The effects of level and duration of play on cognition, mood and behavior among former football players

Thesis (M.A.)--Boston UniversityInterest in the short and long-term effects of concussions has drastically increased due to the recent high-profile deaths of former National Football League (NFL) players. However, research on this subject, especially at the youth level, has moved at a much slower rate. Second Impact Syndrome (SIS), Postconcussive Syndrome (PCS) and Chronic Traumatic Encephalopathy (CTE) are three major consequences that have the potential to negatively affect athletes participating in contact sports immediately or years after their athletic careers are over. The goal of this study is to examine whether the level of first exposure and/or duration of exposure has an effect on a player’s cognition, mood and behavior years after his football career is complete. I hypothesized that the age of onset of exposure to football would have a significant effect on cognition, mood and behavior later in life, and that those who started playing football prior to high school would self-report more problems in all three domains compared to those who started playing in high school when matched for the total number of years played. In order to test my hypotheses, analysis was completed on n=154 cases, all of whom played football at some level. Results showed that age of onset of exposure to football did have a significant effect on the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) assessment, specifically the Global Executive Composite (GEC) (p = .018), Behavioral Regulation Index (BRI) (p = .014) scores and three of the nine clinical subscales (Inhibit [p = .025], Shift [p = .015] and Self-Monitor [p = .048]). Age of onset of exposure to football was also found significant for the mood and behavior assessment scores, the Apathy Evaluation Scale (AES) (p = .024) and Center for Epidemiological Studies Depression Scale CES-D (p = .011). No significant difference in assessment scores was found for level of onset of exposure when matched by number of years of football played. BRIEF-A GEC, BRI and MI raw scores were significantly different than published normative data for each age group, except the 70-79 and 80-90 year olds, both of which had very small sample sizes. Significant differences in all BRIEF-A index scores and all nine clinical subscores were found for the 40-49, 50-59 and 60-69 age groups. Finding significant differences in these age groups is somewhat unsurprising, given that CTE symptoms tend to begin decades after the end of exposure. Also consistent with this idea, the 30-39 years old age group showed a significant difference with the normative data in six of the nine clinical subscales, while the 18-29 years old age group showed a significant difference in three of the nine subscales. Longitudinal studies will need to be conducted to validate these findings and further understand the relationship between level of onset of play and long-term deleterious effects as a result of repetitive brain trauma (RBT)

The Effect of Stress Inoculation Training on Endotracheal Intubation

Introduction Stressful situations pervade emergency medicine. Many studies demonstrate the deleterious impacts of stress on a physician’s immediate actions and lasting mental health. It is well-documented in the literature that preparedness can help mediate stress. Stress inoculation training (SIT) is utilized to prevent adverse stress response. This training teaches coping skills and defensive thinking to actively mitigate the negative physiological effects that occur during stressful events. SIT theory involves a conceptualization phase, skills training phase and application phase. The goal of this study is to evaluate the effect of SIT on endotracheal intubation performance of novice intubators. Methods The study consists of a population of medical students without prior airway training who are randomly assigned to control and intervention groups. Both groups will receive a didactic lecture on airway management followed by a brief intubation attempt on a standard dummy. The experimental group will subsequently receive a lecture on the principles of SIT where they learn to use focused intervention shown to reduce the physiological effects of stress. These techniques include box breathing, positive self-talk and imagery. All participants will then intubate the standard dummy in three different scenarios of varying environmental stressors. The main outcome will be the participant’s ability to successfully perform the procedure. Secondary outcomes will be the number of attempts and time required to successfully intubate, as well as, the participant\u27s post event response to the Perceived Stress Questionnaire. To evaluate the lasting effects of SIT, both groups will return in a month and repeat the intubation scenarios. Results Due to COVID-19 restrictions, pilot testing has been postponed until Fall 2020. Data analysis will focus on participant’s ability to perform the procedure under stressful conditions, their perception of stress, time to intubation and number of attempts. Conclusion The study evaluates the teaching of stress inoculation training (SIT) on emergency airway management. We hope this application of SIT will not only contribute to a growing body of literature on stress management, but also enhance patient safety and better prepare medical students for career resiliency

Partitioning of trace metals between soft tissues and shells of Patella aspera

This paper describes the partitioning of iron, manganese, zinc, copper, cadmium, cobalt, nickel and lead between the soft tissues and the shells of the gastropod mollusc Patella aspera. Specimens of the limpet P aspera were collected from a clean coastal marine site (CMS) and from an estuarine contaminated site (ECS) on the south coast of Portugal. Fe and Zn concentrations were significantly lower on both populations and less variable in the shells than in the soft tissues. In contrast Mn concentrations were higher in the shells than in the soft tissues at ECS. The partitioning factor (PF), defined as the ratio between the mean metal concentrations in soft tissues and in the shells, was maximum for iron and minimum for manganese. Between the soft tissues and the shells, only manganese at ECS recorded a significant relationship between metal concentrations, suggesting that the mechanism that controls the accumulation of this essential metal in both tissues was different from the others. From the obtained data, in biomonitoring sewage contamination studies, shells of P. aspera can be considered as a good indicator for Mn while the soft tissues for Zn. As copper, cadmium, nickel and cobalt concentrations were much higher in the soft tissues than in the shells ( < 0.1 mug g(-1)), this indicates that the shells were not a good indicator for these metals because they do not reflect the environmental bioavailability as do the soft tissues.FRMH/BD/403/92info:eu-repo/semantics/publishedVersio

Investigating user preferences in utilizing a 2D paper or 3D sketch based interface for creating 3D virtual models

Computer modelling of 2D drawings is becoming increasingly popular in modern design as can be witnessed in the shift of modern computer modelling applications from software requiring specialised training to ones targeted for the general consumer market. Despite this, traditional sketching is still prevalent in design, particularly so in the early design stages. Thus, research trends in computer-aided modelling focus on the the development of sketch based interfaces that are as natural as possible. In this report, we present a hybrid sketch based interface which allows the user to make draw sketches using offline as well as online sketching modalities, displaying the 3D models in an immersive setup, thus linking the object interaction possible through immersive modelling to the flexibility allowed by paper-based sketching. The interface was evaluated in a user study which shows that such a hybrid system can be considered as having pragmatic and hedonic value.peer-reviewe

Structure and spectroscopy of doped helium clusters using quantum Monte Carlo techniques

We present a comparative study of the rotational characteristics of various molecule-doped 4He clusters using quantum Monte Carlo techniques. The theoretical conclusions obtained from both zero and finite temperature Monte Carlo studies confirm the presence of two different dynamical regimes that correlate with the magnitude of the rotational constant of the molecule, i.e., fast or slow rotors. For a slow rotor, the effective rotational constant for the molecule inside the helium droplet can be determined by a microscopic two-fluid model in which helium densities computed by path integral Monte Carlo are used as input, as well as by direct computation of excited energy levels. For a faster rotor, the conditions for application of the two-fluid model for dynamical analysis are usually not fulfilled and the direct determination of excitation energies is then mandatory. Quantitative studies for three molecules are summarized, showing in each case excellent agreement with experimental results

Physicians' perspectives on the treatment of patients with eating disorders in the acute setting

Abstract Background Hospitalisation for an eating disorder is rare, however treatment in the acute medical setting can be a life-saving admission. While the multidisciplinary team delivers overall patient care, medical decisions are the responsibility of the treating physicians. Treatment decisions directly impact on patient care and outcomes. This study aimed to explore the considerations that influence the medical decisions of physicians when treating patients with eating disorders in the acute setting. Method Semi-structured interviews were conducted with ten medical physicians who had previously treated eating disorders on a general medical unit in two Australian tertiary hospitals. An interview schedule, based on the literature and four relevant domains from the Consolidated Framework for Implementation Research, was developed. Interviews were audio recorded, transcribed verbatim and analyzed thematically. Coding and interim themes and sub-themes were developed by two dietitian researchers; these were further refined through researcher discussion and triangulation with two additional dietitian researchers. Results Ten doctors were interviewed (3 consultants (1 adult general medical and 2 paediatricians: 13–16 years medical experience), 2 registrars (4–7 years experience), 1 resident (1 year experience), and 4 interns (< 1 year experience). Doctors described memorable patient cases, related to hospital stays over several weeks. Interviews ranged in length from 58 min to 91 min. Four themes (with five sub-themes) were developed: 1) navigating uncertainty (focusing on processes and goals and seeking information), 2) being “the good doctor” (doing the right thing), 3) seeing the big picture (depending on key players and considering short and long-term), and 4) involving family and patient. Conclusions Non-specialist physicians described challenges in the treatment of eating disorders in the inpatient setting. They take a holistic approach that considers both short and longer-term goals, relying on specialist colleagues, the wider multidisciplinary team and sometimes family members to guide treatment decisions during admissions on general medical wards. Additional support, education and training centered on the key themes may increase physicians’ confidence and ability to make effective treatment decisions for this patient group. The results are relevant to all health professionals working in this field to better understand the priorities of medical physicians and to support them to achieve positive outcomes in the inpatient treatment of patients with eating disorders

Measuring and Understanding Throughput of Network Topologies

High throughput is of particular interest in data center and HPC networks. Although myriad network topologies have been proposed, a broad head-to-head comparison across topologies and across traffic patterns is absent, and the right way to compare worst-case throughput performance is a subtle problem. In this paper, we develop a framework to benchmark the throughput of network topologies, using a two-pronged approach. First, we study performance on a variety of synthetic and experimentally-measured traffic matrices (TMs). Second, we show how to measure worst-case throughput by generating a near-worst-case TM for any given topology. We apply the framework to study the performance of these TMs in a wide range of network topologies, revealing insights into the performance of topologies with scaling, robustness of performance across TMs, and the effect of scattered workload placement. Our evaluation code is freely available