Rural elementary school staff's knowledge of and experience with pediatric concussion

The occurrence of a concussion on a young, still-developing brain can result in persistent cognitive, physical, and behavioral consequences (Torres & Shaikh, 2019). Although there has been increased attention on the prevalence of concussions in middle and high school student-athletes (Kasamatsu, Cleary, Bennett, Howard, & McLeod, 2016), there is minimal research concerning concussion management in elementary schools (O’Neill et al., 2017). Furthermore, there is little research to suggest that elementary school staff in rural areas receive proper training to manage a concussion incident or to make classroom modifications for a student recovering from a concussion (Ettel, Glang, Todis, & Davis, 2016). The purpose of this study was to assess the concussion awareness of rural elementary school staff, specifically as it relates to appropriate identification and management of pediatric concussions. In addition, the research sought to determine the prevalence with which rural elementary schools have a school-wide concussion protocol in place. Participants included elementary school staff in rural Western North Carolina. The researcher collected data via an online, anonymous survey consisting of questions related to pediatric concussion awareness, training, and school-wide policies. It was hypothesized that there would be unsatisfactory concussion awareness among school staff and an inadequate occurrence of school-wide concussion training and protocols. The results of the survey suggested that the majority of participants did possess a basic understanding of concussion symptom identification. In addition, the data revealed that the majority of participating schools provided pediatric concussion training and have school-wide concussion response protocols in place. However, more than half of the participants indicated that they do not feel adequately trained to properly address the academic needs of a student recovering from a concussion. Thus, the training methods employed by some public school systems may be inadequate and need revision so that the transition from training to practice may be improved

Upper limits of intraocular pressure in glaucoma clinical trials

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/110560/1/ceo12357.pd

Adolescent Opiate Exposure in the Female Rat Induces Subtle Alterations in Maternal Care and Transgenerational Effects on Play Behavior

The non-medical use of prescription opiates, such as Vicodin® and MSContin®, has increased dramatically over the past decade. Of particular concern is the rising popularity of these drugs in adolescent female populations. Use during this critical developmental period could have significant long-term consequences for both the female user as well as potential effects on her future offspring. To address this issue, we have begun modeling adolescent opiate exposure in female rats and have observed significant transgenerational effects despite the fact that all drugs are withdrawn several weeks prior to pregnancy. The purpose of the current set of studies was to determine whether adolescent morphine exposure modifies postpartum care. In addition, we also examined juvenile play behavior in both male and female offspring. The choice of the social play paradigm was based on previous findings demonstrating effects of both postpartum care and opioid activity on play behavior. The findings revealed subtle modifications in the maternal behavior of adolescent morphine-exposed females, primarily related to the amount of time females’ spend nursing and in non-nursing contact with their young. In addition, male offspring of adolescent morphine-exposed mothers (MOR-F1) demonstrate decreased rough and tumble play behaviors, with no significant differences in general social behaviors (i.e., social grooming and social exploration). Moreover, there was a tendency toward increased rough and tumble play in MOR-F1 females, demonstrating the sex-specific nature of these effects. Given the importance of the postpartum environment on neurodevelopment, it is possible that modifications in maternal–offspring interactions, related to a history of adolescent opiate exposure, plays a role in the observed transgenerational effects. Overall, these studies indicate that the long-term consequences of adolescent opiate exposure can impact both the female and her future offspring

Infant Serum and Maternal Milk Vitamin B-12 Are Positively Correlated in Kenyan Infant-Mother Dyads at 1-6 Months Postpartum, Irrespective of Infant Feeding Practice.

BackgroundVitamin B-12 is an essential nutrient required for many functions including DNA synthesis, erythropoiesis, and brain development. If maternal milk vitamin B-12 concentrations are low, infants may face elevated risks of deficiency when exclusively breastfed.ObjectiveWe evaluated cross-sectional associations between infant serum vitamin B-12 concentrations and maternal milk vitamin B-12 concentrations at 1-6 mo postpartum among an unsupplemented population in rural western Kenya, and assessed biological demographic, and dietary characteristics associated with adequate infant serum vitamin B-12.MethodsWe modeled 1) infant serum vitamin B-12 using maternal milk vitamin B-12 concentration with linear regression; and 2) adequate (>220 pmol/L) infant serum vitamin B-12 using hypothesized biological, demographic, and dietary predictors with logistic regression. In both models, we used generalized estimating equations to account for correlated observations at the cluster-level.ResultsThe median (quartile 1, quartile 3) infant serum vitamin B-12 concentration was 276 pmol/L (193, 399 pmol/L) and approximately one-third of infants had serum vitamin B-12 ≤220 pmol/L, indicating that they were vitamin B-12 depleted or deficient. There was a positive correlation between maternal milk and infant serum vitamin B-12 (r = 0.36, P < 0.001) and in multivariable analyses, maternal milk vitamin B-12 concentration was significantly associated with infant serum vitamin B-12 adequacy (P-trend = 0.03).ConclusionsDespite a high prevalence (90%) of maternal milk vitamin B-12 concentrations below the level used to establish the Adequate Intake (<310 pmol/L), there was a low prevalence of infant vitamin B-12 deficiency. We found few factors that were associated with infant vitamin B-12 adequacy in this population, including infant feeding practices, although maternal vitamin B-12 status was not measured. The contribution of maternal milk to infant vitamin B-12 status remains important to quantify across populations, given that maternal milk vitamin B-12 concentration is modifiable with supplementation. This trial was registered at clinicaltrials.gov as NCT01704105

A complex speciation-richness relationship in a simple neutral model

Speciation is the "elephant in the room" of community ecology. As the ultimate source of biodiversity, its integration in ecology's theoretical corpus is necessary to understand community assembly. Yet, speciation is often completely ignored or stripped of its spatial dimension. Recent approaches based on network theory have allowed ecologists to effectively model complex landscapes. In this study, we use this framework to model allopatric and parapatric speciation in networks of communities and focus on the relationship between speciation, richness, and the spatial structure of communities. We find a strong opposition between speciation and local richness, with speciation being more common in isolated communities and local richness being higher in more connected communities. Unlike previous models, we also find a transition to a positive relationship between speciation and local richness when dispersal is low and the number of communities is small. Also, we use several measures of centrality to characterize the effect of network structure on diversity. The degree, the simplest measure of centrality, is found to be the best predictor of local richness and speciation, although it loses some of its predictive power as connectivity grows. Our framework shows how a simple neutral model can be combined with network theory to reveal complex relationships between speciation, richness, and the spatial organization of populations.Comment: 9 pages, 5 figures, 1 table, 50 reference

Capacity-building and participatory research development of a community-based Nutrition and Exercise Lifestyle Intervention Program (NELIP) for pregnant and postpartum Aboriginal women: Information gathered from talking circles

Objectives were to gather information from Talking Circles of Aboriginal women who participated in a maternal Nutrition and Exercise Lifestyle Intervention Program (NELIP) to identify strategies to bring NELIP into the community. Twelve First Nations women participated. Several main themes were identified regarding health: balance, knowledge/education and time management. Benefits of the NELIP were improvement in health, stamina, stress, and a healthy baby, no gestational diabetes and a successful home birth, with social support as an important contributing factor for success. Suggestions for improvement for the NELIP included group walking, and incorporating more traditional foods into the meal plan. The information gathered is the first step in determining strategies using participatory research and capacity-building to develop a community-based NELIP for pregnant Aboriginal women

Confronting Environmental Inequality: Assessing and Mitigating Students\u27 Exposure to Near Roadway Air Pollution in Silicon Valley

Near roadway vehicle emissions, such as particulate matter (PM), nitrous oxides, and other contaminants, are major sources of air pollution, which can cause respiratory and cardiovascular illnesses.1 Chronic air and noise pollution exposures can also negatively influence cognitive function and student learning. Of greatest concern are concentrations within 500 feet of high traffic street edges, but concentrations can be harmful at distances up to 1320 ft.2 Vulnerable populations such as children, the elderly, or those with impaired health are likely to suffer the greatest impacts. In 2003, the California legislature passed SB 352, prohibiting building new schools within 500 ft of high traffic roadways. However, SB 352 does not address what action should be taken to reduce the health risks for children at school sites already near high traffic roadways, and the Bill acknowledges that a disproportionate amount of low income students attend such schools. A recent report found that nationwide more than 8000 public schools or about one in every 11 public schools, serving roughly 4.4 million students is located within 500 ft. of a road with more than 30,000 vehicles per day, or at least 10,000 cars and 500 trucks per day. Many more head start and private schools are also exposed.3 An earlier study, found that 13.5% of students attended schools within 820 ft of a major roadway, concluding that minority and underprivileged children were disproportionately affected, although some results varied regionally.4 To better understand pollution patterns, environmental justice issues, and the community responses in Santa Clara County (SCC), we started field research in the Greater Washington Neighborhood of San Jose, CA. We started here because of the proximity of schools to high traffic roadways, and the support that Thriving Neighbors Initiative offered through partnerships with Washington Elementary School (WES) and a network of promotoras that are improving their community and interested in a community-based research

Evaluation of a unique and innovative diabetes care model in primary care in Ontario, Canada: protocol for a multiple-methods study with a convergent parallel design

INTRODUCTION: The growth and complexity of diabetes are exceeding the capacity of family physicians, resulting in the demand for community-based, interprofessional, primary care-led transition clinics. The Primary Care Diabetes Support Programme (PCDSP) in London, Ontario, is an innovative approach to diabetes care for high-risk populations, such as medically or socially complex and unattached patients. In this study, we will employ a quadruple-aim approach to evaluate the health system impacts of the PCDSP. METHODS AND ANALYSIS: We will use multiple methods through a convergent parallel design in this project across five unique studies: a case study, a patient study, a provider study, a complications study and a cost-effectiveness study. The project will be conducted in a dedicated stand-alone clinic specialising in chronic disease management, specifically focusing on diabetes care. Participants will include clinic staff, administrators, family physicians, specialists and patients with type 1 or type 2 diabetes who received care at the clinic between 2011 and 2023. The project design will define the intervention, support replication at other sites or for other chronic diseases and address each of the quadruple aims and equity. Following the execution of the five individual studies, we will build a business case by integrating the results. Data will be analysed using both qualitative (content analysis and thematic analysis) and quantitative techniques (descriptive statistics and multiple logistic regression). ETHICS AND DISSEMINATION: We received approval from the research ethics boards at Western University (reference ID: 2023-1 21 766; 2023-1 22 326) and Lawson Health Research Institute (reference ID: R-23-202). A privacy review was completed by St. Joseph\u27s Healthcare Corporation. The findings will be shared among PCDSP staff and patients, stakeholders, academic researchers and the public through stakeholder sessions, conferences, peer-reviewed publications, infographics, posters, media interviews, social media and online discussions. For the patient and provider study, all participants will be asked to provide consent and are free to withdraw from the study, without penalty, until the data are combined. Participants will not be identified in any report or presentation except in the case study, for which, given the number of PCDSP providers, we will seek explicit consent to identify them