Impact of Submaximal versus Supramaximal High-Intensity Interval Training on Blood Glucose Regulation in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

High-intensity interval training (HIIT) is an efficient form of exercise that can potentially induce significant and clinically meaningful blood glucose improvements in patients with Type 2 diabetes mellitus (T2DM). It is unknown whether certain HIIT interval intensities may be more effective than others in combating hyperglycemia in T2DM. PURPOSE: The purpose of this study was to determine if submaximal or supramaximal HIIT reduces blood glucose or improves markers of insulin resistance more than the other in T2DM patients using a systematic review and meta-analytical approach. METHODS: Three databases (Embase/MEDLINE, CENTRAL, and PubMed) were systematically searched in July 2021 and again in April 2022 to identify studies that used submaximal or supramaximal HIIT interventions on T2DM patients. Seventy-eight articles were compared to the defined inclusion and exclusion criteria, with a total of twenty-one selected for this meta-analysis. Six glycemic control outcome variables were analyzed, including HbA1c, FBG, and HOMA-IR. Pre- and post-HIIT means and SDs were used to calculate effect sizes, which were corrected and weighted to produce Hedges’ g values. 95% confidence intervals and p values were also reported. RESULTS: Multivariate meta-analytical analysis found that submaximal HIIT produces an effect size of -0.399 (95% CI [-0.916, -0.226], p = 0.000) in blood glucose metrics, while supramaximal HIIT produces a similar, but non-significant, effect size of -0.366 (95% CI [-0.916, 0.184], p = 0.192). Across five of six outcome variables, submaximal HIIT had a significant small to medium effect, while supramaximal HIIT had a negligible to medium effect. For both HbA1c (%) and fasting blood glucose (FBG), supramaximal HIIT produced effect size values 48% and 67.4% larger, respectively, when compared to submaximal HIIT. Graphing HIIT intensity and training load against HbA1c effect size revealed R2values of 0.08 and 0.2, respectively. CONCLUSION: Submaximal HIIT effectively reduces markers of blood glucose in T2DM patients. Supramaximal HIIT may induce greater and more clinically meaningful improvements in hyperglycemia, but more research is needed. Neither exercise intensity nor training load alone explain improvements to blood glucose homeostasis as measured by HbA1c

Governed by Circumstances as They May Arise: A Short Reflection on The Knowledge School and its Context

As technologies have moved forward and cultural assumptions have changed, we find ourselves at a moment of opportunity. Our sense of the word library is drawn from a rich array of service traditions and a value proposition based on the belief that libraries help those who use them advance in life, engage with others in their communities, and learn more about themselves and the world around them. The Knowledge School concept builds on this assumption and expands it with a broader challenge – a commitment to creating public value, changing communities, and educating those who feel a personal commitment to dealing with the messy complexities of today’s social arrangements. This intriguing idea holds much promise; and if the possibility of success is adequate to drive performance, it is likely to lead to a new and vibrant vision that will support changes in the way we think of libraries and where we are when we are working in them

Developing a substance use screening instrument: the juvenile offender substance abuse screen

Substance use/abuse among juvenile justice youth is alarmingly high. Data from several studies suggest that the prevalence of diagnosable substance use disorders for this population ranges from 19 to 67% (CSAT, 1999). Furthermore, research suggests that substance abuse and delinquent offenses are highly correlated. Given the high prevalence rates of substance use in juvenile justice youth and the limited resources of juvenile justice facilities, a substance abuse screening instrument should help identify those delinquent youth most in need of additional assessment to plan for intensive treatment services. The purpose of this project was to develop, norm, and evaluate a brief screening tool designed for male and female juvenile offenders between the ages of 13 and 18. Instrument development activities included feedback from experts, focus groups with juvenile justice youth and professionals, as well as a pilot study to further refine the instrument. One hundred and four juvenile justice youth at a juvenile justice facility in Pennsylvania participated in the full-scale study. Data were collected at two time points to assess the factor structure of the instrument, concurrent validity test-retest reliability and other psychometric properties. Findings revealed a three-factor solution referring to diagnostic criteria, risk factors, and emotions/cognitions. Seven items from the original instrument were removed due to poor factor loading, resulting in a thirteen item instrument. Internal consistency appeared good for the total sample and male subsample. Test-retest reliability suggested that the instrument was stable across time. As expected the JJ-SAS over-identified youth with substance abuse problems. However, findings suggest that the JJ-SAS had approximately 65% agreement for true positives and true negatives for each drug type, based on C-DISC diagnosis. In addition, tobacco and substance use provided few false negatives, suggesting that the JJ-SAS categories were consistent with C-DISC diagnoses. In addition, findings suggest that the JJ-SAS had good sensitivity and fair specificity. Replication of these findings will impact youth involved with the juvenile justice system who are in need of early substance abuse identification and treatment by providing a quick, cost-effective, and empirically supported screening tool.Ph.D., Clinical Psychology -- Drexel University, 200

Dear Repose and Absent Solace: A Classroom Exploration of U.S. Public Library LGBT Collecting Behavior

Significant attention has recently been focused on establishing the value of public library services, and in most cases, these efforts have explored their topic using currency-based measures. This paper describes a classroom project that introduces an alternate perspective related to the topic of tolerance as conceptualized by the U.S. Southern Poverty Law Center and UNESCO’s Declaration on Principles on Tolerance. The issue that interested the students was the information needs of people who might be considered different or distinct within some communities, and for this project they focused on children with an interest in LGBT materials, using two related research questions: 1) the characteristics of public libraries that appear to be most and least likely to collect materials of interest to these children, and 2) whether collection is more likely to be correlated with library or community characteristics? Although most of the students had little experience with research or statistical analysis, the topic was sufficiently interesting to sustain their attention through the development and statistical analysis of data elements that combined library collection, U.S. Census, and U.S. Public Library Survey data. Student feedback indicated that the students found the work challenging, that they felt that they had a better understanding of the requirements of original research, and that, although the results were disheartening, they would be more likely to pursue a research project in the future based on this experience

To Market, to Market: The Supervisory Skills and Managerial Competencies Most Valued by New Library Supervisors

ALA-accredited schools of library and information science produce several thousand new librarians yearly, and many of these graduates are assigned supervisory responsibilities relatively early in their careers. Most have responsibility for facilitating the work of others, preparing budgets, planning and evaluating programs, making staffing decisions, and maintaining the safety and security of assets that include funds, related property, and library buildings. Others find themselves in leadership roles that require interfacing with other organizations, mobilizing community support, and representing their organizations to their users and supporters. Experience suggests that the approach of these librarians to their supervisory duties and the success of their efforts will have a strong influence on their job satisfaction, the productivity and job satisfaction of those whom they supervise, and the quality of services their organizations provide.1 Yet there is little recent information that focuses on the knowledge and behaviors that new supervisors associate with successful supervision in library settings or the resources and training experiences that currently facilitate their transition. The data reported here reflect an initial effort to remedy this situation through an informal study undertaken by the LAMA Education Committee

Assessing the Value of Public Library Services: A Review of the Literature and Meta-Analysis (Project META)

ABSTRACT This poster summarizes results of the IMLS funded University of South Carolina META project that explored the application of meta-analysis techniques to develop a robust model of public library economic value. Completed in 2014, the project approached this topic with two fundamental questions

Variations of accessory thoracic muscles identified in the ethnically diverse whole-body donation population in Northern California

Accessory thoracic muscles in humans are relatively common and it is important to draw awareness to their variable presentations and potential clinical implications owing to their close association with the axilla. Here we report four cases of accessory thoracic muscle variations identified in the ethnically diverse whole-body donation population in Northern California (4 out of 48 donors, 8.3%). Of these, combined presentations of thoracic accessory muscles were observed in two of the donors, one involving bilateral axillary arches and a pectoralis quartus on the left and the other a unilateral axillary arch on the left and bilateral pairs of pectoral fascicles. In the former, the proximal ends of the left axillary arch and pectoralis quartus joined to form a common aponeurosis which inserted onto the deep tendon of the pectoralis major; in the latter, the pectoral fascicles originated from the surface of the ribs and inserted into the deep surface of the pectoralis major muscle. In the other two donors, unilateral axillary arches were observed. Our observations illustrate that accessory thoracic muscles, in isolated as well as combined forms, are commonplace in the general population. We also describe the proposed embryonic origins of these accessory muscles, which may reflect their frequent occurrence, and potential clinical implications of these muscles, as discussed in literature

Visual dysfunction is a better predictor than retinal thickness for dementia in Parkinson's disease

BACKGROUND: Dementia is a common and devastating symptom of Parkinson's disease (PD). Visual function and retinal structure are both emerging as potentially predictive for dementia in Parkinson's but lack longitudinal evidence. METHODS: We prospectively examined higher order vision (skew tolerance and biological motion) and retinal thickness (spectral domain optical coherence tomography) in 100 people with PD and 29 controls, with longitudinal cognitive assessments at baseline, 18 months and 36 months. We examined whether visual and retinal baseline measures predicted longitudinal cognitive scores using linear mixed effects models and whether they predicted onset of dementia, death and frailty using time-to-outcome methods. RESULTS: Patients with PD with poorer baseline visual performance scored lower on a composite cognitive score (β=0.178, SE=0.05, p=0.0005) and showed greater decreases in cognition over time (β=0.024, SE=0.001, p=0.013). Poorer visual performance also predicted greater probability of dementia (χ² (1)=5.2, p=0.022) and poor outcomes (χ² (1) =10.0, p=0.002). Baseline retinal thickness of the ganglion cell-inner plexiform layer did not predict cognitive scores or change in cognition with time in PD (β=-0.013, SE=0.080, p=0.87; β=0.024, SE=0.001, p=0.12). CONCLUSIONS: In our deeply phenotyped longitudinal cohort, visual dysfunction predicted dementia and poor outcomes in PD. Conversely, retinal thickness had less power to predict dementia. This supports mechanistic models for Parkinson's dementia progression with onset in cortical structures and shows potential for visual tests to enable stratification for clinical trials

Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis

Numerous guidelines have been developed over the past decade regarding treatments for Posttraumatic stress disorder (PTSD). However, given differences in guideline recommendations, some uncertainty exists regarding the selection of effective PTSD therapies. The current manuscript assessed the efficacy, comparative effectiveness, and adverse effects of psychological treatments for adults with PTSD. We searched MEDLINE, Cochrane Library, PILOTS, Embase, CINAHL, PsycINFO, and the Web of Science. Two reviewers independently selected trials. Two reviewers assessed risk of bias and graded strength of evidence (SOE). We included 64 trials; patients generally had severe PTSD. Evidence supports efficacy of exposure therapy (high SOE) including the manualized version Prolonged Exposure (PE); cognitive therapy (CT), cognitive processing therapy (CPT), cognitive behavioral therapy (CBT)-mixed therapies (moderate SOE); eye movement desensitization and reprocessing (EMDR) and narrative exposure therapy (low-moderate SOE). Effect sizes for reducing PTSD symptoms were large (e.g., Cohen's d ~-1.0 or more compared with controls). Numbers needed to treat (NNTs) were <4 to achieve loss of PTSD diagnosis for exposure therapy, CPT, CT, CBT-mixed, and EMDR. Several psychological treatments are effective for adults with PTSD. Head-to-head evidence was insufficient to determine these treatments' comparative effectiveness, and data regarding adverse events was absent from most studies