Integrating a Sport-Based Trauma-Sensitive Program in a National Youth-Serving Organization

There is a pressing need to equip youth-serving community organizations to respond to the unique needs of trauma-exposed children. Early prevention measures can be an effective means of redirecting children to self-regulatory healing, while facilitating their transition toward strength-based thriving. Sport can offer a powerful opportunity to reach these children; however there remains little information on how to effectively develop, deliver, evaluate, and sustain trauma-sensitive sport programs in a community context. The purpose of this paper is to outline a case study of integrating sport-based trauma-sensitive practices with BGC Canada's national Bounce Back League program. An interdisciplinary partnership of academic, community, and practice experts used a community-based participatory action research approach, paired with a knowledge translational approach, to guide the process of program development. Mixed methods (e.g., surveys, logbooks, interviews, focus groups, online communications) were used to generate ongoing insights of staff's training experiences, successes and challenges of program implementation, and potential impact of program on club members. Several stages of program development are described, including: (a) collaboratively planning the program; (b) piloting the program to three clubs; (c) adapting the program using pilot insights; (d) expanding the adapted program to ten clubs; and (e) creating opportunities to maintain, sustain, and scale-out practices throughout grant duration and beyond. Lessons learned regarding the leadership team's experiences in terms of developing, adapting, and integrating trauma-sensitive practices in this community context are shared.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10560-021-00776-7.

1084 Depression and Stress Generation: Can Sleep Quality Bridge the Gap?

Introduction

The stress generation literature has established a bidirectional relationship between depression and stress. Not only do stressful life events predict depressive episodes, but a depressive history is also linked to increased, future stressors. One relevant mechanism that has received little attention to account for this relationship is sleep. Sleep difficulties are intertwined with depression, both as a predictive and maintenance factor. Beyond depression, sleep disruption is also a factor in a plethora of stressful events, from an increased risk of automotive accidents to higher reports of interpersonal conflict. The present study explored the role of sleep quality to account for depression’s association with stressors.

Methods

Ninety-six college students (Age: M = 19.56, SE = .20) reported on their depressive symptoms before undergoing a two-week, online diary, where they reported on sleep quality and the number of stressors experienced. A generalized structural equation model (GSEM) was used to test the relevance of sleep quality to account for baseline depressive symptoms predicting average differences in stressors over the diary. Within the GSEM, a multilevel model was used to explore the daily, within-person association between sleep quality and the number of stressors reported.

Results

Baseline depression was predictive of poorer sleep quality (b = .01, p < .001) and more stressors across the diary (b = .02, p = .017). Sleep quality mediated the effect of depression on stress generation (b = .002, p = .036), accounting for 13% of the variance. On a daily level, poorer sleep quality the night before predicted more stressors the next day (b = .16, p = .027).

Conclusion

The results suggest that sleep quality is a relevant mechanism in the prediction of future stressors from depression. Sleep difficulties may represent a pivotal area of future research and intervention target in breaking the cycle between depression and stress generation.

Support

Hammen, C. (1991). Generation of stress in the course of unipolar depression. Journal of Abnormal Psychology, 100, 555-561.

Tsuno, N., Besset, A., & Ritchie, K. (2005). Sleep and depression. The Journal of Clinical Psychiatry, 66, 1254-1269.

Ankrd2 is a modulator of NF-κB-mediated inflammatory responses during muscle differentiation

Adaptive responses of skeletal muscle regulate the nuclear shuttling of the sarcomeric protein Ankrd2 that can transduce different stimuli into specific adaptations by interacting with both structural and regulatory proteins. In a genome-wide expression study on Ankrd2-knockout or -overexpressing primary proliferating or differentiating myoblasts, we found an inverse correlation between Ankrd2 levels and the expression of proinflammatory genes and identified Ankrd2 as a potent repressor of inflammatory responses through direct interaction with the NF-κB repressor subunit p50. In particular, we identified Gsk3β as a novel direct target of the p50/Ankrd2 repressosome dimer and found that the recruitment of p50 by Ankrd2 is dependent on Akt2-mediated phosphorylation of Ankrd2 upon oxidative stress during myogenic differentiation. Surprisingly, the absence of Ankrd2 in slow muscle negatively affected the expression of cytokines and key calcineurin-dependent genes associated with the slow-twitch muscle program. Thus, our findings support a model in which alterations in Ankrd2 protein and phosphorylation levels modulate the balance between physiological and pathological inflammatory responses in muscle.

Characterization of human skeletal muscle Ankrd2

Human Ankrd2 transcript encodes a 37-kDa protein that is similar to mouse Ankrd2 recently shown to be involved in hypertrophy of skeletal muscle. These novel ankyrin-rich proteins are related to C-193/CARP/MARP, a cardiac protein involved in the control of cardiac hypertrophy. A human genomic region of 14,300 bp was sequenced revealing a gene organization similar to mouse Ankrd2 with nine exons, four of which encode ankyrin repeats. The intracellular localization of Ankrd2 was unknown since no protein studies had been reported. In this paper we studied the intracellular localization of the protein and its expression on differentiation using polyclonal and monoclonal antibodies produced to human Ankrd2. In adult skeletal muscle Ankrd2 is found in slow fibers; however, not all of the slow fibers express Ankrd2 at the same level. This is particularly evident in dystrophic muscles, where the expression of Ankrd2 in slow fibers seems to be severely reduced.

The effects of hormone replacement therapy on antithrombin III and protein C levels in menopausal women

OBJECTIVE

To determine if menopausal women taking estrogen with and without progestin are at increased risk for thrombotic disease as evidenced by decreased levels of antithrombin III and protein C.

DESIGN

A case controlled study.

SETTING

General community in southeastern New Hampshire.

PARTICIPANTS

One hundred seventy-one healthy women aged 38 to 65 years. Women were defined as premenopausal if follicle stimulating hormone levels were < 40 mIU/ml and menopausal if follicle stimulating hormone levels were > 40 mIU/ml. Menopausal women were subdivided according to hormone replacement therapy status; women not taking estrogen or progestin, and women taking estrogen with and without progestin for at least 1 year.

MAIN OUTCOME MEASURES

Significant differences in antithrombin III and protein C levels.

RESULTS

Premenopausal women had significantly less antithrombin III than menopausal women not taking hormone replacement therapy. Premenopausal women had significantly less protein C than menopausal women taking estrogen for at least 1 year with and without progestin.

CONCLUSION

Estrogen taken for at least 1 year with and without progestin by menopausal women will not increase the risk of thrombotic disease by lowering the levels of antithrombin III or protein C. On the contrary, estrogen is associated with an increase in circulating levels of protein C in menopausal women, and could create a protective effect not seen in premenopausal women or menopausal women not taking estrogen therapy.

A study of the fibrinolytic response in healthy men and women following a brief exposure to venous occlusion

In this study, 176 healthy men and women between the ages of 18 and 25 yrs were tested for fibrinolytic activity before and after a 5 min period of venous occlusion (VO) at 100 mm Hg. Using this protocol, 140 demonstrated an increase in fibrin plate lysis following this brief period of venous occlusion and were classified as "Responders." There were 36 individuals in the study who showed either a decrease or no change in fibrin plate lysis after 5 min of venous occlusion and they were classified as "Non-Responders." Responders showed a decrease in PAI-1 following VO. However, neither Responders nor Non-Responders demonstrated any significant differences in the levels of plasminogen, antiplasmin, protein C, free t-PA, or total t-PA following this brief exposure to venous occlusion. When comparing women and men in this study, women had significantly greater fibrin plate lysis both before and after 5 min of VO. They also demonstrated higher pre- and post-VO levels of circulating plasminogen. Also, women had less PAI-1 pre- and post-VO than men. When examining Responders and Non-Responders according to gender, women who were Responders had significantly greater fibrin plate lysis before and after VO than male Responders. Also, women Responders demonstrated a significant decrease in PAI-1 following 5 min of VO when compared to men who were Responders in this study.

A comprehensive strategy for designing a Web-based medical curriculum

In preparing for a full featured online curriculum, it is necessary to develop scaleable strategies for software design that will support the pedagogical goals of the curriculum and which will address the issues of acquisition and updating of materials, of robust content-based linking, and of integration of the online materials into other methods of learning. A complete online curriculum, as distinct from an individual computerized module, must provide dynamic updating of both content and structure and an easy pathway from the professor's notes to the finished online product. At the College of Physicians and Surgeons, we are developing such strategies including a scripted text conversion process that uses the Hypertext Markup Language (HTML) as structural markup rather than as display markup, automated linking by the use of relational databases and the Unified Medical Language System (UMLS), integration of text, images, and multimedia along with interface designs which promote multiple contexts and collaborative study.

Long survival in a 69,XXY triploid male

We report on an infant with a 69,XXY chromosome constitution who survived for 10 1/2 months; this is the longest survival reported with this condition to date. The infrequency of this disorder, data on natural history, and improved survival, possibly due to better management of respiratory illness and prematurity, are all factors worth noting in counseling on such rare conditions. Genotyping demonstrated the extra genome to be of maternal origin.

The effect of cyclical hormonal changes on erythrocyte electrolyte transport mechanisms

Electrolyte transport characteristics were examined in erythrocytes from 13 normal men and from two groups of women: taking combined oral contraceptive preparations (O/C, n = 10), and ovulatory women (non-O/C, n = 10) pre- and post-ovulation, at the same time intervals (days 7-10 and days 15-18) during a menstrual cycle. With rubidium (86Rb+) used as a potassium analogue, co-transport (ouabain-resistant, frusemide-sensitive 86Rb+ influx) values were found to be lowest in non-O/C women (28 +/- SE 2.5 nmol h-1 10(-9) cells) and highest in men (56 +/- 5.7, P less than 0.001), with results between the two in women taking O/C (42 +/- 4.2, P less than 0.05 vs men, P less than 0.01 vs non-O/C). Passive 86Rb leak (frusemide-and ouabain-resistant) was significantly lower in men (13 +/- 1.6 nmol h-1 10(-9) cells) than in both groups of women (non-O/C 29 +/- 1.8, P less than 0.001; O/C 25 +/- 1.2, P less than 0.001). There was no cyclical variation within either group of women. Maximum ouabain binding (number of NA+,K+-ATPase units) was the same in all groups. Na+,K+-ATPase activity, as determined by ouabain-sensitive 86Rb influx, was the same in men and non-O/C groups, but was significantly suppressed in O/C compared with both men (P less than 0.01) and non-O/C women (P less than 0.05). The differences found were not due to alterations in either progesterone or aldosterone, but could represent an androgenic effect in vivo of the 19-nortestosterone derivatives in combined oral contraceptive preparations.

Are the renal functional changes of human pregnancy caused by prostacyclin?

To investigate the hypothesis of others that the many characteristic physiological alterations of pregnancy are due to prostacyclin, the effects of this vasodilator prostaglandin on renal function and related variables were measured. Intravenous infusion of prostacyclin (7 ng/kg/min) for 90 minutes in seven healthy male volunteers resulting in a significant fall in diastolic blood pressure and increase in heart rate. No significant change occurred in renal plasma flow or glomerular filtration rate in response to the prostacyclin, but there were significant falls in uric acid clearance (16 +/- 1.3----10 +/- 1.5 ml/min/ 1.73m2) and in free water clearance (4.0 +/- 1.1-----0.5 +/- 0.4 ml/min) both of which rose rapidly to pre-infusion levels upon cessation of prostacyclin infusion. Plasma renin and aldosterone levels rose sharply during prostacyclin infusion, falling to pre-infusion levels rapidly afterwards. Although the haemodynamic alterations were similar, the renal functional effects of prostacyclin infusion were quite different from (and often opposite in direction to) those of normal pregnancy. This acute study therefore does not add support to the hypothesis suggested by others that these alterations in pregnancy are due to prostacyclin, and that deficiency of prostacyclin will lead to the changes of pregnancy-associated hypertension.

Stroke in a 15-year-old girl secondary to terminal carotid dissection

A 15-year-old girl died 14 days after hemiplegia suddenly developed. On arteriography, intimal separation of the middle cerebral arteries showed as a long attenuated column of dye--the "string" sign. Pathologic examination showed intimal separation starting at the distal bifurcation of the right internal carotid artery and extending into the middle and anterior cerebral arteries. The arteriographic string sign as evidence of dissection may aid diagnosis of this cause of childhood hemiplegia.