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OBJECTIVE: To determine the potential reasons for becoming a program director and reasons for leaving the program director position within athletic training education programs accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP); in addition, to describe the most and least beneficial and satisfying aspects of the program director position. DESIGN AND SETTING: In 1999, we sent a validated survey to athletic training education program directors of CAAHEP-accredited athletic training education programs. SUBJECTS: Of 113 athletic training education program directors of accredited undergraduate programs, 83 participated, for a response rate of 73.4%. MEASUREMENTS: The survey consisted of open-ended questions regarding potential reasons for becoming a program director and possibly leaving the program direction position and most and least beneficial and satisfying aspects of the position. We used inductive content analysis to determine themes for the responses to the open-ended questions. Descriptive statistics, including percentages, were calculated to report the data. RESULTS: Academic environment was the primary theme for becoming an athletic training education program director and professional appointment was the primary theme for possibly leaving the position. Professional advancement and student growth and success were the primary themes for the most beneficial and satisfying aspects. Workload and student issues and discipline were the primary themes for the least beneficial and satisfying aspects. CONCLUSIONS: Factors that affect job selection, satisfaction, and attrition are related to academic environment, teaching, students, professional advancement, program development/advancement, workload, personal issues, and athletics. [ABSTRACT FROM AUTHOR]

Objective: To describe the current roles and responsibilities of program directors of athletic training education programs accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) and to address the dilemmas of program directors' credibility with student athletic trainers, tenure and promotion, and clinical involvement in athletics.Design and Setting: We sent a survey to all program directors who direct CAAHEP athletic training education programs.Subjects: Eighty-three of 113 program directors of undergraduate programs participated in the study-a response rate of 73.4%.Measurements: The survey consisted of demographic data: degree, age, major, years of experience as program director, and route to certification and questions concerning title, job responsibilities, expectations, and academic appointment.Results: Most respondents (72%) indicated that their title was program director, and they had a median of 9 years of experience. Sixty-two percent had been certified as an athletic trainer for a median of 18.5 years. Forty-three percent had doctoral degrees and held the rank of assistant professor. Ninetysix percent indicated teaching was the primary duty and expectation of their program director's position.Conclusions: The dilemmas of tenure and promotion, decreased clinical involvement, and student athletic trainers' perceptions of program directors remain problematic. The dilemmas still exist as they did 12 years ago and are becoming more involved due to educational reform. Program directors must be able to communicate their roles and responsibilities to their administrators. [ABSTRACT FROM AUTHOR]

Objective: To present a new arthroscopic technique, the laser-assisted capsular shift (LACS), which decreases glenohumeral instability and reduces recovery time over traditional surgical procedures. Background: A student-athlete hyperabducted her right shoulder while diving for a ball during a volleyball match. She complained of pain, weakness, and inability to raise her arm above shoulder height in any plane. Differential Diagnosis: Capsular sprain, subluxation, rotator cuff strain, glenoid labral lesion. Treatment: The student-athlete was unable to play due to pain and dysfunction and so elected to have the LACS procedure performed. Uniqueness: The LACS procedure is a relatively new procedure for tightening the capsule and decreasing glenohumeral instability. Immobilization and recovery time are reduced when compared with traditional treatment methods. Conclusions: The LACS procedure appears to be a good alternative to some of the traditional methods used to treat glenohumeral instability. [ABSTRACT FROM AUTHOR]

The maturation of genomic surveillance in the past decade has enabled tracking of the emergence and spread of epidemics at an unprecedented level. During the COVID-19 pandemic, for example, genomic data revealed that local epidemics varied considerably in the frequency of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lineage importation and persistence, likely due to a combination of COVID-19 restrictions and changing connectivity. Here, we show that local COVID-19 epidemics are driven by regional transmission, including across international boundaries, but can become increasingly connected to distant locations following the relaxation of public health interventions. By integrating genomic, mobility, and epidemiological data, we find abundant transmission occurring between both adjacent and distant locations, supported by dynamic mobility patterns. We find that changing connectivity significantly influences local COVID-19 incidence. Our findings demonstrate a complex meaning of "local" when investigating connected epidemics and emphasize the importance of collaborative interventions for pandemic prevention and mitigation., Competing Interests: Declaration of interests K.G.A. has received consulting fees on SARS-CoV-2 and the COVID-19 pandemic., (Copyright © 2023 Elsevier Inc. All rights reserved.)

As SARS-CoV-2 continues to spread and evolve, detecting emerging variants early is critical for public health interventions. Inferring lineage prevalence by clinical testing is infeasible at scale, especially in areas with limited resources, participation, or testing and/or sequencing capacity, which can also introduce biases 1-3 . SARS-CoV-2 RNA concentration in wastewater successfully tracks regional infection dynamics and provides less biased abundance estimates than clinical testing 4,5 . Tracking virus genomic sequences in wastewater would improve community prevalence estimates and detect emerging variants. However, two factors limit wastewater-based genomic surveillance: low-quality sequence data and inability to estimate relative lineage abundance in mixed samples. Here we resolve these critical issues to perform a high-resolution, 295-day wastewater and clinical sequencing effort, in the controlled environment of a large university campus and the broader context of the surrounding county. We developed and deployed improved virus concentration protocols and deconvolution software that fully resolve multiple virus strains from wastewater. We detected emerging variants of concern up to 14 days earlier in wastewater samples, and identified multiple instances of virus spread not captured by clinical genomic surveillance. Our study provides a scalable solution for wastewater genomic surveillance that allows early detection of SARS-CoV-2 variants and identification of cryptic transmission., (© 2022. The Author(s).)

Purpose: To compare the effects of glare on driving performance in patients who had implantation of a blue light-filtering acrylic intraocular lens (IOL) and those who had implantation of an acrylic IOL with no blue-light filter., Setting: Department of Applied Psychology, Arizona State University, Mesa, Arizona, USA., Design: Cross-sectional study., Methods: Patients with a blue light-filtering AcrySof Natural SN60AT IOL (study group) and patients with an AcrySof SA60AT IOL with no blue-light filter (control group) who had good visual acuity and a valid driver's license performed left-turn maneuvers in a driving simulator in front of oncoming traffic. The safety margin (time to collision minus time taken to turn at intersection with oncoming traffic) was calculated. The measurements were repeated with a glare source simulating low-angle sun conditions (daytime driving)., Results: With glare, the safety margin was statistically significantly greater in the study group (n = 17) than in the control group (n = 17) (mean 2.534 seconds ± 0.488 [SD] and 2.116 ± 0.511 seconds, respectively) (P < .05). Comparing no-glare conditions and glare conditions, the study group had significantly lower glare susceptibility, fewer collisions with the oncoming car, and a lower impact on intersection approach speed than the control group., Conclusions: The IOL incorporating blue light-filtering technology significantly reduced glare disability and improved the driver's ability to safely execute a left turn with oncoming traffic in the presence of glare simulating low-angle sun conditions. The real-world benefit of this technology is presumably mediated by a stronger signal to detect approaching objects (motion-in-depth) as a result of a reduction in glare disability., Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes., (Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

This research examined adolescents' judgments about lying to circumvent directives from parents or friends in the moral, personal, and prudential domains. One hundred and twenty-eight adolescents (12.1-17.3 years) were presented with situations in which an adolescent avoids a directive through deception. The majority of adolescents judged some acts as acceptable, including deception regarding parental directives to engage in moral violations and to restrict personal activities. Other acts of deception were judged as unacceptable, including deception of parents regarding prudential acts, as well as deception of friends in each domain. In addition, lying to conceal a misdeed was negatively evaluated. Most adolescents thought that directives from parents and friends to engage in moral violations or to restrict personal acts were not legitimate, whereas parental directives concerning prudential acts were seen as legitimate. Results indicate that adolescents value honesty, but sometimes subordinate it to moral and personal concerns in relationships of inequality.

Background: As part of the United States Food and Drug Administration Phase III clinical trial, patients were implanted with the STAAR posterior chamber phakic intraocular contact lens (ICL). The trial is designed to test the safety and efficacy of this new lens for the treatment of moderate-to-high myopia and hyperopia., Methods: Data were collected from 20 hyperopes--mean preoperative spherical equivalent, +5.55 D, and 65 myopes-mean preoperative spherical equivalent, -8.42 D, who were implanted with ICLs in our clinic, from November 1998 to March 2000., Results: Postoperatively, 40% of the hyperopic eyes were 20/20 or better without correction and 80% of the eyes 20/40 or better without correction, with a mean spherical equivalent of +0.06 D. One hyperopic lens was explanted and no adverse events were reported. Postoperatively, 52.31% of the myopic eyes were 20/20 or better without correction and 92.3% of the eyes were 20/40 or better without correction, with a mean spherical equivalent of -0.31 D. No lenses were explanted and one was treated for angle closure., Conclusions: The STAAR Collamer ICL is a reasonably safe and effective procedure for the treatment of moderate-to-high refractive errors.

Purpose: To evaluate the visual and refractive results of laser in situ keratomileusis (LASIK) for mild to moderate myopia with or without astigmatism., Setting: Barnet-Dulaney Eye Center, Phoenix, Arizona, USA., Methods: Data were prospectively collected on 124 consecutive eyes having LASIK over 12 weeks. Eyes with a preoperative spherical equivalent (SE) from -1.35 to -10.00 diopters (D) (mean -4.81 D +/- 2.21 [SD]) and cylinder from 0 to 5.00 D (mean 1.12 +/- 1.12 D) were entered in the study. Thirty-one eyes had spherical corrections. Ninety-three eyes had spherocylinder corrections; preoperative astigmatism in these eyes ranged from 0.50 to 5.00 D (mean 1.47 +/- 1.09 D). Surgery included creation of a corneal flap using an automated microkeratome with a 160 microns plate followed by photoablation on the exposed stromal bed. Photoablation was performed using five zones varying from 5.0 to 6.6 mm in eyes with 6.25 D of myopia or less and with five passes at a 5.0 mm zone in eyes with 6.50 D of myopia or more. Astigmatism was corrected using a single-pass ablation through a 6.0 mm slit of varying diameter., Results: Six month follow-up was obtained in 89 eyes (72%). All eyes were completely re-epithelialized by the first postoperative day. Uncorrected visual acuity was 20/40 or better in 81% of eyes at 1 day and in 91% at 6 months. At 6 months, the mean SE was -0.35 +/- 0.77 D; 83% were within +/- 1.00 D of plano. Postoperative astigmatism in the 93 eyes having cylinder correction ranged from 0 to 1.22 D (mean 0.38 +/- 0.42 D). No eye lost more than two lines of best spectacle-corrected visual acuity. Three eyes (2%) required surgical intervention for cap problems. Visually significant corneal haze was not observed., Conclusion: In eyes with myopia with or without astigmatism, LASIK provided rapid visual recovery with satisfactory visual and refractive outcomes. The effect of LASIK on visual function (night glare, contrast sensitivity) awaits further study.

Based on experimental studies, sustained total central retinal artery obstruction (CRAO) lasting more than one and one-half hours has been considered to cause irreversible retinal damage. We have seen five cases of patients with pure CRAO that lasted longer than one and one-half hours who regained significant visual acuity. Three of the patients had a completely spontaneous improvement in visual acuity to 20/50 or better. In addition, the other two patients regained significant vision to 20/80 or better with a modified treatment regimen of acetazolamide, inhalation of 5% CO2 and 95% O2, and aspirin. No foveola-sparing cilioretinal arteries were present in any of the cases. We introduce the concept of reversible retinal ischemia following unsustained CRAO to account for these unexpected improvements in visual acuity.

This is the first report in the American literature elaborating on the clinical and angiographic characteristics of an iris arteriovenous malformation. Iris vascular abnormalities that do not leak fluorescein have previously been described only in association with underlying disorders. Iris arteriovenous malformations must be differentiated from neovascularization and other diseases affecting iris vasculature in which treatment is necessary in order to prevent further sequelae.

To our knowledge, this is the first reported case of an embolic three-fourths central retinal-artery obstruction with isolated sparing of the superior temporal branch artery. Multiple nonfoveolar-sparing cilioretinal arteries were also present. As a result of the unusual obstruction distribution, ischemic optic neuropathy was simulated after a five-month interval. Patients who are not seen acutely after a retinal-artery obstruction may be diagnosed and managed incorrectly if this variation from the usual condition is not recognized.