The Safety and Efficacy of Sub-Symptom Threshold Exercise as a Treatment for Post-Concussion Symptoms in Adolescents

Abstract Introduction: Concussions are an unfortunately common injury sustained by many young athletes participating in a variety of sports throughout the country. Concussions are notoriously difficult to diagnose and may lead to serious, long-term difficulties if left untreated or treated incorrectly. Severe or repeated concussions can lead to many physical, psychological, neurological, and other symptoms that could potentially lead to death. Current concussion treatment is largely physical and cognitive rest. This research study aims to identify how limited exercise may decrease the duration of symptoms and make it safer for athletes to resume participation in their sport. Methods: A literature search was performed and completed in November of 2019 using the PUBMED and EBSCO search databases. 11 articles were chosen based on inclusion/exclusion criteria as well as the date they were completed. These articles were then analyzed and their data were compared. Results: The studies evaluated demonstrated benefits to the use of exercise in decreasing post concussive symptoms. Several studies also evaluated and demonstrated the safety and tolerability of exercise programs in adolescents with neurologic symptoms post tbi or concussion. These studies used a variety of metrics, evaluation tools, and statistical tests to demonstrate improvements. However, only a few studies were able to collect follow up data at various points post evaluation. Also, a few studies were not able to use an adequate control group to demonstrate the success of the treatment across different populations. Finally, almost all studies were done on too small of sample sizes to allow for broad extrapolation of data. Discussion: The data collected from the studies were able to show strong data in support of sub-symptom threshold exercise as a better treatment option for adolescents with post-concussion symptoms than strict rest. Despite this, there are many factors that limit the generalizability of the data to state adequately that the exercise treatment is always both safer and more efficacious. More data must be collected through studies with larger sample sizes that extend over much longer periods of time to evaluate future health outcomes must be completed. One important finding of these data is that the findings were found to be safe, and negative findings were extremely minimal. Future, more robust studies should continue to employ and evaluate sub-symptom threshold exercise as a treatment plan for adolescents with post-concussion symptoms. Conclusion: Concussions continue to be a very common issue in adolescent athletes, and a solution on how best to treat them continues to be a mystery. Previous treatment plans have stuck largely to a program of strict cognitive and physical rest until the symptoms improve. As demonstrated in the studies highlighted, properly implemented and monitored exercise has shown data indicating its efficacy as a superior treatment. However, further, more robust studies must be completed to show increased generalizability and long term success before these exercise treatments can be implemented as a mainstream treatment. The demonstrated safety of the exercise and positive findings shown make further research crucial and worthwhile to improve treatment for these millions of adolescent athletes

Scotland Chikwawa Health Initiative - improving health from community to hospital

The Scotland Chikwawa Health Initiative is a three year programme funded by the Scottish Executive International Development Fund which aims to achieve measurable reductions in major causes of disease and death in four villages within the Chikwawa District of Malawi alongside improving the hospital environment for the good of both staff and patients. The initiative has developed a holistic approach to health improvements through the provision of infrastructure at both health facilities and within communities, and training of government personnel and community volunteers. Specific areas targeted have included water and sanitation, maternal health, and communicable disease control with provision of training and materials to facilitate interventions and health education. At the end of the second year the programme has already seen reductions in diarrhoeal disease (30% overall in target communities), improved access to safe water, an increase in the uptake of growth monitoring and immunisations in children under the age of five years (15% increase since training volunteers), improved safe delivery of babies within the community (245 babies delivered safely in target communities with 25 referred due to complications) and increased community health activity (training and integration of village health committees, water point committees, traditional birthing attendants and health surveillance assistants). The programme hopes to act as a model for the District to follow in other communities to achieve it’s obligations under the Malawi Ministry of Health Essential Health Package

Spatial and temporal variation in otolith chemistry for tautog (Tautoga onitis) in Narragansett Bay and Rhode Island coastal ponds

The elemental composition of otoliths may provide valuable information for establishing connectivity between fish nursery grounds and adult fish populations. Concentrations of Rb, Mg, Ca, Mn, Sr, Na, K, Sr, Pb, and Ba were determined by using solution-based inductively coupled plasma mass spectrometry in otoliths of young-of-the year tautog (Tautoga onitis) captured in nursery areas along the Rhode Island coast during two consecutive years. Stable oxygen (δ18O) and carbon (δ13C) isotopic ratios in young-of-the year otoliths were also analyzed with isotope ratio mass spectrometry. Chemical signatures differed significantly among the distinct nurseries within Narragansett Bay and the coastal ponds across years. Significant differences were also observed within nurseries from year to year. Classification accuracy to each of the five tautog nursery areas ranged from 85% to 92% across years. Because accurate classification of juvenile tautog nursery sites was achieved, otolith chemistry can potentially be used as a natural habitat tag

Artillery and prophecy: Sicily in the reign of Dionysius I

On the alleged invention of the catapult at Syracuse in 399 BC, refuting the theory of E. W. Marsden, Greek and Roman Artillery, I-II (Oxford 1969-71)

Life extended : the intimate politics of the antiretroviral era in Northern Nigeria

For more than thirty years, the HIV pandemic has caused immense harm across sub-Saharan Africa. From the middle of the last decade, however, a treatment revolution has been underway, as effective antiretroviral drugs (ARVs) have become available to millions of ordinary people. This thesis examines the far-reaching consequences of this new reality in Northern Nigeria. It argues that the significance of the ARV era cannot be fully understood simply by monitoring how many patients are receiving treatment, but instead must be explained in terms of the multifaceted changes it has driven in institutions and the lives of HIV positive people. This study uses ethnographic case studies and participatory methods to understand this new historical moment from ‘below’. It provides new empirical perspectives on how the ARV era has profoundly altered the ways in which HIV positive people suffer. The difficulties of daily life when subjected to opportunistic infections, side effects from drugs, and social stigma are compounded by memories of past trauma and fears for an uncertain future. Previous studies have indicated HIV positive people often form new relationships (e.g. Rhine, 2009), but rarely have these post-HIV relationships been described. This study argues that these new relationships, often distant from conventional family supervision, have a unique character, blending traditional forms with ‘modern’ ideas about romance. After a HIV disclosure, incomes and assets (particularly those reliant on family relationships) are often reduced. Along with the cost of treatment (broadly defined to include a range of curative practices), this forces those living with HIV to adapt their livelihood strategies, often using networks of solidarity between positive people. The process of lobbying for improvements in medical care is also explored. Both doctors and NGOs advocate on behalf of HIV positive people, but do so with strikingly different tactics and results. This has important implications for continuing debates about working ‘with the grain’ (Crook and Booth, 2011) for development in patrimonial states. In summary, whilst HIV treatment has saved the lives of millions, inventing drugs and getting them to the people who need them are merely the first steps in alleviating suffering. The thesis traces the most important tasks in securing wellbeing in the ARV era – those pursued by HIV positive people themselves

Introduction to diffusion tensor imaging mathematics

ABSTRACT: The mathematical aspects of diffusion tensor magnetic resonance imaging (DTMRI, or DTI), the measurement of the diffusion tensor by magnetic resonance imaging (MRI), are discussed in this three-part series. Part III begins with a comparison of different ways to calculate the tensor from diffusion-weighted imaging data. Next, the effects of noise on signal intensities and diffusion tensor measurements are discussed. In MRI signal intensities as well as DTI parameters, noise can introduce a bias (systematic deviation) as well as scatter (random deviation) in the data. Propagation-of-error formulas are explained with examples. Step-by-step procedures for simulating diffusion tensor measurements are presented. Finally, methods for selecting the optimal b factor and number of b ϭ 0 images for measuring several properties of the diffusion tensor, including the trace (or mean diffusivity) and anisotropy, are presented

Building Successful Neighborhoods

Reviews the literature on direct interventions to revitalize distressed neighborhoods by improving housing, schools, and services in terms of basic policy and strategy, programmatic strategies, and building institutional infrastructure

Defining species specific genome differences in malaria parasites

<p>Abstract</p> <p>Background</p> <p>In recent years a number of genome sequences for different <it>plasmodium </it>species have become available. This has allowed the identification of numerous conserved genes across the different species and has significantly enhanced our understanding of parasite biology. In contrast little is known about species specific differences between the different genomes partly due to the lower sequence coverage and therefore relatively poor annotation of some of the draft genomes particularly the rodent malarias parasite species.</p> <p>Results</p> <p>To improve the current annotation and gene identification status of the draft genomes of <it>P. berghei</it>, <it>P. chabaudi </it>and <it>P. yoelii</it>, we performed genome-wide comparisons between these three species. Through analyses via comparative genome hybridizations using a newly designed pan-rodent array as well as in depth bioinformatics analysis, we were able to improve on the coverage of the draft rodent parasite genomes by detecting orthologous genes between these related rodent parasite species. More than 1,000 orthologs for <it>P. yoelii </it>were now newly associated with a <it>P. falciparum </it>gene. In addition to extending the current core gene set for all plasmodium species this analysis also for the first time identifies a relatively small number of genes that are unique to the primate malaria parasites while a larger gene set is uniquely conserved amongst the rodent malaria parasites.</p> <p>Conclusions</p> <p>These findings allow a more thorough investigation of the genes that are important for host specificity in malaria.</p

The impact of self-help groups on pastoral women’s empowerment and agency: A study in Nigeria

Abstract While women in pastoralist communities are key stakeholders in the production of milk and dairy products for income generation, they are largely ignored in other areas of development such as health. The need to involve women self-help groups, in pastoralist areas in both animal health and human health development programmes, is essential, particularly given the high incidence of zoonotic diseases in these communities (Maudlin I, Eisler MC and Welburn SC, Philosophical Transactions of the Royal Society B: Biological Sciences, 364(1530):2777-2787, 2009). Understanding the process and impact of social networks on livelihoods is essential for any development programme that aims to prevent and control zoonotic diseases. This study examines the roles and responsibilities of women self-help groups in Kachia Grazing Reserve and Bokkos, Jos Plateau, Nigeria. The findings show that groups promoting social, physical and psychological health strongly motivated women’s involvement in self-help groups. Self-help activities showed commitment to effect a change in their livelihoods, despite constraining environmental, cultural and social factors. Engagement of women’s self-help groups in livestock development programmes offers a powerful instrument for driving forward the One Health practice in pastoralist communities, promoting human, animal and environmental health and well-being