Probiotics in the Prevention of the Calcium Oxalate Urolithiasis

Nephrolithiasis ranks third among urological diseases in terms of prevalence, making up about 15% of cases. The continued increase in the incidence of nephrolithiasis is most probably due to changes in eating habits (high protein, sodium, and sugar diets) and lifestyle (reduced physical activity) in all developed countries. Some 80% of all kidney stones cases are oxalate urolithiasis, which is also characterized by the highest risk of recurrence. Frequent relapses of nephrolithiasis contribute to severe complications and high treatment costs. Unfortunately, there is no known effective way to prevent urolithiasis at present. In cases of diet-related urolithiasis, dietary changes may prevent recurrence. However, in some patients, the condition is unrelated to diet; in such cases, there is evidence to support the use of stone-related medications. Interestingly, a growing body of evidence indicates the potential of the microbiome to reduce the risk of developing renal colic. Previous studies have primarily focused on the use of Oxalobacterformigenes in patients with urolithiasis. Unfortunately, this bacterium is not an ideal probiotic due to its antibiotic sensitivity and low pH. Therefore, subsequent studies sought to find bacteria which are capable of oxalate degradation, focusing on well-known probiotics including Lactobacillus and Bifidobacterium strains, Eubacterium lentum, Enterococcus faecalis, and Escherichia coli.

An Overview of the Obese-Asthma Phenotype in Children

Asthma is the most common chronic disease in childhood. Overweight and obesity are included among the comorbidities considered in patients with difficult-to-treat asthma, suggesting a specific phenotype of the disease. Therefore, the constant increase in obesity prevalence in children and adolescents raises concerns about the parallel increase of obesity-associated asthma. The possible correlation between obesity and asthma has been investigated over the last decade by different authors, who suggest a complex multifactorial relationship. Although the particular non-eosinophilic endotype of obesity-related asthma supports the concept that high body weight precedes asthma development, there is ongoing debate about the direct causality of these two entities. A number of mechanisms may be involved in asthma in combination with obesity disease in children, including reduced physical activity, abnormal ventilation, chronic systemic inflammation, hormonal influences, genetics and additional comorbidities, such as gastroesophageal reflux and dysfunctional breathing. The identification of the obesity-related asthma phenotype is crucial to initiate specific therapeutic management. Besides the cornerstones of asthma treatment, lifestyle should be optimized, with interventions aiming to promote physical exercise, healthy diet, and comorbidities. Future studies should clarify the exact association between asthma and obesity and the mechanisms underlying the pathogenesis of these two related conditions with the aim to define personalized therapeutic strategies for asthma management in this population.

Relation between ADHD and COVID-19: A Narrative Review to Guide Advancing Clinical Research and Therapy

Objective: To cope with the COVID-19 pandemic, national health authorities temporarily closed cultural, religious, and educational institutions such as universities and schools. Children and adolescents with ADHD were challenged with the restrictions caused by the Covid-19 pandemic such as homeschooling and reduced physical activity. The present narrative review aimed to summarize the state-of-the-art regarding associations between COVID-19-related social restrictions and possible psychological and behavioral issues in children and adolescents with ADHD. Additionally, we discussed the underlying possible reasons of the association focusing on the role of parental influence and physical activity, vulnerabilities of individuals with ADHD to Covid-19 infection and to school closure and remote learning. Method: To collect data for the present narrative review, recent publications on these topics between February 1st, 2020 and January 10th, 2021 were retrieved from the most popular search engines (PubMed; Scopus; Google Scholar; Psych Info; Embase) through a comprehensive search using relevant keywords. Results: During confinement, children and adolescents with ADHD reported increased behavioral and ADHD-related symptoms and overall decreased psychological well-being. Factors negatively impacting children’s and adolescents’ behavioral symptoms and well-being were: less physical activity, adverse parental behavior, difficulties in coping with preventive guidelines, and school closure and remote learning consequences. Conclusion: Children and adolescents with ADHD and their caregivers faced both specific and general psychological issues related to the school lockdowns and homeschooling. Additionally, Individuals with ADHD seem to be more vulnerable to Covid-19 infection which highlights the need for better healthcare adaptation.

783 The effects of reduced physical activity on the lipid profile in patients with high cardiovascular risk during COVID-19 lockdown

Aims The COVID-19 pandemic is a serious global health problem. In Italy, to limit the infections, the government ordered lockdown from March 2020. This measure, designed to contain the virus, led to serious limitations on the daily life of the individuals it affected, and in particular in the limitation of physical exercise. The aim of this study was to evaluate the effects of reduced physical activity on the lipid profile in patients with high cardiovascular risk. Methods and results We enrolled 38 dyslipidaemic patients, 56% male, with an age range of 44–62 years, considered to be at high cardiovascular risk. All patients were prescribed statin drug therapy (atorvastatin 40 mg) and a vigorous physical activity program four times a week, 1 h per session. In addition, a personalized Mediterranean diet was prescribed to all the patients. Total cholesterol, LDL, HDL, and triglycerides were measured in patients at T0 before lockdown and at T1 during lockdown. Data showed a significant increase (P < 0.01) in total cholesterol (+6.8%) and LDL (+15.8%). Furthermore, the analysis of the data revealed a reduction in HDL (−3%) and an increase in triglycerides (+3.2%), although both were not significant (P > 0.05). Of the 14 patients who were all in perfect therapeutic range at T0, only 4 (28%) had LDL <70 mg/dL at T1. Conclusions Our study showed that the reduction in physical activity during lockdown led to an increase in LDL levels, and therefore, in the risk of ischaemic heart disease in dyslipidaemic patients with high cardiovascular risk.

What Motivates Patients with COPD to Be Physically Active? A Cross-Sectional Study

Motivation can be broadly defined as what moves people to act. Low motivation is a frequently reported factor for the reduced physical activity (PA) levels observed in patients with chronic obstructive pulmonary disease (COPD). This study assessed patients’ motives to be physically active, according to three pulmonary rehabilitation (PR) participation groups (Never PR, Previous PR and Current PR) and explored whether these motives were related to the PA levels and clinical characteristics. The motives to be physically active were assessed with the Exercise Motivation Inventory-2 (EMI-2, 14 motivational factors, five dimensions) and PA with accelerometry (PA groups: <5000 steps/day vs. ≥5000 steps/day). The clinical variables included symptoms, impact of the disease, exercise capacity and comorbidities. Ninety-two patients (67.4 ± 8.1 years, 82.6% male, forced expiratory volume in 1s (FEV1) 48.3 ± 18.9% predicted; 30.4% Never PR, 51% Previous PR and 18.5% Current PR) participated. The motivational dimensions related to health/fitness presented the highest scores (3.8 ± 1.1; 3.4 ± 1.3). The motives to be active were not significantly different between PA groups (p > 0.05) but having less symptoms and ≥two comorbidities were associated with higher scores in psychological/health and body-related motives, respectively (p < 0.05). The findings may encourage health professionals to actively explore with patients their motives to be physically active to individualise PA promotion.

PERKEMBANGAN E-SPORT PADA PELAJAR REMAJA USIA 13-16 TAHUN PADA MASA PANDEMI COVID-19

E-Sport is part of a sport that has grown rapidly in the last 5 years and is a sport that is supported by the government in developing rapidly. The dilemma that occurs is that a student's psychic and physical changes are due to reduced physical activity and social contact due to more work from home or study at home. Researchers try to explore the consequences of student activities that are required to study at home due to the corona virus. The positive and negative impacts or pros and cons in the COVID-19 pandemic can be a blessing or a disaster depending on the perspective of the mind. Researchers try to examine the development of e-sports which is now starting to become popular and even an addiction for all ages from children to adults, and is supported by many athletes who have achieved world-class achievements in FIFA or Pro Evolution Soccer, PUBG, and other online games. The problem from the research is the basis why researchers are interested in researching by using a survey method to the point of view of students and the point of view of parents and the point of view of teachers / lecturers about the development of e-sports which is very popular today. This research data is on a regional scale such as the province of Yogyakarta and if possible will be distributed via google form to all corners of the country so that the data obtained is more diverse according to the point of view of each region according to the culture and circumstances of each region. This research will be very interesting because the issue taken is a national issue in the world of sports today. From this study, it can be concluded that children aged 13-16 years like to play online games, because: 1) Repel boredom 50%, 2) Gathering with friends 30%, 3) Get 20% achievement. Judging from the data, it is clear that the goals of E-Sport have not been fully achieved in Indonesia. Because it should be clear with Esports to hone intelligence thinking quickly and precisely by playing some games.

Physical Activity under Stress: A Perspective of HAPA and Individual Differences

Aims: Physical activity is an effective way for people to cope with stress. However, people often decrease their physical activity in response to stressors. Therefore, we aimed to understand the relationship between perceived stress and physical activity from an outcome expectancies perspective and investigated the moderating role of future orientation in this relationship. Methods: This study recruited 425 students who completed a three-wave survey at six-week intervals. A moderated mediation model was used to examine the mediating effects of outcome expectancies and the moderating effects of future orientation. Results: The results indicated that outcome expectancies mediated the relationship between perceived stress and physical activity. This relationship was moderated by future orientation. In particular, the mediating effects were significant for people with a high future orientation, but not for those with a low future orientation. Conclusion: Our results demonstrate the adaptive function of future orientation in response to general stress. Importantly, the link between perceived stress and reduced physical activity could be mitigated by encouraging people to focus on future consequences. Future studies should consider developing intervention strategies that help those struggling with stressful contexts.

Lifestyle Modification Program on a Metabolically Healthy Elderly Population with Overweight/Obesity, Young-Old vs. Old-Old. CONSEQUENCES of COVID-19 Lockdown in This Program

The SARS-CoV-2 pandemic led to lockdowns, which affected the elderly, a high-risk group. Lockdown may lead to weight gain due to increased food intake and reduced physical activity (PA). Our study aimed to analyze the impact of a 12-month lifestyle intervention on a metabolically healthy overweight/obese elderly (MHOe) population and how the lockdown by COVID-19 affected this program. Methods: MHOe participants (65–87 years) were recruited to participate in a lifestyle modification intervention based on the Mediterranean diet (MedDiet) and regular PA. Participants were classified into two groups: young-old (<75 years) or old-old (≥75 years). Anthropometric and clinical characteristics, energy intake, and energy expenditure were analyzed at baseline and after 12 months of intervention. Results: The final sample included 158 MHOe participants of both sexes (age: 72.21 ± 5.04 years, BMI: 31.56 ± 3.82 kg/m2): 109 young-old (age: 69.26 ± 2.83 years, BMI: 32.0 ± 3.85 kg/m2) and 49 old-old (age: 78.06 ± 2.88 years, BMI: 30.67 ± 3.64 kg/m2). After 12 months of intervention and despite lockdown, the young-old group increased MedDiet adherence (+1 point), but both groups drastically decreased daily PA, especially old-old participants. Fat mass significantly declined in the total population and the young-old. Depression significantly increased (26.9% vs. 21.0%, p < 0.0001), especially in the old-old (36.7% vs. 22.0%, p < 0.0001). No significant changes were found in the glycemic or lipid profile. Conclusions: This study indicates that ongoing MedDiet intake and regular PA can be considered preventative treatment for metabolic diseases in MHOe subjects. However, mental health worsened during the study and should be addressed in elderly individuals.

Prevention of functional decline through gamified interventions in hospitalized older adults

This doctoral thesis focuses on the effects of gamified intervention programmes on the functional capacity of hospitalized older adults. Hospitalization is a process that leads to the development of disability in older adults. Hospitalization-associated disability is mainly induced by reduced physical activity and frequent episodes of bed rest during this process of health restoration. Gamified interventions can be a novel and effective strategy to prevent hospitalization-associated functional impairment in elderly patients. This doctoral thesis is based on three studies that have been published in international scientific journals. The first study (Chapter 1) aimed to evaluate the available evidence on the effectiveness of game-based interventions on health parameters (functional capacity, quality of life, etc.) of hospitalized older adults. In the second study (Chapter 2), the main objective was to detail the validation of a pilot multidomain intervention system (physical and cognitive training) based on gamification technologies to improve the functional capacity of hospitalized older adults. In the last study (Chapter 3), the main purpose was to analyse the effects of different modalities of gamified intervention programmes on functional capacity in hospitalized older adults in acute care for the elderly.