Continuum of Care Following Sports-Related Concussion

2020 ◽  
Vol 29 (3) ◽  
pp. 1389-1403
Author(s):  
Jessica Brown ◽  
Kelly Knollman-Porter

Purpose Although guidelines have changed regarding federally mandated concussion practices since their inception, little is known regarding the implementation of such guidelines and the resultant continuum of care for youth athletes participating in recreational or organized sports who incur concussions. Furthermore, data regarding the role of speech-language pathologists in the historic postconcussion care are lacking. Therefore, the purpose of this retrospective study was to investigate the experiences of young adults with history of sports-related concussion as it related to injury reporting and received follow-up care. Method Participants included 13 young adults with history of at least one sports-related concussion across their life span. We implemented a mixed-methods design to collect both quantitative and qualitative information through structured interviews. Participants reported experiencing 42 concussions across the life span—26 subsequent to sports injuries. Results Twenty-three concussions were reported to a parent or medical professional, 14 resulted in a formal diagnosis, and participants received initial medical care for only 10 of the incidents and treatment or services on only two occasions. Participants reported concussions to an athletic trainer least frequently and to parents most frequently. Participants commented that previous experience with concussion reduced the need for seeking treatment or that they were unaware treatments or supports existed postconcussion. Only one concussion incident resulted in the care from a speech-language pathologist. Conclusion The results of the study reported herein shed light on the fidelity of sports-related concussion care management across time. Subsequently, we suggest guidelines related to continuum of care from injury to individualized therapy.

Crisis ◽  
2016 ◽  
Vol 37 (4) ◽  
pp. 265-270 ◽  
Author(s):  
Meshan Lehmann ◽  
Matthew R. Hilimire ◽  
Lawrence H. Yang ◽  
Bruce G. Link ◽  
Jordan E. DeVylder

Abstract. Background: Self-esteem is a major contributor to risk for repeated suicide attempts. Prior research has shown that awareness of stigma is associated with reduced self-esteem among people with mental illness. No prior studies have examined the association between self-esteem and stereotype awareness among individuals with past suicide attempts. Aims: To understand the relationship between stereotype awareness and self-esteem among young adults who have and have not attempted suicide. Method: Computerized surveys were administered to college students (N = 637). Linear regression analyses were used to test associations between self-esteem and stereotype awareness, attempt history, and their interaction. Results: There was a significant stereotype awareness by attempt interaction (β = –.74, p = .006) in the regression analysis. The interaction was explained by a stronger negative association between stereotype awareness and self-esteem among individuals with past suicide attempts (β = –.50, p = .013) compared with those without attempts (β = –.09, p = .037). Conclusion: Stigma is associated with lower self-esteem within this high-functioning sample of young adults with histories of suicide attempts. Alleviating the impact of stigma at the individual (clinical) or community (public health) levels may improve self-esteem among this high-risk population, which could potentially influence subsequent suicide risk.


Author(s):  
Kristen Simonds ◽  
Lucy Yixuan Zhang ◽  
June I. Matthews

Purpose: This descriptive qualitative study explored young males’ perceptions of food skills in 3 domains: food selection and planning, food preparation, and food safety and storage. Methods: Semi-structured interviews were audio-recorded and transcribed verbatim. Data were analyzed using the constant comparative method. Results: Forty-four young men (aged 17–35) reported varying levels of food skills, from little/no confidence to very confident and skilled. Most participants learned food skills from their mothers. Greater involvement in food selection and planning at a young age appeared to be related to parental influence and encouragement, exposure to food skills at school, and interest in food-related activities, which, in turn, provided a solid foundation for being confident cooks as young adults. Most notable was the lack of knowledge about, or confidence in, food safety and storage. Young men with low self-perceived food skills were deeply embarrassed about this deficiency in front of peers who had higher levels of confidence and skills. Conclusions: Future interventions or curricula should emphasize food safety and storage. This research also illustrates the importance of the home environment in teaching food skills to youth and ensuring that food skills are taught well before young adults begin living independently.


Author(s):  
Garima Sharma

This article explores the transition of youth from childcare institutions as young adults through the lens of youth identity and gender. The research revolves around rethinking the delicate boundaries of adolescence and adulthood for the ‘institutionalised’ youth that is already on the edge of the society. This research tries to understand and decode the experiences of youth, who have lived in the childcare institutions. The childcare institutions reinforce the gender roles through its practices and structure, enabling gaps and challenges for both male and female youth outside the childcare institutions. There is an absence of a strong mechanism, enabling the smooth transition of youth from childcare institutions to adulthood. This results in unprepared young adults for an unplanned transition, fostering several challenges on them as they exit the childcare system. This is a qualitative study. The research includes both male and female youth who have lived in childcare institutions situated in Delhi. The data was collected using semi-structured interviews with the youth. This study finds that youth leaving the childcare institutions are at higher risks of having negative adult outcomes in life. While there is an absolute absence of any body or mechanism to help the youth transit smoothly, childcare institutions reinforce the inferiority and exclusion on a child during the stay period, creating a foundation for youth to perceive the social factor outside the institutions.


2021 ◽  
pp. 136078042110250
Author(s):  
Julie Schweitzer ◽  
Tamara L Mix

Employing the example of France’s civil nuclear program, we connect political opportunity structures (POSs) to mechanisms of knowledge production, identifying how opposing stakeholders generate knowledge about a controversial technology. A history of nuclear dependence in France creates a context that praises, normalizes, and rationalizes nuclear energy while stigmatizing attempts to question or contest the nuclear industry’s dominant position. Integrating Bond’s knowledge-shaping process with Coy and colleagues’ concept of oppositional knowledge, we consider how the broader social, political, and economic context influences opposing stakeholder assessments of nuclear energy. Employing qualitative semi-structured interviews, we offer unique insight into the French nuclear debate, discussing the role of POS in shaping knowledge production.


2021 ◽  
pp. 154041532110117
Author(s):  
Cheryl A. Smith-Miller ◽  
Diane C. Berry ◽  
Cass T. Miller

Introduction: Evidence suggests that gender may influence many aspects of type 2 diabetes (T2DM) self-management (SM) and we posit that limited English language–proficient Latinx immigrants face additional challenges. Methods: Instruments and semi-structured interviews were used to examine gender differences on health literacy, diabetes knowledge, health-promoting behaviors, diabetes, eating and exercise self-efficacy (SE), and T2DM SM practices among a cohort of limited English language–proficient Latinx immigrants. Statistical and qualitative analysis procedures were performed comparing males and females. Results: Thirty persons participated. Males tended to be older, have higher educational achievement, and more financial security than females. Physiologic measures tended worse among female participants. Health literacy and exercise SE scores were similar, but females scored lower on Eating and Diabetes SE. Forty-seven percent ( n= 9) of the women reported a history of gestational diabetes mellitus and a majority of men ( n = 7) cited difficulty with excessive alcohol. Consumption: Males appeared to receive more SM support compared to females. Females more frequently noted how family obligations and a lack of support impeded their SM. Work environments negatively influenced SM practices. Conclusion: Men and women have unique SM challenges and as such require individualized strategies and support to improve T2DM management.


2021 ◽  
Vol 14 (2) ◽  
pp. 1-36
Author(s):  
Theja K. Arachchi ◽  
Laurianne Sitbon ◽  
Jinglan Zhang ◽  
Ruwan Gamage ◽  
Priyantha Hewagamage

This article presents how young adults with intellectual disability (ID) from Sri Lanka, who had not previously used the Internet, interacted with Google search while enhancing their web search abilities throughout three web search workshops. Considering the little attention paid to the learning needs of people with ID in the current offering of web search learning tools, we iteratively developed a suite of learning tools to support our participants when they need help in the web search workshops. We employed an iterative participatory approach, with observations and semi-structured interviews, to reflect on how to design eLearning tools that enhance the participants’ interactions with web search. The qualitative thematic analysis resulted in five distinct themes on strategies to support, build on, and develop the abilities of young adults with IDs as they engage with Google search in their native language: application of existing abilities, basic skills to match learning needs, conceptual understanding, animations to facilitate visual memory, and promoting active engagement. These themes will be a starting point for understanding participants’ learning needs and behavior on web search, which would be important for future research on learning support as well as on software design.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elizabeth Sutton ◽  
Julian Bion ◽  
Russell Mannion ◽  
Janet Willars ◽  
Elizabeth Shaw ◽  
...  

Abstract Background National standards are commonly used as an improvement strategy in healthcare, but organisations may respond in diverse and sometimes negative ways to external quality demands. This paper describes how a sample of NHS hospital trusts in England responded to the introduction of national standards for 7-day services (7DS), from an organisational behaviour perspective. Methods We conducted 43 semi-structured interviews with executive/director level and clinical staff, in eight NHS trusts that varied in size, location, and levels of specialist staffing at weekends. We explored approaches to implementing standards locally, and the impact of organisational culture and local context on organisational response. Results Senior staff in the majority of trusts described a focus on hitting targets and achieving compliance with the standards. Compliance-based responses were associated with a hierarchical organisational culture and focus on external performance. In a minority of trusts senior staff described mobilising commitment-based strategies. In these trusts senior staff reframed the external standards in terms of organisational values, and used co-operative strategies for achieving change. Trusts that took a commitment-based approach tended to be described as having a developmental organisational culture and a history of higher performance across the board. Audit data on 7DS showed improvement against standards for most trusts, but commitment-focused trusts were less likely to demonstrate improvements on the 7DS audit. The ability of trusts to respond to external standards was limited when they were under pressure due to a history of overall poor performance or resource limitations. Conclusions National standards and audit for service-level improvement generate different types of response in different local settings. Approaches to driving improvement nationally need to be accompanied by resources and tailored support for improvement, taking into account local context and organisational culture.


2013 ◽  
Vol 28 (8) ◽  
pp. 463-468 ◽  
Author(s):  
J.M. Azorin ◽  
A. Kaladjian ◽  
M. Adida ◽  
E. Fakra ◽  
R. Belzeaux ◽  
...  

AbstractObjectiveTo analyze the interface between borderline personality disorder (BPD) and bipolarity in depressed patients comorbid with BPD.MethodsAs part of National Multi-site Study of 493 consecutive DSM-IV major depressive patients evaluated in at least two semi-structured interviews 1 month apart, 19 (3.9%) had comorbid BPD (BPD+), whereas 474 (96.1%) did not manifest this comorbidity (BPD−).ResultsCompared to BPD (−), BPD (+) patients displayed higher rates of bipolar (BP) disorders and temperaments, an earlier age at onset with a family history of affective illness, more comorbidity, more stressors before the first episode which was more often depressive or mixed, as well as a greater number and severity of affective episodes.ConclusionsThe hypothesis which fitted at best our findings was to consider BPD as a contributory factor in the development of BP disorder, which could have favoured the progression from unipolar major depression to BP disorder. We could not however exclude that some features of BP disorder may have contributed to the development of BPD.


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