Balancing Time for Health Behaviors: Associations of Time Perspective With Physical Activity and Weight Management in Older Adults.

PURPOSE: To examine associations between time perspective and health promotion behaviors of physical activity and weight management. DESIGN: Quantitative cross-sectional. SETTING: This study is part of the Betula project on aging, memory, and dementia in Northern Sweden. SUBJECTS: 417 older adults aged between 55 and 85 years. MEASURES: Swedish-Zimbardo Time Perspective Inventory; Physical Activity in the past year, past week, and in comparison with others of similar age; Weight Management = Body Mass Index (BMI; kg/m2). RESULTS: After controlling for age, sex, and years of education, hierarchical linear regression indicated a Balanced Time Perspective was significantly associated with more physical activity in the past year (P = .04), the past week (P < .001), and in comparison with others (P < .01). Past Negative time perspective was associated with less physical activity in the past year (P = .03), and in comparison with others (P = .03). Present Fatalistic was associated with less physical activity during the past week (P = .03), and in comparison with others (P = .01). Present Hedonistic was associated with more physical activity the past week (P = .03), and in comparison with others (P = .03). Past Negative was associated with higher BMI (P = .02), and Future Negative were associated with lower BMI (P = .01). Taken collectively, greater positivity and flexibility across time perspectives was associated with more physical activity, whereas negative oriented time perspectives related with less physical activity and poorer weight management. CONCLUSION: Time perspective can be associated with health behaviors in older adults and have implications for health across the lifespan. Health promotion interventions may target older adults' enjoyment of exercise and weight management in the present, rather than highlight potential negative health outcomes in the future.

"Every Cloud Has a Silver Lining": How Three Rare Diseases Defend Themselves from COVID-19 and What We Have Learnt from It.

The process of SARS-CoV-2 infection, responsible for the COVID-19 pandemic, is carried out through different steps, with the interaction between ACE2 and Spike protein (S) being crucial. Besides of that, the acidic environment of endosomes seems to play a relevant role in the virus uptake into cells and its intracellular replication. Patients affected by two rare genetic tubulopathies, Gitelman's and Bartter's Syndromes, and a rare genetic metabolic disease, Fabry Disease, have shown intrinsic protection from SARS-CoV-2 infection and COVID-19 on account of specific intrinsic features that interfere with the virus uptake into cells and its intracellular replication, which will be reported and discussed in this paper, providing interesting insights for present and future research.

Oxidants and Cardiorenal Vascular Remodeling-Insights from Rare Genetic Tubulopathies: Bartter's and Gitelman's Syndromes.

Two human genetic tubulopathies, Bartter's (BS) and Gitelman's (GS) syndromes, have normo/hypotension and absent cardiac remodeling despite their apparent angiotensin system (RAS) activation. This seeming contradiction has led to an extensive investigation of BSGS patients, the result of which is that BSGS represents a mirror image of hypertension. BSGS's unique set of properties has then permitted their use as a human model to probe and characterize RAS system pathways and oxidative stress in cardiovascular and renal remodeling and pathophysiology. This review details the results using GSBS patients that provide a deeper understanding of Ang II signaling and its associated oxidants/oxidative stress in humans. By providing a more complete and complex picture of cardiovascular and renal remodeling pathways and processes, studies of GSBS can inform the identification and selection of new targets and therapies to treat these and other oxidant-related disorders.

Tracing angiotensin II's yin-yang effects on cardiovascular-renal pathophysiology.

Adverse changes in cardiovascular and renal systems are major contributors to overall morbidity and mortality. Human cardiovascular and renal systems exhibit a complex network of positive and negative feedback that is reflected in the control of vascular tone via angiotensin II (Ang II) based signaling. This review will examine in some depth, the multiple components and processes that control the status and reflect the health of these various cardiovascular and renal systems, such as pathways associated to monomeric G proteins, RhoA/Rho kinase system and ERK, oxidative stress and NO balance. It will specifically emphasize the "yin-yang" nature of Ang II signaling by comparing and contrasting the effects and activity of various systems, pathways and components found in hypertension to those found in Gitelman's and Bartter's syndromes (GS/BS), two rare autosomal recessive tubulopathies characterized by electrolytic imbalance, metabolic alkalosis, sodium wasting and prominent activation of the renin-angiotensin-aldosterone system. Notwithstanding the activation of the renin-angiotensin-aldosterone system, GS/BS are normo-hypotensive and protected from cardiovascular-renal remodeling and therefore can be considered the mirror image, the opposite of hypertension.

The psychophysiological influence of exertion and affect on sport-specific cognitive and physical performance.

OBJECTIVES: The purpose of the present study was to examine differences in cognitive and physical performance, affective states, perceived exertion, and physiological responses between trials with cognitive, physical, or combined cognitive and physical load. DESIGN: Randomised cross-over trial. METHODS: Highly trained competitive orienteers (n = 15 men; n = 10 women) completed three randomised trials comprised of: (1) sport-specific cognitive tests; (2) 35-minute cycling time trial; and (3) combined sport-specific cognitive tests and 35-minute cycling time trial. Measures taken during the trials recorded affective states, perceived exertion, heart rate, blood lactate, cycling watts, as well as working memory, updating, planning and decision making. RESULTS: No significant differences in cognitive performance accuracy were observed within or across trials although reaction times improved within trials and were fastest in the combined trial. Blood lactate, heart rate, perceived exertion, negative affective states, and watts were highest in the physical trial. CONCLUSIONS: The combined load of undertaking sport-specific cognitive tests and a cycling time trial did not influence cognitive performance accuracy. Athletes produced greater watts when completing the physical task independently compared with the combined trial, however psychophysiological responses were worse. Further investigation is warranted to determine whether athletes' attentional focus underpins psychophysiological responses to dual-task sport performance.

Social Support, Self-Regulation, and Psychological Skill Use in E-Athletes.

The aims of the present study were twofold. First, to investigate self-reported social support, self-regulation, and psychological skill use in esports athletes (e-athletes) compared to traditional athletes. Second, to determine if self-reported social support, self-regulation, and psychological skill use influenced e-athlete in-game rank. An online survey was used to collect data from an international sample of e-athletes (n = 1,444). The e-athletes reported less social support, self-regulation, and psychological skill use than reported by traditional athletes in previous studies. E-athletes with higher scores in social support, self-regulation, and psychological skill use was associated with higher in-game rank. The lack of an organisational structure in esports may be a contributing factor as to why e-athletes score lower than traditional athletes on social support, self-regulation, and psychological skill use. Future research is warranted to explore the development of esports programs aiming to promote athletes' social support, self-regulation, and use of psychological skills to enhance in-game performance and well-being.

ACE2 and SARS-CoV-2 Infection Risk: Insights From Patients With Two Rare Genetic Tubulopathies, Gitelman's and Bartter's Syndromes.

COVID-19 is spreading globally with the angiotensin converting enzyme (ACE)-2 serving as the entry point of SARS-CoV-2 virus. This raised concerns how ACE2 and the Renin-Angiotensin (Ang)-System (RAS) are to be dealt with given their roles in hypertension and their involvement in COVID-19's morbidity and mortality. Specifically, increased ACE2 expression in response to treatment with ACE inhibitors (ACEi) and Ang II receptor blockers (ARBs) might theoretically increase COVID-19 risk by increasing SARS-CoV-2 binding sites. However, ACE2 is part of the protective counter-regulatory ACE2-Ang1-7-MasR axis, which opposes the classical ACE-AngII-AT1R regulatory axis. We used Gitelman's and Bartter's syndromes (GS/BS) patients, rare genetic tubulopathies that have endogenously increased levels of ACE2, to explore these issues. Specifically, 128 genetically confirmed GS/BS patients, living in Lombardia, Emilia Romagna and Veneto, the Northern Italy hot spots for COVID-19, were surveyed via telephone survey regarding COVID-19. The survey found no COVID-19 infection and absence of COVID-19 symptoms in any patient. Comparison analysis with the prevalence of COVID-19 in those regions showed statistical significance (p < 0.01). The results of the study strongly suggest that increased ACE2 does not increase risk of COVID-19 and that ACEi and ARBs by blocking excessive AT1R-mediated Ang II activation might favor the increase of ACE2-derived Ang 1-7. GS/BS patients' increased ACE2 and Ang 1-7 levels and their characteristic chronic metabolic alkalosis suggest a mechanism similar to that of chloroquine/hydroxychloroquine effect on ACE2 glycosylation alteration with resulting SARS-COV-2 binding inhibition and blockage/inhibition of viral entry. Studies from our laboratory are ongoing to explore GS/BS ACE2 glycosylation and other potential beneficial effects of BS/GS. Importantly, the absence of frank COVID-19 or of COVID-19 symptoms in the BS/GS patients cohort, given no direct ascertainment of COVID-19 status, suggest that elevated ACE2 levels as found in GS/BS patients at a minimum render COVID-19 infection asymptomatic and thus that COVID-19 symptoms are driven by ACE2 levels.

Examining the Impact of School Esports Program Participation on Student Health and Psychological Development.

This study examined the influence of 7 high school esports developmental programs on student self-regulation, growth mindset, positive youth development (PYD), perceived general health and physical activity (PA), and sport behaviour. A total of 188 students (male n = 120; female n = 68) originally participated (89 enrolled in an esports program in their school and 99 acted as aged-matched controls), with 58 participants (n = 19 esports group; n = 39 controls) completing both pre- and post-program information. At baseline, no significant differences were found between youth e-athletes and their aged-matched controls. The analysis for the observation period showed a significant interaction effect for the PYD confidence scale, with post-hoc comparisons showing a significant decrease in the control group from pre- to post assessment whereas the esports group remained the same. Time main effects showed a decrease in the self-regulation motivation factor, PYD connection factor and PA for all participants. Overall, this study showed that students enrolled in their respective school esports program did not differ from those who did not in self-regulation, growth mindset, PYD, perceived health and PA, and sport behaviour. It was likely that all participants showed a decrease in motivation, connection, and PA due to COVID19 lockdown during the study period. This study is the first to investigate the longitudinal impact of student involvement in high school esports and showed that esports participation did not have a negative impact on any health or psychological factors.

Written Emotional Disclosure Can Promote Athletes' Mental Health and Performance Readiness During the COVID-19 Pandemic.

The widespread effects of the coronavirus disease 2019 (COVID-19) pandemic have negatively impacted upon many athletes' mental health and increased reports of depression as well as symptoms of anxiety. Disruptions to training and competition schedules can induce athletes' emotional distress, while concomitant government-imposed restrictions (e.g., social isolation, quarantines) reduce the availability of athletes' social and emotional support. Written Emotional Disclosure (WED) has been used extensively in a variety of settings with diverse populations as a means to promote emotional processing. The expressive writing protocol has been used to a limited extent in the context of sport and predominantly in support of athletes' emotional processing during injury rehabilitation. We propose that WED offers an evidence-based treatment that can promote athletes' mental health and support their return to competition. Research exploring the efficacy of the expressive writing protocol highlights a number of theoretical models underpinning the positive effects of WED; we outline how each of these potential mechanisms can address the multidimensional complexity of the challenging circumstances arising from the COVID-19 pandemic (e.g., loss of earnings, returning to training and competition). Considerations and strategies for using WED to support athletes during the COVID-19 pandemic are presented.

Integrating yoga with psychological group-treatment for mixed depression and anxiety in primary healthcare: An explorative pilot study.

BACKGROUND AND PURPOSE: Yoga has shown promise as a treatment for depression and anxiety. The present pilot study investigated the feasibility of an eight-week grouptreatment integrating emotion-focused psychoeducation, compassion-focused therapy, and Virya yoga for depression and anxiety in primary healthcare. MATERIALS AND METHODS: Patients seeking treatment for depression and anxiety in a primary healthcare centre completed either an integrative group-treatment (N = 14) or treatment as usual (TAU, N = 17). Outcome measures were analysed pre- and posttreatment. Correlations in the intervention group were investigated between treatment outcomes and amount of yoga practice between sessions. RESULTS: Large within-group effect sizes on all outcome measures were found at posttreatment. Symptom reduction did not differ between groups (p = 0.155). Improvement in alexithymia correlated significantly (p < 0.05) with amount of yoga practice between sessions. CONCLUSION: Integrating yoga with a psychological group-treatment is a somewhat feasible approach to treatment for depression and anxiety in primary healthcare.

The Association between Esports Participation, Health and Physical Activity Behaviour.

We investigated the association between obesity, self-reported physical activity, cigarette smoking, alcohol consumption, and perceived health in esports players, and the influence of player in-game rank. Data was collected with an online survey with an international participant sample of esports players representing five esports and all skill levels (n = 1772). Esports players were more likely to be categorized as normal weight, or obesity class 2 and 3 and as non-smokers (92%) and non-drinkers (65.1%) compared to international reference data. Esports players met international physical activity guidelines less than global general population. Esports players ranked in the top 10% were more physically active compared to the remaining esports players. As esports player in-game rank increased, so did the amount of time spent playing esports. Although esports players appear generally healthy, a small group was significantly obese and most esports players did not meet physical activity guidelines, indicating potential future health risks.

Are the Clinical Presentations (Phenotypes) of Gitelman's and Bartter's Syndromes Gene Mutations Driven by Their Effects on Intracellular pH, Their "pH" Enotype?

Gitelman's syndrome (GS) and Bartter's syndrome (BS) are rare inherited salt-losing tubulopathies whose variations in genotype do not correlate well with either clinical course or electrolyte requirements. Using GS/BS patients as nature's experiments, we found them to be a human model of endogenous Ang II antagonism with activated Renin-Angiotensin System (RAS), resulting in high Ang II levels with blunted cardiovascular effects. These patients are also characterized by increased and directly correlated levels of both Angiotensin Converting Enzyme 2 (ACE2) and Ang 1-7. Understanding the myriad of distinctive and frequently overlapping clinical presentations of GS/BS arises remains challenging. Efforts to find a treatment for COVID-19 has fueled a recent surge in interest in chloroquine/hydroxychloroquine and its effects. Of specific interest are chloroquine/hydroxychloroquine's ability to inhibit SARS-CoV infection by impairing ACE2, the SARS-CoV2 entry point, through terminal glycosylation via effects on TGN/post-Golgi pH homeostasis. Several different studies with a GS or a BS phenotype, along with a nonsyndromic form of X-linked intellectual disability linked to a mutated SLC9A7, provide additional evidence that specific gene defects can act via misregulation of TGN/post-Golgi pH homeostasis, which leads to a common mechanistic basis resulting in overlapping phenotypes. We suggest that linkage between the specific gene defects identified in GS and BS and the myriad of distinctive and frequently overlapping clinical findings may be the result of aberrant glycosylation of ACE2 driven by altered TGN/endosome system acidification caused by the metabolic alkalosis brought about by these salt-losing tubulopathies in addition to their altered intracellular calcium signaling due to a blunted second messenger induced intracellular calcium release that is, in turn, amplified by the RAS system.

Temporal aspects of affective states, physiological responses, and perceived exertion in competitive cycling time trials.

Athletes' affective states can vary dramatically before, during, and after competition. Further, intense affect is associated with physiological responses that may amplify biological reactions manifested from the execution of physical tasks underlying performance. Fluctuations in perceptual cues (eg, perceived exertion) and physiological responses (eg, blood lactate, heart rate) can influence performance and vary dramatically in relation to competition. However, the pattern of these fluctuations and potential associations between perceptual cues and biological responses may also diverge during task execution with differential implications for performance. Data collected from highly trained athletes (N = 25; Mage  = 25.4) during a competition (ie, maximum total distance) comprised of three 7-minute cycling time trials and were analyzed with longitudinal multilevel modeling. Results showed that affective states were negatively associated with perceived exertion at the within-person level and negatively associated with heart rate at the between-person level within each trial. Blood lactate and heart rate were positively associated at the between-person level, whereas heart rate was positively associated with perceived exertion at the within-person level. The anticipation of more pleasurable affective states predicted less decline in affective states, but not physiological responses, during each trial. Anticipated affective states prior to each trial were also associated with affective states upon its completion. These findings suggest associations among perceptual cues and physiological responses may differ depending on the level of analysis (between- vs. within-person level associations), and anticipated affective states prior to performance may influence affective states during and after task execution.