The protective role of exercise on stress system dysregulation and comorbidities

Maternal caregiving stress and metabolic health: Sexual activity as a potential buffer

Chronic stress lead to dysregulation of metabolic hormones, creating risk for obesity and type 2 diabetes. Based on previous work suggesting the potential for sexual activity to relieve psychological stress and reduce stress-related neuroendocrine activity, the present research explored sexual activity as a protective factor. We focused on chronic stress in the form of caregiving stress, comparing premenopausal mothers of a child with an autism spectrum disorder vs. a neurotypical child, in relation to metabolic hormones - insulin (and insulin resistance as assessed by HOMA), leptin, and ghrelin. Then, we explored the moderating role of sexual activity. Our results showed that high-stress mothers showed higher levels of insulin, insulin resistance, and lower levels of ghrelin compared to low-stress mothers. However, sexual activity modulated these associations such that among mothers who were sexually active (as coded from their daily diaries), no significant differences in these outcomes were observed between groups. This buffering effect of sexual activity was distinguishable from the buffering effect of physical activity and independent of global relationship satisfaction. Together, our findings provide novel evidence supporting the potential protective effects of sexual activity from chronic stress-related metabolic disease risk.

Physical exercise, social relationships, and bullying perpetration among school adolescents in China

Despite contradictory empirical evidence, some suggest that physical exercise is directly related to bullying perpetration. Moreover, the quality of social relationships between adolescents and their parents, peers, and teachers has been proposed as a crucial mediator in the relationship between physical exercise and bullying perpetration. However, few empirical studies have examined such hypotheses. This study used data obtained from the 2014-2015 China Education Panel Survey to examine the direct association between physical exercise and bullying behaviors, as well as the indirect pathways from physical exercise to bullying that are mediated by teenagers' social relationship quality. The results showed no significant direct relationship between physical exercise and bullying behaviors. However, physical exercise has indirect associations with bullying behaviors mediated through social relationship quality, with peer relationships having the strongest mediating effect. The findings indicate that social relationships could mediate the association between physical exercise and bullying behaviors. The study suggests that future prevention and intervention programs should promote adolescents' participation in physical exercise and their social interactions with parents, peers, and teachers to reduce bullying perpetration.

Multivariate variable selection in N-of-1 observational studies via additive Bayesian networks

An N-of-1 observational design characterizes associations among several variables over time in a single individual. Traditional statistical models recommended for experimental N-of-1 trials may not adequately model these observational relationships. We propose an additive Bayesian network using a generalized linear mixed-effects model for the local mean as a novel method for modeling each of these relationships in a data-driven manner. We validate our approach via simulation studies and apply it to a 12-month observational N-of-1 study exploring the impact of stress on daily exercise engagement. We demonstrate the improved performance of the additive Bayesian network to recover the underlying network structure. From the empirical study, we found statistically discernible associations between reports of stress and physical activity on a population level, but these associations may differ at an individual level.

Can sports participation be a protective factor against suicide-related outcomes in adolescents: a systematic review

Background

Suicide-related outcomes among adolescents have become a serious public health problem worldwide. Emerging evidence suggests that sports participation may interact with suicide-related outcomes. The objective of this systematic review is to systematically review and summarize the association between sports participation and suicide-related outcomes among adolescents.

Design

A systematic review according to PRISMA Statement (International Platform of Registered Systematic Review and Meta-Analysis Protocols registration: INPLASY202330072) https://inplasy.com/inplasy-2023-3-0072/.

Methods

The literature search was conducted in three electronic databases: Web of Science, PubMed, and EBSCOhost.

Results

A total of 16 studies (12 cross-sectional studies, 4 prospective studies) met the inclusion criteria were evaluated. Strong consistent evidence was found for the negative association between suicidal ideation, suicide attempts, and sports participation among adolescents. There was insufficient evidence to support consistency in the association between sports participation and suicide plans, and no evidence regarding gender differences between sports participation and these suicide-related outcomes. Furthermore, there was heterogeneity in the measures of sports participation and suicide-related outcomes across the included studies.

Conclusion

Evidence suggests that more sports participations are associated with lower suicidal ideation and suicide attempts in adolescents. However, the directionality of the observed associations should be examined based on more high-quality longitudinal studies in the future.

Leptin Increase During Dexamethasone and Its Association With Hunger and Fat in Pediatric Acute Lymphoblastic Leukemia

CONTEXT

During treatment, children with acute lymphoblastic leukemia (ALL) receive high doses dexamethasone, which induce acute side effects.

OBJECTIVE

To determine the influence of a 5-day dexamethasone course on changes in leptin, fat mass, BMI, hunger, sleep, and fatigue and to explore associations between these changes.

METHODS

Pediatric ALL patients were included during maintenance treatment. Data were collected before (T1) and after (T2) a 5-day dexamethasone course (6 mg/m2/day). At both time points, BMI, fat mass (bioelectrical impedance analysis), and leptin were assessed, as well as parent-reported questionnaires regarding hunger, fatigue, and sleep problems. Changes between T1 and T2 were assessed using paired tests. Correlation coefficients were calculated to assess associations between these changes (Delta scores: T2-T1). Univariable regression models were estimated to study associations between covariates and elevated leptin.

RESULTS

We included 105 children, with median age 5.4 years (range, 3.0-18.8). Leptin and fat mass, as well as hunger scores, fatigue, and sleep deteriorated after 5 days of dexamethasone (P < .001), in contrast to BMI (P = .12). No correlations between delta leptin and delta fat mass, BMI, hunger, fatigue, or sleep were found. Elevated leptin on T1 was associated with older age (odds ratio [OR] 1.51; 95% CI, 1.28-1.77), higher fat mass (OR 1.19; 95% CI, 1.07-1.33), and earlier maintenance week (OR 0.96; 95% CI, 0.92-0.99).

CONCLUSION

Five days of high-dose dexamethasone treatment led to direct and significant changes in leptin, hunger scores, and fat mass. Since children with ALL are at increased risk for metabolic adverse events, understanding underlying mechanisms is important, and a dexamethasone-induced state of acute leptin resistance might play a role.

Inflammation and Behavior Changes in Dogs and Cats

Sickness is a normal response to infections or stress triggered by proinflammatory cytokines that drive local and systemic inflammatory responses. Proinflammatory cytokines act on the brain causing the so called "sickness behavior,"which is thought to improve recovery but can become maladaptive in the long term. Chronic inflammation characterizes many diseases and there is some evidence that dogs and cats experience age-associated increases in inflammation, a condition named "inflammaging." A complex and multifactorial relationship exists between these inflammatory mechanisms, pain, and psychological illness that may complicate veterinary diagnosis and affect the outcome.

The Relationship Between Aggression and Physical Disease in Dogs

Aggression is a very common behavioral problem in dogs. Although aggression can be part of the normal behavior of dogs, medical conditions can either trigger aggression as in the case of intracranial tumors or aggravate an existing aggression problem as it happens with painful conditions. Therefore, it is essential to include an assessment of physical health in the diagnostic protocol of canine aggression.

Motivations and barriers to exercise among clinicians

According to Kirk & Rhodes (2011), Nooijen et al. (2018), and Saridi et al. (2019), the motivators and barriers to exercise are influenced by one's occupation, especially among those in the healthcare field. We sought to examine the barriers and motivators to physical activity that are distinctive to clinicians. Community hospital clinicians were surveyed regarding motivators and barriers to exercise that they experience, their burnout levels as described by an adaptation of the Mini-Z single item burnout scale, and average weekly exercise habits. The top barriers and motivators were then correlated to burnout levels, levels of physical activity, and demographics. We received 64 total responses from clinicians. The overall average level of burnout was 2.37 and the median level was 2. Approximately 38% of clinicians reported adhering to American Heart Association (AHA) guidelines of 150 minutes of exercise per week, while 33% of clinicians exercise <75 minutes per week. The top general motivator was for one's own well-being and the top clinician-related motivator was reducing stress. The top two barriers to exercise were COVID-19 concerns at an indoor exercise facility and a lack of time. Higher average levels of burnout were experienced by those who marked being too stressed or too burnt out as barriers to exercise. Because of clinicians' roles in propagating healthy practices in their patients from their own habits, wellness programs should be aimed at capitalizing motivators to combat barriers that this group distinctively experiences. Efforts to improve physical and mental wellness among clinicians will translate into better provider and patient health outcomes.

Affective reactions to real-life stressors and the role of physical activity in sports students - An Ambulatory Assessment study

Students are exposed to a variety of stressors that can negatively affect their health and performance. Using an Ambulatory Assessment approach, this study investigated whether and how positive affect (PA) and negative affect (NA) changed in response to real-life stressors in sports students. In addition, the study investigated how physical activity (PhyA) moderated affective reactions to stressors. 62 participants of a German university (m = 23, f = 38, d = 1; age: M = 21.55 years, SD = 2.47) reported their daily stressors, affective states and PhyA (context, intensity and duration) six times per day via smartphone over five days (30 prompts per participants). To test the hypotheses multilevel models were calculated. Stressor context predicted affective reactions. PA was lower and NA was higher when general (financial problems) or academic (exam periods) stressors were reported. General PhyA had a positive effect on sports students affect (higher PA, lower NA). However, when PhyA was performed in exercise classes within their study program and a stressor was reported, PA decreased. The results showed that certain stressors interact negatively with affective states. Furthermore, the results suggested that PhyA, depending on the context where it occurred, may also induce negative affective changes in this target group of sport students. More studies need to examine how PhyA moderates affective reactions to stressors and examine the influences of context specific PhyA (e.g., type of PhyA) in more detail.

The effect of mindfulness interventions on stress in medical students: A systematic review and meta-analysis

BACKGROUND

Medical students have high levels of stress, which is associated with higher incidents of burnout, depression, and suicide compared to age-matched peers. Mindfulness practices have been shown to reduce stress among medical students.

PURPOSE

The purpose of this systematic review and meta-analysis was to examine if mindfulness interventions have an overall effect on stress outcomes in the high-stress population of medical students globally, particularly given the wide variety of interventions. Any intervention designed to promote mindfulness was included.

METHODS

A comprehensive literature search was completed to include multiple databases, ancestry, and hand-searching and 35 studies were included. Standardized mean difference effect sizes (ES) were synthesized across studies using a random-effects model for changes in stress levels in medical students ≥ 18. Moderator analyses were performed to explore variations in effects by participant and intervention characteristics.

RESULTS

Mindfulness interventions significantly improved stress among medical students in both the two-arm studies (d = 0.370, k = 19, n = 2,199, 95% CI 0.239-0.501, p < .001) and one-arm pre-post studies (d = 0.291, k = 30, n = 18 (two cohorts from Dyrbye et al), 95% CI 0.127-0.455, p = 0.001). Moderator analyses found trends in less hours and less required practice resulted in better improvement in stress.

CONCLUSIONS

This study further confirms that despite a wide variety of mindfulness interventions for medical students around the world, they produce an overall small-to-moderate effect on stress reduction. Future research looking at the most effective protocols for high-stress medical students would be beneficial.

Effect of physical activity on attention in school-age children with ADHD: a systematic review and meta-analysis of randomized controlled trials

Background: Attention problems are one of the core symptoms of Attention-deficit/hyperactivity disorder (ADHD) in children. Previous studies have shown that physical activity intervention has a positive impact on executive function in children and adolescents with ADHD, but there is limited research on attention problems in school-aged children with ADHD. There are still uncertainties about the appropriate physical activity interventions to improve attention problems in this population. This study conducted a Meta-analysis of randomized controlled trials (RCTs) related to physical activity intervention for attention problems in school-aged children with ADHD, providing a certain reference for precise intervention in attention problems for this population. Methods: We systematically searched the following databases up to October 2022: PubMed, Embase, Web of Science, and Cochrane Library, to identify RCTs that investigated the effects of physical activity interventions on children with ADHD. Two investigators independently conducted literature screening, extraction, and quality assessment. We performed a meta-analysis using Stata 15.1. Results: In total, we included 10 studies in this meta-analysis. The results indicated that physical activity intervention had a moderate effect in improving attention problems in school-aged children with ADHD (SMD = -0.48, 95% CI: 0.85, -0.07, p < 0.05). Furthermore, subgroup analysis showed that the effect of physical activity intervention was moderated by intervention type, frequency, and period, rather than the physical activity environment or single intervention time. Conclusion: Our study suggests that cognitively engaging exercise is more effective in improving attention problems in school-aged children with ADHD. Specifically, when cognitive-engaging exercise is used as the type of physical activity and the intervention frequency is less than 3 times per week, with an intervention period of less than weeks, it is most beneficial for improving attention problems in school-aged children with ADHD. However, we should also consider individual differences in children with respect to their ADHD symptoms and accurately evaluate each child's specific symptoms before intervention. Systematic Review Registration: identifier (CRD42022363255).

Physical Activity and Cortisol Regulation: A Meta-Analysis

Physical activity participation is associated with effective stress coping, indicated by decreases in both physiological stress reactivity and perceived stress. Quantifying the effect of physical activity on the diurnal regulation of one key physiological stress indicator, the stress hormone, cortisol, across studies may demonstrate the extent to which physical activity participation is associated with diurnal HPA axis regulation. We meta-analyzed studies examining relations between physical activity participation and indices of HPA axis regulation: the diurnal cortisol slope and the cortisol awakening response. We also examined moderators of the relation. The analysis revealed a small, non-zero negative averaged correlation between physical activity and the diurnal cortisol slope (r = -0.043, 95% CI [-0.080, -0.004]). Examination of sample sociodemographic differences, study design characteristics, cortisol measurement methods, and physical activity variables as moderators revealed few effects on the relation between physical activity and diurnal cortisol slope. We did not observe lower levels of variability in the mean cortisol awakening response at higher levels of physical activity participation, and moderator analyses showed little evidence of reductions in heterogeneity for this effect. We found some evidence of systematic publication bias. Findings suggest higher physical activity is associated with a steeper diurnal cortisol slope. However, the cortisol awakening response did not differ by physical activity level. Future studies testing the physical activity and cortisol regulation association should use standardized physical activity measures, follow guidelines for better quality cortisol sampling collection and analysis, and test relations in large-scale empirical studies to confirm the direction and causality of the effect.

Physical exercise in asthma adolescents: a concept review

Background: Asthma is a frequent pathological condition during childhood and adolescence. Young asthmatics demonstrate decreased aptitude for physical activity and a limited exercise capacity. Lower hospitalisation rates, reduced school absenteeism, fewer medical examinations, and limited use of bronchodilators have been documented in children and adolescents with bronchial asthma who engage in physical exercise regularly. Structured physical exercise protocols should be encouraged as they can work as a synergistic therapeutic option in addition to regular pharmacologic treatment. This article outlines the most suitable exercise training techniques for young patients with bronchial asthma and their effects on health status.

Effects of neuromodulation on cognitive and emotional responses to psychosocial stressors in healthy humans

Physiological and psychological stressors can exert wide-ranging effects on the human brain and behavior. Research has improved understanding of how the sympatho-adreno-medullary (SAM) and hypothalamic-pituitary-adrenocortical (HPA) axes respond to stressors and the differential responses that occur depending on stressor type. Although the physiological function of SAM and HPA responses is to promote survival and safety, exaggerated psychobiological reactivity can occur in psychiatric disorders. Exaggerated reactivity may occur more for certain types of stressors, specifically, psychosocial stressors. Understanding stressor effects and how the body regulates these responses can provide insight into ways that psychobiological reactivity can be modulated. Non-invasive neuromodulation is one way that responding to stressors may be altered; research into these interventions may provide further insights into the brain circuits that modulate stress reactivity. This review focuses on the effects of acute psychosocial stressors and how neuromodulation might be effective in altering stress reactivity. Although considerable research into stress interventions focuses on treating pathology, it is imperative to first understand these mechanisms in non-clinical populations; therefore, this review will emphasize populations with no known pathology and consider how these results may translate to those with psychiatric pathologies.

Prevalence, characteristics and measurement of somatic symptoms related to mental health in medical students: a scoping review

INTRODUCTION

Somatic symptoms related to mental health in medical students are under-researched, with nothing on the topic being published in the United States in over three decades. This scoping review is the first of its kind to explore the prevalence, type and severity of somatic symptoms induced by stress, anxiety, depression and burnout amongst medical students, with the objective of describing the significance and breadth of this issue.

METHODS

PRISMA-ScR guidelines were used to guide this review. A comprehensive search was performed of 22 databases, followed by bibliographic and hand searching. Inclusion criteria were published, peer-reviewed articles with a sample of medical students and at least one measure of somatic symptoms related to mental health, in English or with an English-language translation. Excluded were review, companion and editorial articles. Coding was done by an experienced coder trained in systematic review techniques. Two authors reviewed each article.

RESULTS

Twenty-nine articles met inclusion criteria, representing 16 countries, 31 schools/teaching hospitals and 9,887 medical students. The prevalence of somatic symptoms ranged from 5.7 to 80.1%, and somatic symptoms were overwhelmingly found to be significantly correlated with mental ill-health. Somatic symptoms included back pain, neck pain, headaches, sleep disturbances and functional gastrointestinal disorders. Eleven different outcome measures were used, with varying degrees of validity and reliability, which were compared and assessed.

CONCLUSIONS

Somatic symptoms appear strongly correlated with mental ill-health in medical students, and are likely highly prevalent. This review highlights the need for further research on somatic symptoms of mental ill-health in medical students, particularly in the United States, and the addition of larger, multi-institutional cohorts to expand our understanding of prevalence, incidence and inciting factors of somatic symptoms. Longitudinal studies tracking somatic symptoms' effect on career trajectory and professional burnout levels are also needed. Finally, future research should explore interventions for reducing physical symptom burden in medical students.

Changes in health behaviors and conditions during COVID-19 pandemic strict campus lockdown among Chinese university students

Objective

To explore how a stringent campus lockdown affects the physical activity (PA), sleep and mental health of Chinese university students living in student dormitories during the COVID-19 pandemic.

Methods

Data on PA, sleep and mental health were collected between 24 March and 4 April 2022 from 2084 university students (mean age = 22.4 years, 61.1% male students) via an online questionnaire distributed by the students’ advisers of each dormitory. The Chinese short version of the International Physical Activity Questionnaire (IPAQ-C), Athens Insomnia Scale (CAIS) and General Health Questionnaire 12-item (GHQ-12) were applied. The Mann–Whitney test and Kruskal-Wallis tests were used to evaluate the PA profile differences between genders, before and during the lockdown period and between students’ living environments. Chi-squared (χ2) or Fisher’s exact test was used to assess changes in health behaviors by gender and students’ living environment compared to before the lockdown. A mediation model was used to examine whether sleep disorder mediated the relationship between PA and mental health in different students’ living environments.

Results

Participants reported a significant decrease in weekly total PA levels (63.9%). Mean daily sedentary time increased by 21.4% and daily lying time increased by 10.7% compared to before lockdown. Among the participants, 21.2% had experienced insomnia, and 39.0% reported having high mental distress. Female students reported 10% higher rates of sleep disorders than male students (p < 0.001), and also experienced a higher incidence of mental disorders (p < 0.001). Students living with three roommates had a larger decrease in frequencies and durations of participation in light PA than other students (p < 0.001). PA was negatively associated with sleep and mental health, and sleep disorder was a mediating factor between PA and mental health in the students living with two and three roommates.

Conclusion

This study showed that strict lockdowns within university dormitories during the COVID-19 pandemic had a negative effect on the health of university students by changing their health behaviors, physical activity and sleep. Our findings indicate a need for strategies to promote an active lifestyle for students in space-limited dormitories in order to maintain health during a prolonged lockdown.

Associations of Brain-Derived Neurotropic Factor rs6265 Gene Polymorphism with Personality Dimensions among Athletes

Brain-Derived Neurotropic Factor (BDNF) is one of the essential mediating factors of exercise-induced neuroplasticity, but the underlying molecular mechanisms of exercise-induced neuroplasticity are still largely unknown. Personality dimensions differentiate individuals and depend on genes and environmental factors. The dimensions of openness to experience, emotional stability, extraversion and conscientiousness have been reported to be positively related to performance; considering agreeableness, a negative relation with sports performance was emphasized. However, not enough effort has been put into investigating the relationship between genetic polymorphisms affecting psychological abilities and competitive power sports. The aim of this study was to investigate the association of the rs6265 polymorphism of BDNF with personality dimensions in martial arts athletes. The study was conducted among martial arts athletes. The study group included 258 volunteers (martial arts athletes (n = 106) and controls (n = 152). BDNF polymorphism testing was performed using the real-time PCR method; personality dimensions were assessed using standardized NEO-FFI questionnaires. All analyses were performed using STATISTICA 13. We observed that martial arts athletes’ G/G genotypes compared to the control group G/G genotypes presented significantly higher severity of personality dimension “conscientiousness”. In comparison with the controls, the case group subjects had significantly higher scores in the dimension extraversion (M 6.89 vs. M 6.43, p = 0.0405) and conscientiousness/scale (M 7.23 vs. M 5.89, p < 0.0001). The results of 2 × 3 factorial ANOVA noticed a statistically significant effect of combined factor BDNF rs6265 genotype of martial arts/control (F2,252 = 3.11, p = 0.0465, η2 = 0.024). Additionally, we observed that the results of 2 × 3 factorial ANOVA showed a statistically significant influence of combined factor BDNF rs6265 of genotype martial arts/ control (F2,252 = 6.16, p = 0.0024, η2 = 0.047). The combination of the analysis of personality dimensions with genetics—as in the case of the polymorphism of the BDNF gene related to neuroplasticity—indicates that neurobiology cannot be ignored in educating sports champions. We already know that this is related to genetics. However, little is still known about the influence of personality traits on sports performance. We observed that martial arts athletes’ G/G genotypes, in comparison to the control group’s G/G genotypes, presented significantly higher severity of personality dimension “conscientiousness”. This is worthy of further analysis and probably longitudinal studies on a more numerous group of athletes.

The role of the stress system in recovery after traumatic brain injury: A tribute to Bruce S. McEwen

Traumatic brain injury (TBI) represents a major public health concern. Although the majority of individuals that suffer mild-moderate TBI recover relatively quickly, a substantial subset of individuals experiences prolonged and debilitating symptoms. An exacerbated response to physiological and psychological stressors after TBI may mediate poor functional recovery. Individuals with TBI can suffer from poor stress tolerance, impairments in the ability to evaluate stressors, and poor initiation (and cessation) of neuroendocrine stress responses, all of which can exacerbate TBI-mediated dysfunction. Here, we pay tribute to the pioneering neuroendocrinologist Dr. Bruce McEwen by discussing the ways in which his work on stress physiology and allostatic loading impacts the TBI patient population both before and after their injuries. Specifically, we will discuss the modulatory role of hypothalamic-pituitary-adrenal axis responses immediately after TBI and later in recovery. We will also consider the impact of stressors and stress responses in promoting post-concussive syndrome and post-traumatic stress disorders, two common sequelae of TBI. Finally, we will explore the role of early life stressors, prior to brain injuries, as modulators of injury outcomes.

The impact of physical fitness on resilience to modern life stress and the mediating role of general self-efficacy

Substantial evidence shows that physical activity and fitness play a protective role in the development of stress related disorders. However, the beneficial effects of fitness for resilience to modern life stress are not fully understood. Potentially protective effects may be attributed to enhanced resilience via underlying psychosocial mechanisms such as self-efficacy expectations. This study investigated whether physical activity and fitness contribute to prospectively measured resilience and examined the mediating effect of general self-efficacy. 431 initially healthy adults participated in fitness assessments as part of a longitudinal-prospective study, designed to identify mechanisms of resilience. Self-efficacy and habitual activity were assessed in parallel to cardiorespiratory and muscular fitness, which were determined by a submaximal step-test, hand strength and standing long jump test. Resilience was indexed by stressor reactivity: mental health problems in relation to reported life events and daily hassles, monitored quarterly for nine months. Hierarchical linear regression models and bootstrapped mediation analyses were applied. We could show that muscular and self-perceived fitness were positively associated with stress resilience. Extending this finding, the muscular fitness-resilience relationship was partly mediated by self-efficacy expectations. In this context, self-efficacy expectations may act as one underlying psychological mechanism, with complementary benefits for the promotion of mental health. While physical activity and cardiorespiratory fitness did not predict resilience prospectively, we found muscular and self-perceived fitness to be significant prognostic parameters for stress resilience. Although there is still more need to identify specific fitness parameters in light of stress resilience, our study underscores the general relevance of fitness for stress-related disorders prevention.

The Beneficial Role of Physical Exercise on Anthracyclines Induced Cardiotoxicity in Breast Cancer Patients

The increase in breast cancer (BC) survival has determined a growing survivor population that seems to develop several comorbidities and, specifically, treatment-induced cardiovascular disease (CVD), especially those patients treated with anthracyclines. Indeed, it is known that these compounds act through the induction of supraphysiological production of reactive oxygen species (ROS), which appear to be central mediators of numerous direct and indirect cardiac adverse consequences. Evidence suggests that physical exercise (PE) practised before, during or after BC treatments could represent a viable non-pharmacological strategy as it increases heart tolerance against many cardiotoxic agents, and therefore improves several functional, subclinical, and clinical parameters. At molecular level, the cardioprotective effects are mainly associated with an exercise-induced increase of stress response proteins (HSP60 and HSP70) and antioxidant (SOD activity, GSH), as well as a decrease in lipid peroxidation, and pro-apoptotic proteins such as Bax, Bax-to-Bcl-2 ratio. Moreover, this protection can potentially be explained by a preservation of myosin heavy chain (MHC) isoform distribution. Despite this knowledge, it is not clear which type of exercise should be suggested in BC patient undergoing anthracycline treatment. This highlights the lack of special guidelines on how affected patients should be managed more efficiently. This review offers a general framework for the role of anthracyclines in the physio-pathological mechanisms of cardiotoxicity and the potential protective role of PE. Finally, potential exercise-based strategies are discussed on the basis of scientific findings.

Effect of treadmill exercise on serum corticosterone, serum and hippocampal BDNF, hippocampal apoptosis and anxiety behavior in an ovariectomized rat model of post-traumatic stress disorder (PTSD)

There is a sex difference in vulnerability to PTSD and in response to therapeutic interventions. Since relation between gonadal hormones and PTSD has been revealed, this study aimed to understand the severity of PTSD-induced impairments after ovarian hormone deficiency and the influence of exercise on PTSD accompanied by ovarian hormone deficiency. Female adult Wistar rats were subjected to ovariectomy, PTSD, or combination ovariectomy plus PTSD. Twenty days after ovariectomy, PTSD was induced by single prolonged stress (SPS) model. The exercise started 14 days after SPS and continued for 4 weeks. Thirty minutes moderate treadmill exercise was planned for 5 days per week. On day 65, after assessing rats using the elevated plus-maze (EPM) test, corticosterone, BDNF, and apoptotic markers were tested. p < 0.05 was considered as significant level. The results showed that ovariectomy worsened the effect of SPS on hippocampal BDNF and led to greater increase in serum corticosterone and hippocampal caspase 3 and BAX in SPS rats. Also, ovariectomy exacerbated anxiety-like behavior in SPS rats. Exercise improved the alterations of hippocampal BDNF, corticosterone, caspase 3, and BAX in SPS ovariectomized rats. However, exercise had no statistically significant effect on anxiety-like behavior in this group. According to the results, exercise is effective to attenuate SPS-induced impairments in molecular and cellular responses even when the condition becomes more complicated due to ovarian hormone deficiency. However, exercise alone cannot help to improve behavior impairments in PTSD combined with an ovarian hormone deficiency. Therefore, exercise could likely be considered as a complementary intervention to strengthen other treatments.

Effect of exercise intensity and duration on the levels of stress hormones and hypothalamic-pituitary-gonadal axis in adult male rats: an experimental study

PURPOSE

The effect of exercise on stress has been demonstrated in several studies which have shown that exercise intensity and duration have various effects on the reproductive axis. This study evaluated the effect of different intensities and durations of exercise on the hormonal indices of stress, such as corticosterone (CORT), norepinephrine (NEP), and also reproductive performance indices, including gonadotropin-releasing hormone (GnRH), luteinizing hormone (LH), and testosterone (T).

METHODS

In this experimental study, 30 adult Wistar rats were randomly divided into five groups as follows: no-exercise, RME-1 (regular moderate exercise for 1 month), RME-6 (regular moderate exercise for 6 months), RIE-1 (regular intensive exercise for 1 month), and RIE-6 (regular intensive exercise for 6 months). At the end of the experiment, the serum levels of the abovementioned hormones and hypothalamic expression of the Gnrh gene were measured using the enzyme-linked immunosorbent assay and the real-time polymerase chain reaction method, respectively.

RESULTS

The levels of stress hormones, including CORT and NEP, increased only in the RIE-1 group compared with the no-exercise group. In addition, an increase was observed in T hormone levels in the RME-1 group compared with those in the no-exercise group, whereas LH and T hormone levels showed a greater decrease in the RIE-6 group than in the no-exercise group. Gnrh expression levels showed an increase and a decrease in the RME-1 and RIE-6 groups compared with the no-exercise group, respectively.

CONCLUSION

These results confirmed the effects of different intensities and durations of exercise on sex hormone levels.

Direct and Stress-Buffering Effects of COVID-19-Related Changes in Exercise Activity on the Well-Being of German Sport Students

Maintaining or initiating exercise activity in the COVID-19 pandemic may act as a buffer against the observed stress-related deterioration in well-being, with emotion regulation (ER) discussed as a possible moderator. Therefore, the present study investigated the interaction between stress, exercise activity (EA), and ER on mood. In an online survey, 366 German sports science students (56% women, Mage = 23.04, SD = 2.87) reported their stress levels (general and COVID-19-specific), mood (energy, valence, calmness), EA before and during the pandemic, and use of ER strategies in spring 2020. Pandemic-related change in EA was calculated as residual change. Due to gender differences in mental health and EA, the main and interaction effects were tested in twelve hierarchical regression analyses, separately for men and women. Overall, EA significantly decreased during the pandemic and was positively associated with energy in both men and women. ER was positively associated with women's energy, but negatively with all three mood dimensions in men. Only one three-way interaction appeared significant: in the case of high stress, low levels of EA and high use of ER were associated with the greatest deteriorations in energy in men. Our findings suggest that EA may buffer deteriorations in energy in men with high stress and difficulties in ER.

Changes in Perceived Stress After Yoga, Physical Therapy, and Education Interventions for Chronic Low Back Pain: A Secondary Analysis of a Randomized Controlled Trial

OBJECTIVE

Perceived stress and musculoskeletal pain are common, especially in low-income populations. Studies evaluating treatments to reduce stress in patients with chronic pain are lacking. We aimed to quantify the effect of two evidence-based interventions for chronic low back pain (cLBP), yoga and physical therapy (PT), on perceived stress in adults with cLBP.

METHODS

We used data from an assessor-blinded, parallel-group randomized controlled trial, which recruited predominantly low-income and racially diverse adults with cLBP. Participants (N = 320) were randomly assigned to 12 weeks of yoga, PT, or back pain education. We compared changes in the 10-item Perceived Stress Scale (PSS-10) from baseline to 12- and 52-week follow-up among yoga and PT participants with those receiving education. Subanalyses were conducted for participants with elevated pre-intervention perceived stress (PSS-10 score ≥17). We conducted sensitivity analyses using various imputation methods to account for potential biases in our estimates due to missing data.

RESULTS

Among 248 participants (mean age = 46.4 years, 80% nonwhite) completing all three surveys, yoga and PT showed greater reductions in PSS-10 scores compared with education at 12 weeks (mean between-group difference = -2.6, 95% confidence interval [CI] = -4.5 to -0.66, and mean between-group difference = -2.4, 95% CI = -4.4 to -0.48, respectively). This effect was stronger among participants with elevated pre-intervention perceived stress. Between-group effects had attenuated by 52 weeks. Results were similar in sensitivity analyses.

CONCLUSIONS

Yoga and PT were more effective than back pain education for reducing perceived stress among low-income adults with cLBP.

Association of shift work with cardiovascular disease risk among Chinese workers

To evaluate the association of shift work with 10-year cardiovascular disease (CVD) risk among Chinese workers. We included 23,064 workers in the first follow-up of the Dongfeng-Tongji cohort study. Questionnaires and physical examinations were conducted to collect data for all participants. Framingham Risk Score was calculated according to the multivariable risk algorithms, and used to evaluate 10-year CVD risk. Logistic regression models were used to assess the relationship between shift work and 10-year CVD risk. Among 23,064 individuals, 51.92% of workers suffered shift work, and the proportions of shift work duration of 1-<10, 10-<20, and ≥20 years were 17.29%, 17.35% and 17.30%, respectively. Compared with individuals without a shift work history, the odds ratios (ORs) and 95% confidence intervals (CIs) of 10-year CVD were 1.027 (0.900-1.173), 1.058 (0.927-1.206) and 1.191 (1.036-1.368) for individuals with shift work duration of 1-<10 years, 10-<20 years, and ≥20 years, respectively, after adjusting for potential confounders. And the association was more obvious in males. When shift work and obesity were combined, the OR (95%CI) of high 10-year CVD risk (3.373, 2.390-4.761) was significantly increased for obese individuals with shift work of ≥20 years. Besides, the OR (95%CI) for higher 10-year CVD risk associated with shift work decreased as the leaving shift work duration prolonged. Shift work is associated with a higher 10-year CVD risk, especially among males. Obesity has a synergistic effect on such association while leaving shift work reduces such association.

Strange Days: Adult Physical Activity and Mental Health in the First Two Months of the COVID-19 Pandemic

Background: In addition to its physical health benefits, physical activity is increasingly recognized as a means to support mental health. Regular moderate-to-vigorous physical activity (MVPA) is associated with improved mental well-being, reduced likelihood of developing mental illness, and improved symptom management. Despite these benefits, most people fail to achieve minimum recommended levels of MVPA. Population levels of physical activity have further declined since the onset of the COVID-19 pandemic and implementation of public health measures (e.g., shelter-in-place protocols). The potential impact of this decline on mental heath outcomes warrants ongoing investigation. Purpose: To investigate associations between changes in MVPA and mental health (depressive symptoms, anxiety symptoms, and life satisfaction) in adults impacted by the COVID-19 pandemic. Method: Research followed a cross-sectional design. English-speaking adults were invited to complete an online questionnaire. MVPA was assessed retrospectively (before COVID-19) and currently (during COVID-19) with the International Physical Activity Questionnaire. Mental health was assessed with the Patient Health Questionnaire, 9-Item (PHQ-9), the Generalized Anxiety Disorder, 7-Item (GAD-7), and the Satisfaction with Life Scale (SWLS). Regression was used to assess relationships between MVPA and mental health. ANOVA with follow-up tests examined whether participants who differed in mental health status (e.g., no symptoms vs. severe symptoms) differed in their change in MVPA. T-tests were used to examine differences in mental health symptomatology between participants who were sufficiently (i.e., achieving MVPA guidelines of ≥ 150 min/week) vs. insufficiently active. Results: Prior to COVID-19, 68.2% of participants were classified as being sufficiently active, vs. 60.6% during COVID-19. The majority of participants reported experiencing some level of depressive symptoms (62.0%) or anxiety symptoms (53.7%). After controlling for covariates, changes in MVPA accounted for significant variability in the PHQ-9 (7.7%), GAD-7 (2.5%), and SWLS (1.5 %). Participants with clinically significant mental health symptomatology reported greater declines in MVPA than those who reported no symptoms. Conversely, participants who were sufficiently active during COVID-19 reported significantly lower depression and anxiety, and higher life satisfaction. Conclusion: Participants who experienced the greatest declines in MVPA reported relatively greater psychological distress and lower life satisfaction. While preliminary, these findings suggest the importance of maintaining and promoting physical activity during a period of pandemic.

Does Stress Trigger Seizures? Evidence from Experimental Models

This chapter describes the experimental evidence of stress modulation of epileptic seizures and the potential role of corticosteroids and neurosteroids in regulating stress-linked seizure vulnerability. Epilepsy is a chronic neurological disorder that is characterized by repeated seizures. There are many potential causes for epilepsy, including genetic predispositions, infections, brain injury, and neurotoxicity. Stress is a known precipitating factor for seizures in individuals suffering from epilepsy. Severe acute stress and persistent exposure to stress may increase susceptibility to seizures, thereby resulting in a higher frequency of seizures. This occurs through the stress-mediated release of cortisol, which has both excitatory and proconvulsant properties. Stress also causes the release of endogenous neurosteroids from central and adrenal sources. Neurosteroids such as allopregnanolone and THDOC, which are allosteric modulators of GABA-A receptors, are powerful anticonvulsants and neuroprotectants. Acute stress increases the release of neurosteroids, while chronic stress is associated with severe neurosteroid depletion and reduced inhibition in the brain. This diminished inhibition occurs largely as a result of neurosteroid deficiencies. Thus, exogenous administration of neurosteroids (neurosteroid replacement therapy) may offer neuroprotection in epilepsy. Synthetic neurosteroid could offer a rational approach to control neurosteroid-sensitive, stress-related epileptic seizures.

Exercise Prescription to Foster Health and Well-Being: A Behavioral Approach to Transform Barriers into Opportunities

The current literature contains multiple examples of exercise interventions to foster health and to prevent/treat many chronic non-communicable diseases; stress and functional syndromes. On the other hand, sedentariness is increasing and to transform a sedentary subject into a regular exerciser is not only very difficult but considered by some unrealistic in current clinical practice. Ideally a physical activity intervention may be considered actually efficacious when it outgrows the research setting and becomes embedded in a system, ensuring maintenance and sustainability of its health benefits. Physicians need specific skills to improve patients' exercise habits. These range from traditional clinical competencies, to technical competencies to correctly prescribe exercise, to competencies in behavioral medicine to motivate the subject. From a behavioral and medical point of view, an exercise prescription may be considered correct only if the subject actually performs the prescribed exercise and this results in an improvement of physiological mechanisms such as endocrine, immunological and autonomic controls. Here we describe a model of intervention intended to nurture exercise prescription in everyday clinical setting. It aims to a tailored prescription, starts from the subject's assessment, continues defining clinical goals/possible limitations and ends when the subject is performing exercise obtaining results.

The Contribution of Physical Exercise to Brain Resilience

Increasing attention has been given to understanding resilience to brain diseases, often described as brain or cognitive reserve. Among the protective factors for the development of resilience, physical activity/exercise has been considered to play an important role. Exercise is known to induce many positive effects on the brain. As such, exercise represents an important tool to influence neurodevelopment and shape the adult brain to react to life's challenges. Among many beneficial effects, exercise intervention has been associated with cognitive improvement and stress resilience in humans and animal models. Thus, a growing number of studies have demonstrated that exercise not only recovers or minimizes cognitive deficits by inducing better neuroplasticity and cognitive reserve but also counteracts brain pathology. This is evidenced before disease onset or after it has been established. In this review, we aimed to present encouraging data from current clinical and pre-clinical neuroscience research and discuss the possible biological mechanisms underlying the beneficial effects of physical exercise on resilience. We consider the implication of physical exercise for resilience from brain development to aging and for some neurological diseases. Overall, the literature indicates that brain/cognitive reserve built up by regular exercise in several stages of life, prepares the brain to be more resilient to cognitive impairment and consequently to brain pathology.

Associations between inflammatory markers and well-being during 12 weeks of basic military training

PURPOSE

Stress, anxiety and physical exertion are all closely linked to well-being, and each can alter immune function. Diminished well-being has been observed during military training, however there is mixed evidence regarding whether concomitant changes in inflammatory markers occur, with these phenomena indicating potential maladaptive responses to imposed training loads. The aims of this project were (1) assess changes in inflammation and subjective well-being across a 12-week basic military training (BMT) program, and (2) evaluate relationships between circulating inflammatory markers and well-being.

METHODS

A total of 37 men and women undergoing 12 weeks of BMT in Australia were recruited. Well-being was assessed via questionnaire (DASS-21), and plasma samples were collected for the analysis of inflammatory cytokines [interleukin (IL)-4, IL-6, IL-1β, IL-8, IL-10, and tumor necrosis factor (TNF)-α] at weeks 1, 4, 8 and 12. Data were analysed using general linear mixed models.

RESULTS

Depression, anxiety and stress subscale scores all significantly improved (all P ≤ 0.001), and TNF-α decreased (P = 0.031) across time. Compared to baseline (week 1), significant decreases in associations between depression and IL-10, anxiety and IL-10, and stress and IL-10, IL-4 IL-6 and TNF-α (all P < 0.05), were detected across BMT.

CONCLUSION

The BMT program appears to support improved well-being over the 12 weeks, with minimal perturbation to inflammatory markers. Biomarkers and well-being displayed consistent associations and may have utility as psychophysiological indicators of health status in military research, however for now, subjective measures may represent more cost-effective proxies for ongoing monitoring of military personnel.

Prevalence and factors associated to depression and suicidal behavior among medical students

ABSTRACT Objective: Depression and suicidal behavior have been described as major problems among medical students. The aim of this study was to assess the prevalence of depression and suicidal behavior among medical students of an institution and to investigate possible associated variables. Methods: The authors carried out a cross-sectional study through a self-administered questionnaire, including the Beck Depression Inventory (BDI) and the Beck’s Suicide Intent Scale (BSIS) instruments. The diagnosis of depression was based on an instrument adapted according to the DSM-IV and ICD-10 criteria. Logistic regression was performed to search for depression predictor variables. Results: In a total of 381 students, the prevalence of depression was 27.6%. Suicidal ideation of moderate to severe intensity was observed in 10.5% of the sample. About 6% of students had previously attempted suicide. Consumption of licit and illicit drugs was frequent among the participants, reaching 78% and 24% of the sample, respectively. The demand for specialized treatment was lower than expected among students with depression. Logistic regression revealed that female gender, reduced interpersonal contact with friends, reduced physical activity, difficulty in facing new situations and high perception of personal pressure were risk factors for depression. Conclusion: The prevalence of depression and suicidal behavior among medical students is higher than in the general population. There is a need for further studies to enable a better understanding of the risk factors and variables at play, which is fundamental for the development of early intervention strategies and support for students.

Longitudinal determination of resilience in humans to identify mechanisms of resilience to modern-life stressors: the longitudinal resilience assessment (LORA) study

Resilience is the maintenance and/or quick recovery of mental health during and after periods of adversity. It is conceptualized to result from a dynamic process of successful adaptation to stressors. Up to now, a large number of resilience factors have been proposed, but the mechanisms underlying resilience are not yet understood. To shed light on the complex and time-varying processes of resilience that lead to a positive long-term outcome in the face of adversity, the Longitudinal Resilience Assessment (LORA) study has been established. In this study, 1191 healthy participants are followed up at 3- and 18-month intervals over a course of 4.5 years at two study centers in Germany. Baseline and 18-month visits entail multimodal phenotyping, including the assessment of mental health status, sociodemographic and lifestyle variables, resilience factors, life history, neuropsychological assessments (of proposed resilience mechanisms), and biomaterials (blood for genetic and epigenetic, stool for microbiome, and hair for cortisol analysis). At 3-monthly online assessments, subjects are monitored for subsequent exposure to stressors as well as mental health measures, which allows for a quantitative assessment of stressor-dependent changes in mental health as the main outcome. Descriptive analyses of mental health, number of stressors including major life events, daily hassles, perceived stress, and the ability to recover from stress are here presented for the baseline sample. The LORA study is unique in its design and will pave the way for a better understanding of resilience mechanisms in humans and for further development of interventions to successfully prevent stress-related disorder.

Exercise Intervention in Treatment of Neuropsychological Diseases: A Review

Faced with a constant inundation of information and increasing pressures brought by the continuous development of modern civilization, people are increasingly faced with mental health challenges that are only now being actively researched. Mental illness is caused by brain dysfunction due to internal and external pathogenic factors that destroy the integrity of the human brain and alter its function. Regular participation in physical exercise can stimulate the cerebral cortex and simultaneously increase the supply of oxygen and nutrients, helping to preserve or restore normal functioning of the nervous system. In conjunction with other systems of the body, the nervous system constitutes the neuro-humoral regulation system responsible for maintaining the stable state of the human body. This paper is a systematic review of studies investigating the effects of exercise intervention on several common neuropsychological diseases, including depression, anxiety disorder, autism, and attention-deficit/hyperactivity disorder. Furthermore, we discuss possible physiological mechanisms underlying exercise-induced benefits and study limitations that must be addressed by future research. In many cases, drug therapy is ineffective and brings unwanted side effects. Based on the literature, we conclude that exercise intervention plays a positive role and that certain standards must be established in the field to make physical activity consistently effective.

Resilience and physical activity in people under home isolation due to COVID-19: A preliminary evaluation

BACKGROUND

The recent shelter-in-place order issued by the Spanish government (due to the outbreak of the COVID-19) forced the Spanish population to self-isolate at home. The psychological and social effects of this new situation are unknown. Therefore, this study aimed to examine the impact of such scenario on citizens' resilience, as well as the connections between resilience, physical activity (PA), gender, weight and body mass index (BMI) before and after confinement, and COVID-19-related information.

METHODS

A total of 1795 people answered an online questionnaire conducted on March 21st^, , 2020, seven days after the mandatory shelter-in-place health order was issued.

RESULTS

Results showed that individuals who regularly engaged in Vigorous PA during the first week of confinement reported higher resilience in terms of higher locus of control, higher self-efficacy, and higher optimism. Moreover, inter-personal resilience differences were observed based on gender, age groups, BMI, weight, and people living with dependent persons or under health risk conditions.

CONCLUSION

To the best of our knowledge, these findings are the first quantitative evidence pointing towards a link between engagement in Vigorous PA and resilience within the COVID-19 restrictions in Spain. These findings may have important implications for general population during the course of this pandemic, or future ones.

Gender and Exercise in Relation to Obesity in Greek Elderly Population

Purpose: The prevalence of sarcopenic obesity is increasing in older adults (>65 years) and older. Sarcopenic obesity is also related to reduced muscle synthesis, due to low physical activity levels. The purpose of the present study is to investigate possible risk factors, and effects of habitual activity status on different types of obesity in an elderly population. Methods: One hundred and two (n = 102) free living participants, aged >60 years, were randomly selected from Rehabilitation Centers for the Elderly in Thessaloniki and from municipal gymnasiums of Thessaloniki, Greece with a mean age of 68.11 ± 6.40 years. The response rate of the participants was 51%. For the purpose of this study, all the participants selected were healthy and did not receive any medication. Specifically, 46 subjects (19 men and 27 women) were members of Rehabilitation Centers for the Elderly in Thessaloniki, while 56 individuals (31 men and 25 women were members of the municipal gymnasiums of Thessaloniki and exercised 2 to 3 times per week). Anthropometric measurements were taken for all subjects. Body composition was assessed with bioelectrical impedance. Body Mass Index (BMI) was categorized according to the World Health Organization (WHO) (2000) standards. Central obesity was defined as a waist circumference of >102 cm in men and >88 cm in women. All participants completed a specific questionnaire regarding their health status, physical activity and previous weight status. Risk of sarcopenic obesity was diagnosed in the participants with co-existing sarcopenia and obesity resulting in high fat mass concurrent with low lean body mass. Results: Women had more than double risk of developing abdominal obesity (OR:2.133, 95% CI: 0.963–4.725) compared to men. More specifically, 69.6% of the elders who did not exercise regularly had central obesity (men: 52.6% and women: 81.5%), while 38.2% of the exercised elders (men: 36.7% and women: 40%) had central obesity. Sedentary elders demonstrated an increased risk of obesity according to body fat (%BF) (OR: 1.259, 95% CI: 0.576–2.750), double the risk of obesity according to body mass (OR: 2.074, 95% CI: 0.765–5.622), and triple the risk of having central obesity (OR: 3.701, 95% CI: 1.612–8.494) compared to those who exercised. Conclusion Exercise appears to have a protective role against all modes of obesity and thus possibly against obesity-related co-morbidities in the elderly.

The Impact of COVID-19 on Physical Activity Behavior and Well-Being of Canadians

A global pandemic caused by the novel coronavirus (COVID-19) resulted in restrictions to daily living for Canadians, including social distancing and closure of city and provincial recreation facilities, national parks and playgrounds. The objective of this study was to assess how these preemptive measures impacted physical activity behaviour and well-being of Canadians. An online survey was utilized to measure participant physical activity behavior, nature exposure, well-being and anxiety levels. Results indicate that while 40.5% of inactive individuals became less active, only 22.4% of active individuals became less active. Comparatively, 33% of inactive individuals became more active while 40.3% of active individuals became more active. There were significant differences in well-being outcomes in the inactive population between those who were more active, the same or less active (p < 0.001) but this was not seen in the active population. Inactive participants who spent more time engaged in outdoor physical activity had lower anxiety than those who spent less time in outdoor physical activity. Public health measures differentially affected Canadians who were active and inactive and physical activity was strongly associated with well-being outcomes in inactive individuals. This suggests that health promoting measures directed towards inactive individuals may be essential to improving well-being.

Physical exercise, mental health problems, and suicide attempts in university students

BACKGROUND

Physical inactivity and mental health problems are both major public health concerns worldwide. Although several studies have demonstrated the health benefits of regular physical exercise, few epidemiological studies have investigated the nature of the association between different aspects of physical exercise and mental health, and little is known regarding the possible link to suicidality.

STUDY AIM

To examine the association between frequency, intensity, and duration of physical exercise and mental health problems, and to explore whether low levels of physical activity is related to self-harm and suicide attempts among college and university students.

METHODS

We employed data from the SHoT2018-study, a national health survey for higher education in Norway, in which 50,054 students aged 18-35 years participated. Physical exercise was assessed with three questions (frequency, intensity, and duration). Mental health problems were assessed with both a screening tool assessing psychological distress (Hopkins Symptom Checklist-25; HSCL-25) and self-reported depressive disorder (using a pre-defined list of conditions). Suicide attempts and self-harm were assessed with two items from the Adult Psychiatric Morbidity Survey.

RESULTS

Physical exercise was negatively associated with all measures of mental health problems and suicidality in a dose-response manner. The strongest effect-sizes were observed for frequency of physical exercise. Women with low levels of physical activity had a near three-fold increased odds of both scoring high on the HSCL-25, and self-reported depression, compared to women exercising almost every day. Even stronger effect-sizes were observed for men (ORs ranging from 3.5 to 4.8). Also, physical exercise duration and intensity were significantly associated with mental health problems, but with generally smaller ORs. Similarly, graded associations were also observed when examining the link to self-harm and suicide attempts (ORs ranging from 1.9 to 2.5).

CONCLUSION

Given the demonstrated dose-response association between inactivity and both poor mental health, self-harm, and suicidal attempt, there is a need to facilitate college students to become more physically active. This is a shared responsibility that resides both on a political level and on the post-secondary institutions. The cross-sectional nature of the study means that one should be careful to draw firm conclusion about the direction of causality.

Lactate and BDNF: Key Mediators of Exercise Induced Neuroplasticity?

Accumulating evidence from animal and human studies supports the notion that physical exercise can enhance neuroplasticity and thus reduce the risk of several neurodegenerative diseases (e.g., dementia). However, the underlying neurobiological mechanisms of exercise induced neuroplasticity are still largely unknown. One potential mediator of exercise effects is the neurotrophin BDNF, which enhances neuroplasticity via different pathways (e.g., synaptogenesis, neurogenesis, long-term potentiation). Current research has shown that (i) increased peripheral lactate levels (following high intensity exercise) are associated with increased peripheral BDNF levels, (ii) lactate infusion at rest can increase peripheral and central BDNF levels and (iii) lactate plays a very complex role in the brain’s metabolism. In this review, we summarize the role and relationship of lactate and BDNF in exercise induced neuroplasticity.

Physical exercise in attention deficit hyperactivity disorder - evidence and implications for the treatment of borderline personality disorder

A growing body of literature indicates a potential role for physical exercise in the treatment of attention deficit hyperactivity disorder (ADHD). Suggested effects include the reduction of ADHD core symptoms as well as improvements in executive functions. In the current review, we provide a short overview on the neurophysiological mechanisms assumed to underlie the beneficial effects of exercise. Further, we review the current evidence from experimental studies regarding both acute exercise and long-term interventions in ADHD. While the positive effects observed after acute aerobic exercise are promising, very few well-designed long-term intervention studies have been conducted yet. Moreover, although exercise effects have not yet been studied in borderline personality disorder (BPD), in the end of this paper we derive hypotheses why exercise could also be beneficial for this patient population.

Stress and Burnout in Training; Requiem for the Surgical Dream

OBJECTIVE

Burnout among trainee doctors is common with as many as two-thirds reporting poor health. This study aimed to assess burnout in a cohort of UK core and higher general surgical trainees.

DESIGN

The Maslach Burnout Inventory for Medical Personnel was distributed to 158 surgical trainees to evaluate emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). High EE (≥27) and DP (≥10), low PA (≤33) scores were taken to indicate burnout.

SETTING

A single UK (Wales) Deanery.

PARTICIPANTS

One hundred responses were received; 65 core surgical trainees, 31 Higher Surgical Trainees (HST), and 4 not specified.

RESULTS

Median EE, DP, and PA scores were 22.0 (range 2-50), 7.5 (0-25), and 36.0 (19-47), respectively. High burnout by domain was: EE (n = 33), DP (n = 39), PA (n = 34), with 59% of trainees demonstrating burnout in ≥1 one domain, with strong interdomain correlation (EE:DP r = 0.351, p < 0.001; EE:PA r = -0.455, p < 0.001; DP:PA r = -0.446, p < 0.001). Female gender (p = 0.020), core surgical training grade (p = 0.012), and being childless (p = 0.033) were independently associated with higher levels of EE; whereas HST grade (p = 0.007), age >30 years (p = 0.010), married/partner status (p = 0.001), and parenthood (p = 0.015), were associated with lower levels of burnout with regard to DP. Binary logistic regression revealed lower burnout in all domains to be associated with HST status (hazard ratio 0.116, 95% confidence interval 0.014-0.980, p = 0.048) and male gender (hazard ratio 4.365, (1.246-15.293), p = 0.021).

CONCLUSIONS

Burnout among surgical trainees was common in at least 1 Maslach Burnout Inventory domain. Urgent counter measures are required to protect the health and wellbeing of trainees at risk, which ought to be associated with commensurate improvement in patient safety.

An Overview of the Beneficial Effects of Exercise on Health and Performance

Life expectancy is steadily increasing in modern societies, and so are noncommunicable diseases such as cardiovascular diseases, diabetes, obesity, and cancer, accounting for more than 70% of all deaths globally. The costs associated with these diseases are enormous, but it has been estimated that the majority of these noncommunicable diseases are preventable. In addition to an unhealthy diet, tobacco use, and harmful use of alcohol, physical inactivity is a key risk factor. Consequently, physical activity is a logical remedy, and in this chapter an overview of the numerous beneficial effects of physical activity on health and performance is given.The chapter is divided into three parts: First, the basics of physical activity and exercise are discussed, for instance exercise classification, exercise intensity operationalization, energy supply, and the acute effects of exercise such as blood flow redistribution and increased cardiac output. In the second part, the effects of exercise on physical performance are summarized. Specifically, it is discussed how endurance, strength, power, and balance can be improved. This discussion includes recommendations regarding the type, intensity, and duration of the exercise leading to improvements in one of these aspects of physical performance, as well as the mechanisms causing these adaptations. In the third part, the beneficial effects of physical activity on physical and mental health are outlined, with particular attention to cardiovascular diseases, the metabolic syndrome, musculoskeletal diseases, mood, anxiety, depression, and dementia.It can be concluded that with adequate programming, regular physical activity is an effective way to improve physical performance, improve physical and mental health, and reduce the risk factors for many noncommunicable diseases such as cardiovascular diseases, metabolic syndrome, sarcopenia, osteoporosis, and depression. In contrast to medication, physical exercise has no negative side effects, costs very little, and targets many health issues at once. If the multitude of beneficial effects of regular exercise were to be combined in a single low-cost drug, it would be prescribed for almost all types of physical and mental health issues.

Testing for paternal influences on offspring telomere length in a human cohort in the Philippines

OBJECTIVES

Telomeres, emerging biomarkers of aging, are comprised of DNA repeats located at chromosomal ends that shorten with cellular replication and age in most human tissues. In contrast, spermatocyte telomeres lengthen with age. These changes in telomere length (TL) appear to be heritable, as older paternal ages of conception (PAC) predict longer offspring TL. Mouse-model studies raise questions about the potential for effects of paternal experiences on human offspring TL, as they suggest that smoking, inflammation, DNA damage, and stressors all shorten sperm TL. Here, we examined whether factors from the paternal environment predict offspring TL as well as interact with PAC to predict offspring TL.

MATERIALS AND METHODS

Using data from the Philippines, we tested if smoking, psychosocial stressors, or shorter knee height (a measure of early life adversity) predict shorter offspring TL. We also tested if these interacted with PAC in predicting offspring TL.

RESULTS

While we did not find the predicted associations, we observed a trend toward fathers with shorter knee height having offspring with longer TL. In addition, we found that knee height interacted with PAC to predict offspring TL. Specifically, fathers with shorter knee heights showed a stronger positive effect of PAC on offspring TL.

DISCUSSION

While the reasons for these associations remain uncertain, shorter knee height is characteristic of earlier puberty. Since spermatocyte TL increases with the production of sperm, we speculate that individuals with earlier puberty, and its concomitant commencement of production of sperm, had more time to accumulate longer sperm telomeres.

A Review of Medical Conditions and Behavioral Problems in Dogs and Cats

Not all animals behave identically when faced with the same situation. These individual differences in the expression of their behavior could be due to many factors, including medical conditions. These medical problems can change behavior directly or indirectly. The aims of this review are to describe the state of the art of the relationship among some medical and behavioral problems, and to propose new lines of investigation. The revision is focused on the relation between behavioral problems and pain, endocrine diseases, neurological problems, vomeronasal organ alterations, and cardiac disorders. These problems represent a diagnostic challenge from a practical point of view. The most common sign of pain in animals is a change in behavior. Although the relation of pain to behavioral problems has been widely studied, it is not absolutely clear. As an example, the relation between sleep disorders and pain is poorly known in veterinary medicine. New studies in humans and laboratory animals show that a reciprocal relationship does, in fact, exist. More specifically, the literature suggests that the temporal effect of sleep deprivation on pain may be stronger than that of pain on sleep. Some behavioral problems could modify the sleep-awake cycle (e.g., cognitive dysfunction). The impact of these behavioral problems on pain perception is completely unknown in dogs and cats. Thyroid hormones play an important role, regarding behavioral control. Both hypothyroidism and hyperthyroidism have been related to behavioral changes. Concerning hypothyroidism, this relationship remains controversial. Nonetheless, new neuro-imaging studies provide objective evidence that brain structure and function are altered in hypothyroid patients, both in laboratory animals and in humans. There are many neurological problems that could potentially change behavior. This paper reviews those neurological problems that could lead to behavioral changes without modifying neurological examination. The most common problems are tumors that affect central nervous system silent zones, mild traumatic brain injury, ischemic attacks, and epilepsy. Most of these diseases and their relationship to behavior are poorly studied in dogs and cats. To better understand the pathophysiology of all of these problems, and their relation to behavioral problems, may change the diagnostic protocol of behavioral problems.

Cerebrovascular regulation is not blunted during mental stress

NEW FINDINGS

What is the central question of the study? What are the effects of acute mental stress on the mechanisms regulating cerebral blood flow? What is the main finding and its importance? The major new findings are as follows: (i) high mental stress and hypercapnia had an interactive effect on mean middle cerebral artery blood velocity; (ii) high mental stress altered the regulation of cerebral blood flow; (iii) the increased cerebrovascular hypercapnic reactivity was not driven by changes in mean arterial pressure alone; and (iv) this increased perfusion with mental stress appeared not to be justified functionally by an increase in oxygen demand (as determined by near-infrared spectroscopy-derived measures).

ABSTRACT

In this study, we examined the effects of acute mental stress on cerebrovascular function. Sixteen participants (aged 23 ± 4 years; five female) were exposed to low and high mental stress using simple arithmetic (counting backwards from 1000) and more complex arithmetic (serial subtraction of 13 from a rapidly changing four-digit number), respectively. During consecutive conditions of baseline, low stress and high stress, end-tidal partial pressure of CO₂ ( P ET , C O 2 ) was recorded at normocapnia (37 ± 3 mmHg) and clamped at two elevated levels (P < 0.01): 41 ± 1 and 46 ± 1 mmHg. Mean right middle cerebral artery blood velocity (MCAv_mean ; transcranial Doppler ultrasound), right prefrontal cortex haemodynamics (near-infrared spectroscopy) and mean arterial blood pressure (MAP; finger photoplethysmography) were measured continuously. Cerebrovascular hypercapnic reactivity (ΔMCAv_mean /Δ P ET , C O 2 ), cerebrovascular conductance (CVC; MCAv_mean /MAP), CVC CO₂ reactivity (ΔCVC/Δ P ET , C O 2 ) and total peripheral resistance (MAP/cardiac output) were calculated. Acute high mental stress increased MCAv_mean by 7 ± 7%, and more so at higher P ET , C O 2 (32 ± 10%; interaction, P = 0.03), illustrating increased sensitivity to CO₂ (i.e. its major regulator). High mental stress also increased MAP (17 ± 9%; P ≤ 0.01), coinciding with increased near-infrared spectroscopy-derived prefrontal haemoglobin volume and saturation measures. High mental stress elevated both cerebrovascular hypercapnic and conductance reactivities (main effect of stress, P ≤ 0.04). These findings indicate that the cerebrovascular response to acute high mental stress results in a coordinated regulation between multiple processes.

Externalizing Behaviors Buffer the Effects of Early Life Adversity on Physiologic Dysregulation

The present study examined the counterintuitive hypothesis that externalizing behaviors such as aggression, although in many respects detrimental, may be functional and protect against the detrimental health consequences of early life adversity. In particular, in line with evolutionary models of development, we argue that externalizing problems moderate the association between chronic stress exposure and allostatic load, a biological marker of chronic physiological dysregulation. Prospective interactive effects of externalizing behaviors and cumulative risk (a confluence of multiple risk factors) on children's allostatic load were assessed in 260 children (46% female, baseline age = 9). Exposure to early life adversity was assessed at baseline using a cumulative risk index. Externalizing behaviors were reported by parents at baseline. Allostatic load was measured at baseline and at ages 13 and 17, using endocrine, cardiovascular and metabolic parameters. Results of linear-mixed effects models indicated that the association between cumulative risk and allostatic load was attenuated for adolescents who scored high on externalizing behaviors. Further examination of sex differences indicated that the findings were more pronounced among males than females.