Combined Use of Vestibular and Aerobic Exercise to Treat a Patient with Post-Concussion Syndrome Following a Mild Traumatic Brain injury: A Case Report

Background: Prolonged Concussive symptoms following an acute injury, known as Post-Concussion Syndrome (PCS) are beginning to be discussed in literature. There has been recent evidence produced on the benefits of aerobic exercise and vestibular rehabilitation to assess and manage this unique patient population. Purpose: The purpose of this case study is to describe a protracted recovery of a patient experiencing PCS and provide specific assessment tools as well as interventions to help guide rehabilitation strategies following a concussion. Case Description: A 33-year-old female arrived at physical therapy 3-weeks after experiencing a mild traumatic brain injury (mTBI), following a motor vehicle accident (MVA). She was experiencing constant headaches, dizziness, nausea, right-sided neck pain, difficulty sleeping, decreased concentration, fatigue, increased irritability and frustration, and decreased function in daily responsibilities. Interventions: The patient received 22 sessions of physical therapy over a 12-week period, while also receiving psychological services. The interventions included functional strengthening, manual therapy, sub-symptom aerobic exercise, vestibular and oculomotor training, balance interventions, and work simulated tasks. Outcomes: The patient was evaluated using the Vestibular/ Ocular Motor Screening (VOMS) assessment tool. The patient improved from symptomatic with all items of the VOMS to mild headache symptoms with 3 items of the assessment. In addition, on initial evaluation the patient reported 7 on a 0-10 cm on a visual analog scale (VAS) for neck pain, which was reduced to 0/10. The patient returned to previous level of employment following physical therapy rehabilitation demonstrating improvement in overall function. Discussion: Through the physical therapy plan of care the patient demonstrated improvements with reduced frequency and severity of headaches with accompanying dizziness, increased tolerance to activity, and decreased neck pain, and improved concentration. This case study provides an example of a positive outcome following outpatient physical therapy for a patient with prolonged PCS, with full return to work and pre-injury activity

COMMENT: IS OUT-OF-STATE TUITION UNCONSTITUTIONAL AND COULD REMOVING IT EASE THE UNITED STATES’ STUDENT DEBT CRISIS?

This article argues that for the good of the nation the discriminatory practice of charging out-of-state tuition should be ceased and that under the Privileges and Immunities Clause, as well as the Fourteenth Amendment, this practice has violated the law for decades

Health and Safety Receivership: California\u27s Cure for Zombie Foreclosures, Vacant, and Other Nuisance Properties

Almost every city or county has abandoned, fire damaged, vacant or other nuisance properties. The majority these properties sit abandoned and blight communities for years with no solution in sight. However, California has solution for these longstanding nuisance properties known as Health and Safety “H & S” receiverships. The statutory authority for H &S receiverships is found at California Health and Safety Code (“HSC”) §§ 17980.6 and 17980.7. Abandoned, vacant and other nuisance properties surface in a variety of ways. However, a few of the most common occurrences are:Deceased property owners without heirs; Zombie foreclosures; Hoarders and other mental health conditions; Slumlords that allow dangerous conditions at their property; Owners that file bankruptcy and abandon their property; Abandoned and/or vacant properties.HSC section 17980.7 allows a city to nominate a court receiver over a dangerous property. The Receiver is an agent of the court that is authorized to borrow funds to rehabilitate and sell the property. (California Code of Civil Procedure (“CCP”) section 568.5; see also (Santa Monica v. Gonzalez (2008) 43 Cal. 4th 905, 930)Abating a vacant, abandoned or other type of nuisance property cures bighted neighborhoods. Furthermore, the process costs the city nothing. In fact, the city recovers attorney’s fees and costs it incurred in the receivership action. (HSC 17980.7(c)(11) & (d)(1); see also (City and County of San Francisco v. Jen (2005) 135 Cal. App. 4th 305, 310-311). In summary, California’s health and safety receivership process improves blighted neighborhoods and actually generates revenue for cities. Implementing a receivership program is a major undertaking, but the benefits are substantial.This article will explain the following:How nuisance properties arise; How cities typically deal with nuisance properties; How receivership can help cities; How receivership in California; How cities throughout California have practically implemented receivership programs

Cannabis Receiverships: The Alternative for State Legal Cannabis businesses Seeking Financial Rehabilitation Locked Out of Bankruptcy Court by the Controlled Substances Act

This article explores how cannabis businesses suffer by being unable to utilize federal bankruptcy and explore state law receiverships as an alternative remedy to help cannabis businesses weather financial storms. Part I explores the limitations and differences between a receivership and a bankruptcy. Part II discusses how state legal cannabis companies cannot seek financial rehabilitation in bankruptcy court due to cannabis being listed as a schedule I drug federally. Part III explores how receivership be used to help cannabis companies that cannot seek bankruptcy protection to financially rehabilitate themselves. Part IV details how a receiver can help a cannabis company that cannot access bankruptcy court financially rehabilitate itself and how a receiver is appointed. Lastly, Part V concludes by discussing how cannabis companies often fail unnecessarily due to lack of bankruptcy protection, which harms economies and prevents the collection of tax revenue

A Breath of Fresh Air: A Constitutional Amendment Legalizing Marijuana Through an Article V Convention of the States

Criminal enforcement of anti-marijuana laws by the United States federal government has been non-sensical for more than twenty years. Culminating, ultimately, in an anomaly within American jurisprudence when California legalized marijuana in 1996 in direct violation of federal law, yet the federal government did little to stop it. Since then, a majority of states have followed California and legalized marijuana. Currently, thirty-six states and the District of Columbia have legalized medical marijuana despite federal law. Every year billions of dollars are spent on the federal enforcement of anti-marijuana laws while states collect billions in tax revenue from marijuana sales. Even more confusing is the fact that both President Obama and President Trump have issued federal directives loosening federal enforcement of laws criminalizing marijuana. Despite all this, marijuana maintains the status of a Schedule I substance, and the violation of federal marijuana law can, technically, result in a death sentence. The federal government has blundered numerous times on the issue of marijuana. These blunders have cost the country billions of dollars and ruined numerous lives through the unnecessary prosecution of marijuana offenders. This Article argues that because the states are capable of regulating marijuana, they should band together under the authority granted to them by Article V of the United States Constitution. That article provides an avenue to amend the constitution. If thirty-four states apply for an Article V Convention of the States, the federal government must convene one. An Article V Convention has never been held but has often been discussed. Considering a majority of the states and the District of Columbia have already legalized marijuana to some degree, and the federal government is undecided on marijuana enforcement, conditions are perfect for calling an Article V Convention of the States to ratify a Constitutional Amendment ending the archaic federal treatment of marijuana in this country

Intersection Information based on Common Randomness

The introduction of the partial information decomposition generated a flurry of proposals for defining an intersection information that quantifies how much of "the same information" two or more random variables specify about a target random variable. As of yet, none is wholly satisfactory. A palatable measure of intersection information would provide a principled way to quantify slippery concepts, such as synergy. Here, we introduce an intersection information measure based on the G\'acs-K\"orner common random variable that is the first to satisfy the coveted target monotonicity property. Our measure is imperfect, too, and we suggest directions for improvement.Comment: 19 pages, 5 figure

Care, control and the electroconvulsive therapy (ECT) ritual: Making sense of polarised patient narratives

Despite evidence of short-term effectiveness of ECT (electroconvulsive therapy), both positive and negative patient reports are common. However, research examining these polarized accounts has not adequately elucidated why such divergences occur. We thus sought to examine opposing patient narratives to better understand underlying meanings. Eighteen interviews were conducted with UK-based people who had experienced the treatment. Our analysis revealed that the quality of relations with staff, ECT artefacts (e.g. the ECT suite), and perceived outcomes all play a role in divergent accounts. Positive reflections on ECT emerged alongside narratives of trust in staff, comfort with ECT, and perception of sufficient personal control. Conversely, where negative evaluations of ECT predominated, there was anger associated with a lack of control, and a belief that ECT made little sense, and was linked to past abuses and/or the unacceptability of side effects. We discuss the implications of our findings for professionals

Updating the Bridge Construction Cost Database

Adopting a comprehensive suite of methods to track, analyze, and maintain data on bridge construction costs can help state transportation agencies identify and implement strategies to mitigate the influence of factors which escalate project costs. This report discusses how the Kentucky Transportation Cabinet (KYTC) should approach updating, maintaining, and analyzing its bridge construction cost data. Based on a review of practices introduced at other agencies and interviews with public and private industry stakeholders, the report catalogues practical strategies for improving estimating procedures and tracking cost data as well as the most important cost drivers of bridge construction. Analysis of KYTC data on average unit bid prices for eight key bid items on bridge projects found that prices went up for every item between 2015 and 2021. Steel reinforcement and epoxy coated steel reinforcement displayed the most consistent linear upward trend, while greater variability was noticeable in prices for Class A and AA concrete and foundation preparation. This analysis substantiated observations by interviewees that contractors submit higher bid prices when they perceive greater risk associated with a work item. Recommendations for process improvements at the Cabinet focus on agencywide rollout of AASHTOWare Estimation, conducting post-construction reviews, establishing contract durations that reasonably accommodate the completion of all work, and performing more in-depth geotechnical investigations

Comovement in the Cryptocurrency Market

This study examines the comovement between 17 of the most active cryptocurrencies. We are unable to statistically reject the presence of perfect comovement between Bitcoin and six of the 16 non-Bitcoin cryptocurrencies. Consistent with the friction-based explanation for the presence of comovement, once the CBOE introduced futures contracts on Bitcoin, we find that all 16 cryptocurrencies comove with Bitcoin. These results suggest that introducing futures contracts improves the informational environment of the entire cryptocurrency market, which helps explain the unusual comovement in the cryptocurrency market