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Kyriakidis S, Rasmussen CL, Søgaard K, Holtermann A, Rasmussen CDN, Gupta N. The "sweet- and sour-spot" of occupational physical activity for back pain: a prospective accelerometer study among eldercare workers. Scand J Work Environ Health 2024; 50:341-350. [PMID: 38874546 PMCID: PMC11239222 DOI: 10.5271/sjweh.4170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Indexed: 06/15/2024] Open
Abstract
OBJECTIVES Both high and low levels of occupational physical activity are associated with back pain. Thus, there might be a "sweet- and sour-spot" of occupational physical activity for back pain. Our aim was to investigate if there exists an occupational physical activity "sweet- (lowest risk) and sour-spot" (highest risk) for back pain. METHODS A total of 396 eldercare workers from 20 Danish nursing homes participated. Occupational physical activity was measured between 1-4 working days using thigh-worn accelerometry. Back pain intensity was reported monthly on a scale from 0-10 over 1-year. A zero-inflated mixed-effects model was developed regressing occupational physical activity against back pain, adjusted for confounders. The "sweet- and sour-spot" were defined as the occupational physical activity compositions (sitting, standing, light, and moderate-to-vigorous) associated with the 5% lowest and highest risk for back pain, respectively. RESULTS The composition associated with the lowest risk of back pain - the "sweet-spot"- consisted of 71% worktime spent sitting, 18% spent standing, 5% spent on light physical activity and 6% spent on moderate-to-vigorous physical activity. The composition associated with highest risk for back pain -the "sour-spot"- consisted of 8% worktime spent sitting, 66% spent standing, 4% spent on light physical activity, and 21% spent on moderate-to-vigorous physical activity. CONCLUSIONS The "sweet-spot" of occupational physical activity for back pain among eldercare workers involves more sitting and light physical activity time, while the "sour-spot" involves more standing and moderate-to-vigorous physical activity time. Research on the occupational physical activity "sweet- and sour-spot" is needed.
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Affiliation(s)
- Stavros Kyriakidis
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 København Ø, Copenhagen, Denmark.
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Stevens LJ, Hopkins WG, Chittenden JA, Koper BZ, Smith TB. Quantifying Offense and Defense Workloads in Professional Rugby Union. Int J Sports Physiol Perform 2024; 19:307-314. [PMID: 38171349 DOI: 10.1123/ijspp.2023-0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 11/13/2023] [Accepted: 11/20/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE Rugby union is a contact team sport demanding high levels of physical capacity, and understanding the match workloads can be useful to inform training. In this study, the factors influencing locomotion and contact workloads for offensive and defensive ball-in-play periods are quantified. METHODS Locomotion and contact metrics were collected from global positioning system units and videos for 31 professional players of a Super Rugby team across 14 games in the 2021 season. Data were analyzed with a generalized mixed-model procedure that included effects for type of play, playing position, match outcome, and ball-in-play time. Magnitudes were assessed with standardization, and evidence for substantial magnitudes was derived from sampling uncertainty. RESULTS When offense was compared to defense, most metrics showed decisively substantial increases (small to moderate) for forwards and backs. There was decisive evidence that locomotion metrics were substantially lower (large differences) and contact metrics were higher (very large differences) when comparing forwards to backs on offense and defense. When winning was compared to losing, there was good evidence that forwards experienced small increases in overall workload on defense, and backs experienced a small increase in high-speed running and a moderate decrease in contacts on offense. Match-to-match changes associated with ball-in-play time, attributed to fatigue, were decisive (moderate to very large) across most metrics for forwards and backs in offense and defense. CONCLUSIONS The increased locomotion and contact workloads in offensive periods and the differing physical requirements between positions and match outcomes for both types of play are novel findings that should aid practitioners in designing effective training.
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Affiliation(s)
- Luke J Stevens
- Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand
| | - Will G Hopkins
- Internet Society for Sport Science, Auckland, New Zealand
| | - Jessica A Chittenden
- School of Sport and Recreation, Auckland University of Technology (AUT), Auckland, New Zealand
| | - Bianca Z Koper
- School of Physical Education, Sport, and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Tiaki Brett Smith
- Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand
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Madigan S, Vaillancourt T, Dimitropoulos G, Premji S, Kahlert SM, Zumwalt K, Korczak DJ, von Ranson KM, Pador P, Ganshorn H, Neville RD. A Systematic Review and Meta-Analysis: Child and Adolescent Healthcare Utilization for Eating Disorders During the COVID-19 Pandemic. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00077-7. [PMID: 38431196 DOI: 10.1016/j.jaac.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/30/2024] [Accepted: 02/22/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE To conduct a meta-analysis documenting healthcare service utilization rates for pediatric (age <19 years) eating disorders during compared to before the COVID-19 pandemic. METHOD PsycINFO, MEDLINE, Embase, and Web of Science Core Collection were searched for studies published up to May 19, 2023. Studies with pediatric visits to primary care, inpatient, outpatient, and emergency department for eating disorders before and during the pandemic were included. This preregistered review (PROSPERO CRD42023413392) was reported using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were analyzed with random-effects meta-analyses. RESULTS A total of 52 studies reporting >148,000 child and adolescent eating disorder-related visits to >300 health settings across 15 countries were included (mean age, 12.7 years; SD = 4.1 years; 87% girls). There was strong evidence of an increase in healthcare use for eating disorders during the pandemic (rate ratio [RR] = 1.54, 95% CI = 1.38-1.71). Moderator analysis revealed larger rate increases among girls (RR = 1.48, 95% CI = 1.28-1.71) compared to boys (RR = 1.24, 95% CI = 1.06-1.45) and for adolescents (age ≥12 to 19 years) (RR = 1.53, 95% CI = 1.29-1.81) compared to children (RR = 0.87, 95% CI = 0.53-1.43). Moderator analysis demonstrated strong evidence of increased use of emergency department (RR = 1.70, 95% CI = 1.48-1.97), inpatient (RR = 1.56, 95% CI = 1.33-1.84), and outpatient (RR = 1.62, 95% CI = 1.35-1.95) services, as well as strong evidence of increased rates of anorexia nervosa (RR = 1.48, 95% CI = 1.24-1.75). CONCLUSION Healthcare use for pediatric eating disorders increased substantially during the COVID-19 pandemic, particularly among girls and adolescents. It is important to continue to monitor whether changes in healthcare use associated with acute pediatric mental distress are sustained beyond the COVID-19 pandemic. STUDY PREREGISTRATION INFORMATION Risk factors for eating disorders for youth during the COVID-19 pandemic; https://www.crd.york.ac.uk/; CRD42023413392. DIVERSITY & INCLUSION STATEMENT One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as living with a disability. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science.
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Affiliation(s)
- Sheri Madigan
- University of Calgary, Calgary, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada; and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.
| | | | - Gina Dimitropoulos
- University of Calgary, Calgary, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada; and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | | | | | | | - Daphne J Korczak
- Hospital for Sick Children, Toronto, Canada; and the University of Toronto, Toronto, Canada
| | - Kristin M von Ranson
- University of Calgary, Calgary, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada; and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
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4
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Peeters WM, Gram M, Dias GJ, Vissers MCM, Hampton MB, Dickerhof N, Bekhit AE, Black MJ, Oxbøll J, Bayer S, Dickens M, Vitzel K, Sheard PW, Danielson KM, Hodges LD, Brønd JC, Bond J, Perry BG, Stoner L, Cornwall J, Rowlands DS. Changes to insulin sensitivity in glucose clearance systems and redox following dietary supplementation with a novel cysteine-rich protein: A pilot randomized controlled trial in humans with type-2 diabetes. Redox Biol 2023; 67:102918. [PMID: 37812879 PMCID: PMC10570009 DOI: 10.1016/j.redox.2023.102918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/02/2023] [Indexed: 10/11/2023] Open
Abstract
We recently developed a novel keratin-derived protein (KDP) rich in cysteine, glycine, and arginine, with the potential to alter tissue redox status and insulin sensitivity. The KDP was tested in 35 human adults with type-2 diabetes mellitus (T2DM) in a 14-wk randomised controlled pilot trial comprising three 2×20 g supplemental protein/day arms: KDP-whey (KDPWHE), whey (WHEY), non-protein isocaloric control (CON), with standardised exercise. Outcomes were measured morning fasted and following insulin-stimulation (80 mU/m2/min hyperinsulinaemic-isoglycaemic clamp). With KDPWHE supplementation there was good and very-good evidence for moderate-sized increases in insulin-stimulated glucose clearance rate (GCR; 26%; 90% confidence limits, CL 2%, 49%) and skeletal-muscle microvascular blood flow (46%; 16%, 83%), respectively, and good evidence for increased insulin-stimulated sarcoplasmic GLUT4 translocation (18%; 0%, 39%) vs CON. In contrast, WHEY did not effect GCR (-2%; -25%, 21%) and attenuated HbA1c lowering (14%; 5%, 24%) vs CON. KDPWHE effects on basal glutathione in erythrocytes and skeletal muscle were unclear, but in muscle there was very-good evidence for large increases in oxidised peroxiredoxin isoform 2 (oxiPRX2) (19%; 2.2%, 35%) and good evidence for lower GPx1 concentrations (-40%; -4.3%, -63%) vs CON; insulin stimulation, however, attenuated the basal oxiPRX2 response (4%; -16%, 24%), and increased GPx1 (39%; -5%, 101%) and SOD1 (26%; -3%, 60%) protein expression. Effects of KDPWHE on oxiPRX3 and NRF2 content, phosphorylation of capillary eNOS and insulin-signalling proteins upstream of GLUT4 translocation AktSer437 and AS160Thr642 were inconclusive, but there was good evidence for increased IRSSer312 (41%; 3%, 95%), insulin-stimulated NFκB-DNA binding (46%; 3.4%, 105%), and basal PAK-1Thr423/2Thr402 phosphorylation (143%; 66%, 257%) vs WHEY. Our findings provide good evidence to suggest that dietary supplementation with a novel edible keratin protein in humans with T2DM may increase glucose clearance and modify skeletal-muscle tissue redox and insulin sensitivity within systems involving peroxiredoxins, antioxidant expression, and glucose uptake.
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Affiliation(s)
- W M Peeters
- Metabolic and Microvascular Laboratory, School of Sport, Exercise and Nutrition, Massey University, Wellington, Auckland, New Zealand; School of Biomedical, Nutritional and Sport Science, Newcastle University, United Kingdom
| | - M Gram
- Metabolic and Microvascular Laboratory, School of Sport, Exercise and Nutrition, Massey University, Wellington, Auckland, New Zealand
| | - G J Dias
- Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - M C M Vissers
- Centre for Free Radical Research, Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - M B Hampton
- Centre for Free Radical Research, Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - N Dickerhof
- Centre for Free Radical Research, Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - A E Bekhit
- Department of Food Sciences, University of Otago, Dunedin, New Zealand
| | - M J Black
- Metabolic and Microvascular Laboratory, School of Sport, Exercise and Nutrition, Massey University, Wellington, Auckland, New Zealand
| | - J Oxbøll
- Metabolic and Microvascular Laboratory, School of Sport, Exercise and Nutrition, Massey University, Wellington, Auckland, New Zealand
| | - S Bayer
- Centre for Free Radical Research, Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - M Dickens
- School of Health Sciences, Massey University, Wellington, Auckland, New Zealand
| | - K Vitzel
- School of Health Sciences, Massey University, Wellington, Auckland, New Zealand
| | - P W Sheard
- Department of Physiology, University of Otago, Dunedin, New Zealand
| | - K M Danielson
- Department of Anaesthesiology and Surgery, University of Otago, Wellington, New Zealand
| | - L D Hodges
- Metabolic and Microvascular Laboratory, School of Sport, Exercise and Nutrition, Massey University, Wellington, Auckland, New Zealand
| | - J C Brønd
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - J Bond
- Metabolic and Microvascular Laboratory, School of Sport, Exercise and Nutrition, Massey University, Wellington, Auckland, New Zealand
| | - B G Perry
- School of Health Sciences, Massey University, Wellington, Auckland, New Zealand
| | - L Stoner
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, USA
| | - J Cornwall
- Centre for Early Learning in Medicine, University of Otago, Dunedin, New Zealand
| | - D S Rowlands
- Metabolic and Microvascular Laboratory, School of Sport, Exercise and Nutrition, Massey University, Wellington, Auckland, New Zealand.
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Oranchuk DJ, Hopkins WG, Cronin JB, Storey AG, Nelson AR. The effects of regional quadriceps architecture on angle-specific rapid force expression. Appl Physiol Nutr Metab 2023; 48:829-840. [PMID: 37390497 DOI: 10.1139/apnm-2023-0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
Evaluating anatomical contributions to performance can increase understanding of muscle mechanics and guide physical preparation. While the impact of anatomy on muscular performance is well studied, the effects of regional quadriceps architecture on rapid torque or force expression are less clear. Regional (proximal, middle, and distal) quadriceps (vastus lateralis, rectus femoris, and vastus intermedius) thickness (MT), pennation angle (PA), and fascicle length (FL) of 24 males (48 limbs) were assessed via ultrasonography. Participants performed maximal isometric knee extensions at 40°, 70°, and 100° of knee flexion to evaluate rate of force development from 0 to 200 ms (RFD0-200). Measurements were repeated on three occasions with the greatest RFD0-200 and mean muscle architecture measures used for analysis. Linear regression models predicting angle-specific RFD0-200 from regional anatomy provided adjusted correlations (√adjR2) with bootstrapped compatibility limits. Mid-rectus femoris MT (√adjR2 = 0.41-0.51) and proximal vastus lateralis FL (√adjR2 = 0.42-0.48) were the best single predictors of RFD0-200, and the only measures to reach precision with 99% compatibility limits. Small simple correlations were found across all regions and joint angles between RFD0-200 and vastus lateralis MT (√adjR2 = 0.28 ± 0.13; mean ± SD), vastus lateralis FL (√adjR2 = 0.33 ± 0.10), rectus femoris MT (√adjR2 = 0.38 ± 0.10), and lateral vastus intermedius MT (√adjR2 = 0.24 ± 0.10). Between-correlation comparisons are reported within the article. Researchers should measure mid-region rectus femoris MT and vastus lateralis FL to efficiently and robustly evaluate potential anatomical contributions to rapid knee extension force changes, with distal and proximal measurements providing little additional value. However, correlations were generally small to moderate, suggesting that neurological factors may be critical in rapid force expression.
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Affiliation(s)
- Dustin J Oranchuk
- Sports Performance Research Institute New Zealand, Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
- Institute for Health and Sport, Victoria University, Melbourne, Australia
- Muscle Morphology, Mechanics, and Performance Laboratory, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, US
| | - William G Hopkins
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - John B Cronin
- Sports Performance Research Institute New Zealand, Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Adam G Storey
- Sports Performance Research Institute New Zealand, Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - André R Nelson
- Institute for Health and Sport, Victoria University, Melbourne, Australia
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Madigan S, Deneault AA, Racine N, Park J, Thiemann R, Zhu J, Dimitropoulos G, Williamson T, Fearon P, Cénat JM, McDonald S, Devereux C, Neville RD. Adverse childhood experiences: a meta-analysis of prevalence and moderators among half a million adults in 206 studies. World Psychiatry 2023; 22:463-471. [PMID: 37713544 PMCID: PMC10503911 DOI: 10.1002/wps.21122] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/17/2023] Open
Abstract
Exposure to adverse childhood experiences (ACEs), including maltreatment and family dysfunction, is a major contributor to the global burden of disease and disability. With a large body of international literature on ACEs having emerged over the past 25 years, it is timely to now synthetize the available evidence to estimate the global prevalence of ACEs and, through a series of moderator analyses, determine which populations are at higher risk. We searched studies published between January 1, 1998 and August 5, 2021 in Medline, PsycINFO and Embase. Study inclusion criteria were using the 8- or 10-item ACE Questionnaire (±2 items), reporting the prevalence of ACEs in population samples of adults, and being published in English. The review protocol was registered with PROSPERO (CRD42022348429). In total, 206 studies (208 sample estimates) from 22 countries, with 546,458 adult participants, were included. The pooled prevalence of the five levels of ACEs was: 39.9% (95% CI: 29.8-49.2) for no ACE; 22.4% (95% CI: 14.1-30.6) for one ACE; 13.0% (95% CI: 6.5-19.8) for two ACEs; 8.7% (95% CI: 3.4-14.5) for three ACEs, and 16.1% (95% CI: 8.9-23.5) for four or more ACEs. In subsequent moderation analyses, there was strong evidence that the prevalence of 4+ ACEs was higher in populations with a history of a mental health condition (47.5%; 95% CI: 34.4-60.7) and with substance abuse or addiction (55.2%; 95% CI: 45.5-64.8), as well as in individuals from low-income households (40.5%; 95% CI: 32.9-48.4) and unhoused individuals (59.7%; 95% CI: 56.8-62.4). There was also good evidence that the prevalence of 4+ ACEs was larger in minoritized racial/ethnic groups, particularly when comparing study estimates in populations identifying as Indigenous/Native American (40.8%; 95% CI: 23.1-59.8) to those identifying as White (12.1%; 95% CI: 10.2-14.2) and Asian (5.6%; 95% CI: 2.4-10.2). Thus, ACEs are common in the general population, but there are disparities in their prevalence. They are among the principal antecedent threats to individual well-being and, as such, constitute a pressing social issue globally. Both prevention strategies and downstream interventions are needed to reduce the prevalence and mitigate the severity of the effects of ACEs and thereby reduce their deleterious health consequences on future generations.
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Affiliation(s)
- Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Audrey-Ann Deneault
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Nicole Racine
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Julianna Park
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Raela Thiemann
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Jenney Zhu
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Gina Dimitropoulos
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Faculty of Social Work, University of Calgary, Calgary, AB, Canada
| | - Tyler Williamson
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Department of Community Health Sciences, Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Pasco Fearon
- Centre for Family Research, Department of Psychology, University of Cambridge, Cambridge, UK
| | - Jude Mary Cénat
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Sheila McDonald
- Department of Paediatrics, Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Chloe Devereux
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Ross D Neville
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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Howe ST, Aughey RJ, Hopkins WG, Stewart AM. Profiling Professional Rugby Union Activity After Peak Match Periods. Int J Sports Physiol Perform 2023; 18:968-981. [PMID: 37474117 DOI: 10.1123/ijspp.2023-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/07/2023] [Accepted: 05/31/2023] [Indexed: 07/22/2023]
Abstract
The aim of this investigation was to quantify professional rugby union player activity profiles after the most intense (peak) passages of matches. Movement data were collected from 30 elite and 30 subelite professional rugby union athletes across respective competitive seasons. Accelerometer-derived PlayerLoad and global navigation satellite system-derived measures of mean speed and metabolic power were analyzed using a rolling-average method to identify the most intense 5- to 600-second passages (ie, worst-case scenarios) within matches. Player activity profiles immediately post their peak 5- to 600-second match intensity were identified using 5 epoch duration-matched intervals. Mean speed, metabolic power, and PlayerLoad declined sharply (∼29%-86%) after the most intense 5 to 600 seconds of matches. Following the most intense periods of rugby matches, exercise intensity declined below the average match-half intensity 81% of the time and seldom returned to or exceeded it, likely due to a host of individual physical and physiological characteristics, transient and/or accumulative fatigue, contextual factors, and pacing strategies. Typically, player exercise intensities after the most intense passages of matches were similar between match halves, positional groups, and levels of rugby competition. Accurate identification of the peak exercise intensities of matches and movement thereafter using novel methodologies has improved the limited understanding of professional rugby union player activity profiles following the worst-case scenarios of matches. Findings of the present study may inform match-representative training prescription, monitoring, and tactical match decisions (eg, substitutions and positional changes).
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Madigan S, Korczak DJ, Vaillancourt T, Hopkins WG, Racine N, Neville RD. COVID-19, young people, and suicidal behaviour - Authors' reply. Lancet Psychiatry 2023; 10:485-486. [PMID: 37353260 PMCID: PMC10284589 DOI: 10.1016/s2215-0366(23)00187-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/16/2023] [Accepted: 05/18/2023] [Indexed: 06/25/2023]
Affiliation(s)
- Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada; Alberta Children's Hospital Research Institute, Calgary, AB, Canada.
| | - Daphne J Korczak
- Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, ON, Canada
| | - Tracy Vaillancourt
- Counselling Psychology, Faculty of Education, University of Ottawa, ON, Canada; School of Psychology, Faculty of Social Sciences, University of Ottawa, ON, Canada
| | - Will G Hopkins
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Nicole Racine
- School of Psychology, Faculty of Social Sciences, University of Ottawa, ON, Canada; Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Ross D Neville
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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Madigan S, Racine N, Vaillancourt T, Korczak DJ, Hewitt JMA, Pador P, Park JL, McArthur BA, Holy C, Neville RD. Changes in Depression and Anxiety Among Children and Adolescents From Before to During the COVID-19 Pandemic: A Systematic Review and Meta-analysis. JAMA Pediatr 2023; 177:567-581. [PMID: 37126337 PMCID: PMC10152379 DOI: 10.1001/jamapediatrics.2023.0846] [Citation(s) in RCA: 62] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/04/2023] [Indexed: 05/02/2023]
Abstract
Importance There is a growing body of high-quality cohort-based research that has examined changes in child and adolescent mental health during the COVID-19 pandemic vs before the pandemic. Some studies have found that child and adolescent depression and anxiety symptoms have increased, while others have found these symptoms to have remained stable or decreased. Objective To synthesize the available longitudinal cohort-based research evidence to estimate the direction and magnitude of changes in depression and anxiety symptoms in children and adolescents assessed before and during the pandemic. Data Sources Medline, Embase, and PsycInfo were searched for studies published between January 1, 2020, and May 17, 2022. Study Selection Included studies reported on depression and/or anxiety symptoms, had cohort data comparing prepandemic to pandemic estimates, included a sample of children and/or adolescents younger than 19 years, and were published in English in a peer-reviewed journal. Data Extraction and Synthesis In total, 53 longitudinal cohort studies from 12 countries with 87 study estimates representing 40 807 children and adolescents were included. Main Outcomes and Measures Standardized mean changes (SMC) in depression and anxiety symptoms from before to during the pandemic. Results The analysis included 40 807 children and adolescents represented in pre-COVID-19 studies and 33 682 represented in during-COVID-19 studies. There was good evidence of an increase in depression symptoms (SMC, 0.26; 95% CI, 0.19 to 0.33). Changes in depression symptoms were most conclusive for study estimates among female individuals (SMC, 0.32; 95% CI, 0.21 to 0.42), study estimates with mid to high income (SMC, 0.35; 95% CI, 0.07 to 0.63), and study estimates sourced from North America (SMC, 0.25; 95% CI, 0.15 to 0.36) and Europe (SMC, 0.35; 95% CI, 0.17 to 0.53). There was strong evidence that anxiety symptoms increased slightly during the pandemic (SMC, 0.10; 95% CI, 0.04 to 0.16), and there was some evidence of an increase in study estimates with mid to high income. Conclusions This systematic review and meta-analysis of longitudinal studies including children and adolescents found an increase in depression symptoms during the COVID-19 pandemic, particularly among female individuals and those from relatively higher-income backgrounds.
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Affiliation(s)
- Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Nicole Racine
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Tracy Vaillancourt
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Counselling Psychology, Faculty of Education University of Ottawa, Ontario, Canada
| | - Daphne J. Korczak
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Canada
| | - Jackson M. A. Hewitt
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Paolo Pador
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Joanne L. Park
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Brae Anne McArthur
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Celeste Holy
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Ross D. Neville
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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10
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Madigan S, Korczak DJ, Vaillancourt T, Racine N, Hopkins WG, Pador P, Hewitt JMA, AlMousawi B, McDonald S, Neville RD. Comparison of paediatric emergency department visits for attempted suicide, self-harm, and suicidal ideation before and during the COVID-19 pandemic: a systematic review and meta-analysis. Lancet Psychiatry 2023; 10:342-351. [PMID: 36907199 PMCID: PMC10097509 DOI: 10.1016/s2215-0366(23)00036-6] [Citation(s) in RCA: 54] [Impact Index Per Article: 54.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 03/11/2023]
Abstract
BACKGROUND There is a lack of consensus about the effect of the COVID-19 pandemic on the mental health of children and adolescents. We aimed to compare rates of paediatric emergency department visits for attempted suicide, self-harm, and suicidal ideation during the pandemic with those before the pandemic. METHODS For this systematic review and meta-analysis, we searched MEDLINE, Embase, and PsycINFO for studies published between Jan 1, 2020, and Dec 19, 2022. Studies published in English with data on paediatric (ie, those aged <19 years) emergency department visits before and during the COVID-19 pandemic were included. Case studies and qualitative analyses were excluded. Changes in attempted suicide, self-harm, suicidal ideation, and other mental-illness indicators (eg, anxiety, depression, and psychosis) were expressed as ratios of the rates of emergency department visits during the pandemic compared with those before the pandemic, and we analysed these with a random-effects meta-analysis. This study was registered with PROSPERO, CRD42022341897. FINDINGS 10 360 non-duplicate records were retrieved, which yielded 42 relevant studies (with 130 sample-estimates) representing 11·1 million emergency department visits for all indications of children and adolescents across 18 countries. The mean age of the samples of children and adolescents across studies was 11·7 years (SD 3·1, range 5·5-16·3), and there were on average 57·6% girls and 43·4% boys as a proportion of emergency department visits for any health reasons (ie, physical and mental). Only one study had data related to race or ethnicity. There was good evidence of an increase in emergency department visits for attempted suicide during the pandemic (rate ratio 1·22, 90% CI 1·08-1·37), modest evidence of an increase in emergency department visits for suicidal ideation (1·08, 0·93-1·25), and good evidence for only a slight change in self-harm (0·96, 0·89-1·04). Rates of emergency department visits for other mental-illness indications showed very good evidence of a decline (0·81, 0·74-0·89), and paediatric visits for all health indications showed strong evidence of a reduction (0·68, 0·62-0·75). When rates for attempted suicide and suicidal ideation were combined as a single measure, there was good evidence of an increase in emergency department visits among girls (1·39, 1·04-1·88) and only modest evidence of an increase among boys (1·06, 0·92-1·24). Self-harm among older children (mean age 16·3 years, range 13·0-16·3) showed good evidence of an increase (1·18, 1·00-1·39), but among younger children (mean age 9·0 years, range 5·5-12·0) there was modest evidence of a decrease (0·85, 0·70-1·05). INTERPRETATION The integration of mental health support within community health and the education system-including promotion, prevention, early intervention, and treatment-is urgently needed to increase the reach of mental health support that can mitigate child and adolescent mental distress. In future pandemics, increased resourcing in some emergency department settings would help to address their expected increase in visits for acute mental distress among children and adolescents. FUNDING None.
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Affiliation(s)
- Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital Research Institute, Calgary, AB, Canada.
| | - Daphne J Korczak
- Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Tracy Vaillancourt
- Counselling Psychology, Faculty of Education, University of Ottawa, Ottawa, ON, Canada; School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Nicole Racine
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Will G Hopkins
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Paolo Pador
- Department of Psychology, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Jackson M A Hewitt
- Department of Psychology, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Batool AlMousawi
- Department of Psychology, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Sheila McDonald
- Department of Paediatrics, Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Ross D Neville
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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11
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Álvarez-Pardo S, de Paz JA, Romero-Pérez EM, Tánori-Tapia JM, Rendón-Delcid PA, González-Bernal JJ, Fernández-Solana J, Simón-Vicente L, Mielgo-Ayuso J, González-Santos J. Related Factors with Depression and Anxiety in Mastectomized Women Breast Cancer Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2881. [PMID: 36833577 PMCID: PMC9956270 DOI: 10.3390/ijerph20042881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/27/2023] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
Breast cancer (BC) is the most common cancer diagnosis with the highest mortality rate worldwide. The aim of this study was to identify factors related to depression and anxiety in mastectomized women BC survivors. A cross-sectional study was conducted with a sample of 198 women diagnosed with BC aged 30-80 years in Mexico. Depression and anxiety were assessed using the 14-item Hospital Anxiety and Depression Scale (HADS). The results showed that 94.44% and 69.18% of the women scored more than eight points on HADS in the anxiety and depression subscales, respectively; 70.20% and 10.60% were identified as pathological. The following variables were analyzed: age, time elapsed since the start of treatment, received treatment at the time of the evaluation, type of surgery, family history, marital status and employment status. Time elapsed since surgery, having a partner, and employment showed significant results as factors associated to levels of depression and anxiety in these patients. In conclusion, it has been shown that BCSs under 50 years of age receiving some kind of treatment, without family history, without a partner, with a job, with more than secondary education and with more than 5 years since diagnosis could have higher rates of clinical depression. On the other hand, BCSs older than 50 years receiving some kind of treatment, without family history, without a partner, with a job, with more than secondary education and with more than 5 years since diagnosis, could have higher rates of clinical anxiety. In conclusion, the variables studied provide valuable information for the implementation of psychotherapy plans in healthcare systems to reduce the risk of depression and/or anxiety in women with BC who have undergone mastectomy.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Juan Mielgo-Ayuso
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain
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