Associations Between Rank, Sex, and Parity With Musculoskeletal Injuries Sustained During Annual Military Physical Fitness Test.

ABSTRACT: Edwards, CM, da Silva, DF, Puranda, JL, Souza, SCS, Semeniuk, K, and Adamo, KB. Associations between rank, sex, and parity with musculoskeletal injuries sustained during annual military physical fitness test. J Strength Cond Res 38(2): 367-373, 2024-Musculoskeletal injuries pose a significant threat to the well-being of military personnel. Attempts to use physical employment standard test results as predictors of injury are underway, but little is known about injuries sustained during the tests. This study sought to identify body regions most likely to be reported as injured during the annual Canadian Armed Forces (CAF) physical fitness evaluation. In addition, sex, rank, and parity status are explored as possible associated factors for injury. A total of 1,796 actively serving CAF members were categorized by sex (1,030 male participants; 766 female participants), rank (1,142 Non-Commissioned Members [NCM]; 638 Officers), and parity (314 parous female participants; 435 nulliparous female participants). Sex, rank, and parity were associated with body regions reportedly injured during an annual CAF fitness assessment (significance p ≤ 0.05). When compared with male participants, female participants were more likely to be injured {aOR: 1.797 (95% [confidence interval] CI: 1.45-2.23)} and more prone to injury of the wrist (adjusted odds ratio [aOR]: 1.933 [95% CI: 1.20-3.12]), hip (aOR: 3.445 [95% CI: 2.07-5.728]), or lower back (aOR: 1.55 [95% CI: 1.18-2.04]). Non-Commissioned Members were more likely to injure the neck (aOR: 2.14 [95% CI: 1.18-3.88]) or shoulder (aOR: 2.03 [95% CI: 1.31-3.15]), when compared with Officers. Parous female participants reported pelvis/abdomen injury at a higher rate than the nulliparous group (5 vs. 1.7%, p = 0.019). Injuries sustained during an annual CAF fitness assessment differ based on sex, rank, and parity. Canadian Armed Forces female participants, NCM, and parous female participants may require specific physical fitness support in preparation for the annual physical fitness test.

Work-related rumination and worry at bedtime are associated with worse sleep indicators in schoolteachers: a study based on actigraphy and sleep diaries.

OBJECTIVE/BACKGROUND: Work-related rumination and worry are indicators of occupational stress which can impact sleep when they occur close to bedtime. This study examined the relationship between these repetitive thoughts before sleep with objective and subjective sleep parameters. METHODS: A microlongitudinal study was carried out with schoolteachers who answered questions on rumination and worry before sleep, wore a wrist actigraph, and completed a sleep diary for 5 to 7 consecutive days. Analysis used mixed-effects repeated measures linear models adjusted for sociodemographic, lifestyle, and health status. RESULTS: Among the 134 schoolteachers studied, 64.9% were women and were aged 41.9 ± 9.5 years. In the fully adjusted analysis, actigraphy indicated that a wake-up time <6:30 a.m. was associated with both rumination (relative risk (RR) = 1.67; 95% confidence interval (CI) = 1.21-2.31) and worry (RR = 2.44; 95%CI = 1.63-3.64). Moreover, actigraphy-measured nighttime sleep duration <7 h (RR = 1.23; 95%CI = 1.03-1.47) and self-reported sleep latency >15 min (RR = 1.43; 95%CI = 1.02-2.02) were associated with work-related worry. CONCLUSIONS: The occurrence of work-related repetitive thoughts before sleep, particularly worry about next-day issues, is associated with an increased risk of impaired objective and subjective sleep indicators. These findings suggest that these cognitive processes related to work should be addressed in strategies aimed at preventing and treating sleep disturbances and their individual and occupational consequences.

How Many Valid Days Are Necessary to Assess Physical Activity Data From Accelerometry During Pregnancy?

BACKGROUND: The authors examined whether or not ≤3 days wearing Actical® accelerometers provided acceptable results in comparison with the recommendation of ≥4 days in women across gestation. METHODS: A total of 26, 76, and 57 participants at early, mid, and late pregnancy, respectively, were assessed. Participants were instructed to wear the device for 7 days and women who wore it for ≥4 days were included. For each participant, 3, 2, and 1 day(s) were randomly selected. Paired comparisons, intraclass correlations coefficients, and kappa statistics were performed for ≥4 days (criterion) versus 3, 2, and 1 day(s). Averages (in minutes per day) of sedentary time, light, moderate, vigorous, moderate to vigorous physical activity (PA) and steps per day were examined. RESULTS: When 3 valid days were compared with the criterion, no significant differences were found for any gestational period. The intraclass correlations coefficients were "high" for all PA-related variables. The k values varied from .819 to .838 across pregnancy ("strong"). Two and 1 valid day(s) versus the criterion showed significant differences in some PA intensities, reduced intraclass correlations coefficients, "moderate" k values for 2 valid days (.638-.788) and "minimal-to-moderate" k values for 1 valid day (.367-.755). CONCLUSION: In pregnant women during early, mid, and late pregnancy, PA data obtained from 3 valid days of wear was equivalent and agreed with ≥4 valid days.

Influence of Alzheimer's disease on the relationship between nutritional status and risk of fall

Although malnutrition and risk of falls in the elderly have increased in recent years, uncertainties exist as to whether these conditions are associated after controlling for sociodemographic variables, body composition, metabolic condition, and Alzheimer's disease (AD). This study aimed to analyze the association between nutritional status and risk of fall in the elderly population. Participants were matched by gender and age, after they had been grouped on the basis of diagnosis of AD. The risk of falls, nutritional status, and mental status were assessed using the Downton Fall Risk Score (FRS), Mini Nutritional Assessment (MNA), and Mini Mental State Evaluation (MMSE), respectively. Logistic regression modelsadjusted for the main confounders were used in the analyses. Among the 68 elderly individuals studied, participants who were malnourished or at risk of malnutrition were more likely to fall (odds ratio = 8.29; 95% confidence interval = 1.49-46.04) than those with normal nutritional status, regardless of gender, age, education, body composition, and metabolic condition. This association did not remain significant after adjustment for AD, a potential confounder in this association. Malnutrition or its risk was independently associated with high risk of fall; thus, malnutrition should be considered in the prevention of falls among the elderly population.

Análise do poder de discriminação de índices prognósticos em pacientes queimados / Analysis of discrimination power of prognostic scores in burn patients

Introdução: As queimaduras são um grave problema de saúde pública. Os índices prognósticos estimam probabilidade prognóstica e ajudam a quantificar a gravidade do paciente. Objetivo:Avaliar o poder de discriminação dos índices Abbreviated Burn Severity Index (ABSI), Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA) e Therapeutic Intervention Scoring System 28 (TISS 28) da admissão em pacientes de uma Unidade de Terapia Intensiva (UTI) especializada no tratamento de queimados. Casuística e Métodos:Estudo longitudinal prospectivo, realizado em uma Unidade de Terapia Intensiva especializada no atendimento ao paciente queimado, no período de maio de 2011 a maio de 2013. Foram excluídos pacientes com menos de 18 anos e com menos de 24 horas de internação. Foram coletados dados clínicos e demográficos e calculados os escores prognósticos estudados. A acurácia dos índices foi avaliada pela curva Receiver Operating Characteristic (ROC), discriminando o desfecho do paciente (sobrevivente e não sobrevivente). Foi calculada a área sob a curva (AUC). Resultados: Foram incluídos 180 pacientes no período de estudo, sendo 72,8% do sexo masculino (n=131). A mediana de idade foi de 40 anos (ITQ: 30 ­ 52,5). A mortalidade hospitalar foi de 37,2% (n=67). A maior AUC foi a do escore APACHE II, com valor de 0,837 (ponto de corte do escore = 14, sensibilidade de 83,6% e especificidade de 72,3%). Na análise de pontuação dos escores entre sobreviventes e não sobreviventes, observou-se diferença estatisticamente significativa entre os valores de todos os índices estudados. Conclusões: Os escores ABSI, APACHE II, SOFA e TISS 28 na admissão da UTI mostraram bom poder de discriminação para sobrevivência entre pacientes queimados.

Introduction: Burns are a serious public health problem. Prognostic indexes estimate prognostic probability and help to quantify disease severity. Objective: To evaluate the power of discrimination of Abbreviated Burn Severity Index (ABSI), Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA) and Therapeutic Intervention Scoring System 28 (TISS 28) in an Intensive Care Unit (ICU) from a burn center. Patients and Methods: This is a prospective longitudinal study, carried out from May 2011 to May 2013. Patients under 18 years of age and with hospitalization for less than 24 hours were excluded. Clinical and demographic data were collected, and the prognostic scores were calculated. The accuracy of the scores was evaluated by the Receiver Operating Characteristic (ROC) curve, which discriminated against the outcome of the patient (survivor and non-survivor). The area under the curve (AUC) was calculated. Results: A total of 180 patients were included, and 72.8% of them were male (n = 131). The median age was 40 years (IQR: 30 - 52.5). Hospital mortality was 37.2% (n = 67). The highest AUC was from the APACHE II score, with a value of 0.837 (associated criterion = 14, sensitivity = 83.6% and specificity = 72.3%). In the analysis of the scores between survivors and non-survivors statistically significant differences were found in all studied scores. Conclusions: ABSI, APACHE II, SOFA and TISS 28 at ICU resulted in good power of discrimination for survival among burn patients.

Watching television for more than two hours increases the likelihood of reporting poor sleep quality among Brazilian schoolteachers.

Although time spent watching television and sleep problems have increased in the last few decades, it is unclear whether these conditions are associated in working adults after controlling for lifestyle, job characteristics and other individual aspects. The present study analyzed the association between time spent watching television and sleep quality among teachers from public schools in Londrina, Brazil. In this cross-sectional study, information from the Pittsburgh Sleep Quality Index (PSQI) and about time spent watching television was obtained during personal interviews. Logistic regression models adjusted by the main confounders (sociodemographic, occupational and lifestyle variables) were used in the analyses. Among the 959 studied teachers (68.2% women, median age: 42years), teachers who watched >120min/day had a higher likelihood of reporting poor sleep quality (PSQI>5) (odds ratio=1.41; 95% confidence interval=1.01; 1.98) compared with those who watched television for up to 60min/day, regardless of gender, age, work hours, leisure time physical activity and other lifestyle variables. This association did not remain significant after the adjustment for health conditions, i.e., obesity, anxiety, depression and chronic pain, which may act as confounding variables in the relationship between watching television and poor sleep quality. Watching television for >120min/day was independently associated with poorer sleep quality, which should be considered in the prevention and treatment of sleep disturbances among working population.