A cross-sectional survey was made in 56 exceptionally healthy males, ranging in age from 20 to 84 years. Measurements were made of selected steroidal components and peptidic hormones in blood serum, and cognitive and physical tests were performed. Of those blood serum variables that gave highly significant negative correlations with age (r > ؊0.6), bioavailable testosterone (BT), dehydroepiandrosterone sulfate (DHEAS), and the ratio of insulinlike growth factor 1 (IGF-1) to growth hormone (GH) showed a stepwise pattern of age-related changes most closely resembling those of the age steps themselves. Of these, BT correlated best with significantly age-correlated cognitive and physical measures. Because DHEAS correlated well with BT and considerably less well than BT with the cognitive and physical measures, it seems likely that BT and͞or substances to which BT gives rise in tissues play a more direct role in whatever processes are rate-limiting in the functions measured and that DHEAS relates more indirectly to these functions. The high correlation of IGF-1͞GH with age, its relatively low correlation with BT, and the patterns of correlations of IGF-1͞GH and BT with significantly age-correlated cognitive and physical measures suggest that the GH-IGF-1 axis and BT play independent roles in affecting these functions. Serial determinations made after oral ingestion of pregnenolone and data from the literature suggest there is interdependence of steroid metabolic systems with those operational in control of interrelations in the GH-IGF-1 axis. Longitudinal concurrent measurements of serum levels of BT, DHEAS, and IGF-1͞GH together with detailed studies of their correlations with agecorrelated functional measures may be useful in detecting early age-related dysregulations and may be helpful in devising ameliorative approaches.

Background Despite the aging of numerous societies and future health care challenges, clinical research in the elderly is underrepresented. The aim of this review was to analyze the current practice exemplary in gerontotraumatology and to discuss potential improvements. Materials and methods A literature review was performed in 2016 based on a PubMed search for gerontotraumatologic studies published between 2005 and 2015. Trials were evaluated for methodology and ethical and age-related aspects. Results The search revealed 649 articles, 183 of which met the inclusion criteria. The age range for inclusion was heterogeneous; one-third of trials included patients <65 years and only 11% excluded very elderly. Seventy-four trials excluded patients with typical comorbidities, with 55% of these without stating scientific reasons. Frailty was assessed in 94 trials and defined as the exclusion criterion in 66 of them. Informed consent (IC) was reportedly obtained in 144 trials; descriptions of the IC process mostly remained vague. Substitute decision making was described in 19 trials; the consenting party remained unclear in 45 articles. Diagnosed dementia was a primary exclusion criterion in 31% of the trials. Seventeen trials assessed decisional capacity before inclusion, with six using specific assessments. Conclusion Many trials in gerontotraumatology exclude relevant subgroups of patients, and thus risk presenting biased estimates of the relevant treatment effects. Exclusion based on age, cognitive impairment, or other exhaustive exclusion criteria impedes specific scientific progress in the treatment of elderly patients. Meaningful trials could profit from a staged, transparent approach that fosters shared decision making. Rethinking current policies is indispensable to improve treatment and care of elderly trauma patients and to protect study participants and researchers alike.

The objective of this study was to characterize the associations between light exposure in the free-living environment and multiple dimensions of sleep health of typically developing adolescents. Fifty-six (29 girls, 27 boys) typically developing adolescents (mean age = 13.59, SD = 0.89, range = 12-17 years) participated. For six consecutive nights, sleep was assessed in the home environment using actigraphy. During the same period, participants were asked to fill out a daily sleep log and a daily light exposure log, and to complete questionnaires regarding their alertness and subjective sleep satisfaction. Longer self-reported exposure to daylight in the morning was associated with longer objectively measured sleep duration. Longer self-reported exposures to electronic devices in the evening were associated with later objectively measured sleep onset and offset times, shorter sleep duration, and greater day-to-day sleep variability. Longer morning exposure to outdoor light was associated with a longer sleep duration. Self-reported light exposure was not associated with sleep satisfaction, alertness/sleepiness, or sleep efficiency. Among the covariates, circadian preference accounted for the highest percentage of variance. Adolescents’ sleep health is associated with the self-reported duration of exposure to daylight in the morning and to electronic devices in the evening.

Introduction The COVID-19 pandemic continues to evolve internationally, increasing levels of psychological stress in adolescents around the world, and thereby increasing their risk for emotional disorders associated with chronic stress. This ongoing threat to adolescents’ mental health requires that we identify factors that contribute to their ability to cope with situations shown to carry significant risks, such as the COVID-19 pandemic (i.e., their resiliency).Negative emotions are associated with chronic stress, and factors that reduce levels of negative emotions are associated with improved resiliency. Healthier sleep is associated with lower levels of negative emotions. Cognitive reappraisal (changing the way one thinks about potentially emotion-eliciting events) is an emotional regulation strategy that downregulates negative emotions. However, there is little information about the associations between sleep quality, emotional regulation, and resiliency in adolescents. The present study sought to fill this gap by examining the associations between adolescents’ sleep quality and disturbances, emotional regulation strategies and adolescents’ resiliency during the COVID-19 pandemic. Methods Forty-five adolescents (M=13.47, SD=1.7 years) participated in the study during the first wave of the COVID-19 pandemic in Canada (May 15 to June 30, 2020). The Pittsburgh Sleep Quality Index was used to assess adolescents’ self-reported sleep quality and disturbances. The Emotion Regulation Questionnaire was used to assess respondents' tendencies to regulate their emotions using cognitive reappraisal or expressive suppression. The Connor-Davidson Resilience Scale was used to measure resilience. Behavioral/emotional problems were assessed before the pandemic using the Youth Self Report (YSR). Results Hierarchical multiple linear regression analyses revealed that lower levels of sleep disturbances and frequent use of cognitive reappraisal to regulate emotions were associated with a higher level of resiliency during the COVID-19 pandemic, above and beyond the contributions of gender or pre-pandemic emotional or behavioral problems. Conclusion Better sleep quality and the habitual use of an emotional regulation strategy that is effective in downregulating negative emotions are associated with higher resiliency in adolescents facing the COVID-19 pandemic. The cross-sectional nature of the study does not allow the inference of causation. Support (If Any) CIHR 418638 to Reut GruberRGPIN-2015-04467 to Reut Gruber

Zusammenfassung. Die Bursitis olecrani ist ein häufiges Krankheitsbild, das systemische, infektiöse und traumatische Ursachen haben kann. Mit diesem Beitrag wollen wir die Diagnostik, mögliche Differenzialdiagnosen, Komplikationen und die aktuellen Therapieempfehlungen vorstellen und einen Leitfaden für die Praxis an die Hand geben.