time PA, unemployment and being single independently predicting low level of PMH. No associations were found between any domains of PA and high level of PMH. The most common reasons for physical inactivity among men with a low level of PMH were lack of interest (28%) and unwillingness to practise sports alone (27%).

Conclusions

The relationship between physical activity and positive mental health seems to vary between different domains of physical activity. The findings highlight the important role of leisure time physical activity, particularly in men with a low level of positive mental health. Strategies aimed at increasing physical activity for mental health benefits should focus particularly on providing opportunities for leisure time physical activity involving social interactions for men with lower mental wellbeing.