Williston, VT: Evaluating Child Lead Screening Rates and a Potential Exposure

The CDC recommends that all 1-and 2-year-old children be screened for lead and that the most effective measure for mitigating lead poisoning in children is through primary prevention. This study evaluates lead screening rates at a Family Medicine Clinic in Williston, VT and seeks to gather community perspective on a potential failure of primary prevention in the town.https://scholarworks.uvm.edu/fmclerk/1249/thumbnail.jp

Characterization of Hypertension Risk Factors at the Committee on Temporary Shelter

Introduction: The health of homeless populations is at risk due to a high prevalence of undiagnosed hypertension (HTN) and cardiovascular disease (CVD). The interaction of housing and socioeconomic status with the risk factors for HTN and CVD remains unclear. Prevention of HTN through a healthy diet, exercise, adequate sleep, and avoidance of tobacco has been well described, but financial limitations and competing priorities for shelter and food make blood pressure (BP) control difficult for this population. By characterizing the risk factors and awareness of hypertension within the homeless population at the Committee on Temporary Shelter Daystation (COTS) in Burlington, Vermont, we may be able to identify promising avenues for therapeutic intervention.https://scholarworks.uvm.edu/comphp_gallery/1226/thumbnail.jp

Blended learning for teacher professional learning

Lärare behöver professionellt lärande för att skolresultaten ska förbättras. För att det ska göra skillnad för alla elever så behöver alla lärare delta i den. Samtidigt visas en brist på organiserat professionellt lärande för lärare (Skolverket, 2013). Digitaliseringen skapar nya möjligheter. Lärande online kännetecknas av att vara flexibel tids- och rumsmässigt. Något som kan möta det tidsmässiga hinder som skolledare uttrycker (Skolinspektionen, 2015). Forskning, av Means et al. (2009), visar att lärande med blended learning; där undervisning och lärande i det fysiska rummet kombineras med undervisning och lärande online, ger bättre effekt än lärande helt fysiskt respektive helt online. Denna studie har tittat på hur de olika undervisningsmiljöerna i blended learning; fysiskt respektive online, kan tillämpas för att skapa förutsättningar för ett framgångsrikt professionellt lärande. Metoden metasyntes har använts för att sätta samman resultat från olika studier i syfte att skapa en samling vetenskapligt grundade råd; en best practice att luta sig på vid framtida planering. Studien är teoretiskt influerad av ett sociokulturellt perspektiv på lärande. Metasyntesen visar att blended learning kan vara en god form att tillämpa. Det är tydligt att de båda undervisningsmiljöerna; fysiskt och online, är viktiga. Vid de fysiska träffarna vårdas och stärks sociala relationer, medan onlinemiljön erbjuder en betydelsefull tids- och rumsmässig flexibilitet. Förutsättningar för ett framgångsrikt professionellt lärande med blended learning är att strukturella resurser som god IT-miljö och avsatt tid för lärandet finns. Metasyntesen är tänkt som ett stöd för skolledare och andra beslutsfattare inför planering av framtida professionellt lärande för grundskollärare.Teachers need professional learning opportunities to improve school results. To have impact for all students, all teachers need to participate. However, there is currently an acknowledged lack of organized professional learning for teachers (Skolverket, 2013). Technology creates new possibilities. Online learning is known to be flexible in terms of time and space, a feature that can help meet the time-related obstacles that school leaders report (Skolinspektionen, 2015). Research, by Means et al. (2009), shows that blended learning, a method where teaching and learning face-to-face is combined with teaching and learning online, has a better effect then exclusively face-to-face or online approaches. This study has explored how the different teaching environments in a blended learning approach; face-to-face and online, can be used to create successful professional learning opportunities. The method used is research synthesis to combine results from different studies in order to create an overarching account of best practice to draw on during future planning. The study is theoretical influenced by a sociocultural view of learning. The research synthesis shows that blended learning can be a promising approach. It is clear that both the teaching environments; face-to-face and online, are important. It shows that social relationships are particularly strengthened by face-to-face meetings, while online solutions offer increased flexibility in terms of time and space. The results also show that necessary conditions for successful blended learning initiatives include structural resources such as good ICT and allocated time for learning. This research synthesis is intended to support school leaders and policymakers in the planning of future teacher professional learning

Wearable Technology and Analytics as a Complementary Toolkit to Optimize Workload and to Reduce Injury Burden

Wearable sensors enable the real-time and non-invasive monitoring of biomechanical, physiological, or biochemical parameters pertinent to the performance of athletes. Sports medicine researchers compile datasets involving a multitude of parameters that can often be time consuming to analyze in order to create value in an expeditious and accurate manner. Machine learning and artificial intelligence models may aid in the clinical decision-making process for sports scientists, team physicians, and athletic trainers in translating the data acquired from wearable sensors to accurately and efficiently make decisions regarding the health, safety, and performance of athletes. This narrative review discusses the application of commercial sensors utilized by sports teams today and the emergence of descriptive analytics to monitor the internal and external workload, hydration status, sleep, cardiovascular health, and return-to-sport status of athletes. This review is written for those who are interested in the application of wearable sensor data and data science to enhance performance and reduce injury burden in athletes of all ages

Influence of disruption of the acromioclavicular and coracoclavicular ligaments on glenohumeral motion: a kinematic evaluation

Background: Changes to the integrity of the acromioclavicular (AC) joint impact scapulothoracic and clavicular kinematics. AC ligaments provide anterior-posterior stability, while the coracoclavicular (CC) ligaments provide superior-inferior stability and a restraint to scapular internal rotation. The purpose of this cadaveric study was to describe the effect of sequential AC and CC sectioning on glenohumeral (GH) kinematics during abduction (ABD) of the arm. We hypothesized that complete AC ligament insult would result in altered GH translation in the anterior-posterior plane during abduction, while subsequent sectioning of both CC ligaments would result in an increasing inferior shift in GH translation. Methods: Six cadaveric shoulders were studied to evaluate the impact of sequential sectioning of AC and CC ligaments on GH kinematics throughout an abduction motion in the coronal plane. Following an examination of the baseline, uninjured kinematics, the AC ligaments were then sectioned sequentially: (1) Anterior, (2) Inferior, (3) Posterior, and (4) Superior. Continued sectioning of CC ligamentous structures followed: the (5) trapezoid and then the (6) conoid ligaments. For each group, the GH translation and the area under the curve (AUC) were measured during abduction using an intact cadaveric shoulder. Total translation was calculated for each condition between ABD 30° and ABD 150° using the distance formula, and a univariate analysis was used to compare total translation for each axis during the different conditions. Results: GH kinematics were not altered following sequential resection of the AC ligaments. Disruption of the trapezoid resulted in significant anterior and lateral displacement of the center of GH rotation. Sectioning the conoid ligament further increased the inferior shift in GH displacement. Conclusion: A combined injury of the AC and CC ligaments significantly alters GH kinematics during abduction. Type III AC separations, result in a significant change in the shoulder’s motion and may warrant surgical reconstruction to restore normal function

Data from: Glenohumeral joint kinematics following clavicular fracture and repairs

Background. The purpose of this biomechanical study was to determine the effect of shortened clavicle malunion on the center of rotation of the glenohumeral (GH) joint, and the capacity of repair to restore baseline kinematics. Methods. Six shoulders underwent automated abduction (ABD) and abbreviated throwing motion (ATM) using a 7-DoF automated upper extremity testing system in combination with an infrared motion capture system to measure the center of rotation of the GH joint. ATM was defined as pure lateral abduction and late cocking phase to the end of acceleration. Torsos with intact clavicle underwent testing to establish baseline kinematics. Then, the clavicles were subjected to midshaft fracture followed by kinematics testing. The fractured clavicles underwent repairs first by clavicle length restoration with plate fixation, and then by wiring of fragments with a 2-cm overlap to simulate shortened malunion. Kinematic testing was conducted after each repair technique. Center of rotation of the GH joint was plotted across all axes to outline 3D motion trajectory and area under the curve. Results. Throughout ABD, malunion resulted in increased posterior and superior translation compared to baseline. Plate fixation restored posterior and superior translations at lower abduction angles but resulted in excess anterior and inferior translation at overhead angles. Throughout ATM, all conditions were significantly anterior and superior to baseline. Translation with malunion was situated anterior to the fractured and ORIF conditions at lower angles of external rotation. Plate fixation did not restore baseline anteroposterior or superoinferior translation at any angle measured. Conclusions. This study illustrates the complex interplay of the clavicle and the GH joint. While abnormal clavicle alignment alters shoulder motion, restoration of clavicle length does not necessarily restore GH kinematics to baseline. Rehabilitation of the injured shoulder must address the osseous injury and the dynamic forces of the shoulder girdle

Posterior Capsular Plication Constrains the Glenohumeral Joint by Drawing the Humeral Head Closer to the Glenoid and Resisting Abduction

Background: Shoulder pain is a common problem, with 30% to 50% of the American population affected annually. While the majority of these shoulder problems improve, there is a high rate of recurrence, as 54% of patients experience persistent symptoms 3 years after onset. Purpose: Posterior shoulder tightness has been shown to alter glenohumeral (GH) kinematics. Clinically, posterior shoulder contractures result in a significant loss of internal rotation and abduction (ABD). In this study, the effect of a posterior capsular contracture on GH kinematics was investigated using an intact cadaveric shoulder without violating the joint capsule or the rotator cuff. Study Design: Controlled laboratory study. Methods: Glenohumeral motion, humeral load, and subacromial contact pressure were measured in 6 fresh-frozen left shoulders during passive ABD from 60° to 100° using an automated robotic upper extremity testing system. Baseline values were compared with the experimental condition in which the full thickness of posterior tissues was plicated without decompressing the joint capsule. Results: Posterior soft tissue plication resulted in increased compression between the humeral head and the glenoid (axial load) at 90° of ABD. Throughout ABD, the posterior contracture increased the anterior and superior moment on the humeral head, but it did not change the GH kinematics in this intact model. As a result, there was no increase in the subacromial contact pressure during ABD with posterior plication. Conclusion: In an intact cadaveric shoulder, posterior contracture does not alter GH motion or subacromial contact pressure during passive ABD. By tightening the soft tissue envelope posteriorly, there is an increase in compressive load on the articular cartilage and anterior/superior force on the humeral head. These findings suggest that subacromial impingement in the setting of a posterior soft tissue contracture may result from alterations in scapulothoracic motion, not changes in GH kinematics. Clinical Relevance: This investigation demonstrates that posterior capsular plication increases the axial load on the shoulder joint during ABD. While a significant difference from baseline was observed in the plicated condition, posterior capsular plication did not change GH motion or subacromial contact pressure significantly