Jingzhen Yang

Post-Concussion Symptoms of Depression and Anxiety in Division I Collegiate Athletes

This study examined the effect of baseline psychological symptoms on post-concussion symptoms among 67 concussed collegiate athletes. Depression at baseline was the strongest predictor of post-concussion depression and anxiety. Post-concussion depression and anxiety were significantly associated. These results support the importance of baseline screenings for risk of post-concussion psychological symptoms.

Postinjury Anxiety and Social Support Among Collegiate Athletes: A Comparison Between Orthopaedic Injuries and Concussions

CONTEXTnWhen an athlete is injured, the primary focus of the sports medicine team is to treat the physical effects of the injury. However, many injured athletes experience negative psychological responses, including anxiety, regarding their injury.nnnOBJECTIVEnTo compare the anxiety and social support of athletes with concussions and a matched group of athletes with orthopaedic injuries.nnnDESIGNnCross-sectional study.nnnSETTINGnAthletic training room.nnnPATIENTS OR OTHER PARTICIPANTSnA total of 525 injuries among athletes from 2 Big Ten universities were observed. Of these, 63 concussion injuries were matched with 63 orthopaedic injuries for the athletes sex, sport, and time loss due to injury.nnnMAIN OUTCOME MEASURE(S)nClinical measures included the State-Trait Anxiety Inventory (which measures both state and trait anxiety) and the modified 6-item Social Support Questionnaire.nnnRESULTSnThe group with concussions relied on their family for social support 89% of the time, followed by friends (78%), teammates (65%), athletic trainers (48%), coaches (47%), and physicians (35%). The group with orthopaedic injuries relied on their family for social support 87% of the time, followed by friends (84%), teammates (65%), athletic trainers (57%), coaches (51%), and physicians (36%). We found no differences for the State-Trait Anxiety Inventory (t = -1.38, P = .193) between the concussed and orthopaedic-injury groups. Social Support Questionnaire scores were significant predictors for postinjury state anxiety. Specifically, increased scores were associated with decreased postinjury state anxiety (β = -4.21, P = .0001).nnnCONCLUSIONSnBoth the concussed athletes and those with orthopaedic injuries experienced similar state and trait anxiety and relied on similar sources of social support postinjury. However, athletes with orthopaedic injuries reported greater satisfaction with support from all sources compared with concussed athletes. In contrast, concussed athletes showed more significant predictor models of social support on state anxiety at return to play.

Influence of Symptoms of Depression and Anxiety on Injury Hazard among Collegiate American Football Players

The purpose of this study was to examine the effect of depression and anxiety symptoms on the prospective injury hazard among collegiate American football athletes. An open cohort of intercollegiate football players (n = 330) from two Division I universities were enrolled and followed during the 2008–2010 seasons. Of 330 enrolled players, 121 (36.7%) sustained at least one injury during the participation period. A total of 66 players (20.0%) reported experiencing symptoms of depression and 109 (33.0%) reported anxiety at the time of enrollment. Depression was associated with increased likelihood of injury (hazard ratio (HR) = 1.81, 95% confidence interval (CI): 1.65, 1.98). Anxiety had an opposite effect and was protective from injury hazard (HR= 0.79, 95% CI: 0.66, 0.93). Football players who experienced depression at enrollment were 10% less likely to remain injury-free than those who did not have depressive symptoms. Evidence from this study suggests injury prevention efforts need to include strategies targeting psychological risk factors.

Steering teens safe: a randomized trial of a parent-based intervention to improve safe teen driving

BackgroundCrashes are the leading cause of death for teens, and parent-based interventions are a promising approach. We assess the effectiveness of Steering Teens Safe, a parent-focused program to increase safe teen driving.MethodsSteering Teens Safe aimed to improve parental communication with teens about safe driving using motivational interviewing techniques in conjunction with 19 safe driving lessons. A randomized controlled trial involved 145 parent-teen dyads (70 intervention and 75 control). Intervention parents received a 45-minute session to learn the program with four follow-up phone sessions, a DVD, and a workbook. Control parents received a standard brochure about safe driving. Scores were developed to measure teen-reported quantity and quality of parental communication about safe driving. The main outcome measure was a previously validated Risky Driving Score reported by teens. Because the Score was highly skewed, a generalized linear model based on a gamma distribution was used for analysis.ResultsIntervention teens ranked their parent’s success in talking about driving safety higher than control teens (pu2009=u20090.035) and reported that their parents talked about more topics (non-significant difference). The Risky Driving Score was 21% lower in intervention compared to control teens (85% CIu2009=u20090.60, 1.00). Interaction between communication quantity and the intervention was examined. Intervention teens who reported more successful communication had a 42% lower Risky Driving Score (95% CIu2009=u20090.37, 0.94) than control parents with less successful communication.ConclusionsThis program had a positive although not strong effect, and it may hold the most promise in partnership with other programs, such as Driver’s Education or Graduated Driver’s License policies.Trial registrationClinicalTrials.gov NCT01014923. Registered Nov. 16, 2009.

Social Support From the Athletic Trainer and Symptoms of Depression and Anxiety at Return to Play

CONTEXTnFew empirical studies have examined social support from athletic trainers (ATs) and its buffering effect during injury recovery.nnnOBJECTIVEnTo examine the effect of social support received from ATs during injury recovery on reported symptoms of depression and anxiety at return to play among a cohort of collegiate athletes.nnnDESIGNnCohort study.nnnSETTINGnTwo Big 10 Conference universities.nnnPATIENTS OR OTHER PARTICIPANTSnA total of 594 injuries sustained by 387 collegiate athletes (397 injuries by 256 males, 197 injuries by 131 females) on 9 sports teams.nnnMAIN OUTCOME MEASURE(S)nData were collected during the 2007-2011 seasons. Social support was measured using the 6-item Social Support Questionnaire. Symptoms of depression were assessed using the Center for Epidemiological Studies Depression Scale. Anxiety was measured by the State-Trait Anxiety Inventory. We used generalized estimation equation regression models to examine the effect of the social support from ATs on the odds of symptoms of depression and anxiety at return to play.nnnRESULTSnIn 84.3% (n = 501) of injury events, injured athletes received social support from ATs during their recovery. Of these, 264 (53.1%) athletes reported being very satisfied with this social support. Whether or not athletes received social support from ATs during recovery did not affect the symptoms of depression or anxiety experienced at return to play. However, compared with athletes who were dissatisfied with the social support received from ATs, athletes who were very satisfied or satisfied with this social support were 87% (95% confidence interval = 0.06, 0.30) and 70% (95% confidence interval = 0.13, 0.70) less likely to report symptoms of depression at return to play, respectively. Similar results were observed for anxiety.nnnCONCLUSIONSnOur findings support the buffering effect of social support from ATs and have important implications for successful recovery in both the physical and psychological aspects for injured athletes.

Evaluation of Period of PURPLE Crying, an Abusive Head Trauma Prevention Program

The Period of PURPLE Crying program is used to educate parents and caregivers about normal infant crying and the dangers of infant shaking. We evaluated nurse-led, hospital-based implementation of the program using a nonexperimental, posttest-only design. New mothers rated the program as useful, and the program was effective in teaching mothers about normal infant crying, the dangers of infant shaking, and soothing and coping techniques. The findings support the feasibility and need for broad dissemination of the program.

Parents’ experience with child safety restraint in China

BackgroundChild safety restraints are effective measures in protecting children from an injury while traveling in a car. However, the rate of child restraint use is extremely low in Chinese cities. Parent drivers could play an important role in promoting child safety restraint use, but not all of them take active responsibility.MethodsThis study used a qualitative approach and included 14 in-depth interviews among parents with a child, under the age of 6, living in Shantou City (7 child safety restraint users and 7 non-users). Purposive sampling was used to recruit eligible parent drivers who participated in a previous observation study. Interview data were collected from March to April 2013. The audio taped and transcribed data were coded and analyzed to identify key themes.ResultsFour key themes on child safety restraint emerged from the in-depth interviews with parents. These included 1) Having a child safety restraint installed in the rear seat with an adult sitting next to the restrained child is ideal, and child safety restraint is seen as an alternative when adult accompaniment is not available; 2) Having effective parental education strategies could help make a difference in child safety restraint use; 3) Inadequate promotion and parents’ poor safety awareness contribute to the low rate of child safety restraint in China; 4) Mandatory legislation on child safety restraint use could be an effective approach.ConclusionInadequate promotion and low awareness of safe traveling by parents were closely linked to low child safety seat usage under the circumstance of no mandatory legislation. Future intervention efforts need to focus on increasing parents’ safe travel awareness combined with CSS product promotion before the laws are enacted.

Incidence and Cost of Sexual Violence in Iowa

BACKGROUNDnSexual violence is a serious and costly public health problem. Current research that systematically documents the broad range of economic costs of sexual violence is lacking.nnnPURPOSEnTo estimate the incidence and costs of sexual violence in Iowa in 2009.nnnMETHODSnUsing data obtained from population surveys, six Iowa government agencies, and other sources, we estimated sexual violence incidence, costs per incident, and total costs in 2009 dollars, by age and sexual violence category, and for various cost elements. We calculated direct costs of medical care, mental health care, property damage, victim services, investigation, adjudication, and sanctioning, as well as indirect costs for lost work and quality of life. We collected data in 2010-2011 and completed analysis in 2013.nnnRESULTSnIn 2009, an estimated 55,340 individuals experienced sexual violence in Iowa, including 49,510 adults and 5,930 children. Nearly three of every four victims were women. The estimated total cost of sexual violence in 2009 was

New and Recurrent Concussions in High-School Athletes Before and After Traumatic Brain Injury Laws, 2005–2016

4.7 billion, equating to

Lifetime prevalence of traumatic brain injury with loss of consciousness

1,580 per resident. This estimate included