A 2D video-based assessment is associated with 3D biomechanical contributors to dynamic knee valgus in the coronal plane.

Introduction: Adolescent athletes involved in sports that involve cutting and landing maneuvers have an increased risk of anterior cruciate ligament (ACL) tears, highlighting the importance of identifying risky movement patterns such as dynamic knee valgus (DKV). Qualitative movement screenings have explored two-dimensional (2D) scoring criteria for DKV, however, there remains limited data on the validity of these screening tools. Determining a 2D scoring criterion for DKV that closely aligns with three-dimensional (3D) biomechanical measures will allow for the identification of poor knee position in adolescent athletes on a broad scale. The purpose of this study was to establish a 2D scoring criterion that corresponds to 3D biomechanical measures of DKV. Methods: A total of 41 adolescent female club volleyball athletes performed a three-task movement screen consisting of a single-leg squat (SLS), single-leg drop landing (SLDL), and double-leg vertical jump (DLVJ). A single rater scored 2D videos of each task using four criteria for poor knee position. A motion capture system was used to calculate 3D joint angles, including pelvic obliquity, hip adduction, knee abduction, ankle eversion, and foot progression angle. Receiver operating characteristic curves were created for each 2D scoring criterion to determine cut points for the presence of movement faults, and areas under the curve (AUC) were computed to describe the accuracy of each 2D criterion compared to 3D biomechanical data. Results: 3D measures indicated knee abduction angles between 2.4°-4.6° (SD 4.1°-4.3°) at the time point when the center of the knee joint was most medial during the three tasks. AUCs were between 0.62 and 0.93 across scoring items. The MEDIAL scoring item, defined as the knee joint positioned inside the medial border of the shoe, demonstrated the greatest association to components of DKV, with AUCs ranging from 0.67 to 0.93. Conclusion: The MEDIAL scoring criterion demonstrated the best performance in distinguishing components of DKV, specifically pelvic obliquity, hip adduction, ankle eversion, and foot progression. Along with the previously published scoring definitions for trunk-specific risk factors, the authors suggest that the MEDIAL criterion may be the most indicative of DKV, given an association with 3D biomechanical risk factors.

Are Recreational Sports a Relic of the Past OR a Solution for the Future?

ABSTRACT: Children's participation in sport is a critical component to their physical and social development and as such, efforts should be made to provide all children with the opportunity to play. In recent years, there has been an observed shift in the focus of youth sports from that of participation for the health benefits of physical activity and fun to that of winning and competing. As a result, there has been a rise in club sports offerings and a subsequent reduction in recreational sports opportunities. This change presents unique challenges to children's access to sport and may not adequately support their overall physical, social, and emotional development. This commentary will discuss the benefits and barriers to increasing recreational sport opportunities using the Social Ecological Model as a framework. It also will propose solutions that can be implemented at the intrapersonal, interpersonal, organizational, community, and public policy levels to revive recreational sports.

Relationship of Knee Abduction Moment to Trunk and Lower Extremity Segment Acceleration during Sport-Specific Movements.

The knee abduction moment (KAM) has been identified as a significant predictor of anterior cruciate ligament (ACL) injury risk; however, the cost and time demands associated with collecting three-dimensional (3D) kinetic data have prompted the need for alternative solutions. Wearable inertial measurement units (IMUs) have been explored as a potential solution for quantitative on-field assessment of injury risk. Most previous work has focused on angular velocity data, which are highly susceptible to bias and noise relative to acceleration data. The purpose of this pilot study was to assess the relationship between KAM and body segment acceleration during sport-specific movements. Three functional tasks were selected to analyze peak KAM using optical motion capture and force plates as well as peak triaxial segment accelerations using IMUs. Moderate correlations with peak KAM were observed for peak shank acceleration during single-leg hop; peak trunk, thigh, and shank accelerations during a deceleration task; and peak trunk, pelvis, and shank accelerations during a 45° cut. These findings provide preliminary support for the use of wearable IMUs to identify peak KAM during athletic tasks.

Comparison of physical therapy utilization, timing of return-to-sport test completion, and hop test performance by age and between sexes in youth athletes after anterior cruciate ligament reconstruction.

OBJECTIVE: To compare physical therapy (PT) utilization, timing of return-to-sport (RTS) test and hop test performance by age and between sexes in youth after anterior cruciate ligament reconstruction (ACLR). DESIGN: Multicenter retrospective cohort. METHODS: A retrospective review of adolescents after primary ACLR was conducted. Participants completed return-to-sport (RTS) tests including single-legged hop testing. PT frequency, average weekly visits, and timing of RTS test were calculated. T-tests assessed the effect of age and sex on average weekly PT visits and multivariable logistic regressions assessed odds of passing hop tests. RESULTS: 289 participants were included (15.7 ± 1.9 years). There was no difference in average weekly PT visits (p = 0.321) or time to RTS test (p = 0.162) by age. There were significant differences in average weekly PT visits (p = 0.047) and mean time from surgery to RTS test (p = 0.048) between sexes with small effect sizes (d = 0.24 and d = 0.21, respectively). Age and sex had no effect on odds of passing hop tests (OR, 1.29; 95% CI, 0.71-2.35 and OR, 0.79; 95%CI, 0.43-1.45, respectively). CONCLUSION: In a youth cohort, age and sex may have no clinically important effect on PT visit utilization, timing of RTS test or hop test performance.

Refining an ecological momentary assessment study of binge eating among sexual minority and heterosexual young women: a mixed methods pilot study.

Background: Ecological momentary assessment (EMA) is used to capture daily lived experiences, states, and environments. Although EMA is commonly used in behavioral health research, there remains a dearth of literature on how researchers account for design considerations of EMA techniques when designing studies. The goal of this formative mixed methods study was to elicit feedback on EMA study procedures and materials from the target populations for a larger study about binge eating among sexual minority and heterosexual young women, in which data are collected entirely remotely. Methods: Sexual minority (n=12) and heterosexual (n=9) women ages 18-30 who binge ate took part in a pilot EMA study and exit interview and survey. As part of the consent and orientation process, participants reviewed video and written materials describing the study purpose and procedures. Using a smartphone app, for seven consecutive days they completed a survey each morning, 5 random surveys per day, and self-initiated a survey each time they binge ate. Participants then provided feedback on the study via a 1-hour virtual interview and online survey. Interviews were transcribed and reviewed by two coders to identify themes on the acceptability and feasibility of the EMA procedures with a focus on: (I) the training and study description materials; (II) general smartphone app and survey preferences; and (III) specific EMA survey question content and wording. Results: The qualitative and quantitative data converged to suggest participants were able to easily download and use the app to complete surveys and report on binge eating events. Participants provided feedback that was incorporated into revisions on general study procedures, the training video content, and EMA question content for binge eating, identity-related stressors, and appearance-related pressures. No systematic themes in the quantitative or qualitative data emerged to suggest questions were perceived differently by sexual minority and heterosexual young women. Conclusions: These findings provide evidence for the feasibility of conducting a remote EMA study to assess young women's experiences around binge eating. This formative study provides an example of how a mixed methods approach can be used to refine EMA study methods and questions to improve study design.

Concurrent Validity of The Expanded Cutting Alignment Scoring Tool (E-CAST).

Background: The Expanded Cutting Alignment Scoring Tool (E-CAST) has been previously shown to be reliable when assessing lower extremity alignment during a 45-degree sidestep cut, however, the validity of this tool remains unknown. The purpose of this study was to assess the concurrent validity of the E-CAST by comparing visually identified movement errors from two-dimensional (2D) video with three-dimensional (3D) biomechanical variables collected using motion capture. Study Design: Cross Sectional. Methods: Sixty female athletes (age 14.1 ± 1.5 years) who regularly participated in cutting/pivoting sports performed a sidestep cut with 2D video and 3D motion capture simultaneously recording. One clinician scored the 2D videos for each limb using the E-CAST criteria. Joint angles and moments captured in 3D were computed for the trunk and knee. Receiver operating characteristic (ROC) curve analyses were performed to determine the accuracy of each E-CAST item and to provide cut-off points for risk factor identification. Results: ROC analyses identified a cut-off point for all biomechanical variables with sensitivity and specificity ranging from 70-85% and 55-89%, respectively. Across items, the area under the curve ranged from 0.67 to 0.91. Conclusion: The E-CAST performed with acceptable to outstanding area under the curve values for all variables except static knee valgus. Level of evidence: 3b.

No Difference in Two-Dimensional Kinematic Assessment of a 45-Degree Sidestep Cut Compared to Qualitative Assessment.

Background and Purpose: The Expanded Cutting Alignment Scoring Tool (E-CAST) is a two-dimensional qualitative scoring system that has demonstrated moderate inter-rater and good intra-rater reliability for the assessment of trunk and lower extremity alignment during a 45-degree sidestep cut. The primary purpose of this study was to examine the reliability of the quantitative version of the E-CAST among physical therapists and to compare the reliability of the quantitative E-CAST to the original qualitative E-CAST. The hypothesis was that the quantitative version of the E-CAST would demonstrate greater inter-rater and intra-rater reliability compared to the qualitative E-CAST. Study Design: Observational cohort, repeated measures reliability study. Methods: Twenty-five healthy female athletes (age 13.8±1.4 years) performed three sidestep cuts with two-dimensional video capturing frontal and sagittal views. Two physical therapist raters independently scored a single trial using both views on two separate occasions. Based on the E-CAST criteria, select kinematic measurements were extracted using a motion analysis phone application. Intraclass correlation coefficients and 95% confident intervals were calculated for the total score, and kappa coefficients were calculated per kinematic variable. Correlations were converted to z-scores and compared to the six original criteria for significance (α<0.05). Results: Cumulative intra- and inter-rater reliability were both good (ICC=0.821, 95% CI 0.687-0.898 and ICC=0.752, 95% CI 0.565-0.859). Cumulative intra-rater kappa coefficients ranged from moderate to almost perfect, and cumulative inter-rater kappa coefficients ranged from slight to good. No significant differences were observed between the quantitative and qualitative criteria for either inter- or intra-rater reliability (Zobs(intra)= -0.38, p=0.352 and Zobs(inter)= -0.30, p=0.382). Conclusion: The quantitative E-CAST is a reliable tool to assess trunk and lower extremity alignment during a 45-degree sidestep cut. No significant differences were observed in reliability of the quantitative versus qualitative assessment. Level of evidence: 3b.

Highly Active Middle School Athletes Demonstrate Poor Motor Skill Proficiency.

BACKGROUND: Fundamental movement skills (FMS) are critical components to lifelong participation in sports and physical activity. With the rise in early sports specialization, mastery of motor skills may be limited in youth athletes. The purpose of this study was to assess FMS proficiency in highly active middle school athletes and determine whether proficiency differed between specialization levels and sex. HYPOTHESIS: (1) Most athletes would fail to achieve proficiency in all domains of the Test of Gross Motor Development (TGMD-2), (2) highly specialized athletes would demonstrate lower proficiency in all domains of the TGMD-2, and (3) male athletes would demonstrate higher proficiency than female athletes. STUDY DESIGN: Cross-sectional. LEVEL OF EVIDENCE: Level 4. METHODS: A total of 91 athletes were recruited (44 male, 12.6 ± 0.9 years). Activity level was quantified using the Hospital for Special Surgery (HSS) Pediatric Functional Activity Brief Scale (Pedi-FABS), specialization level was determined using the Jayanthi Specialization Scale, and the TGMD-2 was used to assess FMS proficiency. Descriptive statistics were used to describe gross motor, locomotor, and object control percentile rank. A 1-way analysis of variance (ANOVA) was used to assess differences in percentile rank between low, moderate, and high specialization groups and independent samples t tests were used to compare sexes (α < 0.05). RESULTS: Mean Pedi-FABS score was 23.6 ± 4.9. In total, 24.2%, 38.5%, and 37.4% of athletes classified as low, moderate, and highly specialized, respectively. Mean percentile ranks were 56.2%, 64.7%, and 62.6% for locomotor, object control, and gross motor domains, respectively. No athlete achieved a percentile rank >99% in any domain of the TGMD-2, and there was no significant difference between specialization groups or sex. CONCLUSION: Despite high activity levels, no athlete demonstrated proficiency in any domain of the TGMD-2, and there was no difference in proficiency between specialization levels or by sex. CLINICAL RELEVANCE: Sport participation, regardless of level, does not ensure adequate mastery of FMS.

Plasma proteins related to inflammatory diet predict future cognitive impairment.

Dysregulation of the immune system and dietary patterns that increase inflammation can increase the risk for cognitive decline, but the mechanisms by which inflammatory nutritional habits may affect the development of cognitive impairment in aging are not well understood. To determine whether plasma proteins linked to inflammatory diet predict future cognitive impairment, we applied high-throughput proteomic assays to plasma samples from a subset (n = 1528) of Women's Health Initiative Memory Study (WHIMS) participants (mean [SD] baseline age, 71.3 [SD 3.8] years). Results provide insights into how inflammatory nutritional patterns are associated with an immune-related proteome and identify a group of proteins (CXCL10, CCL3, HGF, OPG, CDCP1, NFATC3, ITGA11) related to future cognitive impairment over a 14-year follow-up period. Several of these inflammatory diet proteins were also associated with dementia risk across two external cohorts (ARIC, ESTHER), correlated with plasma biomarkers of Alzheimer's disease (AD) pathology (Aß42/40) and/or neurodegeneration (NfL), and related to an MRI-defined index of neurodegenerative brain atrophy in a separate cohort (BLSA). In addition to evaluating their biological relevance, assessing their potential role in AD, and characterizing their immune-tissue/cell-specific expression, we leveraged published RNA-seq results to examine how the in vitro regulation of genes encoding these candidate proteins might be altered in response to an immune challenge. Our findings indicate how dietary patterns with higher inflammatory potential relate to plasma levels of immunologically relevant proteins and highlight the molecular mediators which predict subsequent risk for age-related cognitive impairment.

Barriers and Facilitators of Research in Pediatric Sports Medicine Practitioners: A Survey of the PRiSM Society.

Background: Barriers and facilitators to research in sports medicine (SM) by physicians and allied health (AH) professions such as physical therapists and athletic trainers are understudied. The purpose of this research was to examine and compare research barriers, facilitators, and other research related facets including interests, comfort, knowledge, and resources among SM physicians and AH practitioners. Study Design: Cross-sectional survey. Methods: The survey was sent to Pediatric Research in Sports Medicine (PRiSM) members. The survey was designed to ask respondents to identify their top barrier and facilitator to conducting research. Research interest (binary), self-rated comfort reading research articles (0-100 scale), self-rated knowledge conducting research independently (0-100 scale), and available research resources were evaluated. Descriptive statistics, chi-square, and t-tests were used to compare the responses between SM physicians and AH practitioners. The value of p<0.05 was set as a statistically significant criterion. Results: The response rate was 35.7% (N=100). For both SM physicians and AH practitioners, the greatest research barrier was a lack of time. However, the leading research facilitators differed in the two professions. The top research facilitator for SM physicians was availability of research personnel, while availability of research mentoring was selected as a prime facilitator by AH practitioners. There were no differences in research interest between SM physicians (87.0%) and AH practitioners (95.5%, p=0.267). However, self-rated comfort reading research articles was higher in SM physicians (75.6±20.6) than AH practitioners (60.6±28.3, p=0.018). There were no differences in self-rated knowledge conducting research independently between SM physicians (70.2±18.6) and AH practitioners (63.4±24.6, p=0.163). Conclusion: Lack of time was the top research barrier for both SM physicians and AH practitioners. Regarding research facilitators, having available time was the main facilitator for SM physicians while availability of mentoring was the leading facilitator in AH practitioners. Level of Evidence: 3.

Rationale and Design of an Ecological Momentary Assessment Study Examining Predictors of Binge Eating Among Sexual Minority and Heterosexual Young Women: Protocol for the Health and Experiences in Real Life (HER Life) Study.

BACKGROUND: Previous research has identified health disparities between sexual minority and heterosexual women, including increased rates of obesity and binge eating in sexual minority women. Established predictors of binge eating behavior include negative emotions and sociocultural processes; however, these studies are generally conducted in samples of young women where sexual identity is not known or reported. There is a dearth of research evaluating how sexual minority-specific factors (eg, minority stress and connectedness to the lesbian, gay, bisexual, transgender, and queer community) may affect binge eating in sexual minority women. In addition, no studies have examined these processes in racially diverse samples or considered how intersecting minority identities (eg, Black and sexual minority) may affect eating behaviors. OBJECTIVE: The Health and Experiences in Real Life (HER Life) Project aims to clarify real-world predictors of binge eating in young heterosexual and sexual minority women using ecological momentary assessment. The role of affective, social, and health behavior factors in binge eating will be examined for all women (aim 1), and sexual minority-specific predictors will also be considered for sexual minority women participants (aim 2). Person-level moderators of race, body- and eating-related factors, and sexual minority-specific factors will also be examined to better understand how real-world binge eating predictors may differ for various demographic groups (aim 3). METHODS: Researchers aim to recruit 150 sexual minority and 150 heterosexual women from across the United States, including at least 50 Black women for each group, using web-based recruitment methods. The eligibility criteria include identifying as a woman, being aged between 18 and 30 years, and having had at least two binge eating episodes in the last 2 weeks. Participants must endorse being only or mostly attracted to men (considered heterosexual) or only or mostly attracted to women or having a current or most recent female partner (considered sexual minority). Eligible participants complete an initial web-based baseline survey and then 14 days of ecological momentary assessment involving the completion of a morning and before-bed survey and 5 prompted surveys per day as well as a user-initiated survey after binge eating episodes. The data will be analyzed using a series of multilevel models. RESULTS: Data collection started in February 2021. We have currently enrolled 129 sexual minority women and 146 heterosexual women. Data collection is expected to conclude in fall 2022. CONCLUSIONS: The Health and Experiences in Real Life Project aims to elucidate potential differences between sexual minority and heterosexual women in within-person factors predicting binge eating and inform eating disorder interventions for sexual minority women. The challenges in recruiting sexual minority women, including the determination of eligibility criteria and considerations for remote data collection, are discussed. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/41199.

Pediatric and Adolescent Knee Injuries: Risk Factors and Preventive Strategies.

It is estimated that approximately 2.5 million sports-related knee injuries occur in the pediatric population annually in the United States. Thus, identifying appropriate screening tools and injury prevention strategies is imperative. To develop successful injury prevention strategies, risk factor identification is the first step. There are two types of risk factors: non-modifiable (age, gender, injury history, and anatomical alignment) and modifiable risk factors (biomechanical and neuromuscular control, training loads, and body mass index). These risk factors can be addressed by three types of preventive interventions: primary, secondary, and tertiary. To translate study evidence to clinical practices and routine trainings, awareness of injury prevention and health promotion needs to be further strengthened.

Differences in the course of rehabilitation and outcomes for publicly insured pediatric patients after anterior cruciate ligament reconstruction.

OBJECTIVE: Examine the effect of insurance type on physical therapy (PT) utilization and outcomes within pediatric and adolescent patients after anterior cruciate ligament reconstruction. DESIGN: Multicenter retrospective cohort study. METHODS: PT visits and functional hop test performance were extracted into a shared database. The average number of PT visits per week was assessed overall and by time period. Independent samples t-test examined the effect of insurance on PT utilization and the effect of insurance status on the odds of passing single-legged hop tests was assessed using multivariable logistic regression. RESULTS: A total of 281 patients (15.7 ± 1.9, 42% female) were included in this analysis. Of these, 128 (45%) had public insurance. Publicly insured patients experienced a longer delay from surgery to hop test (8.3vs7.7 months, p = 0.009), attended overall fewer PT visits per week (0.92vs1.04, p = 0.005), with most of the decreased frequency occurring between weeks 7-24. Insurance status had a significant effect on the odds of passing the single leg hop test (2.72; 95%CI, 1.27-5.81). CONCLUSION: Publicly insured patients average a lower number of weekly PT visits, experienced a longer delay from surgery to hop testing and were 2.7 times less likely to pass the single leg hop for distance test.

Concurrent Validity of Movement Screening Criteria Designed to Identify Injury Risk Factors in Adolescent Female Volleyball Players.

Anterior cruciate ligament (ACL) injuries in female adolescent athletes occur at disproportionately high levels compared to their male counterparts. However, limited prospective data exist on the validity of low-cost screening tools that can proactively identify ACL injury risk, specifically for female athletes. The purpose of this study was to assess the concurrent validity of a three-task injury risk factor assessment by comparing visually derived outcome scores from two-dimensional (2D) video data with dichotomized three-dimensional (3D) biomechanical variables collected using motion capture technology. A total of 41 female club volleyball athletes (14.7 ± 1.4 years) were tested and asked to perform three tasks: double-leg vertical jump (DLVJ), single-leg squat (SLS), and single-leg drop landing (SLDL). One rater was trained on the scoring criteria for the 2D data and independently scored one forward-facing and one side-facing video for each task. Risk factors identified included poor knee position, lateral trunk lean, and excessive trunk flexion/extension. In addition, 3D joint angles were calculated for the trunk and knee in the sagittal and frontal planes and converted to dichotomous variables based on biomechanical thresholds of injury risk. For comparison of 2D and 3D outcomes, percent agreement and Cohen's kappa were calculated for each risk factor individually. Overall, 2D scores were found to exhibit moderate to excellent percent agreement with 3D outcomes for trunk position (69.1-97.1%). Specifically, ipsilateral trunk lean during single-leg tasks exhibited the highest agreement (85.3-88.2%) with moderate reliability (κ = 0.452-0.465). In addition, moderate to substantial reliability was found for trunk flexion during double-leg tasks (κ = 0.521-0.653); however, an evaluation of single-leg tasks resulted in only fair reliability (κ = 0.354). Furthermore, 2D scores were not successful in identifying poor knee position as percent agreement fell below 50% for both the single-leg tasks and averaged 60% agreement across both the phases of the DLVJ. Kappa coefficients further emphasized these trends indicating no to slight concurrent validity (κ = -0.047-0.167) across tasks. Overall, these findings emphasize the potential for valid, low-cost screening tools that can identify high-risk movement patterns. Further study is needed to develop improved assessment guidelines that may be employed through visual assessment in sports environments.

Reliability of the Expanded Cutting Alignment Scoring Tool (E-CAST) to Assess Trunk and Limb Alignment During a 45-Degree Side-Step Cut.

Background: Current clinical screening tools assessing risky movements during cutting maneuvers do not adequately address sagittal plane foot and ankle evaluations. The Cutting Alignment Scoring Tool (CAST) is reliable in evaluating frontal plane trunk and lower extremity alignment during a 45-degree side-step cut. The Expanded Cutting Alignment Scoring Tool (E-CAST) includes two new sagittal plane variables, knee flexion and ankle plantarflexion angle. Hypothesis/Purpose: To assess the inter-and intra-rater reliability of the E-CAST to evaluate trunk and lower extremity alignment during a 45-degree side-step cut. Study Design: Repeated Measures. Methods: Participants included 25 healthy females (13.8 ± 1.4 years) regularly participating in cutting or pivoting sports. Participants were recorded performing a side-step cut in frontal and sagittal planes. One trial was randomly selected for analysis. Two physical therapists independently scored each video using the E-CAST on two separate occasions, with randomization and a two-week wash-out between rounds. Observed movement variables were awarded a score of "1", with higher scores representing poorer technique. Intraclass correlation coefficients (ICC) and 95% confident intervals (95% CI) were calculated for the total score, and a kappa coefficient (k) was calculated for each variable. Results: The cumulative intra-rater reliability was good (ICC=0.78, 95% CI 0.59-0.96) and the cumulative inter-rater reliability was moderate (ICC=0.71, 95% CI 0.50-0.91). Intra-rater kappa coefficients ranged from moderate to excellent for all variables (k= 0.50-0.84) and inter-rater kappa coefficients ranged from slight to excellent for all variables (k=0.20-0.90). Conclusion: The addition of two sagittal plane variables resulted in lower inter-rater ICC compared to the CAST (ICC= 0.81, 95% CI 0.64-0.91). The E-CAST is a reliable tool to evaluate trunk and LE alignment during a 45-degree side-step cut, with good intra-rater and moderate inter-rater reliability. Level of Evidence: Level 2, Diagnosis.

A dyadic examination of alcohol use and intimate partner aggression among women in same-sex relationships.

Despite considerable evidence linking alcohol use and intimate partner aggression among mixed-sex couples, scant research has examined this association in same-sex couples using a dyadic framework. The aim of the present study was to examine associations between one's own and their partner's alcohol use (i.e., drinks per week, hazardous alcohol use) and intimate partner aggression (physical, psychological) perpetration while accounting for the interdependence among partners in alcohol use. Participants were 326 women (Mage = 27.57, SD = 3.65) from 163 female-female couples who independently completed measures of drinks per week, hazardous alcohol use, psychological intimate partner aggression victimization and perpetration, and physical intimate partner aggression victimization and perpetration. Actor-partner interdependence structural equation models found that (1) actor drinks per week were positively associated with one's own physical assault perpetration (2) actor hazardous alcohol use was positively associated with one's own physical assault and psychological aggression perpetration and (3) partner drinks per week and hazardous alcohol use were positively associated with actor's psychological aggression perpetration. No other significant effects were detected. Collectively, findings highlight the nuanced relationship between alcohol use and intimate partner aggression among same-sex female couples and suggest that one's own alcohol use is associated with intimate partner psychological and physical aggression perpetration. In contrast, the only partner effect was partner's alcohol use in association with actor's psychological aggression perpetration. These findings differ from prior research with heterosexual couples and underscore the need for future research with same-sex couples rather than attempts to generalize findings across populations.

Impact of Stress on Menstrual Cyclicity During the Coronavirus Disease 2019 Pandemic: A Survey Study.

Background: The coronavirus disease 2019 (COVID-19) pandemic has introduced acute and persistent psychosocial stressors for many individuals, with emerging gender differences that suggest women may be at greater risk for poorer mental health outcomes. This may have unintended consequences for women's overall health and well-being, including disruptions to reproductive function as elevated stress is often associated with menstrual cycle irregularities. The objective of this study was to determine if and how the COVID-19 pandemic and its related stressors have impacted women's menstrual cyclicity. Materials and Methods: An online survey instrument designed to capture self-reported information on menstrual cycle changes and perceived stress levels was distributed between July and August 2020. A total of 210 women between the ages of 18-45 years met stringent inclusion and exclusion criteria and completed the survey. Results: Of the 210 respondents, more than half (54%) reported changes in their menstrual cycles. These included changes in menstrual cycle length (50%), the duration of menses (34%), and changes in premenstrual symptoms (50%). Respondents with high perceived stress scale (PSS) scores during Covid were more likely to experience a longer duration of menses (p < 0.001) and heavier bleeding during menses (p = 0.028) compared with those with moderate Covid PSS scores. Conclusions: By uncovering a trend in increased menstrual cycle irregularities during the early months of the COVID-19 pandemic, this study contributes to our understanding of the implications that the pandemic may have on women's reproductive health.

Physical Literacy in Elementary Physical Education: A Survey of Fundamental Movement Skill Practice Patterns.

PURPOSE: To describe fundamental movement skill (FMS) practice patterns in the elementary physical education (PE) curriculum. METHODS: A cross-sectional survey was sent to PE teachers of grades 1 through 6. Sixty-eight responses were included for analysis. RESULTS: Only 38.2% of teachers taught all 12 FMS components. Compared with PE teachers for grades 4 to 6, a significantly higher proportion of PE teachers for grades 1 to 3 taught all 12 FMS and used direct instruction methods. For children falling behind, only 8.8% reported referring to an exercise program and no PE teacher sought a health care referral. A video abstract can be found in Supplemental Digital Content 1 (available at: http://links.lww.com/PPT/A342).