Injuries Following Implementation of a Progressive Load Carriage Program in United States Marine Corps Training

PURPOSE: The overall physical demands placed on recruits completing United States Marine Corps (USMC) training is high and comes concomitantly with high rates of injuries. Load carriage with heavy loads is of particular concern. However, load carriage conditioning, if optimised, can reduce injury risk. METHODS: Retrospective injury data of recruits completing training informed this study. Data were drawn from recruits completing an original load carriage (OLC) program (n=2,363) and those completing a modified load carriage (LCMOD) program (n=681). Musculoskeletal injury data were drawn from the USMC San Diego sports medicine injury database. A population estimate of the OLC:LCMOD relative risk ratio (RR) was calculated. RESULTS: The proportion of injuries sustained by the LCMOD cohort (n=268; 39%) was notably lower than that sustained by the OLC cohort (n=1,372; 58%). The reoccurrence rate *f injury for LCMOD soldiers compared to the OLC was 0.68 (95% CI 0.61 to 0.75). The leading nature of injury (i.e., sprains and strains) was consistent between both cohorts (OLC: n=396; 29% vs. LCMOD: n=66; 25%). Inflammation (n=172; 13%) and fractures (n=144; 11%) were next most common for OLC recruits; while pain (n=58; 22%) and medial tibial stress syndrome (n=18; 8%) were next most common for LCMOD recruits. While stress reactions were proportionally higher in LCMOD (n=17; 6%) when compared to OLC (n=4; 0.3%), stress fractures were proportionality lower (LCMOD: n=9; 3% vs. OLC: n=114; 8%). Pre-existing / chronic injuries were higher in LCMOD (+5%) while new overuse injuries were lower (-7%). Totalling 65% (OLC) and 70% (LCMOD) of reported injuries the knee, lower leg, ankle, and foot were the top 4 bodily sites of injuries, although there were variations in the orders of presentations (See Table 1 for top 10 bodily sites). RELEVANCE: Careful periodisation and planning of a load carriage program can reduce injuries without reducing training outcomes

Inequality, emissions, and human well-being

Development strategies generally align with the assumption that economic growth and the use of fossil fuels, despite the resulting emissions, lead to improvements in human well-being. This logic suggests that reductions in emissions could harm human well-being. In addition to raising sustainability concerns, one component left out of such approaches is the role of inequality. This chapter highlights the importance of incorporating inequality into studies of emissions and human well-being. We review the relevant sociological literature and demonstrate how well-being, emissions, and the relationship between the two are shaped by inequality. We also summarize how the nature of these relationships vary by context and scale. We briefly outline two approaches to addressing climate change to protect the planet and promote human well-being: global climate negotiations and social movements for climate justice. We conclude by discussing directions forward for research and policy

Cardiovascular Demand Differences Between Male and Female US Marine Recruits During Progressive Loaded Hikes

Schram, B, Orr, R, Niederberger, B, Givens, A, Bernards, J, and Kelly, KR. Cardiovascular demand differences between male and female US Marine recruits during progressive loaded hikes. J Strength Cond Res XX(X): 000-000, 2024-Despite having to carry the same occupational load, female soldiers tend to be lighter than male soldiers. The aim of this study was to determine the differences in cardiovascular load between female and male US Marine recruits during progressive load carriage hikes. United States Marine Corps recruits (565 male recruits; 364 female recruits) completed 6 loaded hikes over 6 weeks (1: 10 kg, 30 minutes; 2: 10 kg, 45 minutes; 3: 15 kg, 30 minutes, 4: 15 kg, 45 minutes; 5: 20 kg, 30 minutes; 6: 20 kg, 45 minutes) during which cardiovascular response was measured. Average heart rate (HRavg), HR maximum (HRmax), and pace were measured via a wrist-worn physiological monitor. Independent sample t-tests were conducted to compare between sexes, with significance set at 0.008 after adjusting for multiple comparisons. The average female recruit had significantly lower body mass (BM) compared with the average male recruit (p &lt; 0.001) and thus carried a significantly heavier relative load. (10 kg ∼17%, 15 kg ∼25%, 20 kg ∼33%, p &lt; 0.001). There were no significant differences in pace in any hike, and no significant differences were found in HRavg or HRmax when comparing female and male Marines during Hike 1. For female Marines, HRavg was significantly higher compared with male Marines during Hike 2 (+6.5 b·min-1, p &lt; 0.001) and Hike 3 (+7.4 b·min-1, p &lt; 0.001), and both HRavg and HRmax were significantly higher in Hike 4 (+11.9 b·min-1, +8.4 b·min-1, p &lt; 0.001), Hike 5 (+7.7 b·min-1, +7.9 b·min-1, p &lt; 0.001), and Hike 6 (+6.9 b·min-1, +7.1 b·min-1, p &lt; 0.001), respectively. Female Marines endured greater cardiovascular demand compared with male Marines during load carriage events when carrying loads greater than 15 kg (∼25% BM).</p

Stress Response to Winter Warfare Training: Potential Impact of Location

Winter Warfare Training (WWT) is a critical component of military training to prepare individuals to move effectively in harsh conditions. Moving through snow and heavy terrain increases overall stress to the entire human system. PURPOSE: The purpose of this effort was to quantify the stress response during WWT to determine the level of physiological adaptation to extreme environments. METHODS: Mountain and mobility operators (age: 31.5±1.4 years; height: 71.1±0.5 inches; weight: 192.5±6.6 lbs.; body fat percentage: 18.0±5.0%) were recruited for this effort. Participants engaged in baseline laboratory metrics at their home station located in Colorado (CO) prior to WWT for one week in Montana (MT) and one week in Alaska (AK). WWT was separated by approximately one month. Blood was collected upon wake on the first and last day at each location. Plasma was analyzed for anabolic and stress-related hormones via enzyme-linked immunoassay (ELISA). RESULTS: Plasma adrenocorticotropic hormone (ACTH) levels increased from baseline to pre- (p=0.004), decreased from pre- to post-WWT in MT (p=0.004), and increased in from pre- to post-WWT in AK (p=0.005). Plasma cortisol levels decreased from pre- to post-WWT in MT (p=0.001) and, conversely, increased from pre- to post-WWT in AK (pCONCLUSION: The increase in stress-related hormones (i.e., ACTH and cortisol) exhibited throughout during WWT in AK suggest that operators experienced heightened physiological strain during WWT in AK compared to MT, despite similar training. We speculate that differences in sleep environment, changes in environmental temperature and terrain between MT and AK, and cumulative training load may have exacerbated the overall physiological strain on the operators

Gender differences in injuries sustained during United States Marine Corps training

Aim: To investigate gender-specific differences in injuries in United States Marine Corps (USMC) trainees.Design: Retrospective cohort study.Method: Point-of-care injury data for USMC recruits (females=94; males=681) completing training were drawn from the Marine Corps Recruit Depot San Diego sports medicine injury database and analysed descriptively. The male: female incidence rate ratio (IRR) was calculated.Results: Male trainees suffered more injuries (male=268; 39%; female n=22; 23%; IRR=1.68 (95% CI 1.33 to 2.1)). Sprains and strains were the leading nature of injury (female=41%; male=25%) followed by pain(female=23%; male=22%). The leading type of injury was ‘new overuse injuries’ for both genders (54% each). Female trainees experienced more acute injuries (36% versus 26%). While female (55%) and male (58%)rates of ‘moderate’ injuries were similar, female trainees experienced more ‘mild’ injuries (36% versus 25%). The knee (female=27%: male=23%) and lower leg (female=23%: male=21%) were the leading injury sites. All injuries were to the lower limbs in female trainees; male trainees also reported injuries to the upper limb (12%) and trunk (8%).Conclusion: Female trainees experienced fewer injuries than male trainees, with more being mild. Both genders had similar natures of injuries in similar body sites except that male trainees reported some upper body and trunk injuries.</div

Power, Proximity, and Physiology: Does Income Inequality and Racial Composition Amplify the Impacts of Air Pollution on Life Expectancy in the United States?

This study advances research at the intersection of environmental degradation, social stratification, and population health in the United States. Expanding the theoretical principles of power, proximity, and physiology, we hypothesize that the harmful effect of fine particulate matter on life expectancy is greater in states with higher levels of income inequality and larger black populations. To test our hypothesis, we use two-way fixed effects regression analysis to estimate the effect of a three-way interaction between fine particulate matter, income share of the top ten percent, and the percent of the population that is black on state-level average life expectancy for all US states and the District of Columbia (2000–2014). The findings support our hypothesis: the estimated effect of the three-way interaction on average life expectancy is negative and statistically significant, net of various socioeconomic and demographic controls. Using post-estimation techniques, we visually illustrate that the harmful effect of fine particulate matter on life expectancy is especially pronounced in states with both very high levels of income inequality and very large black populations. We conclude by summarizing the theoretical and substantive implications of our findings, the limitations of the study, and potential next steps in this evolving area of interdisciplinary research

Selection models with monotone weight functions in meta analysis

Publication bias, the fact that studies identified for inclusion in a meta analysis do not represent all studies on the topic of interest, is commonly recognized as a threat to the validity of the results of a meta analysis. One way to explicitly model publication bias is via selection models or weighted probability distributions. We adopt the nonparametric approach initially introduced by Dear (1992) but impose that the weight function $w$ is monotonely non-increasing as a function of the $p$-value. Since in meta analysis one typically only has few studies or "observations", regularization of the estimation problem seems sensible. In addition, virtually all parametric weight functions proposed so far in the literature are in fact decreasing. We discuss how to estimate a decreasing weight function in the above model and illustrate the new methodology on two well-known examples. The new approach potentially offers more insight in the selection process than other methods and is more flexible than parametric approaches. Some basic properties of the log-likelihood function and computation of a $p$-value quantifying the evidence against the null hypothesis of a constant weight function are indicated. In addition, we provide an approximate selection bias adjusted profile likelihood confidence interval for the treatment effect. The corresponding software and the datasets used to illustrate it are provided as the R package selectMeta. This enables full reproducibility of the results in this paper.Comment: 15 pages, 2 figures. Some minor changes according to reviewer comment

Kate 2007 Spring

Each year, kate seeks to: explore ideas about normative gender, sex, and sexuality work against oppression and hierarchies of power in any and all forms serve as a voice for race and gender equity as well as queer positivity encourage the silent to speak and feel less afraid build a zine and community that we care about and trusthttps://digitalcommons.otterbein.edu/kate/1006/thumbnail.jp

How patients understand depression associated with chronic physical disease - A systematic review

Background: Clinicians are encouraged to screen people with chronic physical illness for depression. Screening alone may not improve outcomes, especially if the process is incompatible with patient beliefs. The aim of this research is to understand peoples beliefs about depression, particularly in the presence of chronic physical disease. Methods: A mixed method systematic review involving a thematic analysis of qualitative studies and quantitative studies of beliefs held by people with current depressive symptoms. MEDLINE, EMBASE, PSYCHINFO, CINAHL, BIOSIS, Web of Science, The Cochrane Library, UKCRN portfolio, National Research Register Archive, Clinicaltrials.gov and OpenSIGLE were searched from database inception to 31st December 2010. A narrative synthesis of qualitative and quantitative data, based initially upon illness representations and extended to include other themes not compatible with that framework. Results: A range of clinically relevant beliefs was identified from 65 studies including the difficulty in labeling depression, complex causal factors instead of the biological model, the roles of different treatments and negative views about the consequences of depression. We found other important themes less related to ideas about illness: the existence of a self-sustaining depression spiral; depression as an existential state; the ambiguous status of suicidal thinking; and the role of stigma and blame in depression. Conclusions: Approaches to detection of depression in physical illness need to be receptive to the range of beliefs held by patients. Patient beliefs have implications for engagement with depression screening

The Gut Microbiome and Aquatic Toxicology: An Emerging Concept for Environmental Health

The microbiome plays an essential role in the health and onset of diseases in all animals, including humans. The microbiome has emerged as a central theme in environmental toxicology, as microbes interact with the host immune system in addition to its role in chemical detoxification. Pathophysiological changes in the gastrointestinal tissue caused by ingested chemicals, and metabolites generated from microbial biodegradation, can lead to systemic adverse effects. This critical review dissects what we know about the impacts of environmental contaminants on the microbiome of aquatic species, with special emphasis on the gut microbiome. We highlight some of the known major gut epithelium proteins in vertebrate hosts that are targets for chemical perturbation, proteins that also directly cross‐talk with the microbiome. These proteins may act as molecular initiators for altered gut function, and we propose a general framework for an adverse outcome pathway that considers gut dysbiosis as a major contributing factor to adverse apical endpoints. We present two case studies, nanomaterials and hydrocarbons with special emphasis on the Deepwater Horizon oil spill, to illustrate how investigations into the microbiome can improve understanding of adverse outcomes. Lastly, we present strategies to functionally relate chemical‐induced gut dysbiosis with adverse outcomes, as this is required to demonstrate cause‐effect relationships. Further investigations into the toxicant‐microbiome relationship may prove to be a major breakthrough for improving animal and human health. This article is protected by copyright. All rights reserve