Concussions: A general approach to management for coaches

Youth sports (including Central Vermont Little League) are mostly coached by parents and while concussion training is suggested, it often does not occur. This leaves coaches much less likely to recognize concussion symptoms which can be dangerous. Additionally if coaches do not understand the impact of concussions they will be unable to provide any information to the youth athletes they are working with. Concussions symptoms have been shown to last longer in younger athletes and returning to play too soon puts the athlete at increased risk of an additional concussion. Therefore, education was provided to Little League coaches with the goal of ensuring that concussions can be recognized and proper management will be initiated with athletes.https://scholarworks.uvm.edu/fmclerk/1303/thumbnail.jp

A biomechanical model of the spine to predict trunk muscle forces: Optimizing the relationship between spinal stability and spinal loading.

The purpose of this study was to develop an optimization model of the spine that, incorporating a measure of spinal stability as a constraint, allowed for realistic predictions of trunk muscle and spine compression forces. A 3-dimensional, 52 muscle, single joint model of the lumbar spine was developed and tested in situations of pure trunk flexor and lateral bend moments. Spinal stability, about each anatomical axis, was calculated at the L4/L5 spinal joint. Estimates of the optimal level of spinal stability, in a given loading situation, obtained through the use of regression equations developed from experimental findings, were utilized as constraints in the optimization model. Two separate optimization cost functions were tested: (1) minimization of the sum of the cubed trunk muscle forces; (2) minimization of the intervetebral force at the L4/L5 joint level. The addition of spinal stability measures, about each anatomical axis, as constraints in the optimization model, caused significantly improved estimates of the compressive forces acting on the spine, as well as improved prediction of trunk muscle forces as a whole. Furthermore, the addition of stability constraints allowed the model to predict activity in muscles functioning as pure antagonists to the applied external moment, a first for optimization models of the spine. Thus, it is concluded that spinal stability plays a vital role in dictating the recruitment patterns of trunk muscles. Paper copy at Leddy Library: Theses & Major Papers - Basement, West Bldg. / Call Number: Thesis2003 .B76. Source: Masters Abstracts International, Volume: 42-02, page: 0572. Adviser: Jim Potvin. Thesis (M.H.K.)--University of Windsor (Canada), 2003

Examining the Neuromuscular and Mechanical Characteristics of the Abdominal Musculature and Connective Tissues: Implications for Stiffening the Lumbar Spine

Research has uncovered an essential role of proper abdominal muscle function in ensuring the health and integrity of the lumbar spine. The anatomical arrangement of the abdominal musculature (rectus abdominis, external oblique, internal oblique, transverse abdominis) and intervening connective tissues is unique in the human body. Despite the hypothesized importance and uniqueness of the abdominal muscles, very little research has been directed to understanding their role from a neuro-mechanical standpoint. Thus, this thesis was designed to study the neuro-activation and mechanical characteristics of the abdominal musculature and connective tissues, with a specific focus on torso stiffening mechanisms. Several experiments were performed and unified around this theme. The first study explored the fundamental relationship between EMG muscle activation recordings and the moments generated by the trunk musculature. This study was novel in that investigation of the abdominal musculature was augmented with consideration of antagonist muscle co-activation. The main finding was that the EMG-moment relationships were quite similar in both the abdominal and extensor muscle groups; however, the form of this relationship differed from that often reported in the literature. Specifically, consideration of antagonist muscle moments linearized the EMG-moment relationship of the agonist muscle groups. Once this activation-moment relationship had been established, the next line of questioning explored the association between torso muscle activation, driven through the abdominals, and torso stiffness. Two studies addressed this issue: the first examined the intrinsic resistance of the torso to bending in the flexion, extension, and lateral bend directions, while varying the levels of torso muscle activation; the second examined the response of the trunk to perturbations while varying the levels of torso muscle activation under the presence of limited reflexes. The first of these two studies demonstrated a rise in trunk stiffness as muscle activation increased over the lower 40% of range of motion. At greater ranges of motion in flexion and lateral bend the trunk appeared to become less stiff as the musculature contracted to higher levels. The latter study revealed substantial spinal displacements in response to trunk perturbations, indicating that in the absence of reflex activity, the stiffness produced by muscular contraction may be inadequate to stiffen the torso to prevent damage to spinal tissues. The fourth study was designed to enable in-vivo observation of abdominal muscle and connective tissue deformation using ultrasound imaging. During relatively simple abdominal contractions, the oblique aponeurosis demonstrated surprising deformation patterns that often exhibited the characteristic of a negative Poisson’s ratio. This was hypothesized to be facilitated by the composite laminate arrangement of the abdominal wall, whereby the loose connective tissues separating layers of collagen fibres may allow for separation of adjacent layers, giving the appearance of structural volume expansion. Further, a lateral displacement of the rectus abdominis muscle was noted in a majority of contractions, highlighting the dominance of the laterally oriented forces generated by the oblique muscles. The final study questioned, at a basic level, the nature of the anatomical arrangement of the abdominal muscle-connective tissue network. Examining the contraction of the rat abdominal wall uncovered the transfer of muscularly generated force and stiffness through the connective tissues binding the layered muscles. This suggests a functionality of the abdominal wall as a composite laminate structure, allowing substantial multi-directional stiffness to be generated and transmitted around the torso, thereby enhancing the ability to effectively stabilize the spine

Gaps in Adolescent Tobacco Prevention and Counseling in Vermont

Introduction. Tobacco use remains the leading cause of preventable death in Vermont. While the Vermont Blueprint for Health includes compensation for adult tobacco counseling, it includes no specific mention of pediatric populations. Research questions: To what extent are tobacco assessment and cessation efforts occurring in the primary care setting with pediatric patients? What factors influence their practices?Methods. A 12-question electronic survey, modeled on an American Academy of Pediatrics survey, was distributed to primary care providers throughout Vermont; through the UVM departments of pediatrics, family medicine, the Vermont Medical Society and the Vermont Area Health Education Center. We received 70 completed surveys.Results. 70% of the surveyed primary care providers begin tobacco counseling at the age recommended (11 years) by the Vermont Department of Health. Only 45.71% of providers are confident in their understanding of the recommendations for adolescent health screening written in the Blueprint for Health. Additionally, only 67.1% of the providers expressed confidence in their ability to provide guidance regarding the harmful effects of E-cigarettes, compared to 92.8% feeling confident regarding conventional cigarettes. 70% of providers listed time restraints as a significant factor in their decision not to counsel adolescents on tobacco use.Discussion. The Blueprint for Health is a guiding document for provider practices that is not well understood and does not specifically include pediatric tobacco prevention. In an environment where youth E-cigarette use is rising, especially among adolescents, it is especially critical that physicians are confident in their counseling practices.https://scholarworks.uvm.edu/comphp_gallery/1237/thumbnail.jp

Dr Deborah J Morgan, Dr Hannah R Marston & Dr Robin A Hadley – Written Evidence (LBC0135)

There are concerns about the long-term impact of COVID 19 on loneliness. With services moving online for the pandemic, there is a real need to ensure that face-to-face interaction is not replaced solely by technological solutions. Although technology has been beneficial for many during the pandemic, research shows that for the older populations technological solutions are not a replacement for face-to-face interaction. Recent research on the impact of geographic distance on familial relationships by Burholt, Windle, Gott & Morgan (2020), found that loneliness - unlike social isolation - was not diminished through contact by telephone, text or email contact. Technology is a useful but limited tool and not a replacement for face-to-face interaction. There is an urgent need to evaluate responses to the pandemic: how we can be better prepared for any future crisis? This is particularly so for care home sector. The impact of the pandemic on visiting and social interaction for care homes residents has been profound. Having to respond quickly during the pandemic has in some cases, necessitated the use of technology that was often unfamiliar to both care professionals and older adults in care. There is a real need to ensure that care home staff and residents are familiarized with digital technologies to help maintain contact if physical visiting is not possible

Shiver Me Tinders, & Ring a Ding for a Fling - Sex Tech Use During COVID-19: Findings from a UK Study

Existing research surrounding dating apps has primarily focused on younger people with few studies exploring usage of such apps by middle aged and older adults. The worldwide COVID-19 pandemic challenged social behaviours and forced people to adapt intimacy and wider relationship conduct. The objective of this study was to examine how older adults utilized dating apps during the lockdowns of the UK pandemic (December 2020–May 2021). Findings presented here focus//on qualitative data collected from an online survey and eight online, one-to-one interviews with adults aged 40–54 years. The online survey targeted adults across the UK while interviewees were located across England. Employing interpretative phenomenological analysis, findings identified three key themes: 1. Morality, health, and law breaking and COVID-19; 2. Self-surveillance and moral signalling; 3. Loneliness and social isolation. Qualitative findings show engaging with apps was a proxy which alleviated feelings of loneliness and social isolation. Some users used the premise of their social bubble as a way of meeting other people. Using the same premise, others justified breaking the law to engage in physical and sexual intimacy to mitigate their loneliness. The work presented here contributes to the fields of social sciences, gerontology, and human computer interaction. The inter- and multi-disciplinary impact of this study intersects across those fields and offers a cross-sectional insight into behaviours and engagement with technology during one of the most extraordinary global events

A Scoping Review to Assess Risk of Fracture Associated with Anxiolytic Medications

Introduction. Recent research has focused on evaluating the impact of pharmalogical sources on fracture risk. The purpose of this study was to review the literature on anxiolytic medications that may be associated with an increased risk of fracture. Methods. A search was conducted in MEDLINE and Embase databases to identify primary clinical studies of patients who sustained a fracture while prescribed anxiolytic medications and were published prior to July 2021. Anxiolytics defined by ATC Class N05B, beta blockers, and zolpidem were included. The search terms consisted of variations of the following: (“Psychotropic Drugs” or MeSH terms) AND (“Fracture” or MeSH terms).  Results. Of 3,213 studies, 13 (0.4%) met inclusion criteria and were evaluated. Fractures associated with benzodiazepine were reported in 12 of 13 studies; the highest risk occurred in patients aged 60 years and older, RR=2.29, 95% CI (1.48-4.40). The ATC Class N05B showed an increased fracture risk for those < 55 years of age that differed by sex: for men RR=5.42, 95% CI(4.86-6.05) and for women it was RR=3.33, 95% CI (3.03-3.66). Zolpidem also showed an increase fracture risk, RR=2.29, 95% CI(1.48-3.56), but only during the first 4 weeks of treatment. A relative risk of 0.77, 95% CI(.72-.83) was observed for beta blockers. Conclusions.  Fractures are a mainstay of traumatic injuries and are accompanied by economical, physiological, and psychological hardship. Fortunately, with proper assessment and prophylactic measures, fracture risk can be reduced dramatically. Anxiolytic medications have been described widely to increase fracture risk, such as benzodiazepines  in 60+ year old patients, and ATC Class N05B Anxiolytics increased fracture risk of RR=5.42, 95% CI (4.86-6.05) in 55+ year old men and  in 55+ year old women. Yet, some studies showed that at low doses, nitrazepam lowered fracture risk. Other anxiolytic medications, such as zolpidem and beta blockers, also showed a decrease in fracture risk; however, only one study has been published on each of these medications. Ultimately, this scoping review helped to illuminate the inconsistency of anxiolytic fracture risk assessment while simultaneously illustrating the necessary steps to guide future research

Increased Oxygen Recovery from Sabatier Systems Using Plasma Pyrolysis Technology and Metal Hydride Separation

State-of-the-art life support carbon dioxide (CO2) reduction technology is based on the Sabatier reaction where less than 50% of the oxygen required for the crew is recovered from metabolic CO2. The reaction produces water as the primary product and methane as a byproduct. Oxygen recovery is constrained by the limited availability of reactant hydrogen. This is further exacerbated when Sabatier methane (CH4) is vented as a waste product resulting in a continuous loss of reactant hydrogen. Post-processing methane with the Plasma Pyrolysis Assembly (PPA) to recover hydrogen has the potential to dramatically increase oxygen recovery and thus drastically reduce the logistical challenges associated with oxygen resupply. The PPA decomposes methane into predominantly hydrogen and acetylene. Due to the highly unstable nature of acetylene, a separation system is necessary to purify hydrogen before it is recycled back to the Sabatier reactor. Testing and evaluation of a full-scale Third Generation PPA is reported and investigations into metal hydride hydrogen separation technology is discussed