Ethnic and Gender Differences in Sun-Related Cognitions Among College Students: Implications for Intervention

BACKGROUND

Skin cancer incidence and prognosis vary by ethnicity and gender, and previous studies demonstrate ethnic and gender differences in sun-related cognitions and behaviors that contribute to this disease. The current study sought to inform skin cancer interventions tailored to specific demographic groups of college students. The study applied the prototype willingness model (PWM) to examine how unique combinations of ethnic and gender identities influence sun-related cognitions.

METHOD

Using data from a survey of 262 college students, the study tested whether self-reported sun-related cognitions were different for White women, Hispanic women, White men, and Hispanic men. Path modeling was also used to identify which PWM cognitions (e.g., prototypes, norms) were the strongest predictors of risk and protection intentions and willingness in each demographic group.

RESULTS

Several differences in sun-related cognitions and PWM pathways emerged across groups, emphasizing the need for tailored skin cancer education and interventions. Results suggest that, for White women, interventions should primarily focus on creating less favorable attitudes toward being tan.

CONCLUSION

Interventions for Hispanic women may instead benefit from manipulating perceived similarity to sun-related prototypes, encouraging closer personal identification with images of women who protect their skin and encouraging less identification with images of women who tan. For White men, skin cancer interventions may focus on creating more favorable images of men who protect their skin from the sun. Lastly, interventions for Hispanic men should increase perceived vulnerability for skin cancer.

A life span developmental investigation of marriage and problem-drinking reduction

While prior literature has largely focused on marriage effects during young adulthood, it is less clear whether these effects are as strong in middle adulthood. Thus, we investigated age differences in marriage effects on problem-drinking reduction. We employed parallel analyses with two independent samples (analytic-sample Ns of 577 and 441, respectively). Both are high-risk samples by design, with about 50% of participants having a parent with lifetime alcohol use disorder. Both samples have been assessed longitudinally from early young adulthood to the mid-to-late 30s. Separate parallel analyses with these two samples allowed evaluation of the reproducibility of results. Growth models of problem drinking tested marriage as a time-varying predictor and thereby assessed age differences in marriage effects. For both samples, results consistently showed marriage effects to be strongest in early young adulthood and to decrease somewhat monotonically thereafter with age, reaching very small (and nonsignificant) magnitudes by the 30s. Results may reflect that role transitions like marriage have more impact on problem drinking in earlier versus later adulthood, thereby highlighting the importance of life span developmental research for understanding problem-drinking desistance. Our findings can inform intervention strategies aimed at reducing problem drinking by jumpstarting or amplifying natural processes of adult role adaptation.

Food and alcohol disturbance, alcohol use, and negative consequences among college students engaging in binge drinking: A longitudinal examination of between- and within-person effects

OBJECTIVE

Researchers have documented robust associations between food and alcohol disturbance (FAD-intoxication; restricting caloric intake before or during alcohol consumption to experience a quicker and/or more intense alcohol intoxication) and alcohol use and related negative consequences. However, most of this research has utilized cross-sectional designs. Consequently, two crucial gaps have not yet been filled: (a) the separation of the relatively stable, between-person and the fluctuating, within-person components in the relations between FAD-intoxication and alcohol-related constructs; and (b) the examination of the directionality of these within-person relations.

METHOD

Participants were college students (n = 686) who reported past-month binge drinking. Most participants identified as White (71.3%), female (78.4%), non-Hispanic (87.8%), with a mean age of 20.64 (SD = 3.25). Participants completed three online surveys assessing FAD-intoxication (College Eating and Drinking Behaviors Scale), alcohol use (Daily Drinking Questionnaire), and related negative consequences (Brief Young Adult Alcohol Consequences Questionnaire).

RESULTS

Analyses revealed that FAD-intoxication was positively associated with alcohol use and related negative consequences at the between-person level. Additionally, at the within-person level, FAD-intoxication at Time 2 significantly predicted alcohol use at Time 3. Notably, the cross-lagged effect from FAD-intoxication at Time 1 to alcohol use at Time 2 was not significant. FAD-intoxication did not significantly predict negative consequences. Neither use nor consequences significantly predicted FAD-intoxication.

CONCLUSIONS

Our results suggest that FAD-intoxication is relevant to the study of alcohol use and related negative consequences and should be considered in interventions targeting alcohol use and related negative consequences among students who endorse binge drinking. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Examining the validity of the drinking motives questionnaire for identifying reward and relief drinking subgroups in college students

BACKGROUND

Heavy alcohol use in college is associated with a risk of developing alcohol use disorder. Characterizing variability in individual risk factors for alcohol use could help mitigate risk by informing personalized approaches to prevention. This study examined the validity of a brief measure for identifying reward/relief drinking phenotypes in non-treatment-seeking young adults.

METHODS

College students (n = 454) who reported binge drinking completed the Drinking Motives Questionnaire-Revised-Short Form (DMQ-R-SF). Confirmatory factor and latent profile analyses (CFA; LPA) of the DMQ-R-SF were performed to assess structural validity and identify reward/relief drinking subgroups. We compared models measuring reward drinking with the DMQ-R-SF enhancement motives (reward-enhancement) subscale to models measuring reward drinking with enhancement and social motives (reward-enhancement/social). Across models, relief drinking was measured with coping motives. We examined associations between reward/relief drinking subgroups and alcohol and personality variables concurrently and prospectively at a 6-week follow-up.

RESULTS

A two-factor reward and relief structure of the DMQ-R-SF was supported. Three latent profiles were identified (low reward/low relief: n = 133, high reward/low relief: n = 249; high reward/high relief: n = 72). Both CFA and LPA models that utilized reward-enhancement/social items indicated a better fit than reward-enhancement items alone. At baseline, individuals in the high-reward/high-relief profile demonstrated the poorest alcohol use outcomes and higher negative affect. Those in the high-reward/low-relief profile demonstrated greater alcohol use severity than those in the low-reward/low-relief profile. Prospectively, individuals classified in the high-reward/low-relief subgroup reported greater binge drinking frequency and those in the high-reward/high-relief profile reported greater alcohol consequences.

CONCLUSIONS

The DMQ-R-SF is a valid measure for identifying reward and relief drinking subgroups in college students with binge drinking and could have utility for precision prevention efforts that target individuals in the high-reward/low-relief and high-reward/high-relief subgroups.

Age Specificity of Effects of Health Problems on Drinking Reduction: A Lifespan Developmental Analysis

Older adult drinking poses a growing public health concern, especially given the ongoing aging of the United States population. As part of a larger lifespan developmental project contrasting predictors of drinking reductions across different periods of adulthood, we tested age differences in effects of health problems on drinking declines across young adulthood, midlife, and older adulthood. We predicted these effects to be developmentally specific to midlife and older adulthood. We also tested moderation by alcohol use disorder (AUD) symptomatology and by indices of sociodemographic disadvantage (sex and race/ethnicity). Analyses used data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), leveraging NESARC's vast age range (18-90 + ; N = 43,093) and two waves of longitudinal data. Multiple-group cross-lag models tested differences across age groups in cross-lag paths between health problems and alcohol consumption. As hypothesized, health problem effects on drinking reductions were developmentally specific to midlife and older adulthood. However, models testing moderation by AUD symptomatology showed that these adaptive effects of health problems on drinking reductions did not extend to those with one or more AUD symptoms. Little evidence was found for moderation by sex or race/ethnicity. Findings support the notion of health concerns as a pathway to drinking reduction that increases in importance across the adult lifespan. However, given the moderation by AUD symptoms, findings also highlight a need to understand barriers to health-related pathways to drinking reduction among relatively severe midlife and older adult drinkers. These findings hold implications for lifespan developmental tailoring of clinical, public health, and policy interventions.

Sexual minority status and food and alcohol disturbance among college students: The moderating role of body esteem

Food and alcohol disturbance (FAD; restricting caloric intake before, during, or after drinking to either offset calories or to increase intoxication) is common among college students and poses a threat to students' health. In conjunction, sexual minority (SM; i.e., not exclusively heterosexual) college students may be at increased risk of engaging in alcohol misuse and disordered eating compared to their heterosexual peers due to exposure to minority stress. However, little research has examined whether engagement in FAD differs by SM status. Body esteem (BE) is an important resilience factor among SMs that may influence SM students' risk of participating in FAD. Therefore, the aim of the present study was to understand the association between SM status and FAD with additional interest in BE as a moderating factor. Participants were 459 college students who engaged in past 30-day binge drinking. Most participants identified as White (66.7 %), female (78.4 %), heterosexual (69.3 %), with a mean age of 19.60 (SD = 1.54) years. Participants completed two surveys (3 weeks apart) over the course of an academic semester. Analyses revealed a significant interaction between SM status and BE, such that SMs with lower BE (T1) reported more engagement in FAD-intoxication (T2), whereas SMs with higher BE (T1) reported less engagement in FAD-calories (T2) and FAD-intoxication (T2) than their heterosexual peers. Stressors associated with body esteem may contribute to increased FAD engagement among SM students. Consequently, BE may be an especially important target for interventions aimed at reducing FAD among SM college students.

Loneliness and Alcohol-Related Problems among College Students Who Report Binge Drinking Behavior: The Moderating Role of Food and Alcohol Disturbance

Loneliness and alcohol misuse are common among college students and pose a threat to public health. To better understand the longitudinal association between these public health concerns we examined food and alcohol disturbance (FAD; i.e., restricting one's caloric intake prior to drinking) as a moderator in the association between loneliness and alcohol-related problems. Participants were 456 college students from a mid-sized university who engaged in past 30-day binge drinking. The majority of participants identified as being White (67.1%), female (78.1%), and reported a mean age of 19.61 (SD = 1.54) years. Participants completed two surveys (3 weeks apart) over the course of an academic semester. Analyses revealed a significant interaction between loneliness and FAD, such that loneliness (T1) significantly and positively predicted alcohol-related problems (T2), but only among individuals who engaged in relatively higher levels of FAD (T1). FAD may be an appropriate target for interventions aimed at reducing alcohol-related problems among college students experiencing loneliness.

Relations between lab indices of emotion dysregulation and negative affect reactivity in daily life in two independent studies

BACKGROUND

We investigated the extent to which physiological/biological measures of emotion dysregulation collected in the lab, resting respiratory sinus arrhythmia (RSA) in Study 1 and amygdala activation in response to negative stimuli in Study 2, combined with daily measures of interpersonal stressors predicted negative emotional states in outpatients better than the stressors alone.

METHODS

Participants were adult outpatients with emotional distress disorders (N=30 individuals in Study 1, and N=26 women in Study 2). After completing a laboratory session that collected physiological/biological measures of emotion dysregulation, participants then completed 1-3 weeks of ambulatory assessment during which they reported on interpersonal stressors and negative affective states several times per day.

RESULTS

Laboratory measures of emotion dysregulation were largely unrelated to either momentary or mean levels of daily-life hostility, sadness, and fear in both studies. However, resting RSA significantly moderated the association between day-level interpersonal stressors and momentary fear such that low resting RSA strengthened this association. Similarly, amygdala activation tended to moderate this relationship in the predicted direction.

LIMITATIONS

Both samples were relatively small and focused on only a limited set of diagnoses associated with emotion dysregulation. Only two possible physiological/biological markers of emotion dysregulation were examined.

CONCLUSIONS

The current studies support the collection of physiological/biological data on emotion dysregulation when indexing daily-life emotion dysregulation as the degree of emotional reactivity to stressors in daily life among outpatients with emotional distress disorders.

The ironic effects of dietary restraint in situations that undermine self-regulation

Dietary restraint, defined as the cognitive effort to restrict eating, can paradoxically make individuals more susceptible to unhealthy eating when their ability to self-regulate is threatened. Past experiments have found that, in situations that elicit low self-control and/or unhealthy cravings, participants with higher dietary restraint eat more than those with lower restraint. However, these relationships have never been examined in a free-living environment. The current daily diary study examined if dietary restraint would exacerbate the associations between poor self-control and unhealthy cravings with overconsumption, namely, eating more than usual and binge eating. College women (N = 121, M age = 19) reported their restrained eating behavior and completed seven daily surveys. Multilevel analyses showed a significant interaction between dietary restraint and daily self-control on eating more than usual (b = -0.13, p = .001) and binge eating (b = -0.22, p < .001). Lower daily self-control was associated with eating more than usual and with more binge eating that day, but only among women with higher dietary restraint. Dietary restraint also moderated the effect of cravings on eating more than usual (b = 0.10, p = .007); this relationship was stronger for women with higher restraint. Stronger cravings were associated with more binge eating regardless of restraint. Results suggest that situations that undermine self-control are more strongly associated with overeating among those with higher dietary restraint. Findings can inform strategies to reduce overconsumption among restrained eaters.

Ego-resiliency in borderline personality disorder and the mediating role of positive and negative affect on its associations with symptom severity and quality of life in daily life

Borderline personality disorder (BPD) is a serious mental health condition associated with severe symptoms of distress and poor quality of life (QoL). Research outside the field of BPD suggests that ego-resiliency is negatively associated with psychopathology and positively associated with a range of positive life outcomes. Thus, ego-resiliency may be a valuable construct for furthering our understanding and treatment of BPD. However, the mechanisms linking ego-resiliency to psychopathology and QoL in relation to BPD have not been examined and explored by research. This study has addressed this gap in the collective knowledge by evaluating whether within-person associations between daily reports of positive affect (PA) and negative affect (NA) mediated the relationship between ego-resiliency, BPD symptom severity, and QoL. For 21 consecutive days, 72 women diagnosed with BPD completed end-of-day electronic assessments regarding ego-resiliency, PA and NA, symptom severity, and QoL. Multilevel structural equation modelling established that PA and NA were parallel mediators linking ego-resiliency with BPD symptom severity and QoL. As hypothesized, the path to QoL was stronger through PA than through NA. The mediation paths through NA and PA to BPD symptom severity were both significant, but their strength did not differ. Our findings align with the assertions of theories on emotion, thus suggesting a two-factor approach to PA and NA. Future research can build on these findings by developing psychotherapeutic interventions designed not only to reduce symptom severity but also to enhance PA in individuals with BPD and determine whether an increase in PA is associated with improved QoL.

The Association Between Alcohol Consumption and Pain Interference in a Nationally Representative Sample: The Moderating Roles of Gender and Alcohol Use Disorder Symptomatology

BACKGROUND

Prior research on alcohol consumption and pain has yielded inconsistent results regarding the directionality of effects for both consumption-to-pain and pain-to-consumption relations. The present study sought to examine directionality of these relations by testing bidirectional longitudinal associations between consumption and pain interference, a crucial aspect of pain that captures pain-related disability and has been regarded as a valuable measure of treatment outcome. In addition, this study explored possible moderation of these bidirectional longitudinal associations by gender and alcohol use disorder (AUD) symptomatology.

METHODS

Analyses included 29,989 current/former drinkers who were interviewed at both waves (2001 and 2004) of the U.S. National Epidemiological Survey on Alcohol and Related Conditions (NESARC). Analyses used self-report data from both waves on past-year average daily volume of alcohol consumed and past-month pain interference (1 item from the Medical Outcomes Study 12-item Short-Form Health Survey [MOS-SF-12]). AUDADIS-IV data from Wave 1 were used to index baseline AUD symptomatology (i.e., symptom count). Cross-lagged panel modeling and multigroup analyses were employed.

RESULTS

Regarding the consumption-to-pain-interference relation, in general, higher baseline alcohol consumption was associated with lower subsequent pain interference at follow-up. However, among men with higher AUD-symptom counts, the opposite pattern emerged, with higher baseline alcohol consumption being significantly related to higher subsequent pain interference at follow-up. Regarding the pain-interference-to-consumption relation, higher baseline pain interference was significantly associated with lower subsequent alcohol consumption at follow-up, and no moderating effects were observed.

CONCLUSIONS

The distinctive patterns of the consumption-to-pain-interference relation observed among men with elevated AUD symptomatology suggest that this relation might be driven by different mechanisms across different groups of individuals. Specifically, the detrimental effect of alcohol on pain interference might emerge at relatively advanced stages of AUD among men, consistent with Koob's Dark Side of Alcohol Addiction theory in human research.

Comorbidity of Alcohol Use Disorder and Chronic Pain: Genetic Influences on Brain Reward and Stress Systems

Alcohol use disorder (AUD) is highly comorbid with chronic pain (CP). Evidence has suggested that neuroadaptive processes characterized by reward deficit and stress surfeit are involved in the development of AUD and pain chronification. Neurological data suggest that shared genetic architecture associated with the reward and stress systems may contribute to the comorbidity of AUD and CP. This monograph first delineates the prevailing theories of the development of AUD and pain chronification focusing on the reward and stress systems. It then provides a brief summary of relevant neurological findings followed by an evaluation of evidence documented by molecular genetic studies. Candidate gene association studies have provided some initial support for the genetic overlap between AUD and CP; however, these results must be interpreted with caution until studies with sufficient statistical power are conducted and replications obtained. Genomewide association studies have suggested a number of genes (e.g., TBX19, HTR7, and ADRA1A) that are either directly or indirectly related to the reward and stress systems in the AUD and CP literature. Evidence reviewed in this monograph suggests that shared genetic liability underlying the comorbidity between AUD and CP, if present, is likely to be complex. As the advancement in molecular genetic methods continues, future studies may show broader central nervous system involvement in AUD-CP comorbidity.

Relations between adaptive and maladaptive pain cognitions and within-day pain exacerbations in individuals with fibromyalgia

The objectives of this study were to assess within-person hypotheses regarding temporal cognition-pain associations: (1) do morning pain flares predict changes in two afternoon adaptive and maladaptive pain-related cognitions, and (2) do these changes in afternoon cognitions predict changes in end-of-day pain reports, which in turn, carry over to predict next morning pain in individuals with fibromyalgia. Two hundred twenty individuals with fibromyalgia completed electronic assessments of pain intensity, pain catastrophizing, and pain coping efficacy three times a day for three weeks. Multilevel structural equation modeling established that afternoon catastrophizing and coping efficacy were parallel mediators linking late morning with end-of-day pain reports (controlling for afternoon pain), in line with prediction. Catastrophizing was a stronger mediator than coping efficacy. Moreover, afternoon cognitions and end-of-day pain reports served as sequential mediators of the relation between same-day and next-day morning pain. These findings align with assertions of cognitive-behavioral theories of pain that pain flares predict changes in pain both adaptive and maladaptive cognitions, which in turn, predict further changes in pain.

Salivary latent trait cortisol (LTC): Relation to lipids, blood pressure, and body composition in middle childhood

Adversity experienced early in life has the potential to influence physical health later in life. The stress-health relation may be partially explained by stress-related effects on cardiovascular risk factors. This study explored links between individual differences in trait-like variation in the activity of the hypothalamic-pituitary-adrenal (HPA) axis with cardiovascular risk factors in children. 474 children (M age=9.22years; 54% female; 83% Caucasian) were included in this study, in which cardiovascular risk was assessed using the following indices - triglycerides (TG), HDL-cholesterol (HDL-C), glucose (Glu); resting systolic and diastolic blood pressure, body mass index (BMI), waist-to-hip ratio, and % fat. Saliva samples were measured 3 times a day (waking, 30min post-waking and bedtime) over 3days (later assayed for cortisol). A latent trait cortisol (LTC) factor explained 43% of the variance in cortisol levels within and across days. Confirmatory factor analysis identified three cardiovascular risk factors: lipids (i.e., TG and HDL-C), blood pressure (i.e., systolic and diastolic), and body composition (i.e., BMI, Waist-to-hip ratio, and % fat). Lower salivary LTC was associated with higher lipids, higher blood pressure, and higher body composition. The findings further support the internal and external validity of the LTC construct, and may also advance our understanding of the link between interindividual differences in HPA axis activity and cardiovascular risk in middle childhood.

Daily social enjoyment interrupts the cycle of same-day and next-day fatigue in women with fibromyalgia

BACKGROUND

Fatigue is a debilitating symptom of fibromyalgia (FM) that has limited treatment options. Some evidence, however, has linked positive social engagement with reduced within-day fatigue.

PURPOSE

This study elaborated longitudinal within-day and across-day relations between FM fatigue and social enjoyment.

METHODS

One hundred seventy-six women with FM completed 21-day automated diaries assessing morning and end-of-day fatigue, and both afternoon social enjoyment and stress within two social domains: non-spousal and spousal.

RESULTS

In the non-spousal domain, analysis supported a mediational path from lower morning fatigue to higher afternoon social enjoyment, which predicted lower end-of-day fatigue, and subsequently, lower next-morning fatigue. Enjoyment exerted a greater impact on within-day fatigue than did stress. Patterns in the spousal domain were similar, but the mediated path was nonsignificant.

CONCLUSIONS

Positive social engagement offers relief from FM fatigue that carries over across days and may provide an additional target to enhance the effectiveness of current interventions.

The within-day relation between lonely episodes and subsequent clinical pain in individuals with fibromyalgia: Mediating role of pain cognitions

OBJECTIVE

This daily diary study of individuals with fibromyalgia (FM) examined whether morning increases in loneliness relate to worsened evening bodily pain through afternoon negative pain cognitions.

METHODS

220 participants with FM completed electronic diaries 4 times a day for 21days to assess loneliness, negative pain cognitions, bodily pain, and social enjoyment. Multilevel structural equation modeling was used to examine within-person relations of morning increases in loneliness, afternoon negative pain cognitions, and evening pain, controlling for morning pain.

RESULTS

On mornings when individuals experienced higher than their usual levels of loneliness, they experienced higher levels of afternoon maladaptive pain cognitions, which in turn predicted increases in evening pain above the level of morning pain. Afternoon maladaptive pain cognitions fully mediated the relations between morning loneliness and evening pain.

CONCLUSIONS

Lonely episodes are associated with subsequent increases in negative patterns of thinking about pain, which in turn predict subsequent increases in bodily pain within a day. Because pain cognitions mediate the loneliness-pain link, FM interventions may benefit from addressing individuals' vulnerability to maladaptive cognitions following lonely episodes.

A 5-week whole body vibration training improves peak torque performance but has no effect on stretch reflex in healthy adults: a randomized controlled trial

AIM

This study aimed to investigate the neuromuscular adaptation following a 5-week high frequency and low amplitude whole body vibration (WBV) exercise training.

METHODS

The study is a prospective, double blind, randomized controlled intervention design with a total of 19 subjects volunteered to participate in the study. They were randomly assigned either to WBV exercise training or control group. Both groups participated in a 5-week training program. The intervention group received WBV in semi-squat position on a device with an amplitude of 0.76 mm, frequency of 40Hz, and peak acceleration of 23.9 m/s2. Each vibration training session consisted of 6 series of 60s on with 30s rest period in between. The control group underwent the same statically mini-squatting position without exposure to WBV. The effectiveness of the vibration program was evaluated by vertical jump test and the isokinetic knee extensor peak torque. The possible neural factors that contributed to the improved muscular performance were evaluated by the stretch induced knee jerk reflex.

RESULTS

WBV training significantly enhanced the isokinetic knee extensor peak torque performance. Two-way mixed repeated measures analysis of variance revealed significant time effect of the changes in the peak torque (P=0.043) and the effect was significantly different between the intervention and control group (P=0.042). WBV did not affect vertical jump height, reflex latency of VL, EMGVL, and knee jerk angle.

CONCLUSION

The results of this study do not support the hypothesis that the improvement in the muscular performance when subjects exposed to WBV training is attributed by neuromuscular efficiency via modulation of the muscle spindle sensitivity.

Mindfulness and cognitive-behavioral interventions for chronic pain: differential effects on daily pain reactivity and stress reactivity

OBJECTIVE

This study compared the impact of cognitive-behavioral therapy for pain (CBT-P), mindful awareness and acceptance treatment (M), and arthritis education (E) on day-to-day pain- and stress-related changes in cognitions, symptoms, and affect among adults with rheumatoid arthritis (RA).

METHOD

One hundred forty-three RA patients were randomized to 1 of the 3 treatment conditions. CBT-P targeted pain-coping skills; M targeted awareness and acceptance of current experience to enhance coping with a range of aversive experiences; E provided information regarding RA pain and its management. At pre- and posttreatment, participants completed 30 consecutive evening diaries assessing that day's pain, fatigue, pain-related catastrophizing and perceived control, morning disability, and serene and anxious affects.

RESULTS

Multilevel models compared groups in the magnitude of within-person change in daily pain and stress reactivity from pre- to posttreatment. M yielded greater reductions than did CBT-P and E in daily pain-related catastrophizing, morning disability, and fatigue and greater reductions in daily stress-related anxious affect. CBT-P yielded less pronounced declines in daily pain-related perceived control than did M and E.

CONCLUSIONS

For individuals with RA, M produces the broadest improvements in daily pain and stress reactivity relative to CBT-P and E. These findings also highlight the utility of a diary-based approach to evaluating the treatment-related changes in responses to daily life.

A prospective cohort study of hamstring injuries in competitive sprinters: preseason muscle imbalance as a possible risk factor

BACKGROUND

Hamstring injuries are common in sprinters. Identifying preseason risk factors is essential to target injury-prone athletes and develop injury preventive measures.

OBJECTIVE

To investigate the incidence of hamstring muscle injury in sprinters over an athletic season and to explore the preseason predictor of this injury.

DESIGN

Prospective cohort study.

PARTICIPANTS

44 sprinters from the Hong Kong Sports Institute, the Hong Kong Amateur Athletic Association and intercollegiate athletic teams were recruited.

METHODS

Preseason assessment of hamstring flexibility, concentric and eccentric isokinetic peak torque and peak torque angle were obtained at the beginning of an athletic season. The athletes were followed over 12 months and were asked to report all injuries resulting from training and competition.

RESULTS

Eight athletes sustained hamstring injuries over the season. The injury rate was 0.87 per 1000 h of exposure. The incidence of injuries was higher at the beginning of the season, with 58.3% injuries occurring in the first 100 h of exposure. Cox regression analysis revealed that athletes with a decrease in the hamstring : quadriceps peak torque ratio of less than 0.60 at an angular velocity of 180 degrees/s have a 17-fold increased risk of hamstring injury.

CONCLUSION

Performing preseason hamstring : quadriceps peak torque ratio assessments may be useful to identify sprinters susceptible to hamstring injury.

Shift of Peak Torque Angle After Eccentric Exercise

This study aims to investigate the changes in the mechanical properties of quadriceps muscle following a sub-maximal concentric-eccentric stepping exercise protocol. Twenty-four untrained healthy subjects aged 21.9 +/- 0.55 years were asked to perform a 10-minute stepping exercise where the dominant leg worked eccentrically and the non-dominant leg worked concentrically at a rate of 15 cycles/min. The quadriceps isokinetic peak torque and the corresponding peak torque angle at angular velocity of 60 degrees /sec, and muscle soreness were determined at baseline, immediately after, day 1 and day 2 after the exercise protocol. Repeated measures of ANOVA showed no change in the peak torque after the eccentric exercise and concentric exercise (p > 0.05). There was a significant shift in the peak torque angle to longer muscle lengths in the eccentrically-exercised leg immediately (65.6 +/- 2.21 degrees ) and on the following two days after exercise (day 1: 68.3 +/- 2.71 degrees ; day 2: 67.4 +/- 2.51 degrees ) when compared with baseline (61.4 +/- 1.55 degrees , p < 0.05). These features were not observed in the concentrically-exercised leg. Eccentric exercise produced a higher level of soreness than concentric exercise at day 1 and 2 after the protocol. Submaximal eccentric exercise could bring about changes in the muscle properties resulting in a shift in the angle-torque relationship to longer muscle length without significant force deficit.

The 100-km ultradistance race in Hong Kong: physical fitness profile and team performance outcomes

AIM

The aim of this study was to determine different variables leading to a successful completion of a 100-km ultradistance team event.

METHODS

Regular physical activity patterns, self-perceptions of fitness level and physical fitness profile were determined in subjects (n=253) registered for Trailwalker 2000. The battery of fitness tests included cardiopulmonary fitness, flexibility, muscular strength, muscular endurance and body fat composition.

RESULTS

The physical fitness data reveals that the subjects in this study have an above average fitness level compared with the norm. There was association of self-perceived fitness with physical fitness parameters (P=0) and significant correlation of the total fitness score with the completion time (P=0.02). More importantly, the team member with the lowest fitness total score was correlated with the finish time at the event (P=0). Logistic regression model identified that total fitness score and years of experience in Trailwalker were predictive of a successful completion in the event (r=0.37; P=0.007). However, the low variance suggested that the selected physical fitness tests have low prediction sensitivity to characterize the specific population in the study.

CONCLUSIONS

There is a strong need to determine a combination of physical fitness tests that could accurately predict the performance of participants in the Trailwalker event.

Mechanisms of stretch-induced muscle damage in normal and dystrophic muscle: role of ionic changes

Muscle damage, characterized by prolonged weakness and delayed onset of stiffness and soreness, is common following contractions in which the muscles are stretched. Stretch-induced damage of this sort is more pronounced in the muscular dystrophies and the profound muscle damage observed in these conditions may involve similar pathways. It has been known for many years that damaged muscles accumulate calcium and that elevating calcium in normal muscles simulates many aspects of muscle damage. The changes in intracellular calcium, sodium and pH following stretched contractions are reviewed and the various pathways which have been proposed to allow ion entry are discussed. One possibility is that TRPC1 (transient receptor potential, canonical), a protein which seems to form both a stretch-activated channel and a store-operated channel, is the main source of Ca(2+) entry. The mechanisms by which the changes in intracellular ions contribute to reduced force production, to increased protein breakdown and to increased membrane permeability are considered. A hypothetical scheme for muscle damage which incorporates these ideas is presented.

Relationships of perceived benefits and barriers to physical activity, physical activity participation and physical fitness in Hong Kong female adolescents

AIM

Previous studies that examined participation in physical activity suggested that female adolescents were less active compared with males. However, the relationship between physical fitness, physical activity participation, and perceived benefits and barriers for physical activity to adolescents, irrespective of gender, has not been made clear. This study examines the association of these factors in female adolescents.

METHODS

Physical activity participation and perceived benefits and barriers to physical activity were determined in 206 secondary school female subjects (aged 11 to 18) using a validated questionnaire.

RESULTS

Subjects with a correct concept about optimal physical activity participation to maintain health engaged in an activity level higher than the group without a correct concept (t=2.37, p=0.02). A significant correlation was established between the physical activity participation with "health" (r=0.22, p<0.001) and "body image" (r=0.17, p=0.02) in the perceived benefit category. The individual factor, "make me feel better in general" in the "health" category (p=0.04) and the intention to participate (p<0.001) were shown to be significant predictors for physical activity participation. The combined effects of the regression model explained 35.9% of the variance in participation in physical activity.

CONCLUSION

Policies to support regular physical activity participation at school and out-of-school should be strategically developed and promoted, highlighting the promotion of health benefits in exercise and the reinforcement of initial intent towards exercise.

Effect of eccentric contraction-induced injury on force and intracellular pH in rat skeletal muscles

The effect of eccentric contraction on force generation and intracellular pH (pH(i)) regulation was investigated in rat soleus muscle. Eccentric muscle damage was induced by stretching muscle bundles by 30% of the optimal length for a series of 10 tetani. After eccentric contractions, there was reduction in force at all stimulation frequencies and a greater reduction in relative force at low-stimulus frequencies. There was also a shift of optimal length to longer lengths. pH(i) was measured with a pH-sensitive probe, 2',7'-bis-(2-carboxyethyl)-5(6)-carboxyfluorescein AM. pH(i) regulation was studied by inducing an acute acid load with the removal of 20-40 mM ammonium chloride, and the rate of pH(i) recovery was monitored. The acid extrusion rate was obtained by multiplying the rate of pH(i) recovery by the buffering power. The resting pH(i) after eccentric contractions was more acidic, and the rate of recovery from acid load post-eccentric contractions was slower than that from postisometric controls. This is further supported by the slower acid extrusion rate. Amiloride slowed the recovery from an acid load in control experiments. Because the Na(+)/H(+) exchanger is the dominant mechanism for the recovery of pH(i), this suggests that the impairment in the ability of the muscle to regulate pH(i) after eccentric contractions is caused by decreased activity of the Na(+)/H(+) exchanger.

A systematic review of interventions to prevent lower limb soft tissue running injuries

OBJECTIVES

To assess the available evidence for preventive strategies for lower limb soft tissue injuries caused by running.

METHODS

An electronic database search was conducted using The Cochrane Musculoskeletal Injuries Group Specialised Register, The Cochrane Controlled Trials Register, Medline, Embase, Sport Discus, Heracles, Atlantes, Biosis, Cinahl, Scisearch, Current Contents, Index To Theses and Dissertation Abstracts. Any randomised or quasi-randomised trials evaluating interventions to prevent running injuries to lower limb soft tissue were included. The eligibility of trials for inclusion and the quality of the trials were independently assessed by two reviewers.

RESULTS

Exposure to a high training load (duration, frequency, or running distance) increases the risk of injury, and thus modification of the training schedule can reduce the incidence of injury. The effectiveness of stretching exercises and of insoles in the prevention of lower extremity soft tissue injuries caused by running is not known. Wearing a knee brace with a patellar support ring may be effective in the prevention of anterior knee pain caused by running.

CONCLUSIONS

This review provides evidence for the effectiveness of the modification of training schedules in reducing lower limb soft tissue running injuries. More studies are required to quantify the optimal training loads and to confirm that knee braces can prevent knee pain. It is important to note that the studies included in this review had few female participants therefore the results may not be generalisable.

Marathon finishers and non-finishers characteristics. A preamble to success

BACKGROUND

To investigate if the characteristics and training profiles of runners are significant indicators to predict a successful completion of a marathon.

METHODS

EXPERIMENTAL DESIGN

comparative investigation between two groups of runners at a marathon race.

SETTING

participants of the study came from the 1998 Standard Chartered New Airport International Marathon in Hong Kong.

PARTICIPANTS

113 runners were investigated, of which 58 runners dropped out at the first 10 km of the race, while the other 55 were those that consulted for physiotherapy service after the marathon.

MEASURES

using questionnaire, the characteristics and the training profiles of these runners were obtained. These included weekly training distance, longest and shortest training distance per session in one week; warm-up and stretching exercise with the training sessions, number of marathons previously finished and the runners' opinion of optimal training mileage to complete a marathon.

RESULTS

Independent t-tests with Bonferroni adjustment were used to investigate the difference between the two groups, the results showed significant difference in the weekly training distance (p=0.00), longest and shortest training distance per week (p=0.00), and personal opinion on optimal weekly training distance for a marathon (p=0.00). Logistic regression modeling was then employed to determine variables that best predict the likelihood of completing a marathon.

CONCLUSIONS

The findings indicate that the non-finishers are poorly prepared and the results also identify that the longest mileage covered per training session is the best predictor for a successful completion of a marathon with an odds of 1.21.

Interventions for preventing lower limb soft-tissue injuries in runners

BACKGROUND

Overuse musculoskeletal injuries occur frequently in runners. Suggestions for prevention have focused on stretching exercises, modifying training schedules and the use of protective devices such as braces and insoles. To date, no systematic analysis of the literature on the effectiveness of these strategies in the prevention of overuse injuries has been published.

OBJECTIVES

The objective of the review was to evaluate the evidence from randomised controlled trials on the prevention of lower limb soft-tissue running injuries.

SEARCH STRATEGY

An electronic database search included The Cochrane Musculoskeletal Injuries Group specialised register (date of last search October 2000), The Cochrane Controlled Trials Register (The Cochrane Library, Issue 3, 1999), MEDLINE (from 1966), EMBASE (from 1980), SPORT Discus (1975-2000), HERACLES (1975-2000), ATLANTES (1980-1996), BIOSIS, CINAHL, SCISEARCH, Current Contents, Index To Theses and Dissertation Abstracts. Date of last search for these databses: May 2000.

SELECTION CRITERIA

Any randomised or quasi-randomised trials evaluating interventions to prevent lower limb soft-tissue running injuries.

DATA COLLECTION AND ANALYSIS

All trials fulfilling the selection criteria were assessed by two reviewers independently. Data were also extracted independently by the two reviewers using a pre-derived data extraction form. Exploratory analyses, including pooling of results from groups of trials of similar designs were undertaken, using a fixed effects model. Results were reported as relative risks (RR) with 95 per cent confidence intervals (95% CI).

MAIN RESULTS

Twelve trials with 8,806 participants were included. In one trial, a single control group was matched to three different included intervention groups. The effectiveness of stretching exercises (5 trials, 1944 participants in the intervention groups, 3159 controls), and of insoles and footwear modification (5 trials, 903 participants in the intervention groups, 3006 controls) in the prevention of lower extremity soft tissue injuries associated with running is unknown. Reducing the distance, frequency and duration of running may be effective in the prevention of lower extremity soft tissue injuries associated with running (3 trials, 514 participants in intervention groups, 1663 controls). Wearing a knee brace with a patellar support ring may be effective in the prevention of running-associated anterior knee pain (1 trial, 27 participants in the intervention group, 33 controls).

REVIEWER'S CONCLUSIONS

This review provides some evidence for the effectiveness of the modification of training schedules, but there is insufficient evidence to determine the effectiveness of stretching exercises for major lower limb muscle groups in reducing lower limb soft-tissue running injuries. More studies are required to confirm that knee braces may prevent knee pain, to clarify the role of stretching, and to quantify optimal training loads. Generalisability of the results may be limited by the intensive nature of military training (the context for most of the studies) and the inclusion of only small numbers of women.

Self-perceived exertion level and objective evaluation of neuromuscular fatigue in a training session of orchestral violin players

The aim of the study was to investigate the self-perceived exertion level and an objective measurement of muscle fatigue on violin players before and after a training session. Fourteen professional violin players volunteered in this study. Surveillance study was used to investigate the demographic characteristics, instrument playing background, playing habits variables and factors associated with playing-related musculoskeletal complaints (PRMCs). The subjective rating of the training-induced exertion was evaluated by the Borg scale ratings of perceived exertion (RPE). Surface electromyography (EMG) was used to record the fatigue level of the upper trapezius muscles before and after a training session. Medium frequency (MF) of the EMG signals was used to document the fatigue rate of this muscle. Descriptive statistics revealed a 79% prevalence rate of PRMCs with neck and shoulder region accounting for 57.1% of the areas reported. On the self-perceived exertion level associated with the training session, results indicated a significant increase in fatigue level (p = 0.003) after the training session. Regression analysis and paired samples t-tests revealed no significant difference in the slopes of MF on both sides of trapezius muscle, before and after the training sessions. The disparity in the subjective perception with the objective findings indicated that the violinists' self-perceived exertion arises from multiple sources. The high prevalence of PRMCs in this profession warrants further ergonomic investigation of possible work-related risk factors.

The impact of hospice inpatient care on the quality of life of patients terminally ill with cancer

This study explored the expectations and experiences of patients with terminal cancer in a hospice inpatient environment in an attempt to evaluate their quality of life and the impact of the care and services provided. A total of 52 patients terminally ill with cancer from 11 hospice units in Hong Kong participated in the study. Data were collected from patients by devising a Hospice Care Performance Inventory (HCPI), which was an interview schedule consisting of 25 items. The HCPI was developed after a review of the literature on the quality of life experienced by patients with advanced cancer and the aims of hospice units in Hong Kong. Each item was rated by the patient on a Likert scale in terms of its importance and the perceived effectiveness of the care provided. The study identified six issues in which expectations did not seem to match effectiveness. These issues indicated areas in which improvement could be attempted to enhance the quality of life for the patients. The most important was maximizing self-care and mobility. Two issues were identified in which effectiveness was high and importance to the patient relatively low. One of these issues was pain management, and the other was spiritual care.

Provision of physiotherapy at the Tsing Ma Bridge international marathon and 10 km race in Hong Kong

This report examines the delivery of sports physiotherapy at the Tsing Ma Bridge marathon and 10 km race in Hong Kong. The incidence, type of injury encountered, and treatment modalities selected are examined. The report also highlights the flexibility required when planning the provision of such a service.

Kibdelins (AAD-609), novel glycopeptide antibiotics. II. Isolation, purification and structure

A new glycopeptide antibiotic complex was isolated from the fermentation culture of Kibdelosporangium aridum subsp. largum (SK&F AAD-609) by affinity chromatography on a D-alanyl-D-alanine agarose column. This major components of the complex were resolved by preparative reversed-phase HPLC. Mild acid hydrolysis showed that the new antibiotics have the same mannosyl aglycon (2) as the aridicins. FAB mass spectrometry, isoelectric focusing, potentiometric titration and carbohydrate and fatty acid analyses were used to determine the structures of the five major components of the complex. These studies showed that the kibdelins differ from the aridicins only in the oxidation level at the C-6 position of the amino sugar. Kibdelin A (5), B (6), C1 (7), C2 (8) and D (9) are a series of N-acylglucosamine analogs containing saturated straight and branched chain C10-C12 fatty acids whereas, in kibdelin D the fatty acid component is (Z)-4-decenoic acid.