An administrator\u27s guide to implementing effective dual immersion programs

This project fills a void in the area of dual immersion program implementation. Although there are general guidelines that exist, there is a paucity of specific guidelines that explicitly delineate the implementation of these critical components in the current accountability climate. We need to move beyond general categories and tailor them to the unique needs program models within situated contexts

A longitudinal population-based analysis of relationship status and mortality in KwaZulu-Natal, South Africa 2001–2011

BackgroundMortality risk is lower in married than in unmarried men and women. However, little is known about the association between mortality and relationship status in South Africa where marriage rates are low, migration is common, many couples are not co-resident and HIV prevalence is high.MethodUsing demographic surveillance data collected from 2001 to 2011, relationship status was categorised as conjugal (partners belong to the same household), non-conjugal (partners do not belong to the same household) or not partnered. Rates of relationship formation and dissolution were calculated by age and sex. Controlling for antiretroviral treatment (ART) introduction in 2005 as well as education, sex-specific and age-specific Cox proportional hazards models were used to investigate the association between relationship status and (1) all-cause mortality and (2) non-AIDS mortality.ResultsBefore 2005, individuals in conjugal relationships had a lower hazard of all-cause mortality in all age groups than not partnered men and women. Non-conjugal relationships lowered the risk of dying compared with not partnered men and women in fewer age groups. After ART introduction, the protective association of conjugal relationships was weaker but remained generally significant for men and women but not in non-conjugal relationships. In the later period, the association is reversed in young men (20–29?years) with mortality higher in conjugal and non-conjugal relationships compared with men not partnered. The analysis of non-AIDS deaths provided similar results.ConclusionsThe higher degree of social connections within a shared household environment that characterises conjugal relationships affords men and women greater protection against mortality

Changes in Lower Extremity Movement Patterns Following Exercise-induced Fatigue and Verbal Feedback

The present study investigated how exercise-induced fatigue and verbal feedback altered lower extremity coordination, variability, and kinetic variables in male and female athletes. Sixty-one healthy, club level athletes were divided into two groups: one that received a verbal feedback intervention post-fatigue, and one that did not. All subjects performed an unanticipated side-step cut, agility task, and vertical jump pre-fatigue, then completed an intense, intermittent, multi-directional fatigue protocol. Subjects in the feedback group received a quick verbal feedback intervention, focusing on landing technique. All subjects then repeated the pre-fatigue testing. The results indicated that fatigue caused subjects in the non-feedback group to change their coordination pattern in the sagittal plane, while subjects in the feedback group maintained their pre-fatigue pattern in all but one segment pairing (thigh-trunk frontal plane decreased post-fatigue in the feedback group). Fatigue caused all subjects to decrease their variability in the foot-shank and shank-thigh pairings in both the frontal and sagittal plane. Subjects in the non-feedback group also increased their anterior tibial shear force and vertical ground reaction force (VGRF), while the feedback group decreased their VGRF and knee extension moment. Fatigue also decreased vertical jump, and increased the score in the agility task, in both groups post-fatigue. These results suggest that an intermittent, multi-directional fatigue protocol causes a more in-phase, stiffer, less variable movement pattern, but that a simple verbal feedback intervention can prevent many of these changes from occurring. While the implications of these results on actual injury risk are unknown, these changes do suggest that verbal feedback may be an effective method for acutely altering some proposed risk factors for lower extremity injury, particularly anterior cruciate ligament injury. These results also suggest that muscular fatigue may be an important factor to consider when addressing potential injury risk in athletes

Diagnosis of a Chiari Malformation After a Concussion in a Junior College Football Player With a History of Chronic Headaches: A Case Report

The purpose of this report is to present the case of a National Junior Collegiate Athletic Association football player diagnosed with Chiari malformation postconcussion. A Chiari malformation is characterized by the cerebellum presenting below the level of the foramen. The uniqueness of this case stems from the patient’s health history, length of symptoms, and diagnosis. The effectiveness of treatment options, and the primary means to reduce the risk of catastrophic head injury in those with Chiari malformations are debatable. Clinicians should be familiar with the potential for the presence of a Chiari malformation with persistent symptoms postconcussion

Clinical Measures and Their Contribution to Dysfunction in Individuals With Patellar Tendinopathy

Context: Patellar tendinopathy is prevalent in physically active populations and it affects their quality of living, performance of activity, and may contribute to the early cessation of their athletic careers. A number of previous studies have identified contributing factors for patellar tendinopathy however their contributions to self-reported dysfunction remain unclear. Objective: The purpose of this investigation was to determine if strength, flexibility, and various lower extremity static alignments contributed to self-reported function and influence the severity of patellar tendinopathy. Design: Cross sectional research design. Setting: University Laboratory. Participants: 30 participants with patellar tendinopathy volunteered for this study (age: 23.4±3.6 years, height: 1.8±0.1m, mass: 80.0±20.3kg, BMI: 25.7±4.3). Main outcome measures: Participants completed seven different patient-reported outcomes. Isometric knee extension and flexion strength, hamstring flexibility and alignment measures of rearfoot angle, navicular drop, tibial torsion, q angle, genu recurvatum, pelvic tilt, and leg length differences were assessed. Pearson’s correlation coefficients were assessed to determine significantly correlated outcome variables with each of the patient-reported outcomes. The factors with the highest correlations were used to identify factors that contribute the most to pain and dysfunction using backward selection, linear regression models. Results: Correlation analysis found significant relationships between questionnaires and BMI (r=-0.35-0.46), normalized knee extension (r=0.38-0.50) and flexion strength (r=-0.34-0.50), flexibility (r=0.32- -0.38, q angle (r=0.38-0.56) and pelvic tilt (r=-0.40). Regression models (R2= 0.22-0.54) identified thigh musculature strength and supine q angle to have greatest predictability for severity in patient-reported outcomes. Conclusions: These findings put an emphasis of bodyweight management, improving knee extensor and flexor strength, posterior flexibility in patellar tendinopathy patients

Children\u27s memory for painful procedures: the relationship of pain intensity, anxiety, and adult behaviors to subsequent recall.

OBJECTIVE: To examine whether children\u27s experience of pain intensity and anxiety, and adult behaviors during venepuncture, were related to children\u27s memories of the procedure. METHODS: Participants were 48 children (24 males, 24 females) between the ages of 5 and 10 years who underwent venepuncture. The venepunctures were videotaped and adult behaviors were coded. Children self-reported their pain intensity and anxiety immediately and 2 weeks following venepuncture and answered contextual questions at follow-up. RESULTS: Children who initially reported higher levels of pain tended to over-estimate their anxiety at follow-up, whereas children who reported lower levels of pain accurately- or under-estimated their anxiety. Staff coping-promoting behaviors predicted the accuracy of children\u27s contextual memories. Staff and parent behaviors did not predict children\u27s recalled pain intensity and anxiety. CONCLUSIONS: Results indicate that children\u27s direct experience of pain intensity and staff behaviors during venepuncture are related to their memories. These data highlight the importance of effective pain management during medical procedures

Effects of a formal goal setting program on recovery after athletic injury

"The present study investigates the effects of a formal goal setting program on self-confidence, satisfaction, and rehabilitation adherence in injured NCAA student-athletes. Six athletes volunteered for the study (mean age=20.7 years, 4 males and 2 females). A single-subject design was used, with each participant having 3-5 weeks of baseline data collected before starting the goal setting program. Each intervention lasted between 2-6 weeks. Both short- and long-term goals were used during the intervention, and athletes were encouraged to set challenging, specific, measurable goals. Measures of confidence and rehabilitation adherence were collected weekly. Measures of satisfaction (for both the athlete and the supervising certified athletic trainer or physical therapist) were collected post-baseline and post-intervention. Each athlete also participated in a post-intervention debriefing to evaluate the goal setting program. Results demonstrated varied effects across participants. Three participants showed increased confidence and adherence during the goal setting program. Results for satisfaction were mixed. The program evaluation revealed that all participants found the program useful and would recommend it for other injured athletes. This study acts as a preliminary study on the use of a goal-setting program in athletic injury rehabilitation programs. Study limitations are presented and directions for future research provide. "--Abstract from author supplied metadata

Parent–child interactions during pediatric venipuncture: Investigating the role of parent traits, beliefs, and behaviors in relation to child outcomes

Background: The social context is critical to children’s pain, and parents frequently form a major aspect of this context. We addressed several gaps in our understanding of parent–child interactions during painful procedures and identified intrapersonal contributions to parental affective responses and behaviors. We used the pain empathy model framework to examine parent–child interactions during venipuncture to determine predictors of parent distraction and reassurance. Aims: We examined relations among parent and child behaviors along with parent fear and child pain and fear. We empirically tested the contribution of top-down influences in predicting the use of two common parent utterances, reassurance and distraction during venipuncture, including parent beliefs about these behaviors. Methods: Venipunctures of 100 5- to 10-year-old children were filmed, and parent–child interactions were coded using the full 35 item Child Adult Medical Procedure Interaction Scale. Two codes were of particular interest: reassurance and distraction. Self-report measures included child fear and pain, parent fear, trait anxiety, empathy, pain catastrophizing, and beliefs about reassurance and distraction. Results: Findings supported original Child–Adult Medical Procedure Interaction Scale codes linking parent “distress-promoting” behaviors with poorer child outcomes and parent “coping-promoting” behaviors with improved child outcomes. Parent traits accounted for a small portion of the variance in parent reassurance and distraction. Conclusions: Findings are consistent with research on coping and distress promoting behaviors. Using a novel framework of the pain empathy model, we found that parent traits largely did not predict their procedural behaviors, which were more strongly related to child distress behaviors during the needle and parent beliefs about the behaviors

Alterations in Cortical Activation Among Individuals With Chronic Ankle Instability During Single-Limb Postural Control

Context: Chronic ankle instability (CAI) is characterized by repetitive ankle sprains and perceived instability. Whereas the underlying cause of CAI is disputed, alterations in cortical motor functioning may contribute to the perceived dysfunction. Objective: To assess differences in cortical activity during single-limb stance among control, coper, and CAI groups. Design: Cross-sectional study. Setting: Biomechanics laboratory. Patients or Other Participants: A total of 31 individuals (10 men, 21 women; age = 22.3 ± 2.4 years, height = 169.6 ± 9.7 cm, mass = 70.6 ± 11.6 kg), who were classified into control (n = 13), coper (n = 7), and CAI (n = 11) groups participated in this study. Intervention(s): Participants performed single-limb stance on a force platform for 60 seconds while wearing a 24-channel functional near-infrared spectroscopy system. Oxyhemoglobin (HbO2) changes in the supplementary motor area (SMA), precentral gyrus, postcentral gyrus, and superior parietal lobe were measured. Main Outcome Measure(s): Differences in averages and standard deviations of HbO2 were assessed across groups. In the CAI group, correlations were analyzed between measures of cortical activation and Cumberland Ankle Instability Tool (CAIT) scores. Results: No differences in average HbO2 were present for any cortical areas. We observed differences in the standard deviation for the SMA across groups; specifically, the CAI group demonstrated greater variability than the control (r = 0.395, P = .02; 95% confidence interval = 0.34, 0.67) and coper (r = 0.38, P = .04; 95% confidence interval = −0.05, 0.69) groups. We demonstrated a strong correlation that was significant in the CAI group between the CAIT score and the average HbO2 of the precentral gyrus (ρ = 0.64, P = .02) and a strong correlation that was not significant between the CAIT score and the average HbO2 of the SMA (ρ = 0.52, P = .06). Conclusions: The CAI group displayed large differences in SMA cortical-activation variability. Greater variations in cortical activation may be necessary for similar static postural-control outcomes among individuals with CAI. Consequently, variations in cortical activation for these areas provide evidence for an altered neural mechanism of postural control among populations with CAI