232 research outputs found
Feelings about Math and Science: Reciprocal Determinism and Catholic School Education
Applying Bandura’s reciprocal determinism model, differences in math and science experiences influenced by individual, gender, and school variables were investigated within 1,368 elementary students who attended 21 Catholic schools. Math and Science were evaluated positively and favored more than other academic subjects. However, advantages were found for boys by lowered math anxiety levels and favoring of math, and for large schools by lowered math anxiety levels and higher student ratings of science. No advantages were found for small schools. However, school poverty rate appeared to have a confounding effect on school size. Discussion is presented pertaining to the specific need to study Catholic school systems regarding student perceptions in light of distinguishing Catholic school factors
Feelings about Math and Science: Reciprocal Determinism and Catholic School Education
Applying Bandura’s reciprocal determinism model, differences in math and science experiences influenced by individual, gender, and school variables were investigated within 1,368 elementary students who attended 21 Catholic schools. Math and Science were evaluated positively and favored more than other academic subjects. However, advantages were found for boys by lowered math anxiety levels and favoring of math, and for large schools by lowered math anxiety levels and higher student ratings of science. No advantages were found for small schools. However, school poverty rate appeared to have a confounding effect on school size. Discussion is presented pertaining to the specific need to study Catholic school systems regarding student perceptions in light of distinguishing Catholic school factors
Practice patterns for acute ischemic stroke workup: A longitudinal population‐based study
Background
We examined practice patterns of inpatient testing to identify stroke etiologies and treatable risk factors for acute ischemic stroke recurrence.
Methods and Results
We identified stroke cases and related diagnostic testing from four 1‐year study periods (July 1993 to June 1994, 1999, 2005, and 2010) of the Greater Cincinnati/Northern Kentucky Stroke Study. Patients aged ≥18 years were included. We focused on evaluation of extracranial arteries for carotid stenosis and assessment of atrial fibrillation because randomized controlled trials supported treatment of these conditions for stroke prevention across all 4 study periods. In each study period, we also recorded stroke etiology, as determined by diagnostic testing and physician adjudication. An increasing proportion of stroke patients received assessment of both extracranial arteries and the heart over time (50%, 58%, 74%, and 78% in the 1993–1994, 1999, 2005, and 2010 periods, respectively;
P
<0.0001 for trend), with the most dramatic individual increases in echocardiography (57%, 63%, 77%, and 83%, respectively). Concurrently, we observed a decrease in strokes of unknown etiology (47%, 48%, 41%, and 38%, respectively;
P
<0.0001 for trend). We also found a significant increase in strokes of other known causes (32%, 25%, 45% and 59%, respectively;
P
<0.0001 for trend).
Conclusions
Stroke workup for treatable causes of stroke are being used more frequently over time, and this is associated with a decrease in cryptogenic strokes. Future study of whether better determination of treatable stroke etiologies translates to a decrease in stroke recurrence at the population level will be essential.
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Survey of Prevention and Intervention Strategies Reducing Return to Play Post-Concussion in Division 1 Football
Abstract.
Introduction
Sports related concussion, also considered mTBI, has remained in the public eye due to heightened fear concerning playing football and other collision based sports. Concussion prevention, as well as rehabilitating the brain after a concussion, is a high priority for many sports medical practitioners as well as for athletes. For these reasons, researchers associated with the American Athletic Conference (AAC) have surveyed concussion incidence in football. One of the AAC teams engaged in regular neurovisual training (NVT) and concluded this training program is associated with faster return to play post-injury in this observational cohort study.
Methods
The 12 schools of the AAC were surveyed from 2014 - 2018 concerning football induced concussions.
Results
We found that the AAC’s average seasonal concussion rate was m= 12.1, sd=1.02 concussions per year and the average return to play time was m=13.8, sd= 6.3 days. In the team where there was consistent NVT and NVT oriented rehabilitation post-concussion, we found that the concussion rate was m= 3.5, sd= 1.3 concussions per year and the return to play time was m= 8.6, sd= 1.5 days. Both numbers are significantly lower than in the other AAC teams.
Discussion
The current paper reports that there may be mitigation strategies that can be employed to aid in faster return to play times, as well as decrease the incidence of concussions. Such attempts to make football safer are needed as brain injury has been associated with long term consequences. Improving safety and brain health through mitigation strategies along with rehabilitation methods may aid in keeping athletes safer during play and throughout their lifespan
Reduction of the Body Burden of PCBs and DDE by Dietary Intervention in a Randomized Trial
Serum polychlorinated biphenyls (PCBs) in Anniston, AL, residents have been associated with hypertension and diabetes. There have been no systematic interventions to reduce PCB body burdens in Anniston or other populations. Our objective was to determine the efficacy of 15 g/day of dietary olestra to reduce PCBs in Anniston residents. Blood PCBs and 1,1-bis-(4-chlorophenyl)-2,2-dichloroethene were measured at baseline and 4-month intervals in a double-blind, placebo-controlled, 1-year trial. Participants with elevated serum PCBs were randomized into two groups of 14 and received potato crisps made with olestra or vegetable oil (VO). Elimination rates during the study period were compared with 5-year prestudy rates. Eleven participants in the olestra group and 12 in the VO group completed the study. Except for one participant in the VO group, reasons for dropout were unrelated to treatments. The elimination rate of 37 noncoplanar PCB congeners during the 1-year trial was faster during olestra consumption compared to the pretrial period (−0.0829±0.0357 and −0.00864±0.0116 year−1, respectively; P=.04), but not during VO consumption (−0.0413±0.0408 and −0.0283±0.0096 year−1, respectively; P=.27). The concentration of PCBs in two olestra group participants decreased by 27% and 25% during the trial. There was no significant time by group interaction in change from baseline. However, group main effects for total PCBs and PCB 153 were of borderline significance. This pilot study has demonstrated that olestra can safely reduce body burdens of PCBs and supports a larger intervention trial that may also determine whether reduction in PCBs will reduce the risk of hypertension and diabetes
Stable incidence but declining case-fatality rates of subarachnoid hemorrhage in a population
Objective:
To characterize temporal trends in subarachnoid hemorrhage (SAH) incidence and outcomes over 5 time periods in a large population-based stroke study in the United States.
Methods:
All SAHs among residents of the Greater Cincinnati/Northern Kentucky region at least 20 years of age were identified and verified via study physician review in 5 distinct year-long study periods between 1988 and 2010. We abstracted demographics, care patterns, and outcomes, and we compared incidence and case-fatality rates across the study periods.
Results:
The incidence of SAH in the 5 study periods (age-, race-, and sex-adjusted to the 2000 US population) was 8.8 (95% confidence interval 6.8–10.7), 9.2 (7.2–11.2), 10.0 (8.0–12.0), 9.0 (7.1–10.9), and 7.7 (6.0–9.4) per 100,000, respectively; the trend in incidence rates from 1988 to 2010 was not statistically significant (p = 0.22). Advanced neurovascular imaging, endovascular coiling, and neurologic intensive care unit availability increased significantly over time. All-cause 5-day (32%–18%, p = 0.01; for trend), 30-day (46%–25%, p = 0.001), and 90-day (49%–29%, p = 0.001) case-fatality rates declined from 1988 to 2010. When we included only proven or highly likely aneurysmal SAH, the declines in case-fatality were no longer statistically significant.
Conclusions:
Although the incidence of SAH remained stable in this population-based region, 5-day, 30-day, and 90-day case-fatality rates declined significantly. Advances in surgical and medical management, along with systems-based changes such as the emergence of neurocritical care units, are potential explanations for the reduced case-fatality
Sex-specific stroke incidence over time in the Greater Cincinnati/Northern Kentucky Stroke Study
OBJECTIVE:
Recent data suggest stroke incidence is decreasing over time, but it is unknown whether incidence is decreasing in women and men to the same extent.
METHODS:
Within our population of 1.3 million, all incident strokes among residents ≥20 years old were ascertained at all hospitals during July 1993-June 1994 and calendar years 1999, 2005, and 2010. A sampling scheme was used to ascertain out-of-hospital cases. Sex-specific incidence rates per 100,000 among black and white participants, age- and race-adjusted, were standardized to the 2000 US Census population. Trends over time by sex were compared; a Bonferroni correction was applied for multiple comparisons.
RESULTS:
Over the 4 study periods, there were 7,710 incident strokes; 57.2% (n = 4,412) were women. Women were older than men (mean ± SE 72.4 ± 0.34 vs 68.2 ± 0.32, p < 0.001). Incidence of all strokes decreased over time in men (263 [confidence interval 246-281] to 192 [179-205], p < 0.001) but not in women (217 [205-230] to 198 [187-210], p = 0.15). Similar sex differences were seen for ischemic stroke (men, 238 [223-257] to 165 [153-177], p < 0.01; women, 193 [181-205] to 173 [162-184], p = 0.09). Incidence of all strokes and of ischemic strokes was similar between women and men in 2010. Incidence of intracerebral hemorrhage and subarachnoid hemorrhage were stable over time in both sexes.
CONCLUSIONS:
Decreases in stroke incidence over time are driven by a decrease in ischemic stroke in men. Contrary to previous study periods, stroke incidence rates were similar by sex in 2010. Future research is needed to understand why the decrease in ischemic stroke incidence is more pronounced in men
Sex differences in cardiovascular risk profiles of ischemic stroke patients with diabetes in the Greater Cincinnati/Northern Kentucky Stroke Study
Background
The aim of the present study was to compare sex-specific associations between cardiovascular risk factors and diabetes mellitus (DM) among patients with acute ischemic stroke (AIS) in the Greater Cincinnati/Northern Kentucky Stroke Study (GCNKSS).
Methods
The GCNKSS ascertained AIS cases in 2005 and 2010 among adult (age ≥ 20 years) residents of a biracial population of 1.3 million. Past and current stroke risk factors were compared between those with and without DM using Chi-squared tests and multiple logistic regression analysis to examine sex-specific profiles.
Results
There were 3515 patients with incident AIS; 1919 (55%) were female, 697 (20%) were Black, and 1146 (33%) had DM. Among both women and men with DM, significantly more were obese and had hypertension, high cholesterol, and coronary artery disease (CAD) compared with those without DM. For women with AIS, multivariable sex-specific adjusted analyses revealed that older age was associated with decreased odds of having DM (adjusted odds ratio [aOR] 0.88, 95% confidence interval [CI] 0.80–0.98). For women with CAD, the odds of DM were increased (aOR 1.76, 95% CI 1.33–2.32). Age and CAD were not significant factors in differentiating the profiles of men with and without DM.
Conclusions
Women with DM had strokes at a younger age, whereas no such age difference existed in men. Compared with men, women with DM were also more likely to have CAD than those without DM, suggesting a sex difference in the association between DM and vascular disease. These findings may suggest a need for more aggressive risk factor management in diabetic women
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