Introduction

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One speaker, two languages : cross-disciplinary perspectives on code-switching

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Chemotherapy versus supportive care in advanced non-small cell lung cancer: improved survival without detriment to quality of life

BACKGROUND: In 1995 a meta-analysis of randomised trials investigating the value of adding chemotherapy to primary treatment for non-small cell lung cancer (NSCLC) suggested a small survival benefit for cisplatin-based chemotherapy in each of the primary treatment settings. However, the metaanalysis included many small trials and trials with differing eligibility criteria and chemotherapy regimens. METHODS: The aim of the Big Lung Trial was to confirm the survival benefits seen in the meta-analysis and to assess quality of life and cost in the supportive care setting. A total of 725 patients were randomised to receive supportive care alone (n = 361) or supportive care plus cisplatin-based chemotherapy (n = 364). RESULTS: 65% of patients allocated chemotherapy (C) received all three cycles of treatment and a further 27% received one or two cycles. 74% of patients allocated no chemotherapy (NoC) received thoracic radiotherapy compared with 47% of the C group. Patients allocated C had a significantly better survival than those allocated NoC: HR 0.77 (95% CI 0.66 to 0.89, p = 0.0006), median survival 8.0 months for the C group v 5.7 months for the NoC group, a difference of 9 weeks. There were 19 (5%) treatment related deaths in the C group. There was no evidence that any subgroup benefited more or less fromchemotherapy. No significant differences were observed between the two groups in terms of the pre-defined primary and secondary quality of life end points, although large negative effects of chemotherapy were ruled out. The regimens used proved to be cost effective, the extra cost of chemotherapy being offset by longer survival. CONCLUSIONS: The survival benefit seen in this trial was entirely consistent with the NSCLC meta-analysis and subsequent similarly designed large trials. The information on quality of life and cost should enablepatients and their clinicians to make more informed treatment choices

Moving beyond the treatment package approach to developing behavioral interventions: addressing questions that arose during an application of the Multiphase Optimization Strategy (MOST)

Given current pressures to increase the public health contributions of behavioral interventions, intervention scientists may wish to consider moving beyond the classical treatment package approach that focuses primarily on achieving statistical significance. They may wish also to focus on goals directly related to optimizing public health impact. The Multiphase Optimization Strategy (MOST) is an innovative methodological framework that draws on engineering principles to achieve more potent behavioral interventions. MOST is increasingly being adopted by intervention scientists seeking a systematic framework to engineer an optimized intervention. As with any innovation, there are challenges that arise with early adoption. This article describes the solutions to several critical questions that we addressed during the first-ever iterative application of MOST. Specifically, we describe how we have applied MOST to optimize an online program (myPlaybook) for the prevention of substance use among college student-athletes. Our application of MOST can serve as a blueprint for other intervention scientists who wish to design optimized behavioral interventions. We believe using MOST is feasible and has the potential to dramatically improve program effectiveness thereby advancing the public health impact of behavioral interventions

Perceived norms and alcohol use among first-year college student-athletes' different types of friends

Objective: To describe first-year college student-athletes' friendship contexts and test whether their perceptions of alcohol use and approval by different types of friends are associated with their own alcohol use. Participants: First-year student-athletes (N = 2,622) from 47 colleges and universities participating in National Collegiate Athletic Association (NCAA) sports during February–March 2013. Methods: Student-athletes completed online surveys during the baseline assessment of an alcohol and other drug prevention program evaluation. Analyses tested whether perceptions of friends' alcohol use (descriptive norms) and perceptions of friends' approval of alcohol use (injunctive norms) predicted their alcohol use. Results: Both use and approval perceptions by upperclassmen, same-team, and most influential friends significantly predicted alcohol use. By contrast, only perceived use by first-year, nonteam, and less influential friends significantly predicted alcohol use. Conclusions: Athletics departments' alcohol policies and prevention programming for first-year student-athletes should address the potential influence of different types of friends on alcohol use

Student-athlete concussion disclosure and coach communication within collegiate athletics

Background: Between 1.6 and 3.8 million sports- and recreation-related concussions occur in the United States annually. Reports indicate that a significant number of athletes who have experienced symptoms of a potential sport-related concussion did not disclose their symptoms. Aims: The purpose of this study was to investigate the impact of coach communication about concussion disclosure on student-athlete intentions to disclose symptoms of a concussion and encourage another student-athlete to disclose their concussion symptoms. Methods: A total of 2881 student-athletes completed a web-based survey during Fall of 2016. Multiple linear regression was conducted to primarily investigate the relationship between coach communication and intentions to disclose concussion symptoms. Secondarily, biological sex, year in school, athletic division, and sport category was also assessed. Results: Coach communication predicted greater intentions to disclose symptoms to their coach, athletic trainer/sports medicine sports medicine staff member and encourage another athlete to disclose their symptoms of a concussion. Biological sex and sport category also predicted intentions to disclose concussion symptoms. Discussion: Findings from this study provide support for the important role coaches play in an athlete’s regarding concussion safety and introduces preliminary evidence suggesting the impact of coach communication on athlete intentions to disclose concussion symptoms to a coach or athletic trainer/sports medicine staff member. Conclusion: Future studies and behavioral interventions ought to consider the inclusion of coach communication or other coach-related variables when exploring concussion disclosure among athletes

Polysubstance use among first-year NCAA collegiate student-athletes

The purpose of this article is to investigate polysubstance use among college student-athletes and determine whether use is independent of gender, race, season status, and athletic division. College student-athletes responded to questions related to their past-30-day use of alcohol, tobacco, marijuana, and prescription drugs. Findings suggest that polysubstance use differs significantly by gender, race, season status, and athletic division. Although a majority of college student-athletes do not engage in polysubstance use, it is reported more frequently for alcohol and tobacco, and alcohol and marijuana. Due to serious consequences associated with polysubstance use, practitioners should consider expanding prevention and treatment efforts to address polysubstance use

Binge-drinking and non-binge-drinking student-athletes: The Role of Proximal Norms, Negative Expectancies, and Selected Socio-Demographic Variables

Researchers have identified college student-athletes as a subgroup at risk for heavy drinking and associated consequences. Yet, few studies have examined multiple variables simultaneously to determine which stand out as most robust to explain drinking behavior among student-athletes. Student-athletes from 54 National Collegiate Athletic Association (NCAA) member institutions (N = 2,659) completed an online questionnaire as part of an online alcohol education program. Logistic regression analyses demonstrated a unique profile based on descriptive and injunctive norms and alcohol outcome expectancies among binge-drinking student-athletes compared to non-binge-drinking athletes. Gender differences also emerged within the sample. Implications for campus mental health, university, and athletic personnel are discussed

Sport-related Concussion Reporting and Coach-Athlete Attachment Among Collegiate Student-Athletes

Between 2001 and 2015, 3.4 million traumatic brain injury (TBI) occurrences in the U.S. were accounted for by sport participation. It is estimated between 12% and 60% of athletes delay seeking care after sustaining a concussion. Differences in sport-related concussion (SRC) reporting have been attributed to several different factors. Whereas prior research related to SRC reporting behavior focus on normative and competitive pressures to continue play, less attention is given to the interpersonal context in which reporting takes place. Grounded in attachment theory, this study investigated relationships between coach-athlete attachment and help-seeking behavior. Findings suggest that as coach-athlete anxiousness increases, not reporting increases. and as coach-athlete secureness increases, not reporting decreases. Logistic regression analyses indicate that secure coach attachment significantly predicts greater likelihood of SRC reporting. These findings underscore the important role coach-athlete relationships may have on care-seeking behaviors of student-athletes and can inform individual and group interventions promoting SRC reporting