Physical Activity Behavior Comparisons Between Adults With and Without Type 1 Diabetes

Physical activity (PA) is a widely accepted strategy to manage chronic diseases like type 1 diabetes; however, unique PA barriers likely result in lower PA levels among person(s) with type 1 diabetes (PWT1D), compared to person(s) without type 1 diabetes (PWOT1D). The integrated theory of health behavior change (ITHBC) (i.e., knowledge/beliefs, self-regulation, and self-management) provides a helpful framework for understanding PA and other health behaviors. This research aimed to determine differences in PA between adult PWT1D and PWOT1D, and characterize their PA-related behaviors using the ITHBC. Participants (N = 90; 86.7% female, 90% white) were recruited via social media and university listserv to complete an online questionnaire. Questions addressed demographics, anthropometrics, diabetes status, and PA-related behaviors. Participants were matched for race, gender, age, and body mass index. PA and related behaviors were compared between PWT1D and PWOT1D using independent samples t-tests and chi-square-tests. No significant differences were found between PWT1D and PWOT1D for weekly minutes of moderate- or vigorous-aerobic PA, or weekly days of muscle-strengthening PA (p \u3e 0.05). Fifty-one percent of PWT1D and 53.3% of PWOT1D reported enough activity to meet PA guidelines. Almost twice as many PWT1D meeting PA guidelines reported using goal setting, a self-regulation behavior, compared to those who did not meet guidelines (82.6% versus 45.5%, p = 0.009). Targeting PA-related behaviors within ITHBC constructs may help reinforce or influence PA behaviors. These findings can inform future behavior change interventions with PWT1D that focus on educational practices for type 1 diabetes educators or healthcare providers for PWT1D so they can better aid patients

Retrospective Study of Midazolam Protocol for Prehospital Behavioral Emergencies

Introduction: Agitated patients in the prehospital setting pose challenges for both patient care and emergency medical services (EMS) provider safety. Midazolam is frequently used to control agitation in the emergency department setting; however, limited data exist in the prehospital setting. We describe our experience treating patients with midazolam for behavioral emergencies in a large urban EMS system. We hypothesized that using midazolam for acute agitation leads to improved clinical conditions without causing significant clinical deterioration.Methods: We performed a retrospective review of EMS patient care reports following implementation of a behavioral emergencies protocol in a large urban EMS system from February 2014–June 2016. For acute agitation, paramedics administered midazolam 1 milligram (mg) intravenous (IV), 5 mg intramuscular (IM), or 5 mg intranasal (IN). Results were analyzed using descriptive statistics, Levene’s test for assessing variance among study groups, and t-test to evaluate effectiveness based on route.Results: In total, midazolam was administered 294 times to 257 patients. Median age was 30 (interquartile range 24–42) years, and 66.5% were male. Doses administered were 1 mg (7.1%) and 5 mg (92.9%). Routes were IM (52.0%), IN (40.8%), and IV (7.1%). A second dose was administered to 37 patients. In the majority of administrations, midazolam improved the patient’s condition (73.5%) with infrequent adverse events (3.4%). There was no significant difference between the effectiveness of IM and IN midazolam (71.0% vs 75.4%; p = 0.24).Conclusion: A midazolam protocol for prehospital agitation was associated with reduced agitation and a low rate of adverse events

Amish Population Pyramids: Demographic Patterns across Affiliations in the Holmes County, Ohio, Settlement

Research indicates demographic trends within the Amish community remain stable over time, even as Amish populations proliferate. However, most of the research on demographic trends fails to examine variation across affiliations. We use data from Ohio Amish Directory, Holmes County and Vicinity, 2010 to construct age-sex population pyramids for three different affiliations. Population pyramids render the growth, decline, and stability of populations visible. Andy Weaver (or Dan) and Old Order churches present expanding pyramids implying rapid growth, while New Order churches render a stationary pyramid indicating slower growth. Sociologists of religion consistently find that strict churches, cultivating separation from the outside world, tend to grow faster than those that foster accommodation with the outside world. We argue that the data presented in this article suggests a similar dynamic at work in Plain Anabaptist communities

The intersection of racial-ethnic socialization and adolescence: A closer examination at stage-salient issues

The literature on parental racial–ethnic socialization (RES) has established the multiple protective effects of RES on developmental outcomes. Although the majority of this literature examines RES processes in adolescence, with the exception of identity processes this literature has not specifically tackled how these messages intersect with specific adolescent developmental processes. We review the literature on RES processes in non‐White adolescents with a focus on the parent–adolescent relationship, risk‐taking behaviors, romantic relationships, and different contexts (i.e., extracurricular, work, and social media settings). We propose that developmental science needs to account for how parental RES may not only change in adolescence, but in particular responds to the perceived risks associated with this developmental period and interacts with normative developmental tasks and milestones

Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study

Background: South Africa’s unique history, characterised by apartheid, a form of constitutional racial segregation and exploitation, and a long period of political violence and state-sponsored oppression ending only in 1994, suggests a high level of trauma exposure in the general population. The aim of this study was to document the epidemiology of trauma and posttraumatic stress disorder (PTSD) in the South African general population. Methods: The South African Stress and Health Study is a nationally representative survey of South African adults using the WHO’s Composite International Diagnostic Interview (CIDI) to assess exposure to trauma and presence of DSM-IV mental disorders. Results: The most common traumatic events were the unexpected death of a loved one and witnessing trauma occurring to others. Lifetime and 12-month prevalence rates of PTSD were 2.3% and 0.7% respectively, while the conditional prevalence of PTSD after trauma exposure was 3.5%. PTSD conditional risk after trauma exposure and probability of chronicity after PTSD onset were both highest for witnessing trauma. Socio-demographic factors such as sex, age and education were largely unrelated to PTSD risk. Conclusions: The occurrence of trauma and PTSD in South Africa is not distributed according to the sociodemographic factors or trauma types observed in other countries. The dominant role of witnessing in contributing to PTSD may reflect the public settings of trauma exposure in South Africa and highlight the importance of political and social context in shaping the epidemiology of PTSD

Perceived Recovery States and Physical Fitness in Reserve Officers’ Training Corps Cadets

Reserve Officers’ Training Corps (ROTC) cadets are challenged mentally, emotionally, and physically with the physical fitness requirements (e.g., Army Combat Fitness Test or ACFT) required within their military science curriculum. Common physical fitness tests such as those for strength, power, and balance can provide insight into the recovery and readiness status of tactical athletes. PURPOSE: The purpose of this study was to explore the relationship between scores on the Short Recovery and Stress Scale (SRSS) and performance on a physical fitness test battery assessing balance, mobility, body composition, muscular strength, and power in collegiate ROTC cadets. METHODS: Seventeen ROTC cadets (20.1 ± 1.2y, 171.1 ± 11.2cm, 76.7 ± 21.0kg) volunteered to participate in a test battery and complete the eight items on the SRSS during the same week they conducted the ACFT. The test battery included measures of body composition (skinfolds), muscular strength (hand-grip), power (vertical jump), balance (Y-Balance), and mobility (sit and reach test). The SRSS consisted of the short recovery scale (SRS) and the short stress scale (SSS). The SRS contains 4 items on physical (PPC) and mental performance capabilities (MPC), emotional balance and overall stress. The SSS contains 4 items on muscular stress (MS), lack of activation (LA), negative emotional state (NES), and overall stress (OS). Descriptive statistics and correlations were calculated using SPSS version 28 (IBM Corp, Armonk, NY). RESULTS: For the SRS, significant correlations were found between 1) vertical jump power and both PPC (r = 0.59, p = 0.02) and MPC (r = 0.74, p \u3c 0.01), 2) MPC and body composition (r = -0.64, p = 0.01), and 3) PPC and right hand-grip (r = 0.52, p = 0.03). For the SSS, significant correlations were found for 1) vertical jump power and MS (r = -0.59, p = 0.02), LA (r = -0.51, p = 0.04), and OS (r = -0.51, p = 0.04), 2) NES and Y-Balance composite score for the right side of the body (r = 0.57, p = 0.02), and 3) OS and body composition (r = 0.64, p = 0.01). CONCLUSION: Conducting regular physical tests such as hand grip strength or vertical jump to give ROTC cadets feedback on current performance status may help increase awareness of the impact of physical, mental and emotional stress on their readiness for the demanding requirements of the military science curriculum

Perceived Recovery States and Physical Fitness in Reserve Officers’ Training Corps Cadets

Reserve Officers’ Training Corps (ROTC) cadets are challenged mentally, emotionally, and physically with the physical fitness requirements (e.g., Army Combat Fitness Test or ACFT) required within their military science curriculum. Common physical fitness tests such as those for strength, power, and balance can provide insight into the recovery and readiness status of tactical athletes. PURPOSE: The purpose of this study was to explore the relationship between scores on the Short Recovery and Stress Scale (SRSS) and performance on a physical fitness test battery assessing balance, mobility, body composition, muscular strength, and power in collegiate ROTC cadets. METHODS: Seventeen ROTC cadets (20.1 ± 1.2y, 171.1 ± 11.2cm, 76.7 ± 21.0kg) volunteered to participate in a test battery and complete the eight items on the SRSS during the same week they conducted the ACFT. The test battery included measures of body composition (skinfolds), muscular strength (hand grip) and power (countermovement vertical jump), balance (Y-Balance), and mobility (sit and reach test). The SRSS consisted of the short recovery scale (SRS) and the short stress scale (SSS). The SRS contains 4 items on physical (PPC) and mental performance capabilities (MPC), emotional balance and overall stress. The SSS contains 4 items on muscular stress (MS), lack of activation (LA), negative emotional state (NES), and overall stress (OS). Descriptive statistics and correlations were calculated using SPSS version 28 (IBM Corp, Armonk, NY), using an alpha significance level of p \u3c 0.05. RESULTS: For the SRS, significant correlations were found between 1) vertical jump power and both PPC and MPC (r = 0.59 and r = 0.74, respectively), 2) MPC and body composition (r = -0.64), and 3) PPC and right hand-grip (r = 0.52). For the SSS, significant correlations were found for 1) vertical jump power and MS (r = -0.59), LA (r = -0.51), and OS (r = -0.51), 2) NES and Y-Balance composite score for the right side of the body (r = 0.57), and 3) OS and body composition (r = 0.57). CONCLUSION: Conducting regular physical tests such as hand grip strength or vertical jump to give ROTC cadets feedback on current performance status may help increase awareness of the impact of physical, mental, and emotional stress on their readiness for the demanding requirements of the military science curriculum

DSM‐5 and ICD‐11 definitions of posttraumatic stress disorder: Investigating “narrow” and “broad” approaches

Background: The development of the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) and ICD-11 has led to reconsideration of diagnostic criteria for posttraumatic stress disorder (PTSD). The World Mental Health (WMH) Surveys allow investigation of the implications of the changing criteria compared to DSM-IV and ICD-10. Methods: WMH Surveys in 13 countries asked respondents to enumerate all their lifetime traumatic events (TEs) and randomly selected one TE per respondent for PTSD assessment. DSM-IV and ICD-10 PTSD were assessed for the 23,936 respondents who reported lifetime TEs in these surveys with the fully structured Composite International Diagnostic Interview (CIDI). DSM-5 and proposed ICD-11 criteria were approximated. Associations of the different criteria sets with indicators of clinical severity (distress-impairment, suicidality, comorbid fear-distress disorders, PTSD symptom duration) were examined to investigate the implications of using the different systems. Results: A total of 5.6% of respondents met criteria for broadly defined PTSD (i.e., full criteria in at least one diagnostic system), with prevalence ranging from 3.0% with DSM-5 to 4.4% with ICD-10. Only one-third of broadly defined cases met criteria in all four systems and another one third in only one system (narrowly defined cases). Between-system differences in indicators of clinical severity suggest that ICD-10 criteria are least strict and DSM-IV criteria most strict. The more striking result, though, is that significantly elevated indicators of clinical significance were found even for narrowly defined cases for each of the four diagnostic systems. Conclusions: These results argue for a broad definition of PTSD defined by any one of the different systems to capture all clinically significant cases of PTSD in future studies

Development of lifetime comorbidity in the world health organization world mental health surveys

CONTEXT: Although numerous studies have examined the role of latent variables in the structure of comorbidity among mental disorders, none has examined their role in the development of comorbidity. OBJECTIVE: To study the role of latent variables in the development of comorbidity among 18 lifetime DSM-IV disorders in the World Health Organization World Mental Health Surveys. DESIGN: Nationally or regionally representative community surveys. SETTING: Fourteen countries. PARTICIPANTS: A total of 21 229 survey respondents. MAIN OUTCOME MEASURES: First onset of 18 lifetime DSM-IV anxiety, mood, behavior, and substance disorders assessed retrospectively in the World Health Organization Composite International Diagnostic Interview. RESULTS: Separate internalizing (anxiety and mood disorders) and externalizing (behavior and substance disorders) factors were found in exploratory factor analysis of lifetime disorders. Consistently significant positive time-lagged associations were found in survival analyses for virtually all temporally primary lifetime disorders predicting subsequent onset of other disorders. Within-domain (ie, internalizing or externalizing) associations were generally stronger than between-domain associations. Most time-lagged associations were explained by a model that assumed the existence of mediating latent internalizing and externalizing variables. Specific phobia and obsessive-compulsive disorder (internalizing) and hyperactivity and oppositional defiant disorders (externalizing) were the most important predictors. A small number of residual associations remained significant after controlling the latent variables. CONCLUSIONS: The good fit of the latent variable model suggests that common causal pathways account for most of the comorbidity among the disorders considered herein. These common pathways should be the focus of future research on the development of comorbidity, although several important pairwise associations that cannot be accounted for by latent variables also exist that warrant further focused study