scholarly journals The Effect of Pretest Exercise on Baseline Computerized Neurocognitive Test Scores

2017 ◽  
Vol 5 (10) ◽  
pp. 232596711773449 ◽  
Author(s):  
Alec Pawlukiewicz ◽  
Aaron M. Yengo-Kahn ◽  
Gary Solomon
Keyword(s):  
Decision Making ◽  
Test Scores ◽  
Adolescent And Young Adult ◽  
Return To Play ◽  
Strenuous Exercise ◽  
History Of ◽  
Baseline Testing ◽  
Baseline Test ◽  
Composite Scores ◽  
The Impact

Background: Baseline neurocognitive assessment plays a critical role in return-to-play decision making following sport-related concussions. Prior studies have assessed the effect of a variety of modifying factors on neurocognitive baseline test scores. However, relatively little investigation has been conducted regarding the effect of pretest exercise on baseline testing. Purpose/Hypothesis: The aim of our investigation was to determine the effect of pretest exercise on baseline Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) scores in adolescent and young adult athletes. We hypothesized that athletes undergoing self-reported strenuous exercise within 3 hours of baseline testing would perform more poorly on neurocognitive metrics and would report a greater number of symptoms than those who had not completed such exercise. Study Design: Cross-sectional study; Level of evidence, 3. Methods: The ImPACT records of 18,245 adolescent and young adult athletes were retrospectively analyzed. After application of inclusion and exclusion criteria, participants were dichotomized into groups based on a positive (n = 664) or negative (n = 6609) self-reported history of strenuous exercise within 3 hours of the baseline test. Participants with a positive history of exercise were then randomly matched, based on age, sex, education level, concussion history, and hours of sleep prior to testing, on a 1:2 basis with individuals who had reported no pretest exercise. The baseline ImPACT composite scores of the 2 groups were then compared. Results: Significant differences were observed for the ImPACT composite scores of verbal memory, visual memory, reaction time, and impulse control as well as for the total symptom score. No significant between-group difference was detected for the visual motor composite score. Furthermore, pretest exercise was associated with a significant increase in the overall frequency of invalid test results. Conclusion: Our results suggest a statistically significant difference in ImPACT composite scores between individuals who report strenuous exercise prior to baseline testing compared with those who do not. Since return-to-play decision making often involves documentation of return to neurocognitive baseline, the baseline test scores must be valid and accurate. As a result, we recommend standardization of baseline testing such that no strenuous exercise takes place 3 hours prior to test administration.

scholarly journals Unwanted Conflict? The Analysis of the Impact of Misperception, Beliefs and Psychology of President Nasser at the Outbreak of the Six Day War

2019 ◽  
Vol 01 (02) ◽  
pp. 1950003
Author(s):  
Janko Šćepanović
Keyword(s):  
Decision Making ◽  
Decision Makers ◽  
Structural Explanation ◽  
Defining Moments ◽  
The Us ◽  
History Of ◽  
The Subject ◽  
Six Day War ◽  
The Impact

The Six Day War was one of the most defining moments in the history of the Modern Middle East. This paper seeks to add to the existing scholarship on the subject by going beyond the structural explanation. It gives special attention to the role of unit-level variables like perception, personality, and political psychology of decision-makers. As one scholar noted, threats are not perceived in a vacuum, and are, instead, products of complex synthesis of subjective appraisal of events by the decision-makers. The focus will be on the beliefs and perceptions of the most impactful actor in this crisis: Egyptian President Nasser. As will be argued, his decision-making was shaped by his experience with foreign imperialism, a general misconception of super power intentions, an incorrect analogy between two crucial crisis situations with Israel: the February 1960 Rotem Crisis, and the build-up to the June War in 1967, and especially his complicated relations with the US leaders.

scholarly journals Preseason Baseline Neurocognitive Performances and Symptom Reporting on ImPACT®: A Comparison of Adolescent Student-Athletes Tested in Spanish and English

2020 ◽  
Author(s):  
Justin E. Karr ◽  
Mauricio A. Garcia-Barrera ◽  
Jacqueline M. Marsh ◽  
Bruce Maxwell ◽  
Paul D. Berkner ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Student Athletes ◽  
Symptom Reporting ◽  
Group Differences ◽  
Language Group ◽  
Motor Speed ◽  
Language Groups ◽  
Baseline Testing ◽  
Composite Scores ◽  
The Impact

Abstract Context: Student-athletes are commonly administered the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT®) battery at preseason baseline and post concussion. The ImPACT® is available in many different languages, but few studies have examined differences in cognitive performances and symptom ratings based on language of administration. Objective: This study examined differences on ImPACT® neurocognitive composites and symptom reporting at preseason baseline testing between student-athletes completing ImPACT® in Spanish versus English. Design: Cross-sectional study. Setting: Preseason baseline testing for a high school concussion management program in STATE-XXX. Patients of Other Participants: Adolescent student-athletes completing testing in Spanish (n=169) and English (n=169) were matched on age, gender, and health/academic history. Language groups were compared on each outcome for the full sample and for gender-stratified subsamples. Main Outcome Measure(s): Neurocognitive composite scores and individual and total symptom severity ratings from the ImPACT® battery. Results: Athletes tested in Spanish had lower neurocognitive performances on two of five composite scores (i.e., Visual Motor Speed, p<.001, d=.51; Reaction Time: p=.004, d=.33) and reported greater symptom severity (p<.001, r=.21). When analyses were stratified by gender, similar Visual Motor Speed differences were observed between language groups among boys (p=.001, d=.49) and girls (p=.001, d=0.49), whereas Reaction Time showed a larger group difference for boys (p=.012, d=.42) than girls (p=.128, d=.21). Language group differences in symptom reporting were similar for boys (p=.003, r=.22) and girls (p=.008, r=.21), with more frequent endorsement of physical and affective symptoms by athletes tested in Spanish. Conclusions: Language group differences in total symptom severity were small (r=.21), and language group differences in neurocognitive performances were small-to-medium (d=.05–.51). Compared to previous studies comparing athletes tested in Spanish and English on ImPACT®, smaller effects were observed in the current study, which may be attributable to close matching on variables related to neurocognitive performances and symptom reporting. Key points:

scholarly journals Association of visual acuity with educational outcomes: a prospective cohort study

2019 ◽  
Vol 103 (11) ◽  
pp. 1666-1671 ◽  
Author(s):  
Catherine Jan ◽  
Shi-Ming Li ◽  
Meng-Tian Kang ◽  
Luoru Liu ◽  
He Li ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Academic Performance ◽  
Refractive Error ◽  
Test Scores ◽  
Test Score ◽  
Parental Education ◽  
Ninth Grade ◽  
Baseline Test ◽  
Prospective Longitudinal ◽  
The Impact

Background/aimTo quantify the impact of baseline presenting visual acuity (VA), refractive error and spectacles wear on subsequent academic performance among Chinese middle school children.MethodsA prospective, longitudinal, school-based study on grade 7 Chinese children (age, mean±SD, 12.7±0.5 years, range=11.1–15.9) at four randomly selected middle schools in Anyang, China. Comprehensive eye examinations including cycloplegic autorefraction were performed at baseline, and information on demographic characteristics, known risk factors for myopia and spectacle wear was collected. Academic test scores for all subjects in the curriculum were obtained from the local Bureau of Education. Main outcome measure was total test scores for five subjects at the end of grade 9, adjusted for total scored at the beginning of grade 7.ResultsAmong 2363 eligible children, 73.1% (1728/2363) had seventh grade test scores available. 93.9% (1623/1728) completed eye examinations, and 98.5% (1599/1623) of these had ninth grade test scores. Adjusting only for baseline test score, the following were significantly associated with higher ninth grade scores: younger age, male sex, less time outdoors, better baseline presenting VA, higher parental education and income and parental myopia, but refractive error and spectacle wear were not. In the full multivariate model, baseline test score (p<0.001), presenting VA (p<0.01), age (p<0.001), quality of life (p<0.05) and parental education (p<0.001) and myopia (either: p<0.05; both: p<0.05) remained significantly associated with better ninth grade scores.ConclusionsIn this longitudinal study, better presenting VA, but not cycloplegic refractive error or spectacle wear, was significantly associated with subsequent academic performance.

Preseason Symptom Reporting and Cognition in Middle School Athletes with Past Concussions

2022 ◽  
Author(s):  
Grant L. Iverson ◽  
Paul D. Berkner ◽  
Ross Zafonte ◽  
Bruce Maxwell ◽  
Douglas P. Terry
Keyword(s):  
Visual Memory ◽  
Cognitive Testing ◽  
Symptom Reporting ◽  
Symptom Scale ◽  
Health History ◽  
School Sports ◽  
History Of ◽  
Concussion History ◽  
Composite Scores ◽  
The Impact

AbstractThis study examined the association between past concussions and current preseason symptom reporting and cognitive performance in 9,257 youth ages 11–13. Participants completed neurocognitive testing prior to participating in a school sports between 2009 and 2019. We stratified the sample by gender and number of prior concussions and assessed group differences on the Post-Concussion Symptom Scale total score and the ImPACT cognitive composite scores. Those with≥2 prior concussions reported more symptoms than those with 0 concussions (d=0.43–0.46). Multiple regressions examining the contribution of concussion history and developmental/health history to symptom reporting showed the most significant predictors of symptoms scores were (in descending order): treatment for a psychiatric condition, treatment for headaches, history of learning disability (in boys only), history of attention-deficit/hyperactivity disorder, and age. Concussion history was the weakest statistically significant predictor in boys and not significant in girls. Cognitively, boys with 1 prior concussion had worse speed those with 0 concussions (d=0.11), and girls with≥2 prior concussions had worse verbal/visual memory than girls with 0 concussions (ds=0.38–0.39). In summary, youth with≥2 prior concussions reported more symptoms than those with no concussions. Boys with multiple concussions performed similarly on cognitive testing, while girls had worse memory scores.

scholarly journals Supervision and Computerized Neurocognitive Baseline Test Performance in High School Athletes: An Initial Investigation

2014 ◽  
Vol 49 (6) ◽  
pp. 800-805 ◽  
Author(s):  
Andrew Warren Kuhn ◽  
Gary S. Solomon
Keyword(s):  
High School ◽  
Confidence Interval ◽  
Test Performance ◽  
Sports Medicine ◽  
High School Athletes ◽  
Motor Processing ◽  
Baseline Testing ◽  
Baseline Test ◽  
Composite Scores ◽  
Visual Motor Processing

Context:Computerized neuropsychological testing batteries have provided a time-efficient and cost-efficient way to assess and manage the neurocognitive aspects of patients with sport-related concussion. These tests are straightforward and mostly self-guided, reducing the degree of clinician involvement required by traditional clinical neuropsychological paper-and-pencil tests.Objective:To determine if self-reported supervision status affected computerized neurocognitive baseline test performance in high school athletes.Design:Retrospective cohort study.Settings:Supervised testing took place in high school computer libraries or sports medicine clinics. Unsupervised testing took place at the participant's home or another location with computer access.Patients or Other Participants:From 2007 to 2012, high school athletes across middle Tennessee (n = 3771) completed computerized neurocognitive baseline testing (Immediate Post-Concussion Assessment and Cognitive Testing [ImPACT]). They reported taking the test either supervised by a sports medicine professional or unsupervised. These athletes (n = 2140) were subjected to inclusion and exclusion criteria and then matched based on age, sex, and number of prior concussions.Main Outcome Measure(s):We extracted demographic and performance-based data from each de-identified baseline testing record. Paired t tests were performed between the self-reported supervised and unsupervised groups, comparing the following ImPACT baseline composite scores: verbal memory, visual memory, visual motor (processing) speed, reaction time, impulse control, and total symptom score. For differences that reached P &lt; .05, the Cohen d was calculated to measure the effect size. Lastly, a χ2 analysis was conducted to compare the rate of invalid baseline testing between the groups. All statistical tests were performed at the 95% confidence interval level.Results:Self-reported supervised athletes demonstrated better visual motor (processing) speed (P = .004; 95% confidence interval [0.28, 1.52]; d = 0.12) and faster reaction time (P &lt; .001; 95% confidence interval [−0.026, −0.014]; d = 0.21) composite scores than self-reported unsupervised athletes.Conclusions:Speed-based tasks were most affected by self-reported supervision status, although the effect sizes were relatively small. These data lend credence to the hypothesis that supervision status may be a factor in the evaluation of ImPACT baseline test scores.

scholarly journals Neuroimaging findings in pediatric sports-related concussion

2015 ◽  
Vol 16 (3) ◽  
pp. 241-247 ◽  
Author(s):  
Michael J. Ellis ◽  
Jeff Leiter ◽  
Thomas Hall ◽  
Patrick J. McDonald ◽  
Scott Sawyer ◽  
...  
Keyword(s):  
Decision Making ◽  
Arachnoid Cyst ◽  
Clinical Decision Making ◽  
Demyelinating Disease ◽  
Skull Fracture ◽  
Clinical Decision ◽  
Return To Play ◽  
Mri Findings ◽  
Imaging Results ◽  
The Impact

OBJECT The goal in this review was to summarize the results of clinical neuroimaging studies performed in patients with sports-related concussion (SRC) who were referred to a multidisciplinar ypediatric concussion program. METHODS The authors conducted a retrospective review of medical records and neuroimaging findings for all patients referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Inclusion criteria were as follows: 1) age ≤ 19 years; and 2) physician-diagnosed SRC. All patients underwent evaluation and follow-up by the same neurosurgeon. The 2 outcomes examined in this review were the frequency of neuroimaging studies performed in this population (including CT and MRI) and the findings of those studies. Clinical indications for neuroimaging and the impact of neuroimaging findings on clinical decision making were summarized where available. This investigation was approved by the local institutional ethics review board. RESULTS A total of 151 patients (mean age 14 years, 59% female) were included this study. Overall, 36 patients (24%) underwent neuroimaging studies, the results of which were normal in 78% of cases. Sixteen percent of patients underwent CT imaging; results were normal in 79% of cases. Abnormal CT findings included the following: arachnoid cyst (1 patient), skull fracture (2 patients), suspected intracranial hemorrhage (1 patient), and suspected hemorrhage into an arachnoid cyst (1 patient). Eleven percent of patients underwent MRI; results were normal in 75% of cases. Abnormal MRI findings included the following: intraparenchymal hemorrhage and sylvian fissure arachnoid cyst (1 patient); nonhemorrhagic contusion (1 patient); demyelinating disease (1 patient); and posterior fossa arachnoid cyst, cerebellar volume loss, and nonspecific white matter changes (1 patient). CONCLUSIONS Results of clinical neuroimaging studies are normal in the majority of pediatric patients with SRC. However, in selected cases neuroimaging can provide information that impacts decision making about return to play and retirement from the sport.

scholarly journals Scar Resurfacing

2020 ◽  
pp. 311-316
Author(s):  
Fiona M. Wood
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Healing Process ◽  
Clinical Decision ◽  
Skin Surface ◽  
History Of ◽  
Secondary Healing ◽  
The Impact ◽  
Selection Of

AbstractScar resurfacing is focused on the improvement in the quality of a scar by disruption of the skin surface and reducing the bulk of the scar by control of the secondary healing process. The prerequisite is knowledge of the wound healing and scarring process such that the intervention can be designed to reduce the risk of increasing the scarring.The clinical examination and assessment of the scar will guide the selection of the technique addressing the specific aspects of the scar, such as the pigment restoration and volume reduction, with the aim of blending the scar with the surrounding uninjured skin.Understanding the natural history of the scar, the impact it has on the patient, and the techniques available for improvement provides the clinical decision-making matrix to drive an improved scar outcome. Resurfacing is one opportunity for scar modulation which needs to be taken into context relative to the range of conservative and surgical therapeutic opportunities explored within the chapters of the book.

Dynamics of social practices of migration during the pandemic of the example of Republic of Armenia

2022 ◽  
pp. 63-72
Author(s):  
E. М. Hayrapetyan
Keyword(s):  
Decision Making ◽  
Empirical Research ◽  
Professional Growth ◽  
Growth And Development ◽  
Statistical Data ◽  
Social Practices ◽  
Adaptation Strategies ◽  
History Of ◽  
The Impact ◽  
Rich History

Historically rich history of Armenian migration was supplemented in 2020-2021 by new social practices, including the return of migrants to their homeland during the restrictions in the first half of 2020, and new practices of quick decision-making on emigration in the fall and winter of 2020-2021. In this article, the impact of the pandemic and the development of adaptation strategies of reactive (forced), active (making a choice from the available options) and proactive (planning the prospects for self-realization, career and professional growth and development) types. These practices are considered based on the analysis of statistical data and on the basis of our own empirical research by the method of focused interviews among Armenian families.

Abstract P232: Influence of Individualized Risk Prediction and Patient Preferences on Selection of Prasugrel Versus Clopidogrel at the Time of Percutaneous Coronary Intervention for an Acute Coronary Syndrome

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Adam C Salisbury ◽  
Kaijun Wang ◽  
David J Cohen ◽  
Yan Li ◽  
John A Spertus
Keyword(s):  
Decision Making ◽  
Acute Coronary Syndrome ◽  
Bleeding Risk ◽  
Patient Characteristics ◽  
Coronary Intervention ◽  
Bleeding Events ◽  
Coronary Syndrome ◽  
Alternative Outcome ◽  
History Of ◽  
The Impact

Introduction: Given the need to weigh prevention of ischemia against bleeding risk with prasugrel vs. clopidogrel at the time of PCI for an acute coronary syndrome (ACS), we developed risk models for both outcomes from TRITON-TIMI 38. We then applied these models to each TRITON patient and examined how preferences for outcomes could influence thienopyridine selection. Methods: We built separate multivariable regression models for ischemia (cardiac death, MI, stroke) and bleeding (TIMI major/minor) from 12,579 patients in TRITON-TIMI 38 with no history of stroke or TIA. For each patient, we calculated the probability of ischemic and bleeding events with prasugrel vs. clopidogrel and the associated benefit:risk ratio (predicted difference in ischemic events/predicted difference in bleeding). We then examined the impact of alternative outcome weights - benefit:risk preference thresholds - on individualized decision making. Results: Based on individualized risk predictions, the majority of ACS patients treated with PCI (66%) may choose prasugrel when preventing ischemia is considered equally important as avoiding bleeding (Figure), but this proportion varied from 32% to 80% when the benefit:risk preference threshold was varied from 3 (reflecting a 3-times greater preference for avoiding bleeding) to 0.25 (reflecting a 4-times greater preference for avoiding ischemia). Conclusions: Based on empirical analyses, the expected absolute benefits and risks of prasugrel vs. clopidogrel depend highly on patient characteristics and preferences. Presenting individualized predictions of benefits and risks with competing treatments may improve shared decision making.

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