An Evaluation of the Memorandum to Require Concussion Education in Ontario Schools

Introduction: Concussion is a type of traumatic brain injury that is common among children and youth. Concussions can cause multiple short-term problems but can also lead to a number of serious long-term consequences. Recent evidence suggests that concussions are becoming more common, especially in school-aged children. On March 19, 2014, the Ministry of Education of Ontario has issued a Policy/Program Memorandum (PPM) that prompts school boards to create and sustain a concussion policy. The effectiveness of the PPM has not yet been studied. Purpose: The primary objective of this study is to evaluate the effectiveness of the PPM by analyzing the different concussion prevention programs introduced in response to the PPM by the school boards. Methods: This will be a three-part study. The first part of the study will be a qualitative analysis of the concussion programs using questionnaire distributed to school boards. The second study will be a pre-post analysis of the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) data to establish whether or not the policies had an effect on concussion incidence in an emergency department setting. The third study will survey high school physical education teachers, coaches and/or trainers about concussion policies and the PPM. Results: All 72 Ontario public school boards had a concussion protocol on their board's website by June 2016. The analysis of 8 years of CHIRPP data on concussions generally, and school based concussions specifically, revealed that the number of diagnosed concussions increased significantly subsequent to the introduction of PPM 158 while the number of suspected concussions decreased. For the final study, twelve teachers responded to the survey. All were aware of their board's concussion policy; 83% reported that they had received training and/or relevant education, 75% had a trained individual present at every game/practice, 83% noticed a difference in parental involvement, 100% reported changes in the way return-to-play (RTP) and return-to-learn (RTL) protocols are implemented at the schools and 92% agreed that there was a need for a government-mandated concussion law

Obesity- Related Health Risk: A Trajectory Based Approach

The purpose of this study was to evaluate the Edmonton Obesity Staging System (EOSS) approach as a tool for the identification of obesity-related health risk. Using 20 years of follow-up data from the Coronary Artery Risk Development in Young Adults (CARDIA) study (N=5115; age 18-34), trajectory modelling analysis was used to identify distinct clusters of individuals following similar patterns of obesity using modified EOSS criteria. The final model acquired through the Proc Traj macro suggests that there are 4 distinct EOSS stage-increase trajectories. After adjusting for covariates, individuals in the medium risk trajectory were twice more likely to follow protein consumption guidelines (OR=2.08 95% CI=1.18-3.65), 47% less likely to be black (0.53, 0.37-0.76), 43% less likely to have a history of dieting (0.57, 0.37-0.86), and were also less likely to be either occasional (0.51, 0.29-0.9) or frequent (0.25, 0.14-0.45) weight cyclers when compared to the highest risk trajectory

Trends in concussions at Ontario schools prior to and subsequent to the introduction of a concussion policy - an analysis of the Canadian hospitals injury reporting and prevention program from 2009 to 2016

Background: Concussion is a preventable injury that can have long-term health consequences for children and youth. In Ontario, the Policy/Program Memorandum # 158 (PPM) was introduced by the Ministry of Education of Ontario in March 2014. The PPM’s main purpose is to require each school board in the province to create and implement a concussion policy. The purpose of this paper is to examine trends in school-based concussions prior to and subsequent to the introduction of the PPM. Methods: This report examined emergency department (ED) visits in 5 Ontario hospitals that are part of the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), and compared trends over time in diagnosed concussions, and suspected concussions identified as “other head injury” in children and youth aged 4–18. Results: From 2009 to 2016 study years, there were 21,094 suspected concussions, including 8934 diagnosed concussions in youth aged 4–18. The average number of diagnosed concussions in the 5 years before the PPM was 89 concussions/month, compared to approximately 117 concussions per month after; a 30% increase in the monthly rate of concussions presenting to the ED. The total number of concussion or head injury-related ED visits remained relatively unchanged but the proportion of diagnosed concussions rose from 31% in 2009 to 53% in 2016. The proportion of diagnosed concussions in females also increased from 38% in 2013 to 46% in 2016. The percent of all diagnosed concussions occurring at schools increased throughout the study reaching almost 50% in 2016 with most injuries taking place at the playground (24%), gymnasium (22%) or sports field (20%). Conclusions: The introduction of the PPM may have contributed to a general increase in concussion awareness and an improvement in concussion identification at the school level in children and youth aged 4–18. Keywords: Concussion, Policy, Emergency department, YouthYork University Librarie

Finite Size Effects in Addition and Chipping Processes

We investigate analytically and numerically a system of clusters evolving via collisions with clusters of minimal mass (monomers). Each collision either leads to the addition of the monomer to the cluster or the chipping of a monomer from the cluster, and emerging behaviors depend on which of the two processes is more probable. If addition prevails, monomers disappear in a time that scales as $\ln N$ with the total mass $N\gg 1$, and the system reaches a jammed state. When chipping prevails, the system remains in a quasi-stationary state for a time that scales exponentially with $N$, but eventually, a giant fluctuation leads to the disappearance of monomers. In the marginal case, monomers disappear in a time that scales linearly with $N$, and the final supercluster state is a peculiar jammed state, viz., it is not extensive.Comment: 18 pages, 8 figures, 45 reference

Ca2+-dependent Inactivation of CaV1.2 Channels Prevents Gd3+ Block: Does Ca2+ Block the Pore of Inactivated Channels?

Lanthanide gadolinium (Gd3+) blocks CaV1.2 channels at the selectivity filter. Here we investigated whether Gd3+ block interferes with Ca2+-dependent inactivation, which requires Ca2+ entry through the same site. Using brief pulses to 200 mV that relieve Gd3+ block but not inactivation, we monitored how the proportions of open and open-blocked channels change during inactivation. We found that blocked channels inactivate much less. This is expected for Gd3+ block of the Ca2+ influx that enhances inactivation. However, we also found that the extent of Gd3+ block did not change when inactivation was reduced by abolition of Ca2+/calmodulin interaction, showing that Gd3+ does not block the inactivated channel. Thus, Gd3+ block and inactivation are mutually exclusive, suggesting action at a common site. These observations suggest that inactivation causes a change at the selectivity filter that either hides the Gd3+ site or reduces its affinity, or that Ca2+ occupies the binding site at the selectivity filter in inactivated channels. The latter possibility is supported by previous findings that the EEQE mutation of the selectivity EEEE locus is void of Ca2+-dependent inactivation (Zong Z.Q., J.Y. Zhou, and T. Tanabe. 1994. Biochem. Biophys. Res. Commun. 201:1117–11123), and that Ca2+-inactivated channels conduct Na+ when Ca2+ is removed from the extracellular medium (Babich O., D. Isaev, and R. Shirokov. 2005. J. Physiol. 565:709–717). Based on these results, we propose that inactivation increases affinity of the selectivity filter for Ca2+ so that Ca2+ ion blocks the pore. A minimal model, in which the inactivation “gate” is an increase in affinity of the selectivity filter for permeating ions, successfully simulates the characteristic U-shaped voltage dependence of inactivation in Ca2+

Reduction Operators of Linear Second-Order Parabolic Equations

The reduction operators, i.e., the operators of nonclassical (conditional) symmetry, of (1+1)-dimensional second order linear parabolic partial differential equations and all the possible reductions of these equations to ordinary differential ones are exhaustively described. This problem proves to be equivalent, in some sense, to solving the initial equations. The ``no-go'' result is extended to the investigation of point transformations (admissible transformations, equivalence transformations, Lie symmetries) and Lie reductions of the determining equations for the nonclassical symmetries. Transformations linearizing the determining equations are obtained in the general case and under different additional constraints. A nontrivial example illustrating applications of reduction operators to finding exact solutions of equations from the class under consideration is presented. An observed connection between reduction operators and Darboux transformations is discussed.Comment: 31 pages, minor misprints are correcte

Open charm measurements in NA61/SHINE at CERN SPS

The measurements of open charm production was proposed as an important tool to investigate the properties of the hot and dense matter formed in nucleus-nucleus collisions as well as to provide the means for model independent interpretation of the existing data on J/ψ suppression. Recently, the experimental setup of the NA61/SHINE experiment was supplemented with a Vertex Detector which was motivated by the importance and the possibility of the first direct measurements of open charm meson production in heavy ion collisions at SPS energies. First test data taken in December 2016 on Pb+Pb collisions at 150A GeV/c allowed to validate the general concept of D0 meson detection via its D0 → π+ + K− decay channel and delivered a first indication of open charm production. The physics motivation of open charm measurements at SPS energies, pilot results on open charm production, and finally, the future plans of open charm measurements in the NA61/SHINE experiment after LS2 are presented

Penilaian Kinerja Keuangan Koperasi di Kabupaten Pelalawan

This paper describe development and financial performance of cooperative in District Pelalawan among 2007 - 2008. Studies on primary and secondary cooperative in 12 sub-districts. Method in this stady use performance measuring of productivity, efficiency, growth, liquidity, and solvability of cooperative. Productivity of cooperative in Pelalawan was highly but efficiency still low. Profit and income were highly, even liquidity of cooperative very high, and solvability was good