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Purpose: To gather information on practices and perceptions of high-performance experts regarding their athletes' muscle fiber-type composition (MFTC) and its estimation. Methods: A questionnaire on the noninvasive versus invasive estimation of MFTC was completed by 446 experts including coaches and sport-science/sports-medicine staff. Moreover, the perceived importance of MFTC for training and performance optimization was assessed. Differences between sport types (individual and team sports) were analyzed using chi-square tests. Results: Forty percent of the experts implemented MFTC assessment in pursuit of performance optimization, while 50% did not know their athletes' MFTC but expressed a desire to implement it if they would be able to assess MFTC. Ten percent did not perceive value in MFTC assessment. Only 18% of experts believed that their athletes would undergo a muscle biopsy, leading to the adoption of alternative noninvasive techniques. Experts primarily relied on their experience to estimate MFTC (65%), with experts working in individual sports using their experience more frequently than those working in team sports (68% vs 51%; P =.009). Jump tests emerged as the second-most commonly employed method for estimating MFTC (56%). When only considering experts who are currently using MFTC, 87% use MFTC to individualize training volume and 84% to individualize training intensity. Conclusions: Experts value MFTC assessment primarily to individualize training but mainly rely on noninvasive methods to estimate MFTC. Some of these methods lack scientific validity, suggesting a continuing need for education and further research in this area. [ABSTRACT FROM AUTHOR]

Several institutional aspects within the U.S. public school system impede the delivery of adapted physical education (APE) services to disabled children, including a lack of understanding and prioritization of these services by the special education team and a lack of qualified APE professionals to deliver these services. Thus, we conducted a qualitative inquiry grounded in a critical-ableism perspective to explore special education gatekeepers' experiences and perspectives of APE. Gatekeepers included parents, physical educators, and school administrators. Using a reflexive thematic analysis, we developed four interrelated themes: (a) disregard, negative, and charity mindsets toward disability; (b) systemic challenges in valuing and prioritizing APE; (c) presence as inclusion: (un)intentional marginalization in physical education; and (d) physical education for my child was a nightmare. These findings illustrate the complexities around the provision of physical education and APE to disabled children. [ABSTRACT FROM AUTHOR]

This study sought to understand the lived experiences of wheelchair basketball athletes from low- and middle-income countries of recent or current armed conflict and the meaning that they ascribed to their participation. Wheelchair basketball athletes (N = 108) from eight national teams participated in semistructured focus-group interviews. Study data were analyzed thematically using an interpretive descriptive approach. Three themes were developed: "I can do anything I want; not only basketball," self-concept changes through sport participation; "Now they see me as a respectable person," societal belonging through sport; and "I have motivated other disabled people," influence on nonparticipating disabled persons. The findings indicated that participation in wheelchair sports may help disabled persons see themselves as capable individuals on the court and in aspects of daily living, perhaps even peer role models for other disabled persons in their communities and countries. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to investigate the effects of morning versus evening plyometric training (PT) on performance adaptations in male volleyball players. Methods: A total of 30 collegiate national-level young male volleyball players (age = 21.9 [2.1]; height = 186 [4.1]; body mass = 82.4 [4.6]) were randomly divided into 3 groups: morning PT (MPT), evening PT (EPT), and an active control group, each group consisting of 10 subjects. The players engaged in PT sessions twice weekly for a period of 6 weeks. The evaluation of biomotor abilities such as countermovement vertical jump, standing long jump, spike jump, block jump, 10-m sprint, T-test, sit and reach, and Y-balance test took place in the morning and evening before and after the intervention. Results: Both the MPT and EPT groups indicated significant (P <.05) improvements in all biomotor abilities from pretraining to posttraining during both the morning and evening testing sessions. Furthermore, the MPT group displayed greater adaptive responses in the vertical jump (P =.001), standing long jump (P =.023), and Y-balance test (P ≤.01) compared to the EPT group. Time-of-day fluctuations were the same between the MPT and EPT groups at the pretest. Conversely, EPT demonstrated significantly more daytime variations than MPT in the jump, sprint, and balance tests at postintervention (P <.05). Conclusion: Engaging in PT at specific times of the day has a significant impact on biomotor ability adaptations, with a focus on morning being more favorable than the evening for achieving greater gains in jump and balance performance of volleyball players. [ABSTRACT FROM AUTHOR]

Purpose: Travel fatigue impacts cognitive and physiologic systems, but its association with elite soccer match performance is unclear. In this retrospective observational study, we aimed to explore the association between travel and match outcomes in elite North American soccer. Methods: Travel data and match outcomes (team points or goals scored and conceded) and physical performance outcomes from 26 elite professional soccer teams and their players were analyzed (148 matches [team-based data] and 1252 player matches from 297 players; age 22.7 [4.5] y). Player- and match-level correlations between performance measures and both acute and cumulated travel metrics were analyzed. Results: Cumulative travel metrics were positively associated with team (travel distance [r =.20; 95% CI,.03–.25], travel time [r =.20;.06–.37], and time away [r =.20;.06–.37]) and individual player (travel distance, [r =.14;.08–.19], travel time [r =.17–.23], and time away [r =.13;.07–.18]) high-intensity running. Cumulative time away was negatively associated with team points (r = −.14; −.28 to −.001) and positively associated with goals conceded (r =.14;.01–.27); no clear association between acute travel metrics and match outcomes or physical performance was observed. Conclusions: As travel cumulated, away teams and their players ran more but for less reward (team points), although the magnitude of these associations was small. These data are exploratory and do not imply a causal relationship; however, further research should consider cumulation of travel. [ABSTRACT FROM AUTHOR]

Little is known about physical activity (PA) and sedentary behavior (SB) among nursing home residents although PA is known as a health promoter. This study examined PA, SB, and their predictors among nursing home residents (n = 63). Dependent variables were accelerometry-based PA and SB. Predictor variables included in a path analysis were age, sex, body mass index, Barthel Index, cognitive status (Mini-Mental State Examination), physical performance (hand grip strength and habitual walking speed), and well-being (World Health Organization-5 well-being index). PA was very low (M steps per day = 2,433) and SB was high (M percentage of sedentary time = 89.4%). PA was significantly predicted by age (β = −0.27, p =.008), body mass index (β = −0.29, p =.002), Barthel Index (β = 0.24, p =.040), and hand grip strength (β = 0.30, p =.048). SB was significantly predicted by body mass index (β = 0.27, p =.008) and Barthel Index (β = −0.30, p =.012). Results might be helpful for everyday practice to identify individuals at high risk for low PA and high SB. [ABSTRACT FROM AUTHOR]

Purpose: To describe how high-level European sprint coaches (from 100 to 400 m) work to improve important factors associated with the quality of the holistic training process and the quality of the specific training session. Methods: A descriptive analysis was conducted using questionnaires from 31 European elite sprint coaches (ie, training athletes defined as tiers 3, 4, and 5) who participated voluntarily. Results: The coaches used traditional periodization (45%) with a 10- to 15-day tapering phase (48%) that includes a reduction in volume, maintenance of intensity, and focus on correct technical execution. In the 3 mesophases, coaches prioritized the basic development of strength and sprint work in the first phases of the season and emphasized more sprint-specific work in the competitive phase. Before sessions, adjustments were made based on factors such as psychological (77%), technical (48%), and physical (39%) parameters. In-session load management relies on a combination of objective and subjective measures (55%), in which the dialogue with athletes (65%) was regarded as the main resource. Feedback during and after sessions covers technical (54%), psychological (48%), and physical (35%) aspects. Recovery protocols after sessions mainly involve rest and professional guidance (42%). For performance assessment and testing, coaches utilize countermovement jump (52%), force–velocity profile (45%), and 30-m flying (61%) as main tools. Conclusions: European sprint coaches demonstrated a comprehensive approach to planning and management, shedding light on the multifaceted nature of their training methodologies and the diverse tools employed for athlete testing and monitoring. [ABSTRACT FROM AUTHOR]

Introduction: In distance running, pacing is characterized by changes in speed, leading to runners dropping off the leader's pace until a few remain to contest victory with a final sprint. Pacing behavior has been well studied over the last 30 years, but much remains unknown. It might be related to finishing position, finishing time, and dependent on critical speed (CS), a surrogate of physiologic capacity. We hypothesized a relationship between CS and the distance at which runners "fell behind" and "let go" from the leader or were "outsprinted" as contributors to performance. Methods: 100-m split times were obtained for athletes in the men's 10,000-m at the 2008 Olympics (N = 35). Split times were individually compared with the winner at the point of "falling behind" (successive split times progressively slower than the winner), "letting go" (large increase in time for distance compared with winner), or "outsprinted" (falling behind despite active acceleration) despite being with the leader with 400 m remaining. Results: Race times ranged between 26:55 and 29:23 (world record = 26:17). There were 3 groups who fell behind at ∼1000 (n = 11), ∼6000 (n = 16), and ∼9000 m (n = 2); let go at ∼4000 (n = 10), ∼7000 (n = 14), and ∼9500 m (n = 5); or were outkicked (n = 6). There was a moderate correlation between CS and finishing position (r =.82), individual mean pace (r =.79), "fell behind" distance (r =.77), and "let go" distance (r =.79). D′ balance was correlated with performance in the last 400 m (r =.87). Conclusions: Athletes displayed distinct patterns of falling behind and letting go. CS serves as a moderate predictor of performance and final placing. Final placing during the sprint is related to preservation of D′ balance. [ABSTRACT FROM AUTHOR]

Purpose: To quantify the change in session rating of perceived exertion training impulse (RPE-TRIMP) that may occur in response to increased running distance at 3 running velocity ranges in elite sprinters. Methods: We monitored training load in elite sprinters (women: n = 7; men: n = 11) using wearable Global Positioning System technology and RPE-TRIMP for a total of 681 individual training sessions during a 22-week competition-preparation period. Internal training load was operationalized by RPE-TRIMP, and external training load was operationalized by distance covered in 3 velocity ranges. A linear mixed-effects model with athlete as a random effect was fit to RPE-TRIMP with total distance covered at ≤69.99% (low-velocity running [LVR]), 70% to 84.99% (high-velocity running [HVR]), and 85% to 100% (very-high-velocity running [VHVR]) of individual maximum velocity. Results: Increased running distance in all 3 velocity ranges (LVR, HVR, and VHVR) resulted in a significant (P <.001) increase in RPE-TRIMP. Coefficients (95% CIs) were.10 (.08–.11) for LVR,.23 (.18–.28) for HVR, and.44 (.35–.53) for VHVR. A 50-m increase in running distance covered in the LVR, HVR, and VHVR velocity ranges was associated with increases in RPE-TRIMP of 5, 11.5, and 22 arbitrary units, respectively. Conclusions: Internal training load, calculated as RPE-TRIMP, increased with increases in total distance covered in the LVR, HVR, and VHVR velocity ranges (P <.001). RPE-TRIMP can be a practical solution for monitoring global training-session load in elite sprinters. [ABSTRACT FROM AUTHOR]

Objective: To (1) establish extensive physiological profiles of highly trained CrossFit® athletes using gold-standard tests and (2) investigate which physiological markers best correlate with CrossFit Open performance. Methods: This study encompassed 60 participants (30 men and 30 women), all within the top 5% of the CrossFit Open, including 7 CrossFit semifinalists and 3 CrossFit Games finalists. Isokinetic dynamometers were employed to measure maximum isometric and isokinetic leg and trunk strength. Countermovement-jump height and maximum isometric midthigh-pull strength were assessed on a force plate. Peak oxygen uptake (VO2peak) was measured by a cardiopulmonary exercise test, and critical power and W′ were evaluated during a 3-minute all-out test, both on a cycle ergometer. Results: Male and female athletes' median (interquartile range) VO2peak was 4.64 (4.43, 4.80) and 3.21 (3.10, 3.29) L·min−1, critical power 314.5 (285.9, 343.6) and 221.3 (200.9, 238.9) W, and midthigh pull 3158 (2690, 3462) and 2035 (1728, 2347) N. Linear-regression analysis showed strong evidence for associations between different anthropometric variables and CrossFit Open performance in men and women, whereas for markers of cardiorespiratory fitness such as VO2peak, this was only true for women but not men. Conventional laboratory evaluations of strength, however, manifested minimal evidence for associations with CrossFit Open performance across both sexes. Conclusions: This study provides the first detailed insights into the physiology of high-performing CrossFit athletes and informs training optimization. Furthermore, the results emphasize the advantage of athletes with shorter limbs and suggest potential modifications to CrossFit Open workout designs to level the playing field for athletes across different anthropometric characteristics. [ABSTRACT FROM AUTHOR]

Assessment of player's postural control following a lower limb injury is of interest to sports medicine practitioners due to its fundamental role in daily tasks and sporting activities. The aim was to longitudinally monitor professional rugby union players' postural control during each phase of the rehabilitation program (acute, middle, and late) following a lower limb injury. Seven male rugby union players (height 1.80 [0.02] m; mass 100.3 [11.4] kg; age 24 [4] y) sustained a time loss, noncontact lower limb injury. Static postural control was assessed via sway path (in meters), and dynamic postural control was assessed via vertical postural stability index. Group differences (P <.05) were reported across the acute, middle, and late phase. Smaller magnitudes of sway path were observed for eyes-open sway path, and for the middle and late phase smaller magnitudes of vertical postural stability index (P <.05) at the end session compared with first session. Whereas larger magnitudes of vertical postural stability index were found between baseline and the last session (P <.05). Large interindividual and intraindividual variation was apparent across the 3 phases of rehabilitation. Postural control improvements were identified during rehabilitation. However, postural control did not return to baseline, with altered kinetics throughout each rehabilitation phase. [ABSTRACT FROM AUTHOR]

Research indicates a positive relationship between physical literacy and healthy aging; however, there is no consensus on the components required to become a physically literate adult. The objective of this study was to understand how physical literacy for adults with chronic conditions is characterized from the perspective of healthcare professionals. Physiotherapy leaders and physical literacy researchers within North America were invited to an online consensus panel and presented with questions related to physical literacy and rehabilitation. A nominal group technique was used for idea generation, clarification, and ranking. Confidence and safety with movements, motivation and commitment to physical activity, the ability to self-monitor changes in function, and understanding the benefits of physical activity were key components when defining physical literacy. There is a need to reconceptualize physical literacy to include the rehabilitation needs of adults living with chronic conditions, and to design programs that promote physical literacy to enhance function and mobility. [ABSTRACT FROM AUTHOR]

This study explored the classification experiences and views of Para Alpine skiers with visual impairment. Data from 11 interviews were analyzed using reflexive thematic analysis to generate three themes: Suitability—The skiers questioned the suitability of the visual measurements, testing environment, and the information they received regarding classification; Exclusivity—Skiers felt certain aspects of the system remain exclusive due to the restrictions of sport classes and lack of the athlete voice; and (Dis)trust—Skiers felt distrust in those implementing the system and in other athletes due to intentional misrepresentation. Speculation surrounding this resulted in the skiers' feeling doubt in their own classification. While there is not a "one size fits all" approach to classification, understanding skiers' experiences can be a vital first step and will help to guide future research into the evolution of this sport's classification. [ABSTRACT FROM AUTHOR]

Purpose: Postactivation performance enhancement (PAPE), which refers to the phenomena associated with the attainment of enhanced performance in sport-specific tasks after a conditioning activity, is an important objective of warming-up practices in many sports. This is even more relevant for sprinters, as potential increases in sprinting speed will directly influence their competitive results. This systematic review with meta-analysis evaluated the effects of different PAPE protocols (ie, using plyometrics, strength-power exercises, and resisted/assisted sprints) on the sprinting performance (ie, sprint time or sprint speed) of competitive sprinters. Methods: Initially, 1205 records published until last December 18 were identified, using the following databases: PubMed/MEDLINE, Scopus, and Clarivate Web of Science. After removing duplicates and screening titles and abstracts, 14 high-quality studies met the inclusion criteria for the meta-analysis. Results: Overall, there were no significant changes in sprint performance after implementing various types of conditioning activities (standardized mean difference [SMD] = 0.16 [95% CI, −0.02 to 0.33]; Z = 1.78; P =.08; I2 = 0%). In addition, when comparing prechanges and postchanges between experimental, control, and other conditions, no significant differences were found in sprint speed or time across all studies (SMD = 0.09 [95% CI, −0.10 to 0.28]; Z = 0.92; P =.36; I = 0%). Conclusions: Results revealed that different types of conditioning activities may not be capable of acutely enhancing the sprint speed of competitive sprinters. This aligns with previous observations indicating that sprinting is a highly stable physical capacity, a phenomenon that is even more consistent among elite sprinters. Coaches and sport scientists should collaborate to develop more efficient PAPE protocols for these highly specialized athletes, with special attention to study design and individualization, while considering their effects on acceleration versus top speed. [ABSTRACT FROM AUTHOR]

Purpose: Injury prevention is a crucial aspect of sports, particularly in high-performance settings such as elite female football. This study aimed to develop an injury prediction model that incorporates clinical, Global-Positioning-System (GPS), and multiomics (genomics and metabolomics) data to better understand the factors associated with injury in elite female football players. Methods: We designed a prospective cohort study over 2 seasons (2019–20 and 2021–22) of noncontact injuries in 24 elite female players in the Spanish Premiership competition. We used GPS data to determine external workload, genomic data to capture genetic susceptibility, and metabolomic data to measure internal workload. Results: Forty noncontact injuries were recorded, the most frequent of which were muscle (63%) and ligament (20%) injuries. The baseline risk model included fat mass and the random effect of the player. Six genetic polymorphisms located at the DCN, ADAMTS5, ESRRB, VEGFA, and MMP1 genes were associated with injuries after adjusting for player load (P <.05). The genetic score created with these 6 variants determined groups of players with different profile risks (P = 3.1 × 10−4). Three metabolites (alanine, serotonin, and 5-hydroxy-tryptophan) correlated with injuries. The model comprising baseline variables, genetic score, and player load showed the best prediction capacity (C-index:.74). Conclusions: Our model could allow efficient, personalized interventions based on an athlete's vulnerability. However, we emphasize the necessity for further research in female athletes with an emphasis on validation studies involving other teams and individuals. By expanding the scope of our research and incorporating diverse populations, we can bolster the generalizability and robustness of our proposed model. [ABSTRACT FROM AUTHOR]

Purpose: To examine nocturnal sleep patterns, napping behaviors, and subjective wellness responses of elite water polo players within an in-season week and to identify whether sleeping patterns differ between men and women. Methods: Sleep characteristics of 10 male and 17 female professional water polo players were objectively assessed during 1 week of the in-season period, including 5 training days, 1 match day, and 1 day of rest. Internal load (rating of perceived exertion × duration of training or match) was assessed 30 minutes posttraining or postmatch, and the total quality of recovery was recorded every morning. A series of multilevel models were used to analyze the data. Results: Time in bed and wake-up time were earlier on both training (P <.001) and rest days (P <.001) than on the day of the match. Internal workload did not predict any of the players' sleeping patterns. Midday naps predicted less time in bed (P =.03) and likely less sleep time (P =.08). The total quality of recovery was predicted only by the total sleep time (P <.01). Women exhibited higher sleep efficiency (P <.001), less waking after sleep onset (P =.01), and a lower number of awakenings (P =.02) than men. Conclusions: The current results indicate that the nocturnal sleep patterns of elite water polo players are not associated with internal load and that women display better nocturnal sleep quality compared with men. As long naps interfere with nocturnal sleep, and total nocturnal sleep time predicts total quality of recovery, we suggest that athletes follow hygiene sleep strategies to facilitate adequate nocturnal sleep and next-day recovery. [ABSTRACT FROM AUTHOR]

Purpose: Successful participation in taekwondo (TKD) requires athletes to possess quick decision-making abilities and demonstrate technical proficiency during competition. Dehydration, occurring during both training and competition, is widely recognized to have various negative effects. Methods: This study investigated the impact of different levels of dehydration on cognitive function, as measured by the Vienna Test System, and the specific performance of kicking techniques among TKD athletes. Using a randomized crossover design, 12 participants were involved in the study. Before and after 1 hour of training at 80% of maximal heart rate, participants were weighed and provided urine samples. All participants were randomly assigned to 3 different hydration conditions: the euhydrated (EUH) group had unrestricted access to fluid consumption, while the hypohydrated (HYP) and severely HYP (S-HYP) groups experienced reductions of 2.0% and 4.0% of their initial body weight, respectively. Results: The EUH group exhibited better reaction speed in reaction-time test-form S1 than the HYP and S-HYP groups. Notably, the EUH group demonstrated a significantly higher success rate in the front-side kick (EUH 98%, HYP 90%, S-HYP 88%; P <.05). However, the success rates of back roundhouse kick and free head kick were similar among the 3 statuses. Furthermore, postexercise heart rates were found to be significantly higher in the HYP and S-HYP groups compared with the EUH group. Conclusions: This study provides insight into the negative effects of dehydration on cognitive function and TKD-specific performance. It is recommended that TKD athletes maintain optimal hydration levels during training and competition to ensure optimal performance. [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to conduct a comparative analysis of physical performance indicators and assess the levels of performance monotony and strain experienced by basketball referees. Methods: The study involved the participation of 12 basketball referees (mean age: 40.0 [4.9] y) affiliated with the International Basketball Federation. The investigation was carried out throughout 2 density tournaments, wherein the maximum heart rate, average heart rate, performance monotony, and performance strain were documented for 3 variables. Results: The findings indicated significant variations in the mean heart rate, maximum heart rate, total distance monotony, total distance strain, the total number of sprints monotony, the total number of sprints strain, calories monotony, and calories strain (P <.05). Decreasing the density of elite-level basketball competitions has been observed to reduce the monotony and strain experienced by referees. However, this action does not increase motion distance or speed zones. Conclusions: The environmental stressors experienced by senior-level athletes (World Cup) differ from those encountered by younger athletes (World Cup Under 19). Further investigation is required to ascertain the potential effects of competition monotony and strain on decision-making processes and the overall quality of refereeing. [ABSTRACT FROM AUTHOR]

BACKGROUND: Guided by the reserve capacity model, we evaluated the unique relationships between socioeconomic status (SES), reserve capacity (helplessness, self-efficacy, social support), and negative emotions on pain in patients with Rheumatoid Arthritis (RA). METHODS: The secondary analysis used baseline, cross-sectional data from 106 adults in a clinical trial comparing behavioral treatments for RA. Patients were eligible if they were ≥ 18 years old, met the ACR criteria for RA (determined by study rheumatologist), had stable disease and drug regimens for 3 months, and did not have a significant comorbid condition. Structural equation modeling evaluated the direct effects of SES, reserve capacity (helplessness- Arthritis Helplessness Index, self-efficacy -Personal Mastery Scale, social support- Social Provisions Scale) and negative emotions (stress and depressive symptoms- Perceived Stress Scale and Hamilton Depression Rating Scale) on pain (Rapid Assessment of Disease Activity in Rheumatology-RADAR & visual analog scale-VAS), and the indirect effects of SES as mediated by reserve capacity and negative emotions. The SEM model was evaluated using multiple fit criteria: χ2 goodness-of-fit statistic, the comparative fit index (CFI), the standardized root mean square residual (SRMR), and the root mean square error of approximation (RMSEA). RESULTS: Participants were mostly female (85%), 55.45 years old on average, self-identified as white (61%), Hispanic (16%), black (13%), and other (10%), and had RA for an average of 10.63 years. Results showed that low SES contributed to worse pain, through lower reserve capacity and higher negative emotions. Mediational analyses showed that reserve capacity and negative emotions partially mediated the effect of SES on pain. The final model explained 39% of the variance in pain. CONCLUSIONS: The findings indicate that lower SES was related to worse clinical pain outcomes and negative emotions and reserve capacity (helplessness, social support, and self-efficacy) mediated the effect of SES on pain. A primary limitation is the small sample size; future studies should evaluate this model further in larger, longitudinal approaches. Interventions that target negative emotions in patients with low SES may facilitate better pain control with RA. TRIAL REGISTRATION: clinicaltrials.gov NCT00072657 01/02/2004 20/03/2009.

Understanding the daily energy expenditure of athletes during training is important to support recovery, adaptation, and the maintenance of performance. The aim of the current research was to assess the total daily energy expenditure (TDEE) and the acute energy expenditure (EE) of tennis training sessions during habitual training of elite tennis players. Using a cohort study design, 27 (n = 10, male; age; 22.3 ± 3.2 years and n = 17, female; age: 23.8 ± 3.5 years) elite singles tennis players were assessed for TDEE and tennis training EE. Using Actiheart activity monitors during a 2- to 5-day training period, male players were analyzed for 26 days and 33 (1.3 ± 0.5 sessions/day) tennis training sessions, and female players for 43 days and 58 (1.2 ± 0.4 sessions/day) tennis training sessions. Male TDEE (4,708 ± 583 kcal/day) was significantly higher than female (3,639 ± 305 kcal/day). Male absolute and relative tennis training EEs (10.2 ± 2.3 kcal/min and 7.9 ± 1.4 kcal·hr−1·kg−1) were significantly higher than those of females (7.6 ± 1.0 kcal/min and 6.8 ± 0.9 kcal·hr−1·kg−1). The resting metabolic rate was assessed via indirect calorimetry. The physical activity level for both groups was 2.3 AU. The TDEE of male and female players during habitual training now highlights the continual cycle of high energy demands experienced by the elite tennis player. The broad ranges of TDEE and EE reported here suggest individual assessment and nutritional planning be prioritized, with a particular focus on carbohydrate requirements. [ABSTRACT FROM AUTHOR]

Background: Platelet-rich fibrin (PRF) is used to prepare "sticky bone" by combining it with bone graft material. The present study investigated the ability of different bone grafts to absorb growth factors from the PRF and release them over time. Materials and Methods: Human blood was collected from 10 healthy volunteers for liquid PRF preparation. Bovine bone, allograft (mineralized and demineralized), and synthetic bone were each mixed with the PRF to prepare a sticky bone. All sticky bone samples were incubated for up to 4 days. The absorption and release pattern kinetics of two selective growth factors within the PRF--platelet-derived growth factor (PDGF) and bone morphogenetic protein-2 (BMP-2)--were quantified with immunofluorescence staining and enzyme-linked immunoassay (ELISA) testing. Results: All bone graft materials adsorbed the examined growth factors from the PRF. ß-TCP showed the highest adsorption levels, followed by the xenograft, and the allografts showed the lowest adsorption levels. Furthermore, PDGF showed a fast-release pattern from the grafts, whereas BMP-2 was released at a later stage. Similar to the adsorption pattern, the ß-TCP and xenograft were better able to sustain the release of the PRF growth factors from the graft than the allografts. Conclusions: The adsorption of PDGF and BMP-2 differ between graft materials, with superior results for ß-TCP, followed by xenograft, then allograft materials. [ABSTRACT FROM AUTHOR]

We integrate the job characteristics and dual work passion models to explore the indirect (via work meaningfulness) effects of job characteristics (i.e., job autonomy, task identity, skill variety, task significance, feedback from the job and feedback from others) on two types of work passion, harmonious passion (HP) and obsessive passion (OP). We first advance occupation‐specific predictions for job characteristics‐to‐work passion relationships and then explore differences in those relationships between HP and OP across four occupational sectors: knowledge work (n = 201), blue‐collar work (n = 148), nonprofit work (n = 141), and managerial work (n = 133). Our findings demonstrate that job characteristics are important drivers of work passion. However, our key discovery is that the motivational impact of the job characteristics is not universally applicable but rather depends on the specific occupational context and whether passion is harmonious or obsessive. We therefore conclude that when it comes to translating job characteristics into work passion, the one‐size‐fits‐all approach is not appropriate. [ABSTRACT FROM AUTHOR]

This research investigates the impact of algorithmic management on worker behaviors, focusing on workers' commitment to service quality and referral tendencies. Drawing upon the job demands‐resources model, we argue that high levels of algorithmic management could create hindrance demands that impede service quality and demotivate referral behaviors. We propose that high workload, as a challenge demand, buffers the negative effects of algorithmic management on worker outcomes. We find support for our proposed research model in an experiment with a sample of 1362 platform‐based food‐delivery riders. We also conduct a qualitative study with 21 riders, which provides a more nuanced understanding of how algorithmic management affects workers' attitudes, behaviors, and referral tendencies. [ABSTRACT FROM AUTHOR]

Purpose: This 2-year longitudinal study examined the development of upper-extremity bone mineral density (BMD), bone mineral content (BMC), and lean mass (LM) asymmetry magnitudes in male and female youth tennis players. Methods: Dominant and nondominant upper-extremity BMD, BMC, and LM values of 49 male and 31 female players were measured yearly using dual X-ray absorptiometry. From these values, asymmetry magnitudes were calculated and expressed as a percentage. Maturity offset was estimated using anthropometric measurements. Linear mixed effect models examined the development of BMD, BMC, and LM asymmetry magnitudes according to players' maturity offset, sex, and training volume. Results: Adjusted for sex and training volume, a 1-year increment in maturity offset was associated with a significant increase in BMD (1.3% [2.2%]; P <.001) and BMC (0.6% [2.4%]; P =.011) asymmetry magnitudes. Male players displayed significantly higher LM asymmetry magnitudes (Δ3.2% [8.4%]; P =.002) compared with their female counterparts. Training volume was not significantly associated with asymmetry magnitude development. Conclusion: In contrast to LM, male and female youth tennis players' upper-extremity bones are still responsive to mechanical loading with a significant increase in BMD and BMC asymmetry magnitudes according to maturity offset. [ABSTRACT FROM AUTHOR]

Adequate sleep is crucial for elite athletes' recovery, performance readiness, and immune response. Establishing reference ranges for elite athletes enables appropriate contextualization for designing and targeting sleep interventions. Purpose: To establish sleep-quality reference ranges for Olympic and Paralympic cohorts using the Pittsburgh Sleep Quality Index (PSQI) and explore differences based on sex and sport types. Methods: Team USA athletes (men = 805, women = 798) completed the PSQI as part of a health-history questionnaire. Descriptive statistics were used to create reference ranges and linear models, and χ2 test of independence determined differences in PSQI global and component scores between sex, games, season, and participation. Results: Six hundred thirty-two (39.43%) athletes reported poor sleep (PSQIGlobal ≥ 5). Men displayed later bedtimes (P =.006), better global PSQI scores, shorter sleep latency, less sleep disturbance, and less use of sleep medication than women (all P <.001). Winter Games participants had later bedtime (P =.036) and sleep offset time (P =.028) compared with Summer Games athletes. Team-sport athletes woke earlier than individual-sport athletes (P <.001). Individual-sport athletes were more likely to have low (P =.005) and mild (P =.045) risk for reduced sleep duration than team-sport athletes. Conclusion: These data provide PSQI-specific reference ranges to identify groups at greatest risk for poor sleep, who may benefit most from targeted sleep interventions. [ABSTRACT FROM AUTHOR]

Purpose: To examine the impact of oral contraceptive (OC) phases on performance, physiological, and subjective responses to prolonged, intensive exercise when carbohydrate (CHO) stores are reduced. Methods: Ten well-trained female cyclists using monophasic OC completed 4 identical trials (>150 min) under conditions of in-trial 60-g·h−1 CHO supplementation (CHO+) or placebo (CHO−) during the sugar- (SUG) and active-pill (ACT) phases of their OC cycle. Each trial comprised two 400-kcal time trials (TT) separated by 1 hour of submaximal cycling at first ventilatory threshold. Results: Change in completion time from TT1 to TT2 was minimized in CHO+ compared with CHO− (4.06 [2.55] vs 6.08 [5.33] min; P =.019, effect size = −0.36). An interaction effect of OC and CHO was observed for time to complete TT (P =.006), mean TT power (P =.002), mean TT heart rate (P =.002), and posttrial emotional balance (P =.020) and negative emotional state (P =.033). In ACT, mean TT power and heart rate were higher in CHO+ when compared with CHO−, resulting in faster TTs in CHO+ and improved posttrial emotional well-being. When CHO was not supplemented, TT power and heart rate were higher in SUG when compared with ACT, resulting in faster TTs in SUG and improved posttrial emotional balance. Conclusion: CHO depletion during ACT negatively influenced TT performance and emotional well-being when compared with SUG. Irrespective of OC pill phase, CHO supplementation should be prioritized to sustain performance and improve postexercise recovery–stress balance. [ABSTRACT FROM AUTHOR]

Many studies have shown that personalized exergames have a positive effect on promoting regular and proper exercise. However, there is no consensus on the design characteristics and evaluation of exergames. This systematic review of published research literature aimed to explore the general characteristics, personalization characteristics, and evaluation of personalized exergames for middle-aged and older people. We screened published studies in the Web of Science, Scopus, PubMed, ACM, and IEEE Xplore databases, extracted data, and performed a thematic analysis according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist. Three main themes and nine subthemes were generated from 24 included papers. Moreover, a personalization model (FACTS) and evaluation system (PMSS) of exergames were developed. Personalized exergames had potential positive effects on motivating middle-aged and older people to exercise and improve their health, particularly physical, mental, and social health. However, more fine-grained studies on personalized exergames are necessary in the future. [ABSTRACT FROM AUTHOR]

The study proposes and tests a self‐concept‐based perspective for the effects of formal mentoring support on affective organizational commitment (AOC) via multiple mediators. Using time‐lagged multi‐source dyadic data (n = 203), we demonstrate that formal mentoring support significantly influences newcomer–protégés' AOC through an underlying self‐evaluative mechanism indicated by organization‐based self‐esteem (OBSE), even in the presence of a well‐established alternative mediator (perceived organizational support; POS). Moreover, we further demonstrate when or under what circumstances such effects might be attenuated or exaggerated by introducing a salient boundary condition to such a process (i.e., perceived mentor organizational prototypicality). As the findings reveal, by making newcomer–protégés feel good about themselves in the workplace (i.e., perceive self‐value) formal mentoring support can also promote organizational commitment, effects that are likely to be amplified when the formal mentor is perceived to be prototypical of the organization. Thus, bridging the mentoring and socialization literatures, the inclusion of our proposed mediators and moderator and testing their relationships simultaneously not only provides a more nuanced view of the underlying mechanisms through which the effects of formal mentoring support are channeled to influence newcomer–protégés' work attitudes but it offers new theoretical elaboration and contextual understanding that we hope will prompt future research and be of benefit to human resource practitioners. Implications to theory, practice and future research directions are discussed. [ABSTRACT FROM AUTHOR]

Purpose: Transmeridian travel is common for elite athletes participating in competitions and training. However, this travel can lead to circadian misalignment wherein the internal biological clock becomes desynchronized with the light–dark cycle of the new environment, resulting in performance decrement and potential negative health consequences. Existing literature extensively discusses recommendations for managing jet lag, predominantly emphasizing light-based interventions to synchronize the internal clock with the anticipated time at the destination. Nevertheless, visually impaired (VI) athletes may lack photoreceptiveness, diminishing or nullifying the effectiveness of this therapy. Consequently, this invited commentary explores alternative strategies for addressing jet lag in VI athletes. Conclusions: VI athletes with light perception but reduced visual acuity or visual fields may still benefit from light interventions in managing jet lag. However, VI athletes lacking a conscious perception of light should rely on gradual shifts in behavioral factors, such as meal timing and exercise, to facilitate the entrainment of circadian rhythms to the destination time. Furthermore, interventions like melatonin supplementation may prove useful during and after travel. In addition, it is recommended that athlete guides adopt phase-forward or phase-back approaches to synchronize with the athlete, aiding in jet-lag management and optimizing performance. [ABSTRACT FROM AUTHOR]

Purpose: A decline in youth running was observed at the start of the COVID-19 pandemic. We investigated whether the resumption of organized running after social distancing restrictions changed running habits or injury frequency in adolescent runners. Methods: Adolescents (age = 16.1 [2.1] y) who participated in long-distance running activities completed an online survey in the Spring and Fall of 2020. Participants self-reported average weekly running habits and whether they sustained an injury during the Fall 2020 season. Poisson regression models and 1-way analysis of variance compared running habits while Fisher exact test compared differences in frequencies of injuries during Fall 2020 among season statuses (full, delayed, and canceled). Results: All runners, regardless of season status, increased weekly distance during Fall 2020. Only runners with a full Fall 2020 season ran more times per week and more high-intensity runs per week compared with their Spring 2020 running habits. There were no differences in running volume or running-related injury frequency among Fall 2020 season statuses. Conclusions: There were no significant differences in running-related injury (RRI) frequency among runners, regardless of season status, following the resumption of cross-country. Health care providers may need to prepare for runners to increase running volume and intensity following the resumption of organized team activities. [ABSTRACT FROM AUTHOR]

Organizational culture in sports affects well-being, performance, and overall success. Although team culture has been explored within able-bodied teams, little is known about culture development within parasport. Using a descriptive case study approach, our study examined the culture development and experiences of an elite parasport team. Two semistructured individual telephone interviews were conducted with nine participants (athletes and staff), and one athlete-participant completed one interview. An inductive thematic analysis revealed two themes: approach to culture development and team culture components. Culture development was linked with facilitative leadership and important resources. This supported the team to create their shared values and mechanisms, including a behavioral framework, other artifacts (e.g., shared language and team motto), and a relaxed environment. These helped to maintain their agreed culture and benefited their well-being, progress, and team cohesion. Our results offer a starting point regarding research into the culture of elite parasport and have practical implications for managers, coaches, and psychologists. [ABSTRACT FROM AUTHOR]

Clinical Scenario: Injuries that affect the groin region are among the most common in football players. To prevent this condition, studies have focused on strengthening the adductors, hip flexors, or abdominal muscles. Recent investigations have used an eccentric-biased exercise (Copenhagen Adduction Exercise [CAE]) that promotes functional and architectural adaptations in the muscle tissue, though its effect on injury risk reduction is unknown. Clinical Question: Can the Copenhagen Adduction Exercise prevent groin injuries in soccer players? Summary of Key Findings: The literature was searched for studies investigating the potential groin injury risk reduction effect of the CAE. (1) Three studies met the inclusion criteria and were used for this appraisal; (2) one study observed a significantly lower injury rate ratio favoring the group that used the CAE program; and (3) 2 studies found similar or higher injury rates in the intervention groups, not supporting the inclusion of the CAE as a preventative tool. Clinical Bottom Line: There is conflicting evidence that usage of the CAE is superior to not performing adductor strengthening exercises in mitigating the risk of sustaining groin injuries. Given the evidence supporting these findings, it is advisable to exercise caution when contemplating the incorporation of the CAE into training regimens aimed at preventing groin injuries. Strength of Recommendation: There is Grade B evidence to suggest that inclusion of the CAE may not be associated with reduced injury rates. [ABSTRACT FROM AUTHOR]

Online exercise programming has become increasingly popular in recent years, including for older adults. Instructors hold unique perspectives on such programming that could yield important insights for effective program design and delivery. The purpose of this study was to qualitatively examine instructors' perceptions and experiences teaching exercise classes online to older adults. Using qualitative description, 19 instructors from a community exercise program for seniors completed a one-on-one semistructured interview. We analyzed data using reflexive thematic analysis and generated three main themes: (a) characteristics of effective online instructors, (b) challenges to delivering online exercise programming to older adults, and (c) future of online exercise programming. Most participants enjoyed delivering online exercise classes and developing the unique skills (particularly related to fostering social experiences and engaging with participants) required to be effective online exercise instructors. Our findings speak to the importance of ensuring instructors are adequately trained to deliver online exercise to seniors. [ABSTRACT FROM AUTHOR]

When does pay dispersion elicit positive or negative employee attitudes? A review of the pay dispersion literature indicates a controversy around this vital question and suggests that numerous contingency factors moderate the effects of pay dispersion. In an empirical study of four Finnish companies consisting of 141 work units, we examine contingencies in attitudinal reactions to job‐based pay dispersion among blue‐collar workers. Based on archival pay data matched with employee survey responses (n = 536), we find that perceptions of pay basis legitimacy, task interdependence, and an individual's pay standing within the work unit explain the strength and direction of the relation between job‐based pay dispersion and employee attitudes (i.e., work engagement and organizational commitment). Our findings have implications for the design of pay systems and contribute to a better appreciation of the complexities underlying employee attitudinal responses to pay dispersion. [ABSTRACT FROM AUTHOR]

Although guilt is often considered the most prevalent emotional outcome of work–family conflict (WFC), most work–family research focuses on family‐related guilt stemming from work interference with family, rather than job‐related guilt stemming from family interference with work (FIW). In addition, there is little understanding of how different employee social groups experience the implications of FIW in their daily lives. To address these research gaps, this study explores the relationship between daily FIW and job‐related guilt, and its subsequent impact on job satisfaction. It also investigates variation in these relationships by (1) gender and (2) the intersection of gender and ethnicity. Bayesian multilevel structural equation modeling using data from 5‐day diary surveys from 210 solicitors in Britain shows daily FIW is associated with higher job‐related guilt and subsequently lower job satisfaction. The relationship is stronger for women than men in general, but is also stronger for South Asian women than white British women (and men), and for South Asian men than white British men. This suggests that studies focusing on single social group characteristics (e.g., gender) are likely to obscure intersectional effects that might produce significant within‐group variation. The findings also highlight the importance of integrating workplace inequality arguments into theorization of WFC. [ABSTRACT FROM AUTHOR]

This study aimed to examine physical activity (PA) levels and mental health status (i.e., anxiety and depression) among parents of children with autism spectrum disorder (ASD). Secondary data analysis was conducted using the 2018 National Health Interview Survey. We identified 139 parents of children with ASD and 4,470 parents of children with no disability. Their PA levels, anxiety, and depression were analyzed. Compared with parents of children with no disability, parents of children with ASD were significantly less likely to meet the PA guideline for Americans and had lower odds of vigorous PA (aOR = 0.702), strengthening PA (aOR = 0.885), and light to moderate PA (aOR = 0.994). Parents of children with ASD reported significantly higher odds of anxiety (aOR = 1.559) and depression (aOR = 1.885). This study revealed lower PA levels and higher risks of anxiety and depression in parents of children with ASD. [ABSTRACT FROM AUTHOR]

Purpose: This study examined posttravel perceptual responses of national-team footballers (soccer) following different flight paths, arrival/departure times, and trip contexts. Methods: Details of 396 flights from national-team players (N = 68) were obtained and verified via an online flight database. Each player provided ratings of perceptual fatigue, sleep, soreness, stress, and jet lag for 2 days before and after each trip. The flight path (continents of departure and arrival), travel context (into vs out of national team), and arrival and departure times were obtained for each trip. Linear mixed models compared the pretravel with posttravel change in perceptual responses based on flight path, context, and schedule. Results: Perceived jet-lag ratings were more responsive to travel variables (R2 =.48) than other perceptual ratings (R2 <.26). Travel from Asia to Europe (P <.05) and Europe to Australia (P <.001) had significantly higher jet-lag ratings than all other paths. Fatigue scores were worst following Asia to Europe (P <.05) and Europe to Australia (P <.05) travel, while sleep scores were worst following Europe to Australia travel (P <.01). Perceptual responses were poorer following travel from national team to club compared with all other travel contexts (P <.05). Arrival during the daytime (11 AM to 5 PM) resulted in better perceptual responses than early-morning or late-night arrivals (P <.05). Conclusions: Perceived jet-lag ratings are more responsive to travel demands than perceptual wellness scales in national-team football athletes. Poorer perceptual responses may be expected when travel is longer in nature, ends later in the day, or involves travel out of the national team back to club. [ABSTRACT FROM AUTHOR]

Purpose: To explore complex system behavior and subsequent team performance in professional rugby union. Methods: Here, we present 2 studies. In the first, we used global positioning system technology to measure player clustering during stoppages in play in nearly 100 games of professional rugby union to explore team (complex system) behavior and performance. In the second, we measured stress hormones (cortisol and testosterone) prior to team meetings and analyzed these relative to amount of time and the frequency with which players looked at peer presenters, as well as subsequent training performance, to explain how stress may lead to behaviors observed in the first study and subsequent match performance. Results: No link between player clustering during stoppages of play and performance was observed. When players (complex system agents) demonstrated greater levels of stress (as indicated by greater cortisol-awakening response and a greater decline in testosterone-to-cortisol ratio across the morning), they tended to look at peer presenters more; however, training quality declined (P =.02). Correlational analysis also showed that training quality was related to testosterone-to-cortisol ratio (P =.04). Conclusions: Team behavior is complex and can be unpredictable. It is possible that under stress, complex system agents (ie, rugby union players) look at (and cluster toward) their teammates more; however, meaningful interaction may not necessarily occur. Furthermore, while complex system (team) analysis may be valuable strategically in rugby union in the context of describing behavior, without understanding "how" or "why" intrateam/interagent behaviors emerge it may have little meaning. [ABSTRACT FROM AUTHOR]

Purpose: To examine the effect of match schedule on self-reported wellness and sleep in rugby union referees during the 2019 Rugby World Cup. Methods: Following an observational design, 18 international-level male referees participating in the 2019 Rugby World Cup completed a daily questionnaire to quantify wellness status (sleep quality, mood, stress, fatigue, muscle soreness, and total wellness) and sleep characteristics (bedtime, wake-up time, and time in bed) from the previous night across the tournament. Linear mixed models and effect sizes (Hedges gav) assessed differences in wellness and sleep characteristics between prematch and postmatch days surrounding single-game and 2-game congested match schedules (prematch1, postmatch1, prematch2, and postmatch2 days). Results: During regular schedules, all self-reported wellness variables except stress were reduced (gav = 0.33–1.05, mean difference −0.32 to −1.21 arbitrary units [AU]) and referees went to bed later (1.08, 1:07 h:min) and spent less time in bed (−0.78, 00:55 h:min) postmatch compared with prematch days. During congested schedules, only wellness variables differed across days, with total wellness reduced on postmatch1 (−0.88, −3.56 AU) and postmatch2 (−0.67, −2.70 AU) days, as well as mood (−1.01, −0.56 AU) and fatigue (−0.90, −1.11 AU) reduced on postmatch1 days compared with prematch days. Conclusion: Referees were susceptible to acute reductions in wellness on days following matches regardless of schedule. However, only single-game regular match schedules negatively impacted the sleep characteristics of referees. Targeted strategies to maximize wellness status and sleep opportunities in referees considering the match schedule faced should be explored during future Rugby World Cup competitions. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Few studies have examined the associations of psychosocial factors with cognitive change in Hispanics/Latinos. METHODS: Data from the Hispanic Community Health Study/Study of Latinos-Investigation of Neurocognitive Aging (HCHS/SOL INCA) and Sociocultural studies were used (n = 2,155; ages ≥45 years). Psychosocial exposures included intrapersonal (ethnic identity, optimism, purpose in life), interpersonal (family cohesion, familism, social networks, social support), and social factors (ethnic discrimination, loneliness, subjective social status). Survey-linear regression models examined associations between psychosocial exposures and 7-year cognitive change (global cognition [GC], verbal learning, memory, word fluency [WF], and digit symbol substitution [DSS]). RESULTS: Familism predicted decline in GC, verbal learning, and memory; family cohesion predicted DSS decline; and loneliness predicted memory decline. Ethnic identity was protective against decline in GC and memory, optimism and social support were protective against decline in memory, and purpose in life was protective against WF decline. DISCUSSION: Psychosocial factors are differentially related to cognitive changes. Culturally relevant factors should be explored in Hispanic/Latino cognitive aging research. HIGHLIGHTS: Psychosocial factors are differentially related to cognitive changes in Latinos. Role of culturally relevant factors on cognition should be further explored. Familism predicted decline in global cognition, verbal learning, and memory. Ethnic identity predicted increase in global cognition and memory.

Background Pelvic floor dysfunction (PFD) occurs when muscles of the pelvic floor become weakened, impaired, or experience tension leading to a variety of complications. Due to the reactive nature and high demands of many sports, athletes are at increased susceptibility and of particular interest concerning PFD. Hypothesis/Purpose The purpose of this study was to explore the prevalence of PFD among college-aged athletes, assess how PFD impacted athletic performance, and identify contributing factors for increased likelihood of PFD in athletes. Study Design Cross-Sectional Study Methods All fully active LVC NCAA Division 3 athletes were recruited for screening for PFD using the Cozean Pelvic Dysfunction Screening Protocol and were surveyed on their self-knowledge of PFD. Athletes who scored > 3 on this tool completed an additional survey, created by the investigators, to identify the impact PFD had on their athletic performance and personal life and were then randomly assigned to one of three investigators to undergo a noninvasive coccygeal assessment to determine underactive, overactive, or normal pelvic floor muscle (PFM) activity. Results Fifty-three Division III male and female athletes between the ages of 18-25 years old participated in the study. Statistically significant differences were found between Cozean scores and demographic factors of age (p <0.001), gender (p <0.05), self-knowledge of PFD (p <0.001), and sport (p <0.001) among all participants that contributed to the increased likelihood of PFD. Thirteen athletes scored > 3 on the Cozean with the 92.3% experiencing under/over active PFM activity and the majority indicating that PFD significantly impacted their athletic performance and quality of life. Conclusion The results indicate that older female NCAA Division III college athletes who participate in swimming and who possess self-knowledge of PFD are more likely to experience PFD. Additionally, these athletes are likely to encounter a significant impact on their athletic performance and quality of life. These results provide preliminary evidence on the need of PFD awareness and assessment among college athletes. [ABSTRACT FROM AUTHOR]

Background: Diabetes management poses significant challenges worldwide, with individuals often facing increased risks of mental health issues, including suicidal behaviors. While traditional statistical methods have been used to assess risk factors, this study introduces machine learning techniques to predict suicidal behaviors among diabetic patients. Therefore, this study aims to investigate the prevalence and risk factors of suicidal behaviors among individuals with diabetes in Bangladesh using both traditional statistical methods and machine learning models. Methods: A cross‐sectional study was carried out with 390 diabetic patients, assessing demographic characteristics, diabetes‐related variables, mental health indicators, and suicidal behaviors. Statistical analyses including chi‐square tests and logistic regression, and various machine learning models, were employed to examine associations and predict risk factors. Results: This study found that 13.8% of the individuals with diabetes reported lifetime suicidal behavior and 9.0% reported past‐year suicidal behavior. Significant risk factors associated with higher rates of suicidal behaviors included younger age, marital status, lower monthly income, higher educational attainment, being insulin users, not having a family history of diabetes, and suffering from anxiety. Among the machine learning models tested, the CatBoost model outperformed others, obtaining low log loss values of 0.45 and 0.32 for lifetime and past‐year suicidal behaviors, respectively. CatBoost demonstrated excellent accuracy rates of 83.97% and 88.46%, significantly higher than those of traditional logistic regression models. The most significant predictors identified by machine learning were treatment type, followed by occupation, anxiety, age group, and having chronic diseases. Conclusion: The findings suggest the urgent need for comprehensive interventions and support systems for individuals managing diabetes, particularly those at higher risk of suicidal behaviors. Machine learning offers improved predictive power and the ability to identify complex patterns in risk factors. Collaborative efforts between healthcare providers, mental health professionals, and public health initiatives are essential for prioritizing mental well‐being in diabetes management. [ABSTRACT FROM AUTHOR]

Background: As part of efforts to reach the elimination target by 2030, the WHO and CDC recommend that all HCWs adhere to the three‐dose Hepatitis B vaccination schedule to protect themselves against the infection. This study assessed Hepatitis B vaccination coverage and associated factors among personnel working in health facilities in Kumasi, Ashanti Region, Ghana. Materials and Methods: A cross‐sectional study involving 530 HCWs was conducted in four hospitals in Kumasi from September to November 2023. An investigator‐administered questionnaire was employed in gathering participant demographics and other information related to vaccination coverage. IBM SPSS Version 26.0 and GraphPad Prism 8.0 were used for analysing the data. Results: Even though the majority (70.6%) reported having taken at least one dose of the vaccine, only 43.6% were fully vaccinated (≥ 3 doses). More than a quarter (29.4%) had not taken any dose of the HBV vaccine. Close to a quarter (23.6%) had not screened or tested for HBV infection in their lifetime. The statistically significant variables influencing vaccination status were age, marital status, profession, and status in the hospital. Nearly one‐half (44.9%) of the participants who have not taken the vaccine reported they do not have a reason for not taking it, and a high proportion (80.1%) were willing to take the vaccine when given for free. Conclusion: To combat the low Hepatitis B vaccination coverage among healthcare workers in Kumasi, Ghana, amidst the significant public health threat of HBV infection, comprehensive measures are necessary. These include implementing infection prevention control programmes, enhancing occupational health and safety, and conducting health promotion campaigns in healthcare facilities. Extending and intensifying Hepatitis B screening and vaccination initiatives to tertiary institutions and encouraging employers, supervisors, or team leaders to provide these services nationwide are also recommended. [ABSTRACT FROM AUTHOR]

Background: Shamanism is a spiritual tradition in which trance practitioners deliberately modify their state of consciousness to seemingly interact with an invisible world to resolve their community members' problems. This review aims to provide a multidisciplinary overview of scientific research on shamanic trance. Methods: The search was performed using PubMed and Google Scholar databases. Twenty-seven articles were found to be eligible, and their data were classified into four dimensions, namely, a) phenomenology, b) psychology, c) neuro-physiological functions, and d) clinical applications. Results: These studies suggest that these trances are non-pathological, different from normal states of consciousness in terms of phenomenology and neurophysiology, and influenced by multiple personal and environmental variables. Furthermore, while trances may offer therapeutic potential, their scope should be approached cautiously, underscoring the need for rigorous studies to assess the effectiveness of shamanic approaches for complementary therapies. Conclusion: Overall, shamanic trance and its potential benefits remain an intriguing and multifaceted area of scientific study, offering insights into the intersections of consciousness, spirituality, and possibly therapy. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the historical context of the enrolled nurse (EN) and nursing associate (NA) roles • To consider the contribution of roles such as the NA to the overall nursing workforce • To learn about how the experiences of previous roles such as the EN can inform the development of new nursing roles. Background: The enrolled nurse (EN) role (second-level registration) was formalised in the UK in 1961 but phased out from the mid-1980s and training courses leading to second-level registration had ceased completely by 1992. The training and practice experiences of former ENs have garnered interest in recent years due to the similarities between the EN role and the nursing associate (NA) role, which was introduced in England in 2017 to help bridge the gap between healthcare assistants and registered nurses. Aim: To explore the past experiences of former ENs to provide a historical lens through which the contemporary role of the NA can be considered. Method: Semi-structured interviews were undertaken with nine former ENs in learning disability and mental health. Findings: Thematic analysis of interview transcripts generated four main themes – ‘the numbers’, ‘just an enrolled nurse’, ‘a stepping stone’ and ‘considerations for the NA’. Participants valued their EN training and role and believed it had provided them with a foundation on which they could make important contributions to nursing care throughout their careers. However, they also described having a perceived ‘lower status’ than registered nurses, but at the same time were expected to assume responsibilities beyond their scope of practice during workforce shortages. Participants welcomed the concept of the NA role and regarded it as a way of building a strong and reliable nursing workforce but were concerned that NAs could be exploited as a ‘cheaper nursing workforce’ and about the lack of role clarity among the wider nursing and healthcare workforce. Conclusion: Lessons from the historical experiences of former ENs should guide the ongoing development of new roles such as the NA, particularly in relation to ensuring the wider nursing and healthcare workforce are clear about the scope of the role. [ABSTRACT FROM AUTHOR]

The article discusses the importance of equity in pediatric healthcare. It highlights how equity is hardwired into human psyche at an early age and how people have not yet achieved equity in child health and the academic workforce. It addresses why it is the pediatrician's imperative to relentlessly pursue equity. It proposes a roadmap for the steps that pediatricians can take to eliminate disparities and achieve equity.

OBJECTIVE: Previous Pediatrician Life and Career Experience Study (PLACES) 2016 data revealed that female pediatricians reported earning ~94% of what male pediatricians reported, after adjusting for factors that might impact income. Has this disparity persisted? METHODS: Data from PLACES, a national longitudinal study, was used to examine pediatrician-reported income from 2017 to 2022. A regression analysis estimated the adjusted differences in female and male pediatricians' annual income for each survey year. Models included sex and other key personal and practice characteristics for which female and male pediatricians' careers might differ. A mixed effects regression for longitudinal analysis examined income across years for female and male pediatricians and if time-variant characteristics are associated with increased or decreased income. RESULTS: PLACES participation ranged from 83.6% in 2017% to 75.5% in 2022 (analytic n = 1251 in 2017 and 1077 in 2022). The unadjusted mean annual income in 2022 was $237 168, $220 374 for female pediatricians and $284 286 for male pediatricians. Adjusting for key characteristics, female pediatrician income was ~93% of male pediatrician income, a gap of ~$ 11 000 annually. Income increased across years (coefficient = 0.03, P < .001). The year--sex interaction was not significant, indicating that the female--male disparity did not change over time. Three time-variant characteristics associated with increased income over time included increased portion of continuous full-time work, work hours, and time in administrative work. CONCLUSIONS A national longitudinal study revealed that female pediatricians reported earning ~93% of what their male colleagues reported, with a consistent gap from 2017 to 2022. [ABSTRACT FROM AUTHOR]

Promoting peace with patients requires clinicians to be skilled in helping patients feel safe, respected, and heard. Close listening is a teachable skill set that enables clinicians to focus sensory attention on a patient and to cultivate space for reflection before speaking. While communication skills are taught in health professions education, close listening is rarely formally emphasized as an equally important skill. This article draws on musical arts education methods to suggest strategies for teaching close listening that can be applied to peace promotion in patient care. [ABSTRACT FROM AUTHOR]

This commentary on a case of a transgender patient interested in using psychedelics to feel more at peace and achieve a sense of psychological safety argues that health care practitioners can help their patients minimize potential harms of psychedelics by providing psychoeducation and resources to identify clinical trials or skilled and knowledgeable psychedelic practitioners. This approach can support patients' agency in their mental health care and ability to foster moments of peace in their lives. [ABSTRACT FROM AUTHOR]

Purpose: eHealth-based exercise therapies were developed to increase stroke patients' adherence to home-based motor rehabilitation. However, these eHealth tools face a rapid decrease in use after a couple of weeks. This study investigates stroke patients' motivation for home-based upper extremity rehabilitation with eHealth tools and their relation with Basic Psychological Needs. Materials and methods: This is a qualitative study using thematic analysis. We conducted semi-structured interviews with stroke patients with upper extremity motor impairments, who were discharged home from a rehabilitation centre, after they interacted with a novel eHealth coach demonstrator in their homes for five consecutive days. Results: We included ten stroke patients. Thematic analysis resulted in eight themes for home-based rehabilitation motivation: Curiosity, Rationale, Choice, Optimal challenge, Reference, Encouragement, Social Support and Trustworthiness. Those themes are embedded into three Basic Psychological Needs: "Autonomy", "Competence", and "Relatedness". Conclusion: Eight motivational themes related to the three Basic Psychological Needs describe stroke patients' motivation for home-based upper extremity rehabilitation. We recommend considering those themes when developing a home-based eHealth intervention for stroke patients to increase the alignment of eHealth tools to the patient's needs and reduce motivational decreases in home-based rehabilitation. IMPLICATIONS FOR REHABILITATION: Stroke patients show motivational decreases and decreased use of eHealth tools in home-based rehabilitation after a couple of weeks. Eight motivational themes describe home-based rehabilitation motivation in stroke patients: Curiosity, Rationale, Choice, Optimal challenge, Reference, Encouragement, Social Support and Trustworthiness. Those themes are embedded into three Basic Psychological Needs: "Autonomy", "Competence", and "Relatedness". Those themes should be considered when developing a home-based eHealth intervention for stroke patients to increase the alignment of eHealth tools to the patient's needs and reduce motivational decreases in home-based rehabilitation. [ABSTRACT FROM AUTHOR]