Association Between Self-Reported Sleep Quality and Musculoskeletal Injury in Male Army Rangers

ABSTRACT Introduction Musculoskeletal injuries and insufficient sleep are common among U.S. Army Rangers. There has been limited research into whether indices of sleep differ between injured and uninjured Rangers. The purpose of this study was to investigate the association between self-reported sleep and musculoskeletal injury in Rangers. Materials and Methods A total of 82 Army Rangers (male, 25.4 ± 4.0 years) were asked if they currently have any musculoskeletal injuries; completed the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), and the Stanford Sleepiness Scale; and were asked about their average sleep quality/sleep duration over the preceding week. Rangers were then dichotomized into groups, one that reported a current musculoskeletal injury and another that did not. Results The reported musculoskeletal injury prevalence was 15.9% (n = 13). The Rangers that reported an injury, compared to those that did not, had a significantly higher Global PSQI score (6.7 ± 3.7 versus 4.5 ± 2.7, P = .012) and ISI score (10.9 ± 3.7 versus 7.2 ± 4.1, P = .003), both indicative of poorer sleep. The group reporting an injury rated their average sleep quality over the preceding week significantly lower compared to those that did not report an injury (50.8 ± 17.5 versus 68.9 ± 18.3, P = .001). There was no significant group difference in the average nightly sleep duration (6.1 ± 1.0 hours versus 6.5 ± 0.9 hours, P = .099). Conclusion In this cohort of male Army Rangers, In this cohort of male Army Rangers, those with a musculoskeletal injury reported poorer sleep quality than uninjured Rangers. Sleep duration was not associated with reported injuries; however, both the injured group and uninjured group averaged less than the recommended amounts of sleep. Further investigation into the relationship between musculoskeletal injury and sleep in military personnel is warranted.

Improving Usual Care Outcomes in Major Depression in Youth by Targeting Memory Specificity: A Randomized Controlled Trial of Adjunct Computerised Memory Specificity Training (c-MeST)

Objective: Memory Specificity Training (MeST) improves the recall of past personal experiences, an impairment in Major Depressive Disorder (MDD). Extending on previous findings that computerised MeST (c-MeST) improves memory specificity and depressive symptoms in adults, this study aimed to answer two questions: 1) does c-MeST improve memory specificity and depressive symptoms in youth with MDD; and 2) does c-MeST improve memory specificity and depression in addition to other treatment? Methods: Participants aged 15-25 (N=359, 76.5% female; M age=19.2, SD=3.1), receiving predominantly psychological therapy or counselling (85%) and/or antidepressants (52.9%) were randomised to c-MeST or wait-list. Cognitive and clinical outcomes were assessed at baseline and at one, three, and six-month follow-ups. Results: The c-MeST group reported higher memory specificity at one-month (M change=1.13, 95%CI [0.16,2.10], d=.42, p=.022), but not other follow-ups. There was no significant group difference for Major Depressive Episode diagnosis at six-months (55.6% c-MeST vs. 68.8% control, odds ratio=0.56 95%CI [0.21,1.53], p=.266), but the c-MeST group did report lower depressive symptoms at one (M change=-1.84, 95%CI[-3.42,-0.25], d = .42, p = .023) and six-month follow-ups (M change=-3.91, 95%CI [-6.19,-1.63], d = .84, p = .001). Conclusions: c-MeST reduces symptoms in youth with MDD when provided alongside other treatments. There was some evidence that change in memory specificity drives these changes. Contrary to previous findings, specificity effects were not maintained, potentially due to the low intensity of c-MeST in this study. Further study is needed to understand more about co-occurring mechanisms that produce antidepressant effects.

A Longitudinal Analysis on the Duration of Utterance in a Conversational Turn and Turn-Switching Pause in Preschool Children who Stutter during Interactions with Their Mothers

Objectives: The purpose of this study was to investigate, longitudinally, the duration of utterance in a conversational turn, duration of turn-switching pause, and frequency of disfluency which young children who stutter (CWS) and children who do not stutter (CWNS) showed during interactions with their mothers.Methods: Subjects for this study consisted of 2-5 year old CWS (male 2 and female 4), an age-matched group of CWNS (male 3 and female 3), and their mothers. Frequencies of normal disfluency (ND) and abnormal disfluency (AD), and duration of utterance in a conversational turn and duration of turn-switching pause were measured two times (initial visit and 12 months later) over the course of one year.Results: At initial visit, a significant group difference was found in frequency of AD. However, no significant difference was observed in duration of utterance in a conversational turn and duration of turn-switching pause both between two parent groups and between two child groups at initial visit and 12 months later. In the CWS group, at initial visit, a positive correlation was found between frequency of AD and mother’s duration of utterance in a conversational turn. Frequency of AD was negatively correlated with both duration of turn-switching pause of mothers and that of children. After 12 months, there was a negative correlation between frequency of AD and mother’s duration of utterance in a conversational turn.Conclusion: These findings suggest that the longitudinal study of individual characteristics of CWS · mothers interactions can help speech-language pathologists to identify the interactional factors related to the recovery or persistence of stuttering and to enhance the efficacy of parent · child interaction therapy for CWS.

Effects of Cannabidiol Supplementation on Skeletal Muscle Regeneration after Intensive Resistance Training

Cannabidiol supplements (CBD) are increasingly consumed by athletes to improve regeneration. However, the evidence for the pro-regenerative effects of CBD in sports is quite limited. Therefore, our aim was to investigate the effects of a single CBD supplementation in a six-arm placebo-controlled crossover study after resistance training on performance and muscle damage. Before and after the resistance training, one-repetition maximum in the back squat (1RM BS), countermovement jump (CMJ), and blood serum concentrations of creatine kinase (CK) and myoglobin (Myo) were measured in healthy, well-trained participants. 16 out of 21 participants completed the study and were included in the analysis. In 1RM BS, a significant decrease was observed after 24 h (p < 0.01) but not after 48 and 72 h. A significant group difference was detected after 72 h (p < 0.05; ES = 0.371). In CMJ, no significant changes were observed. The CK and Myo concentrations increased significantly after 24 h (CK: p < 0.001; Myo: p < 0.01), 48 h (CK: p < 0.001; Myo: p < 0.01) and 72 h (CK: p < 0.001; Myo: p < 0.001). After 72 h, significant group differences were observed for both muscle damage biomarkers (CK: p < 0.05 ES = 0.24; Myo: p < 0.05; ES = 0.21). The results show small but significant effects on muscle damage and recovery of squat performance after 72 h. However, more data are required for clearer statements concerning potential pro-regenerative effects of CBD supplementation after resistance training.

Cognitive and psychosocial effects of an acute sun salutation intervention among adults with stress

Evidence suggests that yoga can improve executive functioning (EF) and psychological well-being, but there is no evidence whether flow-based, moderate-intensity forms of yoga can deliver similar benefits. The purpose of this randomized controlled trial was to test the aforementioned effects of engaging in a 30-minute, video-guided sun salutation exercise (n = 25), relative to aerobic exercise (n = 22) and attentional control (n = 24). Low-active participants (Mage = 27.84; 87.3% female) completed psychosocial assessments and tasks assessing EF, before and after the session. Results showed a significant group difference for state anxiety (p = .01, ηp² = .13) and stress (p &lt; .05, ηp² = .09), in favor of the yoga group. No significant between-groups differences in EF were observed. Results suggest that video-guided, flow-based forms of yoga can induce immediate improvements in well-being, yet extended involvement may be required to realize performance improvements in memory and processing speed.

Everyday Emotional Experiences in Current and Remitted Major Depressive Disorder: An Experience-Sampling Study

The emotional experiences of people with major depressive disorder (MDD) are characterized by emotional disturbances. We examined whether these patterns characterize people with MDD in remission. Participants included individuals who had experienced at least two major depressive episodes (remitted-MDD group; n = 80), had current MDD (current-MDD group; n = 48), or were control participants ( n = 87). Participants reported their momentary affect five times per day for 14 days, from which we computed the mean (i.e., intensity), standard deviation (i.e., variability), and autocorrelation (i.e., inertia). Negative affect (NA) intensity and variability, but not inertia, differed between groups; the current-MDD group had the highest levels, the control group had the lowest, and the remitted-MDD group fell in between. Differences in NA variability held after accounting for mean NA. The only significant group difference for positive affect (PA) was that PA intensity was lower in the current-MDD group compared with the other two groups. Emotional disturbances of participants with remitted MDD appear limited to NA.

Game Spacing and Density in Relation to the Risk of Injuries in the National Hockey League

Background: Ice hockey has significant workload demands. Research of other sports has suggested that decreased rest between games as well as an increased workload may increase the risk of injuries. Purpose: To evaluate whether condensed game schedules increase the frequency and severity of injuries in the National Hockey League (NHL). Study Design: Descriptive epidemiology study. Methods: Data were obtained from publicly available online sources on game schedules and injuries for all NHL teams for the 2005-2006 through 2018-2019 seasons. Injury rates (per team per game) and the proportion of severe and nonsevere injuries were determined. The game-spacing analysis assessed the risk of injuries in relation to the number of days between games played (range, 0-≥6 days). The game-density analysis assessed the risk of injuries in relation to the number of games played within 7 days (range, 1-5 games). Results were assessed by analysis of variance, the post hoc Tukey test, and the chi-square test of distribution. Results: The game-spacing analysis included 33,170 games and 7224 injuries, and a significant group difference was found ( P = 1.44×10–5), with the post hoc test demonstrating an increased risk of injuries when games were spaced with <1 day of rest. There was no significant difference in the ratio of severe to nonsevere injuries. The game-density analysis included 33,592 games and 10,752 injuries, and a significant group difference was found ( P = 8.22×10–48), demonstrating an increased risk of injuries with an increased number of games in all conditions except for the comparison between 4 versus 5 games in 7 days. There was also a significant difference in injury severity ( P = .008), indicating that the least dense condition had a higher ratio of severe to nonsevere injuries compared with the other game-density conditions. Finally, the game-density analysis was repeated after excluding games played with <1 day of rest, and the finding of increased injury rates with increasingly condensed schedules remained significant ( P = 9.52×10–46), with significant differences between all groups except for the comparison between 1 versus 2 games in 7 days. Conclusion: We found that a condensed schedule and <1 day of rest between games were associated with an increased rate of injuries in the NHL. These findings may help in the design of future game schedules.

Educational Intervention Reduced Family Medicine Residents’ Intention to Request Diagnostic Tests: Results of a Controlled Trial

Objective Dealing with uncertainty is a core competence for physicians. To evaluate the impact of an educational intervention on family medicine residents’ (FMRs’) intention to request diagnostic tests and their attitudes toward uncertainty. Methods Nonrandomized controlled trial. Intervention group (IG) FMRs participated in interactive “dealing with uncertainty” seminars comprising statistical lessons and diagnostic reasoning. Control group (CG) FMRs participated in seminars without in-depth diagnostic lessons. FMRs completed the Dealing with Uncertainty Questionnaire (DUQ), comprising the Diagnostic Action and Diagnostic Reasoning scales. The Physicians’ Reaction to Uncertainty (PRU) questionnaire, comprising 4 scales (Anxiety Due to Uncertainty, Concern about Bad Outcomes, Reluctance to Disclose Uncertainty to Patients, and Reluctance to Disclose Mistakes to Physicians) was also completed. Follow-up was performed 3 months later. Differences were calculated with repeated-measures analysis of variance. Results In total, 107 FMRs of the IG and 102 FMRs of the CG participated at baseline and follow-up. The mean (SD) Diagnostic Action scale score decreased from 24.0 (4.8) to 22.9 (5.1) in the IG and increased in the CG from 23.7 (5.4) to 24.1 (5.4), showing significant group difference ( P = 0.006). The Diagnostic Reasoning scale increased significantly ( P = 0.025) without a significant group difference ( P = 0.616), from 19.2 (2.6) to 19.7 (2.4) in the IG and from 18.1 (3.3) to 18.8 (3.2) in the CG. The PRU scale Anxiety Due to Uncertainty decreased significantly ( P = 0.029) without a significant group difference ( P = 0.116), from 20.5 (4.8) to 18.5 (5.5) in the IG and from 19.9 (5.5) to 19.0 (6.0) in the CG. Conclusion The structured seminar reduced self-rated diagnostic test requisition. The change in Anxiety Due to Uncertainty and Diagnostic Reasoning might be due to an unspecific accompanying effect of the extra-occupational seminars for residents.

Behavioral and electrophysiological indices of inhibitory control in maltreated adolescents and nonmaltreated adolescents

Early adverse experiences are believed to have a profound effect on inhibitory control and the underlying neural regions. In the current study, behavioral and event-related potential (ERP) data were collected during a go/no-go task from adolescents who were involved with the child welfare system due to child maltreatment (n = 129) and low-income, nonmaltreated adolescents (n = 102). The nonmaltreated adolescents were more accurate than the maltreated adolescents on the go/no-go task, particularly on the no-go trials. Paralleling the results with typically developing populations, the nonmaltreated adolescents displayed a more pronounced amplitude of the N2 during the no-go trials than during the go trials. However, the maltreated adolescents demonstrated a more pronounced amplitude of the N2 during the go trials than during the no-go trials. Furthermore, while the groups did not differ during the go trials, the nonmaltreated adolescents displayed a more negative amplitude of the N2 than the maltreated adolescents during no-go trials. In contrast, there was not a significant group difference in amplitude of the P3. Taken together, these results provide evidence that the early adverse experiences encountered by maltreated populations impact inhibitory control and the underlying neural activity in early adolescence.

Restricted visual scanpaths during emotion recognition in childhood social anxiety disorder

Background: Social anxiety disorder (SAD) has its typical onset in childhood and adolescence. Maladaptive processing of social information may contribute to the etiology and maintenance. During face perception, individuals extract information with a succession of visual fixations known as a scanpath. Atypically long scanpaths have been reported in adults with SAD, but no data exists from pediatric samples. SAD has also been linked to atypical arousal. Both metrics were examined in one of the largest eye-tracking studies of pediatric SAD to dateMethods: Children and adolescents with SAD (n = 62) and healthy controls (n = 39) completed an emotion recognition task. The visual scanpath and pupil dilation (an indirect index of arousal) were examined. The analysis plan was preregistered.Results: Youth with SAD showed restricted scanpaths, a finding supported by both frequentist and Bayesian statistics. Higher pupil dilation was also observed in the SAD group, but despite a statistically significant group difference, this result was not supported by the Bayesian analysis.Conclusions: Findings are contrary to findings from adult studies, but similar to what has been reported in neurodevelopmental conditions associated with social interaction impairments. Restricted scanpaths may disrupt holistic representation of faces known to favor adaptive social understanding.