Test-Retest Reliability and Responsiveness of Gaze Stability and Dynamic Visual Acuity in High School and College Football Players

Objectives: The purpose of this study was to establish reliability and responsiveness of the active dynamic visual acuity test (DVAT) at speeds of 150 to 200 degrees per second (deg/sec) and the gaze stabilization test (GST) in high school and college football players. Design: Reliability design Setting, Participants, Main Outcome Measures: A total of 50 high school and college football athletes completed vestibulo-ocular reflex testing using the DVAT and GST in the yaw (horizontal) and pitch (vertical) planes on two separate occasions within 14 days. Results: Test-retest reliability for the DVAT was good in yaw, Intraclass Correlation Coefficient (ICC) (3,3) = 0.770 (95% confidence interval (CI): 0.595 to 0.861), and moderate to good in pitch, ICC (3,3) = 0.725 (95% CI: 0.515 to 0.844). Minimal detectable change (MDC) at the 95% confidence level was 0.16 logMAR for yaw and 0.21 logMAR for pitch. Test-retest reliability for the GST was moderate in yaw, ICC (3,3) = 0.634 (95% CI: 0.355 to 0.792), and poor in pitch, ICC (3,3) = 0.411 (95% CI: -0.037 to 0.666). MDC was 73.4 deg/sec for yaw and 81.2 deg/sec for pitch. Conclusions: Our results provide evidence that the DVAT is reliable at relatively high speeds in high school and college football athletes in both yaw and pitch. GST speeds were considerably higher than previously reported in the literature, but reliability of this tool for this population is only poor to moderate according to our results. From a clinical perspective, DVAT can be reliably used in the assessment of vestibular concussion for high school and college football athletes; however, GST requires further evaluation of its reliability and clinical use

Using information prescriptions to refer patients with metabolic conditions to the Genetics Home Reference website

pre-printObjectives: The objectives of this study were to assess the reactions of adult patients and parents of children with metabolic conditions to receipt of an ‘‘information prescription'' (IP) to visit Genetics Home Reference (GHR), a National Institutes of Health/National Library of Medicine online resource, and evaluate the perceived utility of information found on the site. Methods: Patients seen at the University of Utah Metabolic Service Clinic were invited to participate in the study and asked to complete an initial survey to gather demographic data and an online survey six weeks later to obtain information about user experience. Results: Fifty-three of 82 individuals completed both surveys, for an overall response rate of 64.6%. Most respondents (88.7%) agreed that receiving the IP was a ‘‘good idea,'' and nearly all used the IP to visit GHR. More than three-quarters (79.6%) agreed that information on GHR supplemented a physician's advice; 60.4% reported an improved understanding of a health condition; and 41.5% either looked for or would consider looking for additional information. Eighty-six percent of respondents were satisfied with the information found on GHR, and 80% would recommend the site. Conclusions: Use of an IP to direct patients to GHR was well received, and retrieved information was perceived as useful in key areas. The high level of satisfaction with GHR argues for expanded use of the IP approach in this patient population

CRIMINAL JUSTICE CONTACT AND PHYSICAL HEALTH OUTCOMES AMONG U.S. ADULTS

This project examines whether being stopped by police, arrested, convicted of a crime, or incarcerated is associated with poor physical health among U.S. young adults. Scholars have begun examining whether pre-incarceration contacts with law enforcement—such as being stopped by the police or arrested—are associated with health. Findings are inconsistent regarding whether pre-incarceration contacts are associated with poorer physical health. Previous research has tended to use single biomarker measures such as C-reactive protein or self-reported health, neither of which captures overall disease risk or poor health in young adult populations. I use a sample of Black, Latino, and White young adults ages 34-44 from the National Longitudinal Study of Adolescent to Adult Health (n=2,986) along with negative binomial regression models to examine the associations between criminal justice contacts and allostatic load. Results show that arrests at Wave III are associated with allostatic load at Wave V.Master of Art

Using the TEACHING WELL Model for Evaluation of Online Counselor Educators

As enrollment in online counselor education programs continues to grow, faculty must develop self-awareness regarding their own teaching practices. Research across various disciplines offers a variety of tools and strategies for best practices in online education, including how to effectively engage students and promote student success. The purpose of this article is to offer the TEACHING WELL Model as one practical option for online counselor educators to use as a self-evaluation or peer mentoring tool. The authors hope to offer a robust guide to streamline a process for faculty quality assurance and continued improvement in online counselor education programs

Crosstalk Between Dysfunctional Mitochondria and Inflammation in Glaucomatous Neurodegeneration

Mitochondrial dysfunction and excessive inflammatory responses are both sufficient to induce pathology in age-dependent neurodegenerations. However, emerging evidence indicates crosstalk between damaged mitochondrial and inflammatory signaling can exacerbate issues in chronic neurodegenerations. This review discusses evidence for the interaction between mitochondrial damage and inflammation, with a focus on glaucomatous neurodegeneration, and proposes that positive feedback resulting from this crosstalk drives pathology. Mitochondrial dysfunction exacerbates inflammatory signaling in multiple ways. Damaged mitochondrial DNA is a damage-associated molecular pattern, which activates the NLRP3 inflammasome; priming and activation of the NLRP3 inflammasome, and the resulting liberation of IL-1β and IL-18 via the gasdermin D pore, is a major pathway to enhance inflammatory responses. The rise in reactive oxygen species induced by mitochondrial damage also activates inflammatory pathways, while blockage of Complex enzymes is sufficient to increase inflammatory signaling. Impaired mitophagy contributes to inflammation as the inability to turnover mitochondria in a timely manner increases levels of ROS and damaged mtDNA, with the latter likely to stimulate the cGAS-STING pathway to increase interferon signaling. Mitochondrial associated ER membrane contacts and the mitochondria-associated adaptor molecule MAVS can activate NLRP3 inflammasome signaling. In addition to dysfunctional mitochondria increasing inflammation, the corollary also occurs, with inflammation reducing mitochondrial function and ATP production; the resulting downward spiral accelerates degeneration. Evidence from several preclinical models including the DBA/2J mouse, microbead injection and transient elevation of IOP, in addition to patient data, implicates both mitochondrial damage and inflammation in glaucomatous neurodegeneration. The pressure-dependent hypoxia and the resulting metabolic vulnerability is associated with mitochondrial damage and IL-1β release. Links between mitochondrial dysfunction and inflammation can occur in retinal ganglion cells, microglia cells and astrocytes. In summary, crosstalk between damaged mitochondria and increased inflammatory signaling enhances pathology in glaucomatous neurodegeneration, with implications for other complex age-dependent neurodegenerations like Alzheimer’s and Parkinson’s disease. © Copyright © 2021 Jassim, Inman and Mitchell

Addressing Supervisee Anxiety During COVID-19: Applying Models of Supervision

Graduate counseling supervisees are experiencing unprecedented obstacles, compounding stressors, and heightened anxiety amidst the global COVID-19 pandemic. If not addressed, excessive anxiety can impede professional growth and limit the competence of future counselors. While theoretical-based models of supervision exist, the application of such models has not been fully explored in relation to addressing supervisee anxiety. Prompt and pointed action is needed from counseling supervisors, who are professionally and ethically responsible for training future counselors and the gatekeeping process. Three supervision models, including the Integrative Developmental Model, Solution-Focused Supervision, and Cognitive-Behavioral Supervision, are utilized to address heightened anxiety among counseling supervisees. Implications for counseling faculty supervisors and future research are included

The impact of built environment change on all-cause and cause specific mortality: a novel longitudinal method and study

Background: Public health research increasingly acknowledges the influence of built environments (BE) on health; however, it is uncertain how BE change is associated with better population health and whether BE change can help narrow health inequalities. This knowledge gap is partly due to a lack of suitable longitudinal BE data in most countries. We devised a method to quantify BE change longitudinally and explored associations with mortality. The method is replicable in any nation that captures BE vector map data. Methods: Ordnance Survey data were used to categorise small areas as having no change, loss or gain, in buildings, roads, and woodland between 2015 and 2019. We examined individual mortality records for 2012–2015 and 2016–2019, using negative binomial regression to explore associations between BE change and all-cause and cause-specific mortality, adjusting for income deprivation. Results: BE change varied significantly by deprivation and urbanicity. Change in the BE and change in mortality were not related, however, areas that went on to experience BE change had different baseline mortality rates compared with those that did not. For example, areas that gained infrastructure already had lower mortality rates. Conclusion: We provide new methodology to quantify BE change over time across a nation. Findings provide insight into the health of areas that do/do not experience change, prompting critical perspectives on cross-sectional studies of associations between BE and health. Methods and findings applied internationally could explore the context of BE change and its potential to improve health in areas most in need beyond the UK

Changes in insulin sensitivity over time and associated factors in HIV-infected adolescents

OBJECTIVE: To compare prevalence of insulin resistance between perinatally HIV-infected (PHIV+) and perinatally HIV-exposed, but uninfected adolescents (PHEU), determine incidence of and contributory factors to new and resolved cases of insulin resistance in PHIV+, and evaluate glucose metabolism. DESIGN: Cross-sectional design for comparison of prevalence among PHIV+ and PHEU. Longitudinal design for incidence and resolution of insulin resistance among PHIV+ at risk for these outcomes. METHODS: The source population was adolescents from pediatric HIV clinics in the United States and Puerto Rico participating in the Pediatric HIV/AIDS Cohort Study, an ongoing prospective cohort study designed to evaluate impact of HIV infection and its treatment on multiple domains in preadolescents and adolescents. Insulin resistance was assessed by homeostatic model assessment of insulin resistance. Those with incident insulin resistance underwent 2-h oral glucose tolerance test and HbA1c. Baseline demographic, metabolic, and HIV-specific variables were evaluated for association with incident or resolved insulin resistance. RESULTS: Unadjusted prevalence of insulin resistance in PHIV+ was 27.3 versus 34.1% in PHEU. After adjustment for Tanner stage, age, sex, and race/ethnicity, there was no significant difference between groups. Factors positively associated with developing insulin resistance included female sex, higher BMI z score, and higher waist circumference; those associated with resolving insulin resistance included male sex and lower BMI z score. CONCLUSION: Prevalence of insulin resistance in PHIV+ and PHEU was substantially higher than that reported in HIV-uninfected nonoverweight youth, but similar to that in HIV-uninfected obese youth. Factors associated with incident or resolved insulin resistance among PHIV+ were similar to those reported in HIV-negative obese youth. However, a contributory role of HIV infection and/or its treatment to the incident risk of insulin resistance cannot be excluded

Caregiving among community-dwelling grandparents in Jamaica

Grandparents play invaluable caregiving roles in the general upbringing of grandchildren. The objective of the present study is to provide a profile of grandparents providing care to co-resident grandchildren younger than 18 years old in Jamaica. A subsample of 451 grandparents providing care to co-resident grandchildren under than 18 years old was derived from a larger nationally-representative community-based study of 2943 older adults residing in Jamaica. Data pertaining to caregiving, demography, health, socioeconomic status, and social participation were analysed using bivariate and multivariate analyses. Seventy one percent of grandparents were involve in regular care of their grandchildren. Hypertension (65.9%), arthritis (39.5%) and diabetes (27.2%) were the most common non-communicable diseases among grandparents. Approximately 60% of grandparents relied on family members for income and few reported other sources. Attendance at religious services was high at 78% while only about 40% were involved in voluntary activities. Only age was confirmed as a significant predictor of frequency of care in multivariate analyses with grandparents 80 years and older being 64% less likely to be involved in regular care compared to 60-69 year olds. In conclusion, grandparents are actively engaged in the provision of care to grandchildren. Specific health and social interventions are required to support and empower grandparents in their caregiving roles