Bridging the NCAA's Accident Insurance Coverage Gaps? A Deep Dive into the Uncertainties of Injury Coverage in College Contact Sports, and the Impact that has on Athletes' Future Physical and Financial Comfort.

This Note analyzes the flaws in the NCAA's current accidental injury health coverage policies for student-athletes and suggests ways to remedy the issues that plague student-athletes incurring serious injuries that may not be covered under current policies. Part I of this Note outlines the history of the NCAA and the policies relevant to the issues with accidental injury coverage currently in place. Part II looks at the significance of these coverage gaps in today's world of modern medicine and technology as well as the impact they have on the everyday life of college athletes. Part III suggests solutions to bridge the gaps in accidental injury coverage for the physical and financial futures of these student-athletes.

Effectiveness of Exercise on Functional Mobility in Adults with Cerebral Palsy: A Systematic Review.

Purpose: We identified evidence evaluating the effect of exercise on functional mobility in adults (aged 18 y or older) with cerebral palsy (CP). Method: An exhaustive search was conducted using the electronic databases PubMed, MEDLINE, CINAHL, PsycINFO, SPORTDiscus, and Cochrane Database of Systematic Reviews from the earliest available evidence (1975) to the present (January 2016) for studies whose participants were ambulatory adults with CP receiving conservative treatment to address functional mobility limitations. Two independent reviewers agreed on the eligibility, inclusion, and level of evidence of each study. The Maastricht-Amsterdam List (MAL) was used to assess evidence quality. Results: Five of the six studies included were randomized controlled trials, and one was a pre-post case series. Interventions included whole-body vibration, treadmill training without body-weight support, rhythmic auditory stimulation, dynamic balance and gait activities, progressive resistance training, and interactive serious gaming for balance. All studies were considered high quality, as indicated by their MAL scores. Four studies showed no statistical difference and trivial effect sizes between the intervention and the control group. Rhythmic auditory stimulation and interactive serious gaming were found to be statistically significant in benefiting adults with CP. Conclusions: Evidence of the effect of exercise on functional mobility for ambulatory adults with CP is lacking. A need exists for quality research to determine the best interventions for adults with CP to maximize functional mobility.

Objectif : recenser les données probantes sur l'efficacité de l'exercice sur la mobilité fonctionnelle des adultes (18 ans et plus) atteints de paralysie cérébrale (PC). Méthode : une recherche exhaustive a été menée dans les bases de données électroniques PubMed, MEDLINE, CINAHL, PsycInfo, SPORTDiscus et Cochrane Database of Systematic Reviews à partir des données les plus anciennes (1975) jusqu'à aujourd'hui (janvier 2016) sur des études menées auprès d'adultes ambulatoires atteints de PC recevant un traitement conservateur pour leur mobilité fonctionnelle réduite. Deux examinateurs indépendants ont convenu de l'admissibilité, de l'inclusion et du niveau de données probantes de chaque étude. La liste de critères Maastricht-Amsterdam (MA) a été utilisée pour évaluer la qualité des preuves. Résultats : cinq des six études incluses étaient des essais randomisés et l'autre était une série de cas avant/après. Les interventions incluaient des vibrations transmises à l'ensemble du corps, un entraînement sur tapis roulant sans support du poids corporel, une stimulation auditive rythmique, des activités d'équilibre dynamique et de démarche, des exercices progressifs de musculation et des jeux interactifs d'équilibre. Toutes les études étaient de grande qualité, comme l'indique leur score de la liste de critères MA. Quatre études n'ont montré aucune différence statistique et ont montré une ampleur de l'effet négligeable entre l'intervention et le groupe témoin. La stimulation auditive rythmique et les jeux interactifs ont montré des bienfaits significatifs d'un point de vue statistique chez les adultes atteints de PC. Conclusions : il n'y a pas suffisamment de données probantes sur l'effet de l'exercice sur la mobilité fonctionnelle des adultes ambulatoires atteints de PC. Des recherches de qualité sont nécessaires pour déterminer les interventions les plus efficaces pour améliorer la mobilité fonctionnelle des adultes atteints de PC.

New universal strain software accurately assesses cardiac systolic and diastolic function using speckle tracking echocardiography.

BACKGROUND: We have developed new universal strain software (USS) that can be used to perform speckle tracking of any Digital Imaging and Communications in Medicine (DICOM) image, regardless of the ultrasound system used to obtain it. METHODS: Fifty patients prospectively underwent echocardiography immediately prior to cardiac catheterization. Biplane peak global longitudinal strain (GLS), peak systolic longitudinal strain rate (SSR), peak early diastolic longitudinal strain rate (DSR), and peak early diastolic circumferential strain rate (DCSR) were determined using conventional strain software (CSS) that uses raw data, and using the new USS applied to DICOM images. RESULTS: Universal strain software correlated with CSS for GLS (r = 0.78, P < 0.001), SSR (r = 0.78, P < 0.001), DSR (r = 0.54, P < 0.001), and DCSR (r = 0.43, P = 0.019). GLS and SSR using USS correlated with left ventricular ejection fraction (LVEF) (r = -0.67 and -0.71, respectively) as well as using CSS (r = -0.66 and -0.71). Patients with diastolic dysfunction had significantly lower DSR (0.61 vs. 0.87/sec, P = 0.02) and DCSR (0.89 vs. 1.23/sec, P = 0.03), and less negative GLS (-10.8 vs. -16.1%, P = 0.002) using USS in all patients, as well as among those with LVEF ≥ 50%. Receiver-operating characteristic (ROC) analysis for detection of diastolic dysfunction revealed a sensitivity and specificity of 82% and 83% for DCSR < 1.09/sec (area under the curve [AUC = 0.80]) and 85% and 83% for GLS > -13.7% (AUC = 0.84) using USS. CONCLUSION: Universal strain software can be used to accurately assess LV systolic and diastolic function using speckle tracking echocardiography.

Blockade of mesolimbic dopamine D3 receptors inhibits stress-induced reinstatement of cocaine-seeking in rats.

RATIONALE: The dopamine (DA) D3 receptor is preferentially expressed in the mesolimbic system. We have previously shown that selective D3 receptor blockade by the novel D3 antagonist SB-277011A inhibits cocaine's reinforcing action and cocaine-induced reinstatement of cocaine-seeking behavior. OBJECTIVE: In the present study, we investigated whether SB-277011A similarly inhibits stress-induced reinstatement of cocaine-seeking behavior. METHODS: Rats were allowed to self-administer cocaine (0.5 mg/kg per infusion, 3 h per session) for 10-14 days, followed by a once-daily extinction session for 7-14 days during which saline was substituted for cocaine. Extinction criteria were fewer than ten lever-presses per 3-h session for at least 3 consecutive days. After cocaine-seeking behavior was extinguished, each animal was tested twice for footshock-stress-induced reinstatement, once with vehicle (25% hydroxypropyl-beta-cyclodextrin) and once with one of three doses of SB-277011A in counterbalanced fashion. RESULTS: During the last 3 days of cocaine self-administration (SA), active lever-presses were approximately 100 per session under fixed-ratio 2 reinforcement (approximately 25 mg/kg cocaine per session). After extinction, intermittent footshock (10 min, 0.5 mA, 0.5 s on with a mean inter-shock interval of 40 s) robustly reinstated the cocaine-seeking behavior (8.4+/-3.6 active lever-presses in last extinction session to 35.3+/-5.2 in animals after footshock stress). Intraperitoneal (i.p.) injections of SB-277011A (3, 6, and 12 mg/kg) dose-dependently blocked stress-induced reinstatement of cocaine-seeking. Reinstatement was also blocked by microinjections of SB-277011A (1.5 microg/0.5 microl per side) bilaterally into the nucleus accumbens, but not into the dorsal striatum. CONCLUSIONS: The mesolimic DA D3 receptor plays an important role in mediating stress-induced reinstatement.