Playing-Related Medical Injuries and Health Conditions in Collegiate Saxophonists: A Survey of Saxophonists in North American Universities

When compared to other areas of musical performance, medical research on the performing arts is limited when it comes to studies on woodwind players, particularly saxophonists. The gap in research may be attributed to the circumstances surrounding selection processes and identifying subjects for study. For example, saxophonists are not salaried professionals in orchestras, which are commonly pooled for medical research. Establishing contact with saxophonists to conduct studies can prove difficult due to the wide range of genres that utilize the saxophone. Some issues may also be attributed to research methodology. To find the onset of injuries, researchers in previous studies approached universities to investigate playing-related injuries and health conditions in collegiate musicians. Studies reveal injuries can occur before students in music enter the professional realm, and sometimes as early as high school or middle school. Studies pertaining to collegiate saxophonists are limited to multi-instrumental studies or specific case studies. The purpose of this study is to identify the presence of playing-related injuries and health conditions among collegiate saxophonists. For the purposes of this investigation, a survey was distributed to collegiate members of the North American Saxophone Alliance in 2018, asking students to respond to questions about whether they had experienced playing-related injuries or illnesses. To qualify for the survey, participants had to be at least 18 years old, be pursuing a music degree at a university in Canada or the United States, have saxophone as their primary instrument, and have been studying saxophone for at least one semester/trimester. There were 87 responses analyzed using Qualtrics Stats iQ. A total of 79 students (90.80%) reported musculoskeletal playing-related pain. The neck (66.67%), thumbs (52.87%), and wrists (52.87%) were the most reported areas. There were 71 orofacial injuries (81.61%), which included difficulty maintaining the embouchure and/or lip pain (52.87%), jaw pain (49.43%), tooth movement (43.68%), and velopharyngeal insufficiency (31.03%). Eighty students (91.95%) reported other playing-related complications, including stage fright (85.06%), hearing loss (32.18%), dizziness/blackouts (31.03%), and chest discomfort (13.79%). Of the 46 students who reported thumb pain, 41 students (89.13%) reported pain in the right thumb, while 21 students (45.65%) reported pain in the left thumb. While demographics, musical background, practice routine, and lifestyle correlated with some specific illnesses and areas with playing-related pain, there were not enough students free of playing-related complications to determine the significance of these findings. The survey did reveal that playing-related pain and health conditions are present among collegiate saxophonists. Therefore, it is necessary to educate students on the importance of seeking help at the onset of symptoms and to provide ways to mitigate them within performance practice. Further research is needed to determine the possible causation of playing-related pain in the right thumb, what preventative and treatment options students have used to resolve their symptoms and what factors or activities they have found worsen their symptoms, and lastly, to what extent injuries are prevalent among the saxophone community as a whole

Backward recall and benchmark effects of working memory

Working memory was designed to explain four benchmark memory effects: the word length effect, the irrelevant speech effect, the acoustic confusion effect, and the concurrent articulation effect. However, almost all research thus far has used tests that emphasize forward recall. In four experiments, we examine whether each effect is observable when the items are recalled in reverse order. Subjects did not know which recall direction would be required until the time of test, ensuring that encoding processes would be identical for both recall directions. Contrary to predictions of both the primacy model and the feature model, the benchmark memory effect was either absent or greatly attenuated with backward recall, despite being present with forward recall. Direction of recall had no effect on the more difficult conditions (e.g., long words, similar-sounding items, items presented with irrelevant speech, and items studied with concurrent articulation). Several factors not considered by the primacy and feature models are noted, and a possible explanation within the framework of the SIMPLE model is briefly presented

Working Memory Capacity as a Determinant of Proactive Interference and Auditory Distraction

Individual differences in working memory capacity are related to performance on a range of elemental and higher order cognitive tasks. The current experiment tests the assumptions of two theoretical approaches to working memory capacity: working memory as executive attention and working memory as temporary binding. These approaches are examined using a short-term updating task where proactive interference is manipulated, such that old responses have to be suppressed in favour of new responses. A second source of distraction is introduced by way of irrelevant, to-be-ignored background speech that accompanies presentation of the list items. This speech reinforces either the to-be-remembered item on the current list, or the to-be-suppressed item. Working memory capacity was significantly related to overall level of correct performance on the short-term task, and to the degree of proactive interference experienced. However, there was no evidence for individual differences in the ability to suppress the interfering foil, nor in priming effects associated with the irrelevant speech. The results provided little support for the working memory capacity as executive attention perspective, some evidence for the binding perspective, but also evidence supporting the fact that some effects of distraction are not under voluntary control

Working memory capacity as a determinant of proactive interference and auditory distraction

Individual differences in working memory capacity are related to performance on a range of elemental and higher order cognitive tasks. The current experiment tests the assumptions of two theoretical approaches to working memory capacity: working memory as executive attention and working memory as temporary binding. These approaches are examined using a short-term updating task where proactive interference is manipulated, such that old responses have to be suppressed in favour of new responses. A second source of distraction is introduced by way of irrelevant, to-be-ignored background speech that accompanies presentation of the list items. This speech reinforces either the to-be-remembered item on the current list, or the to-be-suppressed item. Working memory capacity was significantly related to overall level of correct performance on the short-term task, and to the degree of proactive interference experienced. However, there was no evidence for individual differences in the ability to suppress the interfering foil, nor in priming effects associated with the irrelevant speech. The results provided little support for the working memory capacity as executive attention perspective, some evidence for the binding perspective, but also evidence supporting the fact that some effects of distraction are not under voluntary control

Developing a typology for peer education and peer support delivered by prisoners

Peer interventions delivered for prisoners by prisoners offer a means to improve health and reduce risk factors for this population. The variety of peer programs poses challenges for synthesizing evidence. This paper presents a typology developed as part of a systematic review of peer interventions in prison settings. Peer interventions are grouped into four modes: peer education, peer support, peer mentoring and bridging roles, with the addition of a number of specific interventions identified through the review process. The paper discusses the different modes of peer delivery with reference to a wider health promotion literature on the value of social influence and support. In conclusion, the typology offers a framework for developing the evidence base across a diverse field of practice in correctional health care

Morphology and dynamics of inflated subaqueous basaltic lava flows

International audienceDuring eruptions onto low slopes, basaltic Pahoehoe lava can form thin lobes that progressively coalesce and inflate to many times their original thickness, due to a steady injection of magma beneath brittle and viscoelastic layers of cooled lava that develop sufficient strength to retain the flow. Inflated lava flows forming tumuli and pressure ridges have been reported in different kinds of environments, such as at contemporary subaerial Hawaiian-type volcanoes in Hawaii, La Réunion and Iceland, in continental environments (states of Oregon, Idaho, Washington), and in the deep sea at Juan de Fuca Ridge, the Galapagos spreading center, and at the East Pacific Rise (this study). These lava have all undergone inflation processes, yet they display highly contrasting morphologies that correlate with their depositional environment, the most striking difference being the presence of water. Lava that have inflated in subaerial environments display inflation structures with morphologies that significantly differ from subaqueous lava emplaced in the deep sea, lakes, and rivers. Their height is 2-3 times smaller and their length being 10-15 times shorter. Based on heat diffusion equation, we demonstrate that more efficient cooling of a lava flow in water leads to the rapid development of thicker (by 25%) cooled layer at the flow surface, which has greater yield strength to counteract its internal hydrostatic pressure than in subaerial environments, thus limiting lava breakouts to form new lobes, hence promoting inflation. Buoyancy also increases the ability of a lava to inflate by 60%. Together, these differences can account for the observed variations in the thickness and extent of subaerial and subaqueous inflated lava flows

Order recall in verbal short-term memory: The role of semantic networks

In their recent article, Acheson, MacDonald, and Postle (Journal of Experimental Psychology: Learning, Memory, and Cognition 37:44-59, 2011) made an important but controversial suggestion: They hypothesized that (a) semantic information has an effect on order information in short-term memory (STM) and (b) order recall in STM is based on the level of activation of items within the relevant lexico-semantic long-term memory (LTM) network. However, verbal STM research has typically led to the conclusion that factors such as semantic category have a large effect on the number of correctly recalled items, but little or no impact on order recall (Poirier & Saint-Aubin, Quarterly Journal of Experimental Psychology 48A:384-404, 1995; Saint-Aubin, Ouellette, & Poirier, Psychonomic Bulletin & Review 12:171-177, 2005; Tse, Memory 17:874-891, 2009). Moreover, most formal models of short-term order memory currently suggest a separate mechanism for order coding-that is, one that is separate from item representation and not associated with LTM lexico-semantic networks. Both of the experiments reported here tested the predictions that we derived from Acheson et al. The findings show that, as predicted, manipulations aiming to affect the activation of item representations significantly impacted order memory

Magnetic resonance enterography compared with ultrasonography in newly diagnosed and relapsing Crohn's disease patients: the METRIC diagnostic accuracy study

Magnetic resonance enterography and enteric ultrasonography are used to image Crohn's disease patients. Their diagnostic accuracy for presence, extent and activity of enteric Crohn's disease was compared. To compare diagnostic accuracy, observer variability, acceptability, diagnostic impact and cost-effectiveness of magnetic resonance enterography and ultrasonography in newly diagnosed or relapsing Crohn's disease. Prospective multicentre cohort study. Eight NHS hospitals. Consecutive participants aged ≥ 16 years, newly diagnosed with Crohn's disease or with established Crohn's disease and suspected relapse. Magnetic resonance enterography and ultrasonography. The primary outcome was per-participant sensitivity difference between magnetic resonance enterography and ultrasonography for small bowel Crohn's disease extent. Secondary outcomes included sensitivity and specificity for small bowel Crohn's disease and colonic Crohn's disease extent, and sensitivity and specificity for small bowel Crohn's disease and colonic Crohn's disease presence; identification of active disease; interobserver variation; participant acceptability; diagnostic impact; and cost-effectiveness. Out of the 518 participants assessed, 335 entered the trial, with 51 excluded, giving a final cohort of 284 (133 and 151 in new diagnosis and suspected relapse cohorts, respectively). Across the whole cohort, for small bowel Crohn's disease extent, magnetic resonance enterography sensitivity [80%, 95% confidence interval (CI) 72% to 86%] was significantly greater than ultrasonography sensitivity (70%, 95% CI 62% to 78%), with a 10% difference (95% CI 1% to 18%;  = 0.027). For small bowel Crohn's disease extent, magnetic resonance enterography specificity (95%, 95% CI 85% to 98%) was significantly greater than ultrasonography specificity (81%, 95% CI 64% to 91%), with a 14% difference (95% CI 1% to 27%). For small bowel Crohn's disease presence, magnetic resonance enterography sensitivity (97%, 95% CI 91% to 99%) was significantly greater than ultrasonography sensitivity (92%, 95% CI 84% to 96%), with a 5% difference (95% CI 1% to 9%). For small bowel Crohn's disease presence, magnetic resonance enterography specificity was 96% (95% CI 86% to 99%) and ultrasonography specificity was 84% (95% CI 65% to 94%), with a 12% difference (95% CI 0% to 25%). Test sensitivities for small bowel Crohn's disease presence and extent were similar in the two cohorts. For colonic Crohn's disease presence in newly diagnosed participants, ultrasonography sensitivity (67%, 95% CI 49% to 81%) was significantly greater than magnetic resonance enterography sensitivity (47%, 95% CI 31% to 64%), with a 20% difference (95% CI 1% to 39%). For active small bowel Crohn's disease, magnetic resonance enterography sensitivity (96%, 95% CI 92% to 99%) was significantly greater than ultrasonography sensitivity (90%, 95% CI 82% to 95%), with a 6% difference (95% CI 2% to 11%). There was some disagreement between readers for both tests. A total of 88% of participants rated magnetic resonance enterography as very or fairly acceptable, which is significantly lower than the percentage (99%) of participants who did so for ultrasonography. Therapeutic decisions based on magnetic resonance enterography alone and ultrasonography alone agreed with the final decision in 122 out of 158 (77%) cases and 124 out of 158 (78%) cases, respectively. There were no differences in costs or quality-adjusted life-years between tests. Magnetic resonance enterography and ultrasonography scans were interpreted by practitioners blinded to clinical data (but not participant cohort), which does not reflect use in clinical practice. Magnetic resonance enterography has higher accuracy for detecting the presence, extent and activity of small bowel Crohn's disease than ultrasonography does. Both tests have variable interobserver agreement and are broadly acceptable to participants, although ultrasonography produces less participant burden. Diagnostic impact and cost-effectiveness are similar. Recommendations for future work include investigation of the comparative utility of magnetic resonance enterography and ultrasonography for treatment response assessment and investigation of non-specific abdominal symptoms to confirm or refute Crohn's disease. Current Controlled Trials ISRCTN03982913. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in ; Vol. 23, No. 42. See the NIHR Journals Library website for further project information

Magnetic resonance enterography, small bowel ultrasound and colonoscopy to diagnose and stage Crohn’s disease; patient acceptability, and perceived burden

Objectives: To compare patient acceptability and burden of magnetic resonance enterography (MRE) and ultrasound (US) to each other, and to other enteric investigations, particularly colonoscopy. Methods: 159 patients (mean age 38, 94 female) with newly diagnosed or relapsing Crohn’s disease, prospectively recruited to a multicentre diagnostic accuracy study comparing MRE and US, completed an experience questionnaire on the burden and acceptability of small bowel investigations between December 2013 and September 2016. Acceptability, recovery time, scan burden and willingness to repeat the test were analysed using the Wilcoxon signed rank and McNemar tests; and group differences in scan burden with Mann-Whitney U and Kruskal-Wallis tests. Results: Overall, 128 (88%) patients rated MRE as very or fairly acceptable, lower than US (144, 99%; p<0.001), but greater than colonoscopy (60, 60%; p<0.001). MRE recovery time was longer than US (p<0.001), but shorter than colonoscopy (p<0.001). Patients were less willing to undergo MRE again than US (127 vs 133, 91% vs. 99%; p=0.012), but more willing than for colonoscopy (68, 75%; p=0.017). MRE generated greater burden than US (p<0.001), although burden scores were low. Younger age and emotional distress were associated with greater MRE and US burden. Higher MRE discomfort was associated with patient preference for US (p=0.053). Patients rated test accuracy as more important than scan discomfort. Conclusions.: MRE and US are well tolerated. Although MRE generates greater burden, longer recovery, and is less preferred than US, it is more acceptable than colonoscopy. Patients however place greater emphasis on diagnostic accuracy than burden