Some Problems in the Measurement of Stress and Social Readjustment

Abstract

Although the Social Readjustment Rating Scale has been a useful stimulant to the study of life change and illness, it has important limitations. The existing scale cannot be used to determine the role of varying types of life changes (e.g., favorable or adverse) in the occurrence of illness. Other problems discussed are ambiguity of items, the confounding of independent and dependent variables, and lack of item specification. Suggestions are made for improved measurement of life change and for more effective study of life change and illness.     

Relationship of Life Stress to Injury in Intercollegiate Volleyball

Abstract

The present study examined whether male and female National Collegiate Athletic Association (NCAA) Division I intercollegiate volleyball players with high life stress would be at greater risk for the occurrence of injury. Life stress was measured with the Social and Athletic Readjustment Rating Scale (SARRS) and the Athletic Life Experiences Survey (ALES). Regardless of how the data were analyzed (injured v non-injured, high stress v low stress, severity of injury), no relationship was found between life stress and injury, indicating that previous findings for football players were not duplicated for intercollegiate volleyball players. Also, different levels of coping resources among volleyball players did not mediate the life stress to injury rate but did differentiate injured from noninjured players.     

Life Stress and Athletic Injury: Examination of Positive versus Negative Events and Three Moderator Variables

Abstract

A modified version of the Life Experiences Survey (LES) was used to examine the relationship between positive and negative life change and subsequent athletic injury among 104 collegiate varsity football players drawn from two teams. The findings from Team One indicated that players who incurred a significant time-loss injury had experienced greater negative—but not positive—life changes in the previous twelve months than noninjured players. Further, injured players tended to have higher object loss scores than noninjured players. No between-group differences were found for Team Two. Trait anxiety, competitive trait anxiety, and locus of control were examined as possible moderator variables in the life change—injury relationship, and were found to have no significant effects. While partially supporting past research, the findings indicate that more work on the stress—injury relationship is needed before life change measures can contribute to the assessment of athletes' injury potential.     

Epidemiology of Injuries in National Collegiate Athletic Association Men's Football: 2014–2015 Through 2018–2019

ContextFootball is among the most popular collegiate sports in the United States, and participation in National Collegiate Athletic Association (NCAA) football has risen in recent years.BackgroundContinued monitoring of football injuries is important for capturing the evolving burden of injuries in NCAA football. The purpose of this study was to describe the epidemiology of football-related injuries among men''s NCAA football players during the 2014–2015 through 2018–2019 academic years.MethodsExposure and injury data collected in the NCAA Injury Surveillance Program were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differential injury rates.ResultsThe overall injury rate was 9.31 per 1000 athlete-exposures. Most injuries occurred during general play (17.5%), blocking (15.8%), and tackling (14.0%). Concussions (7.5%), lateral ligament complex tears (6.9%), and hamstring tears (4.7%) were the most commonly reported injuries.ConclusionsResults of this study were generally consistent with previous findings, though changes over time in rates of commonly reported injuries warrant attention. Continued monitoring of injury incidence is needed to appraise the effectiveness of recently implemented rules changes.     

The effect of playing surface on the incidence of ACL injuries in National Collegiate Athletic Association American Football

BackgroundArtificial playing surfaces are widely used for American football practice and competition and anterior cruciate ligament (ACL) injuries are common. This study analyzed the National Collegiate Athletic Association (NCAA) Injury Surveillance System (ISS) men's football ACL injury database from 2004–2005 through 2008–2009 to determine the effect of playing surface on ACL injury in NCAA footballathletes.MethodsThis database was reviewed from the 2004–2005 through 2008–2009 seasons using the specific injury code, “Anterior cruciate ligament (ACL) complete tear.” The injury rate was computed for competition and practice exposures. Ninety-five percent confidence intervals were calculated using assumptions of a Poisson distribution. Pair-wise, two-sample tests of equality of proportions with a continuity correction were used to estimate the associations of risk factors.ResultsThere was an incidence rate of 1.73 ACL injuries per 10,000 athlete-exposures (A-Es) (95% CI 1.47–2.0) on artificial playing surfaces compared with a rate of 1.24 per 10,000 A-Es (1.05–1.45, p < 0.001) on natural grass. The rate of ACL injury on artificial surfaces is 1.39 times higher than the injury rate on grass surfaces. Non-contact injuries occurred more frequently on artificial turf surfaces (44.29%) than on natural grass (36.12%).ConclusionsNCAA football players experience a greater number of ACL injuries when playing on artificial surfaces.     

National Collegiate Athletic Association Division I Football Players' Perceptions of Women in the Athletic Training Room Using a Role Congruity Framework

Context:

Previous researchers have demonstrated that male and female athletes feel more comfortable with treatment by a same-sex athletic trainer for sex-specific injuries and conditions.

Objective:

To address football players'' comfort with care provided by same-sex and opposite-sex athletic trainers for sex-specific and non–sex-specific injuries and conditions through the lens of role congruity theory.

Design:

Cross-sectional study for the quantitative data and qualitative study for the qualitative data.

Setting:

Two National Collegiate Athletic Association Division I Football Bowl Series university football programs.

Patients or Other Participants:

Male football players within the 2 university programs.

Data Collection and Analysis:

We replicated existing methods and an existing survey to address male football players'' comfort levels. Additionally, an open-ended question was used to determine male football players'' perceptions of female athletic trainers. Paired-samples t tests were conducted to identify differences between the responses for the care given by a male athletic trainer and for the care given by a female athletic trainer. Three categories were analyzed: general medical conditions, psychological conditions, and sex-specific injuries. The qualitative data were coded and analyzed using content analysis.

Results:

Male football players were more comfortable with treatment by a male athletic trainer (mean  =  3.61 ± 1.16) for sex-specific injuries and conditions than they were with treatment by a female athletic trainer (mean  =  2.82 ± 1.27; P < .001). No significant results were found for comfort with overall psychological conditions, although a female athletic trainer was preferred over a male athletic trainer for the treatment of depression (mean  =  3.71 ± 1.07 versus mean  =  3.39 ± 1.16, respectively; P < .001). Qualitative data provided support for role congruity theory.

Conclusions:

Both quantitative and qualitative evidence were provided for the support of role congruity theory.     

Endoscopist specialty is associated with high-quality endoscopy in Korea

Purpose

The present study was aimed to determine whether endoscopist specialty is associated with high-quality endoscopy.

Materials and Methods

We prospectively collected endoscopy quality related data based on the Endoscopy Quality Rating Scale (EQRS) of 277 endoscopy units in a hospital setting from the National Cancer Screening Program of Korea in 2009. Gastroenterology medical professors (n=154) from university hospitals visited each endoscopy unit and graded the unit according to the EQRS. The scores from the EQRS were analyzed and compared in relation to endoscopy training during residency and endoscopy subspecialist certification.

Results

After excluding data from 3 endoscopy units, EQRS data from 274 endoscopy units were analyzed: 263 esophagogastroduodenoscopy (EGD) screening units and 90 colonoscopy screening units. There were no significant differences in the scores of EQRS with respect to endoscopy training during residency (p=no significance), except for scores of EGDs for "Facility and Equipment" (p=0.030). However, EQRS scores were significantly higher in the endoscopy units where endoscopy subspecialists performed the endoscopies than those where Endoscopy Subspecialists did not perform the endoscopies (p<0.05, except p=0.08 for the "Process" criteria of EGD).

Conclusion

Endoscopist specialty is an important determinant of high-quality endoscopy in Korea.     

Life Change and Lung Cancer

Abstract

Seventy-four lung cancer patients were studied with the Social Readjustment Rating Scale. There was a significantly higher association of recent life change with younger cancer patients than with older ones. There was no such difference in a control group of colorectal cancer patients. These results imply that lung cancer patients fall into two groups: a younger group, in which life change is a promoting factor, and an older group, in which life change has little or no effect in precipitating the onset of the disease.     

Genu varum and football participation: Does football participation affect lower extremity alignment in adolescents?

BackgroundGenu varum is one of the most common anatomical variations of knee alignment which is considered a risk factor for anterior knee pain and anterior cruciate ligament injury among football players. Considering that millions of children participate in high-level football training, the purpose of this study was to determine the genu varum development in adolescent football players and non-athlete peers. The hypothesis of this study was that genu varum incidence was higher in adolescent football players compared with non-athletic peers.MethodsThe design was a cross-sectional study. Two-hundred and thirty-seven male football players (FG) and aged-matched and anthropometrically similar non-athletes (CG) were recruited into the study. The quadriceps angle and intercondylar–intermalleolar distance were measured to evaluate the leg alignment. The distance between the medial edges of the condyles and malleoli was measured in millimeters using a digital caliper while angle measurements were performed using a photographic technique in a standing position. To analyze the variables, comparison, correlation and regression statistical tests were performed.ResultsThe intercondylar–intermalleolar distance and quadriceps angle values were significantly higher in FG than CG in all ages. In FG, a very strong correlation was found between number of training years and the intercondylar–intermalleolar distance. The prevalence of genu varum was markedly higher in FG than CG (~37% vs. 2%, respectively) based on intercondylar–intermalleolar distance.ConclusionThis study determined that the prevalence of genu varum and abnormal quadriceps angles in adolescent football players is significantly higher compared with their non-athletic peers.     

Comparative analysis of anxiety/depression scores in COVID-19 patients with disease severity,sleep patterns,and certain laboratory test results

IntroductionCoronavirus disease 2019 (COVID-19) is associated with severe emotional changes. This research aims to investigate the prevalence of anxiety and depression in COVID-19 patients and its relationship with disease severity, sleep patterns, lifestyle, and specific laboratory test results.Material and methodsAn observational study of 52 Chinese patients with COVID-19 was conducted to assess the relation between anxiety and depression (evaluated with the Hospital Anxiety and Depression Scale) and laboratory findings (lymphocytes, C-reactive proteins, leukocytes, alanine aminotransferase, aspartate aminotransferase). The relationships between the severity of COVID-19 in patients, the Insomnia Severity Index (ISI) score, and the Hospital Anxiety and Depression Scale (HADS) score were also investigated.ResultsThere were statistically significant associations between disease, smoking, and HADS-A scores (p = 0.011/0.020). The HADS-D score of patients with the disease was higher than in those without a past medical history (p = 0.008). The difference in C-reactive protein (CRP) between different lung infections, the HADS-A and HADS-D scores between different ages and ISI groups, and the correlation between the two scores were statistically significant.ConclusionsAnxiety and depression are associated with poor sleep quality, smoking, and past medical history in patients with COVID-19. Additionally, anxiety and depression were seen to coexist, and there was a positive correlation between them. Further, the inflammatory index CRP was significantly increased in bilateral lung infections.     

Development of a coronavirus social distance attitudes scale

ObjectiveOur goal was to develop a scale to assess social distance attitudes related to COVID-19.MethodsWe performed an online national survey of US adults (n = 1,074) to assess social distance attitudes, COVID-19 related beliefs and behaviors, and demographics. We assessed scale structure using confirmatory factor analysis and evaluated internal consistency and validity. We assessed association of scale factors with respondent characteristics.ResultsConfirmatory factor analysis supported a hypothesized two-factor solution. Internal consistency was high for both positive (Alpha = 0.92) and negative (Alpha = 0.91) attitude factors. Analyses supported construct and predictive validity with expected associations between scale factors and perceived norms and behavior (e.g. trips out of the home). We found an interaction suggesting that holding highly negative attitudes reduced the effect of holding positive beliefs. Both attitude factors were related to age, gender, race/ethnicity, and political affiliation. Perceived COVID-19 risk (to others but not for self) and perceived severity were consistently associated with higher positive and lower negative attitudes.ConclusionThis COVID-19 Social Distance Attitude Scale contains positive and negative factors with high internal consistency and construct and predictive validity.Practice implicationA greater understanding and ongoing assessment of COVID-19 social distance attitudes could inform policymakers, researchers, and clinicians who seek to promote protective social distance behaviors.     

Early Results of a Helmetless-Tackling Intervention to Decrease Head Impacts in Football Players

ObjectiveTo test a helmetless-tackling behavioral intervention for reducing head impacts in National Collegiate Athletic Association Division I football players.DesignRandomized controlled clinical trial.SettingFootball field.Intervention(s)The intervention group participated in a 5-minute tackling drill without their helmets and shoulder pads twice per week in the preseason and once per week through the season. During this time, the control group performed noncontact football skills.ResultsHead impacts/AE decreased for the intervention group compared with the control group by the end of the season (9.99 ± 6.10 versus 13.84 ± 7.27, respectively). The intervention group had 30% fewer impacts/AE than the control group by season''s end (9.99 ± 6.10 versus 14.32 ± 8.45, respectively).ConclusionA helmetless-tackling training intervention reduced head impacts in collegiate football players within 1 season.Key Words: injury prevention, athletic injuries, head and neck injuries

Key Points

• Given proper training, education, and instruction, collegiate football players can safely perform supervised tackling and blocking drills in practice without helmets.
• Helmetless tackling eliminates the false sense of security a football player may feel when wearing a helmet.
• Younger football players and those with less experience may require modifications to the intervention to realize a positive effect. More research is needed on players at these levels before widespread implementation.

Head impacts in football players are directly associated with brain and spine injury, have been proposed to be associated with chronic injuries such as chronic traumatic encephalopathy, and have become a national concern. High school and college football participants can experience more than 1000 head impacts in a single season.^1,2 Youth football players may sustain more than 100 impacts in a season, with linear acceleration greater than 80g reported.³ To mitigate the risk of head-impact injury, researchers, league officials, and administrators have sought to improve helmet technology, reduce the number of allowable contact practices, and alter game rules. Although each of these factors has merit, none directly address the common fundamental cause: impacts to the head. In fact, current efforts directed at improving helmet technology may promote a false sense of security⁴ and perpetuate the use of the head as a point of contact during play.^1,5To directly address these concerns, we initiated a study to investigate the effectiveness of a helmetless-tackling behavioral intervention to reduce head-impact exposure in a National Collegiate Athletic Association Division I football program. We share important findings on our primary variable of interest after the first year of data collection.     

Distal Medial Collateral Ligament Grade III Injuries in Collegiate Football Players: Operative Management,Rehabilitation, and Return to Play

ContextManagement of isolated grade III medial collateral ligament injuries is controversial, as both nonoperative and operative management can result in return to play. However, operative management is recommended in elite athletes who have a grade III injury with distal avulsion.ObjectiveWe present a standardized rehabilitation protocol in a case series of 7 National Collegiate Athletic Association Division I American football athletes who sustained grade III distal medial collateral ligament tears that were repaired operatively, with emphasis on return to play.ResultsMedian time to surgery was 4 days (range = 2–67 days). Median time from surgery to noncontact drills was 120.5 days (range = 104–168 days), and median time from surgery to full-contact sport was 181 days (range = 139–204 days). All athletes returned to play at their preinjury level of competition.ConclusionsOur study highlighted how operative management with a standardized rehabilitation protocol can be applied to Division I football players and result in safe return to play.     

National Athletic Trainers' Association Position Statement: Head-Down Contact and Spearing in Tackle Football

OBJECTIVE: To present recommendations that decrease the risk of cervical spine fractures and dislocations in football players. BACKGROUND: Axial loading of the cervical spine resulting from head-down contact is the primary cause of spinal cord injuries. Keeping the head up and initiating contact with the shoulder or chest decreases the risk of these injuries. The 1976 rule changes resulted in a dramatic decrease in catastrophic cervical spine injuries. However, the helmet-contact rules are rarely enforced and head-down contact still occurs frequently. Our recommendations are directed toward decreasing the incidence of head-down contact. RECOMMENDATIONS: Educate players, coaches, and officials that unintentional and intentional head-down contact can result in catastrophic injuries. Increase the time tacklers, ball carriers, and blockers spend practicing correct contact techniques. Improve the enforcement and understanding of the existing helmet-contact penalties.     

潜艇官兵社交回避及苦恼的心理社会因素研究

目的探讨导致潜艇官兵社交回避及苦恼的心理社会因素。方法对568名潜艇官兵进行量表测评,包括社交回避及苦恼量表、卡特尔16种人格因素问卷、生活事件量表、特质应对问卷、领悟社会支持量表、症状自评量表。数据采用SPSS15.0软件包进行统计分析。结果潜艇官兵社交回避(SA)和社交苦恼(SD)分值均显著低于国内大学生常模(SA:t=-3.28,P<0.01;SD:t=-2.24,P<0.05);不同衔级(SA:F=13.02,P<0.01;SD:F=5.58,P<0.01)、文化程度(SA:F=3.94,P<0.05;SD:F=3.77,P<0.05)、婚姻状况(SA:t=-5.22,P<0.01;SD:t=-2.63,P<0.01)潜艇官兵的社交焦虑状况比较存在显著差异;潜艇官兵社交回避及苦恼与个性、生活事件、特质应对、社会支持、心理健康水平有显著相关性;多元回归分析显示,人际关系敏感、敢为性、消极应对方式和兴奋性对社交回避行为的影响较大(标准回归系数依次为-0.274-、0.246、0.230-、0.227);敢为性、强迫症状、积极应对方式和敌对对社交苦恼情感的影响较大(标准回归系数依次为-0.332-、0.305-、0.300-、0.258)。结论个性、生活事件、特质应对、社会支持和心理健康水平等心理社会因素影响潜艇官兵社交回避及苦恼。     

Assessment of subjective sleep disturbance and related factors during female mid-life with the Jenkins Sleep Scale

Objective

To assess sleep disturbance and related factors among mid-aged women.

Methods

This was a cross-sectional study in which 288 women (40–59 years) were requested to complete the Jenkins Sleep Scale (JSS), the 12-item General Health Questionnaire (GHQ-12), the Menopause Rating Scale (MRS) and a general socio-demographic questionnaire containing female and partner data.

Results

Median [interquartile range] age of the whole sample was 47 [8] years. A 62.2% of women were rural residents, 21.2% were postmenopausal, 20.1% were receiving psychotropic drugs, 64.2% had abdominal obesity (waist ≥ 88 cm), and 9.7% reported intimate violence. A 12.8% had an abnormal GHQ-12 score (total score ≥ 3) whereas 14.2% had severe menopause-related symptoms (total MRS score ≥ 17). The prevalence of disturbed sleep (JSS score ≥ 12) was 37.5%. JSS scores displayed significant differences in relation to menopausal status, presence of stress urinary incontinence, use of psychiatric treatment, intimate partner violence, self-perception of healthiness, and partner factors (perception of healthiness, educational level, and regular exercise). Higher JSS scores (disturbed sleep) positively correlated with GHQ-12 and MRS scores, number of co-morbid conditions, body mass index, and female and partner age. Multiple linear regression analysis found that JSS scores correlated positively with somatic MRS scores and with intimate violence, and inversely with partner educational level (r² = 0.375, p < 0.05).

Conclusion

In this mid-aged female sample, disturbed sleep was related to somatic menopause-related symptoms, intimate violence and partner educational level.     

Effects of second-hand smoking on lung functions in athlete and non-athlete school-aged children – observational study

BackgroundSecond-hand smoking or environmental tobacco smoke is a critical health risk. Children are the most vulnerable to second-hand smoking because of their small bronchial ducts, less developed immunity, and low-physical activity.ObjectivesThe purpose of this study was to ascertain the effects of second-hand smoking on lung functions in athlete and non-athlete school-aged children.MethodsThis observational study included forty-six school-aged children, their age was 8–15 years, assigned to three groups; 2 study groups and 1 control group (n=15). The study groups comprised of 16 football players, and of 15 cyclists. Lung functions were evaluated recording forced vital capacity, forced expiratory volume in 1 sec and peak expiratory flow using digital spirometer.ResultsAll measures were recorded in definite values and the children were also classified into second-hand smoking (SH), or non-exposed to tobacco smoking (NE). The findings presented a significant increase (p<0.05) of the study groups in forced vital capacity, forced expiratory volume in 1 sec and peak expiratory flow solely for the non-exposed children. However, there were non-significant differences between the cyclists and football players or between the passive smoking children and non-exposed children in any of the two study groups (p>0.05).ConclusionThe outcomes of this study suggest beneficial influences of the sports activity on the lung functions, without different influences of the cyclists and football players on the lung functions.     

Bio-banding in academy football: player’s perceptions of a maturity matched tournament

Abstract

Background: Individual differences in biological maturation impact player selection and development in youth football.

Aim: To evaluate players perceptions of competing in a football tournament where they were matched by maturity rather than chronological age.

Subjects: Participants included male junior footballers from three professional academies (n?=?115).

Methods: The study employed multiple methods of analysis, including one sample mean t-tests, equivalence tests, ANOVAs, and thematic analysis of qualitative data derived from open-ended questions.

Results and conclusions: Player’s perceived the bio-banding format as providing two main benefits. Early maturing players perceived greater physical and technical challenge, and in turn new opportunities and challenges. Late maturing players perceived less physical and technical challenge, yet greater opportunity to demonstrate technical and tactical abilities. The players reported that they enjoyed and understood the purpose of the bio-banded format, and perceived less risk for injury. Players in all three maturity groups reported more opportunity to engage in leadership behaviours, influence game-play, and express themselves on the ball in the bio-banded format. Bio-banding may facilitate development for both early and late maturing academy players by presenting new learning environments and challenges.     

大学生社交焦虑与成人依恋类型关系的研究

目的探讨大学生社交焦虑与成人依恋类型的关系。方法以整群抽样的方式选取大学生324名,用Liebowitz社交焦虑量表（LSAS）、亲密关系体验问卷（ECR-R）、社交苦恼与回避量表（SAD）、自尊量表（SES）、信任量表（TS）和惧怕否定评价量表（FNE）进行测查。结果324名大学生社交焦虑阳性筛查率30.6%。不安全型依恋对社交焦虑阳性的影响作用是对照组的2.45倍。不安全型依恋中恐惧型对社交焦虑的影响作用最大,是对照组的5.59倍;迷恋型次之,为2.10倍。不同依恋类型社交焦虑阳性的被试在社交苦恼、惧怕负性否定评价、自尊和信任他人方面有显著差异。结论大学生成人依恋类型是社交焦虑的重要影响因素。不安全型依恋,尤其是恐惧型对社交焦虑的情绪、认知影响最大。