Mental Health and the Role of Physical Activity During the COVID-19 Pandemic

The 100-Days: Physical Exercise and Challenges to Assess, Maintain and Improve Physical Fitness During Lockdown

The COVID-19 pandemic reduced physical activity and increased sedentary behavior, raising health risks. To combat this, a 100-day training program was designed to maintain and improve fitness during lockdown. This program, which included a challenge with physical assessments and online sessions, aimed to enhance fitness and motivation.

METHODS

Twenty participants (mean age 45.2 ± 12.7 years) with good baseline fitness completed strength, endurance, coordination, and flexibility exercises over 100 days, with monthly challenges. Fitness was assessed at baseline (T0), mid-program (T1), and completion (T2).

RESULTS

Males initially showed higher BMI and mild cardiovascular risks. Flexibility improved for both genders, with females increasing from 12.5 ± 4.51 cm to 14.8 ± 6.65 cm and males from 4.4 ± 6.33 cm to 8.8 ± 10.69 cm. Males' vertical jump height increased from 20.7 ± 13.05 cm to 28.2 ± 10.49 cm. In the challenge, push-up repetitions rose for both genders, achieving excellent scores (>24 reps for females, >25 for males). Males advanced in the repeated crunch test, while females consistently excelled in the repeated squat. Weight and BMI reductions were also observed, particularly in overweight males.

CONCLUSIONS

The 100-day training program, combined with the challenge, effectively sustained physical fitness and motivation among participants during pandemic-related restrictions. Notable strength and endurance improvements were observed across both genders, reinforcing the potential of interactive, remote training programs to promote physical health in periods of limited activity.

Self-reported physical activity and sleep quality is associated with working memory function in middle-aged and older adults during the COVID-19 pandemic

While previous work has shown a positive relationship between cognitive performance and lifestyle factors in younger adults, evidence for this relationship among middle-aged and older adults has been mixed. The current study aimed to further test the relationship among physical activity, sleep quality, and memory performance in middle-aged and older adults, and to test whether this relationship holds up during the COVID-19 pandemic. Our results showed that physical activity was associated with better sleep quality and better working memory performance, and better sleep quality was associated with better working memory and self-perceptions of everyday memory abilities. Additionally, we found that the effects of physical activity on working memory were partially mediated by sleep quality. While these effects were small and only correlational in nature, they lend further support to the notion that sleep quality and physical activity are beneficial to memory later in life, even during a global pandemic.

Effect of physical activity on anxiety and depression in COVID-19 adults: A systematic review and meta-analysis

While the benefits of physical activity on mental health are well-known, systematic reviews and meta-analyses on its impact on mental illness in adults with COVID-19 are scarce. This study of 25 randomized controlled trials shows that physical activity significantly reduces anxiety (standardized mean difference [SMD] = -0.915; 95% confidence interval [CI] = -1.182 to -0.648; I2 = 82.0%; p < 0.001) and depression (SMD = -0.752; 95% CI = -1.034 to -0.470; I2 = 81.4%; p < 0.001). Traditional Chinese ethnic sports are notably effective. Interventions under 3 weeks best reduce depression, while 3 ≤ 7 weeks optimally reduce anxiety. Sessions ≤5 times weekly, with 30 ≤ 60 min for anxiety and >60 min for depression, yield the best outcomes. These results highlight the specific effectiveness of physical activity in alleviating anxiety and depression in COVID-19 patients.

Causal effect of video gaming on mental well-being in Japan 2020-2022

The widespread use of video games has raised concerns about their potential negative impact on mental well-being. Nevertheless, the empirical evidence supporting this notion is largely based on correlational studies, warranting further investigation into the causal relationship. Here we identify the causal effect of video gaming on mental well-being in Japan (2020-2022) using game console lotteries as a natural experiment. Employing approaches designed for causal inference on survey data (n = 97,602), we found that game console ownership, along with increased game play, improved mental well-being. The console ownership reduced psychological distress and improved life satisfaction by 0.1-0.6 standard deviations. Furthermore, a causal forest machine learning algorithm revealed divergent impacts between different types of console, with one showing smaller benefits for adolescents and females while the other showed larger benefits for adolescents. These findings highlight the complex impact of digital media on mental well-being and the importance of considering differential screen time effects.

Motor self-efficacy and physical education in school bullying

In recent years, there has been a notable increase in bullying rates in school. Bullying is characterized as a repeated set of malicious actions by an individual or group toward another individual in an imbalanced power dynamic, resulting in physical, psychological, social, or material harm to the victim, with the intention of causing social exclusion. The scientific literature has investigated the factors that influence this type of behavior, environmental factors, such as school location and student age, as well as other factors, such as gender and level of physical fitness, also play an important role. This study examined the correlation between motor self-efficacy and bullying, considering that physical activity acts as a regulator in these cases. The Kolmogorov-Smirnov test was employed to assess the normality of the data distribution, and Spearman's Rho test was used to analyze the relationship between each dimension of the EBIPQ and E-AEM scores. The Cronbach's alpha was used to evaluate the reliability of each instrument. The results indicated a significant inverse correlation between the EBIP-Q and E-AEM in the variables of sex, educational stage and school environment. In conclusion, an inverse correlation was observed between motor self-efficacy and bullying, indicating that higher levels of motor self-efficacy are related to lower levels of bullying victimization. Motor self-efficacy could be used as a tool to reduce bullying situations at school. It would be important for government policies to encourage the practice of physical activity in all areas of life in order to improve motor self-efficacy and end bullying.

Effects of replacing sedentary time with alterations in physical activity or sleep on mood states in Chinese young adults during the pandemic

BACKGROUND

Poor mood states pose the most frequent mental health, creating a considerable burden to global public health. Sedentary behavior is an essential factor affecting mood states, however, previous measures to reduce sedentary time in Chinese young adults have focused only on increasing physical activity (PA). Sedentary, PA, and sleep make up a person's day from the standpoint of time use. It is not known whether reallocating sedentary time to different types of PA (e.g. daily PA and structured PA) or sleep during an epidemic has an effect on mood states. Therefore, this study aimed to examine the association between replacing sedentary time with different types of PA or sleep during the pandemic and the mood states of Chinese young adults and to further examine whether this association varies across sleep populations and units of replacement time.

METHOD

3,579 young adults aged 18 to 25 years living in China and self-isolating at home during the COVID-19 outbreak were invited to complete an online questionnaire between February from 23 to 29, 2020. Subjects' PA, sedentary time, and mood states were assessed using the International Physical Activity Questionnaire and the Chinese version of the Profile of Mood States, respectively. Participants also reported sleep duration and some sociodemographic characteristics. Participants were divided into short sleepers (< 7 h/d), normal sleepers (7-9 h/d), and long sleepers (> 9 h/d) based upon their reported sleep duration. Relevant data were analyzed using Pearson correlation analysis and isotemporal substitution model (ISM).

RESULTS

Sedentary time was negatively associated with mood states in Chinese young adults during the pandemic (r = 0.140) and correlated strongest among short sleepers (r = 0.203). Substitution of sedentary time with structured PA was associated with good mood states (β=-0.28, 95% CI: -0.49, -0.08). Additionally, substituting sedentary time with daily PA (e.g. occupational PA, household PA) was also associated with good mood states among normal sleepers (β=-0.24, 95% CI: -0.46, -0.02). The substitution of sedentary time with sleep could bring mood benefits (β=-0.35, 95% CI: -0.47, -0.23). This benefit was particularly prominent among short sleepers. Furthermore, for long sleepers, replacing sedentary time with sleep time also resulted in significant mood benefits (β=-0.41, 95% CI: -0.69, -0.12). The longer the duration of replacing sedentary behavior with different types of PA or sleep, the greater the mood benefits.

CONCLUSIONS

A reallocation of as little as 10 min/day of sedentary time to different types of PA or sleep is beneficial for the mood states of young adults. The longer the reallocation, the greater the benefit. Our results demonstrate a feasible and practical behavior alternative for improving mood states of Chinese young adults.

Exploring the influence of leadership styles on psychological well-being and satisfaction of Pilates classes clients

BACKGROUND

The recent trend of increased indoor activities has significantly influenced daily life, enhancing the popularity of exercises like Pilates. This study explores how Pilates instructors' leadership styles affect class satisfaction and psychological well-being, addressing the research gap concerning the specific impact of leadership within the context of Pilates classes.

METHODS

The study surveyed 388 participants from 39 Pilates studios across South Korea, utilizing a questionnaire to assess leadership styles (transformational, transactional, and servant leadership), class satisfaction, and psychological well-being. Using statistical analyses, leadership styles were assessed for their correlation with class satisfaction and psychological well-being.

RESULTS

Findings revealed that transformational and transactional leadership styles were positively correlated with class satisfaction and psychological well-being. Specifically, transformational leadership significantly enhanced educational satisfaction and personal growth, while transactional leadership most strongly influenced social satisfaction and the sense of purpose in life. Servant leadership was notably effective in improving physical class satisfaction. The study also highlighted the critical role of class satisfaction in promoting psychological well-being among participants.

CONCLUSION

This research underscores the importance of leadership styles in enhancing the Pilates class experience, suggesting that instructors' leadership approaches can significantly impact participants' satisfaction and psychological well-being. The study advocates developing training programs that equip Pilates instructors with the skills to adopt effective leadership styles, fostering a more positive and fulfilling class environment.

Adolescent mental health interventions: a narrative review of the positive effects of physical activity and implementation strategies

Introduction

The psychological well-being of adolescents is a global concern due to increasing societal pressures and mental health issues. Physical activity is known to enhance physical health and has potential benefits for mental health, including reducing symptoms of anxiety and depression, boosting self-esteem, and improving social skills. This narrative review explores how physical activity can serve as an intervention to help adolescents manage psychological stress and prevent mental health issues.

Methods

An extensive literature search was conducted using databases such as PubMed, PsycINFO, Web of Science, and Scopus. Keywords included "adolescent mental health," "physical activity," "psychological intervention," "types of exercise," "anxiety," "depression," "self-esteem," "social skills," and "emotional regulation." Studies were included based on relevance, peer-reviewed status, and involvement of adolescent populations. Data were extracted and analyzed qualitatively, focusing on the psychological impacts of different types of physical activity. Sixty one articles were eventually included.

Results and conclusion

The review identified multiple studies highlighting the positive effects of various physical activities on adolescent mental health. Aerobic exercises were found to improve mood and cognitive function, strength training reduced depressive symptoms and increased self-efficacy, team sports enhanced social skills and a sense of community, and mind-body practices like yoga and tai chi improved stress management and emotional regulation. The findings suggest that physical activity can play a significant role in promoting adolescent mental health. Implementation strategies in school and community settings, including integrating physical activity into school curricula, offering diverse activity options, training professional instructors, encouraging family and community involvement, and regular monitoring and evaluation, are recommended. Future research should address limitations such as sample diversity and long-term effects. This narrative review underscores the importance of physical activity in enhancing adolescent mental health. Effective implementation strategies and multi-sector collaboration are essential for maximizing the benefits of physical activity interventions.

Anthropomorphic and Physical Fitness Characteristics of United States Air Force Basic Military Training: Special Warfare Versus Nonspecial Warfare Recruits, Fiscal Year 2019-2023

INTRODUCTION

Each year, thousands of individuals enlist in the Department of the Air Force (DAF), with some seeking to become DAF Special Warfare (SW) candidates. This study aimed to compare the anthropomorphic and physical fitness characteristics between these groups during fiscal years (FYs) 2019-2023.

METHODS

 The sample includes male candidates below the age of 30 who attended the DAF basic military training (BMT) from FY2019 to 2023 (N = 119,415). Initial physical fitness testing was conducted during week 1 of BMT. Physical fitness results, height, weight, and body mass index (BMI) were compared between the two cohorts. A two-way analysis of variance was performed to analyze the effects of group (SW and non-SW) and FY on mean anthropomorphic and physical fitness test variables. Dependent variables were evaluated for homogeneity of variance using Levene's test and for normality using the Shapiro-Wilk test. The Tukey-Kramer test was employed for post hoc analyses with a threshold for statistical significance of α < 0.05.

RESULTS

 The cohort of SW recruits displayed superior physical fitness results across all FYs (p < 0.001) with the exception of FY2021. They were significantly taller and heavier, and had a higher BMI when compared to non-SW DAF BMT recruits (p < 0.001). Mean values for maximum push-ups and sit-ups for SW recruits were significantly lower in FY2021 (p < 0.001) and not significantly different from non-SW recruits. Additionally, run times for both SW- and non-SW-bound recruits during FY2022 and FY2023 were significantly slower than previous years.

CONCLUSIONS

 These findings can be used to establish a baseline for anthropometric and physical fitness profiles of incoming SW and non-SW DAF BMT recruits that may inform clinicians, human performance professionals, and military training leaders with information necessary to guide future research and physical fitness policy.

A structural model of EFL teachers' physical activity, emotion regulation, and competence for online teaching

BACKGROUND

The COVID-19 pandemic has prompted a rapid shift to online teaching, placing unprecedented demands on educators' physical and mental well-being. However, the relationship between English as a Foreign Language (EFL) teachers' physical activity, emotion regulation, and competence for online teaching remains underexplored.

OBJECTIVES

This study aimed to investigate the interplay between EFL teachers' physical activity, emotion regulation strategies, and competence for online teaching.

RESULTS

Structural equation modeling revealed significant direct and indirect effects, indicating that physical activity positively influences emotion regulation, which, in turn, enhances teachers' competence for online instruction. Furthermore, emotion regulation was found to mediate the relationship between physical activity and online teaching competence.

CONCLUSIONS

These findings underscore the importance of promoting physical activity among EFL teachers as a means to enhance their emotion regulation skills and competence for online teaching, particularly in the context of the COVID-19 pandemic.

IMPLICATIONS

The study highlights the need for targeted interventions aimed at supporting EFL teachers' well-being and professional development, with implications for educational policies, teacher training programs, and institutional support structures in the digital learning landscape.

Effects of no mask, a surgical mask and a fabric buff on peripheral oxygenation saturation during moderate intensity exercise: a randomised cross-over study

Background

Mask-wearing caused significant reductions in coronavirus disease 2019 (COVID-19) transmission. We aimed to determine whether face mask-wearing during exercise caused reductions in peripheral oxygen saturation (SpO2) and whether it affected secondary physiological measures [end-tidal carbon dioxide (EtCO2), respiratory rate (RR), heart rate (HR), expired breath temperature (EBT)]. Subjective measurements included ratings of perceived exertion (RPE), ratings of perceived breathlessness (RPB), and symptomology.

Methods

A randomised cross-over trial examined no mask (NM), surgical mask (SM) and a buff mask (BM). Thirty participants (30-45 years) cycled at 60% power output for 30 min in three exercise sessions, 24 h apart, within 6 days. Each session recorded all measures at resting baseline (T0), 9 min (T1), 18 min (T2), and 27 min (T3). Dependent statistical tests determined significant differences between masks and time-points.

Results

SpO2 decreased for SM and BM between T0 compared to T1, T2 and T3 (all P<0.005). BM caused significant reductions at T1 and T2 compared to NM (P<0.001 and P=0.018). Significant changes in EtCO2 and EBT occurred throughout exercise and between exercise stages for all mask conditions (P<0.001). As expected for moderate intensity exercise, RR and HR were significantly higher during exercise compared to T0 (P<0.001). RPB significantly increased for each condition at each time point (P<0.001). RPE was not significant between mask conditions at any exercise stage.

Conclusions

SM and BM caused a mild but sustained reduction in SpO2 at commencement of exercise, which did not worsen throughout short (<30 min) moderate intensity exercise. Level of perception was similar, suggesting healthy people can wear masks during moderate exercise and activities of daily living.

Higher level of physical activity reduces mental and neurological symptoms during and two years after COVID-19 infection in young women

Previous studies found that regular physical activity (PA) can lower the risk of SARS-CoV-2 (COVID-19) infection and post-COVID-19 condition (PCC), yet its specific effects in young women have not yet been investigated. Thus, we aimed to examine whether regular physical activity reduces the number of symptoms during and after COVID-19 infection among young women aged between 18 and 34 (N = 802), in which the confounding effect of other morbidities could be excluded. The average time since infection was 23.5 months. Participants were classified into low, moderate, and high PA categories based on the reported minutes per week of moderate and vigorous PA. Using the Post-COVID-19 Case Report Form, 50 different symptoms were assessed. Although regular PA did not decrease the prevalence of COVID-19 infection and PCC but significantly reduced the number of mental and neurological symptoms both in acute COVID-19 and PCC. Importantly, the high level of PA had a greater impact on health improvements. In addition, the rate of reinfection decreased with an increased level of PA. In conclusion, a higher level of regular PA can reduce the risk of reinfection and the number of mental and neurological symptoms in PCC underlying the importance of regular PA, even in this and likely other viral disease conditions.

Climate change, ambient air pollution, and students' mental health

The impact of global climate change and air pollution on mental health has become a crucial public health issue. Increased public awareness of health, advancements in medical diagnosis and treatment, the way media outlets report environmental changes and the variation in social resources affect psychological responses and adaptation methods to climate change and air pollution. In the context of climate change, extreme weather events seriously disrupt people's living environments, and unstable educational environments lead to an increase in mental health issues for students. Air pollution affects students' mental health by increasing the incidence of diseases while decreasing contact with nature, leading to problems such as anxiety, depression, and decreased cognitive function. We call for joint efforts to reduce pollutant emissions at the source, improve energy structures, strengthen environmental monitoring and gover-nance, increase attention to the mental health issues of students, and help student groups build resilience; by establishing public policies, enhancing social support and adjusting lifestyles and habits, we can help students cope with the constantly changing environment and maintain a good level of mental health. Through these comprehensive measures, we can more effectively address the challenges of global climate change and air pollution and promote the achievement of the United Nations Sustainable Development Goals.

The Psychosocial Effects of Lockdown Due to the COVID-19 Pandemic on Children in 2021

Objectives The COVID-19 pandemic led to a nationwide lockdown that isolated numerous children and adolescents, significantly affecting their mental well-being. Therefore, this study aimed to assess the challenges faced by children during the pandemic and identify the potential contributing factors. Additionally, given the existing concerns surrounding the mental health of female children and adolescents, our study aimed to investigate the presence of sex-based disparities in children's observed emotional and behavioral difficulties during the COVID-19 lockdown. Methods Participants in this study were parents of children aged 6-17 years. An observational cross-sectional study was conducted through verbal administration of a validated semi-structured questionnaire, the Parent Report Measure, from June 2021 to August 2021 at a nearby community health center. The questionnaire collected socio-demographic details and utilized the Strengths and Difficulties Questionnaire (SDQ), a screening tool to assess children's emotional and behavioral aspects during the six-month lockdown period. The responses were then analyzed using appropriate statistical tools like SPSS statistics, and cumulative SDQ scores were used to categorize participants. Results Out of the total 280 responses analyzed, the prosocial subscale exhibited the highest number of abnormal responses, 73 (26.1%), followed by conduct (42; 15%), hyperactivity (41; 14.6%), and peer (41; 14.6%) subscales. These results indicated that children displayed decreased empathy towards others, restlessness, fidgetiness, reduced attention span, frequent tantrums, and a preference for solitary activities. Furthermore, there was a significant association between abnormal subscale scores and the sex of children. Females showed a considerably higher prevalence of emotional problems (172; 61.5%) than males. Among the behavioral responses, a more significant proportion of females displayed abnormal scores in the conduct subscale (170; 60.7%), while abnormal hyperactivity scores were more frequently observed among males (178; 63.4%). Regarding the peer problems subscale, the proportion of females was slightly higher than males (150; 53.7%) and nearly equal in the prosocial domain. A more significant proportion of females displayed abnormal scores for overall difficulties 144 (51.5%), indicating a notable sex-based disparity. Conclusion Our findings highlight the pandemic's significant impact on many children's psychological well-being. The results emphasize the need for targeted interventions to address the mental health concerns that arose in this population. The observed disparity in emotional and behavioral difficulties among female children is particularly concerning, highlighting the need for gender-sensitive support and care. Various strategies can be helpful, such as virtual support groups, indoor recreational activities, reduced screen time and excessive news consumption, and effective communication with parents. Furthermore, our study also indicates the need to dive deep into such areas of pediatric research to understand and plan timely interventions.

Global landscape of COVID-19 research: a visualization analysis of randomized clinical trials

The emergence of COVID-19 in 2019 has resulted in a significant global health crisis. Consequently, extensive research was published to understand and mitigate the disease. In particular, randomized controlled trials (RCTs) have been considered the benchmark for assessing the efficacy and safety of interventions. Hence, the present study strives to present a comprehensive overview of the global research landscape pertaining to RCTs and COVID-19. A bibliometric analysis was performed using the Scopus database. The search parameters included articles published from 2020 to 2022 using keywords specifically related to COVID-19 and RCTs. The data were analyzed using various bibliometric indicators. The volume of publications, contributions of countries and institutions, funding agencies, active journals, citation analysis, co-occurrence analysis, and future research direction analysis were specifically analyzed. A total of 223,480 research articles concerning COVID-19 were published, with 3,727 of them related to RCTs and COVID-19. The ten most productive countries collectively produced 75.8% of the documents, with the United States leading the way by contributing 31.77%, followed by the UK with 14.03% (n = 523), China with 12.96% (n = 483) and Canada with 7.16% (n = 267). Trials (n = 173, 4.64%), BMJ Open (n = 81, 2.17%), PLOS One (n = 73, 1.96%) and JAMA Network Open (n = 53, 1.42%) were the most active journals in publishing articles related to COVID-19 RCTs. The co-occurrence analysis identified four clusters of research areas: the safety and effectiveness of COVID-19 vaccines, mental health strategies to cope with the impact of the pandemic, the use of monoclonal antibodies to treat patients with COVID-19, and systematic reviews and meta-analyses of COVID-19 research. This paper offers a detailed examination of the global research environment pertaining to RCTs and their use in the context of the COVID-19 pandemic. The comprehensive body of research findings was found to have been generated by the collaborative efforts of multiple countries, institutions, and funding organizations. The predominant research areas encompassed COVID-19 vaccines, strategies for mental health, monoclonal antibodies, and systematic reviews. This information has the potential to aid researchers, policymakers, and funders in discerning areas of weakness and establishing areas of priority.

Physical activity, acute severity and long-term consequences of COVID-19: an 18-month follow-up survey based on a Swedish national cohort

OBJECTIVE

To investigate how changes in levels of physical activity (PA) in regard to acute disease severity relate to perceived difficulties in performing daily life activities 18 months after COVID-19 infection.

DESIGN

An observational study with an 18-month follow-up survey based on registry data from a national cohort.

PARTICIPANTS

5464 responders to the 18-month follow-up survey of a Swedish national cohort of 11 955 individuals on sick leave due to COVID-19 during the first wave of the pandemic.

OUTCOMES

The follow-up survey included questions on daily life activities, as well as present and retrospective level of PA. Changes in PA level from before COVID-19 to follow-up were assessed by the Saltin-Grimby PA Level Scale and analysed by the Wilcoxon signed-rank test. Comparisons of groups were analysed by the Student's t-test, Mann-Whitney U test and χ2. Multiple binary logistic regression was performed to assess the association of changes in PA with perceived difficulties in performing daily life activities.

RESULTS

Among the 5464 responders (45% of national cohort), the PA level decreased. Hospitalised individuals had a lower PA level both prior to COVID-19 (p=0.035) and at the 18-month follow-up (p=0.008) compared with non-hospitalised responders. However, the level of PA decreased in both groups. A decrease in PA level increased the odds (OR 5.58, 95% CI 4.90 to 6.34) of having difficulties performing daily life activities.

CONCLUSIONS

PA levels were reduced 18 months after COVID-19 infection. A decrease in PA over that time was associated with perceived difficulties performing daily life activities 18 months after COVID-19. As PA is important in maintaining health and deconditioning takes time to reverse, this decline may have long-term implications for PA and health.

Association between physical activity levels and anxiety or depression among college students in China during the COVID-19 pandemic: A meta-analysis

BACKGROUND

This meta-analysis aimed to investigate the links between the level of physical activity and the risk of anxiety or depression among college students in China during the Coronavirus Disease 2019 pandemic.

METHODS

Eligible studies were searched from the PubMed, Embase, and Web of Science databases. The associations between them were assessed with odd ratio (OR) and 95% confidence interval (CI). The heterogeneity of the included studies was evaluated and subgroup analysis was performed. Sensitivity analysis was executed using leave-one-out method. Publication bias of included studies was evaluated. Ten studies with moderate quality were included.

RESULTS

Physical activity levels of college students were associated with reduced risk of depression (OR [95%CI] = 0.69 [0.58, 0.82], P < .001) and anxiety (OR [95%CI] = 0.71 [0.62, 0.80], P < .001). The measurement scale of depression or anxiety and whether multi-factor correction was performed or not did not influence the pooled results. The pooled results of depression and anxiety were stable and were not significantly influenced by a single study. No publication bias was observed in the included studies reporting depression and anxiety.

CONCLUSION

The physical activity level of college students is negatively correlated with anxiety and depression in China during the pandemic. During the Coronavirus Disease 2019 pandemic, it is necessary to strengthen the construction of university physical education courses. As an organized form of physical activity, physical education classes are a necessary and effective way to increase physical activity among college students.

A Comparison of Changes in Health Behavior, Obesity, and Mental Health of Korean Adolescents Before and During the COVID-19 Pandemic: Online Cross-Sectional Study

OBJECTIVE

The health behavior and mental health problems of adolescents have shown a variety of changes due to the coronavirus disease-2019 (COVID-19) pandemic. This study compared health behavior, obesity, and mental health among Korean adolescents before and during the early COVID-19 pandemic.

METHODS

Population-based and cross-sectional data from the 2019 and 2020 Korea Youth Risk Behavior Web-Based Surveys were used. Data of 57,048 and 54,948 adolescents from the 2019 and 2020 surveys, respectively, were compared. Multiple logistic regression analysis was conducted to compare health behavior, obesity, and mental health before and during the COVID-19 pandemic.

RESULTS

The adjusted odds ratio (aOR) of overweight, obesity, and body image perceived subjectively as fat, were higher in the 2020 sample compared to the 2019 sample. The aOR of the frequency (more than 3 times a week) of fast-food consumption was higher in 2020 than in 2019. However, the aOR of physical activity, alcohol use, and smoking experience were lower in 2020 than in 2019. In addition, during COVID-19, adolescents were less likely to have perceived severe stress, depressive moods, and suicidal ideation.

CONCLUSION

Current evidence suggests the co-occurrence of positive and negative changes in health behavior, obesity, and mental health among Korean adolescents during the early COVID-19 pandemic. The results contribute insights for monitoring adolescents' health behavior and promoting their mental health during school shutdowns.

Return to Play after SARS-CoV-2 Infection: Focus on the Pediatric Population with Potential Heart Involvement

The COVID-19 pandemic has entailed consequences on any type of physical activities, mainly due to the social restriction measures applied to reduce the spreading of SARS-CoV-2. When public health policies progressively reduced limitations and resuming a normal life was possible, the return to previous physical activity and sports was not only requested by people who had deeply suffered from limitations, but was also recommended by experts as a means of reducing the physical and psychological consequences induced by the pandemic. The aim of this narrative review is to summarize the available evidence on the return to play in children after SARS-CoV-2 infection, suggesting an algorithm for clinical practice and highlighting priorities for future studies. Criteria to identify subjects requiring laboratory and radiological tests before returning to physical activity are severity of COVID-19 and existence of underlying disease. Children of any age with asymptomatic infection or mild disease severity, i.e., the great majority of children with previous COVID-19, do not need a cardiologic test before resumption of previous physical activity. Only a visit or a telephonic contact with the primary care pediatricians should be established. On the contrary, children with moderate COVID-19 should not exercise until they are cleared by a physician and evaluated for resting electrocardiogram, exercise testing, and echocardiogram. Finally, in those with severe COVID-19, return to play should be delayed for several months, should be gradual and should be performed only after a cardiologist's clearance. Further studies are needed to assess the risks of returning to sports activity in pediatric age, including careful age-adjusted risk stratification, in order to improve the cost-benefit ratio of specific screenings.

Age group differences in psychological distress and leisure-time exercise/socioeconomic status during the COVID-19 pandemic: a cross-sectional analysis during 2020 to 2021 of a cohort study in Japan

Objective

This study aimed to determine the association between psychological distress and leisure-time exercise/socioeconomic status by age group, using data from a cohort study in Japan during the COVID-19 pandemic.

Methods

This cross-sectional study was conducted among participants in the ME-BYO cohort, aged 20-85 years, living or working in Kanagawa, Japan. A questionnaire was disseminated to 1,573 participants (51.7% men) between December 2020 and March 2021. The questionnaire items included psychological distress (using the 6-item Kessler Psychological Distress Scale [K6]), leisure-time exercise, and socioeconomic status. Multivariate analyses were conducted using logistic regression analysis for each age group.

Results

We found that 47.4% of 20-39-year-olds, 40.6% of 40-64-year-olds, and 28.3% of 65-85-year-olds experienced psychological distress (K6: ≥5 points). For those aged 20-39 years, leisure-time exercise (odds ratio [OR] (95% confidence interval) = 0.45 (0.28-0.73)) and higher annual household income [0.53 (0.32-0.90)] were associated with less psychological distress. For those aged 40-64 years, older age was associated with less psychological distress, while full-time work [1.98 (1.05-9.71)] was associated with more psychological distress. In the 65-85-year age group, higher education and higher annual income tended to be associated with less psychological distress. For those over 40 years of age, living with other(s) was associated with reduced psychological distress.

Conclusion

In the general population of Japan, not engaging in leisure-time exercise and low income affect psychological distress among young adults. Further detailed studies are needed to consider overall physical activity, job type, and work style.

Structural modeling of EFL/ESL teachers' physical activity, mental health, psychological well-being, and self-efficacy

BACKGROUND

Physical activity (PA) is known to positively affect individuals' mental and physical health, especially those who experience high levels of stress, such as teachers. Previous studies have examined the relationship between teachers' PA, mental health, and well-being. Still, there is a lack of research on the direct and indirect effects of PA and self-efficacy.

PURPOSE

This study aimed to investigate the structural relationship between teachers' PA, mental health, well-being, and self-efficacy among ESL/EFL teachers. A total of 364 Chinese English language teachers were selected through convenience sampling. Mental health, physical activity, psychological well-being, and self-efficacy instruments were used.

METHODOLOGY

The data was analyzed using Smart PLS software, and the hypothesized model was evaluated. The results indicated an acceptable level of divergent and convergent validity and goodness of fit.

RESULTS

The findings revealed that PA directly predicts teachers' mental health and well-being, but the direct structural relationship between teachers' PA and self-efficacy was not confirmed. However, the results showed that teachers' PA contributes to their self-efficacy by enhancing their mental and psychological well-being. The total effect of teachers' PA on their self-efficacy was significant. Additionally, mental health and psychological well-being strongly influenced teachers' self-efficacy.

CONCLUSION

In conclusion, regular weekly physical activity can help EFL/ESL teachers foster their mental health, psychological well-being, and self-efficacy. These findings have theoretical and practical significance for teachers, trainers, and educational psychologists.

Sports activity limitation during the COVID-19 pandemic in young Italian athletes: impact on mental health in children, adolescents, and young adults

Introduction

The closure of sports centres was implemented as a preventive measure to mitigate the transmission of SARS-CoV-2. Given the observed global decline in physical activity and concurrent rise in sedentary behaviour, even among younger age groups, a retrospective cross-sectional study was undertaken to evaluate the effects of this measure on mental health in children, adolescents, and young adults during the initial phases of the COVID-19 pandemic.

Methods

A total of 1,717 non-professional athletes (age range: 6-25; 53.9% males, 44.6% females) completed an online questionnaire including widely used and validated measures for mental health assessment (SDQ and PGWB-S) and questions regarding sociodemographic characteristics (such as gender), physical activity, and screen time. The association between mental health and sociodemographic characteristics, physical activity, and screen time was evaluated by using univariate and multivariable logistic regression models.

Results

In children and adolescents, the incidence of psychological difficulties was associated with not being physically active (OR = 1.49; 95% CI: 1.09, 2.07; p = 0.015). Engaging in physical activity during the period of closures, particularly if more than twice a week, was significantly associated with less psychological difficulties for children/adolescents (OR = 0.54; 95% CI: 0.35, 0.82; p = 0.004) and psychological symptoms (i.e., psychological well-being lower than the median) for youth/young adults (OR = 0.25; 95% CI: 0.14, 0.45; p < 0.001). More psychological difficulties were also found in males for children and adolescents (OR = 1.37; 95% CI: 1.06, 1.79; p = 0.018). However, young adult males showed less psychological symptoms than females (OR = 0.35; 95% CI: 0.22, 0.55; p = 0.001). Additionally, a greater amount of screen time was associated with a higher incidence of psychological symptoms in the whole sample.

Conclusions

Our results confirm the positive impact of physical activity on mental health during the COVID-19 pandemic among younger age groups. They also provide valuable insights into the risk-benefit relationship of interrupting sports activities as a preventive measure for infectious diseases.

Differential mechanisms affecting weight loss and weight loss maintenance

In most lifestyle, pharmacological and surgical interventions, weight loss occurs over an approximately 6- to 9-month period and is followed by a weight plateau and then weight regain. Overall, only about 15% of individuals can sustain a 10% or greater non-surgical, non-pharmacological, weight loss. A key question is the degree to which the genotypes, phenotypes and environmental correlates of success in weight loss and weight loss maintenance are continuous or dichotomous. This Perspective is a comparison of the interactions of weight loss and maintenance with genetic, behavioural, physiological and environmental homeostatic systems and a discussion of the implications of these findings for research in, and treatment of, obesity. Data suggest that weight loss and weight loss maintenance are physiologically and psychologically different in many ways. Consequently, individuals may require different interventions designed for temporarily sustaining a negative energy balance during weight loss versus permanently maintaining energy balance after weight loss.

Effectiveness of an Integrated Mobile Application for Lifestyle Modifications in Overweight Women with Polycystic Ovarian Syndrome: A Randomized Controlled Trial

Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women, characterized by hormonal imbalances and metabolic disturbances. Lifestyle modifications, including weight loss, are crucial for the management of PCOS symptoms. Mobile applications have emerged as promising tools to support lifestyle modifications. This study aimed to evaluate the effectiveness of a 12-week integrated lifestyle modification program, which used a mobile application, among overweight women with PCOS. A randomized controlled trial was conducted with 28 participants, who were assigned to either treatment group, which received a 12-week lifestyle modification program facilitated by a mobile application, or the control group, who were instructed to maintain their usual lifestyle and received an evidence-based leaflet containing information on PCOS. The primary outcome measure was a change in weight over 12 weeks. Insulin resistance, levels of sex hormones, hirsutism, acne, and depressive symptoms were measured as secondary outcomes. The results showed significant weight loss in the treatment group compared to the control group (3.19 vs. 0.79 kg; p < 0.05). Similarly, significant improvements were observed across time in postprandial insulin levels (22.25 vs. 9.29 μIU/mL), hirsutism (2.98 vs. -0.16 points), and depression (7.73 vs. 1.7 points) (p < 0.05) between the two groups. This study highlights the potential benefits of using a mobile application to support lifestyle modifications, including weight loss and improvement in depressive symptoms, in overweight women with PCOS. Further research is needed to explore the long-term effects and incorporation of advanced technologies to enhance PCOS management outcomes. Mobile applications for lifestyle modifications offer a promising avenue for addressing the unique challenges faced by women with PCOS and provide accessible and personalized support for their health needs.

Exploring the relationship between unemployment perception and health during COVID-19: a comparative study of rural and urban adults in China

Introduction

The COVID-19 pandemic has significantly impacted global economies and individual health. This study uses data from the China Family Panel Data (CFPS) in 2018 (before the pandemic) and 2020 (during the pandemic) to a) estimate the relationships between the perceived risk of unemployment and individuals' mental health, physical health, and health behaviors; and b) explore the variations of these relationships between rural and urban adults in China.

Methods

Ordinary linear regression models or Logit models are employed, depending on the nature (continuous vs. discrete) of the dependent variables.

Results

We find that the perceived risk of unemployment was statistically and positively associated with the risk of depression, and the association was greater for rural adults than for urban adults. Rural-urban variations were observed in various dimensions. For rural adults, the perceived risk of unemployment was statistically and negatively associated with life satisfaction, the probability of gaining weight and becoming obese, the probability of having adequate sleep, and computer-based screen time. These associations were statistically insignificant for urban adults. On the other hand, the perceived risk of unemployment was statistically and negatively associated with self-rated very-good-to-excellent health condition and health-compromising behaviors (e.g., smoking and drinking) for urban adults; but such associations were statistically insignificant for rural adults.

Discussion

These findings suggest that rural and urban adults exhibited different psychological and behavioral responses to the unemployment risk during the COVID-19 pandemic. Public policies aiming to improve health and employment should be strategically designed to address the unique needs of urban and rural populations.

Sport and physical exercise in sustainable mental health care of common mental disorders: Lessons from the COVID-19 pandemic

The large-scale disruptions to physical activity during the coronavirus pandemic have been found to be a leading predictor of common mental disorders. In addition, regular physical exercise has been found to alleviate anxiety, sadness and depression during the pandemic. These findings, together with numerous studies published before the pandemic on the effects of physical activity on mental health, should be considered in the provision of mental health care following the pandemic. Cross-sectional research has revealed that all types of exercise and sport are associated with a reduced mental health burden. Therefore, the effectiveness of exercise and sport participation in sustainable mental health care as well as the causal relationship between exercise, psychosocial health and common mental disorders merit further investigation. Physical activity and sport, with their global accessibility, significant and clinically meaningful efficacy as well as virtual absence of adverse effects, offer a promising option for the promotion of mental health, including the prevention and treatment of common mental disorders. Physical exercise and sport are likely to become valuable public mental health resources in the future.

Bidirectional associations of physical activity, sleep, and self-reported mental health in young adults participating in an online wellness intervention during the COVID-19 pandemic

Purpose

The purpose of this study was to examine the bidirectional associations of physical activity (PA), sleep, and mental health in young adults participating in an online wellness intervention from October 2021 to April 2022.

Methods

Participants were a sample of undergraduate students from one US university (N = 89; 28.0% freshman; 73.0% female). The intervention was a 1-h health coaching session that was delivered either once or twice by peer health coaches on Zoom during COVID-19. The number of coaching sessions was determined by random allocation of participants to experimental groups. Lifestyle and mental health assessments were collected at two separate assessment timepoints after each session. PA was assessed using the International Physical Activity Questionnaire-Short Form. Weekday and weekend sleep were assessed by two one-item questionnaires and mental health was calculated from five items. Cross-lagged panel models (CLPMs) examined the crude bidirectional associations of PA, sleep, and mental health across four-time waves (i.e., T1 through T4). To control for individual unit effects and time-invariant covariates, linear dynamic panel-data estimation using maximum likelihood and structural equation modeling (ML-SEM) was also employed.

Results

ML-SEMs showed that mental health predicted future weekday sleep (β = 0.46, p < 0.001) and weekend sleep predicted future mental health (β = 0.11, p = 0.028). Although CLPMs showed significant associations between T2 PA and T3 mental health (β = 0.27, p = 0.002), no associations were observed when unit effects and time-invariant covariates were accounted for.

Conclusion

Self-reported mental health was a positive predictor of weekday sleep and weekend sleep positively predicted mental health during the online wellness intervention.

Adolescents' Lifestyle Determinants in Relation to Their Nutritional Status during COVID-19 Pandemic Distance Learning in the North-Western Part of Romania-A Cross-Sectional Study

Several studies have examined how the lockdown restrictions enforced to halt the spread of COVID-19 have affected adults' movement behaviors; however, there is limited information regarding the effects on youth. This study aimed to report on the lifestyle habits of adolescents during COVID-19 pandemic remote learning and explore associations between the participants' bodyweight and lifestyle behaviors. We used a cross-sectional study applied to 285 students studying in the gymnasium. The response rate was 74.21%. They completed an online questionnaire regarding lifestyle, eating habits, and nutritional status (assessed by the Body Mass Index-BMI). The study was conducted in January-February 2021. The percentage of overweight and obese was higher among boys (p = 0.001). The mean sleep duration was 8.12 (SD:1.284) hours per night, and was higher in boys than in girls. The respondents met the physical activity (PA) recommendation for their age, based mainly on unorganized PA. The screen time was 4-6 h or more for the majority of the respondents. Dietary habits included a high consumption of comfort food, like cereals, sweets, soft drinks, snacks, and fried food, but a lower consumption of vegetables and fast food. The regression analyses showed that the BMI was correlated with the BMI of the parents and the number of hours spent in front of the computers in free time. The study identified behavioral and environmental factors that can be modified with effective strategies to reduce overweight and obesity among school students and to promote a healthy lifestyle.

Life in a time of COVID: retrospective examination of the association between physical activity and mental well-being in western Australians during and after lockdown

BACKGROUND

The aim of this study was to examine physical activity and sedentary behaviours during Western Australia's COVID-19 lockdown and their association with mental well-being.

METHODS

Participants completed activity related questions approximately two months after a three-month lockdown (which formed part of a larger cross-sectional study from August to October 2020) as part of a 25-minute questionnaire adapted from the Western Australia Health and Well-being Surveillance system. Open-ended questions explored key issues relating to physical activity behaviours.

RESULTS

During the lockdown period, 463 participants (female, n = 347; 75.3%) reported lower number of active days (W = 4.47 p < .001), higher non-work-related screen hours per week (W = 11.8 p < .001), and higher levels of sitting time (χ²=28.4 p < .001). Post lockdown body mass index was higher (U = 3.0 p = .003), with obese individuals reporting the highest non-work-related screen hours per week (Wald χ²= 8.9 p = .012). Inverse associations were found for mental well-being where higher lockdown scores of Kessler-10 (p = .011), Dass-21 anxiety (p = .027) and Dass-21 depression (p = .011) were associated with lower physical activity levels. A key qualitative message from participants was wanting to know how to stay healthy during lockdown.

CONCLUSIONS

Lockdown was associated with lower physical activity, higher non-work-related screen time and more sitting time compared to post lockdown which also reported higher body mass index. Lower levels of mental well-being were associated with lower physical activity levels during lockdown. Given the known positive affect of physical activity on mental well-being and obesity, and the detrimental associations shown in this study, a key public health message should be considered in an attempt to maintain healthy activity behaviours in future lockdowns and similar emergency situations to promote and maintain positive well-being. Furthermore, consideration should be given to the isolation of a community due to infectious disease outbreaks and to recognise the important role physical activity plays in maintaining weight and supporting good mental health.

Association of Physical Activity With SARS-CoV-2 Infection and Severe Clinical Outcomes Among Patients in South Korea

Importance

The association of moderate to vigorous physical activity (MVPA) with COVID-19 outcomes is unclear and needs to be investigated.

Objective

To identify the association of longitudinal changes in MVPA with SARS-CoV-2 infection and severe COVID-19 outcomes.

Design, Setting, and Participants

This nested case-control study used data from 6 396 500 adult patients in South Korean who participated in National Health Insurance Service (NHIS) biennial health screenings from period 1 (2017-2018) to period 2 (2019-2020). Patients were followed from October 8, 2020, until the diagnosis of COVID-19 or December 31, 2021.

Exposure

Moderate to vigorous physical activity was measured by self-report on questionnaires during both NHIS health screenings and calculated by adding the frequency (times per week) of each moderate (≥30 minutes per day) and vigorous (≥20 minutes per day) physical activity.

Main Outcomes and Measures

The main outcomes were a positive diagnosis of SARS-CoV-2 infection and severe COVID-19 clinical events. Adjusted odds ratio (aORs) and 99% CIs were calculated using multivariable logistic regression analysis.

Results

A total of 183 350 patients with COVID-19 (mean [SD] age, 51.9 [13.8] years; female, 89 369 [48.7%]; male, 93 981 [51.3%]) among 2 110 268 participants were identified. For participants with vs without COVID-19, the proportion of MVPA frequency at period 2 was 35.8% vs 35.9% for physically inactive, 18.9% vs 18.9% for 1 to 2 times per week, 17.7% vs 17.7% for 3 to 4 times per week, and 27.5% vs 27.4% for 5 or more times per week. Among unvaccinated, physically inactive patients at period 1, the odds for infection increased when engaged in MVPA 1 to 2 times per week (aOR, 1.08; 99% CI, 1.01-1.15), 3 to 4 times per week (aOR, 1.09; 99% CI, 1.03-1.16), or 5 or more times per week (aOR, 1.10; 99% CI, 1.04-1.17) at period 2. Conversely, among unvaccinated patients with MVPA of 5 or more times per week at period 1, the odds for infection decreased when engaged 1 to 2 times per week (aOR, 0.90; 99% CI, 0.81-0.98) or physically inactive (aOR, 0.80; 99% CI, 0.73-0.87) at period 2. The trend of MVPA and incident infection was mitigated when participants were fully vaccinated. Furthermore, the odds for severe COVID-19 showed significant but limited associations with MVPA.

Conclusions and Relevance

The findings of this nested case-control study show a direct association of MVPA with risk of SARS-CoV-2 infection, which was mitigated after completion of the COVID-19 vaccination primary series. In addition, higher levels of MVPA were associated with a lower risk of severe COVID-19 outcomes to limited proportions.

Does exercise participation promote happiness?: Mediations and heterogeneities

This paper uses a nationally representative and large-scale dataset from China to empirically examine the relationship between exercise participation and happiness. To address the problem of reverse causality between the two factors, the instrumental variable (IV) approach is used to deal with endogeneity to some extent. It is demonstrated that higher frequencies of exercise participation are positively related to happiness. Findings also demonstrate that physical exercise could significantly decrease depressive disorders, improves self-rated health conditions and reduces the frequency of health problems affecting people's work and life. At the same time, all of above health factors significantly influence subjective wellbeing. When these health variables are included in regressions, the correlation between exercise participation and happiness declines. This confirms that physical activity helps to improve happiness by enhancing mental and overall health conditions. In addition, results show that physical activities are more prominently related to happiness for male, older and unmarried individuals and those living in rural areas, lacking social security and with higher levels of depression as well as lower socioeconomic status. Furthermore, a series of robustness checks are carried out and exercise participation's positive role in improving happiness is further confirmed using different happiness measures and instrumental variables, various IV models, as well as penalized machine learning methods and placebo tests. With the increasing emphasis of improving happiness as an important goal in the global public health policy, findings of this paper have important policy implications for enhancing subjective wellbeing.

Association between Stress and Physical Fitness of University Students Post-COVID-19 Pandemic

Post-COVID-19 pandemic, most universities changed their educational model from online courses to onsite learning, allowing students to attend regular face-to-face classes. These changes can cause stress in students, which affects physical fitness. The aim of this study was to investigate the relationship between stress levels and physical fitness in female university students. The participants were 101 female university students, 18-23 years of age. All participants completed the Suan Prung Stress Test-60 (SPST-60). The physical fitness test included body composition, cardiorespiratory fitness, as well as musculoskeletal fitness. Multiple linear regression analysis was used to determine the associations between SPST-60 scores and physical fitness. A p-value < 0.05 was considered statistically significant. We found a negative correlation between the sources of stress scores, here environment, and maximal oxygen consumption (β = -0.291; 95% CI, -0.551, -0.031). We also found that symptoms of stress scores in the parasympathetic and sympathetic nervous systems were positively associated with waist-hip circumference ratio (WHR) (β = 0.010; 95% CI, 0.002, 0.017 and β = 0.006; 95% CI, 0.000, 0.012, respectively). Moreover, the symptoms of stress, here emotion, were positively associated with the WHR (β = 0.005; 95 %CI, 0.001, 0.009) and negatively associated with upper extremity muscle strength (β = -0.005; 95% CI, -0.009, 0.000). The results of this study confirmed the associations between stress levels in the post-COVID-19 pandemic era and WHR, maximal oxygen consumption, and upper extremity muscle strength. As a result, stress reduction or prevention alternatives should be considered in order to maintain physical fitness and prevent stress disorders.

Who uses mHealth apps? Identifying user archetypes of mHealth apps

Objective

This study aims to explore the user archetypes of health apps based on average usage and psychometrics.

Methods

The study utilized a dataset collected through a dedicated smartphone application and contained usage data, i.e. the timestamps of each app session from October 2020 to April 2021. The dataset had 129 participants for mental health apps usage and 224 participants for physical health apps usage. Average daily launches, extraversion, neuroticism, and satisfaction with life were the determinants of the mental health apps clusters, whereas average daily launches, conscientiousness, neuroticism, and satisfaction with life were for physical health apps.

Results

Two clusters of mental health apps users were identified using k-prototypes clustering: help-seeking and maintenance users and three clusters of physical health apps users were identified: happy conscious occasional, happy neurotic occasional, and unhappy neurotic frequent users.

Conclusion

The findings from this study helped to understand the users of health apps based on the frequency of usage, personality, and satisfaction with life. Further, with these findings, apps can be tailored to optimize user experience and satisfaction which may help to increase user retention. Policymakers may also benefit from these findings since understanding the populations' needs may help to better invest in effective health technology.

Pandemic-Related Life Events and Physical Inactivity During COVID-19 Among Israeli Adults: The Smoking and Lifestyles in Israel Study

BACKGROUND

Public health measures to contain the COVID-19 pandemic have led to disruptions in daily life, such as job loss and changes in activity. The present study examines the relationship between pandemic-related life events and disuse (prolonged sitting coupled with inactivity) among adults.

METHODS

A cross-sectional study of 4084 adults in Israel (September 2020). The primary independent variables were pandemic-related life events, such as job loss. The primary dependent variable was disuse as measured by the Rapid Assessment Disuse Index (RADI). The RADI was examined continuously and dichotomously as a low RADI score (<26: yes/no).

RESULTS

Linear regression indicated that experiencing a major life event during the pandemic was associated with lower RADI scores (-1.04; 95% confidence interval, -1.48 to -0.61). Similarly, logistic regression revealed that those experiencing a major life event had 1.18 (95% confidence interval, 1.03 to 1.34) times greater odds for low RADI scores in comparison to those not experiencing an event.

CONCLUSIONS

Experiencing pandemic-related major life events was linked to less sitting time and increased activity levels among Israeli adults. Future research should examine underlying mechanisms explaining this relationship to facilitate the design and implementation of targeted interventions.

Parent-child relationships and psychological distress: survey of parents from low-income families after the COVID-19 pandemic

Introduction

This study aims to shed light on parent-child relationships and the psychological health of parents from low-income families after the easing of the COVID-19 pandemic restrictions.

Methods

This cross-sectional study recruited 553 parents of children aged 13-24 years in low-income community settings. The Parent-Child Conflict scale of the Parental Environment Questionnaire (PEQ) was used to measure parent-child conflict. Psychological distress was assessed using the Depression, Anxiety, and Stress Scale short form (DASS-21).

Results

The study revealed a low level of parent-child conflict in the overall study population, with a median PEQ of 48.0 (interquartile range [IQR] 36 to 48). Concerning demographics, married parents reported a likelihood of having a higher level of parent-child conflict over 3 times higher than single parents (OR = 3.18 95%, CI 1.30-7.75). More parent-child conflicts were also found in parents aged 60-72 years old who were unemployed, retired, or housewives and from lower-income groups. In regard to lifestyle factors, a higher level of physical activity and having enough sleep were associated with lower levels of parent-child conflict. Only approximately 1% of the participants reported symptoms of depression, anxiety, or stress.

Discussion

Low risk exists for parent-child conflict and psychological sequelae following the easing of the COVID-19 pandemic restrictions, which could be due to various support measures implemented by the government. Vulnerable parents identified as being at risk of parent-child conflict warrant attention in future advocacy efforts.

Protective effects of physical activity on mental health outcomes during the COVID-19 pandemic

The COVID-19 pandemic has been linked with increased reports of depression, anxiety, and stress. Stay-at-home directives during the pandemic-imposed lifestyle changes, including eating and sedentary behaviors that can further undermine mental health outcomes. Physical activity is a vital component for metabolic health, as well as for mental health by serving as an active coping strategy to manage stress and promote resilience. Global reports of increased sedentary leisure behaviors have been associated with feelings of depression and anxiety, but it unclear whether the relationship between physical activity and depression or anxiety persists over time. In this longitudinal study, we investigated (i) whether physical activity at the onset of the pandemic was related to feelings of depression or anxiety over time and (ii) whether this relationship was mediated by stress appraisals during the pandemic. We surveyed 319 adults living in Canada or the United States to assess physical activity, stress appraisals, and mental health outcomes at two time points over a 6-month period. We found a reduction in leisure-time physical activity that was linked to subsequent feelings of depression. Furthermore, individuals with lower levels of physical activity were more likely to appraise their COVID-19 situation to be uncontrollable at pandemic onset and as the pandemic continued. Stress appraisals of threat and uncontrollability were also positively related to feelings of depression. Modelling these three factors together showed that appraising a situation as uncontrollable mediated the relationship between initial physical activity and subsequent depressive feelings. Although correlational, these data highlight the protective role of leisure-time physical activity against worsened mental health outcomes during periods of prolonged stress.

How do digital lives affect resident mental health in the digital era? Empirical evidence based on Chinese general social survey

Having good mental health means we are better able to connect, function, cope and thrive. The widespread application of digital technology in daily life provides new ways and promising tools for residents to maintain their mental health. Given the importance of mental health for everyone, and the fact that mental health problems are prevalent worldwide, this study discusses how digital lives affects the mental health of residents. The results suggest that digital lives are significantly and positively associated with mental health. Mechanisms analysis identifies personal perceptions (self-rated physical exercise and subjective wellbeing) as the important paths for digital lives to promote mental health, while social perceptions (social trust and social fairness) play a suppressing effect on the relationship between them. The results of further discussion show that the degree of the influence of digital lives on mental health of individuals is heterogeneous among different regions. Due to the difference in development level, the positive impact of digital lives is greater in urban areas than in rural areas, and it is stronger in western regions than in eastern and central regions. This study enriches the nascent research stream of digitalization, explores new paths of harnessing digital technologies for mental health, and offers useful insights for the government to guide them in formulating digital development strategies and achieving the Healthy China Strategy.

The impact of the COVID-19 pandemic on physical activity, life satisfaction, anxiety, stress perception and coping strategies in student-athletes: A comparison between Belarus and Poland-countries with a different approach of anti-pandemic measures

Background

More than two years of the COVID-19 pandemic has changed lives of people around the world and had a profound impact on the field of sports. This has resulted in decreased physical activity (PA) and changes in mental health. The goal was to assess self-reported physical activity, life satisfaction, perceived stress, choice of coping strategies and their correlations among student athletes from two neighboring countries facing different anti-pandemic strategies.

Methods

Cross-sectional surveys using standardized questionnaires: International Physical Activity Questionnaire-Short Form (IPAQ-SF), Satisfaction With Life Scale (SWLS), State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS-10), and Coping Orientation to Problems Experienced (Mini-COPE) to compare 600 students from Physical Education and Sports departments of universities in Belarus (n = 333), where restrictions were found to be less stringent than in neighboring Poland (n = 267).

Results

Minor differences in physical activities between both countries indicate that student athletes have adapted fairly quickly and found ways to keep their PA at a fairly high level. Nevertheless, higher PA was reported in the group of student athletes from Belarus. PA levels correlated with life satisfaction, anxiety and stress levels. Female students from Poland reported lower satisfaction with their lives. Their perception of stress was twice as high as that of their Belarusian counterparts. The most common coping strategy in both groups was active coping. Polish respondents less frequently used strategies of avoiding problems and seeking outside support.

Conclusion

The level of physical activity and well-being of student athletes are associated with increased mental health and coping with stress. They also contribute to prevention of affective disorders during the COVID-19 pandemic. Moreover, it is dependent on the country's anti-pandemic policies.

Intervention of Physical Activity for University Students with Anxiety and Depression during the COVID-19 Pandemic Prevention and Control Period: A Systematic Review and Meta-Analysis

(1) Background: Although physical activity has been widely recognized as an effective way to improve anxiety and depression, we lack a systematic summary of research on improving anxiety and depression during the COVID-19 pandemic. The study aims to systematically analyze how physical activity impacts on this situation in college students during COVID-19. (2) Methods: Both Chinese and English databases (PubMed the Cochrane Library, EMBASE, Web of Science, Scopus, Chinese National Knowledge Infrastructure, Wanfang) were analyzed. All the randomized controlled trials (RCTs) about physical activity intervention for this were included. We received eight eligible RCT experiments before the retrieval time (4 October 2022) in the meta-analysis. (3) Results: Physical activity benefits for college students with significant anxiety were (SMD = -0.50; 95% CI = -0.83 to -0.17; I² = 84%; p < 0.001; Z = 2.98;) and depression (SMD = -0.62; 95% CI = -0.99 to -0.25; I² = 80.7%; p < 0.001; Z = 3.27). Subgroup analyses showed physical activity of different intensities significantly impacted on improving college students' depression and anxiety, but physical activity of 6 < 9 Mets intensity had a greater effect on anxiety than on depression. Interventions of eight weeks or less performed better than those of over eight weeks while interventions less than four times per week had a significant effect on improving the situation. The overall effect of a single intervention of 30 min was more effective than one of over 60 min. (4) Conclusion: Physical activities can effectively improve the situation of anxiety and depression for college students during the COVID-19 pandemic. However, a higher quality RCT experiment is needed to prove it.

Modeling Community Residents' Exercise Adherence and Life Satisfaction: An Application of the Influence of the Reference Group

To expand the application area of the reference group and enrich exercise theoretical research, based on Stimulus-Organism-Response (SOR) framework, this study examines the external factors that motivate adherence to exercise. Taking reference group and strategy and cultural fit as the main stimuli, and personal investment and life satisfaction as mediating variables, this study explores the influence of external stimuli on residents' exercise behavior. In order to enrich the sample size, two surveys of 734 Chinese residents in two cities (Xiamen vs. Fuzhou) were conducted using factor analyses, regression analysis, and t-test analysis. The results indicated that the reference group and strategic and cultural fit as external stimuli impact on residents' personal investment, life satisfaction and exercise adherence, and that personal investment and life satisfaction as the organism has an impact on residents' exercise adherence. Personal investment and life satisfaction play a chain mediating role between the reference group and exercise adherence, and between strategy and cultural fit and exercise adherence. Moreover, the t-test determined the differences between Xiamen and Fuzhou residents' exercise adherence and life satisfaction. Residents' surroundings affect their exercise behavior and life satisfaction. These findings have implications for policymaking aimed at promoting national exercise, which could gradually improve residents' physical fitness, particularly in light of the current coronavirus emergency.

Neurological Consequences, Mental Health, Physical Care, and Appropriate Nutrition in Long-COVID-19

SARS-CoV-2 pandemic has caused a collapse of the world health systems. Now, vaccines and more effective therapies have reversed this crisis but the scenario is further aggravated by the appearance of a new pathology, occurring as SARS-CoV-2 infection consequence: the long-COVID-19. This term is commonly used to describe signs and symptoms that continue or develop after acute infection of COVID-19 up to several months. In this review, the consequences of the disease on mental health and the neurological implications due to the long-COVID are described. Furthermore, the appropriate nutritional approach and some recommendations to relieve the symptoms of the pathology are presented. Data collected indicated that in the next future the disease will affect an increasing number of individuals and that interdisciplinary action is needed to counteract it.

The COVID-19 Pandemic and Overall Wellbeing: Mediating Role of Virtual Reality Fitness for Physical-Psychological Health and Physical Activity

Background

Virtual reality applications are made for various objectives such as business, entertainment, education, and healthcare. Anxiety, phobias, distress, disordered eating, drug addiction, panic disorder, post-traumatic stress disorder, schizophrenia, bipolar disorder, psychosis, depression, and autism spectrum disorders may benefit from virtual reality-based approaches. The 2019 coronavirus (COVID-19) pandemic has impacted the way we live, enjoy, study, sport, and socialize significantly. Virtual reality fitness technology gained much attention during the COVID-19 preventive measures time.

Objective

The present study explores the role of virtual reality fitness in improving overall wellbeing during the COVID-19 pandemic home isolation period in terms of physical-psychological health and physical activity.

Methods

A total of 2300 individuals were recruited using the snowball sampling technique to participate in the study. The primary data were collected using an anonymous web-based survey. SPSS-23 and Smart-PLS 3.2.9 software were used to analyze the data.

Results

The direct path coefficient analysis of the study constructs show that virtual reality fitness has (preventive measures -> virtual reality fitness -> overall wellbeing, preventive measures -> virtual reality fitness -> physical exercise, and preventive measures -> virtual reality fitness -> physical health) profound effects on the research participants’ mental and physical wellbeing of the study participants while indirect mediation analysis shows that virtual reality fitness has (preventive measures -> virtual reality fitness ->overall wellbeing, preventive measures -> virtual reality fitness -> physical exercise, preventive measures -> virtual reality fitness ->physical health) significant impacts.

Conclusion

Our study results concluded that house exercises through virtual reality fitness are a good substitute for public gyms and private group fitness programs during the first pandemic wave for physical-psychological and overall wellbeing. Virtual reality fitness technology can alleviate many of the challenges brought on by the epidemic, resulting in increased utilization.

Changes in Corporate Social Responsibility Efficiency in Chinese Food Industry Brought by COVID-19 Pandemic—A Study With the Super-Efficiency DEA-Malmquist-Tobit Model

Coronavirus disease 2019 (COVID-19) has brought about a significant and far-reaching impact on the world's business environment, corporations, and individuals. In the face of the general shortage of funds caused by the pandemic, assuming corporate social responsibility (CSR) is a problem for every enterprise manager. In the recent years, as corporate social responsibility (CSR) has become a hot topic globally, many enterprises have chosen to incorporate social responsibility into their development strategies. The food industry is a basic industry related to people's livelihood, especially in the pandemic. Its social responsibility efficiency deserves our attention. This article takes 17 sample enterprises whose CSR performance between 2012 and 2020 in China and reports are above the industry level as examples. Constructing the super-efficiency data envelopment analysis (DEA)-Malmquist-Tobit model explores the social responsibility efficiency of these enterprises. It analyzes the pandemic's impact on CSR efficiency. The results show that COVID-19 has promoted the social responsibility efficiency of the sample enterprises in the food industry. Besides, the level of technical efficiency and technological progress in the food industry is relatively high. Still, most enterprises are below the industry's average level. Before the outbreak of the pandemic, the size of enterprises is the key factor affecting the efficiency of CSR. After then, the listing years of enterprises then become the key factor.

Feasibility of a Home-Based Exercise Program for Managing Posttransplant Metabolic Syndrome in Lung and Liver Transplant Recipients: Protocol for a Pilot Randomized Controlled Trial

Background

Posttransplant metabolic syndrome (PTMS) is a common contributor to morbidity and mortality among solid organ transplant recipients in the late posttransplant period (≥1 year). Patients diagnosed with PTMS are at a higher risk of cardiovascular disease and frequently experience decreased physical function and health-related quality of life (HRQL). Studies in the early posttransplant period (<1 year) have shown the benefits of facility-based exercise training on physical function and HRQL, but have not evaluated the effects on metabolic risk factors. It remains unclear whether home-based exercise programs are feasible and can be delivered at a sufficient exercise dose to have effects on PTMS. This protocol outlines the methodology of a randomized controlled trial of a partly supervised home-based exercise program in lung transplant (LTx) and orthotopic liver transplant (OLT) recipients.

Objective

This study aims to evaluate the feasibility (ie, recruitment rate, program adherence, attrition, safety, and participant satisfaction) of a 12-week individualized, home-based aerobic and resistance training program in LTx and OLT recipients initiated 12 to 18 months after transplantation, and to assess estimates of intervention efficacy on metabolic risk factors, exercise self-efficacy, and HRQL.

Methods

In total, 20 LTx and 20 OLT recipients with ≥2 cardiometabolic risk factors at 12 to 18 months after transplantation will be randomized to an intervention (home-based exercise training) or control group. The intervention group will receive an individualized exercise prescription comprising aerobic and resistance training, 3 to 5 times a week for 12 weeks. Participants will meet on a weekly basis (via videoconference) with a qualified exercise professional who will supervise exercise progression, provide support, and support exercise self-efficacy. Participants in both study groups will receive a counseling session on healthy eating with a dietitian at the beginning of the intervention. For the primary aim, feasibility will be assessed through recruitment rate, program adherence, satisfaction, attrition, and safety parameters. Secondary outcomes will be measured at baseline and 12 weeks, including assessments of metabolic risk factors (ie, insulin resistance, abdominal obesity, blood pressure, and cholesterol), HRQL, and exercise self-efficacy. Descriptive statistics will be used to summarize program feasibility and effect estimates (means and 95% CIs) for sample size calculations in future trials.

Results

Enrollment started in July 2021. It is estimated that the study period will be 18 months, with data collection to be completed by December 2022.

Conclusions

A partly supervised home-based, individually tailored exercise program that promotes aerobic and resistance training and exercise self-efficacy may be an important intervention for improving the metabolic profile of LTx and OLT recipients with cardiometabolic risk factors. Thus, characterizing the feasibility and effect estimates of home-based exercise constitutes the first step in developing future clinical trials designed to reduce the high morbidity associated with PTMS.

Trial Registration

ClinicalTrials.gov NCT04965142; https://clinicaltrials.gov/ct2/show/NCT04965142

International Registered Report Identifier (IRRID)

DERR1-10.2196/35700

Symptoms of Post-Traumatic Stress Disorder and the Sense of Gains and Losses during the COVID-19 Pandemic: An International Study

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The interface of COVID-19, diabetes, and depression

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Students' negative emotions and their rational and irrational behaviors during COVID-19 outbreak

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