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In recent years, the United States has seen an increase in gun-related violence and school shootings. The Centers for Disease Control and Prevention (CDC) estimates that the incidence of gun carrying among high-school students has declined. Nevertheless, an examination of the underlying factors that increase the risk of violence-related behaviors is necessary to develop interventions to decrease gun use among high-school students. General Strain Theory (GST) predicts that victims of violence are (a) significantly more likely to engage in violent behaviors and (b) the increased risk of violent behavior by persons who experience violence is significantly greater among male victims. This research aims to test these predictions of the strain theory with data from the Youth Risk Behavior Survey (YRBS). To that end, it investigates whether the relationship between forced sexual intercourse victimization (FSIV) and gun or weapon carrying or physical fighting is significantly greater among male students. Using R and pooled data from the nationally representative YRBS (2017 and 2019), additive interactions were estimated according to Strengthening the Reporting of Observational Studies in Epidemiology guidelines to determine the association between FSIV and weapon carry, gun carry, or physical fighting. Multiplicative interactions and odds ratios were also estimated for comparison. Results show a high risk of gun and weapon carrying and physical fighting among both male and female students who experience FSIV and a significant relationship between FSIV and increased risk of these violence-related behaviors. Additive interactions show that the relationship between FSIV and these violent behaviors is each significantly greater among male students than female students. Results confirm the predictions of GST and show that FSIV significantly increases the risk of gun carrying and other violence-related behaviors among male and female U.S. high-school students; the increased risk is significantly greater among male students.
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PURPOSE: Although previous studies have examined the association between youth psychosocial risks and their perceptions of their neighborhood, it is unclear how objective neighborhood characteristics are associated with psychosocial risks and mental health symptoms among adolescents. We investigated how neighborhood characteristics moderate the relationship between youth psychosocial characteristics and mental health symptoms. METHODS: This cross-sectional study examined 13,837 emergency department visits by 14-18-year-olds who completed a standardized Behavioral Health Screening in a tertiary pediatric hospital in Philadelphia from 2013 to 2020. Psychosocial risk factors and mental health symptoms were assessed based on self-reported survey responses. We characterized neighborhoods as low-, moderate-, and high-stress based on gun violence incidence from 2013 to 2020 and the census tract-level Child Opportunity Index. Mixed effects logistic regression and Poisson models were used to examine moderation effects. RESULTS: The 9,814 included patients were 64% female and 64% non-Hispanic Black. The following psychosocial risk factors were associated with two to eight times higher odds of depressive symptoms and suicide risk: exposure to trauma, bullying at school, at-risk substance use, fighting, and retaliation. Adolescents living in high-stress neighborhoods were twice as likely to report fighting and retaliation and reported more psychosocial risk factors than those in low-stress neighborhoods. Odds of mental health symptoms increased with the number of psychosocial risk factors, particularly in youth from low-stress neighborhoods. DISCUSSION: Objective neighborhood characteristics had a significant interaction effect on the relationship between psychosocial risks and depression and suicide risk among adolescents seeking care in a pediatric emergency department.
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Salud Mental , Características de la Residencia , Humanos , Adolescente , Femenino , Masculino , Estudios Transversales , Factores de Riesgo , Philadelphia/epidemiología , Servicio de Urgencia en Hospital/estadística & datos numéricos , Depresión/epidemiología , Depresión/psicología , Trastornos Relacionados con Sustancias/epidemiología , Acoso Escolar/psicología , Acoso Escolar/estadística & datos numéricos , Estrés Psicológico/epidemiología , Estrés Psicológico/psicologíaRESUMEN
Study Design: This retrospective cohort study utilized the National Inpatient Sample (NIS) database for the years 2016-2018. Incidences of street fighting were identified using the corresponding ICD-10 codes. Objective: To determine whether alcohol use (measured by blood alcohol content (BAC)) in patients sustaining maxillofacial trauma from hand-to-hand fighting influence hospitalization outcomes. Methods: The primary predictor variable was BAC stratified into six categories of increasing magnitude. The primary outcome variable was mean length of hospital stay (days). The secondary outcome variable was total hospital charges (US dollars). Results: Our final sample consisted of 3038 craniomaxillofacial fractures. Each additional year in age added +$545 in hospital charges (P < .01). Non-elective admissions added $14 210 in hospital charges (P < .05). Patients admitted in 2018 experienced approximately $7537 more in hospital charges (P < .01). Le Fort fractures (+$61 921; P < .01), mandible fractures (+$13 227, P < .01), and skull base fractures (+$22 170; P < .05) were all independently associated with increased hospital charges. Skull base fractures added +7.6 days to the hospital stay (P < .01) and each additional year in patient age added +.1 days to the length of the hospital stay (P < .01). Conclusions: BAC levels did not increase length of stay or hospitalization charges. Le Fort fractures, mandible fractures, and skull base fracture each independently increased hospital charges. This reflects the necessary care (ie, ICU) and treatment (ie, ORIF) of such fractures. Older adults and elderly patients are associated with increased length of stay and hospital charges-they are likely to struggle in navigating the healthcare system and face socioeconomic barriers to discharge.
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PURPOSE: To evaluate the 3-year outcomes of VEGF inhibitors in the treatment of cystoid macular edema due to branch retinal vein occlusion (BRVO) in an international multicenter cohort of eyes. DESIGN: Multicenter, international, BRVO database study. SUBJECTS: Seven hundred forty-seven patients (760 eyes) undergoing intravitreal therapy for BRVO for 3 years in a multicenter international setting. METHODS: Demographics, visual acuity (VA) in logarithm of the minimum angle of resolution letters, central subfield thickness (CST), treatments, number of injections, and visits data was collected using a validated web-based tool. MAIN OUTCOME MEASURES: Visual acuity gain at 3 years in logarithm of the minimum angle of resolution letters. Secondary outcome measures included anatomical results, treatment pattern, and percentage of completers. A subgroup analysis by study drug was conducted for clinical outcomes. RESULTS: Mean adjusted VA change was +11 letters (95% confidence interval 9-13), mean adjusted change in CST was -176 µm (-193, -159). Median number of injections/visits was 16 of 24 at 3 years of follow-up. Most eyes received VEGF inhibitors exclusively (89%, n = 677) and as a monotherapy in 71% (n = 538). Few eyes were switched to steroids (11%, n = 83). Suspensions in treatment >180 days occurred in 26% of study eyes. Aflibercept showed greater CST reductions (-147 vs. -128 vs. -114 µm; P < 0.001) and significantly lower switching rates (14% vs. 38% vs. 33%; P < 0.001) compared with ranibizumab and bevacizumab, respectively. CONCLUSIONS: This international study of 3-year BRVO outcomes after starting treatment with VEGF inhibitors found adequate visual and anatomical results in routine clinical care. Visual outcomes were similar among the different initiating VEGF inhibitors, although eyes starting with aflibercept had better anatomical outcomes and a lower switching rate. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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BACKGROUND: This study views sustainability after the exit of development assistance for health (DAH) as a shared responsibility between donors and recipients and sees transitioning DAH-supported interventions into domestic health policy as a pathway to this sustainability. It aims to uncover and understand the reemergent aspects of the donor-recipient dynamic in DAH and how they contribute to formulating domestic health policy and post-DAH sustainability. METHODS: We conducted a case study on two DAH-supported interventions: medical financial assistance in the Basic Health Services Project supported by the World Bank and UK (1998-2007) and civil society engagement in the HIV/AIDS Rolling Continuation Channel supported by the Global Fund (2010-2013) in China. From December 2021 to December 2022, we analyzed 129 documents and interviewed 46 key informants. Our data collection and coding were guided by a conceptual framework based on Walt and Gilson's health policy analysis model and the World Health Organization's health system building blocks. We used process tracing for analysis. RESULTS: According to the collected data, our case study identified three reemergent, interrelated aspects of donor-recipient dynamics: different preferences and compromise, partnership dialogues, and responsiveness to the changing context. In the case of medical financial assistance, the dynamic was characterized by long-term commitment to addressing local needs, on-site mutual learning and understanding, and local expertise cultivation and knowledge generation, enabling proactive responses to the changing context. In contrast, the dynamic in the case of HIV/AIDS civil society engagement marginalized genuine civil society engagement, lacked sufficient dialogue, and exhibited a passive response to the context. These differences led to varying outcomes in transnational policy diffusion and sustainability of DAH-supported interventions between the cases. CONCLUSIONS: Given the similarities in potential alternative factors observed in the two cases, we emphasize the significance of the donor-recipient dynamic in transnational policy diffusion through DAH. The study implies that achieving post-DAH sustainability requires a balance between donor priorities and recipient ownership to address local needs, partnership dialogues for mutual understanding and learning, and collaborative international-domestic expert partnerships to identify and respond to contextual enablers and barriers.
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Síndrome de Inmunodeficiencia Adquirida , Administración Financiera , Humanos , Cooperación Internacional , Política de Salud , China , Reino UnidoRESUMEN
When emergency situations occur, it is essential that individuals can effectively respond to keep themselves and others safe. One attempt at increasing individuals' readiness for an emergency is the Run-Hide-Fight® campaign, which has been adopted by several higher education institutions in the United States. This study explores the dissemination of this campaign by instructors at a large Midwestern university in the United States. We generally find support for the reasoned action perspective, with attitudes, norms, and perceived behavioral control influencing intentions to share the emergency preparedness video with students. Through open-ended responses provided by the instructors, we identify four main themes surrounding video dissemination. First, most instructors felt comfortable sharing the video, believing it would be useful in preparing students for an emergency. Second, some instructors voiced concerns about the negative emotional effects the video may have on students. Third, instructors generally appreciated the brief and effective delivery of the message, though some were concerned about dramatizing emergencies. Finally, instructors suggested ways of improving the video, such as including more specific guidance on how to behave in an emergency situation. Practically, these findings suggest that universities should consider their emergency preparedness information dissemination strategy to maximize credibility, minimize message fatigue, and reach more students. Theoretically, this study affirms the tenets of reasoned action and suggests alternative theoretical approaches for future scholarship.
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Planificación en Desastres , Estudiantes , Humanos , Estados Unidos , Estudiantes/psicología , Actitud , Instituciones Académicas , UniversidadesRESUMEN
Background: Adequate adaptation of the autonomic nervous system (ANS) is crucial in potentially life-threatening situations. The defence cascade provides a descriptive model of progressing dominant physiological reactions in such situations, including cardiovascular parameters and body mobility. The empirical evidence for this model is scarce, and the influence of physiological reactions in this model for predicting trauma-induced intrusions is unresolved.Objectives: Using a trauma-film paradigm, we aimed to test physiological reactions to a highly stressful film as an analogue to a traumatic event along the defence cascade model. We also aimed to examine the predictive power of physiological activity for subsequent intrusive symptoms.Method: Forty-seven healthy female participants watched a stressful and a neutral film in randomized order. Heart rate (HR), heart rate variability (HRV), and body sway were measured. Participants tracked frequency, distress, and quality of subsequent intrusions in a diary for 7 consecutive days.Results: For the stressful film, we observed an initial decrease in HR, followed by an increase, before the HR stabilized at a high level, which was not found during the neutral film. No differences in HRV were observed between the two films. Body sway and trembling frequency were heightened during the stressful film. Neither HR nor HRV predicted subsequent intrusions, whereas perceived distress during the stressful film did.Conclusions: Our results suggest that the physiological trauma-analogue response is characterized by an orientation response and subsequent hyperarousal, reaching a high physiological plateau. In contrast to the assumptions of the defence cascade model, the hyperarousal was not followed by downregulation. Potential explanations are discussed. For trauma-associated intrusions in the subsequent week, psychological distress during the film seems to be more important than physiological distress. Understanding the interaction between physiological and psychological responses during threat informs the study of ANS imbalances in mental disorders such as post-traumatic stress disorder.
We used a trauma-film analogue to examine the defence cascade model and to investigate the influence of psychophysiological response on subsequent intrusions.While we found an orientation phase, upregulation phase, and coactivation indicated by heart rate, no downregulation phase was observed.None of the physiological parameters examined predicted subsequent intrusions, whereas subjective distress during the film did.
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Trastornos por Estrés Postraumático , Humanos , Femenino , Trastornos por Estrés Postraumático/psicología , Películas Cinematográficas , Sistema Nervioso Autónomo , Frecuencia Cardíaca , Estrés Psicológico/psicologíaRESUMEN
The acute stress response can be considered the primary evolutionary adaptation to maximise fitness in the face of unpredictable environmental challenges. However, the difficulties of assessing physiology in natural environments mean that comparatively little is known about how response variation influences fitness in free-living animals. Currently, determining acute stress physiology typically involves blood sampling or cardiac monitoring. Both require trapping and handling, interrupting natural behaviour, and potentially biasing our understanding toward trappable species/individuals. Importantly, limits on repeated sampling also restrict response phenotype characterisation, vital for linking stress with fitness. Surface temperature dynamics resulting from peripheral vasomotor activity during acute stress are increasingly promoted as alternative physiological stress indicators, which can be measured non-invasively using infrared thermal imaging, overcoming many limitations of current methods. Nonetheless, which aspects of stress physiology they represent remains unclear, as the underlying mechanisms are unknown. To date, validations have primarily targeted the hypothalamic-pituitary-adrenal axis, when the sympathetic-adrenal-medullary (SAM) system is likely the primary driver of vasomotor activity during acute stress. To address this deficit, we compared eye and bill region surface temperatures (measured using thermal imaging) with SAM system activity (measured as heart rate variability via electrocardiogram telemetry) in wild-caught captive house sparrows (Passer domesticus) during capture and handling. We found that lower body surface temperatures were associated with increased sympathetic nervous system activation. Consequently, our data confirm that body surface temperatures can act as a proxy for sympathetic activation during acute stress, providing potentially transformative opportunities for linking the acute stress response with fitness in the wild.
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Sistema Hipotálamo-Hipofisario , Sistema Hipófiso-Suprarrenal , Humanos , Animales , Temperatura , Sistema Nervioso Simpático , Frío , Estrés FisiológicoRESUMEN
The scientific article analyses modern terrorist threats in the territory of Ukraine, associated with the active use of financial assets, the latest technologies and innovative financial instruments, in particular cryptocurrencies. The positive experience of legislative initiatives and advanced practices of several foreign countries in combatting the legalisation of funds by illegal means and the financing of terrorism is highlighted. The problems of implementation of state policy in this sphere are revealed. Based on this, ways of improving the system of fighting terrorism in Ukraine on the international and national levels have been determined. It was concluded that the basis of the state policy in the field of combatting terrorism during the period of martial law and in the post-war period in Ukraine should be the development of the Strategy for Combatting Terrorism in Ukraine, which should take into account both the best world practices and the modern realities of waging war in the conditions of supporting terrorism with financial infusions.
El artículo científico analiza las amenazas terroristas modernas en el territorio de Ucrania, asociadas al uso activo de activos financieros, las últimas tecnologías e instrumentos financieros innovadores, en particular las criptodivisas. Se destaca la experiencia positiva de las iniciativas legislativas y las prácticas avanzadas de varios países extranjeros en la lucha contra la legalización de fondos por medios ilegales y la financiación del terrorismo. Se ponen de manifiesto los problemas de aplicación de la política estatal en este ámbito. Se concluye que la base de la política estatal en el ámbito de la lucha contra el terrorismo durante el período de la ley marcial y en el período de posguerra en Ucrania debe ser el desarrollo de la Estrategia de Lucha contra el Terrorismo en Ucrania, que debe tener en cuenta tanto las mejores prácticas mundiales y las realidades modernas de hacer la guerra en las condiciones de apoyo al terrorismo con infusiones financieras.
O artigo científico analisa as ameaças terroristas modernas no território da Ucrânia, associadas ao uso ativo de ativos financeiros, às tecnologias mais recentes e aos instrumentos financeiros inovadores, em especial as criptomoedas. A experiência positiva de iniciativas legislativas e práticas avançadas de vários países estrangeiros no combate à legalização de fundos por meios ilegais e ao financiamento do terrorismo é destacada. Os problemas de implementação da política estatal nessa esfera são revelados. Com base nisso, foram determinadas formas de aprimorar o sistema de combate ao terrorismo na Ucrânia em nível internacional e nacional. Concluiu-se que a base da política do Estado no campo do combate ao terrorismo durante o período da lei marcial e no período pós-guerra na Ucrânia deve ser o desenvolvimento da Estratégia de Combate ao Terrorismo na Ucrânia, que deve levar em conta tanto as melhores práticas mundiais quanto as realidades modernas de guerra nas condições de apoio ao terrorismo com infusões financeiras.
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HumanosRESUMEN
In response to the World Health Organization Report on ageism and the spread of ageism during the COVID-19 pandemic, varied actions to combat ageism have taken place, worldwide. To examined what older people think about combating ageism, 731 Israelis, ages 60-85, responded to an online survey. Thematic analysis of their responses identified that the two main reasons for combating ageism rely on "moral-social justification" and "financial-employment justification." Respondents suggested various strategies to combat ageism including, "changes in law and adjudication," "inter-generational ties," "educational activities," and "campaigns." Respondents also identified "inner work" as the fifth and most important way to eliminate self-ageism. The results of this qualitative study contribute to the global campaign to combat ageism because of the emphasis on "inner work" of older people as a strategy in and of itself. Moreover, the study demonstrates the importance of including older adults in all stages of the global campaign to reduce and eliminate ageism.
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Common marmosets usually give birth to twins and form a social group consisting of a breeding couple and pairs of same-aged siblings. The twins may engage in the first agonistic fights between them, twin-fights (TFs), during adolescence. This study investigated the TFs based on records accumulated in our captive colony over 12 years to elucidate the proximate causations that trigger the TFs. We aimed to determine whether the TF onset mainly depended on internal events (such as the onset of puberty) as previously suggested or external events (such as the birth of the younger siblings and the behavioral change of the group members). Although both events usually occur simultaneously, the birth control method (i.e., manipulation of ovulation and interbirth-intervals by prostaglandin administration to females) could temporally separate these events. A comparison of the onset day and occurrence rate with or without the birth control procedure revealed that TFs were triggered by a combination of internal and external events, that is, external events were the predominant triggers of TF, under the influence of internal events. The timing of TF onset was significantly delayed when the birth of the younger siblings was delayed and the twins grew older under the birth-controlled condition, suggesting that the birth of younger siblings and related behavioral changes of group members, as well as twins' developmental maturation, could trigger TF. Higher TF rates between same-sex twins were consistent with previous studies, reflecting the characteristics of same-sex directed aggression in callitrichines.
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Agresión , Callithrix , Animales , Femenino , Embarazo , Humanos , Parto , HermanosRESUMEN
In 2022, the "Will to Fight Act" was referred to the US Congress urging attention to measuring and assessing will to fight. That Bill was not enacted, and evaluation efforts within the political and military establishment remain contentious, fragmented, and meager. This likely will persist, along with attendant policy failures and grievous costs, without awareness of research that the social and psychological sciences reveal on the will to fight [S. Atran, Science 373, 1063 (2021)]. We illustrate such research using converging data from a multimethod and multicultural approach, including field and online studies from the Middle East, North Africa, and Europe. These studies reveal specific psychosocial pathways, within a general causal framework, that predict willingness to make costly sacrifices, including to cooperate, fight, and die in war and sustained conflict. From the continuing strife in Iraq to embattled Ukraine, 31 studies were conducted in 9 countries with nearly 12,000 participants. These include people in longstanding conflicts, refugees, imprisoned jihadists and gangs, US military, studies in Ukraine before and during the current war, and rolling studies with a European ally of Ukraine. Results provide evidence for a mediation model of transcultural pathways to the will to fight. Building on our previous behavioral and brain research, on the battlefield in Iraq, with violent extremists, and with US military, the linear mediation yielding the will to fight involves identity fusion, perceived spiritual formidability, and trust. The model, a variation on "The Devoted Actor Framework," applies to primary reference groups, core cultural values, and leaders.
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Conflictos Armados , Humanos , África del Norte , Europa (Continente) , Medio Oriente , Ucrania , Conflictos Armados/psicologíaRESUMEN
This study aimed to analyze the influence of the competitive level and weight class on technical performance and physiological and psychophysiological responses during simulated MMA fights. Twenty MMA male athletes were divided into four groups: heavyweight elite (HWE; n = 6), lightweight elite (LWE; n = 3), heavyweight professional (HWP; n = 4), and lightweight professional (LWP; n = 7). All athletes performed four simulated fights of three 5-min rounds with a 1-min rest interval. Each fight was recorded using a video camera to analyze offensive and defensive actions. Moreover, the following measures were made: heart rate (before and after each round), blood lactate concentration (before and after the fight), readiness state (before each round), and the rate of perceived exertion (RPE) (after each round). The main findings were: i) LWE athletes applied more offensive touches than LWP athletes; ii) HWP athletes presented higher heart rate values than LWP athletes after the first round; however, LWP athletes presented greater heart rate changes than HWP athletes from the first to the second round; iii) no differences existed between groups in blood lactate concentration and readiness state; and iv) HWP and LWP athletes presented higher RPE values than LWE athletes in the first and third rounds; however, LWE athletes presented greater RPE changes than HWE, HWP, and LWP athletes from the first to the second and third rounds. This study shows that LWE athletes apply more offensive touches than LWP athletes during simulated MMA fights. Moreover, lightweight athletes tend to increase their physiological demand as the combat evolves, which is also reflected in their RPE.
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The Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund) has become an increasingly active and influential organization in global health during the past two decades. It is now playing an increasingly important role in the prevention and control of major infectious diseases, international financing for health, public procurement market development across the world. The article outlines the basic architecture of the Global Fund, including its overall information, financing mechanism, operational models and key experiences accumulated. Based on previous cooperation, the article analyzes the importance of the long-term partnership between China and the Global Fund, and proposes policy suggestions to achieve more win-win outcomes in the near future.
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Síndrome de Inmunodeficiencia Adquirida , Administración Financiera , Malaria , Tuberculosis , Humanos , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Salud Global , Cooperación Internacional , Tuberculosis/prevención & control , Malaria/prevención & control , ChinaRESUMEN
Nanotechnology-based approaches are emerging as promising strategies to treat different bone pathologies such as infection, osteoporosis or cancer. To this end, several types of nanoparticles are being investigated, including those based on mesoporous bioactive glasses (MGN) which exhibit exceptional structural and textural properties and whose biological behaviour can be improved by including therapeutic ions in their composition and loading them with biologically active substances. In this study, the bone regeneration capacity and antibacterial properties of MGNs in the SiO2-CaO-P2O5 system were evaluated before and after being supplemented with 2.5% or 4% ZnO and loaded with curcumin. in vitro studies with preosteoblastic cells and mesenchymal stem cells allowed determining the biocompatible MGNs concentrations range. Moreover, the bactericidal effect of MGNs with zinc and curcumin against S. aureus was demonstrated, as a significant reduction of bacterial growth was detected in both planktonic and sessile states and the degradation of a pre-formed bacterial biofilm in the presence of the nanoparticles also occurred. Finally, MC3T3-E1 preosteoblastic cells and S. aureus were co-cultured to investigate competitive colonisation between bacteria and cells in the presence of the MGNs. Preferential colonisation and survival of osteoblasts and effective inhibition of both bacterial adhesion and biofilm formation of S. aureus in the co-culture system were detected. Our study demonstrated the synergistic antibacterial effect of zinc ions combined with curcumin and the enhancement of the bone regeneration characteristics of MGNs containing zinc and curcumin to obtain systems capable of simultaneously promoting bone regeneration and controlling infection. STATEMENT OF SIGNIFICANCE: In search of a new approach to regenerate bone and fight infections, a nanodevice based on mesoporous SiO2-CaO-P2O5 glass nanoparticles enriched with Zn2+ ions and loaded with curcumin was designed. This study demonstrates the synergistic effect of the simultaneous presence of zinc ions and curcumin in the nanoparticles that significantly reduces the bacterial growth in planktonic state and is capable to degrade pre-formed S. aureus biofilms whereas the nanosystem exhibits a cytocompatible behaviour in the presence of preosteoblasts and mesenchymal stem cells. Based on these results, the designed nanocarrier represents a promising alternative for the treatment of acute and chronic infections in bone tissues, while avoiding the significant current problem of bacterial resistance to antibiotics.
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Curcumina , Nanopartículas , Curcumina/farmacología , Dióxido de Silicio/química , Zinc/farmacología , Staphylococcus aureus , Nanopartículas/uso terapéutico , Nanopartículas/química , Huesos , Antibacterianos/farmacología , Antibacterianos/química , Iones , Vidrio/químicaRESUMEN
Introduction: We conducted basic hands-on training in oxygen therapy and ventilatory management of coronavirus disease-2019 (COVID-19) patients to health care workers (HCWs) at our tertiary care hospital. We designed this study aiming to find out the impact of hands-on training in oxygen therapy for COVID-19 patients on the knowledge and degree of retention of this gained knowledge 6 weeks after the training session among HCWs. Materials and methods: The study was conducted after obtaining approval from the Institutional Ethics Committee. A structured questionnaire consisting of 15 multiple-choice questions was given to the individual HCW. This was followed by a structured 1-hour training session on "Oxygen therapy in COVID-19", following which the same questionnaire was given to the HCWs with the questions in a different order. After 6 weeks, the same questionnaire with questions in a different format was sent to the participants as a Google form. Results: A total of 256 responses were obtained for the pre-training test and post-training test. The median [IQR] pre-training test scores and post-training test scores were 8 [7-10] and 12 [10-13], respectively. The median retention score was 11 [9-12]. The retention scores were significantly higher than the pre-test scores. Conclusion: About 89% of the HCWs had a significant gain of knowledge. About 76% of the HCWs were able to retain knowledge, which also means the training program was successful. A definitive improvement in baseline knowledge was observed after 6 weeks of training. We propose conducting reinforcement training after 6 weeks of primary training to further augment retention. How to cite this article: Singh A, Salhotra R, Bajaj M, Saxena AK, Sharma SK, Singh D, et al. Retention of Knowledge and Efficacy of a Hands-on Training Session in Oxygen Therapy for COVID-19 among Healthcare Workers. Indian J Crit Care Med 2023;27(2):127-131.
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BACKGROUND: Kickboxing is a combat sport that encompasses various forms of competition. K1 kickboxing is conducted without any restrictions on the force of strikes, and the bout can end prematurely through a knockout. Headgear has been introduced in amateur kickboxing to safeguard the head. However, scientific studies have shown that despite their use, serious head injuries can still occur. The aim of this study was to evaluate the temporal structure of the bout by calculating the number of head strikes in K1 kickboxing bouts with and without headgear. METHODS: Thirty K1 kickboxing bouts were analyzed, with 30 participants included in the study. The fights were conducted according to the World Association Kickboxing Organization (WAKO) rules. The bouts consisted of three rounds of 2 min each, with a 1 min break between rounds. Sparring pairs were arranged according to weight categories. The first bouts were conducted without headgear, and two weeks later, the fights were repeated with WAKO-approved headgear. The number of head strikes was assessed retrospectively by analyzing video recordings of the bouts, categorizing strikes as hand or foot strikes, and differentiating between strikes that hit the head directly or indirectly. RESULTS: The results showed statistically significant differences between bouts with and without headgear in terms of the number of strikes to the head (p = 0.002), strikes directly to the head (p < 0.001), all hand strikes to the head (p = 0.001), hand strikes directly to the head (p = 0.003), and foot strikes directly to the head (p = 0.03). Higher values were observed in bouts with headgear. CONCLUSIONS: Headgear increases the probability of direct strikes to the head. Therefore, it is important to familiarize kickboxers with the use of headgear in their sport to minimize head injuries.
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Traumatismos Craneocerebrales , Dispositivos de Protección de la Cabeza , Humanos , Proyectos Piloto , Incidencia , Estudios Retrospectivos , Traumatismos Craneocerebrales/epidemiología , Traumatismos Craneocerebrales/prevención & controlRESUMEN
Most combat sports (CS) are structured in weight categories, and it is very common to carry out body weight adjustment strategies in order to compete in lower weight categories. For this reason, different rapid weight loss (RWL) strategies are usually performed to pass the pre-competition weigh-in test, and then a replenishment of fluids and carbohydrate-rich foods is conducted in an attempt to recover the weight and avoid a performance loss. In this context, no clear references have been found on whether these types of strategies have negative effects, impairing the athlete's combat and/or physical performance. For this reason, the aim of this study was to review the scientific literature on the effect of rapid weight reduction strategies on the performance of CS athletes. A literature search was performed through four different databases (PubMed, SPORTDiscus, Web of Science and ScienceDirect). Four inclusion criteria were established as follows: (1) the subjects had to be competitors in the CS and carry out RWL strategies; (2) at least two measurement points, that is, normal conditions and dehydration condition; (3) measurements in a real competition or simulating the same conditions; (4) original research articles written in English or Spanish and available in full text. Finally, a total of 16 articles were finally included in this research. All subjects (n = 184) were athletes from combat disciplines, with a minimum of 3-4 years of practice, as well as with certain experience in RWL. Six of the studies reported that an RWL strategy of around 5% of body weight loss did not affect performance parameters. However, the other ten studies with RWL between 3 and 6% or even higher reported negative effects or impairments on different parameters related to performance and/or athlete's psychophysiology, such as perceived fatigue, mood states, strength and power production, as well as changes in hormonal, blood and urine parameters, body composition, or the kinematics of the technical gesture. Although there is still no clear answer to the issue approached in this research, in general terms, it seems that in order to guarantee an acceptable athletic performance of the competitor, the weight loss should not exceed 3% to ≤5% of body weight together with ≥24 h for adequate (or at least partial) recovery and rehydration processes. In addition, it is highly recommended to lose weight progressively over several weeks, especially focusing on competitions lasting several days, as well as multiple rounds or qualifying stages.
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Artes Marciales , Humanos , Atletas , Artes Marciales/fisiología , Pérdida de Peso/fisiologíaRESUMEN
The cardiac calcium channel CaV1.2 conducts L-type calcium currents that initiate excitation-contraction coupling and serves as a crucial mediator of ß-adrenergic regulation of the heart. We evaluated the inotropic response of mice with mutations in C-terminal phosphoregulatory sites under physiological levels of ß-adrenergic stimulation in vivo, and we assessed the impact of combining mutations of C-terminal phosphoregulatory sites with chronic pressure-overload stress. Mice with Ser1700Ala (S1700A), Ser1700Ala/Thr1704Ala (STAA), and Ser1928Ala (S1928A) mutations had impaired baseline regulation of ventricular contractility and exhibited decreased inotropic response to low doses of ß-adrenergic agonist. In contrast, treatment with supraphysiogical doses of agonist revealed substantial inotropic reserve that compensated for these deficits. Hypertrophy and heart failure in response to transverse aortic constriction (TAC) were exacerbated in S1700A, STAA, and S1928A mice whose ß-adrenergic regulation of CaV1.2 channels was blunted. These findings further elucidate the role of phosphorylation of CaV1.2 at regulatory sites in the C-terminal domain for maintaining normal cardiac homeostasis, responding to physiological levels of ß-adrenergic stimulation in the fight-or-flight response, and adapting to pressure-overload stress.
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The study aims to identify the mechanisms underlying the findings that will to exist, live, survive and fight (WTELS-F) optimizes executive functions. Defining executive functions (EF) as having cold (working memory, inhibition, and cognitive flexibility) and hot (e.g., motivation) components, we hypothesized that WTELS-F affects executive functions positively via two pathways. The first pathway is through the hot executive function (motivation), and the second is via survival or existential processing. In a longitudinal study of 228 adult participants two times with ten weeks in between, we used measures for WTELS-F, working memory, inhibition, shift/cognitive flexibility, and self-motivation. We tested the structural validity of the four factors' executive function by exploratory factor analysis in time 1 data and confirmatory factor analysis in time 2 data. We conducted structural equation modeling WTELS-F change as a latent variable predicted by the change in its three components between times 1 and 2., affecting changes in self-motivation (the hot EF), and changes in the latent variable of cold EF as predicted by changes in working memory, inhibition, and shift. Results indicated that the model of EF fit the data well without modification. WTELS-F significantly affected self-motivation (the hot EF) and the cold EF longitudinally. It had further mediated effects on cold EF via its impact on self-motivation. The results provided evidence for the two pathways hypothesis of the effects of WTELS-F on EF. The conceptual and clinical implications of these findings were discussed.