scholarly journals HOW DO LEARNING DISORDERS IMPACT CLINICAL MEASURES FOLLOWING CONCUSSION?

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0018
Author(s):  
Aaron J. Zynda ◽  
Mathew A. Stokes ◽  
Jane S. Chung ◽  
C. Munro Cullum ◽  
Shane M. Miller
Keyword(s):  
Symptom Score ◽  
Learning Disorders ◽  
Total Symptom Score ◽  
Adhd Group ◽  
Motor Speed ◽  
The North ◽  
History Of ◽  
Visual Motor ◽  
Clinical Measures ◽  
The Impact

Background: There is limited evidence examining the impact of learning disorders on testing and screening scores used in evaluation following concussion in adolescents. Purpose: To examine differences in clinical measures between adolescents with a history of dyslexia or ADD/ADHD and those without a history of learning disorder (LD) following concussion. Methods: Data were collected from participants enrolled in the North Texas Concussion Network Prospective Registry (ConTex). Participants ages 10-18 who had been diagnosed with a concussion sustained within 30 days of enrollment were included. Participants were separated into three groups based on self-reported prior diagnosis: dyslexia, ADD/ADHD, and no history of LD. Clinical measures from initial presentation were examined, including ImPACT®, King-Devick (KD), SCAT-5 symptom log, Patient Health Questionnaire (PHQ-8), and Generalized Anxiety Disorder (GAD-7) scale. Independent t-test analysis was performed to compare scores between groups. Results: A total of 993 participants were included; 68 with dyslexia, 141 with ADD/ADHD, and 784 with no history of LD. There was no difference in age, sex, time since injury, or history of concussion between the dyslexia group and no LD group. In the ADD/ADHD group, there were significantly more male participants (64.5% and 50.3% respectively, p=0.002). Participants with a history of dyslexia had a significant increase in KD time (63.7 sec vs 56.5 sec, p=0.019). Additionally, ImPACT® testing showed a decrease in visual motor speed (28.87 vs 32.99, p= 0.010). Total symptom score was higher in this group as well (36.22 vs 28.27, p=0.013). In those with a history of ADD/ADHD, multiple domains were found to be significantly different on ImPACT® testing including visual motor speed (30.05), reaction time (0.75), and cognitive efficiency (0.23) when compared to those with no LD (32.99, 0.71, and 0.27 respectively, p=0.004, 0.047, 0.027). KD time was also significantly higher in this group (62.1 sec vs 56.5 sec, p=0.008), as was the total symptom score (32.99 vs 28.27, p=0.043). PHQ-8 and GAD-7 were both significantly higher in the group with ADD/ADHD (5.79 and 5.06 respectively, p=0.001) than those with no LD (4.32 and 3.56, p=0.001). Conclusion: Differences were seen in participants with a history of dyslexia and ADD/ADHD on clinical concussion measures, including ImPACT® and KD testing, SCAT-5 symptom log, and screenings for depression and anxiety. A better understanding of the unique profiles seen in these patients will aid providers in their evaluation and assist as they counsel families regarding their child’s injury.

scholarly journals A-07 The Impact of Learning Disorders on Clinical Measures Following Concussion

2020 ◽  
Vol 35 (5) ◽  
pp. 603-603
Author(s):  
C M Carpenter ◽  
A J Zynda ◽  
M A Stokes ◽  
J S Chung ◽  
C M Cullum ◽  
...  
Keyword(s):  
Motor Control ◽  
Symptom Score ◽  
Learning Disorders ◽  
Adhd Group ◽  
The North ◽  
Patient Health ◽  
History Of ◽  
Visual Motor ◽  
Clinical Measures ◽  
The Impact

Abstract Objective To examine differences in clinical measures between adolescents with dyslexia, ADD/ADHD, and those without a learning disorder (LD) following concussion. Method Data from the North Texas Concussion Registry (ConTex) were extracted. Participants ages 10–18 with a diagnosed concussion within 30 days of enrollment were included and categorized based on self-reported prior diagnosis of dyslexia, ADD/ADHD, and no history of LD. ImPACT, King-Devick (KD), SCAT-5 symptom log, Patient Health Questionnaire (PHQ-8), and Generalized Anxiety Disorder (GAD-7) scale were compared between groups using a one-way ANOVA followed by a Tukey test for multiple comparisons. Results Of 993 eligible participants, 68 had dyslexia, 141 had ADD/ADHD, and 784 had no history of LD. There were significantly more male participants in the ADD/ADHD group compared to the no LD group (64.5% vs. 50.3%, p = 0.002). No other demographic differences were noted between groups. In the dyslexia group, SCAT-5 symptom score was higher (36.22 vs. 28.27, p = 0.037) and ImPACT visual motor control was lower compared to the no LD group (28.87 vs. 32.99, p = 0.027). In the ADD/ADHD group, ImPACT symptom score was higher (30.69 vs. 20.94, p < 0.001) and visual motor control was lower compared to the no LD group (30.05 vs. 32.99, p = 0.009). KD time (62.1 sec), PHQ-8 (5.79), and GAD-7 (5.06) were higher in the ADD/ADHD group compared to the no LD group (56.5 sec, 4.32, 3.56; p = 0.022, p = 0.003, p = 0.002). Conclusions Differences in clinical measures were seen in participants with a history of dyslexia and ADD/ADHD that may aid providers in their evaluation following adolescent concussion.

Do Learning Disorders Impact Clinical Measures Following Concussion?

Neurology ◽  
2020 ◽  
Vol 95 (20 Supplement 1) ◽  
pp. S16.3-S17
Author(s):  
Mathew Stokes ◽  
Aaron J. Zynda ◽  
Jane Chung ◽  
Cheryl Silver ◽  
Munro Cullum ◽  
...  
Keyword(s):  
Impulse Control ◽  
Clinical Findings ◽  
Learning Disorders ◽  
Adhd Group ◽  
North Texas ◽  
The North ◽  
Patient Health ◽  
History Of ◽  
Clinical Measures ◽  
Time Since Injury

ObjectiveEvaluate differences in clinical testing following concussion between adolescents with no history of learning disorder (LD) and those with a history of dyslexia and/or ADD/ADHD.BackgroundLearning disorders, such as ADHD, can affect ImPACT® baseline neurocognitive testing. The effect that ADHD has on other clinical measures is less well understood. Additionally, limited data exists on the effect of dyslexia on these measures.Design/MethodsData were prospectively collected from participants enrolled in the North Texas Concussion Registry (ConTex). Participants ages 10–18 years old, diagnosed with a concussion sustained within 30 days of enrollment were included and assessed for self-reported history of LD type (dyslexia and/or ADD/ADHD). Clinical findings examined included symptom scores (derived from SCAT5™), ImPACT®, King-Devick (KD) test, patient health questionnaire 8(PHQ-8) scores, and generalized anxiety disorder 7(GAD-7) scores. Mann-Whitney tests were used to compare groups.ResultsIn total, 1,298 participants were included: 58 with dyslexia, 158 with ADD/ADHD, 35 with both (dyslexia and ADD/ADHD), and 1,047 with no LD. There was no difference in age, sex, time since injury, or history of concussion apart from the ADD/ADHD group, which had more males (p < 0.001). The dyslexia group had slower mean KD time (p = 0.011) and increased error scores (p = 0.028). In those with ADD/ADHD, impulse control scores on ImPACT® were significantly higher (p = 0.007), but no other ImPACT® score differences reached significance. PHQ-8 and GAD-7 scores were significantly higher in those with ADD/ADHD (p < 0.001). Participants with both dyslexia and ADHD demonstrated slower KD times (p = 0.009) and had higher PHQ-8 (p < 0.001) and GAD-7 (p = 0.001) scores.ConclusionsParticipants with dyslexia and/or ADD/ADHD had worse scores on commonly used concussion clinical measures including ImPACT® impulse control, KD testing, and depression and anxiety screenings. Understanding the differences in these groups will aid providers in their evaluation and assist in counseling families regarding the injury.

scholarly journals Concussion Baseline Testing: Preexisting Factors, Symptoms, and Neurocognitive Performance

2017 ◽  
Vol 52 (2) ◽  
pp. 77-81 ◽  
Author(s):  
Jordan E. Cottle ◽  
Eric E. Hall ◽  
Kirtida Patel ◽  
Kenneth P. Barnes ◽  
Caroline J. Ketcham
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Symptom Score ◽  
Attention Deficit ◽  
Verbal Memory ◽  
Total Symptom Score ◽  
Strenuous Exercise ◽  
Motor Speed ◽  
Concussion Management ◽  
Hyperactivity Disorder ◽  
Visual Motor

Context: Neurocognitive test scores are often considered an important aspect of concussion management. To best use these data, clinicians must understand potential factors that may influence baseline performance on these tests. Objective: To determine preexisting factors that may influence performance on the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT). Design: Cross-sectional study. Setting: Research laboratory. Patients or Other Participants: A total of 486 National Collegiate Athletic Association Division I collegiate student-athletes. Main Outcome Measure(s): To determine neurocognitive functioning and total symptom score at baseline, ImPACT was administered. Outcomes were verbal memory, visual memory, visual motor speed, reaction time, and total symptom score. A self-report demographic section at the beginning of ImPACT was used to gather information concerning previous treatment for headaches, migraines, and psychiatric conditions; diagnosis of attention-deficit/hyperactivity disorder; and exposure to previous strenuous exercise. We conducted multivariate analyses of variance to determine if the ImPACT composite and total symptom scores differed according to preexisting factors (P &lt; .0083). Results: Sex showed an effect on verbal memory (P = .001), visual motor speed (P &lt; .001), and reaction time (P = .006), with women performing better than men. A previous diagnosis of attention-deficit/hyperactivity disorder affected visual motor speed (P = .008). Previous treatment for headaches (P &lt; .001), migraines (P = .001), a psychiatric condition (P &lt; .001), or a diagnosis of attention-deficit/hyperactivity disorder (P &lt; .001) all showed effects on the total symptom score. Strenuous exercise did not affect neurocogntive performance or total symptom score. Conclusions: Based on our findings and the previous literature, we suggest that many preexisting factors influence baseline neurocognitive data. Baseline testing is an important aspect of concussion management. Sports medicine professionals should be cognizant of these factors when developing concussion-management protocols.

scholarly journals Swiss Architectural Origins, Le Corbusier, and the Pātaka of Lake Horowhenua (1845)

2014 ◽  
Vol 11 ◽  
pp. 72-81
Author(s):  
Peter Wood
Keyword(s):  
Le Corbusier ◽  
Direct Influence ◽  
The North ◽  
The Pacific ◽  
History Of ◽  
The One ◽  
Swiss Lake ◽  
Richard Taylor ◽  
The Impact ◽  
The Town

In April, 1845, the Rev. Richard Taylor passed through the area of the North Island now marked by the town of Levin. At this time, he described Lake Horowhenua as being of singular appearance for the small storehouses built over the water on poles. As was his predilection, Taylor made a drawing of the lake huts, a version of which was belatedly included in the second edition of his most important literary contribution, Te Ika-a-Māui (1870). This image would have remained as little more than a questionable curiosity was it not for Messrs Black Bros who, in the course of exploring the lake bed for Māori artefacts in 1932, legitimised Taylor's observation with their discovery of the submerged architectural remains of an aquatic hut. Nonetheless, almost a century after Taylor's original diary entry, GL Adkin, writing for The Journal of the Polynesian Society, lamented the neglect shown toward these remarkable structures, and which he cited as just one example of the "tantalising gaps" in the recorded history of Māori custom and culture. Sadly, it is well beyond the scope of this research to properly redress the historical neglect shown toward lake pātaka. What I do wish to do is to link these structures to an event on the shores of the Lake of Zurich, Switzerland, when Dr Ferdinand Keller noticed some half-submerged piles in 1854. Upon these remains Keller made a great, if erroneous, case for primitive "pile-work habitations" in the Swiss lakes. The impact of this argument cannot be understated. It became the privileged model for architectural origins in the German and French parts of Switzerland, and by the 1890s it was a part of standard teaching texts in Swiss schools, where it was firmly inculcated into the curriculum at the time that Charles Edouard Jeanneret was a child. This in turn has led Vogt to suggest that, in Keller's "dwellings on the water," Le Corbusier found a Primitive Hut typology that underpinned all his architectural thinking, and which is made most explicit in his principled use of piloti. What makes this all the more involved is that Keller, in searching for examples to visualise the construction of the Swiss lake dwellings, turned to the Pacific (which he categorised as at a developmental stage of architectural evolution akin to early Europe). In this paper I identify the exact etching by Louis Auguste de Sainson that Keller took for direct influence. The problem, however, is that de Sainson depicted a conventional whare built on land, and Keller transposed it to the water. So we have on the one side of this paper an authentic lake whare that is all but forgotten, and a famed European lake-hut that is all but Māori, and between the two is the figure of Le Corbusier who may or may not have unknowingly based one on his major innovations on influences found in the pātaka of Lake Horowhenua.

scholarly journals Particularity of Canada-Mexico bilateral relations (from beginning to entry into force NAFTA Agreement)

2018 ◽  
pp. 31-41
Author(s):  
Oleh Bulka
Keyword(s):  
Trade Agreement ◽  
The United States ◽  
Mutual Cooperation ◽  
Economic Relations ◽  
The North ◽  
Bilateral Relations ◽  
Organizational Mechanism ◽  
History Of ◽  
The 1960S ◽  
The Impact

The article is devoted to the particularity of Canada-Mexico bilateral relations in the period from their beginning to signing and entry into force the North American Free Trade Agreement (NAFTA). It is noted that from the time of first contacts bilateral relations between two countries have developed unevenly with periods of increase and periods of decline. It is determined that in the history of Canada-Mexico relations before signing NAFTA can be identified four main periods. The first one is a period of early contacts that lasted from the end of XIX century to the establishment of the official diplomatic relations between Canada and Mexico in 1944. In this period of time ties between the two countries were extremely weak. The second period lasted from 1944 to the end of the 1960s. This period clearly shows the limits of cooperation between Canada and Mexico after the establishment of the official diplomatic ties, but it is also possible to see a certain coincidence between the values and diplomatic strategies of these countries. The third period of Canada-Mexico relations lasted from the beginning of the 1970s to the end of the 1980s. During this period, both Canada and Mexico try to diversify their foreign policy and strengthen the organizational mechanism of mutual cooperation. But it is also shown that despite the warm political rhetoric, there was some distance in Canada-Mexico relations. The fourth period of the relations lasted from the late 1980s until the NAFTA treaty came into force in 1994. At that time Canadian and Mexican governments began to give priority to economic relations over political and diplomatic ones. It was revealed that the main influencing factors of bilateral relations between Mexico and Canada were the impact of third countries, especially the United Kingdom and the United States, regional and global economic conditions, and the attitude to the bilateral relations of the political elites of both countries.

Music and Censorship in Vietnam since 1954

2015 ◽  
Author(s):  
Barley Norton
Keyword(s):  
Reform Era ◽  
The North ◽  
Vietnamese American ◽  
Cultural Climate ◽  
History Of ◽  
Impact Of Technology ◽  
Conventional Systems ◽  
Cultural Freedom ◽  
The Impact ◽  
North And South

This chapter traces the history of music censorship in Vietnam since 1954 with reference to a broad range of music genres. It discusses music censorship from 1954 to 1975, when Vietnam was divided into North and South. The tight ideological control established by the Vietnamese Communist Party in the North is compared with music movements linked to antiwar protests in the South. The chapter then examines the period of severe censorship following the end of the Vietnamese-American war in 1975 and considers how the cultural climate changed in the reform era after 1986. It highlights the limits of cultural freedom in the reform era and discusses how music censorship has become intertwined with concerns about the effects of globalization on morality and national identity. Finally, the chapter addresses the impact of technology since the late 1990s, paying particular attention to Vietnamese rap and the potential for musicians to use the Internet to bypass conventional systems of state censorship.

Second reply to the comment by Romero and Kannada on “Genetic analysis of 16th-century whale bones prompts a revision of the impact of Basque whaling on right and bowhead whales in the western North Atlantic”Appears in Can. J. Zool. 84(7): 1059–1065.

2008 ◽  
Vol 86 (1) ◽  
pp. 76-79 ◽  
Author(s):  
Jeff W. Higdon
Keyword(s):  
Genetic Analysis ◽  
North Atlantic ◽  
16Th Century ◽  
Bowhead Whales ◽  
Potential Value ◽  
The North ◽  
The Pacific ◽  
History Of ◽  
The North Atlantic ◽  
The Impact

The comments by A. Romero and S. Kannada (2006. Can. J. Zool. 84: 1059–1065) provide a brief summary of North Atlantic whaling history as a critique of T. Rastogi et al. (2004. Can. J. Zool. 82: 1647–1654) . However, they fall far short of providing an accurate review of whaling history in this region. The authors present a number of factual errors, misuse several key sources, and make significant omissions, ultimately defeating the purpose of providing information to biologists, managers, and historians. In this comment I highlight the mistakes in their representation of the history of North Atlantic whaling for bowhead whales ( Balaena mysticetus L., 1758). There are unacceptable errors for most nations covered, and for American whaling in particular. The authors assert that over 30 000 bowhead whales were landed by Yankee whalers in the North Atlantic when the vast majority were in fact taken on the Pacific grounds. Although a summary of whaling history is an admirable goal and of potential value, it is unfortunate that the authors missed such an opportunity by failing to adequately research this topic, failing to include important citations, and by including sources that do not provide the information indicated. Providing a whaling summary with such errors and omissions only adds further confusion to an already confusing theme.

Artistic Influences Analysis of Iraqi National Costumes

2013 ◽  
Vol 821-822 ◽  
pp. 735-745
Author(s):  
Alttabi Furat Jamal Hassan ◽  
Xiang Yang Bian ◽  
Xiao Yu Xin
Keyword(s):  
The Body ◽  
Northern Iraq ◽  
The North ◽  
Wool Material ◽  
History Of ◽  
The Right ◽  
In The Beginning ◽  
Head Cover ◽  
The Impact ◽  
Southern Iraq

There were signs of the first civilization known to humanity for more than 6000 years BC in the north of Iraq have disappeared this civilization to appear after 500 years in southern Iraq, the Sumerian civilization, which was considered as the opinion of scientists or civilizations, exceeds the impact to Asia and the countries that had been in contact (Sumerians) and see them today in other towns and villages. In subsequent periods of time appeared distinct personalities to their nature, religious, social, special clothing with clothes seem especially long. And usually dress is made from raw wool material making them in the Sumerian era. Put the garment on the body and leaves the top of the right shoulder with the survival of an open hand. There are of special clothing used by the clergy in the exercise of religious mourning rituals .There are traditional clothes to the clergy of other faiths. The clothing we see in the beginning of the third millennium BC has gained status in society in general, and was also the head cover. The animals have for centuries symbolized the signs of a divinity that we see hanging on the walls of some temples in northern Iraq. Centuries have been mentioned in the history of the Arabian were animal horns in Sumerian times to symbolize the moon in the Sumerian language .

scholarly journals Evaluating Meridian-Sinew Release Therapy for the Treatment of Knee Osteoarthritis

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Song Wei ◽  
Zhi-Huang Chen ◽  
Wei-Feng Sun ◽  
Geng-Peng Zhang ◽  
Xiao-Hao Li ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Symptom Score ◽  
Joint Stiffness ◽  
The Elderly ◽  
Outcome Evaluation ◽  
Total Symptom Score ◽  
Control Group ◽  
Osteoarthritis Of The Knee ◽  
Functional Movement ◽  
The Impact

Objective. In recent years, public health experts have concluded that the impact of osteoarthritis is equal in magnitude to that of cardiovascular disease. Osteoarthritis of the knee is prevalent in the elderly population; however, there are currently no effective treatments for this condition. In this study, we investigated the efficacy of “meridian-sinew release,” a newly developed technique which entails using a meridian-sinew scope and a meridian-sinew knife to treat osteoarthritis of the knee.Methods. Patients (N=90) with knee osteoarthritis were prospectively randomized to meridian-sinew release therapy, acupuncture therapy, or drug therapy groups, respectively. Outcome evaluation included pain, stiffness, physiological function, total symptom score, and overall changes in the condition.Results. After 12 weeks, patients' general assessment (GA) and doctors' general assessment (GA) of the condition were not significantly different among the three groups. However, significant differences in primary endpoint pain, joint stiffness, and total symptom score were found between the meridian-sinew group and the acupuncture group and between the meridian-sinew group and the control group (P<0.05). No adverse events occurred during the trial.Conclusion. Our study suggests that meridian-sinew release therapy can improve knee osteoarthritis, alleviate joint pain, and improve functional movement disorder. It is a safe and effective treatment for knee osteoarthritis.

scholarly journals Concussion Incidence and Recovery Among Youth Athletes With ADHD Taking Stimulant-Based Therapy

2021 ◽  
Vol 9 (10) ◽  
pp. 232596712110325
Author(s):  
Muhammad Ali ◽  
Nickolas Dreher ◽  
Theodore Hannah ◽  
Adam Li ◽  
Nek Asghar ◽  
...  
Keyword(s):  
Motor Skills ◽  
Verbal Memory ◽  
Visual Memory ◽  
Adhd Group ◽  
Neurocognitive Dysfunction ◽  
Stimulant Use ◽  
Youth Athletes ◽  
Visual Motor ◽  
The Impact

Background: Attention deficit hyperactivity disorder (ADHD) may affect concussion risk and recovery in youth athletes. Purpose: To evaluate the association between incidence of concussion and postinjury recovery of symptoms and neurocognitive dysfunction among youth athletes with ADHD and differential stimulant use. Study Design: Cohort study; Level of evidence, 3. Methods: From 2009 to 2019, the authors administered the Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) to youth athletes at the beginning of each season. Throughout the season, athletes with concussions were examined and readministered the ImPACT both postinjury and again 7 days after the postinjury administration. These athletes (N = 7453) were divided into those with ADHD on stimulant-based therapy (ADHD+meds; n = 167), those with ADHD not on stimulant-based therapy (ADHD-only; n = 354), and those with no ADHD (non-ADHD; n = 6932). Recovery of neurocognitive dysfunction at postinjury and follow-up was calculated using the ImPACT symptom score, verbal memory, visual memory, visual motor skills, and reaction time (calculated as standardized deviations from baseline). Univariate results were confirmed with multivariate analysis. Results: The ADHD+meds cohort had a lower incidence of concussion (37.3 concussions per 100 patient-years) compared with the ADHD-only group (57.0 concussions per 100 patient-years) (odds ratio [OR], 0.51 [95% CI, 0.37-0.71]; P < .0001) and non-ADHD group (52.8 concussions per 100 patient-years) (OR, 0.50 [95% CI, 0.37-0.67]; P < .0001). At postinjury, ImPACT scores were elevated from baseline to a similar extent in the ADHD+meds cohort compared with the other 2 groups. By follow-up, however, deviations from baseline were lower among the ADHD+meds group compared with the non-ADHD group in verbal memory (OR, 0.46 [95% CI, 0.28-0.76]; P = .002), visual memory (OR, 0.27 [95% CI, 0.10-0.66]; P = .005), and visual motor skills (OR, 0.58 [95% CI, 0.33-0.99]; P = .048). The deviation at follow-up was also lower among the ADHD+meds group compared with the ADHD-only group in visual memory (OR, 0.56 [95% CI, 0.33-0.96]; P = .04) and visual motor skills (OR, 0.42 [95% CI, 0.22-0.81]; P = .01). Conclusion: Stimulant use among youth athletes with ADHD was independently associated with reduced incidence for concussion and lower deviation from baseline in verbal memory, visual memory, and visual motor skills at 7 days postconcussion, suggesting lower neurocognitive impairment at follow-up in this group versus their peers.

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