Race Participation Research Articles

Determinants of Interindividual Variation in Exercise-Induced Cardiac Troponin I Levels.

BackgroundPostexercise cardiac troponin levels show considerable interindividual variations. This study aimed to identify the major determinants of this postexercise variation in cardiac troponin I (cTnI) following 3 episodes of prolonged high‐intensity endurance exercise.Methods and ResultsStudy subjects were recruited among prior participants in a study of recreational cyclists completing a 91‐km mountain bike race in either 2013 or 2014 (first race). In 2018, study participants completed a cardiopulmonary exercise test 2 to 3 weeks before renewed participation in the same race (second race). Blood was sampled before and at 3 and 24 hours following all exercises. Blood samples were analyzed using the same Abbot high‐sensitivity cTnI STAT assay. Fifty‐nine individuals (aged 50±9 years, 13 women) without cardiovascular disease were included. Troponin values were lowest before, highest at 3 hours, and declining at 24 hours. The largest cTnI difference was at 3 hours following exercise between the most (first race) (cTnI: 200 [87–300] ng/L) and the least strenuous exercise (cardiopulmonary exercise test) (cTnI: 12 [7–23] ng/L; P<0.001). The strongest correlation between troponin values at corresponding times was before exercise (r=0.92, P<0.0001). The strongest correlations at 3 hours were between the 2 races (r=0.72, P<0.001) and at 24 hours between the cardiopulmonary exercise test and the second race (r=0.83, P<0.001). Participants with the highest or lowest cTnI levels showed no differences in race performance or baseline echocardiographic parameters.ConclusionsThe variation in exercise‐induced cTnI elevation is largely determined by a unique individual cTnI response that is dependent on the duration of high‐intensity exercise and the timing of cTnI sampling.RegistrationURL: https://www.clinicaltrials.gov; Unique identifier: NCT02166216.

The Influence of Sociodemographic Heterogeneity on the Perceptions of COVID-19: A Countrywide Survey Study in the USA

Background: Sociodemographic factors such as age, race, education, family income, and sex have been reported to influence COVID-related perceptions, reflected by knowledge, stress, and preventive behavior. We conducted a US-based survey to estimate the difference in COVID-related perceptions among diverse sociodemographic groups and the influence of sociodemographic heterogeneity on COVID-related perceptions. Methods: The survey enquired about sociodemographic parameters and relevant information to measure knowledge, stress, and preventive behavior. COVID-perception scores among sociodemographic subgroups were compared with ANOVA (Bonferroni). The general linear model (GLM) was used to estimate the association among sociodemographic factors and COVID-related perceptions. Results: Females (75%) and White participants (78%) were the predominant (N = 3734). Females, White participants, wealthy, and educated participants demonstrated better knowledge, while participants of minority races, younger ages, low incomes, and females experienced high stress. Females, African-Americans, and educated participants better adopted preventive behaviors. Race, family income, and sex were the highest contributors to the predictive model. Sociodemographic determinants had statistically significant associations with knowledge (F-score = 7.72, p < 0.001; foremost predictor: race), stress (F-score = 16.46, p < 0.001; foremost predictor: income), and preventive behavior (GLM: F-score = 7.72, p < 0.001, foremost predictor: sex). Conclusion: Sociodemographic heterogeneity significantly influenced COVID-related perceptions, while race, family income, and sex were the strongest determinants of COVID-related perceptions.

Reply

Dear Editor:We appreciate the opportunity to respond to the letter about our investigation of age, sex, environmental conditions, and the incidence of exertional heat stroke (EHS) in a warm-weather road race.1 The letter author raises some points that allow us to further expand on our findings and, we hope, provide adequate context for his concerns.Overall, in examining the implications of this investigation, we appear to diverge from the author of the letter on a key point. He argues that EHS is preventable. Although every case of EHS is theoretically preventable, the large numbers of people with a variety of individual risk factors exercising in warm environments make total prevention nearly impossible. In addition to running road races, large-scale events involving exercise, such as military basic training,2 are subject to similar concerns regarding exertional heat illnesses despite comprehensive prevention efforts. However, we reiterate that data from this very race indicated that mortality from EHS did appear to be preventable with appropriate treatment.3The purpose of this investigation was to examine the factors that influenced the incidence of EHS on a population level. Furthermore, we sought to identify the factors that medical teams and race organizers might be able to consider before the road race to help determine the staff and supplies needed to appropriately treat patients with EHS. In our discussion, we fully acknowledged that EHS risk is multifactorial and consists of both intrinsic and extrinsic factors.4 However, the individual factors of the participants in running road races cited by the letter author (fitness, heat acclimatization, adiposity, and exertional intensity) are unknown and would likely require advanced laboratory techniques to ascertain. Even if these data were available for the cases presented, the utility of these analyses for onsite medical providers is limited. The mechanistic insights the author of the letter tried to glean from the presented data are beyond the scope of these data.Several times, the letter author referenced our findings, saying that males and youth were found to be at a higher risk of EHS. Throughout the paper, we referred to the results as applying to “younger runners,” not “youth,” and further clarified in the conclusion that these results primarily applied to runners aged 19 to 39 years. We made this distinction for many of the reasons the author of the letter stated, including the fact that the physiological and behavioral circumstances of individuals under the age of 18 participating in this race were unique.The letter author denoted several factors that may play a role in children having altered susceptibility to EHS. He correctly indicated that an altered body mass-to-surface area ratio did not solely explain the altered risk in youth individuals, and it is clear from his review that a description of the nuances of this risk extends beyond what is included in our manuscript. Runners under the age of 14 accounted for only 2.4% of race participants and 2.6% of patients with EHS. However, we would caution the author to avoid comparing EHS- and heat-related deaths (which include nonexertional cases); the mechanisms and causes of these conditions are clearly disparate.Finally, the author of this letter highlighted the claim that “only younger age accounted for an increased incidence of EHS,” yet we would like to stress that this statement was taken out of context: the other part of that sentence reads, “However, when sex was considered with age and WBGT [wet bulb globe temperature]. . .” We did not characterize age as the sole risk factor for EHS but rather our data supported that, of those variables we could study, age did statistically explain the greatest variance in EHS incidence.We conclude by emphasizing that our findings were epidemiologic in nature. Many factors influence an individual's susceptibility to EHS; by examining the patterns of EHS incidence in events such as the Falmouth Road Race, we can observe trends that either allow researchers to study these mechanisms in controlled environments or establish reference incidences for medical providers. We agree with the letter author's recommendations to increase community collaboration and minimize the risk globally for all runners using the precautions listed.

Health Impacts of Alcohol Consumption: Report on Focus Group Findings

Introduction: Alcohol is one of the most widely used drug substances in the world. Most people drink a small or moderate amount of alcohol to make them calm and enhance their social activities. Alcohol have become many individuals’ livelihood and that itself is a major catastrophe for some people. This study aims to obtain perspectives in regards to Alcohol consumption among participants of different age groups, education backgrounds, religions, races and social statuses.&#x0D; Methods: A focus group discussion consists of 3 male and 3 female Malaysians with age range from 16 to 45 was conducted. It consists of a mix group of alcohol consumers and non-alcohol consumers, students and adults from different racial backgrounds, genders and age groups. The participants were approached through qualitative research where they were asked both open-ended and close-ended questions based on various themes regarding the subject matter.&#x0D; Results: In this study, peer pressure is one of the root causes that made most of the participants to initially try alcohol. Family’s acceptance towards alcohol drinking becomes a confounding factor that gives the child to do as they wish. Those who are still in school or universities showed that they consumed more alcohol. The realization of the younger age group towards health implications of alcohol consumption is still poor compared to those of the older age group. Although participants were well aware of the social problems, it is limited to their experiences as well as social backgrounds.&#x0D; Conclusion: Participants’ knowledge regarding alcohol consumption has to be improved. Further analysis on the alcohol drinking behaviour on a larger scale might be needed to alleviate all the problems caused by alcohol consumption.

DOP58 Non-white race is associated with decreased efficacy of tumor necrosis factor antagonist therapy in Ulcerative Colitis: A post-hoc analysis of individual level data from golimumab clinical trials

Abstract Background Observational studies suggest non-white patients with inflammatory bowel disease (IBD) have worse clinical outcomes.1 There are limited data on whether race impacts response to biologic therapy. We therefore aimed to evaluate the efficacy of the tumor necrosis factor (TNF) antagonist golimumab comparing white to non-white participants, using individual participant level data from phase 2/3 randomized clinical trials of TNF antagonist therapy in ulcerative colitis (UC). Methods We conducted a pooled analysis of individual-level data from the induction and maintenance trials of golimumab in UC accessible through Yale University Open Data Access Project (YODA). There were insufficient non-white participants in infliximab studies accessible through YODA, precluding meaningful analysis. We analyzed patients in the placebo and treatment arms separately. Our primary outcome was clinical response and secondary outcomes were clinical remission and endoscopic healing according to clinical trial definitions. We compared white and non-white (defined as Black, Asian, or Other race) participants using multivariable logistic regression a priori adjusting for age, sex, treatment group, baseline Mayo score, immunomodulator and corticosteroid use. Effect estimates were expressed as adjusted odds ratios (aOR) and 95% confidence intervals (95% CI). Results A total of 1,006 participants were included in the induction trial (PURSUIT-SC; 18% non-white) and 783 participants in the maintenance trial (PURSUIT-M; 17% non-white). Non-white participants had significantly lower odds of week 6 clinical response (aOR 0.43, 95%CI 0.28–0.66), clinical remission (aOR 0.41, 95%CI 0.22–0.77) and endoscopic remission (aOR 0.48, 95%CI 0.30–0.74) compared to white participants (Figure). Non-white participants also had a lower adjusted odds of week 30 clinical response (aOR 0.64, 95%CI 0.40–1.01), clinical remission (aOR 0.45, 95%CI 0.28–0.74), and endoscopic remission (aOR 0.62, 95%CI 0.41–0.96). By week 54, the lower odds of these outcomes among non-whites were no longer statistically significant (Figure). Conclusion Non-white UC patients were less likely to achieve clinical response, clinical remission, and endoscopic healing with golimumab compared to white patients in these clinical trials. Further studies are needed to understand these differences and whether they are observed with other drugs or outside the context of clinical trials. Reference

Individual knowledge of, perceptions about, and barriers to physical literacy (PL) in Malaysia

Abstract The purpose of this study was to evaluate individuals’ knowledge of, perceptions about, and barriers to promoting physical literacy (PL) in Malaysia. Random samples of 360 participants of different genders, ages, races, and education levels (aged 15–60 years) residing in Malaysia participated in this study, which was conducted on online platforms between the months of February and May, 2019. The participants’ knowledge was assessed using a modified Physical Literacy Knowledge questionnaire (PLKQ). Open-ended questions were also conducted to assess perceived perceptions and barriers to improving participants’ PL, thus strengthening the validity and reliability of data collection. Quantitative data were analyzed using descriptive statistics (e.g., means, SD) and the Pearson correlation coefficient, while the analysis of qualitative data involved the usage of the Interpretive Phenomenological Approach (IPA). The participants showed greater efficacy about standards in physical education and believed that PL is developed throughout one’s lifetime, with (M = 3.2, SD = 1.02) and (M = 3.78, SD = 1.02), respectively. Additionally, most participants pointed to the necessity of having specific skills and experience to develop PL among young people as the main barrier to improving PL in Malaysia, with (M = 3.25, SD = 1.02). This initial study will provide better direction for future researchers and educators to plan an intervention to increase PL among Malaysians and advocate for physical activity in individuals’ daily lives. Additionally, this study will be useful to inform future educators’ teaching practices, particularly in Malaysian schools.

Spiritual Care Competence among Malaysian Staff Nurses

Background: Perceptions and levels of understanding of spiritual care vary among nurses, which may affect their competency to meet the patient’s spiritual needs. Therefore, determining nurses' perception of spiritual care is the first important step in addressing the spiritual needs of patients, and may also help nursing management in developing spiritual care education and training programs.Purpose: This study aimed to assess the competence of Malaysian nurses toward providing spiritual care and identify the relationship between nurses’ spiritual care competence and their sociodemographic factors. Methods: This study employed a cross-sectional design to assess nurses' competence in spiritual care by using a simple random sampling method which involved 271 staff nurses from a public hospital in Northeast of Peninsular Malaysia. Spiritual care competence scale in Bahasa Malaysia version was used for data collection. Data analysis was performed using descriptive (frequency, percent, mean, standard deviation) and inferential (Chi-square and Pearson’s correlation test) statistics.Results: This study showed that 69.7% of staff nurses had an average level of competence toward providing spiritual care for the patients (M=95.44, SD=4.34). The highest mean difference among the domains was personal support and patients counseling (MD=5.789), while the lowest mean difference was assessment and implementation of spiritual care (MD=1.258). Furthermore, there was no significant relationship between spiritual care competence and sociodemographic factors (gender, age, marital status, educational level, nurses' experience, race, religion, and previous participation in training spiritual care programs).Conclusion: The majority of nurses have an average level of competence toward providing spiritual care. There is no significant relationship between nurses’ spiritual care competence and sociodemographic factors.

Assessment of Cumulative Incidence and Severity of Primary Open-Angle Glaucoma Among Participants in the Ocular Hypertension Treatment Study After 20 Years of Follow-up

Ocular hypertension is an important risk factor for the development of primary open-angle glaucoma (POAG). Data from long-term follow-up can be used to inform the management of patients with ocular hypertension. To determine the cumulative incidence and severity of POAG after 20 years of follow-up among participants in the Ocular Hypertension Treatment Study. Participants in the Ocular Hypertension Treatment Study were followed up from February 1994 to December 2008 in 22 clinics. Data were collected after 20 years of follow-up (from January 2016 to April 2019) or within 2 years of death. Analyses were performed from July 2019 to December 2020. From February 28, 1994, to June 2, 2002 (phase 1), participants were randomized to receive either topical ocular hypotensive medication (medication group) or close observation (observation group). From June 3, 2002, to December 30, 2008 (phase 2), both randomization groups received medication. Beginning in 2009, treatment was no longer determined by study protocol. From January 7, 2016, to April 15, 2019 (phase 3), participants received ophthalmic examinations and visual function assessments. Twenty-year cumulative incidence and severity of POAG in 1 or both eyes after adjustment for exposure time. A total of 1636 individuals (mean [SD] age, 55.4 [9.6] years; 931 women [56.9%]; 1138 White participants [69.6%]; 407 Black/African American participants [24.9%]) were randomized in phase 1 of the clinical trial. Of those, 483 participants (29.5%) developed POAG in 1 or both eyes (unadjusted incidence). After adjusting for exposure time, the 20-year cumulative incidence of POAG in 1 or both eyes was 45.6% (95% CI, 42.3%-48.8%) among all participants, 49.3% (95% CI, 44.5%-53.8%) among participants in the observation group, and 41.9% (95% CI, 37.2%-46.3%) among participants in the medication group. The 20-year cumulative incidence of POAG was 55.2% (95% CI, 47.9%-61.5%) among Black/African American participants and 42.7% (95% CI, 38.9%-46.3%) among participants of other races. The 20-year cumulative incidence for visual field loss was 25.2% (95% CI, 22.5%-27.8%). Using a 5-factor baseline model, the cumulative incidence of POAG among participants in the low-, medium-, and high-risk tertiles was 31.7% (95% CI, 26.4%-36.6%), 47.6% (95% CI, 41.6%-53.0%), and 59.8% (95% CI, 53.1%-65.5%), respectively. In this study, only one-fourth of participants in the Ocular Hypertension Treatment Study developed visual field loss in either eye over long-term follow-up. This information, together with a prediction model, may help clinicians and patients make informed personalized decisions about the management of ocular hypertension. ClinicalTrials.gov Identifier: NCT00000125.

Portugal on the eve of presidential elections

In 2015, Portugal entered a new political cycle with the main actors being the left-wing parties under the auspices of the Socialist Party and its leader Antonio Costa who took over as prime minister. The author analyzes the results of the socialist government activities carried out with the parliamentary support of the left. The author also studies the electoral process of 2017-2019, the dynamics of strengthening the position of the Socialist Party, and significance of the results of elections to national authorities. The trajectory of the country’s membership in the European Union, the history of the results of the European Parliament elections, including the 2019 elections, and the positions of the main political parties are analyzed. In connection with force majeure circumstances arising from the COVID-19 pandemic, the situation in the healthcare system was also studied and a program of the authorities to prevent the spread of coronavirus infection is presented in the article. The author touches upon the economic consequences of the pandemic, especially on those industries that will be most affected – tourism in particular. The article contains a brief forecast of the alignment of political forces on the eve of the presidential elections in 2021. The key is the idea that the pandemic will make possible adjustments in terms of the image and ratings of the country’s leaders and other participants in the election race. While presidential election results are usually a foregone conclusion in the event that a current head of state runs for a second term (as it is shown in the brief historical overview leading up to the article), the prime minister’s growing leadership can make adjustments to the final outcomes.

Sustainable Strategies for Marathon Tourism in the Time of Pandemics

This study established a new assessment framework to explore the mutual influences of the international marathon tourism indices. A hybrid multiple-criteria decision-making model was used to determine solutions. The surveyed expert team revealed that satisfaction with the Kaohsiung International marathon indices requires improvement, especially in the age of pandemic crisis. To make marathon tourism sustainable, we propose the following systematic improvement procedures: Decision-makers should improve the manager’s professional capabilities and ability to use a comprehensive thinking model to solve problems. Next, managers should invite tourism practitioners from neighboring areas to provide more diverse food and performances along the marathon route. Citizens should be invited to join the cheerleaders to create a lively atmosphere. In addition to the full marathon and half marathon, a completion certificate and a better gift should be provided to participants of races of other distances to increase their sense of self-worth and to encourage more runners to participate, thereby ensuring a more robust crowd of runners at the starting line.

Cardiovascular Risk Factor Profiles and Disease in Black Compared to Other Africans with Chronic Kidney Disease.

Methods Cardiovascular risk factors, aortic and cardiac function, atherosclerosis extent, and cardiovascular event rates were assessed in 115 consecutive predialysis (n = 67) and dialysis patients (n = 48) including 46 black and 69 other (32 Asian, 28 white, and 9 mixed race) participants. Data were analysed in multivariable regression models. Results Overall, black compared to other African CKD patients had less frequent carotid artery plaque (OR (95% CI) = 0.38 (0.16–0.91)) despite an increased cardiovascular risk factor burden. In receiver operator characteristic curve analysis, the Framingham score performed well in identifying non-black but not black CKD patients with carotid plaque (area under the curve (AUC) (95% CI) = 0.818 (0.714–0.921) and AUC (95% CI) = 0.556 (0.375–0.921), respectively). Black compared to other African predialysis patients experienced larger Framingham scores and more adverse nontraditional cardiovascular risk factors, impaired arterial and diastolic function but similar cardiovascular event rates (OR (95% CI) = 0.93 (0.22 to 3.87)). Among dialysis patients, black compared to other Africans had an overall similar traditional and nontraditional cardiovascular risk factor burden, similar arterial and diastolic function but increased systolic function (partial R = 0.356, p = 0.01 and partial R = 0.315, p = 0.03 for ejection fraction and stroke volume, respectively) and reduced cardiovascular event rates (OR (95% CI) = 0.22 (0.05 to 0.88)). Conclusion Black compared to other African CKD patients have less frequent very high risk atherosclerosis and experience weaker cardiovascular risk factor-atherosclerotic CVD relationships. These disparities may be due to differences in epidemiological health transition stages. Among dialysis patients, black compared to other Africans have less cardiovascular events, which may represent a selection bias as previously documented in black Americans.

Exhibiting Inclusion: An Examination of Race, Ethnicity, and Museum Participation

Museum visitors are not reflective of the diversity present in communities around the nation. In this study, we investigate the racial and ethnic diversity of art museum participants as well as the potential motivations and barriers to visiting a museum. Using the General Social Survey, we examine race and ethnicity and arts participation in the USA. We find Black individuals are less likely to attend an art museum than white individuals. Certain motivations and barriers to participating may explain part of the lack of diversity. We find Black and Latinx individuals are motivated to participate in art museums for cultural heritage reasons more than white individuals, but race and ethnicity are unrelated to perceiving admission fees as a barrier. This research highlights the urgency in the field to make museums more inclusive.

Epidemiology of Injury and Illness Among Trail Runners: A Systematic Review

Trail running is characterised by large elevation gains/losses and uneven varying running surfaces. Limited information is available on injury and illness among trail runners to help guide injury and illness prevention strategies. The primary aim of this review was to describe the epidemiology of injury and illness among trail runners. Eight electronic databases were systematically searched (MEDLINE Ovid, PubMed, Scopus, SportsDiscus, CINAHL, Health Source: Nursing/Academic, Health Source: Consumer Ed., and Cochrane) from inception to November 2020. The search was conducted according to the PRISMA statement and the study was registered on PROSPERO international prospective register of systematic reviews (CRD42019135933). Full-text English and French studies that investigated injury and/or illness among trail runners participating in training/racing were included. The main outcome measurements included: trail running injury (incidence, prevalence, anatomical site, tissue type, pathology-type/specific diagnosis, severity), and illness (incidence, prevalence, symptoms, specific diagnosis, organ system, severity). The methodological quality of the included studies was assessed using an adapted Downs and Black assessment tool. Sixteen studies with 8644 participants were included. Thirteen studies investigated race-related injury and/or illness and three studies included training-related injuries. The overall incidence range was 1.6-4285.0 injuries per 1000h of running and 65.0-6676.6 illnesses per 1000h of running. The foot was the most common anatomical site of trail running injury followed by the knee, lower leg, thigh, and ankle. Skin lacerations/abrasions were the most common injury diagnoses followed by skin blisters, muscle strains, muscle cramping, and ligament sprains. The most common trail running illnesses reported related tothe gastro-intestinal tract (GIT), followed by the metabolic, and cardiovascular systems. Symptoms of nausea and vomiting related to GIT distress and dehydration were commonly reported. Current trail running literature consists mainly of injury and illness outcomes specifically in relation to single-day race participation events. Limited evidence is available on training-related injury and illness in trail running. Our review showed that injury and illness are common among trail runners, but certain studies included in this review only focused on dermatological injuries (e.g. large number of feet blisters) and GIT symptoms. Specific areas for future research were identified that couldimprove the management of trail running injury and illness.

Physiological Indicators of Trail Running Performance: A Systematic Review

To provide a systematic overview of physiological parameters used to determine the training status of a trail runner and how well these parameters correlate with real-world trail running performance. An electronic literature search of the PubMed and Scopus digital databases was performed. Combinations of the terms "trail run" or "trail runner" or "trail running" and "performance" were used as search terms. Seven studies met the inclusion criteria. Trail running performance most commonly correlated (mean [SD]) with maximal aerobic capacity (71%; r = -.50 [.32]), lactate threshold (57%; r = -.48 [.28]), velocity at maximal aerobic capacity (43%; r = -.68 [.08]), running economy (43%; r = -.31 [.22]), body fat percentage (43%; r = .55 [.21]), and age (43%; r = .52 [.14]). Regression analyses in 2 studies were based on a single variable predicting 48% to 60% of performance variation, whereas 5 studies included multiple variable regression analyses predicting 48% to 99% of performance variation. Trail running performance is multifaceted. The classic endurance model shows a weaker association with performance in trail running than in road running. Certain variables associated with trail running research (such as testing procedures, race profiles, and study participants) hinder the execution of comparative studies. Future research should employ trail-specific testing protocols and clear, objective descriptions of both the race profile and participants' training status.

Media Portrayals of Athlete-Perpetrated Intimate Partner Violence: An Examination of the Social Ecological Model, Race, and Communication Perceptions

This study examined how participants responded to incidents of athlete-perpetrated intimate partner violence in two separate contexts: one featuring an athlete from a league that is at peak popularity among sports audiences (National Football League; NFL) and one featuring an athlete from an up-and-coming league that currently has a lower standing in professional sports (Ultimate Fighting Championship League; UFC). The authors used the social ecological model to qualitatively analyze participant perceptions about athlete-perpetrated intimate partner violence composite news packages. For the purpose of this study specifically, they centered on 1,124 responses to one of the open-ended qualitative questions asked in a larger quantitative experiment. The authors found that the participants most frequently attributed the perpetrator’s behavior to either individual or relationship-level reasons and that there were differences in the level attributed for participants of different races and ethnicities. They also determined that the participants were more likely to ascribe the violence to the suspect’s job (i.e., athlete) if they were a UFC fighter than an NFL player. Theoretical extensions of the social ecological model and practical implications for journalists, the media, and fans are offered.

Prevalence and Predictors of Limited Literacy in Public Mental Health Care.

Literacy is an important predictor of health care utilization and outcomes. We examine literacy among people seeking care in a state funded mental health clinic (Site 1) and a safety-net hospital clinic (Site 2). Limited literacy was defined as literacy at or below the 8th grade level. At Site 1, 53% of participants had limited reading literacy and 78% had limited aural literacy. At Site 2, 72% had limited reading and 90% had limited aural literacy. Regression analyses examined associations among limited literacy and psychiatric, neurocognitive and sociodemographic characteristics. Few associations among psychiatric and neurocognitive factors, and literacy were found. At Site 2, black and "other" race participants had higher odds for limited literacy compared to white participants suggesting that limited literacy may be an under-examined mechanism in understanding racial disparities in mental health. Work is needed to understand the relationships among literacy, mental health and mental health care.

Ordinary, Adequate, and Crazy: Reconsidering the “Pyramid” Metaphor for Mass-participation Sports

The article critically examines the “pyramid” metaphor for mass-participation sports. It focuses on the heterogeneity of intra-group structure and motives among adult amateurs participating in open races in running, triathlon, etc. The study is based on comparative participant observation at Russian and European mass-sports events and semi-formalized interviews. We describe the lifestyle and motives of non-elite athletes. Mostly they participate “for fit, for fun, for challenge, for socialization”, defined as key motives. Participation in races is essential for healthy lifestyle. However, the motive “for health” is peripheral. We noted a latent motive of “to win, to be ahead of others”. It reflects the very nature of sports, but creates a “loser's problem” subverting participation. We show how skill-level and a balance between key and latent motives constitute three strata among non-elite athletes. We define these strata as “Ordinary”, “Adequate” and “Crazy” and demonstrate how the motivation difference produces hidden controversies among them. Our theoretical interpretation is based on Norbert Elias’s concept of civilizing process and Konrad Lorenz’s comparative anthropology. We outline two normative sports models. For the Expressive model, the key motives “fit, fun, challenge, socialization” are socially approved, but for the Traditional-competitive or Top-achievements model, only the latent motive of “to win” looks legitimate. We believe that mass-participation sports emerged due to modern recognition of the Expressive model as a new social norm, while the Competitive model hinders its development. Rejecting the “pyramid” metaphor in sports, we propose an “iceberg” metaphor wherein these models coexist through different social roles.

Investigation of the natural supplement IQP-AS-119 for the prevention of upper respiratory tract infections in marathon race participants: A randomized, double-blind, placebo-controlled pilot study.

Intense and prolonged exercise leads to immune suppression, causing upper respiratory tract infections (URTI). A proprietary standardized dietary supplement, IQP-AS-119 has been previously developed to aid immune responses under such conditions. The current randomized, double-blind, placebo-controlled pilot study aimed to investigate the effects of IQP-AS-119 on marathon runners. A total of 80 participants were randomized equally into groups receiving either placebo (P group) or IQP-AS-119 (V group) treatment, starting 3 weeks before and for 14 days after the marathon. Benefit assessment was performed using different questionnaires. Post-marathon, the V and P groups reported 1±2.38 and 2.11±3.25 days with upper respiratory tract symptoms (URTS), respectively (P=0.038). During the 14 days post-marathon, 20.0% of the participants in the V group compared with 44.4% in the P group reported URTS (P=0.042). The V group reported significantly milder URTS compared with the P group on Days 9, 12, 13 and 14 post-marathon (P<0.05). The total Perceived Stress Questionnaire-20 score on days 2-14 were significantly lower for the V group compared with the P group (P=0.035). In the Short Form 12 Health Survey, the V group exhibited significant improvement in mental composite score on days -5 to 14 compared with the P group (P=0.038). In the overall treatment effect assessment, there were no statistically significant differences between the groups. The IQP-AS-119 was rated ‘very good’ or ‘good’ by investigators and participants, respectively, for 71 and 65% of the participants. The tolerability of IQP-AS-119 was rated as ‘very good’ or ‘good’ by both investigators and 95% of participants. No clinically relevant differences were observed between groups regarding adverse events or other safety parameters. Therefore, IQP-AS-119 was demonstrated to reduce the incidence and severity of URTI in marathon runners. Given its good tolerability profile, IQP-AS-119 may be a good nutritional supplement for the reduction of URTS in susceptible individuals.

Review: The Caribbeanization of Black Politics: Race, Group Consciousness, and Political Participation in America, by Sharon D. Wright Austin

Review: <i>The Caribbeanization of Black Politics: Race, Group Consciousness, and Political Participation in America</i>, by Sharon D. Wright Austin

Virtual Strategy Engineer: Using Artificial Neural Networks for Making Race Strategy Decisions in Circuit Motorsport

In circuit motorsport, race strategy helps to finish the race in the best possible position by optimally determining the pit stops. Depending on the racing series, pit stops are needed to replace worn-out tires, refuel the car, change drivers, or repair the car. Assuming a race without opponents and considering only tire degradation, the optimal race strategy can be determined by solving a quadratic optimization problem, as shown in the paper. In high-class motorsport, however, this simplified approach is not sufficient. There, comprehensive race simulations are used to evaluate the outcome of different strategic options. The published race simulations require the user to specify the expected strategies of all race participants manually. In such simulations, it is therefore desirable to automate the strategy decisions, for better handling and greater realism. It is against this background that we present a virtual strategy engineer (VSE) based on two artificial neural networks. Since our research is focused on the Formula 1 racing series, the VSE decides whether a driver should make a pit stop and which tire compound to fit. Its training is based on timing data of the six seasons from 2014 to 2019. The results show that the VSE makes reasonable decisions and reacts to the particular race situation. The integration of the VSE into a race simulation is presented, and the effects are analyzed in an example race.