Descriptive Analysis of Mental and Physical Wellness in Collegiate Dancers.

INTRODUCTION: Understanding the physical and mental health of collegiate dancers is important for developing appropriate screening protocols and treatment interventions. This study aims to provide descriptive data on the overall health, injury burden, and well-being of a group of collegiate dancers, including the interactions between injury, nutrition, and mental health, to provide insight for wellness screening and interventions in collegiate dance programs. METHODS: Members of the School of Dance at the University of Utah were sent an electronic general health survey. The survey included questions regarding medical history, family history, injuries, diet, sleep quality, symptoms of depression and anxiety, and history of eating disorders. RESULTS: Of the 231 dancers who received the survey, 198 responded (response rate = 85.7%). Fifty 2% of respondents had an active injury. Symptoms of depression and anxiety were common (35.4%), and 37.4% of the dancers were interested in receiving mental health support. Symptoms of depression and anxiety had a significant association with both a history of injury and active injuries (P = .033 and .039, respectively). History of eating disorder was also significantly associated with active injuries (P = .005). The most commonly injured body area was ankle or foot (n = 144, 72.7%), followed by lower leg or shin (n = 76, 38.4%), and knee (n = 61, 30.8%). Over a quarter of the dancers (n = 54, 27.3%) reported having trouble sleeping, and 9.1% reported having a history of eating disorder. CONCLUSIONS: This study highlights the important interplay between mental health, sleep, nutrition, and injury. These results show that in a group of collegiate dancers, active injuries and mental health concerns are common, and that there are statistically significant associations between injury, nutrition, and mental health. These data provide insight into factors that affect dancer wellness and help inform future screening and intervention protocols for dance programs.

Patient Perspectives on Longitudinal Adherence to Lung Cancer Screening.

BACKGROUND: Annual lung cancer screening (LCS) has mortality benefits for eligible participants; however, studies demonstrate low adherence to follow-up LCS. RESEARCH QUESTION: What are patients' perspectives on barriers and facilitators to adherence to annual LCS? STUDY DESIGN AND METHODS: Forty participants enrolled in the University of Washington/Seattle Cancer Care Alliance LCS program completed a demographic questionnaire and a semistructured interview based on the Tailored Implementation in Chronic Diseases framework to determine attitudes, barriers, and facilitators to longitudinal LCS. Interviews were coded using principles of framework analysis to identify and compare themes between adherent and nonadherent participants. RESULTS: The 40 participants underwent initial LCS in 2017 with negative results. Seventeen were adherent to follow-up annual LCS, whereas 23 were not. Seven overall themes emerged from qualitative analysis, which are summarized as follows: (1) screening experiences are positive and participants have positive attitudes toward screening; (2) provider recommendation is a motivator and key facilitator for most patients; (3) many patients are influenced by personal factors and symptoms and do not understand the importance of asymptomatic screening; (4) common barriers to longitudinal screening include cost, insurance coverage, accessibility, and other medical conditions; (5) patients have variable preferences about how they receive their screening results, and many have residual questions about their results and future screening; (6) reminders are an important facilitator of annual screening; and (7) most patients think a navigator would be beneficial to the screening process, with different aspects of navigation thought to be most helpful. Those who were not adherent more commonly reported individual barriers to screening, competing health concerns, and less provider communication. INTERPRETATION: Key facilitators (eg, patient reminders, provider recommendations) may improve long-term screening behavior, and a number of barriers to the screening process could be addressed through patient navigation.

Implementing an Anonymous Closed-Loop Feedback Process and Associations With ACGME Annual Survey Scores in a Family Medicine Residency.

BACKGROUND AND OBJECTIVES: The annual Accreditation Council for Graduate Medical Education (ACGME) survey evaluates numerous variables, including resident satisfaction with the training program. We postulated that an anonymous system allowing residents to regularly express and discuss concerns would result in higher ACGME survey scores in areas pertaining to program satisfaction. METHODS: One family medicine residency program implemented a process of quarterly anonymous closed-loop resident feedback and discussion in academic year 2012-2013. Data were tracked longitudinally from the 2011-2019 annual ACGME resident surveys, using academic year 2011-2012 as a baseline control. RESULTS: For the survey item "Satisfied that evaluations of program are confidential," years 2013-2014, 2014-2015, and 2018-2019 showed a significantly higher change from baseline. For "Satisfied that program uses evaluations to improve," year 2018-2019 had a significantly higher percentage change from baseline. For "Satisfied with process to deal with problems and concerns," year 2018-2019 showed significantly higher change. For "Residents can raise concerns without fear," years 2013-2014 and 2018-2019 saw significantly higher changes. CONCLUSIONS: These results suggest that this feedback process is perceived by residents as both confidential and promoting a culture of safety in providing feedback. Smaller changes were seen in residents' belief that the program uses evaluations to improve, and in satisfaction with the process to deal with problems and concerns.

Validity of a Sham Dry Needling Technique on a Healthy Population.

BACKGROUND: Various methods of sham procedures have been used in controlled trials evaluating dry needling efficacy although few have performed validation studies of the sham procedure. HYPOTHESIS/PURPOSE: The purpose of this study was to examine the validity of a sham dry needling technique on healthy, active subjects. STUDY DESIGN: Validation study. METHODS: Runners capable of completing a half-marathon or marathon race and were randomized to receive true (using an introducer and needle) or sham (using an introducer and fixed, blunted needle) dry needling. Blinded subjects were asked to identify if they received sham or true dry needling following the procedure. Proportions of those who correctly identified their needling were also examined on the basis of past experience of receiving dry needling. RESULTS: Fifty-three participants were included in this study, with 25 receiving the true dry needling procedure and 28 receiving the sham. Of those who had received dry needling in the past (n = 16), 11 (68.8%) correctly identified their respective groups. For those who had not previously received dry needling (n = 37), 13 (35.1%) accurately identified their group. Most importantly, 94.1% of dry needling-naïve participants were unable to identify they received the sham procedure (p < 0.001). CONCLUSIONS: This study shows that a fixed needle in an introducer tube is a simple, inexpensive, effective sham procedure in patients who have never received dry needling before. This technique may be useful for randomized controlled trials in the future. LEVELS OF EVIDENCE: 2.

Postrace Dry Needling Does Not Reduce Subsequent Soreness and Cramping-A Randomized Controlled Trial.

OBJECTIVE: To identify whether a single session of postrace dry needling can decrease postrace soreness and quantity of postrace leg cramps in half-marathon and full-marathon runners. DESIGN: Single-blind, prospective, randomized, controlled trial. SETTING: Finish line of 2018 Salt Lake City Marathon & Half-Marathon. PARTICIPANTS: Runners aged 18 years or older who completed a marathon or half-marathon. INTERVENTIONS: True or sham dry needling of the bilateral vastus medialis and soleus muscles within 1 hour of race completion by 2 experienced practitioners. MAIN OUTCOME MEASURES: The primary outcome measure was numeric pain rating improvements for soreness on days 1, 2, 3, and 7 compared to immediately postrace. Secondary outcome measures included number of postrace cramps and subjective improvement of soreness. RESULTS: Sixty-two runners were included with 28 receiving true and 34 receiving sham dry needling. Objective pain scores showed an increase in pain of the soleus muscles at days 1 and 2 (P ≤ 0.003 and P ≤ 0.041, respectively) in the dry needling group. No differences were seen in postrace pain in the vastus medialis muscles (P > 0.05). No association was seen between treatment group and presence of postrace cramping at any time point (P > 0.05). Subjectively, there was a nonsignificant trend for those receiving dry needling to feel better than expected over time (P = 0.089), but no difference with cramping (P = 0.396). CONCLUSIONS: A single postrace dry needling session does not objectively improve pain scores or cramping compared to sham therapy.