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Sports Medicine News — ScienceDaily

August 30th, 2015 12:46 am

Disabilities: Playing Adaptive Sports Linked to Higher Employment, Economic Impact Aug. 25, 2015 A new study finds playing an adaptive sport can have dramatic results on the athlete and the ... read more Former Professional Rugby Players Have Greater Cervical Spine Degeneration July 21, 2015 Clinical examinations and magnetic resonance imaging studies have determined whether retired professional rugby players experience more serious symptoms of cervical spine degeneration than people in ... read more Coaches Can Be a Strong Influence in Preventing Football Injuries, Say Researchers July 17, 2015 Teaching coaches about injury prevention and contact restrictions pays off, say researchers who tracked injury rates among youth football players during the 2014 ... read more Trading the Laboratory for the Farm: A Look at D-Ribose Supplementation in Horses July 14, 2015 A new research study has the potential to broaden our understanding of the popular dietary supplement d-Ribose. It may be helpful as a supplement for humans and the equine because of its crucial role ... read more July 13, 2015 Contact with another player was the most common way boys and girls sustained concussions in a study of US high school soccer players, while heading the ball was the most common soccer-specific ... read more Surgeries Before College Athletics May Result in More Injuries During College Play July 12, 2015 Athletes who've had lower extremity surgeries before going on to play in college, might be at a higher risk for another surgery independent of gender and sport, say researchers presenting their ... read more Tommy John Surgeries Increasing for Youth Athletes July 12, 2015 Surgeries related to overuse elbow injuries, i.e. Tommy John Surgery, are more common among youth athletes than previously believed, according to new ... read more Older Athletes Able to Return to Sport After Rotator Cuff Repair July 11, 2015 Outcomes following the arthroscopic repair of rotator cuff tears in older athletes appears to be successful a majority of the time, according to new ... read more No Need to Treat Stable Meniscus Tears During ACL Surgery, New Research Shows July 10, 2015 While athletes undergoing anterior cruciate ligament (ACL) surgery often have an additional meniscus injury, treating these tears at the same time may not be necessary. Research shows positive ... read more Treatment of Shoulder Instability Helps Return Collegiate Athletes to Playing Field July 10, 2015 Athletes who suffer a shoulder instability injury may return to play more successfully after being treated arthroscopically compared to nonoperative treatment, say ... read more Bone-Tendon-Bone Grafts Not Necessarily a Better Choice for ACL Reconstruction July 9, 2015 Surgeons making reconstruction choices for an injured ACL can consider both bone-tendon-bone grafts and hamstring autografts as equally viable options in regards to healing, researchers ... read more New Study Shows Ankle Sleeves and Lace-Up Braces Can Benefit Athlete Performance July 9, 2015 An athlete's use of silicone ankle sleeves and lace-up ankle braces during sports participation can improve neuromuscular control, according to ... read more Taking the Pain out of Office Work July 7, 2015 Treadmill work stations are potentially helpful in reducing the neck and shoulder muscle pain associated with computer work, a researcher ... read more Gym Steroid Use Has Impact on Memory July 7, 2015 People using anabolic steroids to improve muscle growth and sporting performance are far more likely to experience issues with their memory, according to new ... read more High Risks from High Heels July 1, 2015 A new study showing the negative effects of prolonged high heel use confirms expert consensus on the footwear. An expert says that there are ways to minimize the risk of injury, however, with ... read more Make No Bones About It: Female Athlete Triad Can Lead to Problems With Bone Health July 1, 2015 Participation in sports by women and girls has increased from 310,000 individuals in 1971 to 3.37 million in 2010. At the same time, sports-related injuries among female athletes have skyrocketed. ... read more 'Drink When Thirsty' to Avoid Fatal Drops in Blood Sodium Levels During Exercise June 29, 2015 For hikers, football players, endurance athletes, and a growing range of elite and recreational exercisers, the best approach to preventing potentially serious reductions in blood sodium level is to ... read more Running With Prosthetic Lower-Limbs: Advantage or Disadvantage? June 29, 2015 Researchers have been looking at the impact of lower-limb prosthetics on competitive running, specifically looking at whether athletes with prosthesis are at an unfair advantage when running against ... read more June 26, 2015 Physical performance after periods of hypoxic training -- in low-oxygen conditions -- has become a matter of growing controversy within the scientific community. An international study compared ... read more June 24, 2015 When it comes to overuse injuries in high school sports, girls are at a much higher risk than boys, a new study shows. Overuse injuries include stress fractures, tendonitis and joint pain, and occur ... read more

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Bridgewater New Jersey Office of the American Diabetes …

August 29th, 2015 6:46 pm

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New Jerseyans are increasingly feeling the effects of diabetes as thousands of people suffer from the disease, and many others may have diabetes and not know it! It is estimated that one out of every three children born after 2000 in the United States will be directly affected by diabetes.

That is why the American Diabetes Association's New Jersey office is so committed to educating the public about how to stop diabetes and support those living with the disease.

We are here to help.

The American Diabetes Association's New Jersey office provides great local programs for people living with diabetes, their friends and family. Learn about our available programs.

Sign up for our monthly newsletter to learn about news and events in the New Jersey area.

If you would like a representative from the American Diabetes Association to speak at your event or if you would like materials to distribute at a health fair or expo, please call 732-469-7979. You can also email your request to bmarsicano@diabetes.org.

We welcome your help.

Your involvement as an American Diabetes Association volunteer whether on a local or national level will help us expand our community outreach and impact, inspire healthy living, intensify our advocacy efforts, raise critical dollars to fund our mission, and uphold our reputation as the moving force and trusted leader in the diabetes community.

Find volunteer opportunities in our area through the Volunteer Center.

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Bridgewater New Jersey Office of the American Diabetes ...

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NJDOH – Family Health services

August 29th, 2015 6:46 pm

Behavioral Risk Factor Surveillance System (BRFSS) data for 2003-2005 estimate that 473,000 adults 18 years and older, 7.2 % (margin of sampling error .3%) of the population, have been diagnosed with diabetes. It is estimated that 190,000 individuals have diabetes but have not been diagnosed.

For a variety of reasons, it is anticipated that the trend of increasing numbers and rates of people with diabetes will continue unless measures are taken that are geared toward prevention. Among people at the highest risk are persons over the age of 45, persons who are obese, and minorities. New Jersey 's population is aging. The number of persons over the age of 45 went from 2,594,232 in 1990 to an estimated 3,340,127 in 2005. Obesity rates, as estimated by BRFSS, went from 10% in 1991 to 22.1% in 2005. The state has always been diverse and is becoming more so. The percentage of black-non-Hispanics in New Jersey went from 12.7% in 1990 to 13.3% in 2005; while the percentage of the population that is Hispanic went from 9.6% to 14.5%. The Asian population had the fastest rate of growth increasing from 3% to 7.3% of the total population in 2005. The fastest growing subgroup among Asians is Asian-Indians. That group increased from 79,440 in 1990 to 169,180 in 2000.

According to the BRFSS for the period of 2003-2005, the highest rate by age of diagnosed diabetes was for persons 65 and over. For that group, the rate was 16.7% (margin of sampling error .9) compared to 7.2% (margin of error.3) for all persons over age 18. The survey shows blacks have the highest rate by race/ethnicity. The rate among non- Hispanic blacks of all ages was 12.2% (margin of sampling error 1.3).

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Diabetes | Nutrition.gov

August 29th, 2015 6:46 pm

MedlinePlus: Diabetes

DHHS. NIH. National Library of Medicine.

Read information related to diabetes, including a definition, causes and risk factors, symptoms, treatments, complications, and more. Also in Spanish.

DHHS. National Institutes of Health; Centers for Disease Control and Prevention.

Find resources, statistics, news and more to help with diabetes prevention and management.

DHHS. CDC. National Center for Chronic Disease Prevention and Health Promotion.

Read about national estimates and general information on diabetes and prediabetes in the United States, 2011.

DHHS. National Institutes of Health.

See statistics and the status of current research and knowledge on Type 1 diabetes. Also discusses possible future discoveries in Type 1 diabetes prevention and management.

DHHS. NIH. National Diabetes Education Program.

Take this quiz to learn more about how to manage your diabetes.

DHHS. NIH. National Institute of Diabetes and Digestive and Kidney Diseases.

Learn about type 2 diabetes including the risks, complications, and prevention strategies. Also in PDF|757 KB and in Spanish.

DHHS. CDC. NCCDPH. Division of Diabetes Translation.

Learn the basics about diabetes from the Center for Disease Control. Also find:

DHHS. CDC. National Center on Birth Defects and Developmental Disabilities.

Get answers to frequently asked questions about diabetes and pregnancy.

DHHS. NIH. National Institute of Diabetes and Digestive and Kidney Diseases.

Get definitions of diabetes-related words. Also in PDF|703 KB and in Spanish.

DHHS. NIH. National Diabetes Information Clearinghouse.

Find several resources on diabetes for Hispanics and Latino Americans, including Spanish language versions.

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Diabetes | Nutrition.gov

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Diabetes | Overview

August 29th, 2015 6:46 pm

If you just found out you have diabetes, you probably have a lot of questions and you may feel a little uncertain. But you're not alone. In the United States, 23.6 million people have diabetes. Most of these people lead full, healthy lives. One of the best things you can do for yourself is to learn all you can about diabetes. This article will tell you some of the basics about diabetes.

Diabetes is a disease that occurs when a persons body doesnt make enough of the hormone insulin or cant use insulin properly. There are 2 types of diabetes. Type 1 diabetes occurs when your bodys pancreas doesnt produce any insulin. Type 2 diabetes occurs when the pancreas either doesnt produce enough insulin or your bodys cells ignore the insulin. Between 90% and 95% of people who are diagnosed with diabetes have type 2 diabetes.

Type 1 diabetes is also called insulin-dependent diabetes. It is sometimes called juvenile diabetes because it is usually discovered in children and teenagers, but adults may also have it.

Type 2 diabetes occurs when the body doesnt produce enough insulin or the bodys cells ignore the insulin.

Yes. In the past, doctors thought that only adults were at risk of developing type 2 diabetes. However, an increasing number of children in the United States are now being diagnosed with the disease. Doctors think this increase is mostly because more children are overweight or obese and are less physically active.

Pre-diabetes occurs when blood sugar levels are higher than they should be, but not so high that your doctor can say you have diabetes. Pre-diabetes is becoming more common in the United States. It greatly increases the risk of developing type 2 diabetes.

The good news is that you can take steps to prevent or delay the onset of full-blown type 2 diabetes by making lifestyle changes, such as eating a healthy diet, reaching and maintaining a healthy weight, and exercising regularly.

Yes, you can live a normal life. You can stay healthy if you do what it takes to control your diabetes.

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Diabetes mellitus – Lab Tests Online

August 29th, 2015 6:46 pm

Note: This article addresses diabetes mellitus, not . Although the two share the same reference term "diabetes" (which means increased urine production), diabetes insipidus is much rarer and has a different underlying cause.

Diabetes is a group of conditions linked by an inability to produce enough insulin and/or to respond to insulin. This causes high blood glucose levels () and can lead to a number of and health problems, some of them life-threatening.

Diabetes is the seventh leading cause of death in the United States. According to the Centers for Disease Control and Prevention, about 29 million people in the U.S. currently have diabetes, but as many as 8 million are not yet aware that diabetes is affecting their health.

People with diabetes are unable to process glucose, the body's primary energy source, effectively. Normally, after a meal, carbohydrates are broken down into glucose and other simple sugars. This causes blood glucose levels to rise and stimulates the pancreas to release insulin into the bloodstream. Insulin is a produced by the in the pancreas. It regulates the transport of glucose into most of the body's cells and works with glucagon, another pancreatic hormone, to maintain blood glucose levels within a narrow range.

If someone is unable to produce enough insulin, or if the body's cells are resistant to its effects (insulin resistance), then less glucose is transported from the blood into cells. Blood glucose levels remain high but the body's cells "starve." This can cause both short-term and long-term health problems, depending on the severity of the insulin deficiency and/or resistance. Diabetics typically have to control their blood glucose levels on a daily basis and over time to avoid health problems and complications. Treatment, which may involve specialized diets, exercise and/or medications, including insulin, aims to ensure that blood glucose does not get too high or too low.

Chronic high blood glucose can cause long-term damage to blood vessels, nerves, and organs throughout the body and can lead to other conditions such as kidney disease, loss of vision, strokes, cardiovascular disease, and circulatory problems in the legs. Damage from hyperglycemia is cumulative and may begin before a person is aware that he or she has diabetes. The sooner that the condition is detected and treated, the better the chances are of minimizing long-term complications.

The following table summarizes some types of diabetes. Click on the links to read more about the various types.

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Diabetes, Type 2 Medication | Drugs.com

August 29th, 2015 6:46 pm

Definition of Diabetes, Type 2:

Type 2 diabetes is characterized by "insulin resistance" as body cells do not respond appropriately when insulin is present. This is a more complex problem than type 1, but is sometimes easier to treat, since insulin is still produced, especially in the initial years. Type 2 may go unnoticed for years in a patient before diagnosis, since the symptoms are typically milder (no ketoacidosis) and can be sporadic. However, severe complications can result from unnoticed type 2 diabetes, including renal failure, and coronary artery disease. Type 2 diabetes was formerly known by a variety of partially misleading names, including "adult-onset diabetes", "obesity-related diabetes", "insulin-resistant diabetes", or "non-insulin-dependent diabetes" (NIDDM). It may be caused by a number of diseases, such as hemochromatosis and polycystic ovary syndrome, and can also be caused by certain types of medications (e.g. long-term steroid use). About 90-95% of all North American cases of diabetes are type 2, and about 20% of the population over the age of 65 is a type 2 diabetic. The fraction of type 2 diabetics in other parts of the world varies substantially, almost certainly for environmental and lifestyle reasons. There is also a strong inheritable genetic connection in type 2 diabetes: having relatives (especially first degree) with type 2 is a considerable risk factor for developing type 2 diabetes. The majority of patients with type 2 diabetes mellitus are obese - chronic obesity leads to increased insulin resistance that can develop into diabetes, most likely because adipose tissue is a (recently identified) source of chemical signals (hormones and cytokines).

The following drugs and medications are in some way related to, or used in the treatment of Diabetes, Type 2. This service should be used as a supplement to, and NOT a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.

See sub-topics

See 58 generic medications used to treat this condition

Alternative treatments for Diabetes, Type 2

The following products are considered to be alternative treatments or natural remedies for Diabetes, Type 2. Their efficacy may not have been scientifically tested to the same degree as the drugs listed in the table above. However there may be historical, cultural or anecdotal evidence linking their use to the treatment of Diabetes, Type 2.

Micromedex Care Notes:

Drugs.com Health Center:

Mayo Clinic Reference:

Synonym(s): Diabetes; Noninsulin-dependent Diabetes; Type 2 Diabetes

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About Diabetes – American Heart Association

August 29th, 2015 6:46 pm

"Diabetes mellitus," more commonly referred to as "diabetes," is a condition that causes blood sugar to rise to dangerous levels: a fasting blood glucose of 126 milligrams per deciliter (mg/dL) or more.

How Diabetes Develops

Types of Diabetes

Type 1DiabetesType 1 diabetes is a serious condition that occurs when the pancreas makes little or no insulin. Without insulin, the body is unable to take the glucose (blood sugar) it gets from food into cells to fuel the body. So without daily injections of insulin, people with type 1 diabetes won't survive. For that reason, this type of diabetes is also referred to as insulin-dependent diabetes.

Type 1 diabetes was previously known as juvenile diabetes because it's usually diagnosed in children and young adults. However, this chronic, lifelong disease can strike at any age, and those with a family history of it are particularly at risk.

Health Risks for Type 1 Diabetes

During the development of type 1 diabetes, the body's immune system attacks certain cells (called beta cells) in the pancreas. Although the reasons this occurs are still unknown, the effects are clear. Once these cells are destroyed, the pancreas produces little or no insulin, so the glucose stays in the blood. When there's too much glucose in the blood, especially for prolonged periods, all the organ systems in the body suffer long-term damage. Learn more about the health consequences of diabetes and how to treat it.

Type2DiabetesType 2 diabetes is the most common form of diabetes. Historically, type 2 diabetes has been diagnosed primarily in middle-aged adults. Today, however, adolescents and young adults are developing type 2 diabetes at an alarming rate. This correlates with the increasing incidence of obesity and physical inactivity in this population, both of which are risk factors for type 2 diabetes.

This type of diabetes can occur when:

Precursors to Diabetes

Pre-diabetesPre-diabetes means your body is not fully able to handle the job of converting sugars into energy. If youve been told by your healthcare provider that you have pre-diabetes it also means that without making some healthy changes, your body will most likely eventually develop diabetes. Learn more about pre-diabetes. Insulin Resistance Both type 2 diabetes and pre-diabetes usually result from insulin resistance.

Insulin resistance, which is a condition that affects more than 60 million Americans, occurs when the body can't use insulin efficiently. To compensate, the pancreas releases more and more insulin to try to keep blood sugar levels normal. Gradually, the insulin-producing cells in the pancreas become defective and ultimately decrease in total number. As a result, blood sugar levels begin to rise, causing pre-diabetes and, eventually, type 2 diabetes to develop.

When a fasting individual has too much glucose in the blood (hyperglycemia) or too much insulin in the blood (hyperinsulinemia), it indicates a person may have insulin resistance.

Health Risks of Insulin Resistance

People with insulin resistance are at greater risk of developing type 2 diabetes. They also are more likely to have too much LDL ("bad") cholesterol, not enough HDL ("good") cholesterol, and high triglycerides, which cause atherosclerosis.

Untreated diabetes can lead to many serious medical problems, including heart disease and stroke. That's why it's important to be aware of the symptoms as well as the risk factors and to take appropriate steps to prevent and treat insulin resistance and diabetes.

This content was last reviewed on 6/28/2012.

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Diabetes center – US News

August 29th, 2015 6:46 pm

Type 1 Diabetes

Many people have this type of diabetes, which usually develops in children and young adults when their immune systems attack cells in the pancreas that produce insulin, a hormone that helps cells absorb glucose from the bloodstream. More

People with this disease don't produce enough insulin and/or are unable to use it properly. Unless diet and medications are carefully managed, glucose can build up in the bloodstream. Possible complications include heart attacks and kidney failure. More

Studies show that most people with prediabetes will develop type 2 diabetes within 10 years if they don't make some lifestyle changes such as losing weight and starting a program of moderate physical activity. They also have a higher risk of developing cardiovascular disease. More

As it grows, the placenta secretes hormones that make it harder for a woman's body to use insulin normally. She needs an increasingly large amount of insulin to maintain normal blood glucose levels. When Mom's pancreas can't keep up with the higher demand, the body falls behind in processing glucose, and gestational diabetes results. More

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Diabetes mellitus type 2 – Wikipedia, the free encyclopedia

August 29th, 2015 6:46 pm

Diabetes mellitus type2 (formerly noninsulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes) is a metabolic disorder that is characterized by hyperglycemia (high blood sugar) in the context of insulin resistance and relative lack of insulin.[2] This is in contrast to diabetes mellitus type1, in which there is an absolute lack of insulin due to breakdown of islet cells in the pancreas.[3] The classic symptoms are excess thirst, frequent urination, and constant hunger. Type2 diabetes makes up about 90% of cases of diabetes, with the other 10% due primarily to diabetes mellitus type 1 and gestational diabetes. Obesity is thought to be the primary cause of type2 diabetes in people who are genetically predisposed to the disease (although this is not the case in people of East-Asian ancestry).

Type2 diabetes is initially managed by increasing exercise and dietary changes. If blood sugar levels are not adequately lowered by these measures, medications such as metformin or insulin may be needed. In those on insulin, there is typically the requirement to routinely check blood sugar levels.

Rates of type2 diabetes have increased markedly since 1960 in parallel with obesity. As of 2010 there were approximately 285million people diagnosed with the disease compared to around 30million in 1985.[4][5] Type 2 diabetes is typically a chronic disease associated with a ten-year-shorter life expectancy.[4] Long-term complications from high blood sugar can include heart disease, strokes, diabetic retinopathy where eyesight is affected, kidney failure which may require dialysis, and poor blood flow in the limbs leading to amputations. The acute complication of ketoacidosis, a feature of type1 diabetes, is uncommon,[6] however hyperosmolar hyperglycemic state may occur.

The classic symptoms of diabetes are polyuria (frequent urination), polydipsia (increased thirst), polyphagia (increased hunger), and weight loss.[7] Other symptoms that are commonly present at diagnosis include a history of blurred vision, itchiness, peripheral neuropathy, recurrent vaginal infections, and fatigue.[3] Many people, however, have no symptoms during the first few years and are diagnosed on routine testing.[3] People with type2 diabetes mellitus may rarely present with hyperosmolar hyperglycemic state (a condition of very high blood sugar associated with a decreased level of consciousness and low blood pressure).[3]

Type 2 diabetes is typically a chronic disease associated with a ten-year-shorter life expectancy.[4] This is partly due to a number of complications with which it is associated, including: two to four times the risk of cardiovascular disease, including ischemic heart disease and stroke; a 20-fold increase in lower limb amputations, and increased rates of hospitalizations.[4] In the developed world, and increasingly elsewhere, type2diabetes is the largest cause of nontraumatic blindness and kidney failure.[8] It has also been associated with an increased risk of cognitive dysfunction and dementia through disease processes such as Alzheimer's disease and vascular dementia.[9] Other complications include acanthosis nigricans, sexual dysfunction, and frequent infections.[7]

The development of type2 diabetes is caused by a combination of lifestyle and genetic factors.[8][10] While some of these factors are under personal control, such as diet and obesity, other factors are not, such as increasing age, female gender, and genetics.[4] A lack of sleep has been linked to type2 diabetes.[11] This is believed to act through its effect on metabolism.[11] The nutritional status of a mother during fetal development may also play a role, with one proposed mechanism being that of altered DNA methylation.[12]

A number of lifestyle factors are known to be important to the development of type2 diabetes, including obesity and being overweight (defined by a body mass index of greater than 25), lack of physical activity, poor diet, stress, and urbanization.[4][13] Excess body fat is associated with 30% of cases in those of Chinese and Japanese descent, 60-80% of cases in those of European and African descent, and 100% of cases in Pima Indians and Pacific Islanders.[3] Those who are not obese often have a high waisthip ratio.[3]

Dietary factors also influence the risk of developing type2 diabetes. Consumption of sugar-sweetened drinks in excess is associated with an increased risk.[14][15] The type of fats in the diet are also important, with saturated fats and trans fatty acids increasing the risk, and polyunsaturated and monounsaturated fat decreasing the risk.[10] Eating lots of white rice appears to also play a role in increasing risk.[16] A lack of exercise is believed to cause 7% of cases.[17]Persistent organic pollutants may also play a role.[18]

Most cases of diabetes involve many genes, with each being a small contributor to an increased probability of becoming a type2 diabetic.[4] If one identical twin has diabetes, the chance of the other developing diabetes within his lifetime is greater than 90%, while the rate for nonidentical siblings is 2550%.[3] As of 2011, more than 36genes had been found that contribute to the risk of type2 diabetes.[19] All of these genes together still only account for 10% of the total heritable component of the disease.[19] The TCF7L2 allele, for example, increases the risk of developing diabetes by 1.5times and is the greatest risk of the common genetic variants.[3] Most of the genes linked to diabetes are involved in beta cell functions.[3]

There are a number of rare cases of diabetes that arise due to an abnormality in a single gene (known as monogenic forms of diabetes or "other specific types of diabetes").[3][4] These include maturity onset diabetes of the young (MODY), Donohue syndrome, and Rabson-Mendenhall syndrome, among others.[4] Maturity onset diabetes of the young constitute 15% of all cases of diabetes in young people.[20]

There are a number of medications and other health problems that can predispose to diabetes.[21] Some of the medications include: glucocorticoids, thiazides, beta blockers, atypical antipsychotics,[22] and statins.[23] Those who have previously had gestational diabetes are at a higher risk of developing type2 diabetes.[7] Other health problems that are associated include: acromegaly, Cushing's syndrome, hyperthyroidism, pheochromocytoma, and certain cancers such as glucagonomas.[21]Testosterone deficiency is also associated with type2 diabetes.[24][25]

Type2 diabetes is due to insufficient insulin production from beta cells in the setting of insulin resistance.[3] Insulin resistance, which is the inability of cells to respond adequately to normal levels of insulin, occurs primarily within the muscles, liver, and fat tissue.[26] In the liver, insulin normally suppresses glucose release. However, in the setting of insulin resistance, the liver inappropriately releases glucose into the blood.[4] The proportion of insulin resistance versus beta cell dysfunction differs among individuals, with some having primarily insulin resistance and only a minor defect in insulin secretion and others with slight insulin resistance and primarily a lack of insulin secretion.[3]

Other potentially important mechanisms associated with type2 diabetes and insulin resistance include: increased breakdown of lipids within fat cells, resistance to and lack of incretin, high glucagon levels in the blood, increased retention of salt and water by the kidneys, and inappropriate regulation of metabolism by the central nervous system.[4] However, not all people with insulin resistance develop diabetes, since an impairment of insulin secretion by pancreatic beta cells is also required.[3]

The World Health Organization definition of diabetes (both type1 and type2) is for a single raised glucose reading with symptoms, otherwise raised values on two occasions, of either:[29]

A random blood sugar of greater than 11.1mmol/l (200mg/dL) in association with typical symptoms[7] or a glycated hemoglobin (HbA1c) of 48mmol/mol (6.5 DCCT%) is another method of diagnosing diabetes.[4] In 2009 an International Expert Committee that included representatives of the American Diabetes Association (ADA), the International Diabetes Federation (IDF), and the European Association for the Study of Diabetes (EASD) recommended that a threshold of 48mmol/mol (6.5 DCCT%) should be used to diagnose diabetes.[30] This recommendation was adopted by the American Diabetes Association in 2010.[31] Positive tests should be repeated unless the person presents with typical symptoms and blood sugars >11.1mmol/l (>200mg/dl).[30]

Threshold for diagnosis of diabetes is based on the relationship between results of glucose tolerance tests, fasting glucose or HbA1c and complications such as retinal problems.[4] A fasting or random blood sugar is preferred over the glucose tolerance test, as they are more convenient for people.[4] HbA1c has the advantages that fasting is not required and results are more stable but has the disadvantage that the test is more costly than measurement of blood glucose.[32] It is estimated that 20% of people with diabetes in the United States do not realize that they have the disease.[4]

Diabetes mellitus type2 is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency.[2] This is in contrast to diabetes mellitus type 1 in which there is an absolute insulin deficiency due to destruction of [islet cells in the pancreas and gestational diabetes mellitus that is a new onset of high blood sugars associated with pregnancy.[3] Type1 and type2 diabetes can typically be distinguished based on the presenting circumstances.[30] If the diagnosis is in doubt antibody testing may be useful to confirm type1 diabetes and C-peptide levels may be useful to confirm type2 diabetes,[33] with C-peptide levels normal or high in type2 diabetes, but low in type1 diabetes.[34]

No major organization recommends universal screening for diabetes as there is no evidence that such a program improve outcomes.[35][36] Screening is recommended by the United States Preventive Services Task Force (USPSTF) in adults without symptoms whose blood pressure is greater than 135/80mmHg.[37] For those whose blood pressure is less, the evidence is insufficient to recommend for or against screening.[37] There is no evidence that it changes the risk of death in this group of people.[38]

The World Health Organization recommends testing those groups at high risk[35] and in 2014 the USPSTF is considering a similar recommendation.[39] High-risk groups in the United States include: those over 45 years old; those with a first degree relative with diabetes; some ethnic groups, including Hispanics, African-Americans, and Native-Americans; a history of gestational diabetes; polycystic ovary syndrome; excess weight; and conditions associated with metabolic syndrome.[7] The American Diabetes Association recommends screening those who have a BMI over 25 (in people of Asian descent screening is recommending for a BMI over 23.[40]

Onset of type2 diabetes can be delayed or prevented through proper nutrition and regular exercise.[41][42] Intensive lifestyle measures may reduce the risk by over half.[8][43] The benefit of exercise occurs regardless of the person's initial weight or subsequent weight loss.[44] Evidence for the benefit of dietary changes alone, however, is limited,[45] with some evidence for a diet high in green leafy vegetables[46] and some for limiting the intake of sugary drinks.[14] In those with impaired glucose tolerance, diet and exercise either alone or in combination with metformin or acarbose may decrease the risk of developing diabetes.[8][47] Lifestyle interventions are more effective than metformin.[8] While low vitamin D levels are associated with an increased risk of diabetes, correcting the levels by supplementing vitamin D3 does not improve that risk.[48]

Management of type2 diabetes focuses on lifestyle interventions, lowering other cardiovascular risk factors, and maintaining blood glucose levels in the normal range.[8] Self-monitoring of blood glucose for people with newly diagnosed type2 diabetes may be used in combination with education,[49] however the benefit of self monitoring in those not using multi-dose insulin is questionable.[8][50] In those who do not want to measure blood levels, measuring urine levels may be done.[49] Managing other cardiovascular risk factors, such as hypertension, high cholesterol, and microalbuminuria, improves a person's life expectancy.[8] Decreasing the systolic blood pressure to less than 140mmHg is associated with a lower risk of death and better outcomes.[51] Intensive blood pressure management (less than 130/80mmHg) as opposed to standard blood pressure management (less than 140/85100mmHg) results in a slight decrease in stroke risk but no effect on overall risk of death.[52]

Intensive blood sugar lowering (HbA1c<6%) as opposed to standard blood sugar lowering (HbA1c of 77.9%) does not appear to change mortality.[53][54] The goal of treatment is typically an HbA1c of around 7% or a fasting glucose of less than 7.2mmol/L (130mg/dL); however these goals may be changed after professional clinical consultation, taking into account particular risks of hypoglycemia and life expectancy.[55][56] It is recommended that all people with type2 diabetes get regular ophthalmology examination.[3] Treating gum disease in those with diabetes may result in a small improvement in blood sugar levels.[57]

A proper diet and exercise are the foundations of diabetic care,[7] with a greater amount of exercise yielding better results.[58]Aerobic exercise leads to a decrease in HbA1c and improved insulin sensitivity.[58]Resistance training is also useful and the combination of both types of exercise may be most effective.[58] A diabetic diet that promotes weight loss is important.[59] While the best diet type to achieve this is controversial,[59] a low glycemic index diet or low carbohydrate diet has been found to improve blood sugar control.[60][61] Culturally appropriate education may help people with type2 diabetes control their blood sugar levels, for up to six months at least.[62] If changes in lifestyle in those with mild diabetes has not resulted in improved blood sugars within six weeks, medications should then be considered.[7] There is not enough evidence to determine if lifestyle interventions affect mortality in those who already have DM2.[43]

There are several classes of anti-diabetic medications available. Metformin is generally recommended as a first line treatment as there is some evidence that it decreases mortality;[8] however, this conclusion is questioned.[63] Metformin should not be used in those with severe kidney or liver problems.[7]

A second oral agent of another class or insulin may be added if metformin is not sufficient after three months.[55] Other classes of medications include: sulfonylureas, thiazolidinediones, dipeptidyl peptidase-4 inhibitors, SGLT2 inhibitors, and glucagon-like peptide-1 analog.[55] There is no significant difference between these agents.[55]Rosiglitazone, a thiazolidinedione, has not been found to improve long-term outcomes even though it improves blood sugar levels.[64] Additionally it is associated with increased rates of heart disease and death.[65]Angiotensin-converting enzyme inhibitors (ACEIs) prevent kidney disease and improve outcomes in those with diabetes.[66][67] The similar medications angiotensin receptor blockers (ARBs) do not.[67]

Injections of insulin may either be added to oral medication or used alone.[8] Most people do not initially need insulin.[3] When it is used, a long-acting formulation is typically added at night, with oral medications being continued.[7][8] Doses are then increased to effect (blood sugar levels being well controlled).[8] When nightly insulin is insufficient, twice daily insulin may achieve better control.[7] The long acting insulins glargine and detemir are equally safe and effective,[68] and do not appear much better than neutral protamine Hagedorn (NPH) insulin, but as they are significantly more expensive, they are not cost effective as of 2010.[69] In those who are pregnant insulin is generally the treatment of choice.[7]

Weight loss surgery in those who are obese is an effective measure to treat diabetes.[70] Many are able to maintain normal blood sugar levels with little or no medications following surgery[71] and long-term mortality is decreased.[72] There however is some short-term mortality risk of less than 1% from the surgery.[73] The body mass index cutoffs for when surgery is appropriate are not yet clear.[72] It is recommended that this option be considered in those who are unable to get both their weight and blood sugar under control.[74]

no data

7.5

7.515

1522.5

22.530

3037.5

37.545

4552.5

52.560

6067.5

67.575

7582.5

82.5

Globally as of 2010 it was estimated that there were 285million people with type2 diabetes making up about 90% of diabetes cases.[4] This is equivalent to about 6% of the world's adult population.[75] Diabetes is common both in the developed and the developing world.[4] It remains uncommon, however, in the underdeveloped world.[3]

Women seem to be at a greater risk as do certain ethnic groups,[4][76] such as South Asians, Pacific Islanders, Latinos, and Native Americans.[7] This may be due to enhanced sensitivity to a Western lifestyle in certain ethnic groups.[77] Traditionally considered a disease of adults, type2 diabetes is increasingly diagnosed in children in parallel with rising obesity rates.[4] Type2 diabetes is now diagnosed as frequently as type1 diabetes in teenagers in the United States.[3]

Rates of diabetes in 1985 were estimated at 30million, increasing to 135million in 1995 and 217million in 2005.[5] This increase is believed to be primarily due to the global population aging, a decrease in exercise, and increasing rates of obesity.[5] The five countries with the greatest number of people with diabetes as of 2000 are India having 31.7million, China 20.8million, the United States 17.7million, Indonesia 8.4million, and Japan 6.8million.[78] It is recognized as a global epidemic by the World Health Organization.[79]

Diabetes is one of the first diseases described[80] with an Egyptian manuscript from c. 1500 BCE mentioning "too great emptying of the urine."[81] The first described cases are believed to be of type1 diabetes.[81] Indian physicians around the same time identified the disease and classified it as madhumeha or honey urine noting that the urine would attract ants.[81] The term "diabetes" or "to pass through" was first used in 230BCE by the Greek Appollonius Of Memphis.[81] The disease was rare during the time of the Roman empire with Galen commenting that he had only seen two cases during his career.[81]

Type1 and type2 diabetes were identified as separate conditions for the first time by the Indian physicians Sushruta and Charaka in 400-500AD with type1 associated with youth and type2 with being overweight.[81] The term "mellitus" or "from honey" was added by the Briton John Rolle in the late 1700s to separate the condition from diabetes insipidus which is also associated with frequent urination.[81] Effective treatment was not developed until the early part of the 20th century when the Canadians Frederick Banting and Charles Best discovered insulin in 1921 and 1922.[81] This was followed by the development of the long acting NPH insulin in the 1940s.[81]

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Diabetes Symptoms: Common Symptoms of Diabetes

August 29th, 2015 6:46 pm

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Last updated: Tuesday 16 June 2015

Last updated: Tue 16 Jun 2015

People can often have diabetes and be completely unaware. The main reason for this is that the symptoms, when seen on their own, seem harmless. However, the earlier diabetes is diagnosed the greater the chances are that serious complications, which can result from having diabetes, can be avoided.

The most common signs and symptoms of diabetes are:

We will examine each of these symptoms in more detail below.

Have you been going to the bathroom to urinate more often recently? Do you notice that you spend most of the day going to the toilet? When there is too much glucose (sugar) in your blood you will urinate more often. If your insulin is ineffective, or not there at all, your kidneys cannot filter the glucose back into the blood. The kidneys will take water from your blood in order to dilute the glucose - which in turn fills up your bladder.

If you are urinating more than usual, you will need to replace that lost liquid. You will be drinking more than usual. Have you been drinking more than usual lately?

As the insulin in your blood is not working properly, or is not there at all, and your cells are not getting their energy, your body may react by trying to find more energy - food. You will become hungry.

This might be the result of the above symptom (intense hunger).

This is more common among people with Diabetes Type 1. As your body is not making insulin it will seek out another energy source (the cells aren't getting glucose). Muscle tissue and fat will be broken down for energy. As Type 1 is of a more sudden onset and Type 2 is much more gradual, weight loss is more noticeable with Type 1.

If your insulin is not working properly, or is not there at all, glucose will not be entering your cells and providing them with energy. This will make you feel tired and listless.

Irritability can be due to your lack of energy.

This can be caused by tissue being pulled from your eye lenses. This affects your eyes' ability to focus. With proper treatment this can be treated. There are severe cases where blindness or prolonged vision problems can occur.

Do you find cuts and bruises take a much longer time than usual to heal? When there is more sugar (glucose) in your body, its ability to heal can be undermined.

When there is more sugar in your body, its ability to recover from infections is affected. Women with diabetes find it especially difficult to recover from bladder and vaginal infections.

A feeling of itchiness on your skin is sometimes a symptom of diabetes.

If your gums are tender, red and/or swollen this could be a sign of diabetes. Your teeth could become loose as the gums pull away from them.

As well as the previous gum symptoms, you may experience more frequent gum disease and/or gum infections.

If you are over 50 and experience frequent or constant sexual dysfunction (erectile dysfunction), it could be a symptom of diabetes.

If there is too much sugar in your body your nerves could become damaged, as could the tiny blood vessels that feed those nerves. You may experience tingling and/or numbness in your hands and feet.

Diabetes can often be detected by carrying out a urine test, which finds out whether excess glucose is present. This is normally backed up by a blood test, which measures blood glucose levels and can confirm if the cause of your symptoms is diabetes.

If you are worried that you may have some of the above symptoms, you are recommended to talk to your Doctor or a qualified health professional.

This diabetes information section was written by Christian Nordqvist. It was first published on 15 September 2010 and last updated on 19 May 2015.

Disclaimer: This informational section on Medical News Today is regularly reviewed and updated, and provided for general information purposes only. The materials contained within this guide do not constitute medical or pharmaceutical advice, which should be sought from qualified medical and pharmaceutical advisers.

Please note that although you may feel free to cite and quote this article, it may not be re-produced in full without the permission of Medical News Today. For further details, please view our full terms of use

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Diabetes Symptoms: Common Symptoms of Diabetes

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Questions & Answers about Diabetes in the Workplace and …

August 29th, 2015 6:46 pm

INTRODUCTION

The Americans with Disabilities Act (ADA), which was amended by the ADA Amendments Act of 2008 ("Amendments Act" or "ADAAA"), is a federal law that prohibits discrimination against qualified individuals with disabilities. Individuals with disabilities include those who have impairments that substantially limit a major life activity, have a record (or history) of a substantially limiting impairment, or are regarded as having a disability.1

Title I of the ADA covers employment by private employers with 15 or more employees as well as state and local government employers. Section 501 of the Rehabilitation Act provides similar protections related to federal employment. In addition, most states have their own laws prohibiting employment discrimination on the basis of disability. Some of these state laws may apply to smaller employers and may provide protections in addition to those available under the ADA.2

The U.S. Equal Employment Opportunity Commission (EEOC) enforces the employment provisions of the ADA. This document, which is one of a series of question-and-answer documents addressing particular disabilities in the workplace,3 explains how the ADA applies to job applicants and employees who have or had diabetes. In particular, this document explains:

Diabetes is a group of diseases characterized by high blood glucose or sugar levels that result from defects in the body's ability to produce and/or use insulin.4 Insulin is a hormone that helps the glucose enter the body's cells to give them energy. With Type 1 diabetes, the body does not make insulin. With Type 2 diabetes, the more common type, the body does not make or use insulin well. Some women develop a type of diabetes called gestational diabetes during pregnancy when their bodies are not able to make and use all the insulin it needs, but may not have diabetes after giving birth. Without enough insulin, the glucose stays in the blood.5

Although diabetes cannot be cured, it can be managed. Some people are able to control their diabetes by eating a balanced diet, maintaining a healthy body weight, and exercising regularly. Many individuals, however, must take oral medication and/or administer insulin injections to manage their diabetes.6

With nearly two million new cases diagnosed each year, diabetes is becoming more prevalent in the United States and is the most common endocrine disease.7 Today, an estimated 18.8 million adults in the United States have diabetes.8

As a result of changes made by the ADAAA, individuals who have diabetes should easily be found to have a disability within the meaning of the first part of the ADA's definition of disability because they are substantially limited in the major life activity of endocrine function.9 Additionally, because the determination of whether an impairment is a disability is made without regard to the ameliorative effects of mitigating measures, diabetes is a disability even if insulin, medication, or diet controls a person's blood glucose levels. An individual with a past history of diabetes (for example, gestational diabetes) also has a disability within the meaning of the ADA.10 Finally, an individual is covered under the third ("regarded as") prong of the definition of disability if an employer takes a prohibited action (for example, refuses to hire or terminates the individual) because of diabetes or because the employer believes the individual has diabetes.11

Title I of the ADA limits an employer's ability to ask questions related to diabetes and other disabilities and to conduct medical examinations at three stages: pre-offer, post-offer, and during employment.

Before an Offer of Employment Is Made

1. May an employer ask a job applicant whether she has or had diabetes or about her treatment related to diabetes before making a job offer?

No. An employer may not ask questions about an applicant's medical condition12 or require an applicant to have a medical examination before it makes a conditional job offer. This means that an employer cannot legally ask an applicant questions such as:

Of course, an employer may ask questions pertaining to the qualifications for, or performance of, the job, such as:

2. Does the ADA require an applicant to disclose that she has or had diabetes or some other disability before accepting a job offer?

No. The ADA does not require applicants to voluntarily disclose that they have or had diabetes or another disability unless they will need a reasonable accommodation for the application process (for example, a break to eat a snack or monitor their glucose levels). Some individuals with diabetes, however, choose to disclose their condition because they want their co-workers or supervisors to know what to do if they faint or experience other symptoms of hypoglycemia (low blood sugar), such as weakness, shakiness, or confusion. 13

Sometimes, the decision to disclose depends on whether an individual will need a reasonable accommodation to perform the job (for example, breaks to take medication or a place to rest until blood sugar levels become normal). A person with diabetes, however, may request an accommodation after becoming an employee even if she did not do so when applying for the job or after receiving the job offer.

3. May an employer ask any follow-up questions if an applicant voluntarily reveals that she has or had diabetes?

No. An employer generally may not ask an applicant who has voluntarily disclosed that she has diabetes any questions about her diabetes, its treatment, or its prognosis. However, if an applicant voluntarily discloses that she has diabetes and the employer reasonably believes that she will require an accommodation to perform the job because of her diabetes or treatment, the employer may ask whether the applicant will need an accommodation and what type. The employer must keep any information an applicant discloses about her medical condition confidential. (See "Keeping Medical Information Confidential.")

After an Offer of Employment Is Made

After making a job offer, an employer may ask questions about the applicant's health (including questions about the applicant's disability) and may require a medical examination, as long as all applicants for the same type of job are treated equally (that is, all applicants are asked the same questions and are required to take the same examination). After an employer has obtained basic medical information from all individuals who have received job offers, it may ask specific individuals for more medical information if it is medically related to the previously obtained medical information. For example, if an employer asks all applicants post-offer about their general physical and mental health, it can ask individuals who disclose a particular illness, disease, or impairment for more medical information or require them to have a medical examination related to the condition disclosed.

4. What may an employer do when it learns that an applicant has or had diabetes after she has been offered a job but before she starts working?

When an applicant discloses after receiving a conditional job offer that she has diabetes, an employer may ask the applicant additional questions such as how long she has had diabetes; whether she uses insulin or oral medication; whether and how often she experiences hypoglycemic episodes; and/or whether she will need assistance if her blood sugar level drops while at work. The employer also may send the applicant for a follow-up medical examination or ask her to submit documentation from her doctor answering questions specifically designed to assess her ability to perform the job's functions safely. Permissible follow-up questions at this stage differ from those at the pre-offer stage when an employer only may ask an applicant who voluntarily discloses a disability whether she needs an accommodation to perform the job and what type.

An employer may not withdraw an offer from an applicant with diabetes if the applicant is able to perform the essential functions of the job, with or without reasonable accommodation, without posing a direct threat (that is, a significant risk of substantial harm) to the health or safety of himself or others that cannot be eliminated or reduced through reasonable accommodation. ("Reasonable accommodation" is discussed at Questions 10 through 15. "Direct threat" is discussed at Questions 6 and 16 through 18.)

The ADA strictly limits the circumstances under which an employer may ask questions about an employee's medical condition or require the employee to have a medical examination. Once an employee is on the job, her actual performance is the best measure of ability to do the job.

5. When may an employer ask an employee whether diabetes, or some other medical condition, may be causing her performance problems?

Generally, an employer may ask disability-related questions or require an employee to have a medical examination when it knows about a particular employee's medical condition, has observed performance problems, and reasonably believes that the problems are related to a medical condition. At other times, an employer may ask for medical information when it has observed symptoms, such as extreme fatigue or irritability, or has received reliable information from someone else (for example, a family member or co-worker) indicating that the employee may have a medical condition that is causing performance problems. Often, however, poor job performance is unrelated to a medical condition and generally should be handled in accordance with an employer's existing policies concerning performance.15

Example 4: A normally reliable secretary with diabetes has been coming to work late and missing deadlines. The supervisor observed these changes soon after the secretary started going to law school in the evenings. The supervisor can ask the secretary why his performance has declined but may not ask him about his diabetes unless there is objective evidence that his poor performance is related to his medical condition.

6. May an employer require an employee on leave because of diabetes to provide documentation or have a medical examination before allowing her to return to work?

Yes. If the employer has a reasonable belief that the employee may be unable to perform her job or may pose a direct threat to herself or others, the employer may ask for medical information. However, the employer may obtain only the information needed to make an assessment of the employee's present ability to perform her job and to do so safely.

7. Are there any other instances when an employer may ask an employee with diabetes about his condition?

Yes. An employer also may ask an employee about diabetes when it has a reasonable belief that the employee will be unable to safely perform the essential functions of his job because of diabetes. In addition, an employer may ask an employee about his diabetes to the extent the information is necessary:

With limited exceptions, an employer must keep confidential any medical information it learns about an applicant or employee. Under the following circumstances, however, an employer may disclose that an employee has diabetes:

8. May an employer tell employees who ask why their co-worker is allowed to do something that generally is not permitted (such as eat at his desk or take more breaks) that she is receiving a reasonable accommodation?

No. Telling co-workers that an employee is receiving a reasonable accommodation amounts to a disclosure that the employee has a disability. Rather than disclosing that the employee is receiving a reasonable accommodation, the employer should focus on the importance of maintaining the privacy of all employees and emphasize that its policy is to refrain from discussing the work situation of any employee with co-workers. Employers may be able to avoid many of these kinds of questions by training all employees on the requirements of equal employment opportunity laws, including the ADA.

Additionally, an employer will benefit from providing information about reasonable accommodations to all of its employees. This can be done in a number of ways, such as through written reasonable accommodation procedures, employee handbooks, staff meetings, and periodic training. This kind of proactive approach may lead to fewer questions from employees who misperceive co-worker accommodations as "special treatment."

9. If an employee experiences an insulin reaction at work, may an employer explain to other employees or managers that the employee has diabetes?

No. Although the employee's co-workers and others in the workplace who witness the reaction naturally may be concerned, an employer may not reveal that the employee has diabetes. Rather, the employer should assure everyone present that the situation is under control. An employee, however, may voluntarily choose to tell her co-workers that she has diabetes and provide them with helpful information, such as how to recognize when her blood sugar may be low, what to do if she faints or seems shaky or confused (for example, offer a piece of candy or gum), or where to find her glucose monitoring kit. However, even when an employee voluntarily discloses that she has diabetes, the employer must keep this information confidential consistent with the ADA. An employer also may not explain to other employees why an employee with diabetes has been absent from work if the absence is related to her diabetes or another disability.

The ADA requires employers to provide adjustments or modifications -- called reasonable accommodations -- to enable applicants and employees with disabilities to enjoy equal employment opportunities unless doing so would be an undue hardship (that is, a significant difficulty or expense). Accommodations vary depending on the needs of the individual with a disability. Not all employees with diabetes will need an accommodation or require the same accommodations, and most of the accommodations a person with diabetes might need will involve little or no cost. An employer must provide a reasonable accommodation that is needed because of the diabetes itself, the effects of medication, or both. For example, an employer may have to accommodate an employee who is unable to work while learning to manage her diabetes or adjusting to medication. An employer, however, has no obligation to monitor an employee to make sure that she is regularly checking her blood sugar levels, eating, or taking medication as prescribed.

10. What other types of reasonable accommodations may employees with diabetes need?

Some employees may need one or more of the following accommodations:

Although these are some examples of the types of accommodations commonly requested by employees with diabetes, other employees may need different changes or adjustments. Employers should ask the particular employee requesting an accommodation what he needs that will help him do his job. There also are extensive public and private resources to help employers identify reasonable accommodations. For example, the website for the Job Accommodation Network (JAN)(http://askjan.org/media/Diabetes.html) provides information about many types of accommodations for employees with diabetes.

11. How does an employee with diabetes request a reasonable accommodation?

There are no "magic words" that a person has to use when requesting a reasonable accommodation. A person simply has to tell the employer that she needs an adjustment or change at work because of her diabetes. A request for a reasonable accommodation also can come from a family member, friend, health professional, or other representative on behalf of a person with diabetes.

12. May an employer request documentation when an employee who has diabetes requests a reasonable accommodation?

Yes. An employer may request reasonable documentation where a disability or the need for reasonable accommodation is not known or obvious. An employer, however, is entitled only to documentation sufficient to establish that the employee has diabetes and to explain why an accommodation is needed. A request for an employee's entire medical record, for example, would be inappropriate as it likely would include information about conditions other than the employee's diabetes.20

13. Does an employer have to grant every request for a reasonable accommodation?

No. An employer does not have to provide an accommodation if doing so will be an undue hardship. Undue hardship means that providing the reasonable accommodation will result in significant difficulty or expense. An employer also does not have to eliminate an essential function of a job as a reasonable accommodation, tolerate performance that does not meet its standards, or excuse violations of conduct rules that are job-related and consistent with business necessity and that the employer applies consistently to all employees (such as rules prohibiting violence, threatening behavior, theft, or destruction of property).

If more than one accommodation will be effective, the employee's preference should be given primary consideration, although the employer is not required to provide the employee's first choice of reasonable accommodation. If a requested accommodation is too difficult or expensive, an employer may choose to provide an easier or less costly accommodation as long as it is effective in meeting the employee's needs.

14. May an employer be required to provide more than one accommodation for the same employee with diabetes?

Yes. The duty to provide a reasonable accommodation is an ongoing one. Although some employees with diabetes may require only one reasonable accommodation, others may need more than one. For example, an employee with diabetes may require leave to attend a class on how to administer insulin injections and later may request a part-time or modified schedule to better control his glucose levels. An employer must consider each request for a reasonable accommodation and determine whether it would be effective and whether providing it would pose an undue hardship.

15. May an employer automatically deny a request for leave from someone with diabetes because the employee cannot specify an exact date of return?

No. Granting leave to an employee who is unable to provide a fixed date of return may be a reasonable accommodation. Although diabetes can be successfully treated, some individuals experience serious complications that may be unpredictable and do not permit exact timetables. An employee requesting leave because of diabetes or resulting complications (for example, a foot or toe amputation), therefore, may be able to provide only an approximate date of return (e.g., "in six to eight weeks," "in about three months"). In such situations, or in situations in which a return date must be postponed because of unforeseen medical developments, employees should stay in regular communication with their employers to inform them of their progress and discuss the need for continued leave beyond what originally was granted. The employer also has the right to require that the employee provide periodic updates on his condition and possible date of return. After receiving these updates, the employer may reevaluate whether continued leave constitutes an undue hardship.

When it comes to safety concerns, an employer should be careful not to act on the basis of myths, fears, or stereotypes about diabetes. Instead, the employer should evaluate each individual on her skills, knowledge, experience and how having diabetes affects her.

16. When may an employer refuse to hire, terminate, or temporarily restrict the duties of a person who has diabetes because of safety concerns?

An employer only may exclude an individual with diabetes from a job for safety reasons when the individual poses a direct threat. A "direct threat" is a significant risk of substantial harm to the individual or others that cannot be eliminated or reduced through reasonable accommodation.21 This determination must be based on objective, factual evidence, including the best recent medical evidence and advances in the treatment of diabetes.

In making a direct threat assessment, the employer must evaluate the individual's present ability to safely perform the job. The employer also must consider:

The harm must be serious and likely to occur, not remote or speculative. Finally, the employer must determine whether any reasonable accommodation (for example, temporarily limiting an employee's duties, temporarily reassigning an employee, or placing an employee on leave) would reduce or eliminate the risk.23

Example 13: When an actor forgets his lines and stumbles during several recent play rehearsals, he explains that the fluctuating rehearsal times are interfering with when he eats and takes his insulin. Because there is no reason to believe that the actor poses a direct threat, the director cannot terminate the actor or replace him with an understudy; rather, the director should consider whether rehearsals can be held at a set time and/or whether the actor can take a break when needed to eat, monitor his glucose, or administer his insulin

17. May an employer require an employee who has had an insulin reaction at work to submit periodic notes from his doctor indicating that his diabetes is under control?

Yes, but only if the employer has a reasonable belief that the employee will pose a direct threat if he does not regularly see his doctor. In determining whether to require periodic documentation, the employer should consider the safety risks associated with the position the employee holds, the consequences of the employee's inability or impaired ability to perform his job, how long the employee has had diabetes, and how many insulin reactions the employee has had on the job.

Example 15:The owner of a daycare center knows that one of her teachers has diabetes and that she once had an insulin reaction at work when she skipped lunch. When the owner sees the teacher eat a piece of cake at a child's birthday party, she becomes concerned that the teacher may have an insulin reaction. Although many people believe that individuals with diabetes should never eat sugar or sweets, this is a myth. The owner, therefore, cannot require the teacher to submit periodic notes from her doctor indicating that her diabetes is under control because she does not have a reasonable belief, based on objective evidence, that the teacher will pose a direct threat to the safety of herself or others.

18. What should an employer do when another federal law prohibits it from hiring anyone who uses insulin?

If a federal law prohibits an employer from hiring a person who uses insulin, the employer is not be liable under the ADA. The employer should be certain, however, that compliance with the law actually is required, not voluntary. The employer also should be sure that the law does not contain any exceptions or waivers. For example, the Department of Transportation's Federal Motor Carrier Safety Administration (FMCSA) issues exemptions to certain individuals with diabetes who wish to drive commercial motor vehicles (CMVs).24

The ADA prohibits harassment, or offensive conduct, based on disability just as other federal laws prohibit harassment based on race, sex, color, national origin, religion, age, and genetic information. Offensive conduct may include, but is not limited to, offensive jokes, slurs, epithets or name calling, physical assaults or threats, intimidation, ridicule or mockery, insults or put-downs, offensive objects or pictures, and interference with work performance. Although the law does not prohibit simple teasing, offhand comments, or isolated incidents that are not very serious, harassment is illegal when it is so frequent or severe that it creates a hostile or offensive work environment or when it results in an adverse employment decision (such as the victim being fired or demoted).

19. What should employers do to prevent and correct harassment?

Employers should make clear that they will not tolerate harassment based on disability or on any other basis. This can be done in a number of ways, such as through a written policy, employee handbooks, staff meetings, and periodic training. The employer should emphasize that harassment is prohibited and that employees should promptly report such conduct to a manager. Finally, the employer should immediately conduct a thorough investigation of any report of harassment and take swift and appropriate corrective action. For more information on the standards governing harassment under all of the EEO laws, see http://www.eeoc.gov/policy/docs/harassment.html.

The ADA prohibits retaliation by an employer against someone who opposes discriminatory employment practices, files a charge of employment discrimination, or testifies or participates in any way in an investigation, proceeding, or litigation related to a charge of employment discrimination. It is also unlawful for an employer to retaliate against someone for requesting a reasonable accommodation. Persons who believe that they have experienced retaliation may file a charge of retaliation as described below.

Any person who believes that his or her employment rights have been violated on the basis of disability and wants to make a claim against an employer must file a charge of discrimination with the EEOC. A third party may also file a charge on behalf of another person who believes he or she experienced discrimination. For example, a family member, social worker, or other representative can file a charge on behalf of someone who is incapacitated because of diabetes. The charge must be filed by mail or in person with the local EEOC office within 180 days from the date of the alleged violation. The 180-day filing deadline is extended to 300 days if a state or local anti-discrimination agency has the authority to grant or seek relief as to the challenged unlawful employment practice.

The EEOC will send the parties a copy of the charge and may ask for responses and supporting information. Before formal investigation, the EEOC may select the charge for EEOC's mediation program. Both parties have to agree to mediation, which may prevent a time consuming investigation of the charge. Participation in mediation is free, voluntary, and confidential.

If mediation is unsuccessful, the EEOC investigates the charge to determine if there is "reasonable cause" to believe discrimination has occurred. If reasonable cause is found, the EEOC will then try to resolve the charge with the employer. In some cases, where the charge cannot be resolved, the EEOC will file a court action. If the EEOC finds no discrimination, or if an attempt to resolve the charge fails and the EEOC decides not to file suit, it will issue a notice of a "right to sue," which gives the charging party 90 days to file a court action. A charging party can also request a notice of a "right to sue" from the EEOC 180 days after the charge was first filed with the Commission, and may then bring suit within 90 days after receiving the notice. For a detailed description of the process, you can visit our website at http://www.eeoc.gov/employees/howtofile.cfm.

If you are a federal employee or job applicant and you believe that a federal agency has discriminated against you, you have a right to file a complaint. Each agency is required to post information about how to contact the agency's EEO Office. You can contact an EEO Counselor by calling the office responsible for the agency's EEO complaints program. Generally, you must contact the EEO Counselor within 45 days from the day the discrimination occurred. In most cases the EEO Counselor will give you the choice of participating either in EEO counseling or in an alternative dispute resolution (ADR) program, such as a mediation program.

If you do not settle the dispute during counseling or through ADR, you can file a formal discrimination complaint against the agency with the agency's EEO Office. You must file within 15 days from the day you receive notice from your EEO Counselor about how to file.

Once you have filed a formal complaint, the agency will review the complaint and decide whether or not the case should be dismissed for a procedural reason (for example, your claim was filed too late). If the agency doesn't dismiss the complaint, it will conduct an investigation. The agency has 180 days from the day you filed your complaint to finish the investigation. When the investigation is finished, the agency will issue a notice giving you two choices: either request a hearing before an EEOC Administrative Judge or ask the agency to issue a decision as to whether the discrimination occurred. For a detailed description of the process, you can visit our website at http://www.eeoc.gov/federal/fed_employees/complaint_overview.cfm.

Footnotes

1 See 42 U.S.C. 12102(2); 29 C.F.R. 1630.2(g).

2 For example, disability laws in California, Pennsylvania, New Jersey, and New York apply to employers with fewer than 15 employees.

3 See "The Question and Answer Series" under "Available Resources" on EEOC's website at http://www.eeoc.gov/laws/types/disability.cfm.

4 See Diabetes Basics, http://www.diabetes.org/diabetes-basics (last visited January 10, 2013); see also http://www.diabetes.org/diabetes-basics/gestational/

5 Id.; see also information on diabetes from the National Institutes of Health, http://www.nlm.nih.gov/medlineplus/diabetes.html.

6 Diabetes Basics, supra note 4.

7 According to the Centers for Disease Control and Prevention (CDC), about 1.9 million people aged 20 or older were newly diagnosed with diabetes in the United States in 2010. See National Diabetes Fact Sheet (2011), http://www.cdc.gov/diabetes/pubs/factsheet11.htm (last visited January 10, 2013);see also Endocrine Diseases, http://www.nim.nih.gov/medlineplus/endocrinediseases.html#cat1.

8 See 2011 National Diabetes Fact Sheet (released January 26, 2011), http://www.diabetes.org/diabetes-basics/diabetes-statistics (last visited January 13, 2013).

9 See 29 C.F.R. 1630.2(j)(3)(iii).

10 Id. at 1630.2(k).

11 Id. at 1630.2(l).

12 Federal contractors are required under 41 C.F.R. 60-741.42, a regulation issued by the Office of Federal Contract Compliance Programs (OFCCP), to invite applicants to voluntarily self-identify as persons with disabilities for affirmative action purposes. The ADA prohibition on asking applicants about medical conditions at the pre-offer stage does not prevent federal contractors from complying with the OFCCP's regulation. See Letter from Peggy R. Mastroianni, EEOC Legal Counsel, to Patricia A. Shiu, Director of OFCCP, http://www.dol.gov/ofccp/regs/compliance/section503.htm#bottom.

13 Insulin and some oral medications can sometimes cause a person's blood sugar levels to drop too low. A person experiencing hypoglycemia (low blood sugar) may feel weak, shaky, confused, or faint. Most people with diabetes, however, recognize these symptoms and will immediately drink or eat something sweet. Many individuals with diabetes also carry a blood glucose monitoring kit with them at all times and test their blood sugar levels as soon as they feel minor symptoms such as shaking or sweating. Often, a person's blood sugar returns to normal within 15 minutes of eating or drinking something sweet. See generally information from the American Association of Diabetes, http://www.diabetes.org.

14 Asking an applicant or employee about family medical history also violates Title II of the Genetic Information Nondiscrimination Act (GINA), 42 U.S.C. 2000ff et seq., which prohibits employers from requesting, requiring, or purchasing genetic information (including family medical history) about applicants or employees. 29 C.F.R. 1635.8(a).

15 An employer also may ask an employee about his diabetes or send the employee for a medical examination when it reasonably believes the employee may pose a direct threat because of his diabetes. See "Concerns About Safety."

16 An employer also may ask an employee for periodic updates on his condition if the employee has taken leave and has not provided an exact or fairly specific date of return or has requested leave in addition to that already granted. See also Q&A 15. Of course, an employer may call employees on extended leave to check on their progress or to express concern for their health without violating the ADA.

17 The ADA allows employers to conduct voluntary medical examinations and activities, including obtaining voluntary medical histories, which are part of an employee wellness program (such as a smoking cessation or diabetes detection screening and management program), as long as any medical records (including, for example, the results any diagnostic tests) acquired as part of the program are kept confidential. See Q&A 22 in EEOC Enforcement Guidance on Disability-Related Inquiries and Medical Examinations of Employees Under the ADA, http://www.eeoc.gov/policy/docs/guidance-inquiries.html

18 An employee with diabetes who needs continuing or intermittent leave, or a part-time or modified schedule, as a reasonable accommodation also may be entitled to leave under the Family and Medical Leave Act (FMLA). For a discussion of how employers should treat situations in which an employee may be covered both by the FMLA and the ADA, see Questions 21 and 23 in the EEOC Enforcement Guidance on Reasonable Accommodation and Undue Hardship Under the Americans with Disabilities Act (rev. Oct. 17, 2002) at http://www.eeoc.gov/policy/docs/accommodation.html.

19 Diabetic neuropathy is a common complication of diabetes in which nerves are damaged as a result of high blood sugar levels (hyperglycemia). See National Center for Biotechnology Information, U.S. National Library of Medicine, http://www.ncbi.nlm.nih.gov.

20 Requests for documentation to support a request for accommodation may violate Title II of GINA where they are likely to result in the acquisition of genetic information, including family medical history. 29 C.F.R. 1635.8(a). For this reason employers may want to include a warning in the request for documentation that the employee or the employee's doctor should not provide genetic information. Id. at 1635.8(b)(1)(i)(B).

21 See 29 C.F.R. 1630.2(r).

22 Id.

23 Id.

24 Under FMCSA's Diabetes Exemption Program, an individual who intends to operate a CMV in interstate commerce may apply for an exemption from the diabetes standard if he or she meets all medical standards and guidelines, other than diabetes, in accordance with 49 CFR 391.41 (b) (1-13).

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Inattentional blindness – Wikipedia, the free encyclopedia

August 29th, 2015 6:45 pm

Inattentional blindness, also known as perceptual blindness, is a psychological lack of attention and is not associated with any vision defects or deficits. It may be further defined as the event in which an individual fails to recognize an unexpected stimulus that is in plain sight. The term was coined by Arien Mack and Irvin Rock in 1992 and was used as the title of their book of the same name, published by MIT press in 1998.[1] Here, they describe the discovery of inattentional blindness and include a collection of procedures used describing the phenomenon.[2] Research[citation needed] on inattentional blindness suggests that the phenomenon can occur in any individual, independent of cognitive deficits. When it simply becomes impossible for one to attend to all the stimuli in a given situation, a temporary blindness effect can take place as a result; that is, individuals fail to see objects or stimuli that are unexpected and quite often salient.[citation needed]

Inattentional blindness also has an effect on peoples perception. There have been numerous experiments performed that demonstrate this phenomenon.[3]

The following criteria are required to classify an event as an inattentional blindness episode: 1) the observer must fail to notice a visual object or event, 2) the object or event must be fully visible, 3) observers must be able to readily identify the object if they are consciously perceiving it,[2] and 4) the event must be unexpected and the failure to see the object or event must be due to the engagement of attention on other aspects of the visual scene and not due to aspects the visual stimulus itself.[2] Individuals who experience inattentional blindness are usually unaware of this effect, which can play a subsequent role on behavior.

Inattentional blindness is related to but distinct from other failures of visual awareness such as change blindness, repetition blindness, visual masking, and attentional blink. The key aspect of inattentional blindess which makes it distinct from other failures in awareness rests on the fact that the undetected stimulus is unexpected.[4] It is the unexpected nature of said stimulus that differentiates inattentional blindness from failures of awareness such as attentional failures like the aforementioned attentional blink. It is critical to acknowledge that occurrences of inattentional blindness are attributed to the failure to consciously attend to an item in the visual field as opposed the absence of cognitive processing.

Findings such as inattentional blindness - the failure to notice a fully visible but unexpected object because attention was engaged on another task, event, or object - has changed views on how the brain stores and integrates visual information, and has led to further questioning and investigation of the brain and importantly of cognitive processes.

Cognitive capture or, cognitive tunneling, is an inattentional blindness phenomenon in which the observer is too focused on instrumentation, task at hand, internal thought, etc. and not on the present environment. For example, while driving, a driver focused on the speedometer and not on the road is suffering from cognitive capture.[5]

One of the most foremost conflicts among researchers of inattentional blindness surrounds the processing of unattended stimuli. More specifically, there is disagreement in the literature about exactly how much processing of a visual scene is completed before selection dictates which stimuli will be consciously perceived, and which will not be (i.e. inattentional blindness). There exists two basic schools of thought on the issue - those who believe selection occurs early in the perceptual process, and those who believe it occurs only after significant processing.[6] Early selection theorists propose that perception of stimuli is a limited process requiring selection to proceed. This suggests that the decision to attend to specific stimuli occurs early in processing, soon after the rudimentary study of physical features; only those selected stimuli are then fully processed. On the other hand, proponents of late selection theories argue that perception is an unlimited operation, and all stimuli in a visual scene are processed simultaneously. In this case, selection of relevant information is done after full processing of all stimuli.[7]

While early research on the topic was heavily focused on early selection, research since the late 1970s has been shifted mainly to the late selection theories. This change resulted primarily from a shift in paradigms used to study inattentional blindness which revealed new aspects of the phenomenon.[8] Today, late selection theories are generally accepted, and continue to be the focus of the majority of research concerning inattentional blindness.

A significant body of research has been gathered in support of late selection in the perception of visual stimuli.

One of the popular ways of investigating late selection is to assess the priming properties (i.e. influencing subsequent acts[9]) of unattended stimuli. Often used to demonstrate such effects is the stem completion task. While there exist a few variations, these studies generally consist of showing participants the first few letters of words, and asking them to complete the string of letters to form an English word.[9] It has been demonstrated that observers are significantly more likely to complete word fragments with the unattended stimuli presented in a trial than with another similar word.[1] This effect holds when stimuli are not words, but instead objects. When photos of objects are shown too quickly for participants to identify, subsequent presentation of those items lead to significantly faster identification in comparison to novel objects.[9]

A notable study by Mack and Rock has also revealed that showing a word stimulus differing from the participant's name by one letter did not generally call conscious attention. By simply changing a character, transforming the presented word into the observer's first name, the now highly meaningful stimulus is significantly more likely to be attended to. This suggests that the stimuli are being extensively processed, at least enough to analyze their meaning. These results point to the fact that attentional selection may be determined late in processing.[1]

The evidence outlined above suggests that even when stimuli are not processed to the level of conscious attention, they are nonetheless perceptually and cognitively processed, and can indeed exert effects on subsequent behavior.[10]

While the evidence supporting late selection hypotheses is significant and has been consistently reproduced, there also exists a body of research suggesting that unattended stimuli in fact may not receive significant processing.

For example, in an functional magnetic resonance imaging (fMRI) study by Rees and colleagues, brain activity was recorded while participants completed a perceptual task. Here they examined the neural processing of meaningful (words) and meaningless (consonant string) stimuli both when attended to, and when these same items were unattended. While no difference in activation patterns were found between the groups when the stimuli were unattended, differences in neural processing were observed for meaningful versus meaningless stimuli to which participants overtly attended. This pattern of results suggests that ignored stimuli are not processed to the level of meaning, i.e. less extensively than attended stimuli.[11] Participants do not seem to be detecting meaning in stimuli to which they are not consciously attending.

This particular hypothesis bridges the gap between the early and late selection theories. Authors integrate the viewpoint of early selection stating that perception is a limited process (i.e. cognitive resources are limited), and that of the late selection theories assuming perception as an automatic process.[7] This view proposes that the level of processing which occurs for any one stimulus is dependent on the current perceptual load. That is, if the current task is attentionally demanding and its processing exhausts all the available resources, little remains available to process other non-target stimuli in the visual field. Alternatively, if processing requires a small amount of attentional resources, perceptual load is low and attention is inescapably directed to the non-target stimuli.[6]

The effects of perceptual load on the occurrence of inattentional blindness is demonstrated in a study by Fougnie and Marois. Here, participants were asked to complete a memory task involving either the simple maintenance of verbal stimuli, or the rearrangement of this material, a more cognitively demanding exercise. While subjects were completing the assigned task, an unexpected visual stimulus was presented. Results revealed that unexpected stimuli were more likely to be missed during manipulation of information than in the more simple rehearsal task.[12]

In a similar type of study, fMRI recordings were done while subjects took part in either low-demand or high-demand subtraction tasks. While performing these exercises, novel visual distractors were presented. When task demands were low and used a smaller portion of the finite resources, distractors captured attention and sparked visual analysis as shown by brain activation in the primary visual cortex. These results, however, did not hold when perceptual load was high; in this condition, distractors were significantly less often attended to and processed.[6]

Thus, higher perceptual load, and therefore more significant use of attentional resources, appears to increase the likelihood of inattentional blindness episodes.

The theory of inattentional amnesia provides an alternative in the explanation of inattentional blindness in suggesting that the phenomenon does not stem from failures in capture of attention or in actual perception of stimuli, but instead from a failure in memory. The unnoticed stimuli in a visual scene are attended to and consciously perceived, but are rapidly forgotten rendering them impossible to report.[13] In essence, inattentional amnesia refers to the failure in creating a lasting explicit memory: by the time a subject is asked to recall seeing an item, their memory for the stimulus has vanished.[14]

While it is difficult to tease apart a failure in perception from one in memory, some research has attempted to shed light on the issue. In a now-classic study of inattentional blindness, a woman carrying an umbrella through a scene goes unnoticed. Despite stopping the video while she is walking through and immediately asking participants to identify which of two people they have seen - leaving as little delay as possible between presentation and report - observers very often fail to correctly identify the woman with the umbrella. No differences in performance were identified whether the video was stopped immediately after the unexpected event or moments later. These findings would seem to oppose the idea of inattentional amnesia, however advocates of the theory could always contend that the memory test simply came too late and that the memory had already been lost.[15]

The very phenomenon of inattentional blindness is defined by a lack of expectation for the unattended stimulus. Some researchers believe that it is not inattention that produces blindness, but in fact the aforementioned lack of expectation for the stimuli.[10] Proponents of this theory often state that classic methods for testing inattentional blindness are not manipulating attention per se, but instead the expectation for the presentation of a visual item.[16]

Studies investigating the effect of expectation on episodes of inattentional blindness have shown that once observers are made aware of the importance of the to be presented stimuli, for example stating that one will later be tested on it, the phenomenon essentially disappears.[1] While admitting to possible ambiguities in methodology, Mack, one of the foremost researchers in the field, holds strongly that inattentional blindness stems predominantly from a failure of attentional capture. She points out that if expectation does not mediate instances of very closely linked phenomena such as attentional blink and change blindness (whereby participants have difficulty identifying the changing object even when they are explicitly told to look for it), it is unlikely that inattentional blindness can be explained solely by a lack of expectation for stimulus presentation.[10]

The perceptual cycle framework has been used as another theoretical basis for inattentional blindness. The perceptual cycle framework describes attention capture and awareness capture as occurring at two different stages of processing. Attention capture occurs when there is a shift in attention due to the salience of a stimuli, and awareness capture refers to the conscious acknowledgement of stimuli. Attentional sets are important because it is composed of characteristics of stimuli an individual is processing. Inattentional blindness occurs when there is an interaction between an individual's attentional set and the salience of the unexpected stimulus. Recognizing the unexpected stimulus can occur when the characteristics of the unexpected stimulus resembles the characteristics of the perceived stimuli. The attentional set theory of inattentional blindness has implications for false memories and eyewitness testimony. The perceptual cycle framework offers four major implications about inattentional blindness 1) environmental cues aid in the detection of stimuli by providing orienting cues but is not enough to produce awareness, 2) perception requires effortful sustained attention, interpretation, and reinterpretation, 3) implicit memory may precede conscious perception, and 4) visual stimuli that is not expected, explored, or interpreted may not be perceived.[17]

Other bases for attentional blindness include top down and bottom up processing.

To test for inattentional blindness, researchers ask participants to complete a primary task while an unexpected stimulus is presented. Afterwards, researchers ask participants if they saw anything unusual during the primary task. Arien Mack and Irvin Rock describe a series of experiments that demonstrated inattentional blindness in their 1998 book, Inattentional Blindness.

The best-known study demonstrating inattentional blindness is the Invisible Gorilla Test, conducted by Daniel Simons of the University of Illinois at Urbana-Champaign and Christopher Chabris of Harvard University. This study, a revised version of earlier studies conducted by Ulric Neisser, Neisser and Becklen in 1975, asked subjects to watch a short video of two groups of people (wearing black and white t-shirts) pass a basketball around. The subjects are told to either count the number of passes made by one of the teams or to keep count of bounce passes vs. aerial passes. In different versions of the video a woman walks through the scene carrying an umbrella (as discussed above), or wearing a full gorilla suit. After watching the video the subjects are asked if they noticed anything out of the ordinary take place. In most groups, 50% of the subjects did not report seeing the gorilla (or the woman with the umbrella). The failure to perceive the anomalies is attributed to the failure to attend to it while engaged in the difficult task of counting the number of passes of the ball. These results indicate that the relationship between what is in one's visual field and perception is based much more on attention than was previously thought.[18]

Although it was found that 50% of the test subjects demonstrated change blindness to the introduction of the gorilla or the umbrella, it is difficult to find published information on what percentage of study participants were able to accurately count the passes.[19]

The basic Simons and Chabris study was re-used on British television as a public safety advert designed to point out the potential dangers to cyclists caused by inattentional blindness in motorists. In the advert the gorilla is replaced by a moon-walking bear.[20]

In 1995, Officer Kenny Conley was chasing a shooting suspect. An undercover officer was in the same vicinity and was mistakenly taken down by other officers while Conley ran by and failed to notice. A jury later convicted Officer Conley of perjury and obstruction of justice, believing he had seen the fight and lied about it to protect fellow officers, yet he stood by his word that he had, in fact, not seen it.[21]

Christopher Chabris, Adam Weinberger, Matthew Fontaine and Daniel J. Simons took it upon themselves to see if this scenario was possible. They designed an experiment in which participants were asked to run about 30 feet behind Officer Conley himself, and count how many times he touched his head. A fight was staged to appear about 8 meters off the path, and was visible for approximately 15 seconds. The procedure in its entirety lasted about 2 minutes and 45 seconds, and participants were then asked to report the number of times they had seen Officer Conley touch his head with either hand (medium load), both hands (high load), or were not instructed to count at all (low load). After the run, participants were asked 3 questions: 1) If they had noticed the fight; 2) if they had noticed a juggler, and 3) if they had noticed someone dribbling a basketball. Questions 2) and 3) were control questions, and no one falsely reported these as true.

Participants were significantly more likely to notice the fight when the experiment was done during the day as opposed to in the dark. Additionally, sightings of the fight were most likely to be reported in the low load condition (72%) than in either the medium load (56%), or high load conditions (42%).[22] These results exemplify a real world occurrence of inattentional blindness, and provide evidence that officer Conley could indeed have missed the fight because his attention was focused elsewhere. Moreover, these results add to the body of knowledge suggesting that as perceptual load increases, less resources remain to process items not explicitly focused on, and in turn episodes of inattentional blindness become more frequent.

Another experiment was conducted by Steven Most, along with Daniel Simons, Christopher Chabris and Brian Scholl. Instead of a basketball game, they used stimuli presented by computer displays. In this experiment objects moved randomly on a computer screen. Participants were instructed to attend to the black objects and ignore the white, or vice versa. After several trials, a red cross unexpectedly appeared and traveled across the display, remaining on the computer screen for five seconds. The results of the experiment showed that even though the cross was distinctive from the black and white objects both in color and shape, about a third of participants missed it. They had found that people may be attentionally tuned to certain perceptual dimensions, such as brightness or shape. Inattentional blindness is most likely to occur if the unexpected stimuli presented resembles the environment.[23]

One interesting experiment displayed how cell phones contributed to inattentional blindness in basic tasks such as walking. The stimuli for this experiment was a brightly colored clown on a unicycle. The individuals participating in this experiment were divided into four sections. They were either talking on the phone, listening to an mp3 player, walking by themselves or walking in pairs. The study showed that individuals engaged in cell phone conversations were least likely to notice the clown. This experiment was designed by Ira E. Hyman, S. Matthew Boss, Breanne M. Wise, Kira E. Mckenzie and Jenna M. Caggiano at Western Washington University.[24]

Daniel Memmert conducted an experiment which suggests that an individual can look directly at an object and still not perceive it. This experiment was based on the invisible gorilla experiment. The participants were children with an average age of 7.7 years. Participants watched a short video of a six player basketball game (three with white shirts, three with black shirts). The participants were instructed to watch only the players wearing black shirts and to count the number of times the team passed the ball. During the video a person in a gorilla suit walks through the scene. The film was projected onto a large screen (3.2 m X 2.4 m) and the participants sat in a chair 6 meters from the screen. The eye movement and fixations of the participants were recorded during the video and afterward the participants answered a series of questions.

Only 40% of the participants reported seeing the gorilla, leaving 60% who did not report seeing the gorilla. There was no significant difference in accuracy of the counting between the two groups. Analyzing the eye movement and fixation data showed no significant difference in the time spent looking at the players (black or white) between the two groups. However, the 60% of participants who did not report seeing the gorilla spent an average of 25 frames (about one second) fixated on the gorilla, despite not perceiving it.[25]

A more common example of the above is illustrated in the game of Three-card Monte.

Another experiment conducted by Daniel Memmert tested the effects of different levels of expertise can have on inattentional blindness. The participants in this experiment included six different groups: Adult basketball experts with an average of twelve years of experience, junior basketball experts with an average of five years, children who had practiced the game for an average of two years, and novice counterparts for each age group. In this experiment the participants watched the invisible gorilla experiment video. The participants were instructed to watch only the players wearing white and to count the number of times the team passed the ball.

The results of the experiment showed that experts did not count the number of passes more accurately than novices but did show that adult subjects were more accurate than the junior and children subjects. A much higher percentage of experts noticed the gorilla compared to novices and even the practiced children. 62% of the adult experts and 60% of the junior experts noticed the gorilla, suggesting that the difference between five and twelve years of experience has minimal effect on inattentional blindness. However, only 38% of the adult, 35% of the junior, and none of the children novices noticed the gorilla. Only 18% of the children with two years of practice noticed. This suggests that both age and experience can have a significant effect on inattentional blindness.[25]

Arien Mack and Irvin Rocks concluded in 1998 that no conscious perception can occur without attention.[1] Evidence through research on inattentional blindness contemplates that it may be possible that inattentional blindness reflects a problem with memory rather than with perception.[1] It is argued that at least some instances of inattentional blindness are better characterized as memory failures than perceptual failures. The extent to which unattended stimuli fail to engage perceptual processing is an empirical question that the combination of inattentional blindness and other various measures of processing can be used to address.[2]

The theory behind inattentional blindness research suggests that we consciously experience only those objects and events to which we directly attend.[1] That means that the vast majority of information in our field of vision goes unnoticed. Thus if we miss the target stimulus in an experiment, but are later told about the existence of the stimulus, this sufficient awareness allows participants to report and recall the stimulus now that attention has been allocated to it.[2] Mack and Rock, and their colleagues discovered a striking array of visual events to which people are inattentionally blind.[1] However the debate arises whether this inattentional blindness was due to memory or perceptual processing limitations.

Mack and Rock note that explanations for inattentional blindness can reflect a basic failure of perceptual processes to be engaged by unattended stimuli. Or that it may reflect a failure of memorial processes to encode information about unattended stimuli. It is important to note that the memory failure does not have to do with forgetting something that has been encoded by losing access to the memory of the stimulus from time of presentation to time of retrieval, rather that the failure is attributed to information not being encoded when the stimulus was present.[1] It seems that inattentional blindness can be explained by both memory and perceptual failures because in experimental research participants may fail to report what was on display due to failures in encoded information (memory) or a failure in perceptually processed information (perception).[1]

There are similarities in the types of unconscious processing apparent in inattentional blindness and in neuropsychological syndromes such as visual neglect and extinction. The analogy between these phenomenons seems to generate more questions as well as answers. These answers are fundamental for our understanding of the relationship between attention, stimulus coding and behavior.

Research has shown that some aspects of the syndrome of unilateral visual neglect appear to be similar to normal subjects in a state of inattentional blindness. In neglect, patients with lesions to the parietal cortex fail to respond to and report stimuli presented on the side of space contralateral to damage.[10][26] That is, they appear to be functionally blind to a range of stimuli. Since such lesions do not result in any sensory deficits, shortcomings have been explained in terms of a lack of attentional processing, for which the parietal cortex plays a large role.[27] These phenomena draw strong parallels to one another, as in both cases stimuli are perceptible but unreported when unattended.

In the phenomenon of extinction, patients can report the presence of a single stimulus presented on the affected side, but then fail to detect it when a second stimulus is presented simultaneously on the "good" (ipsilateral) side.[28] Here the stimulus on the affected side seems to lose under conditions of attentional competition from stimuli in the ipsilesional field.[28] The consequence of this competition is that the extinguished items may not be detected.

Similar to studies of inattentional blindness, there is evidence of processing taking place in the neglected field. For example, there can be semantic priming from a stimulus presented in the neglected field, which affects responses to stimuli subsequently presented on the unimpaired side.[29] Apparently in both neglect and inattentional blindness, there is some level processing of stimuli even when they are unattended.[29] However one major difference between neuropsychological symptoms such as neglect and extinction, and inattentional blindness concerns the role of expectation.[29] In inattentional blindness, subjects do not expect the unreported stimulus. In contrast, in neglect and extinction, patients may expect a stimulus to be presented on the affected side but still fail to report it when another it may be that expectation affects reportability but not the implicit processing of stimuli.[29]

Further explanations of the phenomenon of inattentional blindness include inattentional amnesia, inattentional agnosia and change blindness.

An explanation for this phenomenon is that observers see the critical object in their visual field but fail to process it extensively enough to retain it. Individuals experience inattentional agnosia after having seen the target stimuli but not consciously being able to identify what the stimuli is. It is possible that observers are not even able to identify that the stimuli they are seeing are coherent objects.[30] Thus observers perceive some representation of the stimuli but are actually unaware of what that stimulus is. It is because the stimulus is not encoded as a specific thing, that it later is not remembered. Individuals fail to report what the stimuli is after it has been removed. However, despite a lack in ability to fully process the stimuli, experiments have shown a priming effect of the critical stimuli. This priming effect indicates that the stimuli must have been processed to some degree, this occurs even if observers are unable to report what the stimuli is.[31]

Inattentional blindness is the failure to see a stimulus, such as an object that is present in a visual field. However, change blindness is the failure to notice something different about a visual display. Change blindness is a directly related to memory, individuals who experience the effects of change blindness fail to notice something different about a visual display from one moment to the next.[4] In experiments that test for this phenomenon participants are shown an image that is then followed by another duplicate image that has had a single change made to it. Participants are asked to compare and contrast the two images and identify what the change is. In inattentional blindness experiments, participants fail to identify some stimulus in a single display, a phenomenon that doesnt rely on memory the way change blindness does.[4] Inattentional blindness refers to an inability to identify an object all together where as change blindness is a failure to compare a new image or display to one that was previously stored in memory.[4]

In 2006, Daniel Memmert conducted a series of studies in which he tested the how age and expertise of participants affect inattentional blindness. Using the gorilla video, he tested 6 different groups of participants. There were 2 groups of children (average age=7) half with no experience in basketball, and the other half with 2 years experience; 2 groups of juniors (average age=13) half with no experience in basketball, and the other half with 5 years of experience; and 2 groups of adults (average age = 24) half with no experience in basketball, the other half with over 12 years of experience. He then instructed all the groups to keep track of how many passes the people on the black team made.

Overall, the children with or without any basketball experience failed to perceive the gorilla more than the juniors or the adults. There were no significant difference between the inexperienced junior and adult groups, or between the experienced junior and adult groups.[32] This pattern of results suggests that until the approximate age of 13, presumably because certain aspects of cognition are still under development, inattentional blindness occurrences are more frequent, but become consistent throughout the remainder of the life span.

Additionally, the juniors with basketball experience noticed the gorilla significantly more than the juniors with no basketball experience; and the group of experienced adults noticed the gorilla significantly more than the non-experienced adults. This suggests that if one has had much experience with the stimuli in a visual field, they are more likely to consciously perceive the unexpected object.

A series of studies conducted to test how similarity can influence the perception of a present stimulus. In the study, they asked participants to fixate on a central point on a computer screen and count how many times either white or black letters bounced off the edges of the screen. The first 2 trials did not contain an unexpected event, but the third trial was the critical trial in which a cross that had the same dimensions as the letters and varied in colour (white/light gray/dark gray/black) moved from the right side of the screen to the left side and passed through the central point. The results revealed the following: during the critical event, the more similar the colour of the cross was to the colour of the attended letters, the more likely the participants were to perceive it, and the less similar the colour of the cross was to the attended colour decreased the likelihood of the cross being noticed. For the participants attending to the black letters, 94% perceived the black cross; 44% perceived the dark gray cross; 12% perceived the light gray cross, and only 6% perceived the white cross. Similarly, if the participant was attending to the white letters, they were more likely to notice the cross it was white (94%) than if it was light gray (75%), dark gray (56%), or black (0%).[33] This study demonstrates that the more similar an unexpected object is to the attended object, the more likely it is to be perceived, thus reducing the chance of inattentional blindness.

The research that has been done on inattentional blindness suggests that there are four possible causes for this phenomenon. These include: conspicuity, mental workload, expectations, and capacity.[34]

Conspicuity refers to an object's ability to catch a person's attention. When something is conspicuous it is easily visible. There are two factors which determine conspicuity: sensory conspicuity and cognitive conspicuity. Sensory conspicuity factors are the physical properties an object has. If an item has bright colors, flashing lights, high contrast with environment, or other attention-grabbing physical properties it can attract a persons attention much easier. For example, people tend to notice objects that are bright colors or crazy patterns before they notice other objects. Cognitive conspicuity factors pertain to objects that are familiar to someone. People tend to notice objects faster if they have some meaning to their lives. For example, when a person hears his/her name, their attention is drawn to the person who said it. The cocktail party effect describes the cognitive conspicuity factor as well. When an object isnt conspicuous, it is easier to be inattentionally blind to it. People tend to notice items if they capture their attention in some way. If the object isnt visually prominent or relevant, there is a higher chance that a person will miss it.

Mental workload is a person's cognitive resources. The amount of a person's workload can interfere with processing of other stimuli. When a person focuses a lot of attention on one stimulus, he/she focuses less attention on other stimuli. For example, talking on the phone while driving the attention is mostly focused on the phone conversation, so there is less attention focused on driving. The mental workload could be anything from thinking about tasks that need to be done to tending to a baby in the backseat. When people have most of their attention focused on one thing, they are more vulnerable to inattentional blindness. However, the opposite is true as well. When a person has a very small mental workload he/she is doing an everyday task the task becomes automatic. Automatic processing can lessen one's mental workload, which can lead to a person to missing the unexpected stimuli. Working memory also has an effect on inattentional blindness. Those that experience inattentional blindness are more likely to have a lower working memory capacity.

Working memory also contributes to inattentional blindness. Cognitive psychologists have examined the relationship between working memory and inattention, but evidence is inconclusive. For example, some researchers state that individuals that have more space in their working memory and those with stronger working memory are less likely to be susceptible to inattentional blindness. Other researchers state that working memory does not influence inattentional blindness because working memory does not influence all attentional processes. For example, research conducted by Bredemeier and Simons, participants were given working memory tasks and a sustained-attention task. The first working memory task required participants to indicate whether a combination of letters matched a previous combination of letters that appeared earlier on a computer screen. The second working memory task required participants to determine if a target letter was in the same position as previous letters. For the sustained-attention task, participants were asked to count how many times a white square touched the edges of a computer screen. Once the tasks were completed, researchers asked participants if they noticed anything else besides the white squares during the sustained-attention task. During the sustained-attention task, a grey cross moved around the screen during some of the trails. Results indicated that 70% of participants did notice the grey cross moving on the computer screen, suggesting working memory does not have an influence on susceptibility to inattentional blindness.

On the other hand, a follow-up study to the Bredemeiser and Simons was conducted to further explore the impact of working memory using another working memory task. For this study, participants were asked to complete a math problem, and a letter was presented after each problem. After completing the math problems, participants were asked to recall the series of letters in sequential order. This task served as a working memory measure. The same sustained attention task was completed after the working memory task. Using this method, only 27% of participants noticed the grey square. Researchers concluded that working memory does influence one's experience of attentional blindness, but not an individual's ability to handle the task demands. These two studies demonstrate the inconsistencies in the relationship between working memory and inattentional blindness.[35]

When a person expects certain things to happen, he/she tends to block out other possibilities. This can lead to inattentional blindness. For example, person X is looking for their friend at a concert, and that person knows their friend (person Y) was wearing a yellow jacket. In order to find person Y, person X looks around for people wearing yellow. It is easier to pick a color out of the crowd than a person. However, if person Y took off the jacket, there is a chance person X could walk right past person Y and not notice because he/she was looking for the yellow jacket. Because of expectations, experts are more prone to inattentional blindness than beginners. An expert knows what to expect when certain situations arise. Therefore, that expert will know what to look for. This could cause that person to miss out on other important details that he/she may not have been looking for.

Attentional capacity, or neurological salience, is a measure of how much attention must be focused to complete a task. For example, an expert pianist can play a piano without thinking much, but a beginner would have to consciously think of every note they hit. This capacity can be lessened by drugs, alcohol, fatigue, and age. With a small capacity, it is more possible to miss things. Therefore, if a person is drunk, he/she will probably miss more than a sober person would. If your attentional capacity is large, you are less likely to experience inattentional blindness.

William James addressed the benefits of attention by saying, "Only those items which I notice shape my mind without selective interest, experience is utter chaos".[36] Humans have a limited mental capacity that is incapable of attending to all the sights, sounds and other inputs that rush the senses every moment. Inattentional blindness is beneficial in the sense that it is a mechanism that has evolved with attention to help filter out irrelevant input, allowing only important information to reach consciousness.[36] Several researchers, notably James J. Gibson, have argued that, even before the retina, perception begins in the ecology, which has turned perceptual processes into informational relationships in the environment through evolution.[37] This allows humans to focus our limited mental resources more efficiently in our environment. For example, New et al. maintain that survival required monitoring animals, both human and non-human, to become part of the evolutionary adaptiveness of the human species. They found that when participants were shown an image with a rapidly altering scene where the scene change included an animate or inanimate object that the participants were significantly better at identifying humans and animals. New et al. argue that better performance in detecting animals and humans is not a factor of acquired expertise, rather it is an evolved survival mechanism in human perception.[37]

Although the bulk of inattentional blindness research has been conducted in laboratory studies, the phenomenon occurs in a variety of everyday contexts. Depending upon the context, the occurrence of inattentional blindness could range from embarrassing and/or humorous to potentially devastating.

Several recent studies of explicit attention capture have found that when observers are focused on some other object or event, they often experience inattentional blindness.[38] This finding has potentially tragic implications for distracted driving. If a persons attention is focused elsewhere while driving, carrying on a conversation or text messaging, for example, they could fail to notice salient and distinctive objects, such as a stop sign, which could lead to serious injury and possibly even death. There have also been heinous incidents attributed to inattentional blindness behind the wheel. For example, a Pennsylvania highway crew accidentally paved over a dead deer that was lying on the road. When questioned regarding their actions, the workers claimed to have never seen it.[39]

Many policies are being implemented around the world to decrease the competition for explicit attention capture while operating a vehicle. For example, there are legislative efforts in many countries aimed at banning or restricting the use of cell phones while driving. Research has shown that the use of both hands-free and hand-held cellular devices while driving results in the failure of attention to explicitly capture other salient and distinctive objects, leading to significantly delayed reaction times, as well as inattentional blindness.[40] A study published in 1997, based on accident data in Toronto, found the risk involved in driving while using a cell phone to be similar to that of driving drunk. In both cases, the risk of a collision was three to six times higher compared to a sober driver not using a cell phone.[41] Moreover, Strayer et al. (2003) found that when controlling for driving difficulty and time on task, cell-phone drivers exhibited greater impairment than intoxicated drivers, using a high-fidelity driving simulator.[42]

Inattentional blindness is also prevalent in aviation. The development of heads-up display (HUD) for pilots, which projects information onto the windshield or onto a helmet-mounted display, has enabled pilots to keep their eyes on the windshield, but simulator studies have found that HUD may cause runway incursion accidents, where one plane collides with another on the runway.[36] This finding is particularly concerning because HUDs are being employed in automobiles, which could lead to potential roadway incursions.[36] When a particular object or event captures attention to the extent to which the beholders attentional capacity is completely absorbed, the resulting inattentional blindness has been known to cause dramatic accidents. For example, an airliner crew, engrossed with a blinking console light, failed to notice the approaching ground and register hearing the danger alarm sounding before the airliner crashed.[36]

Collaborative efforts to establish links between science and illusion have examined the relationship of the processes underlying inattentional blindness and the concept of misdirectiona magicians ability to manipulate attention in order to prevent his/her audience from seeing how a trick was performed. In several misdirection studies, including Kuhn and Tatler (2005),[43] participants watch a "vanishing item" magic trick. After the initial trial, participants are shown the trick until they detect the item dropping from the magicians hand. Most participants see the item drop on the second trial. The critical analyses involved differences in eye movements between the detected and undetected trials. These repetition trials are similar to the full-attention trial in the inattentional blindness paradigm, as both involve the detection of the unexpected event and, by detecting the unexpected event on the second trial, demonstrate that the event is readily perceivable.[44]

The main difference between inattentional blindness and misdirection involves how attention is manipulated. While inattentional blindness tasks require an explicit distractor, the attentional distraction in misdirection occurs through the implicit yet systematic orchestration of attention.[45] Moreover, there are several varieties of misdirection and different types are likely to induce different cognitive and perceptual processes, which vary the misdirection paradigms resemblance to inattentional blindness.[45]

Although the aims of magic and illusion differ from those of neuroscience, magicians wish to exploit cognitive weaknesses, whereas neuroscientists seek to understand the brain and the neuronal significance of cognitive functions. Several researchers have argued that neuroscientists and psychologists can learn from incorporating the real world experience and knowledge of magicians into their fields of research. The techniques developed over centuries of stage magic by magicians may also be utilized by neuroscience as powerful probes of human cognition.[46]

When a police officer's version of events differs from video or forensic evidence, inattentional blindness has been used by defense lawyers as a possibility.[47] The criticism of this defense is that this view could be used to defend nearly any police shooting.[48]

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Inattentional blindness - Wikipedia, the free encyclopedia

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Sports Medicine – URMC Orthopaedics and Rehabilitation …

August 29th, 2015 9:44 am

Sports Medicine

URMC Sports Medicine, a program at URMC Orthopaedics and Rehabilitation, offers the latest in medical and surgical care to prevent, evaluate, treat, and rehabilitate injuries for both recreational and competitive athletes of all ages. We also help people with active jobs who sometimes suffer the same injuries and need the same care.

URMC Sports Medicine is the only medical practice in the Rochester, NY nine-county region dedicated soley to sports medicine. Our physicians are fellowship-trained sports medicine primary care physicians and orthopaedic surgeons. They work together with physical therapists and athletic trainers to provide complete medical care for patients.

Our physicians assistants, physical therapists, and athletic trainers have completed extensive training in the management of the full array of orthopaedic conditions. All critical resources for treatment and aftercare of sports injuries are available at Clinton Crossings in Brighton, South Pointe Landing in Greece or at the Platinum Office Complex in Penfield.

We are the sports medicine provider for athletes from many of the area high schools, and the official team doctors for athletes from local colleges and professional teams.

Our state-of-the-art Sports and Spine Rehabilitation center features an indoor track, weight machines, free weights, and a special area to work on golf, baseball, tennis, and basketball skills. In addition, we offer special services that allow you to contact our physicians any day, at any hour to consult on the best course of urgent care and treatment. And during normal office hours, we can arrange for a same-day appointment.

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Sports Medicine | Ochsner Health System

August 29th, 2015 9:44 am

The Ochsner Sports Medicine Institute provides a comprehensive and coordinated multidisciplinary approach to the treatment of sports- and fitness-related injuries. The Institute is a one-stop-shop where you will find specially-trained physicians, the latest diagnostic imaging technology and outpatient rehabilitation making it easier and more convenient to return to your desired activity level. It also provides preventive care through the promotion of wellness, fitness, performance enhancement and education.

Conditions Treated:

The Ochsner Sports Medicine Institute is the source for comprehensive care of sports and fitness-related injuries and preventive care including fitness, wellness, athletic performance enhancement, and patient education. We offer physician services, diagnostic imaging, outpatient rehabilitation and physical therapy and wellness all conveniently located in one location

New Expansive Therapy Gymnasium The new gymnasium will include the most advanced therapy equipment (Cybex, Sports Art, Nautilus, Triton, and Game Ready equipment). Future plans will also include the Biodex 4 and Vestibular Unit for research and testing of patients.

Hydroworx Rehabilitation Pool This is a treadmill-in-a-pool, complete with underwater cameras that allow physicians to view their patients running gait and then assess therapies on the spot. This is typically used to treat any sports medicine-related injury, post operatively and non-operative. It will likewise utilize the benefits of aquatic therapy to speed recovery and return the athlete to full performance in a much faster time frame.

MRI Suite Coming soonThis MRI Suite will contain a 1.7 Tesla Unit that will be used to detect acute, subacute and chronic musculoskeletal injuries with high resolution. A skilled musculoskeletal radiologist will be on site to read these studies in real time and will be available for intra-articular gadolinium enhanced complex evaluations of specific joints such as the shoulder, hip, wrist, elbow and knee. In addition, state-of-the-art cartilage-specific T2 mapping will be available daily.

Human Performance Lab Coming soonThis lab will conduct clinical studies that analyze sports biomechanics, perform gait and running assessments, analyze pitching and throwing mechanics, and assess overall pre- and post-operative joint kinetics/kinematics and clinical outcomes. Motion and force assessments can be performed on specific joints (shoulder, below and knee) while changing internal and external forces, as demonstrated by low handicap golfers aiming to improve their technique. This information will create an extensive database through which rehabilitative protocols can be designed. This same biomechanical data base can be used to evaluate the effects of orthopaedic devices and procedures.

Concussion Management Program

The Ochsner Concussion Management Program is the first of its kind in Louisiana. Our program is designed to tailor rehabilitation to an individual's specific needs. Patients are assessed by board-certified physicians experienced in the field of concussion management. Following evaluation and assessment, patients will receive prompt treatment, including medical care from a physician, ongoing services (e.g., serial assessment, concussion education, counseling, return to play surveillance, cognitive therapy) if neccessary, a referral to our extensive network of additional pediatric specialists and ancillary medical professionals. An individualized approach to developing an appropriate Return to Play protocol is emphasized.

Our program utilizes a state-of-the-art computerized neurocognitive assessment, called ImPACT. It is currently used for professional athletes including those in the NFL, NHL, NASCAR, professional boxing and over 400 colleges and universities across the country. The use of computerized neurocognitive assessment enables our doctors to conduct a simple, 25-minute evaluation of an athlete's neurocognitive status ( i.e., memory, processing speed and other related functions) following concussion. Athletes/patients in this clinic will also undergo a broader neurologic and physical examination in order to ensure that all the information needed for the proper evaluation and treatment of mild head trauma is obtained. The program's primary focus is on expediting the concussed athlete's safe return to the field of play using the most current, up-to-date guidelines in concussion management. In doing this, we aim to significantly reduce the athlete's risk of repeat concussion, prolonged recovery time, long-term neuro-cognitive deficits and potential catastrophic events such as second - impact syndrome.

Click here for a brochure about the services and benefits provided by Ochsners Athletic Training Outreach Program.

Expect the finest care from Ochsner Sports Medicines Athletic Training Outreach Program

Benefits to your school or events

Professional Sports

Universities and Colleges

High Schools and Middle Schools

Community Outreach and Event Support

For information about the Athletic Training Outreach Program, contracts or other services, contact:

Chris Young, MAT, ATC, LAT, CSCS Coordinator - Athletic Training Outreach Program Ochsner Sports Medicine Institute 1201 S. Clearview Parkway, Suite 104 Jefferson, LA 70121 504-736-4615 ChrYoung@ochsner.org

For an appointment with one of our sports health physicians, please call:

Ochsner Sports Medicine Institute 504-736-4800

Colleen Amedee, LAT, ATC Outreach Athletic Trainer for Ben Franklin High School

Mark Armour II, MS, LAT, ATC Outreach Assistant Athletic Trainer

Jeanne Baldwin, LAT, ATC Outreach Athletic Trainer for Pearl River High School

Jeff Berger, LAT, ATC Outreach Athletic Trainer for John Curtis Christian School

Cyd Bertrand, LAT, ATC Outreach Athletic Trainer for Ursuline Academy

Jordan Blough, LAT, ATC

Coordinator - Athletic Training Outreach Program Ochsner Sports Medicine Institute

1201 S. Clearview Parkway, Suite 104 Jefferson, LA 70121 504-736-4615 Jblough@ochsner.org

Kim Brou, LAT, ATC Outreach Athletic Trainer for Bonnabel High School

Russ Carlisle, LAT, ATC Outreach Athletic Trainer for L.W. Higgins High School

Allan Chase, MS, LAT, ATC Outreach Athletic Trainer for University of New Orleans

Delesseps Dolese, MS, LAT, ATC Outreach Athletic Trainer forSalmen High School

Dan Doucet, MS, LAT, ATC, LCEP Outreach Athletic Trainer for John Ehret High School

Nicole Dufrene, LAT Outreach Athletic Trainer for Lusher Charter School

James Edelman, MS, LAT, ATC Outreach Athletic Trainer for St. Augustine High School

Benjamin Evans, MS, LAT, ATC, CES Outreach Athletic Trainer for East Jefferson High School

Christie Findley, MS, LAT, ATC PRN

Tiffany Gary, MHRD, LAT, ATC Outreach Athletic Trainer for Baton Rouge Community College

Summer Gebhart, MS, LAT, ATC Outreach Athletic Trainer for Grace King High School

Chuck Haaga, LAT, ATC, CSCS Outreach Athletic Trainer for Slidell High School

Michelle Harrell Anthony, LAT, ATC Outreach Trainer for Mandeville High School

Anthony Johnson, LAT PRN

Becky Mihalovits, MS, LAT, ATC Outreach Athletic Trainer for Helen Cox High School

Amanda Palazola, ATC, LAT Outreach Trainer for Northshore High School

Ryan Pickert, LAT, ATC Outreach Athletic Trainer for West Jefferson High School

David Pilet, LAT Outreach Athletic Trainer for Lakeshore High School

Raymond Raphael, LAT, ATC, LPN Outreach Athletic Trainer for Delgado Community College

Courtney Rauschkolb, LAT, ATC Outreach Athletic Trainer for Academy of Our Lady, Ecole Classique, St. Katherine Drexel Preparatory School and Louisiana Fire Soccer Club

Eric Richardson, MS, LAT, ATC, CES, PES Outreach Athletic Trainer for Archbishop Hannan High School

Nichole Saverino, MS, LAT, ATC Outreach Athletic Trainer for Dillard University

Kacie Sommerfeld, LAT, ATC Outreach Athletic Trainer for Riverdale High School

Brad Steverson, LAT, ATC Outreach Athletic Trainer

Reggie Stone, MS, LAT, ATC Outreach Assistant Athletic Trainer for New Orleans Saints

Erica Taylor, MS, LAT, ATC, CES Outreach Athletic Trainer for University of New Orleans

Melina Todesco, MA, LAT, ATC Outreach Athletic Trainer for Haynes Academy for Advanced Studies and Patrick F. Taylor Science & Technology Academy

Kristina Tyson, LAT, ATC Outreach Athletic Trainer for St. Martin's Episcopal School

Britt Vallot, LAT, ATC Outreach Athletic Trainer for Dillard University

Allison Wood, MBA, LAT, ATC Outreach Athletic Trainer for Xavier University

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Sports Medicine | Ochsner Health System

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Sports Medicine : Rothman Institute Orthopaedics

August 29th, 2015 9:44 am

[To view information and photos about Rothman Institute's recent "Impact of Sports" conference please click this link]

Sports Medicine is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of injuries due to athletic activity. Many of these disorders are treated with arthroscopic surgery, a minimally invasive surgical method that utilizes a camera to look inside a joint and specialized instruments to carry out any necessary surgery in that joint.

The practice of sports medicine is a team approach with input from orthopaedic surgeon, non-surgical sports specialists, rehabilitation specialist, athletic trainer, and physical therapist. The internationally recognized Sports Medicine Center at the Rothman Institute is one of the worlds most trusted practices for the treatment of sports related injuries. Pioneers of advanced surgical equipment and innovative surgical techniques, our specialists evaluate over 40,000 sports injuries and perform more than 5,000 sports surgeries for athletes of all levels per year.

Rothman Institutes Sports Medicine team is the leading provider of sports medicine orthopaedic care in the region. Our team provides care for all levels of athletes including the Philadelphia Phillies, Philadelphia Eagles, USA Olympic Womens Gymnastics Team, Villanova University, Saint Josephs University Hawks, Rutgers University-Camden Raptors and dozens of regional high schools as well as the Philadelphia Marathon, Distance Run, and International Cycling Race.

If you are an athletic director, athletic trainer, or anyone who is tasked with finding coverage for an athletic program, team, or large scale sporting event, the Rothman Institute Sports Medicine Team can help you. Our team of physicians can provide medical coverage, clinics, and educational seminars for your athletes, coaches, and families.

Please contact Rich Sharpnack, Sports Medicine Services Manager, at rsharpnack@velocitysp.com for more information.

You can learn more by visiting the Women's Sports Medicine Program page here.

This is a center where patients can go the have their disabled joint biological resurfaced, realigned, and stabilized without having the joint replaced by artificial materials such as metal and plastic. It is well know that the outcomes of patients under the age of 50 undergoing artificial joint replacement are not as good as we would like. Therefore we feel the future of Orthopaedics is to try to restore a joint back to its original anatomy by realignment, ligament reconstruction, and cartilage restoration.

You can learn more by visiting the Cartilage Resoration Program page here.

The Hip Arthroscopy Program at the Rothman Institute is a part of the Hip Preservation Center. Hip arthroscopy is a unique, minimally invasive outpatient technique that uses fiber-optic cameras and small instruments to treat painful hip conditions that previously were repaired through larger open incisions. It can allow for a quicker recovery period, less scarring, and a return to pre-injury activity levels which make it an ideal technique for athletes and those under the age of 55.

You can learn more by visiting the Hip Arthroscopy Program page here.

The Sports Concussion Program at the Rothman Institute is led by our team of top sports medicine physicians who are specially trained in concussion evaluation, treatment, and management. Our physicians are Credentialed ImPACT Consultants (CIC) who utilize cutting-edge treatment options for our patients return-to-activity and return-to-play recovery protocol. Our comprehensive care promotes coordinated communication across all entities involved in the treatment process including athletic trainers, coaches, parents, school administrators and referring physicians, enabling our athletes to return to their pre-injury status as quickly as possible.

Rothman Institute is a clinical partner in the Jefferson Comprehensive Concussion Center, in the Navy Yard. Visit this link for more information.

Whether its throwing a javelin or pitching a baseball, the overhead or throwing athlete is exposed to tremendous forces during overhead sports. The Overhead/Throwing Athlete Program at the Rothman Institute is one of the first in the nation to focus on the particular health needs of these unique athletes. The team includes our world-class orthopaedic surgeons, non-operative sports medicine physicians, physical medicine and rehabilitation physicians, nutritionists, nurses, athletic trainers, and physical therapists. Research studies help us to identify those aspects of the overhead/throwing mechanism that are most demanding biomechanically as well as identifying those athletes potentially at risk for injury during this activity. This helps to create preventative conditioning and training programs to help them avoid injury.

You can learn more by visiting the OverheadThrowing Program page here.

Over the years Rothman Institute has really integrated Certified Athletic Trainers into its world-renowned private physician practice. If you look at the evolution of the job settings for Athletic Trainers, you will see Rothman captures both the traditional and the non-traditional setting. In the clinic Rothman Institute is utilizing ATs distinctive skill set as physician extenders and orthotic technicians. Our Field Athletic Trainers provide direct sports medicine care to youth, high school, college and professional athletes. Rothman ATs provide athletic training services throughout Southeastern PA and NJ to interscholastic high schools, colleges, as well as tournaments and special events.

You can learn more by visiting theAthletic Training - Sports Medicine Outreach Program here.

The Injury Prevention Program at the Rothman Institute is dedicated to the prevention of injuries from athletic participation, particularly youth sports. The goal is to help educate parents, coaches, healthcare providers and athletes on the importance of injury prevention, treatment, and long-term consequences of overuse and traumatic injuries. As the leading provider of sports medicine care in the region, we rely on a team approach from world-renowned orthopaedic surgeons, non-surgical sports specialists, rehabilitation specialists, athletic trainers, physical therapists, and performance experts to provide the same level of care we provide our professional sports teams. In addition to providing community education, our program is dedicated to research in the area of injury prevention to promote the safety of athletic participation.

You can learn more by visiting theInjury Prevention Program here.

You should see a doctor for an injury when...

Of course, if you are injured during the course of a sporting event it is always best to seek the advice of your team physician.Sports Medicine is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of injuries due to athletic activity. Many of these disorders are treated with arthroscopic surgery, a minimally invasive surgical method that utilizes a camera to look inside a joint and specialized instruments to carry out any necessary surgery in that joint.

Over the years Rothman Institute has really integrated Certified Athletic Trainers into its world-renowned private physician practice. If you look at the evolution of the job settings for Athletic Trainers, you will see Rothman captures both the traditional and the non-traditional setting. In the clinic Rothman Institute is utilizing ATs distinctive skill set as physician extenders and orthotic technicians. Our Field Athletic Trainers provide direct sports medicine care to youth, high school, college and professional athletes. Rothman ATs provide athletic training services throughout Southeastern PA and NJ to interscholastic high schools, colleges, as well as tournaments and special events.

Certified Athletic Trainers can schedule appointments for their athletes by using our ATC Appointment Form.

[To view information and photos about Rothman Institute's recent "Impact of Sports" conference please click this link]

Sports Medicine is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of injuries due to athletic activity. Many of these disorders are treated with arthroscopic surgery, a minimally invasive surgical method that utilizes a camera to look inside a joint and specialized instruments to carry out any necessary surgery in that joint.

The practice of sports medicine is a team approach with input from orthopaedic surgeon, non-surgical sports specialists, rehabilitation specialist, athletic trainer, and physical therapist. The internationally recognized Sports Medicine Center at the Rothman Institute is one of the worlds most trusted practices for the treatment of sports related injuries. Pioneers of advanced surgical equipment and innovative surgical techniques, our specialists evaluate over 40,000 sports injuries and perform more than 5,000 sports surgeries for athletes of all levels per year.

Rothman Institutes Sports Medicine team is the leading provider of sports medicine orthopaedic care in the region. Our team provides care for all levels of athletes including the Philadelphia Phillies, Philadelphia Eagles, USA Olympic Womens Gymnastics Team, Villanova University, Saint Josephs University Hawks, Rutgers University-Camden Raptors and dozens of regional high schools as well as the Philadelphia Marathon, Distance Run, and International Cycling Race.

If you are an athletic director, athletic trainer, or anyone who is tasked with finding coverage for an athletic program, team, or large scale sporting event, the Rothman Institute Sports Medicine Team can help you. Our team of physicians can provide medical coverage, clinics, and educational seminars for your athletes, coaches, and families.

Please contact Rich Sharpnack, Sports Medicine Services Manager, at rsharpnack@velocitysp.com for more information.

You can learn more by visiting the Women's Sports Medicine Program page here.

This is a center where patients can go the have their disabled joint biological resurfaced, realigned, and stabilized without having the joint replaced by artificial materials such as metal and plastic. It is well know that the outcomes of patients under the age of 50 undergoing artificial joint replacement are not as good as we would like. Therefore we feel the future of Orthopaedics is to try to restore a joint back to its original anatomy by realignment, ligament reconstruction, and cartilage restoration.

You can learn more by visiting the Cartilage Resoration Program page here.

The Hip Arthroscopy Program at the Rothman Institute is a part of the Hip Preservation Center. Hip arthroscopy is a unique, minimally invasive outpatient technique that uses fiber-optic cameras and small instruments to treat painful hip conditions that previously were repaired through larger open incisions. It can allow for a quicker recovery period, less scarring, and a return to pre-injury activity levels which make it an ideal technique for athletes and those under the age of 55.

You can learn more by visiting the Hip Arthroscopy Program page here.

The Sports Concussion Program at the Rothman Institute is led by our team of top sports medicine physicians who are specially trained in concussion evaluation, treatment, and management. Our physicians are Credentialed ImPACT Consultants (CIC) who utilize cutting-edge treatment options for our patients return-to-activity and return-to-play recovery protocol. Our comprehensive care promotes coordinated communication across all entities involved in the treatment process including athletic trainers, coaches, parents, school administrators and referring physicians, enabling our athletes to return to their pre-injury status as quickly as possible.

Rothman Institute is a clinical partner in the Jefferson Comprehensive Concussion Center, in the Navy Yard. Visit this link for more information.

Whether its throwing a javelin or pitching a baseball, the overhead or throwing athlete is exposed to tremendous forces during overhead sports. The Overhead/Throwing Athlete Program at the Rothman Institute is one of the first in the nation to focus on the particular health needs of these unique athletes. The team includes our world-class orthopaedic surgeons, non-operative sports medicine physicians, physical medicine and rehabilitation physicians, nutritionists, nurses, athletic trainers, and physical therapists. Research studies help us to identify those aspects of the overhead/throwing mechanism that are most demanding biomechanically as well as identifying those athletes potentially at risk for injury during this activity. This helps to create preventative conditioning and training programs to help them avoid injury.

You can learn more by visiting the OverheadThrowing Program page here.

Over the years Rothman Institute has really integrated Certified Athletic Trainers into its world-renowned private physician practice. If you look at the evolution of the job settings for Athletic Trainers, you will see Rothman captures both the traditional and the non-traditional setting. In the clinic Rothman Institute is utilizing ATs distinctive skill set as physician extenders and orthotic technicians. Our Field Athletic Trainers provide direct sports medicine care to youth, high school, college and professional athletes. Rothman ATs provide athletic training services throughout Southeastern PA and NJ to interscholastic high schools, colleges, as well as tournaments and special events.

You can learn more by visiting theAthletic Training - Sports Medicine Outreach Program here.

The Injury Prevention Program at the Rothman Institute is dedicated to the prevention of injuries from athletic participation, particularly youth sports. The goal is to help educate parents, coaches, healthcare providers and athletes on the importance of injury prevention, treatment, and long-term consequences of overuse and traumatic injuries. As the leading provider of sports medicine care in the region, we rely on a team approach from world-renowned orthopaedic surgeons, non-surgical sports specialists, rehabilitation specialists, athletic trainers, physical therapists, and performance experts to provide the same level of care we provide our professional sports teams. In addition to providing community education, our program is dedicated to research in the area of injury prevention to promote the safety of athletic participation.

You can learn more by visiting theInjury Prevention Program here.

You should see a doctor for an injury when...

Of course, if you are injured during the course of a sporting event it is always best to seek the advice of your team physician.Sports Medicine is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of injuries due to athletic activity. Many of these disorders are treated with arthroscopic surgery, a minimally invasive surgical method that utilizes a camera to look inside a joint and specialized instruments to carry out any necessary surgery in that joint.

Over the years Rothman Institute has really integrated Certified Athletic Trainers into its world-renowned private physician practice. If you look at the evolution of the job settings for Athletic Trainers, you will see Rothman captures both the traditional and the non-traditional setting. In the clinic Rothman Institute is utilizing ATs distinctive skill set as physician extenders and orthotic technicians. Our Field Athletic Trainers provide direct sports medicine care to youth, high school, college and professional athletes. Rothman ATs provide athletic training services throughout Southeastern PA and NJ to interscholastic high schools, colleges, as well as tournaments and special events.

Certified Athletic Trainers can schedule appointments for their athletes by using our ATC Appointment Form.

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Sports Medicine : Rothman Institute Orthopaedics

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Nicklaus Children’s Hospital – Preventive Medicine

August 29th, 2015 12:47 am

The Division of Community Pediatrics and Preventive Medicine at Nicklaus Children's Hospital, formerly Miami Children's Hospital, was founded in 1991 to enhance the health and well being of the children of South Florida. The division advances the hospitals commitment to all children of the region, through advocacy, health promotion, and community outreach to promote prevention of illness and early identification of life-threatening diseases. Program components include:

Nicklaus Children's Hospital, formerly Miami Children's Hospitals Division of Community Pediatrics and Preventive Medicine provides medical outreach through a variety of programs to bring healthcare to children in need.

Division of Community Pediatrics and Preventive Medicine

Mission and Vision

Mission: To provide early, accessible preventive and interventional health services to improve the health status of children and adolescents in South Florida by early identification of risk factors that affect their health through the implementation of clinical, educational and research programs.

Vision: Nicklaus Children's Hospital, formerly Miami Children's Hospital, will be recognized as a national leader in disease prevention, health policy/advocacy and health promotion efforts by addressing the health needs of children and adolescents. This vision will be driven by ongoing monitoring, assessment leading to policy-making oriented towards the prevention of diseases and related risk factors, therefore improving morbidity and mortality rates

School-Based Programs

The Nicklaus Children's Hospital, formerly Miami Children's Hospital, Division of Community Pediatrics and Preventive Medicine is partnering with The Childrens Trust of Miami-Dade County to offer school-based health clinics, as part of the Health Connect in Our Schools Program.

This initiative, which provides a nurse practitioner and licensed practical nurse (LPN) at high-risk schools, provides preventive and basic school health services in an effort to decrease absenteeism and improve health outcomes of the student population. The program also seeks to assign medical homes for children without a pediatrician.

Services offered through the program include:

For more information on this program, please call 305-663-6800.

The Division of Community Pediatrics and Preventive Medicine offers a variety of health and safety classes and programs for parents, caregivers and children. Topics and programs include:

For more information on this program, please call 305-663-6800.

Injury Prevention Program/SafeKids

Locally the program focuses on reducing injuries to children by promoting and educating the community on child passenger safety, pedestrian/bike and wheeled sport safety and water/ drowning prevention, among other important safety topics. The passenger safety Buckle Up Program funded through SafeKids USA and the General Motors Foundation has been widely recognized by the Department of Pedestrian Safety, the State Department of Health, as well as nationally by the Department of Transportation and by the Institute of Health for Latino Children through the Corazon de mi Vida Car Seat Initiative.

These injury prevention programs have also been made possible in part from grants received from the Department of Transportation, the Ford Motor Company, United Automobile Insurance Company and SafeKids USA.

Nicklaus Children's Hospital, formerly Miami Children's Hospital, has opened the first Car Seat Check Station for parents to ensure appropriate sizing and fitting of their childrens car safety devices.

For more information, please call 305-663-6800.

Partnerships and Collaborations

The Division of Community Pediatrics and Preventive Medicine has forged partnerships with recognized local, state, national and international lead agencies in maternal/child health to include some of the following:

See more here:
Nicklaus Children's Hospital - Preventive Medicine

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Microbiology & Molecular Genetics – Rutgers New Jersey …

August 29th, 2015 12:46 am

Nikhat Parveen, Ph.D. Associate Professor Office: ICPH-E350T Tel: 973-972-5218 Lab: ICPH-E-310N.1 Tel: 973-972-4437

Email: parveeni@njms.rutgers.edu

My laboratory is studying the molecular basis of pathogenesis of bacterial species, Borrelia burgdorferi, Treponema pallidum and Pseudomonas aeruginosa. These clinically important bacterial pathogens are transmitted to humans using different mechanisms and also show different disease manifestations. B. burgdorferi is transmitted by Ixodes tick vector, T. pallidum by sexual contact and P. aeruginosa, a ubiquitously present organism, is transmitted through ventilation or by direct contact of the patient with the contaminated source.

B. burgdorferi, a spirochete, is causative agent of Lyme disease, a multisystemic illness that affects various organs including joints, heart, nervous system and skin. If untreated, it may result in chronic disease with the symptoms including arthritis, acrodermatitis or neuroborreliosis. It is an extracellular pathogen often found adhering to the host cells in the biopsy specimens of the patients. We have been studying the molecular mechanisms involved in the attachment of Lyme disease spirochetes to a variety of host cells. The specific interaction between the spirochete and host cells may be responsible for the tissue tropism exhibited by B. burgdorferi. Our objective is to understand whether different B.burgdorferi adhesins show affinity for different host receptors on various host cells. We use genetics, biochemical techniques and tissue culture system to identify and characterize the bacterial and host molecules involved in this interaction in vitro. We have already identified two types of glycosaminoglycan receptors on mammalian cells that are recognized by several B. burgdorferi proteins and we are further characterizing this interaction. Mouse is a natural host of B. burgdorferi and C3H mice show several manifestations of Lyme disease observed in humans. We have recently adapted firefly luciferase-based detection system for B. burgdorferi. Using a combination of bioluminescent B. burgdorferi and mouse model of infection, we will further analyze the contribution of each bacterial ligand-host receptor interaction in Lyme pathogenesis. Tissue colonization by the spirochetes will be monitored non-invasively by employing in vivo imaging system. Recently, we have initiated studies to understand molecular basis of T. pallidum pathogenesis using this as a surrogate system.

P. aeruginosa is an opportunistic pathogen and produces a wide variety of virulence factors. It results in a variety of illnesses and is responsible for high morbidity and mortality in immunocompromised and elderly patients. Due to a highly adaptable nature of P. aeruginosa and its ability to survive even in detergents, it is a major contributor to infections in the hospital environment. We have been studying the quorum-sensing mediated induction of several virulence factors in this organism both as free-living organism and in association with its different hosts. We will assess the role of selected virulence factors in biofilm formation while P. aeruginosa is present in communities along with the other organisms. Our current focus is to investigate genetics of production and regulation of PrpL protease and pyocyanin pigment of P. aeruginosa and examine the roles of these virulence factors in tissue destruction. The roles of these two virulence factors in corneal damage, in burn wounds and in the cystic fibrosis patients will then be examined.

1988-1991 Scientist at IARI, New Delhi and Investigator in Indo-US Bilateral Program

1991-1995 Ph.D. in Microbiology, University of Hawaii at Manoa, Honolulu, HI

1996-Nov.00 Postdoctoral Fellow, mentor: John Leong, Univ. Mass. Med. School, MA

2000-May 05 Research Assistant Professor, Univ. Mass. Med. School, MA

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Microbiology & Molecular Genetics - Rutgers New Jersey ...

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Integrative Medicine – Cleveland Clinic

August 29th, 2015 12:45 am

Cleveland Clinic Childrens Center for Pediatric Integrative Medicine is dedicated to addressing the increasing demand for integrative healthcare by researching and providing access to practices that address the physical as well as lifestyle, emotional, and spiritual needs of children. As the body of evidence for integrative medicine grows, we remain at the forefront of providing the most updated education and practices to our patients. We are able to care for children through their mid-20s, then provide seamless transition to adult providers.

Integrative Medicine services have become very popular in the United States, with more than 70 percent of Americans using them in some form.

Your child may benefit from integrative medicine as a complement to the care they are already receiving to treat chronic illness. Integrative medicine may help to reduce the severity or frequency of disease episodes, decrease stress related to chronic disease, and enjoy a better quality of life.

Our team members can coordinate appointments together to provide the patient with the best care.

Conditions that are commonly treated with integrative medicine include:

Our team of dedicated pediatric physicians and therapists are certified to perform a number of complementary therapies, including:

Increasingly, research shows that how we live, what we think, and how we feel affect our health. While conventional medicine can help diminish the consequences of unhealthy lifestyles, integrative medicine can reverse those consequences, prevent illness and reduce symptoms, resulting in:

Our team of dedicated pediatric physicians and therapists are certified to perform a number of complementary therapies, including:

The Center for Pediatric Integrative Medicine looks into the role of mind, body, spirit and lifestyle changes and how they can affect chronic disease. Studies yield evidence-based results that continue to encourage medical schools, hospitals and physicians to accept and incorporate these methods.

For example, research at Cleveland Clinic has shown that integrative medicine, including guided imagery, massage or Reiki, can help patients reduce their anxiety before surgery, to cope better with postoperative pain and to maximize their recovery.

To learn more, we invite you to explore research from the:

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Integrative Medicine - Cleveland Clinic

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