Concussion Competencies: A Framework for School-Based Concussion Management (flyer)

This volume grew out of many years of clinical practice, research, and program projects. It is the culmination of more than 50 years of work with kids, brains, and schools. While there is research behind the Competencies and the underlying content, the intent was to create a user-friendly manual that cut across levels of responsibility and care. Concussion Competencies was not intended to be a textbook in the traditional manner; however, the Competencies have been shown to be a useful approach to teaching this material. This volume is organized around a set of Competencies that have been shown to be useful to practitioners in the field. The 10 Compentencies fall into three main areas of information we have found to be important for effective work with students (and parents): SECTIONS 1. Biological aspects of concussion 2. Behavioral aspects of concussion 3. Programmatic considerations An important consideration is that not everyone who works with kids and concussions needs the same depth of training. With this in mind, chapters are broken by type of reader. AUDIENCE / CONSTITUENTS • Superintendents, Boards, and Administrators • Athletic Directors and Coaches • Licensed and Ancillary Health Care Providers • Teachers • Parents and Students The 10 Competencies address: • Biological Aspects of concussion management • Behavioral aspects of concussion • Programmatic considerations. This volume intends to: • Bridge the gaps between schools, community health care and families; • Focus on behavior and not medicine; • Assume that schools are a proper focus of activity, but does not assume all schools have equal resources; • Elevate the role of the student-patient and the family in the recovery process. The material is aimed at a broad range of interested parties: • School Superintendents, Boards, and Administrators • Athletic Directors and Coaches • Teachers • Licensed and Ancillary Health Care Providers • Parents and Students

Patterns of referral in high school concussion management programs: A pilot study of consultants from different disciplines

School-based concussion management programs cover thousands of young athletes, yet there is little in the way of research to assess program processes or outcomes. This study examined the referral patterns of consultants working with ten high school concussion management programs. In addition to the number of referrals made to specialists, other potential outcome variables were explored. The sample included over 5,000 athlete-seasons and 298 concussions managed directly by certified athletic trainers. All programs used computerized neuropsychological testing (both baseline and post injury). Two groups were compared: five programs used a clinical neuropsychologist (NP) as the testing consultant and five used nonneuropsychologists (non-NP) with advanced clinical degrees as the testing consultant. There was no significant difference in concussion incidence rates between groups. Referrals to outside specialists were significantly higher for the non-NP group: X2(1) = 16.474, p \u3c .0001. Further, concussions in the non-NP group took longer to recover overall (Mann-Whitney U, p = .013) and had significantly more cases taking longer than 2 weeks to complete their testing protocol: X2(1) = 9.672, p = .003. The findings of this pilot study support the idea that neuropsychologists are best suited for the role of testing consultant to high school concussion management programs

Concussion competencies: a training model for school-based concussion management

This study reports on the use of ten knowledge competencies related to the behavioral management of concussion in schools. Trainings using these competencies as learning objectives were delivered to school personnel. This aims of the use of competencies in this way are to streamline the education of key stakeholders, to establish clear roles and responsibilities for constituents and equip individuals working with students following a concussion with the relevant knowledge to optimize outcomes. The majority of participants, primarily speech language pathologists working as related service providers in the schoolswhere the trainings occurred, judged the use of the competencies to be informative and useful to their practice both immediately following the training and at a 5-month follow-up. The greatest gains in knowledge were noted by those participants self-reporting the least amount of knowledge pre-training. Participants also ranked the perceived value and relative importance of each of the ten competencies

Role of Coulomb correlation on magnetic and transport properties of doped manganites: La0.5Sr0.5MnO3 and LaSr2Mn2O7

Results of LSDA and LSDA+U calculations of the electronic structure and magnetic configurations of the 50% hole-doped pseudocubic perovskite La0.5Sr0.5MnO3 and double layered LaSr2Mn2O7 are presented. We demonstrate that the on-site Coulomb correlation (U) of Mn d electrons has a very different influence on the (i) band formations, (ii) magnetic ground states, (iii) interlayer exchange interactions, and (iv) anisotropy of the electrical transport in these two manganites. A possible reason why the LSDA failures in predicting observed magnetic and transport properties of the double layered compound - in contrast to the doped perovskite manganite - is considered on the basis of a p-d hybridization analysis.Comment: 11 pages, 3 figure

The Effect of in-Service Methodology on Learning Transfer for School Personnel Managing Students following Concussion

Background: It is essential to increase the knowledge base of teachers involved in facilitating return to learning in middle school students following a concussion. However, the best method to enhance the transfer of learning for teachers remains to be elucidated. Application of Adult Learning Theory (ALT) is a plausible solution to this problem. Purpose: The purpose of this randomized post-test study was to examine the effects of ALTon the transfer of learning in teachers who work with individuals with concussion. Methods: A convenience sample of 169 teachers at four middle schools were randomized to receive an in-service regarding concussion management either in ALT or traditional lecture format. Vignettes approximating classroom practice evaluated learning transfer. Results: one-way between subjects ANOVA revealed no significant difference between the methods of educational delivery on group assessment scores (p¼.22). Additionally, a regression analysis did not identify any demographic variables that predicted learning transfer (p¼.65). A statistically significant difference existed for four questions (1, 4, 7, 25) between the groups (p¼.03, .02, .01, .00, respectively). These vignettes were those that assessed information that was likely novel to the learner. Discussion: The current study demonstrated that ALT applied to teacher in-service did not impact transfer of learning immediately post training compared to a traditional lecture format. Future research should continue to examine the effects of various educational strategies to enhance learning transfer for teachers managing students in the classroom after concussion

Coulomb correlation and magnetic ordering in double-layered manganites: LaSr2_2Mn2_2O7_7

A detailed study of the electronic structure and magnetic configurations of the 50 % hole-doped double layered manganite LaSr$_2$Mn$_2$O$_7$ is presented. We demonstrate that the on-site Coulomb correlation (U) of Mn d electrons {\it (i)} significantly modifies the electronic structure, magnetic ordering (from FM to AFM), and interlayer exchange interactions, and {\it (ii)} promotes strong anisotropy in electrical transport, reducing the effective hopping parameter along the {\it c} axis for electrically active $e_g$ electrons. This findng is consistent with observations of anisotropic transport -- a property which sets this manganite apart from conventional 3D systems. A half-metallic band structure is predicted with both the LSDA and LSDA+U methods. The experimentally observed A-type AFM ordering in LaSr$_2$Mn$_2$O$_7$ is found to be energetically more favorable with U $\geq$ 7 eV. A simple interpretation of interlayer exchange coupling is given within double and super-exchange mechanisms based on the dependencies on U of the effective exchange parameters and $e_g$ state sub-band widths.Comment: 10 pages, 5 figure

Association of polymorphisms in HCN4 with mood disorders and obsessive compulsive disorder

Hyperpolarization activated cyclic nucleotide-gated (HCN) potassium channels are implicated in the control of neuronal excitability and are expressed widely in the brain. HCN4 is expressed in brain regions relevant to mood and anxiety disorders including specific thalamic nuclei, the basolateral amygdala, and the midbrain dopamine system. We therefore examined the association of HCN4 with a group of mood and anxiety disorders. We genotyped nine tag SNPs in the HCN4 gene using Sequenom iPLEX Gold technology in 285 Caucasian patients with DSM-IV mood disorders and/or obsessive compulsive disorder and 384 Caucasian controls. HCN4 polymorphisms were analyzed using single marker and haplotype-based association methods. Three SNPs showed nominal association in our population (rs12905211, rs3859014, rs498005). SNP rs12905211 maintained significance after Bonferroni correction, with allele T and haplotype CTC overrepresented in cases. These findings suggest HCN4 as a genetic susceptibility factor for mood and anxiety disorders; however, these results will require replication using a larger sample

Mutations and Deregulation of Ras/Raf/MEK/ERK and PI3K/PTEN/Akt/mTOR Cascades Which Alter Therapy Response

The Ras/Raf/MEK/ERK and PI3K/PTEN/Akt/mTOR cascades are often activated by genetic alterations in upstream signaling molecules such as receptor tyrosine kinases (RTK). Certain components of these pathways, RAS, NF1, BRAF, MEK1, DUSP5, PP2A, PIK3CA, PIK3R1, PIK3R4, PIK3R5, IRS4, AKT, NFKB1, MTOR, PTEN, TSC1, and TSC2 may also be activated/inactivated by mutations or epigenetic silencing. Upstream mutations in one signaling pathway or even in downstream components of the same pathway can alter the sensitivity of the cells to certain small molecule inhibitors. These pathways have profound effects on proliferative, apoptotic and differentiation pathways. Dysregulation of components of these cascades can contribute to: resistance to other pathway inhibitors, chemotherapeutic drug resistance, premature aging as well as other diseases. This review will first describe these pathways and discuss how genetic mutations and epigenetic alterations can result in resistance to various inhibitors

Decision-making biases and affective states: Their potential impact on best practice innovations

This is the peer reviewed version of the following article: smith, f.l. [sic], Stone, T.H., Kisamore, J.L. & Jawahar, I.M. (2010). Decision-making biases and affective states: Their potential impact on best practice innovations. Canadian Journal of Administrative Sciences / Revue Canadienne des Sciences de l'Administration, 27(4), 277-291. which has been published in final form at https://doi.org/10.1002/cjas.132. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.Rogers’s (2003) stages of innovation adoption and diffusion (knowledge of innovation, persuasion, decision, implementation, and confirmation) are used as a framework for understanding the decision-making biases and heuristics (i.e., anchoring, framing, confirmatory and availability biases, overconfidence, and representativeness) embedded in an organization’s adoption and implementation of best practices. Also, the role of affect on the diffusion of innovations is examined using the Affect Infusion Model (Forgas, 1995). Propositions are stated specifying effects of decision heuristics and affect on each stage of the diffusion of innovations.Ye