The Impact of Structural Racism on Continuity of Care at Pediatric Academic Primary Care Clinics.

OBJECTIVE: Using a structural racism framework, we assessed for racial inequities in continuity of care, using the Usual Provider Continuity Index (UPC - the proportion of visits with the provider the patient saw most frequently out of all visits), in a set of large pediatric academic clinics. METHODS: We conducted a retrospective cohort study. Patients 12-24 months seen at 3 pediatric academic primary care clinics for any visit during October 1-31, 2021 were included. We then reviewed continuity for these patients in the preceding 12 months. Outcomes included each patient's UPC for all visits, and a modified UPC for well child checks only (UPC Well). Covariates included race, ethnicity, insurance, clinic site, age, sex, care management, or seeing a social worker. We evaluated for differences in outcomes using bivariate analyses and multivariable regression models. RESULTS: Our cohort included 356 patients (74% Black, 5% Hispanic, 85% Medicaid, 52% female, median age 15.8 months). The median UPC was 0.33 and median UPC Well was 0.40. Black patients had significantly lower median values for UPC (0.33 Black vs 0.40 non-Black, p<0.0001) and UPC Well (0.33 Black vs 0.50 non-Black, p<0.0001). There were similar inequities in continuity rates by insurance and clinic site. In multivariable models, clinic site was the only variable significantly associated with continuity. CONCLUSIONS: Clinic sites serving higher percentages of Black patients had lower rates of continuity. The main driver of racial inequities in continuity rates was at the institutional level. WHAT'S NEW: This is the first study to assess racial inequities in primary care provider continuity rates across clinics within a single academic pediatric center. Racial inequities in continuity have not previously been described across pediatric academic primary care clinic sites.

Fat-Free Mass Index in a Large Sample of Collegiate American Football Athletes.

High levels of fat-free mass (FFM) are favorable for athletes and are related to sport performance. However, fat-free mass index (FFMI), which includes adjustments for height, may offer a better way to characterize FFM beyond raw values. As FFMI is understudied relative to sport, the purpose of the current study was to assess position and age group differences in FFMI among collegiate American football players. National Collegiate Athletic Association DIII (n=111) football players underwent body composition assessment via bioelectrical impedance analysis. FFMI was calculated by dividing FFM by height squared. One-way analyses of variance with Bonferroni post-hoc tests were conducted to evaluate differences in FFMI by position and age groups (α<0.05). The overall mean FFMI was 23.50 ± 2.04 kg · m-2, with values ranging from 18.1-27.7 kg · m-2. FFMI was highest in linemen (24.8 ± 1.5 kg · m-2) and lowest in specialty players (20.6 ± 1.4 kg · m-2) (p<0.05). No differences in FFMI were apparent across age groups (p>0.05). Current findings demonstrate that an athlete's upper limit for FFMI may exceed 25 kg · m-2, and differences exist across positions, likely due to position-specific demands. These measurements serve as a foundation for tailoring nutritional and exercise plans, forecasting athletic performance, and supplying coaches with standardized data about the potential for additional FFM accretion in collegiate American football players.

Determining the Effects of Zero-Field Splitting and Magnetic Exchange in Dimeric Europium(II) Complexes.

Related BAP [BAP = bis(acyl)phosphide] and Acac (Acac = ß-diketonate) molecules perform as robust supports for both lanthanide and actinide metals. Here, a molecular bimetallic Eu2+ complex was successfully targeted and isolated by employing sodium bis(mesitoyl)phosphide [Na(mesBAP)] in a salt metathesis with EuI2, producing [Eu(mesBAP)2(et2o)]2 (et2o = metal-coordinated diethyl ether). The corresponding Acac-Eu2+ complex was targeted using mesAcac- (1,3-dimesityl-1,3-propanedione), generating [Eu(mesAcac)2(et2o)]2. Both complexes were characterized by single-crystal X-ray diffraction, UV-vis, IR, and NMR spectroscopies, and variable-temperature magnetic susceptibility. [Eu(mesBAP)2(et2o)]2 was persistent under anaerobic, anhydrous conditions, whereas the analogous [Eu(mesAcac)2(et2o)]2 showed evidence of decomposition under identical conditions. Variable-temperature magnetic susceptibility and magnetization studies of [Eu(mesBAP)2(et2o)]2 and [Eu(mesAcac)2(et2o)]2 were performed, resulting in similar magnetic exchange coupling values of Jex = -0.018 and -0.023 cm-1 and axial zero-field-splitting D values of -0.38 and -0.51 cm-1, respectively.

Causal Mediation of Neighborhood-Level Pediatric Hospitalization Inequities.

BACKGROUND AND OBJECTIVES: Population-wide racial inequities in child health outcomes are well documented. Less is known about causal pathways linking inequities and social, economic, and environmental exposures. Here, we sought to estimate the total inequities in population-level hospitalization rates and determine how much is mediated by place-based exposures and community characteristics. METHODS: We employed a population-wide, neighborhood-level study that included youth <18 years hospitalized between July 1, 2016 and June 30, 2022. We defined a causal directed acyclic graph a priori to estimate the mediating pathways by which marginalized population composition causes census tract-level hospitalization rates. We used negative binomial regression models to estimate hospitalization rate inequities and how much of these inequities were mediated indirectly through place-based social, economic, and environmental exposures. RESULTS: We analyzed 50 719 hospitalizations experienced by 28 390 patients. We calculated census tract-level hospitalization rates per 1000 children, which ranged from 10.9 to 143.0 (median 45.1; interquartile range 34.5 to 60.1) across included tracts. For every 10% increase in the marginalized population, the tract-level hospitalization rate increased by 6.2% (95% confidence interval: 4.5 to 8.0). After adjustment for tract-level community material deprivation, crime risk, English usage, housing tenure, family composition, hospital access, greenspace, traffic-related air pollution, and housing conditions, no inequity remained (0.2%, 95% confidence interval: -2.2 to 2.7). Results differed when considering subsets of asthma, type 1 diabetes, sickle cell anemia, and psychiatric disorders. CONCLUSIONS: Our findings provide additional evidence supporting structural racism as a significant root cause of inequities in child health outcomes, including outcomes at the population level.

Racial Inequities in Palliative Referral for Children with High-Intensity Neurologic Impairment.

OBJECTIVE: To evaluate whether racial and socioeconomic inequities in pediatric palliative care utilization extend to children with high-intensity neurologic impairment (HI-NI), which is a chronic neurological diagnosis resulting in substantial functional morbidity and mortality. STUDY DESIGN: We conducted a retrospective study of patients with HI-NI who received primary care services at a tertiary care center from 2014 through 2019. HI-NI diagnoses that warranted a palliative care referral were identified by consensus of a multidisciplinary team. The outcome was referral to palliative care. The primary exposure was race, categorized as Black or non-Black to represent the impact of anti-Black racism. Additional exposures included ethnicity (Hispanic/non-Hispanic) and insurance status (Medicaid/non-Medicaid). Descriptive statistics, bivariate analyses, and multivariable logistic regression models were performed to assess associations between exposures and palliative care referral. RESULTS: A total of 801 patients with HI-NI were included; 7.5% received a palliative referral. There were no differences in gestational age, sex, or ethnicity between patients who received a referral and those who did not. In multivariable analysis, adjusting for ethnicity, sex, gestational age, and presence of complex chronic conditions, Black children (aOR 0.47, 95% CI 0.26, 0.84) and children with Medicaid insurance (aOR 0.40, 95% CI 0.23, 0.70) each had significantly lower odds of palliative referral compared with their non-Black and non-Medicaid-insured peers, respectively. CONCLUSIONS: We identified inequities in pediatric palliative care referral among children with HI-NI by race and insurance status. Future work is needed to develop interventions, with families, aimed at promoting more equitable, antiracist systems of palliative care.

Collegiate women's wrestling body fat percentage and minimum wrestling weight values: time for revisiting minimal body fat percent?

BACKGROUND: The estimation of body fat percentage (BF%) in wrestling is used to determine the minimum wrestling weight (MWW) and lowest allowable weight class (MWC) in which wrestlers are eligible to compete. A 12% minimum threshold is currently used for women wrestlers, yet a potential increase for safety has been discussed. Because of the novelty of collegiate women's wrestling, there is a paucity of literature available on the body composition norms of this population. The purpose of this study was to provide a descriptive summary of BF% and MWW values of female wrestlers and how MWW values would change with the use of different BF% thresholds. METHODS: Data from the 2022-2023 collegiate season were retrospectively analyzed resulting in a sample of 1,683 collegiate women wrestlers from the National Association of Intercollegiate Athletics (NAIA, n = 868) and the National Collegiate Athletics Association (NCAA, n = 815). All wrestlers completed skinfold assessments for weight certification at the start of the competition season. The skinfold values were used to estimate BF% using the Slaughter skinfold prediction equation. Frequency statistics and descriptive analysis were performed to compute normative MWW and BF% profiles. BF% thresholds of 12% (12MWW) and the BF% value defined as the lowest 5th percentile, which would be considered unusually lean, were used to determine the resulting MWW and MWC for each method. The lowest recorded weight and weight class division throughout the season was also recorded for each wrestler. RESULTS: There was a positively skewed (0.94) and platykurtic (1.86) distribution of MWW values. The median ± interquartile range BF% for all wrestlers was 27.4 ± 10.22%, with 17% BF representing the 5th percentile. Only 354 out of 1,579 (22.4%) wrestlers competed in their lowest allowable weight class, based on the 12MWW. Of these 354 wrestlers, the mean BF% was 21.3 ± 5.2% at weight certification with only n = 17 being at or below 12% body fat and an average weight loss of 11.1 ± 8.8 lbs. from the time of weight certification. Throughout the season, wrestlers competed at weights that were, on average (mean ± SD), 19.4 ± 16.9 lbs. higher than their 12MWW (95% CI: 18.6, 20.2 lbs. p < 0.001; effect size [ES] = 1.1), 13.4 ± 19.0 lbs. higher than the 17MWW (p < 0.001; ES = 0.70), and 8.7 ± 8.3 lbs. lower than their weight at the certification (95% CI: 8.3, 9.1 lbs. p < 0.001; ES = 1.1). CONCLUSIONS: Nearly all BF% values were well above the 12% threshold used to determine MWW. Increasing the minimum BF% threshold from 12% to 17% would affect a small percentage of wrestlers, likely reduce the need for excessive weight cutting, and minimize the deleterious health effects of an athlete at such a low BF%.

An Investigation into the Portrayal of Organ Donation on Grey's Anatomy Seasons 1 Through 15.

The current project sought to extend prior research examining organ donation portrayals on Grey's Anatomy by examining the first fifteen seasons. Guided by the health belief model, content analysis revealed more attention was given to benefits of donation than barriers. Contrary to previous research, more attention was given to refuting rather than promoting commonly cited myths. The results also address attention to the health threat as well as Grey's Anatomy's representation of self-efficacy in registering to be an organ donor. Finally, proportion tests revealed significant differences between the types of organs transplanted on Grey's Anatomy compared to organs transplanted in the United States. The results are discussed with an emphasis on portrayal trends throughout Season 1 through 15 as well as the theoretical and practical implications of our findings.

Fat-Free Mass Index in a Large Sample of National Collegiate Athletic Association Men and Women Athletes From a Variety of Sports.

ABSTRACT: Magee, MK, Fields, JB, Jagim, AR, and Jones, MT. Fat-free mass index in a large sample of National Collegiate Athletic Association men and women athletes from a variety of sports. J Strength Cond Res 38(2): 311-317, 2024-Fat-free mass index (FFMI) can be used to categorize fat-free mass (FFM) relative to height. Normative values have been established in a variety of sports, as has suggested lower and upper thresholds of FFMI. However, FFMI has not been reported in a large sample of athletes, representing both sexes and multiple sport types. The purpose of this study was to evaluate differences in FFMI and establish normative values across a large sample of collegiate sports. A total of 1,961 athletes (men: n = 596, 10 sports; women: n = 1,365, 8 sports) participated. Height and mass were measured using a stadiometer and calibrated digital scale, respectively. Fat-free mass was assessed with air displacement plethysmography and used to calculate FFMI. Kruskal-Wallis test and one-way analysis of variance evaluated differences in FFMI in women's and men's sports, respectively. When collapsed across sport type and stratified by sex, men had a higher FFMI (21.5 ± 1.9 kg·m -2 vs. 17.9 ± 1.8 kg·m -2 ; p < 0.001). Differences occurred in FFMI across sport. In women, basketball athletes had the highest FFMI (18.9 kg·m -2 ) and highest 99th percentile for FFMI, whereas rowers had the lowest (16.9 kg·m -2 ). In men, throwers had the highest FFMI (25.7 kg·m -2 ) and highest 99th percentile, whereas volleyball athletes had the lowest (19.9 kg·m -2 ). Differences in FFMI may be attributable to dietary habits and physiological demands of respective sports. These results can provide information relative to differences in FFMI values across sports. In addition, sport-specific normative values can be used as benchmarks and targets for training, nutrition, and goal setting.

Analysis of In-Season External Load and Sport Performance in Women's Collegiate Basketball.

ABSTRACT: Brown, FSA, Fields, JB, Jagim, AR, Baker, RE, and Jones, MT. Analysis of in-season external load and sport performance in women's collegiate basketball. J Strength Cond Res 38(2): 318-324, 2024-Quantifying and monitoring athlete workload throughout a competitive season is a means to manage player readiness. Therefore, the purpose of the current study was to quantify practice and game external loads and to assess the relationship between such loads and basketball-specific performance metrics across a women's collegiate basketball season. Thirteen National Collegiate Athletic Association Division I women basketball athletes (age 20.08 ± 1.55 years) wore Global Positioning Systems sensors equipped with triaxial accelerometers for 29 games and 66 practices during the 2019-20 season. A multivariate analysis of variance was used to assess differences in external load between high- and low-minute players and across quarters within games ( p < 0.05). Bivariate Pearson correlation coefficients were run to determine relationships between external loads and metrics of basketball performance. Findings indicated that high- and low-minute athletes experienced different loads during games and practices ( p < 0.001). External loads differed by quarter, such that player load (PL) was highest in Q4 ( p = 0.007), PL·min -1 was highest in Q1 and lowest in Q4 ( p < 0.001), and explosive ratio (i.e., ratio of PL and explosive efforts) was lowest in Q3 ( p = 0.45). Relationships existed between PL·min -1 and field goals ( r = 0.41; p = 0.02) and between the explosive ratio and free throws ( r = 0.377 p = 0.04). These results can be used to inform design of training sessions with the intent to prepare athletes for the demands of the competitive season. It is recommended that future research continue to explore the relationship of sport-specific performance metrics and athlete external load.

Relationships between external loads, sRPE-load, and self-reported soreness across a men's collegiate soccer season.

The purpose was to examine relationships between external loads (ELs), perceived exertion, and soreness. Collegiate men soccer players (n = 19) were monitored for 72 sessions (training: n = 53; matches: n = 19). Likert scale assessments (0-6) of lower body soreness were collected prior to each session, and ELs were collected using positional monitoring technology. Session rate of perceived exertion (sRPE-load) was calculated by multiplying perceived exertion values (Borg CR-10 Scale) by respective session duration to determine internal load. Multiple analyses of variance were used to determine differences in ELs across seasons (pre-season, in-season, post-season) and sessions (training, match). Bivariate Pearson correlation coefficients and linear regression analyses were used to evaluate relationships among soreness, ELs, and sRPE-load. Greatest ELs were observed during pre-season and post-season phases (p < 0.001). Sessions with high perceived exertion and low soreness were associated with higher ELs (p < 0.05). Duration (t = 16.13), total distance (t = 9.17), sprint distance (t = 7.54), player load (t = 4.22), top speed (t = 4.69), and acceleration (t = 2.02) positively predicted sRPE-load (F = 412.9, p < 0.001, R2 = 0.75). Soreness was weakly and trivially correlated with ELs (p < 0.05). The very strong relationship between ELs and sRPE-load highlights the utility of sRPE-load as a practical means to estimate workload; however, more research into the relationship between soreness and workload is warranted.

Health and well-being of serving and ex-serving UK Armed Forces personnel: protocol for the fourth phase of a longitudinal cohort study.

INTRODUCTION: This is the fourth phase of a longitudinal cohort study (2022-2023) to investigate the health and well-being of UK serving (Regulars and Reservists) and ex-serving personnel (veterans) who served during the era of the Iraq and Afghanistan conflicts. The cohort was established in 2003 and has collected data over three previous phases including Phase 1 (2004-2006), Phase 2 (2007-2009) and Phase 3 (2014-2016). METHODS AND ANALYSIS: Participants are eligible to take part if they completed the King's Centre for Military Health Research Health and Wellbeing Cohort Study at Phase 3 (2014-2016) and consented to be recontacted (N=7608). Participants will be recruited through email, post and text message to complete an online or paper questionnaire. Data are being collected between January 2022 and September 2023. Health and well-being measures include measures used in previous phases that assess common mental disorders, post-traumatic stress disorder (PTSD) and alcohol misuse. Other areas of interest assess employment, help-seeking and family relationships. New topics include the impact of the British withdrawal from Afghanistan in 2021, complex PTSD (C-PTSD), illicit drug use, gambling and loneliness. Analyses will describe the effect size between groups deployed to Iraq and/or Afghanistan or not deployed, and those who are currently in service versus ex-service personnel, respectively, reporting prevalences with 95% CIs, and ORs with 95% CI. Multivariable logistic and multiple linear regression analyses will be conducted to assess various health and well-being outcomes and associations with risk and protective factors. ETHICS AND DISSEMINATION: Ethical approval has been granted by the Ministry of Defence Research Ethics Committee (Ref: 2061/MODREC/21). Participants are provided with information and agree to a series of consent statements before taking part. Findings will be disseminated to UK Armed Forces stakeholders and international research institutions through stakeholder meetings, project reports and scientific publications.

Sex Differences in Resting Metabolic Rate among Athletes and Association with Body Composition Parameters: A Follow-Up Investigation.

The purpose of this study was to examine sex differences in resting metabolic rate (RMR) and associations between measured RMR and body composition parameters in athletes. One-hundred and ninety collegiate men (n = 98; age: 20.1 ± 1.6 yr.; body mass: 92.7 ± 17.5 kg; height: 181.6 ± 6.2 cm, body mass index: 28.0 ± 4.7 kg/m2) and women (n = 92; age: 19.4 ± 1.1 yr.; body mass: 65.2 ± 11.0 kg; height: 168.0 ± 6.6 cm, body mass index: 23.0 ± 3.6 kg/m2) athletes volunteered to participate in this study. Athletes completed a body composition assessment using air displacement plethysmography and RMR using indirect calorimetry. Assessments were completed in a fasted state and after refraining from intense physical activity > 24 h prior to testing. Data were collected during the 2016-2019 seasons. Men had a higher RMR compared to women (2595 ± 433 vs. 1709 ± 308 kcals; p < 0.001); however, when adjusted for body mass (p = 0.064) and fat-free mass (p = 0.084), the observed differences were not significant. Height, body mass, body mass index, fat-free mass, and fat mass were positively associated with RMR in both men and women athletes (r = 0.4-0.8; p < 0.001). Body mass (men: ß = 0.784; women: ß = 0.832)) was the strongest predictor of RMR. Men athletes have a higher absolute RMR compared to their women counterparts, which is influenced by greater body mass and fat-free mass. Body mass is the strongest predictor of RMR in both men and women athletes.

Comparison of Match External Loads across a Men's and Women's Lacrosse Season.

The purpose of this study was to compare external workloads between collegiate men's (MLAX) and women's lacrosse (WLAX) matches and examine positional differences across the season. Athletes (MLAX: n = 10; WLAX: n = 13) wore a global positional system device during all matches. External load metrics included in the analysis were total distance (TD), sprint distance (SD), accelerations (>3 m/s2), sprint efforts, player load per minute (PL/min), top speed, and distances spent in various speed zones. WLAX had higher TD (p = 0.001), SD (p < 0.001), distances in SZs 2-5 (p < 0.001), PL (p < 0.001), and sprint efforts (p < 0.001) compared to MLAX. However, MLAX performed more acceleration (p < 0.001) and deceleration (p < 0.001) efforts. WLAX midfielders (M) and defenders (D) reached higher top speeds and performed more accelerations than attackers (p < 0.001). Midfielders covered the greatest distance at high speeds (p = 0.011) and the smallest distance at low speeds (<0.001) for WLAX. For MLAX, midfielders performed the highest SDs, top speeds, accelerations, decelerations, and distances in higher speed zones (p < 0.001) compared to attackers and defenders. Results indicate that there are significant gender and positional differences in external workload demands during match play, specifically for volume- and intensity-derived workload parameters, between men's and women's lacrosse. Therefore, sports performance coaches should create gender- and position-specific conditioning programs to prepare athletes for match demands.

Validation of skinfold equations and alternative methods for the determination of fat-free mass in young athletes.

Intoduction: To cross-validate skinfold (SKF) equations, impedance devices, and air-displacement plethysmography (ADP) for the determination of fat-free mass (FFM). Methods: Male and female youth athletes were evaluated (n = 91[mean ± SD] age: 18.19 ± 2.37 year; height: 172.1 ± 9.8 cm; body mass: 68.9 ± 14.5 kg; BMI: 23.15 ± 3.2 kg m-2; body fat: 19.59 ± 6.9%) using underwater weighing (UWW), ADP, and SKF assessments. A 3-compartment (3C) model (i.e., UWW and total body water) served as the criterion, and alternate body density (Db) estimates from ADP and multiple SKF equations were obtained. Validity metrics were examined to establish each method's performance. Bioelectrical impedance analysis (BIA), bioimpedance spectroscopy (BIS), and the SKF equations of Devrim-Lanpir, Durnin and Womersley, Jackson and Pollock (7-site), Katch, Loftin, Lohman, Slaughter, and Thorland differed from criterion. Results: For females, Pearson's correlations between the 3C model and alternate methods ranged from 0.51 to 0.92, the Lin's concordance correlation coefficient (CCC) ranged from 0.41 to 0.89, with standard error of the estimate (SEE) ranges of 1.9-4.6 kg. For SKF, the Evans 7-site and J&P 3 Site equations performed best with CCC and SEE values of 0.82, 2.01 kg and 0.78, 2.21 kg, respectively. For males, Pearson's correlations between the 3C model and alternate methods ranged from 0.50 to 0.95, CCC ranges of 0.46-0.94, and SEE ranges of 3.3-7.6 kg. For SKF, the Evans 3-site equation performed best with a mean difference of 1.8 (3.56) kg and a CCC of 0.93. Discussion: The Evans 7-site and 3-site SKF equations performed best for female and male athletes, respectively. The field 3C model can provide an alternative measure of FFM when necessary.

Small Molecule Activation of NAPE-PLD Enhances Efferocytosis by Macrophages.

N-Acyl-phosphatidylethanolamine hydrolyzing phospholipase D (NAPE-PLD) is a zinc metallohydrolase that hydrolyzes N-acyl-phosphatidylethanolamines (NAPEs) to form N-acyl-ethanolamines (NAEs) and phosphatidic acid. Several lines of evidence suggest that reduced NAPE-PLD activity could contribute to cardiometabolic diseases. For instance, NAPEPLD expression is reduced in human coronary arteries with unstable atherosclerotic lesions, defective efferocytosis is implicated in the enlargement of necrotic cores of these lesions, and NAPE-PLD products such as palmitoylethanolamide and oleoylethanolamide have been shown to enhance efferocytosis. Thus, enzyme activation mediated by a small molecule may serve as a therapeutic treatment for cardiometabolic diseases. As a proof-of-concept study, we sought to identify small molecule activators of NAPE-PLD. High-throughput screening followed by hit validation and primary lead optimization studies identified a series of benzothiazole phenylsulfonyl-piperidine carboxamides that variably increased activity of both mouse and human NAPE-PLD. From this set of small molecules, two NAPE-PLD activators (VU534 and VU533) were shown to increase efferocytosis by bone-marrow derived macrophages isolated from wild-type mice, while efferocytosis was significantly reduced in Napepld-/- BMDM or after Nape-pld inhibition. Together, these studies demonstrate an essential role for NAPE-PLD in the regulation of efferocytosis and the potential value of NAPE-PLD activators as a strategy to treat cardiometabolic diseases.

Analysis of Accumulated Workloads and Performance Testing Across a Collegiate Women's Lacrosse Season.

ABSTRACT: Fields, JB, Kuhlman, NM, Jagim, AR, Dulak-Sigler, C, and Jones, MT. Analysis of accumulated workloads and performance testing across a collegiate women's lacrosse season. J Strength Cond Res 37(11): 2213-2221, 2023-Monitoring accumulated workloads, acute:chronic workload ratios (ACWR), and training monotony (TM) are practical methods for monitoring athlete physical stress. Performance testing provides useful information about the changing nature of physical abilities. Therefore, the purpose was to examine differences in accumulated workloads based on session type, explore seasonal trends in ACWR and TM, and assess changes in performance assessments in collegiate women's lacrosse athletes. Athletes, who were identified as starters ( n = 12), wore positional monitoring technology during training sessions ( n = 61) and games ( n = 17) and completed preseason and postseason assessments of speed, agility, power (jump tests), strength, aerobic capacity, and body composition. Separate 1-way analyses of variance were used to determine differences in accumulated workloads for session type and differences in performance assessments from preseason to postseason ( p < 0.05). When compared with games, practice sessions elicited greater ( p < 0.001) accumulated total distance, player load, repeated high-intensity efforts, accelerations, change of direction, explosive efforts, high-speed efforts ( p = 0.002), and high-speed distance ( p = 0.002). Throughout the season, ACWR and TM ranged from 0.16 to 1.40 AU and 0.68-1.69 AU, respectively. The 40-yd sprint ( p < 0.001) and pro-agility ( p < 0.001) improved from preseason to postseason, whereas no changes in aerobic capacity, lower-body power, or strength were observed ( p > 0.05). The monitoring of accumulated loads, ACWR and TM, and performance tests revealed novel information about the seasonal demands of collegiate women's lacrosse. Women lacrosse players are able to improve speed and agility throughout the season, while maintaining strength, power, and endurance, with minimal reductions in fat-free mass.

Athlete External Load Measures Across a Competitive Season in High School Basketball.

ABSTRACT: Askow, AT, Jennings, W, Jagim, AR, Fields, JB, Beaudoin, RG, Sanchez, GM, Weeks, JE, Oliver, JM, and Jones, MT. Athlete external load measures across a competitive season in high school basketball. J Strength Cond Res 37(11): 2206-2212, 2023-The purpose of this retrospective analysis was to quantify in-season external load and to determine if relationships existed between load metrics and basketball performance. Eleven male high school varsity basketball athletes (n = 11; mass 80.5 ± 9.6 kg, height 190.2 ± 9.4 cm, age 17.6 ± 0.7 years) were monitored across a season. PlayerLoad (PL), PL per minute (PL·min -1 ), total jumps, and explosive movements (EMs) were quantified using a commercially available local positioning unit. Basketball-specific performance metrics, including points scored, points allowed, point differentials, and shooting percentages for each quarter and game, were compiled. Data were analyzed using repeated-measure analysis of variance to evaluate differences in load by starting status, session type, game outcome, and game type. Pearson's correlation coefficients were used to assess relationships between load metrics and basketball performance. Statistical significance was set at p < 0.05. The mean values across 23 games for PL, PL·min -1 , total jumps, and EMs were 457 ± 104 AU, 10.9 ± 1.6 AU, 42.6 ± 9.6, and 46.7 ± 7.2, respectively. Relationships were observed ( p < 0.05) between PL and points scored ( r = 0.38) and free throw percentage ( r = 0.21). Further relationships were observed between PL·min -1 and free throw shooting percentage ( r = -0.27), and between points scored and total jumps ( r = 0.28), and EMs ( r = 0.26). Notable differences in game demands were observed for playing status. Meaningful differences in measures of external load were observed between each quarter of play, with the highest measures evident in quarters 1 and 3. Guards and forwards experienced minimal differences in external load during gameplay, and game outcome did not result in differences. Higher point totals corresponded with higher PL, total jumps, and EM.

Anger Among UK Ex-Service Military Personnel During the COVID-19 Pandemic.

ABSTRACT: Military service and ex-service personnel commonly experience difficulties with anger. The COVID-19 pandemic had several negative consequences upon social, economic, and health factors that influence anger. This study aimed to explore 1) levels of anger in an ex-serving military cohort during the COVID-19 pandemic; 2) self-reported changes in anger compared with prepandemic levels; and 3) identify sociodemographic characteristics, military characteristics, COVID-19 experiences, and COVID-19 stressors associated with anger. UK ex-service personnel ( n = 1499) completed the Dimensions of Anger Reactions 5-item measure within an existing cohort study. Overall, 14.4% reported significant difficulties with anger, and 24.8% reported their anger worsened during the pandemic. Anger was associated with factors such as financial difficulties, extra/new caring responsibilities, and COVID-19 bereavement. Endorsing more COVID-19 stressors was associated with higher odds of anger difficulties. This study highlights the impact of the pandemic on ex-service personnel, including a strain on family/social relationships and financial hardship, which affected anger.

Calibrating the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) for detecting alcohol-related problems among Canadian, UK and US soldiers: cross-sectional pre-deployment and post-deployment survey results.

OBJECTIVES: Excessive alcohol use can bring about adverse health and work-related consequences in civilian and military populations. Screening for excessive drinking can help identify individuals at risk for alcohol-related problems who may require clinical interventions. The brief validated measures of alcohol use such as the Alcohol Use Disorders Identification Test (AUDIT), or abbreviated AUDIT-Consumption (AUDIT-C), are often included in military deployment screening and epidemiologic surveys, but appropriate cut-points must be used to effectively identify individuals at risk. Although the conventional AUDIT-C cut-points ≥4 for men and ≥3 for women are commonly used, recent validation studies of veterans and civilians recommend higher cut-points to minimise misclassification and overestimation of alcohol-related problems. This study aims to ascertain optimal AUDIT-C cut-points for detecting alcohol-related problems among serving Canadian, UK and US soldiers. DESIGN: Cross-sectional pre/post-deployment survey data were used. SETTINGS: Comprised Army locations in Canada and UK, and selected US Army units. PARTICIPANTS: Included soldiers in each of the above-mentioned settings. OUTCOME MEASURES: Soldiers' AUDIT scores for hazardous and harmful alcohol use or high levels of alcohol problems served as a benchmark against which optimal sex-specific AUDIT-C cut-points were assessed. RESULTS: Across the three-nation samples, AUDIT-C cut-points of ≥6/7 for men and ≥5/6 for women performed well in detecting hazardous and harmful alcohol use and provided comparable prevalence estimates to AUDIT scores ≥8 for men and ≥7 for women. The AUDIT-C cut-point ≥8/9 for both men and women performed fair-to-good when benchmarked against AUDIT ≥16, although inflated AUDIT-C-derived prevalence estimates and low positive predictive values were observed. CONCLUSION: This multi-national study provides valuable information regarding appropriate AUDIT-C cut-points for detecting hazardous and harmful alcohol use, and high levels of alcohol problems among soldiers. Such information can be useful for population surveillance, pre-deployment/post-deployment screening of military personnel, and clinical practice.

Relationships between surrogate measures of mechanical and psychophysiological load, patellar tendon adaptations, and neuromuscular performance in NCAA division I men's volleyball athletes.

Introduction: Patellar tendon adaptations occur in response to mechanical load. Appropriate loading is necessary to elicit positive adaptations with increased risk of injury and decreased performance likely if loading exceeds the capacity of the tendon. The aim of the current study was to examine intra-individual associations between workloads and patellar tendon properties and neuromuscular performance in collegiate volleyball athletes. Methods: National Collegiate Athletics Association Division I men's volleyball athletes (n = 16, age: 20.33 ± 1.15 years, height: 193.50 ± 6.50 cm, body mass: 84.32 ± 7.99 kg, bodyfat%: 13.18 ± 4.72%) competing across 9 weeks of in-season competition participated. Daily measurements of external workloads (i.e., jump count) and internal workloads [i.e., session rating of perceived exertion (sRPE)] were recorded. Weekly measurements included neuromuscular performance assessments (i.e., countermovement jump, drop jump), and ultrasound images of the patellar tendon to evaluate structural adaptations. Repeated measures correlations (r-rm) assessed intra-individual associations among performance and patellar tendon metrics. Results: Workload measures exhibited significant negative small to moderate (r-rm =-0.26-0.31) associations with neuromuscular performance, negative (r-rm = -0.21-0.30), and positive (r-rm = 0.20-0.32) small to moderate associations with patellar tendon properties. Discussion: Monitoring change in tendon composition and performance adaptations alongside workloads may inform evidence-based frameworks toward managing and reducing the risk of the development of patellar tendinopathy in collegiate men's volleyball athletes.