Connected through movement: a feasibility study of online mindfulness-based dance/movement therapy for older adults with age-related cognitive decline during COVID-19.

OBJECTIVES: Social isolation and loneliness pose significant public health risks, especially among older adults experiencing age-related cognitive decline (ACD). This mixed methods feasibility study explored the potential of an online mindfulness-based dance/movement therapy (M-DMT) program to alleviate loneliness, enhance psychological well-being, and promote physical activity among older adults experiencing ACD during the COVID-19 pandemic. METHOD: Sixteen participants engaged in a 12-week online group M-DMT program. Feasibility was assessed via enrollment and retention rates, attendance, adverse events, credibility/expectancy, participant perceptions, and satisfaction. Qualitative data were collected to capture participants' perspectives on the intervention's usefulness and perceived benefits. The intervention's preliminary impact on loneliness, depression, positive affect, psychological well-being, and physical activity was also examined. RESULTS: The study met all feasibility criteria, with 65% reporting post-intervention improvement. Significant reductions in loneliness and depression, along with enhanced positive affect and psychological well-being, were observed. Though physical activity increased, statistical significance was not achieved. Qualitative feedback highlighted improved social connectedness, overall quality of life, body awareness, kinematic strategy, and satisfaction with the program. CONCLUSION: Online M-DMT holds promise in addressing well-being and loneliness challenges in older adults experiencing ACD. Further research is necessary to validate and expand upon these promising findings.

Development and feasibility of a mindfulness-based dance/movement therapy intervention for chronic low back pain.

Introduction: Responding to the need for innovative, multi-modal, non-pharmacological strategies in chronic low back pain (cLBP) care, this article presents the development and a mixed methods feasibility trial of a manualized Mindfulness-based Dance/Movement Therapy (M-DMT) program for cLBP. The 12-week program is designed as a group therapy, integrating mindfulness principles, creative/expressive dance and movement, and psychoeducational content focused on cLBP management. This holistic program seeks to cultivate nonjudgmental awareness of pain experiences, challenge maladaptive pain-related beliefs, enhance emotional well-being, foster social support, and promote effective coping strategies for the daily challenges associated with cLBP. Methods: The 12-week M-DMT intervention was administered to individuals with non-specific cLBP (N = 18, aged 51.7 ± 13.9 years, 72% female, 55% Black and 39% White). We assessed feasibility and acceptability through monitoring enrollment and retention rates, attendance, and adverse events. Moreover, we measured the intervention's credibility/expectancy, participants' perception of changes, and overall satisfaction. Additionally, we collected qualitative data, capturing participants' perspectives on the intervention's usefulness and perceived benefits. Specific benchmarks were established to gauge the successful feasibility and acceptability of the program. Results: The adherence rate stood at 80%, with a perfect retention rate of 100%. The study successfully met the benchmarks for treatment acceptability and satisfaction criteria, with 61% of participants reporting "feeling better" or a "great deal better" after the intervention. No adverse events were observed. Participants found the intervention enjoyable and reported that it provided effective tools for cLBP and related symptoms. Notably, participants reported a decrease in fear-avoidance behaviors, increased motivation for physical activity, and a boost in self-efficacy for pain management. Discussion: These encouraging findings establish a strong basis for considering the M-DMT intervention as a promising approach for cLBP management, warranting further investigation in larger-scale studies.

Inflammatory markers in world trade center workers with asthma: Associations with post traumatic stress disorder.

BACKGROUND: Post-traumatic stress disorders (PTSD) is associated with worse asthma outcomes in individuals exposed to the World Trade Center (WTC) site. RESEARCH QUESTION: Do WTC workers with coexisting PTSD and asthma have a specific inflammatory pattern that underlies the relationship with increased asthma morbidity? STUDY DESIGN AND METHODS: We collected data on a cohort of WTC workers with asthma recruited from the WTC Health Program. Diagnosis of PTSD was ascertained with a Structured Clinical Interview for DSM-5 (Diagnostic and Statistical Manuel of Mental Disorders) and the severity of PTSD symptoms was assessed with the PTSD Checklist 5. We obtained blood and sputum samples to measure cytokines levels in study participants. RESULTS: Of the 232 WTC workers with diagnosis of asthma in the study, 75 (32%) had PTSD. PTSD was significantly associated with worse asthma control (p = 0.002) and increased resource utilization (p = 0.0002). There was no significant association (p>0.05) between most blood or sputum cytokines with PTSD diagnosis or PCL-5 scores both in unadjusted and adjusted analyses. INTERPRETATION: Our results suggest that PTSD is not associated with blood and sputum inflammatory markers in WTC workers with asthma. These findings suggest that other mechanisms likely explain the association between PTSD and asthma control in WTC exposed individuals.

A single dose multi-ingredient pre-workout supplement enhances upper body resistance exercise performance.

Introduction: Multi-ingredient pre-workout supplements (MIPS) are commonly used by individuals looking to enhance exercise performance and augment adaptations to training. However, the efficacy of commercially available MIPS is largely dependent on the ingredient profile, and new formulations should be investigated to determine their effectiveness. Therefore, the purpose of this study was to examine the effects of a commercially available MIPS product on performance during an upper body resistance exercise protocol. Methods: Twenty resistance-trained participants (10 men, 10 women) volunteered to complete this double-blind, placebo-controlled, crossover study consisting of 3 visits. Visit 1 consisted of body composition, 1-repetition maximum (1RM) testing, and familiarization. Visits 2 and 3 consisted of supplementation with either MIPS or placebo (PLA) 1 h prior to completion of an upper body resistance exercise workout during which power output, repetitions completed, rating of perceived exertion (RPE), and perceived recovery were recorded. Assessments of reaction time, isometric mid-thigh pull, and perceived levels of focus, energy, fatigue, and "muscle pump" were also completed before supplementation, 1 h after supplementation, and immediately after exercise. Results: Statistical analysis revealed significant main effects of trial for reaction time (p < 0.001) and bench press peak power (p = 0.026) indicating better performance during the MIPS trial. Furthermore, total number of repetitions completed significantly increased (p = 0.003) during the MIPS (96.90 ± 21.31 repetitions) trial compared to PLA (89.50 ± 18.37 repetitions). Additionally, overall session RPE was significantly lower (p = 0.002) during the MIPS (7.6 ± 1.2) trial compared to PLA (8.3 ± 0.9). Discussion: These findings suggest that acute supplementation with this MIPS improved upper body resistance exercise performance while reducing participant RPE. Further research should investigate the efficacy of chronic supplementation with this MIPS as the acute response provided an ergogenic benefit.

World Trade Center workers with asthma and post-traumatic stress disorder perceive airflow limitation more accurately.

BACKGROUND: Post-traumatic stress disorder (PTSD) is a major risk factor for increased asthma morbidity among World Trade Center (WTC) workers. OBJECTIVE: To investigate whether differences in perception of airflow limitation mediate the association of PTSD with worse asthma control in WTC workers. METHODS: We collected data from WTC workers on asthma control (Asthma Control Questionnaire and Asthma Quality of Life Questionnaire) and daily peak expiratory flow (PEF) measures over 6 weeks. Perception of airway limitation was assessed by comparing guessed vs actual PEF values. Post-traumatic stress disorder was diagnosed using the Structured Clinical Interview. We used unadjusted and adjusted models to compare PEF and perception measures in WTC workers with PTSD with those of workers without PTSD. RESULTS: Overall, 25% of 224 participants had PTSD. Post-traumatic stress disorder was associated with worse Asthma Control Questionnaire (2.2±0.8 vs 1.1±0.9, P < .001) and Asthma Quality of Life Questionnaire (3.9±1.1 vs 5.4±1.1, P < .001) scores. Adjusted analyses showed no significant differences in PEF between WTC workers with (351.9±143.3 L/min) and those without PTSD (364.6±131.6 L/min, P = .55). World Trade Center workers with PTSD vs those without PTSD had increased proportion of accurate perception (67.0±37.2% vs 53.5±38.1%, P = .01) and decreased underperception (23.3.0±32.1% vs 38.9±37.5%, P = .004) of airflow limitation during periods of limitation. Similar results were obtained in adjusted analyses. CONCLUSION: This study indicates that differences in perception of airflow limitation may mediate the relationship of PTSD and increased asthma symptoms, given WTC workers with PTSD have worse self-reported asthma control, an increased proportion of accurate perception, and decreased underperception, despite no differences in daily PEF measures.

Depression and anxiety among patients treated for bladder cancer: examining clinical, demographic, and psychosocial predictors.

INTRODUCTION AND OBJECTIVE: The significant impact of bladder cancer and treatment on patient health related quality of life (HRQoL) and emotional wellbeing has been documented. Increasing evidence from cancer research emphasizes the importance of examining patients supportive care needs and received social support as factors that could influence their emotional adjustment. The purpose of the study was to assess the demographic and clinical predictors of depression and anxiety among bladder cancer patients and its associations with patient reported supportive care needs and perceived availability of social support. METHODS: A cross-sectional design was used to investigate the study questions. Bladder cancer patients were recruited from the Bladder Cancer Advocacy Network (BCAN) to complete a questionnaire that included the Hospital Anxiety and Depression Scale (HADS), bladder cancer patient need survey (BCNAS-32), and the social provisions scale (SPS). The inclusion criteria restricted our sample to include bladder cancer patients who were English speakers, aged 18-85 years, and were able and willing to provide informed consent. Patients who had metastatic disease, cancer recurrence, or other primary cancers at the time of assessment were excluded from the study. RESULTS: Participants included 159 bladder cancer patients. The mean age was 62±9.4 years and 51% were male. Almost two-thirds (62%) of patients reported a diagnosis of muscle invasive bladder cancer (MIBC), 25% patient reported clinically significant levels of anxiety, 17% reported clinically significant levels of depression, and 13% and 17% reported abnormal borderline abnormal levels for anxiety and depression, respectively. Univariate regression analyses revealed significant associations between HADS total score, HADS depression and anxiety subscales, patient age, physical functioning/daily living needs, sexuality needs, and perceived social support with higher total scores, anxiety, and depression scores associated with younger age, higher unmet needs, and lower levels of social support. Multivariate regression analyses, showed similar findings confirming the associations depicted by the univariate regression analyses. CONCLUSIONS: Bladder cancer patients experience significant levels of depression and anxiety and these levels are associated with patient age, supportive care unmet needs and lack of social support. Patient focused interventions could be tailored to address these issues with the goal to improve patient HRQoL and emotional adjustment.

Nutrient synergy: definition, evidence, and future directions.

Nutrient synergy refers to the concept that the combined effects of two or more nutrients working together have a greater physiological impact on the body than when each nutrient is consumed individually. While nutrition science traditionally focuses on isolating single nutrients to study their effects, it is recognized that nutrients interact in complex ways, and their combined consumption can lead to additive effects. Additionally, the Dietary Reference Intakes (DRIs) provide guidelines to prevent nutrient deficiencies and excessive intake but are not designed to assess the potential synergistic effects of consuming nutrients together. Even the term synergy is often applied in different manners depending on the scientific discipline. Considering these issues, the aim of this narrative review is to investigate the potential health benefits of consuming different nutrients and nutrient supplements in combination, a concept we define as nutrient synergy, which has gained considerable attention for its impact on overall well-being. We will examine how nutrient synergy affects major bodily systems, influencing systemic health. Additionally, we will address the challenges associated with promoting and conducting research on this topic, while proposing potential solutions to enhance the quality and quantity of scientific literature on nutrient synergy.

Quantification of horizontal force for the EXER-GENIE® resisted sprint training device.

Sport performance coaches use a range of modalities to apply a horizontal force (Fh) to athletes during resisted sprint training (RST). These modalities include parachutes, weighted vests, pulley devices, motored tethered devices, and, most notably, weighted sleds. Despite the widespread use of these devices, the resistance forces of the pulley devices have not been evaluated for reliability and accuracy. Therefore, the primary aim of this study is to quantify the Fh of a commercially available pulley device (EXER-GENIE®) and determine how resistance force is related to the load settings on the device. The secondary aim is to identify the differences in the Fh values between three EXER-GENIE® devices that use 36 m and 60 m ropes. The Fh values in the Newtons (N) of the three EXER-GENIE® devices were analyzed using a motorized winch, a lead acid battery, and an S-beam load cell. Four 10 s winch-driven trials were performed using 15 different EXER-GENIE® loads, ranging from 0.028 kg to 3.628 kg, employing two different 36 m devices and one 60 m device. The mean ± standard deviation for Fh was reported across the four trials for each load setting. All devices produced similar Fh values across lighter load settings (loads ≤0.141 kg). However, at heavier loads (loads ≥0.226 kg), the 60 m device had Fh values 50-85 N greater than those of the 36 m device. The coefficient of variation across the four trials was extremely high at light loads but sharply decreased to <10% at heavy loads. Absolute reliability was high for each device [intraclass correlation coefficient (ICC) = 0.99]. A regression analysis for Fh values and EXER-GENIE® load indicated a strong positive relationship between load and Fh values across all devices (R2 = 0.96-0.99). Caution should be exercised when using identical loads on the different-length pulley devices, as the 60 m device produced greater Fh values than the 36 m devices at load settings higher than 0.226 kg. These results can provide coaches and practitioners with a better understanding of the magnitude of resistance that is applied when prescribing EXER-GENIE® devices for higher training loads.

Acute Effect of L-Citrulline Supplementation on Resistance Exercise Performance and Muscle Oxygenation in Recreationally Resistance Trained Men and Women.

L-citrulline serves as a nitric oxide precursor with the potential to increase blood flow and improve resistance exercise performance, yet more research is needed to examine its ergogenic potential. To examine the effect of L-citrulline supplementation on resistance exercise performance, muscle oxygenation, and the subjective perception of effort, energy, focus, fatigue, and muscle pump, eighteen resistance-trained men (n = 11) and women (n = 7) (21.4 ± 1.8 years; 172.3 ± 7.5 cm; 76.9 ± 10.8 kg) were randomly assigned for supplementation with 8 g of L-citrulline (CIT) or a placebo (PL) in a cross-over fashion one hour prior to testing. Participants completed an isometric mid-thigh pull test (IMTP), a ballistic bench press protocol [two sets of two repetitions at 75% 1-repetition maximum (1 RM) with maximum ballistic intent], and a strength-endurance bench press protocol [five repetition-maximum sets at 75% 1RM]. Barbell velocity and power were measured via a linear position transducer during the ballistic protocol, while the repetitions completed, volume load and muscle oxygenation were quantified during the strength-endurance protocol. Subjective measures were assessed at the baseline and immediately pre- and post-exercise. Repeated measures of the analysis of variance and Bayesian equivalents revealed no significant interactions, providing evidence favoring the null hypothesis (BF10 < 1) for IMTP (PL 497.5 ± 133.6 vs. CIT 492.5 ± 129.4 N), barbell velocity, and power, and repetitions completed (PL 36.7 ± 7.2 vs. CIT 36.9 ± 8.1 repetitions). There were also no significant interactions for muscle oxygenation parameters or subjective measures except perceived fatigue. Women reported greater fatigue across all time points compared to men (~1.88 au, p = 0.045, BF10 = 0.2). The results indicate that a single 8 g dose of L-citrulline did not enhance isometric force production, muscle endurance, or muscle oxygenation parameters during the protocol implemented in this study.

International society of sports nutrition position stand: energy drinks and energy shots.

Position Statement: The International Society of Sports Nutrition (ISSN) bases the following position stand on a critical analysis of the literature regarding the effects of energy drink (ED) or energy shot (ES) consumption on acute exercise performance, metabolism, and cognition, along with synergistic exercise-related performance outcomes and training adaptations. The following 13 points constitute the consensus of the Society and have been approved by the Research Committee of the Society: Energy drinks (ED) commonly contain caffeine, taurine, ginseng, guarana, carnitine, choline, B vitamins (vitamins B1, B2, B3, B5, B6, B9, and B12), vitamin C, vitamin A (beta carotene), vitamin D, electrolytes (sodium, potassium, magnesium, and calcium), sugars (nutritive and non-nutritive sweeteners), tyrosine, and L-theanine, with prevalence for each ingredient ranging from 1.3 to 100%. Energy drinks can enhance acute aerobic exercise performance, largely influenced by the amount of caffeine (> 200 mg or >3 mg∙kg bodyweight [BW-1]) in the beverage. Although ED and ES contain several nutrients that are purported to affect mental and/or physical performance, the primary ergogenic nutrients in most ED and ES based on scientific evidence appear to be caffeine and/or the carbohydrate provision. The ergogenic value of caffeine on mental and physical performance has been well-established, but the potential additive benefits of other nutrients contained in ED and ES remains to be determined. Consuming ED and ES 10-60 minutes before exercise can improve mental focus, alertness, anaerobic performance, and/or endurance performance with doses >3 mg∙kg BW-1. Consuming ED and ES containing at least 3 mg∙kg BW-1 caffeine is most likely to benefit maximal lower-body power production. Consuming ED and ES can improve endurance, repeat sprint performance, and sport-specific tasks in the context of team sports. Many ED and ES contain numerous ingredients that either have not been studied or evaluated in combination with other nutrients contained in the ED or ES. For this reason, these products need to be studied to demonstrate efficacy of single- and multi-nutrient formulations for physical and cognitive performance as well as for safety. Limited evidence is available to suggest that consumption of low-calorie ED and ES during training and/or weight loss trials may provide ergogenic benefit and/or promote additional weight control, potentially through enhanced training capacity. However, ingestion of higher calorie ED may promote weight gain if the energy intake from consumption of ED is not carefully considered as part of the total daily energy intake. Individuals should consider the impact of regular coingestion of high glycemic index carbohydrates from ED and ES on metabolic health, blood glucose, and insulin levels. Adolescents (aged 12 through 18) should exercise caution and seek parental guidance when considering the consumption of ED and ES, particularly in excessive amounts (e.g. > 400 mg), as limited evidence is available regarding the safety of these products among this population. Additionally, ED and ES are not recommended for children (aged 2-12), those who are pregnant, trying to become pregnant, or breastfeeding and those who are sensitive to caffeine. Diabetics and individuals with preexisting cardiovascular, metabolic, hepatorenal, and/or neurologic disease who are taking medications that may be affected by high glycemic load foods, caffeine, and/or other stimulants should exercise caution and consult with their physician prior to consuming ED. The decision to consume ED or ES should be based upon the beverage's content of carbohydrate, caffeine, and other nutrients and a thorough understanding of the potential side effects. Indiscriminate use of ED or ES, especially if multiple servings per day are consumed or when consumed with other caffeinated beverages and/or foods, may lead to adverse effects. The purpose of this review is to provide an update to the position stand of the International Society of Sports Nutrition (ISSN) integrating current literature on ED and ES in exercise, sport, and medicine. The effects of consuming these beverages on acute exercise performance, metabolism, markers of clinical health, and cognition are addressed, as well as more chronic effects when evaluating ED/ES use with exercise-related training adaptions.

Supplementation with Nitric Oxide Precursors for Strength Performance: A Review of the Current Literature.

Nitric-oxide-stimulating dietary supplements are widely available and marketed to strength athletes and weightlifters seeking to increase muscle performance and augment training adaptations. These supplements contain ingredients classified as nitric oxide (NO) precursors (i.e., "NO boosters"). Endogenous NO is generated via a nitric oxide synthase (NOS)-dependent pathway and a NOS-independent pathway that rely on precursors including L-arginine and nitrates, with L-citrulline serving as an effective precursor of L-arginine. Nitric oxide plays a critical role in endothelial function, promoting relaxation of vascular smooth muscle and subsequent dilation which may favorably impact blood flow and augment mechanisms contributing to skeletal muscle performance, hypertrophy, and strength adaptations. The aim of this review is to describe the NO production pathways and summarize the current literature on the effects of supplementation with NO precursors for strength and power performance. The information will allow for an informed decision when considering the use of L-arginine, L-citrulline, and nitrates to improve muscular function by increasing NO bioavailability.

Results from an LGBTQ+ Community Health Needs Assessment in Nassau and Suffolk Counties of New York State.

LGBTQ+ individuals experience health care disparities and difficulty accessing affirming care. Little is known regarding the health and experiences among subpopulations of specific sexual orientations and gender identities (SOGI). We implemented the first LGBTQ + health needs assessment survey in Nassau and Suffolk Counties, New York, to assess individuals' health care experiences, behaviors, access to care, and health care needs. The sample (N = 1150) consisted of many SOGI subgroups. Greater than 60% of respondents reported symptoms of chronic depression; over one third reported disrespectful health care experiences; and two thirds experienced verbal harassment. Bisexual/bicurious, pansexual, queer, gender nonconforming and transgender individuals experienced highest rates of mental health concerns and difficulty accessing care. Behavioral health concerns were also high among Black, multiracial, Hispanic, Asian, young adult, and lower-income respondents. Gaining an understanding of unique differences among LGBTQ+ subgroups can guide implementation of services targeting specific subpopulations to improve access to care and reduce disparities.

Crimean-Congo Hemorrhagic Fever: A Refresher and Update for the SOF Provider.

Crimean-Congo Hemorrhagic Fever (CCHF) is the most widespread tickborne virus causing human disease. CCHF wields a mortality rate up to 30% and was responsible for the death of a US Soldier in 2009. The virus is spread by the Hyalomma species of hard tick found across Central Europe, the Middle East, Africa, and Asia south of the 50° parallel. Infection typically consists of a 1-7-day non-specific viral prodrome, followed by onset of hemorrhagic disease on days 7-10. Severe disease may cause thrombocytopenia, transaminitis, petechial hemorrhage, hematemesis, and death typically by day 10 of illness. Education and insect control are paramount to disease prevention. Treatment is predominantly supportive care, though evidence suggests a benefit of early ribavirin administration. CCHF has caused multiple nosocomial outbreaks, and therefore consideration should be given to safe transport and evacuation of infected and exposed patients. Given the wide area of distribution, transmissibility, innocuous arthropod vectors, and high mortality rate, it is imperative that Special Operations Forces (SOF) providers be aware of CCHF and the existing countermeasures.

Four-factor prothrombin complex concentrate use for on-label versus off-label indications: a retrospective cohort study.

This study aimed to characterize the utilization of four-factor prothrombin complex concentrate (4F-PCC) at a tertiary academic medical center and evaluate the incidence of thromboembolic events (TEs) and mortality when used in an on-label versus off-label context. All medical records for consecutive patients having received 4F-PCC over 61-months were retrospectively evaluated. On-label indications for 4F-PCC were defined per FDA guidance, with the remaining indications considered off-label. Three hundred sixty-nine 4F-PCC doses were administered to 355 patients, with 46.6% of administrations classified as off-label. On-label and off-label groups demonstrated similar rates of TEs (16.2% vs. 14%). On-label patients receiving repeated administrations of 4F-PCC or with a post-administration INR ≤ 1.5 had a significantly higher incidence of TE. Off-label patients with a prior history of TE were more likely to develop a TE following 4F-PCC administration. Off-label patients also had a significantly higher 30-day mortality relative to on-label patients (29.1% versus 18.3%). In conclusion, in a large cohort of patients, observed rates of off-label 4F-PCC use were high. Underlying prothrombotic risk factors were predictive of TEs in off-label patients. Moreover, patients receiving off-label 4F-PCC demonstrated higher transfusion rates. Overall, our study findings suggest that the utilization of 4F-PCC in an off-label context may convey a significant risk to patients with uncertain clinical benefits.

Analysis of the efficacy, safety, and cost of alternative forms of creatine available for purchase on Amazon.com: are label claims supported by science?

Creatine monohydrate (CM) is an established and effective dietary supplement, but it is not the only form of creatine. We analyzed forms of creatine for sale on Amazon.com" title = "http://Amazon.com">Amazon.com and evaluated if the advertised claims are supported by the available scientific evidence. We also analyzed the cost per gram of the forms of creatine. A total of 175 creatine supplements were included and we reported the total creatine content per serving, form(s) of creatine in products, product claims, and prevalence of products third party certified. The identified products contained 16 forms of creatine other than CM. The prevalence of products containing functional ingredients with CM or forms of creatine was 29.7%, and the prevalence of products containing blends of different forms of creatine was 21.7%. Only 8% of products were third party certified. The products using only CM (n = 91) had a mean price per gram of $0.12 ± 0.08, whereas products using only other forms of creatine (n = 32) had a mean price per gram of $0.26 ± 0.17. Approximately 88% of alternative creatine products in this study are classified as having limited to no evidence to support bioavailability, efficacy, and safety.

Assessing the Feasibility and Effectiveness of a Linkage Into Mental Health Care Program for Adults Affected by Hurricane Sandy.

OBJECTIVE: Research indicates that greater exposure to Hurricane Sandy is associated with increased mental health difficulties. This study examined whether Project Restoration, a program that linked adults into mental health care (L2C), was effective in reducing post-Sandy mental health difficulties as compared to a cohort of adults matched on mental health difficulties that were not linked into post-Sandy mental health care. METHODS: Project Restoration participants (n = 52) with elevated self-reported mental health difficulties had the option to enroll into L2C. Project LIGHT (n = 63) used similar methodologies but did not have a L2C component and served as the matched control group. RESULTS: Multivariable modeling showed significant decreases in all mental health difficulties except for depression in the Project Restoration group, whereas there were no significant decreases in LIGHT. The decrease in anxiety from baseline to follow-up was significantly greater for Project Restoration as compared to LIGHT. CONCLUSION: Findings confirm the powerful impact community outreach and treatment have on reducing mental health difficulties after a disaster.

Dialectical behaviour therapy (DBT) for high-risk transgender and gender diverse (TGD) youth: A qualitative study of youth and mental health providers' perspectives on intervention relevance.

OBJECTIVES: Despite the significant mental health challenges and unique treatment needs of transgender and gender diverse (TGD) youth, research on the acceptability of evidence-based treatments for these youth is limited. To address this gap, the current study explored the perceived relevance of dialectical behaviour therapy (DBT) for high-risk TGD youth. METHODS: Qualitative data were collected from six focus group discussions with a purposive sample of 21 TGD youth aged 18-25 years old who endorsed a history of depression, suicidality or self-harm and individual interviews with 10 mental health treatment providers with prior DBT and TGD client experience. The data were analysed inductively using thematic content analysis. RESULTS: The results highlighted the perceived relevance of DBT in targeting chronic and acute stressors, some of which are unique to TGD youth such as issues related to gender dysphoria, hormone-related treatment and gender identity. Possible areas for treatment modifications including the adaptation of body awareness exercises and physiological-related coping techniques for youth experiencing gender dysphoria, and the reinforcement of self-care skills, were identified. While interpersonal effectiveness skills were acknowledged as important, treatment providers highlighted a need to prioritize safety over the practice of these skills. This is because TGD youth often experience more hostile and prejudiced interpersonal experiences than their cisgender peers. CONCLUSION: The study's findings shed light on previously unexplored perspectives of TGD youth and treatment providers on the perceived relevance of DBT and provide treatment providers and implementation researchers with some critical issues to consider when working with high-risk TGD youth.

Conceptual Invariance, Trajectories, and Outcome Associations of Working Alliance in Unguided and Guided Internet-Based Psychological Interventions: Secondary Analysis of a Randomized Controlled Trial.

BACKGROUND: The role of working alliance remains unclear for many forms of internet-based interventions (IBIs), a set of effective psychotherapy alternatives that do not require synchronous interactions between patients and therapists. OBJECTIVE: This study examined the conceptual invariance, trajectories, and outcome associations of working alliance across an unguided IBI and guided IBIs that incorporated clinician support through asynchronous text messaging or video messaging. METHODS: Adults with high education attainment (n=145) with subclinical levels of anxiety, stress, or depressive symptoms were randomized to 1 of 3 treatment conditions for 7 weeks. All participants received treatments from MyCompass, an unguided IBI using cognitive behavior therapy. Participants in condition 2 and 3 received supplemental, asynchronous clinician support through text and video, respectively. Working alliance with the IBIs was measured weekly using select items from the 12-item version of the Agnew Relationship Measure. Symptom and functional outcomes were assessed at baseline, at the end of treatment, and 1-month follow-up. RESULTS: Working alliance with the IBIs was conceptually invariant across the 3 conditions. Working alliance followed a quadratic pattern of change over time for all conditions and declined significantly only in the text-support condition. After controlling for baseline symptoms, higher baseline levels of working alliance predicted less depression and less functional impairment at follow-up, whereas faster increases in working alliance predicted less worry at the end of treatment and at follow-up, all of which only occurred in the video-support condition. CONCLUSIONS: Working alliance with the IBIs was generally established in the initial sessions. Although working alliance is conceptually invariant across IBIs with or without clinician support, the associations between working alliance and treatment outcomes among IBIs may differ depending on clinician involvement and the modalities of support. TRIAL REGISTRATION: ClinicalTrials.gov NCT05122429; https://clinicaltrials.gov/ct2/show/NCT05122429.

Level of Agreement, Reliability, and Minimal Detectable Change of the MusclelabTM Laser Speed Device on Force-Velocity-Power Sprint Profiles in Division II Collegiate Athletes.

This study examined the level of agreement (Pearson product-moment correlation [rP]), within- and between-day reliability (intraclass correlation coefficient [ICC]), and minimal detectable change of the MusclelabTM Laser Speed (MLS) device on sprint time and force−velocity−power profiles in Division II Collegiate athletes. Twenty-two athletes (soccer = 17, basketball = 2, volleyball = 3; 20.1 ± 1.5 y; 1.71 ± 0.11 m; 70.7 ± 12.5 kg) performed three 30-m (m) sprints on two separate occasions (seven days apart). Six time splits (5, 10, 15, 20, 25, and 30 m), horizontal force (HZT F0; N∙kg−1), peak velocity (VMAX; m∙s−1), horizontal power (HZT P0; W∙kg−1), and force−velocity slope (SFV; N·s·m−1·kg−1) were measured. Sprint data for the MLS were compared to the previously validated MySprint (MySp) app to assess for level of agreement. The MLS reported good to excellent reliability for within- and between-day trials (ICC = 0.69−0.98, ICC = 0.77−0.98, respectively). Despite a low level of agreement with HZT F0 (rP = 0.44), the MLS had moderate to excellent agreement across nine variables (rp = 0.68−0.98). Bland−Altman plots displayed significant proportional bias for VMAX (mean difference = 0.31 m∙s−1, MLS < MySp). Overall, the MLS is in agreement with the MySp app and is a reliable device for assessing sprint times, VMAX, HZT P0, and SFV. Proportional bias should be considered for VMAX when comparing the MLS to the MySp app.

Effect of watermelon supplementation on exercise performance, muscle oxygenation, and vessel diameter in resistance-trained men.

INTRODUCTION: Watermelon shows promise as an ergogenic aid due to its high concentration of L-citrulline, vitamins, minerals, and antioxidants. PURPOSE: The purpose of this study was to examine the effect of watermelon supplementation on exercise performance, muscle oxygenation, and vessel diameter. METHODS: In a crossover design fashion, 15 resistance-trained men (22.4 ± 2.9 years; 177.5 ± 7.1 cm; 82.7 ± 11.2 kg) were randomly assigned to supplement with either watermelon juice concentrate (WM; 2.2 g·day-1 L-citrulline) or placebo (PL) for 7 days prior to completing an experimental trial consisting of an isometric mid-thigh pull test and acute bench press protocol. Participants completed two sets of two repetitions at 75% 1 repetition maximum (1-RM) with maximum ballistic intent followed by five repetition-maximum (RM) sets at the same load. Barbell velocity and power were measured via linear position transducer during the first two sets, while volume load and muscle oxygenation were quantified during RM sets. Brachial artery diameter and subjective perception measures were assessed at baseline and immediately pre- and post-exercise. RESULTS: Except for a greater percent change in skeletal muscle oxygenation during WM compared to PL on average and across sets (mean difference = + 4.1%, p = 0.033, BF10 = 2.2-54.5), separate traditional and Bayesian analyses of variance with repeated measures, as well as paired-samples t tests for calculated summary measures, revealed no evidence favoring conditional differences in any measure of performance, perception, or muscle oxygenation. CONCLUSION: Short-term watermelon supplementation does not appear to enhance isometric force production, bench press performance, blood vessel diameter, or muscle oxygenation parameters compared to PL in resistance-trained men.