Sedentary individuals, particularly new military recruits, who start a physical training program have a substantial risk of developing an overuse injury of the lower limb. In this study we investigated the effect of neoprene insoles on the incidence of overuse injuries during 9 weeks of basic military training. The experimental group consisted of 237 randomly selected new recruits, while 1151 recruits were the control group. Insoles were given to the experimental group and compliance was monitored. A panel of doctors documented and classified all injuries occurring during the 9 week period. A total of 54 (22.8%) and 237 (31.9%) injuries were reported in the experimental and control groups, respectively. In both groups, the majority of injuries were overuse (experimental group, 90.7%; control group, 86.4%). The mean weekly incidence of total overuse injuries and tibial stress syndrome was significantly lower (P less than 0.05) in the experimental group. The mean incidence of stress fractures was lower in the experimental group but not significantly so (0.05 less than P less than 0.1). This study shows that the incidence of total overuse injuries and tibial stress syndrome during 9 weeks of basic military training can be reduced by wearing insoles.

IntroductionResearch has shown that eating disorder (ED) patients who abuse substances demonstrate worse ED symptomatology and poorer outcomes than those with EDs alone, including increased general medical complications and psychopathology, longer recovery times, poorer functional outcomes and higher relapse rates. This article provides a broad overview of the prevalence, aetiology, assessment and management of co-morbid EDs and substance use disorders (SUDs).ReviewThe co-occurrence of EDs and SUDs is high. The functional relationship between EDs and SUDs vary within and across ED subtypes, depends on the class of substance, and needs to be carefully assessed for each patient. Substances such as caffeine, tobacco, insulin, thyroid medications, stimulants or over the counter medications (laxatives, diuretics) may be used to aid weight loss and/or provide energy, and alcohol or psychoactive substances could be used for emotional regulation or as part of a pattern of impulsive behaviour. A key message conveyed in the current literature is the importance of screening and assessment for co-morbid SUDs and EDs in patients presenting with either disorder. There is a paucity of treatment studies on the management of co-occurring EDs and SUDs. Overall, the literature indicates that the ED and SUD should be addressed simultaneously using a multi-disciplinary approach. The need for medical stabilization, hospitalization or inpatient treatment needs to be assessed based on general medical and psychiatric considerations. Common features across therapeutic interventions include psycho-education about the aetiological commonalities, risks and sequelae of concurrent ED behaviours and substance abuse, dietary education and planning, cognitive challenging of eating disordered attitudes and beliefs, building of skills and coping mechanisms, addressing obstacles to improvement and the prevention of relapse. Emphasis should be placed on building a collaborative therapeutic relationship and avoiding power struggles. Cognitive behavioural therapy has been frequently used in the treatment of co-morbid EDs and SUDs, however there are no randomized controlled trials. More recently evidence has been found for the efficacy of dialectical behavioural therapy in reducing both ED and substance use behaviours.ConclusionFuture research would benefit from a meta-analysis of the current research in order to better understand the relationships between these two commonly co-occurring disorders.

A study was undertaken to document the incidence of overuse injuries sustained during basic military training. The injuries in military recruits (N = 1,261) undergoing basic training were documented prospectively over a 9-week period. Injury incidence was expressed as percentage of all recruits injured, weekly incidence (injuries/1,000 recruits/week), and injuries/1,000 training hours. The incidence of six common specific overuse injuries was also recorded. The overall incidence of injuries over the 9-week period was 31.9% (acute, 13.6%; overuse, 86.4%), or 1.8/1,000 training hours. The highest incidence of injuries was recorded in weeks 1 to 3 and week 9 of training, which were weeks characterized by marching ( > 77% of the training time). The highest incidence (injuries/1,000 training hours) of specific overuse injuries were tibial bone stress reaction (0.33), patellofemoral pain (0.22), and the iliotibial band friction syndrome (0.08). The incidence of stress fractures over the 9-week period was 1.2% (0.07/1,000 training hours). Injuries to the knee, lower leg, and ankle accounted for more than 80% of all injuries. A total of 3.6% of training days were lost during this period, mainly due to bone stress injuries. In order to reduce injuries during basic military training, attention must be directed towards (1) modifying the type of training and (2) prevention of bone stress injuries.

The use of naturally available materials not conforming to traditional specifications or standards in the base and sub-base layers of road pavement structures and stabilised with New-age (Nano) Modified Emulsions (NME) have been tested, implemented and successfully verified through Accelerated Pavement Testing (APT) in South Africa. This was made possible through the development and use of a materials design procedure addressing fundamental principles and based on scientific concepts which are universally applicable. The understanding and incorporation of the chemical interactions between the mineralogy of the materials and an NME stabilising agent (compatibility between the chemistry of the reactive agents and material mineralogy) into the design approach is key to achieving the required engineering properties. The evaluation of the stabilised materials is performed using tests indicative of the basic engineering properties (physics) of compressive strengths, tensile strengths and durability. This article describes the basic materials design approach that was developed to ensure that organofunctional nano-silane modified emulsions can successfully be used for pavement layer construction utilising naturally available materials at a low risk. The enablement of the use of naturally available materials in all pavement layers can have a considerable impact on the unit cost and lifecycle costs of road transportation infrastructure.

Upgrading, maintenance and rehabilitation of road infrastructure is expensive, especially in view of the growing scarcity and cost of suitable road building materials. In areas with high mica content and secondary minerals such as smectite in the natural materials, stabilisation with cement is not viable. The Council for Scientific and Industrial Research of South Africa has embarked on a research programme to evaluate the performance of substandard materials improved with anionic nanosilane modified bitumen emulsions for use in base and subbase layers. This work comprises laboratory testing as well as Accelerated Pavement Testing using the Heavy Vehicle Simulator (HVS). The results of a full-scale HVS test on a light pavement as well as initial analysis on a medium traffic road are discussed. It has been shown that stabilisation of available substandard materials using an anionic nano-silane modified bitumen emulsion compared with the standard approach of importing high quality crushed aggregate can lead to savings as high as 40%-50% for equivalent performance. In addition, there was also a significant reduction in construction effort and time.