An evaluation of veteran to civilian reintegration stressors, co-occurrence, and perception of procedure

Though the majority of veterans are able to reintegrate into civilian society without incident, a portion of the population does experience mild to severe stressors such as mental health disorders, suicide risk, incarceration, substance abuse and dependence, interpersonal relationships and readjustment, workplace difficulties, and sleep disturbance (Blow et al., 2013; Bonanno et al., 2012; Haller, Angkaw, Hendricks & Norman, 2016; Sayer et al., 2010; Short et al., 2016). Unfortunately, the current literature focuses on only one or two stressors, and rarely acknowledges all stressors as they coexist among the veteran population. The current study will focus on all prevalent reintegration stressors, and the relationship they may have for veterans. More specifically, the study will identify: (1) which reintegration stressors are more prevalent than others, (2) which co-occur with other stressors, and (3) the perception of the reintegration process. A sample of 31 veterans completed a comprehensive questionnaire that assessed these reintegration stressors; frequencies and Spearman’s r correlations were conducted to evaluate the previously mentioned relationships. Many of the veterans experienced each of the reintegration stressors measured, at varying degrees. More veterans experienced at least one mental health diagnosis, but there were many who experienced more than one. Almost half of the sample had thought about suicide, and almost 20 percent had made a plan. A large portion of the veterans in this sample experienced relationship difficulties as well as interpersonal difficulties. The overall co-occurrence of reintegration stressors are consistent with the previous literature, providing more insight into what has been previously found. In regard to veteran perception of the process, several themes emerged including: difficulty finding a “tribe”, adjusting to the loose structure of civilian life, lack of a marketable trade, and difficulties with mental health issues. These findings demonstrate a deep need to re-evaluate the reintegration process and increase the number of programs and support systems available to veterans after leaving the military

Co-occurring, externalizing, and internalizing symptoms in early childhood: child and contextual factors

The goal of this study was to examine patterns of co-occurring, externalizing, and internalizing symptoms across early childhood. These constructs, along with child emotionality, maternal emotion socialization (ES), and child emotion expression were assessed in a sample of 435 children at ages 2, 4, 5, and 7. Cross-sectional multinomial logistic regression analyses were performed. At age 2, compared to the internalizing group, the co-occurring group was higher on anger proneness, but lower on social fearfulness. Compared to the externalizing group, the co-occurring group was higher on social fearfulness. At age 4, the co-occurring group did not differ significantly from the internalizing group. At age 5, the co-occurring group did not differ significantly from the externalizing group. At age 7, the co-occurring group was lower on fear than the internalizing group. Latent transition analyses were performed to create both 2- and 3- class models representing longitudinal group patterns. These patterns of change were compared. In the 2-class model, the co-occurring stable group was higher on sad/fear expression than the decreasing group. The interaction between supportive ES and anger expression was also significant. In the 3-class model, compared to the high decreasing group, the co-occurring stable group was lower on anger. Compared to the average stable group, the co-occurring group was lower on SES and higher on anger. Results are discussed in the context of existing research on the development of emotional and behavioral problems

Maternal socialization of emotion : child, maternal, and relational factors

"Previous research has implicated maternal emotion socialization as an important predictor of children's future social competence and behavior. However, the factors related to emotion socialization strategies have yet to be explored. This study examined the relative contribution of child temperament, maternal parenting stress and psychopathology, and the mother-child relationship as factors related to dimensions of non-supportive and supportive emotion socialization practices of mothers of 4-year-old children. Results indicated that maternal psychopathology, maternal parenting stress, and a positive mother-child relationship were related to non-supportive emotion socialization practices. In addition, a negative mother-child relationship mediated the relationship between child frustration distress and non-supportive emotion socialization. Exploratory analyses examined the possibility that mothers may fall into groups based on their patterns of emotion socialization."--Abstract from author supplied metadata

Return to Play and Performance Following Anterior Cruciate Ligament Reconstruction in the National Women’s Soccer League

Background: The anterior cruciate ligament (ACL) is a commonly injured ligament in athletes, usually requiring ACL reconstruction (ACLR). Hypothesis/Purpose: To compare the return to play (RTP) and performance level of players following ACLR in the National Women’s Soccer League (NWSL). We hypothesized that there would be a high return to play rate following ACLR in the NWSL, but with a decrease in performance. Methods: NWSL players that underwent ACLR were identified by cross-referencing multiple online resources that were identified between the 2013 and 2020 seasons. Players were classified into the following positions: forward, defender, midfielder, and goalkeeper. The following RTP statistics were assessed: games played, games started, percentage of minutes played, and plus/minus net per 90 minutes. A sub-analysis was also performed to divide players based on median age (≤ 24 vs. \u3e25) at time of injury. Since a majority of these outcomes significantly violated the assumption of normality, continuous variables were reported using medians and interquartile ranges and nonparametric testing methods were used throughout the analysis. Results: A total of 30 NWSL athletes underwent ACLR between the 2013 and 2020 seasons. Midfielders constituted the highest percentage of injuries (n=11, 36.7%) followed by forwards (n=10, 33.3%). Of these 30 players, 27 returned to the NWSL post-injury, constituting a 90.0% RTP rate. The median RTP time was 12.1 months [interquartile range (IQR), 10.9 – 14.3 months]. There was a statistically significant decrease in the percentage of minutes played 1-year pre- and post-injury [median 87.9 (IQR: 80.7 – 90.6) vs. 25.1 (IQR: 16.3 – 57.2); p=0.031]. On age based sub-analysis, older players started significantly more games [median 12.0 (IQR: 3.8 – 18.5) vs. 3.0 (0.5 – 6.0); p=0.048)] and had a higher percentage of minutes played [median 63.0 (IQR: 18.8 – 77.3) vs. 14.9 (2.0 – 21.2); p=0.046] 1-year post injury compared to younger players. Conclusion: Our results support the hypothesis that there is a high RTP rate following ACLR in the NWSL. Following injury, players played in a lower percentage of minutes in the season they returned, with older players starting more games and playing a greater percentage of minutes compared to younger players

What outcomes do studies use to measure the impact of prognostication on people with advanced cancer? Findings from a systematic review of quantitative and qualitative studies

Background: Studies evaluating the impact of prognostication in advanced cancer patients vary in the outcomes they measure, and there is a lack of consensus about which outcomes are most important. Aim: To identify outcomes previously reported in prognostic research with people with advanced cancer, as a first step towards constructing a core outcome set for prognostic impact studies. Design: A systematic review was conducted and analysed in two subsets: one qualitative and one quantitative. (PROSPERO ID: CRD42022320117; 29/03/2022). Data sources: Six databases were searched from inception to September 2022. We extracted data describing (1) outcomes used to measure the impact of prognostication and (2) patients’ and informal caregivers’ experiences and perceptions of prognostication in advanced cancer. We classified findings using the Core Outcome Measures in Effectiveness Trials (COMET) initiative taxonomy, along with a narrative description. We appraised retrieved studies for quality, but quality was not a basis for exclusion. Results: We identified 42 eligible studies: 32 quantitative, 6 qualitative, 4 mixed methods. We extracted 70 outcomes of prognostication in advanced cancer and organised them into 12 domains: (1) survival; (2) psychiatric outcomes; (3) general outcomes; (4) spiritual/religious/existential functioning/wellbeing, (5) emotional functioning/wellbeing; (6) cognitive functioning; (7) social functioning; (8) global quality of life; (9) delivery of care; (10) perceived health status; (11) personal circumstances; and (12) hospital/hospice use. Conclusion: Outcome reporting and measurement varied markedly across the studies. A standardised approach to outcome reporting in studies of prognosis is necessary to enhance data synthesis, improve clinical practice and better align with stakeholders’ priorities

How does receiving a survival estimate affect the general health and wellbeing of people living with terminal cancer and their carers? Findings from a systematic review of qualitative experiences

Introduction: We are developing a core outcome set (COS) for palliative cancer care research into prognostication (prediction of survival). Studies in this field often measure a variety of clinical and service-level outcomes, but do not routinely measure outcomes that are important to patients and carers. The experiences of these stakeholders are essential for producing a meaningful COS. / Aims: To identify and synthesise qualitative data on patients’ and carers’ experiences of prognostication in palliative cancer care. / Methods: We searched five electronic databases (MEDLINE, Embase, CINAHL, PsycINFO, and the Cochrane Library) from inception up to March 2022. The search included qualitative or mixed methods studies exploring how adult cancer patients and/or carers are affected by prognostication. Data describing outcomes and experiences of prognostication were extracted and thematically synthesised, using the Core Outcome Measures in Effectiveness Trials (COMET) taxonomy as a framework to develop themes. / Results: From 8,075 results, we identified 9 papers describing patients’ and carers’ experiences of prognostication. We identified 28 themes from these papers and organised these into eight domains within the COMET taxonomy: 1) psychiatric outcomes; 2) spiritual, religious, and/or existential functioning/wellbeing; 3) emotional functioning/wellbeing; 4) social functioning; 5) global quality of life; 6) delivery of care; 7) perceived health status; 8) personal circumstances. The main themes identified were: avoidance/denial, maintaining hope, preparedness for end-of-life, and treatment preferences. / Conclusions: We have identified 28 themes as potential candidates for inclusion in the future COS. The next stage of the study will investigate stakeholders’ perspectives on these themes and other potentially suitable items for inclusion, identified through linked reviews. / Impact: Standardising outcome reporting through a COS will improve the comparability of future prognostic research, and match better with patient and carer experiences. This will lead to better evidence synthesis, clinical practice, and ultimately improve access to support for those living with terminal cancer when receiving a prognosis

High Variability Exists in Reporting Clinical and Patient-Reported Outcome Measures Following Meniscal Surgery

Purpose: To evaluate the variability in outcomes following surgical meniscal repair and compare responsiveness between patient reported outcome measures (PROMs). Methods: A systematic search of the PubMed/MEDLINE and Web of Science databases was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A total of 257 unique studies met inclusion criteria. Patient and study attributes were extracted, including pre- and postoperative means for PROMs. Of the studies that met inclusion criteria for responsiveness analysis (2+ PROMs reported, 1-year minimum follow-up; n=172), we compared the responsiveness between PROM instruments using effect size and relative efficiency (RE) if a PROM could be compared to another in at least 10 articles. Results: A total of 18,612 patients (18,690 menisci, mean age = 38.6 years, mean body mass index = 26.3 kg/m2) were included in this study. Thirty-five different PROM instruments were identified, and the mean number of PROMs in each article was 3.6. The most cited PROMs were Lysholm (74.5%) and International Knee Documentation Committee (IKDC) (51.0%). IKDC was found to be more responsive than other PROMs, which include Lysholm (RE=2.29), Tegner (RE=3.90), and Knee Injury and Osteoarthritis Outcome Score (KOOS) Activities of Daily Living (ADL) (RE=1.08). KOOS Quality of Life (QoL) was also more responsive than other PROMs, such as IKDC (RE=1.42) and KOOS ADL (RE=1.43). Lysholm was more responsive compared to KOOS QoL (RE=1.14), KOOS ADL (RE=1.96), and Tegner (RE=3.53). Conclusion: Our study found that IKDC, KOOS QoL, and Lysholm were the most responsive PROMs

Association between Pitch Break on the 4-Seam Fastball and Slider and Shoulder Injury in Major League Baseball Pitchers: A Case-Control Study

Background: Few specific risk factors are known for shoulder injury in professional pitchers. New pitch-tracking data allow for risk stratification based on advanced metrics. Purpose/Hypothesis: The purpose of this study was to determine the association between shoulder injury, pitch frequency, and pitch metrics (velocity, total break, break angle, and spin rate) for the 4-seam fastball, curveball, and slider. We hypothesized that more frequent use of the 4-seam fastball would be associated with shoulder injury. Study Design: Case-control study; Level of evidence, 3. Methods: The Major League Baseball (MLB) database was queried for pitchers who had been placed on the injury list (IL) with a shoulder injury between 2015 and 2019. Injured pitchers were matched 1:1 with controls (pitchers not on the IL with a shoulder injury during the study period), based on age (±1 year), history of ulnar collateral ligament reconstruction, position (starter vs reliever), and pitches thrown during the injury season (±500). Pitch frequency, velocity, horizontal break, vertical break, total break, and spin rate for the season were collected from the Baseball Savant website for the 4-seam fastball, curveball, and slider. Univariate analysis was used to determine group differences for individual variables. Multiple logistic regression was performed to determine odds ratios (ORs) for shoulder injury associated with pitch frequency, velocity, total break, break angle, and spin rate. Covariates included age, position, ulnar collateral ligament reconstruction status, expected weighted on-base average, and total pitches thrown. Results: Overall, 233 injured pitchers were evaluated. The most common reason for IL placement was inflammation (78/233; 33.5%) followed by strain or sprain (61/233; 26.2%). Increased total pitch break was associated with an increased risk of shoulder injury for the 4-seam fastball (OR, 1.340 [95% confidence interval (CI), 1.199-1.509]; P \u3c .001) and slider (OR, 1.360 [95% CI, 1.206-1.554]; P \u3c .001). For the slider, a decreased spin rate (OR = 0.998 [95% CI, 0.997-0.999]; P = .026) and a more vertical break angle (OR = 1.170 [95% CI: 1.073-1.278]; P = .004) were associated with increased risk of injury. Conclusion: Increased pitch break of the 4-seam fastball and slider was associated positively with shoulder injury in MLB pitchers. These findings add to the understanding of throwing injury and ability to detect risk using ball-tracking technology

Development of an HPV Educational Protocol for Adolescents

To develop an educational protocol about HPV and Pap tests for adolescents, to evaluate the protocol for understandability and clarity, and to evaluate the protocol for its effectiveness in increasing knowledge about HPV

The Lantern, 2013-2014

• Strikes • Pietro di Venezia • To the Lover of Small Things • Jim\u27s Big Day • Akademiks • Redamancy • A Love Poem for Arctia Caja • Mother River • The Lyrics to Your Song • Nerves • Gemini Season • White Interface • The Last Time I Played with Dolls • The Mechanic • My Goldfish • Put Down Your Hammer • Strip • Hollywood • Identity • The Grey Zone • Sophia • When I Became a Poet • Unbroken • The Veteran Aeronaut • I Have Running Water but They had the Stars • Not A Nigga • Mother, Adam, Eve • From Fragile Seeds: A Palindrome • Conspiring, The Spires • Finally Working Out What Goes Where (God, For Example, is in His Kingdom) • Identity Crisis • Affection • Patience • An Enchanting Lost Cause • False Starts • Soggy Rice, Lukewarm Water • The Glow • Heat • 9-14 • Filigree • Diane Arbus • Touched • Dying Alive • Just Another Drunkard on the Train • Dinner • The French Legionnaire • Conspiracy and Theory • 1249am • Colored Pencils • Sea Glass • Roundtrip • The Muse Heard Music • Lacrimosa • The Allegory of the Maze • The Stars on Stuart Road • To Isabella • For Want of a Potato Chip • Termite Nests • Saving a Rose • Today and Yesterday • A Foggy New York • Cat; Wurtzburg • Embrace • Faces • Geisha • Pacis Leo • Patterns • Te-Whanganui-a-Tara (The Dock)https://digitalcommons.ursinus.edu/lantern/1180/thumbnail.jp