Optimal Intramuscular Injection Site and Maximum Volume in Adult Population

Intramuscular (IM) injections are a common, yet complex technique used to deliver medication into the muscles of the body. More than 12 billion IM injections are administered annually throughout the world (Jin et al., 2015). Unsafe injection practices can lead to further complications, such as “abscess, hematoma, ecchymosis, pain, and vascular and nerve injury” (Potter et. al., 2020, p.633). The choice of an injection site and needle length varies based on the volume to be administered, size of the patient’s muscle, and the patient’s body mass index (BMI). With the proper education, utilizing the best injection technique and optimal site limits further patient complications and provides positive outcomes

Mindfulness-Based Stress Reduction Intervention for the Treatment of Chronic Pain in the Elderly

One of the most common complaints of adults in their 80s and above, a growing portion of our population, is chronic pain and it is often inadequately treated. A secular mindfulness-based stress reduction (MBSR) program was developed by Jon Kabat-Zinn in 1979 and has since shown measurable benefits to individuals in decreasing depression, pain, and anxiety. Considering the significant risk of side effects and age-associated changes of pharmacodynamics and pharmacokinetics in the traditional pharmacologic approach to chronic pain in the elderly, non-pharmacologic intervention such as MBSR may be particularly effective for the elderly population. Methods: We conducted a 6 week, 90 minutes per week MBSR program. We will measure feasibility (ability to recruit 18-20 residents). We will also measure pain intensity and interference before and after the program. Results: A total of 21 patients participated in the MBSR for chronic pain program. The pain intensity and pain interference scores after the MBSR program decreased with statistical significance from the pre-program scores (p \u3c 0.001 and p \u3c 0.01 respectively). These scores remained significantly decreased from pre-program scores at 2 month follow up (p \u3c 0.001 and p \u3c 0.01 respectively). Conclusion: These data suggests that a MBSR program for chronic pain in the elderly is a feasible and effective intervention for lowering pain intensity and interference. This small study paves the way for larger efficacy studies that may compare this intervention to other current chronic pain standards of care

Caffeine Supplementation Strategies Among Endurance Athletes

Caffeine is widely accepted as an endurance-performance enhancing supplement. Most scientific research studies use doses of 3–6 mg/kg of caffeine 60 min prior to exercise based on pharmacokinetics. It is not well understood whether endurance athletes employ similar supplementation strategies in practice. The purpose of this study was to investigate caffeine supplementation protocols among endurance athletes. A survey conducted on Qualtrics returned responses regarding caffeine supplementation from 254 endurance athletes (f = 134, m =120; age = 39.4 ± 13.9 y; pro = 11, current collegiate athlete = 37, recreational = 206; running = 98, triathlon = 83, cycling = 54, other = 19; training days per week = 5.4 ± 1.3). Most participants reported habitual caffeine consumption (85.0%; 41.2% multiple times daily). However, only 24.0% used caffeine supplements. A greater proportion of men (31.7%) used caffeine supplements compared with women (17.2%; p = 0.007). Caffeine use was also more prevalent among professional (45.5%) and recreational athletes (25.1%) than in collegiate athletes (9.4%). Type of sport (p = 0.641), household income (p = 0.263), education (p = 0.570) or working with a coach (p = 0.612) did not have an impact on caffeine supplementation prevalence. Of those reporting specific timing of caffeine supplementation, 49.1% and 34.9% reported consuming caffeine within 30 min of training and races respectively; 38.6 and 36.5% used caffeine 30–60 min before training and races. Recreational athletes reported consuming smaller amounts of caffeine before training (1.6 ± 1.0 mg/kg) and races (2.0 ± 1.2 mg/kg) compared with collegiate (TRG: 2.1 ± 1.2 mg/kg; RACE: 3.6 ± 0.2 mg/kg) and professional (TRG: 2.4 ± 1.1 mg/kg; RACE: 3.5 ± 0.6 mg/kg) athletes. Overall, participants reported minor to moderate perceived effectiveness of caffeine supplementation (2.31 ± 0.9 on a four-point Likert-type scale) with greatest effectiveness during longer sessions (2.8 ± 1.1). It appears that recreational athletes use lower caffeine amounts than what has been established as ergogenic in laboratory protocols; further, they consume caffeine closer to exercise compared with typical research protocols. Thus, better education of recreational athletes and additional research into alternative supplementation strategies are warranted

Caffeine Supplementation Strategies Among Endurance Athletes

Caffeine is widely accepted as an ergogenic aid for endurance performance. Many laboratory studies use doses of 3-6 mg/kg of caffeine 60 min prior to exercise. It is unclear if endurance athletes employ similar supplementation schemes in practice. Further, there is a paucity of data regarding caffeine consumption in this population. PURPOSE: The purpose of this study was to investigate caffeine supplementation strategies and consumption among endurance athletes. METHODS: A survey conducted on Qualtrics returned responses regarding caffeine supplementation from 247 endurance athletes (f = 129, m =118; age = 40.4 ± 18.4 y; pro = 11, current/former collegiate athlete = 67, recreational = 169; running = 95, triathlon = 80, cycling = 54, other = 18; training days per week = 5.4 ± 1.3). Descriptive statistics were calculated using SPSS V26. Pearson chi-square tests of independence were performed to investigate potential associations between a variety of grouping variables and caffeine use. Further, supplementation schemes were analyzed. Finally, athletes’ perception of the effectiveness of caffeine were examined. RESULTS: The majority of participants reported habitual caffeine consumption (84.2%; 34.8% multiple times daily). Yet, only 23.5% reported using caffeine supplements. A greater percentage of men (30.5%) used caffeine supplements compared with women (17.1%; p = .013). Athlete status was significantly associated with caffeine consumption (p = .004). Caffeine use was more prevalent among professional (36.4%) and recreational athletes (28.4%) compared with current/former collegiate athletes (9.0%). There were no significant differences in caffeine supplementation when comparing across type of sport (p = .505), household income (p = .191), education (p = .453) or working with a coach (p = .560). While not statistically significant (p = .064), 53.4% of those using caffeine supplements reported placing among the top 3 in their age group in the past year, compared with only 39.7% of those not using caffeine supplements. Sixty-eight athletes (27.5%) reported that they specifically timed caffeine supplementation around training (60.3% only before, 14.7% only during, 25.0% before and during sessions). Seventy-seven (31.2%) athletes reported timing caffeine intake around races (55.8% before, 13.0% during, 31.2% both). Of those reporting specific timing of caffeine use, 47.3% and 33.9% reported consuming caffeine within 30 min of training sessions and races respectively; 40.0% and 35.5% used caffeine 30-60 min before training and races; 12.7% and 36.6% reported taking caffeine \u3e60 min before training and races. The most frequently reported interval of supplementation during training (64.0%) and races (45.2%) was every 60-90 minutes. Those reporting specific amounts of caffeine consumed before training (n = 27) and races (n = 14), used 1.8 ± 1.0 mg/kg and 2.4 ± 1.3 mg/kg respectively. On average, 53.6% and 39.1% of athletes reported that caffeine exerted no effects to only minor effects during various types of training and racing respectively. A greater percentage of athletes reported moderate and major effects during more intense training as well as longer training sessions and races (52.7 - 72.7%). CONCLUSION: Most athletes in the present study did not follow typical laboratory protocols that have elicited ergogenic effects of caffeine. Better education among athletes and coaches or research into more diverse supplementation schemes are needed

FLEA: Fresnel-limited extraction algorithm applied to spectral phase interferometry for direct field reconstruction (SPIDER)

We present a novel extraction algorithm for spectral phase interferometry for direct field reconstruction (SPIDER) for the so-called X-SPIDER configuration. Our approach largely extends the measurable time windows of pulses without requiring any modification to the experimental X-SPIDER set-up.Comment: 24 pages 26 references 8 figure

The Impact of Dieting Culture Is Different Between Sexes In Endurance Athletes: A Cross-Sectional Analysis

Background: Frequent dieting is common in athletes attempting to achieve a body composition perceived to improve performance. Excessive dieting may indicate disordered eating (DE) behaviors and can result in clinical eating disorders. However, the current nutrition patterns that underly dieting culture are underexplored in endurance athletes. Therefore, the purpose of this study was to identify the sex differences in nutrition patterns among a group of endurance athletes. Methods: Two-hundred and thirty-one endurance athletes (females = 124) completed a questionnaire regarding their dieting patterns and associated variables. Results: The majority of athletes did not follow a planned diet (70.1%). For endurance athletes on planned diets (n = 69), males were more likely follow a balanced diet (p = 0.048) and females were more likely to follow a plant-based diet (p = 0.021). Female endurance athletes not on a planned diet (n = 162) were more likely to have attempted at least one diet (p \u3c 0.001). Male athletes attempted 2.0 ± 1.3 different diets on average compared to 3.0 ± 2.0 for females (p = 0.002). Female athletes were more likely to attempt ≥ three diets (p = 0.022). The most common diet attempts included carbohydrate/energy restrictive, plant-based, and elimination diets. Females were more likely to attempt ketogenic (p = 0.047), low-carbohydrate (p = 0.002), and energy restricted diets (p = 0.010). Females made up the entirety of those who attempted gluten-/dairy-free diets (F = 22.0%, M = 0.0%). Conclusions: Being a female athlete is a major determinant of higher dieting frequency and continual implementation of popular restrictive dietary interventions. Sports dietitians and coaches should prospectively assess eating behavior and provide appropriate programming, education, and monitoring of female endurance athletes

The Relationship between Dietary Intake and Sleep Quality in Endurance Athletes

Athletes have a high prevalence of poor sleep quality. It is unknown if dietary intake affects sleep quality in athletes. PURPOSE: To examine if sleep quality in endurance athletes is related to dietary intake. METHODS: Endurance athletes (n=187), 42.0±13.7 y, participated in the study. Participants completed questionnaires on demographics, dietary intake, and sleep quality. Sleep quality was assessed using the Athlete Sleep Screening Questionnaire (ASSQ), a validated tool, with scores ranging from 0-40 (higher scores indicate poorer sleep quality). The ASSQ subscales included sleep difficulty (SD), chronotype (C), and sleep disordered breathing (SDB). ASSQ-SD was categorized as having none (0-4), mild (5-7), moderate (8-10), and severe (11-17) SD. ASSQ-C was categorized as morning (\u3e4) or evening (higher risk for sleep issues) (≤4) type. ASSQ-SDB was categorized as difficulty breathing (\u3e1) or not ( RESULTS: ASSQ score was 22.3±3.96, indicating average sleep quality among athletes. ASSQ-SD score showed that 33.7% of athletes had no SD, and 38.5%, 21.9%, and 5.9% had mild, moderate, and severe SD, respectively. ASSQ-C score was 9.4±2.82, and 93% of athletes were morning type and 7% were evening type. ASSQ-SDB score indicated that 79.1% of athletes had normal and 20.9% had disordered breathing. Preliminary analyses revealed that ASSQ scores were significantly related to vegetable (p=.038) and caffeinated beverage (p=0.034) intake, but not to the other dietary variables. Significantly higher ASSQ score, (i.e., poorer sleep quality) was found in athletes who consumed ≥5 servings/d (24.0±4.0) of vegetables compared with \u3c1 \u3e(20.9±3.18, p=.011) or 1-2 (21.6±4.11, p=.030) servings/d. Athletes who drank \u3e2.5 cups/d of caffeinated beverages had higher ASSQ score or poorer sleep quality versus those who consumed 3 cups/d of milk had a higher disordered breathing score (.69±.947) versus those who drank 1-2 (.18±.521, p=.009) and \u3c1 \u3e(.30±.641, p=.016) cups/d. Athletes who consumed /d of whole grains had a higher ASSQ-DBS score (.48±.79) versus those who consumed 3-4 servings/d (.09±.401, p=.029). ASSQ-SD was not related to any of the dietary variables. CONCLUSIONS: Increased vegetable and caffeinated beverage consumption were associated with decreased sleep quality. Less whole grains and fruits were associated with evening chronotype. Athletes who consumed more milk and less whole grains had increased disordered breathing

The Relationship Between Dietary Intake and Sleep Quality in Endurance Athletes

Many endurance athletes have poor sleep quality which may affect performance and health. It is unclear how dietary intake affects sleep quality among athletes. We examined if sleep quality in endurance athletes is associated with consumption of fruit, vegetables, whole grains, dairy milk, and caffeinated beverages. Two hundred thirty-four endurance athletes (39.5 ± 14.1 year) participated in a survey. Participants provided information on demographics, anthropometry, sleep behavior and quality, and dietary intake via questionnaires. Sleep quality was assessed using the Athlete Sleep Screening Questionnaire (ASSQ) with a global score (ASSQ-global) and subscales including sleep difficulty (ASSQ-SD), chronotype (ASSQ-C), and disordered breathing while sleeping (ASSQ-SDB). A general linear model (GLM), adjusted for age, body mass index, sleep discomfort, sleep behavior, gender, race, and ethnicity, showed that higher caffeinated beverage intake was related to poorer global sleep quality (p = 0.01) and increased risk for disordered breathing while sleeping (p = 0.03). Higher whole grain intake was associated with a morning chronotype and lower risk for sleep issues (p = 0.01). The GLM did not reveal a relationship between sleep quality and dairy milk, fruit, and vegetable intake. In conclusion, caffeinated beverages and whole grain intake may influence sleep quality. This relationship needs to be confirmed by further research

Nutrient Adequacy in Endurance Athletes

Adequate nutrition is critical to optimal performance in endurance athletes. However, it remains unclear if endurance athletes are consuming enough energy, macronutrients, and micronutrients. PURPOSE: The purpose of this study was to determine if endurance athletes are meeting their nutritional requirements and whether it varies by gender. METHODS: Endurance athletes (n=44), 39.0±14.2 y, participated in the study. Dietary intake was assessed using the five-step multiple-pass 24-hour recall method, a validated measure, that involved asking the participants to recall in detail the type and amount of foods and beverages they consumed the previous day. Energy, macronutrient, and micronutrient intakes were computed from the recalls using the ESHA Food Processor Diet Analysis Software. Nutritional adequacy was calculated by comparing the nutrient intakes of the participants with nutrient standards set by the Food and Nutrition Board, Institute of Medicine, the American College of Sports Medicine (ACSM), the Dietary Guidelines for Americans, and the American Heart Association (AHA). Fisher’s Exact test was used to compare the proportion of male and female endurance athletes that did not meet the requirements for energy, macronutrient, and micronutrient intakes. RESULTS: Over 50% of male athletes did not consume enough water, protein, carbohydrates, dietary fiber, linoleic acid, α-linolenic acid, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), vitamins D, E, and K, pantothenic acid, biotin, manganese, chromium, zinc, molybdenum, choline, potassium, and magnesium. More than 50% of female athletes did not consume enough protein, carbohydrates, linoleic acid, α-linolenic acid, EPA, DHA, vitamins D, E, and B12, pantothenic acid, thiamine, biotin, manganese, chromium, zinc, molybdenum, choline, and potassium. About 50% of male and female athletes consumed more than the recommended amount of total fat, saturated fat, cholesterol, and sodium. Many athletes (male: 20%; female: 8%) did not meet the energy requirements. A significantly higher portion of male athletes compared to female athletes did not meet the nutrient requirements for dietary fiber (70.0% and 24.0%, respectively; p ≤ 0.001), α-linolenic acid (90.0% and 60.0%, respectively; p = 0.04), and total water (75.0% and 40.0%, respectively; p = 0.03). CONCLUSION: Many endurance athletes are not meeting the nutrient requirements for energy, water, and several macronutrients and micronutrients, with some differences by gender. These results need to be confirmed by a larger study. Endurance athletes would benefit from dietary counseling by a registered dietitian

African-Americans and the Administration of Justice

The status of African Americans in relationship to the administration of justice has improved since the 1940s. Significantly, however, researchers continue to find racial discrimination and racial disadvantage operating in various aspects of the criminal justice process in numerous jurisdictions. Such findings are unacceptable in a society that claims to honor equal justice under law. This article is reprinted from Summary, Volume 1 of the Assessment of the Status of African-Americans series, published in 1990 by the William Monroe Trotter Institute, University of Massachusetts at Boston, and edited by Wornie L. Reed. Materials included in the article were adapted from papers submitted by members of the Assessment of the Status of African-Americans Study Group on Political Participation and the Administration of Justice