Movement demands and perceived wellness associated with preseason training camp in NCAA Division I college football players

The aims of this study were to examine the movement demands of preseason practice in National Collegiate Athletic Association Division I college football players using portable global positioning system (GPS) technology and to assess perceived wellness associated with preseason practice to determine whether GPS-derived variables from the preceding day influence perceived wellness the following day. Twenty-nine players were monitored using GPS receivers (Catapult Innovations, Melbourne, Australia) during 20 preseason practices. Individual observations (n = 550) were divided into offensive and defensive position groups. Movement variables including low-, medium-, high-intensity, and sprint distance, player load, and acceleration and deceleration distance were assessed. Perceived wellness ratings (n = 469) were examined using a questionnaire which assessed fatigue, soreness, sleep quality, sleep quantity, stress, and mood. A 1-way analysis of variance for positional movement demands and multilevel regressions for wellness measures were used, followed by post hoc testing to evaluate the relational significance between categorical outcomes of perceived wellness scores and movement variables. Results demonstrated significantly (p ≤ 0.05) greater total, high-intensity, and sprint distance, along with greater acceleration and deceleration distances for the defensive back and wide receiver position groups compared with their respective offensive and defensive counterparts. Significant (p ≤ 0.05) differences in movement variables were demonstrated for individuals who responded more or less favorably on each of the 6 factors of perceived wellness. Data from this study provide novel quantification of the position-specific physical demands and perceived wellness associated with college football preseason practice. Results support the use of position-specific training and individual monitoring of college football players

The Prevalence and Cost of Unapproved Uses of Top-Selling Orphan Drugs

Introduction: The Orphan Drug Act encourages drug development for rare conditions. However, some orphan drugs become top sellers for unclear reasons. We sought to evaluate the extent and cost of approved and unapproved uses of orphan drugs with the highest unit sales. Methods We assessed prescription patterns for four top-selling orphan drugs: lidocaine patch (Lidoderm) approved for post-herpetic neuralgia, modafinil (Provigil) approved for narcolepsy, cinacalcet (Sensipar) approved for hypercalcemia of parathyroid carcinoma, and imatinib (Gleevec) approved for chronic myelogenous leukemia and gastrointestinal stromal tumor. We pooled patient-specific diagnosis and prescription data from two large US state pharmaceutical benefit programs for the elderly. We analyzed the number of new and total patients using each drug and patterns of reimbursement for approved and unapproved uses. For lidocaine patch, we subcategorized approved prescriptions into two subtypes of unapproved uses: neuropathic pain, for which some evidence of efficacy exists, and non-neuropathic pain. Results: We found that prescriptions for lidocaine patch, modafinil, and cinacalcet associated with non-orphan diagnoses rose at substantially higher rates (average monthly increases in number of patients of 14.6, 1.45, and 1.58) than prescriptions associated with their orphan diagnoses (3.12, 0.24, and 0.03, respectively (p75%). Increases in lidocaine patch use for non-neuropathic pain far exceeded neuropathic pain (10.2 vs. 3.6 patients, p<0.001). Discussion In our sample, three of four top-selling orphan drugs were used more commonly for non-orphan indications. These orphan drugs treated common clinical symptoms (pain and fatigue) or laboratory abnormalities. We should continue to monitor orphan drug use after approval to identify products that come to be widely used for non-FDA approved indications, particularly those without adequate evidence of efficacy

Why less may be more: a mixed methods study of the work and relatedness of 'weak ties' in supporting long-term condition self-management

Background: The distribution of the roles and responsibilities of long-term condition management (LTCM) outside of formal health services implicates a wide set of relationships and activities of involvement. Yet, compared to studies of professional implementation, patient systems of implementation remain under-investigated. The aim of this paper is to explore the work, meaning and function attributed to ‘weaker’ ties relative to other more bonding relationships in order to identify the place of these within a context of systems of support for long-term conditions. Methods: This is a mixed methods survey with nested qualitative study. A total of 300 people from deprived areas in the North West of England with chronic illnesses took part in a survey conducted in 2010 to 2011. A concentric circles diagram was used as a research tool with which participants identified 2,544 network members who contributed to illness management. Notions of ‘work’ were used to describe activities associated with chronic illness and to identify how weaker ties are included and perceived to be involved through social network members (SNM) contributions. Results: The results provide an articulation of how SNMs are substantially involved in weak tie illness management. Weaker ties constituted 16.1% of network membership involved in illness work. The amount of work undertaken was similar but less than that of stronger ties. Weaker ties appeared more durable and less liable to loss over time than stronger ties. The qualitative accounts suggested that weak ties enabled the moral positioning of the self-managing ‘self’ and acted on the basis of a strong sense of reciprocity. Conclusions: Weak ties act as an acceptable bridge between a sense of personal agency and control and the need for external support because it is possible to construct a sense of moral acceptability through reciprocal exchange. Access to weak tie resources needs to be taken into account when considering the ways in which systems of health implementation for chronic illness are designed and delivered

Perceived Wellness Associated With Practice and Competition in National Collegiate Athletic Association Division I Football Players

Perceived wellness associated with practice and competition in National Collegiate Athletic Association Division I football players. J Strength Cond Res 33(1): 112–124, 2019—This study assessed the influence of movement demands resulting from weekly practice sessions and games, on perceived wellness measurements taken postgame (Sunday) and 48 hours pregame (Thursday) throughout the in-season period in National Collegiate Athletic Association (NCAA) Division I football players. Thirty players were monitored using global positioning system receivers (OptimEye S5; Catapult Innovations) during 12 games and 24 in-season practices. Movement variables included low-intensity distance, medium-intensity distance, high-intensity distance, sprint distance, total distance, player load, and acceleration and deceleration distance. Perceived wellness, including fatigue, soreness, sleep quality and quantity, stress, and mood, was examined using a questionnaire on a 1–5 Likert scale. Multilevel mixed linear regressions determined the differential effects of movement metrics on perceived wellness. Post hoc tests were conducted to evaluate the pairwise differentials of movement and significance for wellness ratings. Notable findings included significantly (p ≤ 0.05) less player load, low-intensity distance, medium-intensity distance, high-intensity distance, total distance, and acceleration and deceleration distance at all intensities, in those reporting more favorable (4–5) ratings of perceived fatigue and soreness on Sunday. Conversely, individuals reporting more favorable Sunday-perceived stress ratings demonstrated significantly (p ≤ 0.05) higher player load, low-intensity and medium-intensity distance, total distance, low-intensity and medium-intensity deceleration distance, and acceleration distance at all intensities than individuals reporting less favorable (1–2) perceived stress ratings. Data from this study provide a novel investigation of perceived wellness associated with college football practice and competition. Results support the use of wellness questionnaires for monitoring perceived wellness in NCAA Division I college football players