Preliminary evidence-based recommendations for return to learn: a novel pilot study tracking concussed college students

Aim: Students re-entering the academic setting after a concussion is commonly referred to as return-to-learn and, to date, very few studies have examined the return-to-learn aspect of concussion recovery. Methodology: Nine college-aged, full-time students who were diagnosed with concussions were monitored throughout their concussion recovery. The severity for five chief symptoms (headache, dizziness, difficulty concentrating, fatigue, anxiety) were recorded six-times per day through text messages, and daily phone calls recorded participant's behavioral traits. Results: We identified five behavioral variables which significantly influenced symptom resolution (music, sleep, physical activity, water and time) (p = 0.0004 to p = 0.036). Additionally, subjects reported math and computer-oriented courses as the most difficult (33 and 44%, respectively). Conclusion: We introduce a novel approach to monitor concussed students throughout their recovery, as well as factors that may influence concussion recovery process.

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Preliminary Evidence-Based Recommendations for Return to Learn: a novel pilot study tracking concussion recovery in college students

Neurology ◽

10.1212/01.wnl.0000581156.65140.2e ◽

2019 ◽

Vol 93 (14 Supplement 1) ◽

pp. S33.3-S34

Author(s):

Zachary Bevilacqua ◽

Mary Kerby ◽

David Fletcher ◽

Zhongxue Chen ◽

Becca Merritt ◽

...

Keyword(s):

Physical Activity ◽

Longitudinal Design ◽

Text Messages ◽

Return To Play ◽

Evidence Based ◽

Full Time ◽

Symptom Resolution ◽

Phone Calls ◽

Return To Learn ◽

Concussion Recovery

ObjectiveInvestigate the potential factors influencing resolution of chief concussion symptoms in a longitudinal design. Second, assess subjects’ perception of their concussion recovery and what types of activities and accommodations appeared beneficial.BackgroundAthletes re-entering the academic setting after a concussion is commonly referred as return-to-learn (RTL), which has appeared secondary to the abundantly researched return-to-play protocols implemented ubiquitously. Importantly, every concussed collegiate, adolescent, and pediatric athlete is first and foremost a student-athlete, with “student” holding the emphasis. To date, very few studies have examined the RTL aspect of concussion recovery, and the effects premature classroom attendance may cause.Design/MethodsNine concussed, college aged (18-26 years), full-time students were monitored longitudinally throughout their recovery from diagnosis to full symptom-free academic participation. Symptom severity for five prevalent symptoms were recorded 4 times per day, along with a daily phone call to report participant’s diet, duration of screen-time usage and music listened to, physical activity participation, and types of classes attended.ResultsResponse rates to text messages and phone calls yielded a mean 92% and 93% respectively across the nine subjects. Additionally, five variables were significantly associated with symptom resolution (music, sleep, physical activity, water, and time) (p = 0.0004 to p = 0.036). Lastly, subjects reported math and computer-oriented courses as the most difficult (33% and 44% respectively). Additional time on assignments/exams and reducing screen brightness were the most beneficial accommodations (66% and 56% respectively).ConclusionsOur findings introduce a novel and robust approach to monitoring concussed students throughout their recovery. Furthermore, this methodology is the first to produce holistic evidence-based results concerning re-integrating students to the classroom. Lastly, it appears that dietary and social behaviors can indeed influence symptom resolution.

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P076: Assessment of a newly integrated and standardized approach for pediatric concussions aimed to improve the concussion recovery process

CJEM ◽

10.1017/cem.2020.282 ◽

2020 ◽

Vol 22 (S1) ◽

pp. S91-S92

Author(s):

J. St.Onge ◽

E. Karreman ◽

M. McCarron ◽

L. Harasen ◽

C. Ames

Keyword(s):

Positive Impact ◽

Qualitative Content Analysis ◽

Recovery Process ◽

Return To School ◽

Structured Interviews ◽

Discharge Data ◽

Written Information ◽

Return To Learn ◽

Concussion Recovery ◽

The Impact

Introduction: Children with concussions presenting to emergency departments often receive very different recommendations for how to recover. In addition, there are no instructions for teachers to how children should return to learn and play after a concussion. Therefore, some children take too long to return to learn and play at school while others return too soon, thereby risking long-term problems because their brain injury is not fully healed. The purpose of this project is to determine the impact of a new integrated, standardized approach aimed to help a concussed child recover faster and whether the recovery experience for all involved has improved. Methods: Structured interviews were conducted with 11 parents of children treated for concussion at the Emergency Department of Pasqua Hospital in Regina, SK, four of whom received care after a change in practice whereby parents were provided with a return-to-school protocol form prior to discharge. Data were analyzed using an inductive qualitative content analysis approach using NVivo 12 software. Results: Three main categories were noted in the data: Parental response to the child's concussion, satisfaction with health services, and the communication amongst parents, physicians, and teachers. It was with regard to the last theme in particular that the impact of the return to school protocol was noted, helping to at least indirectly address the issue of the parent as the “middleman” in the communication triad. Most parents whose children received care prior to the introduction of the protocol suggested that providing written information at discharge to guide parents through the concussion recovery process would be helpful. Conclusion: Our initial results show a positive impact in regards to the process of children returning to learn and play after a concussion. Specifically, the increased communication between physician, teacher, and parent seems to benefit and improve the child's recovery process.

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Anomaly Detection via Mining Numerical Workflow Relations from Logs

10.36227/techrxiv.12570926.v1 ◽

2020 ◽

Author(s):

Bo Zhang ◽

Hongyu Zhang ◽

Pablo Moscato

Keyword(s):

Distributed Systems ◽

Anomaly Detection ◽

Text Messages ◽

Distributed File System ◽

Log Data ◽

Sliding Windows ◽

Novel Approach ◽

Hadoop Distributed File System ◽

Blue Gene ◽

Online Anomaly Detection

<div>Complex software intensive systems, especially distributed systems, generate logs for troubleshooting. The logs are text messages recording system events, which can help engineers determine the system's runtime status. This paper proposes a novel approach named ADR (stands for Anomaly Detection by workflow Relations) that employs matrix nullspace to mine numerical relations from log data. The mined relations can be used for both offline and online anomaly detection and facilitate fault diagnosis. We have evaluated ADR on log data collected from two distributed systems, HDFS (Hadoop Distributed File System) and BGL (IBM Blue Gene/L supercomputers system). ADR successfully mined 87 and 669 numerical relations from the logs and used them to detect anomalies with high precision and recall. For online anomaly detection, ADR employs PSO (Particle Swarm Optimization) to find the optimal sliding windows' size and achieves fast anomaly detection.</div><div>The experimental results confirm that ADR is effective for both offline and online anomaly detection. </div>

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Patient Education and Sacubitril/Valsartan: A Randomized Comparative Trial

Hospital Pharmacy ◽

10.1177/0018578721999808 ◽

2021 ◽

pp. 001857872199980

Author(s):

Christopher Giuliano ◽

Bradley St. Pierre ◽

Jamie George

Keyword(s):

Controlled Trial ◽

Comparative Trial ◽

Text Messages ◽

Phone Call ◽

Secondary Outcome ◽

Short Term ◽

Phone Calls ◽

Video Education ◽

Pharmacist Education

Objective: To compare video to pharmacist education for patients taking sacubitril/valsartan. Methods: We conducted a randomized controlled trial comparing video to pharmacist education with a second randomized intervention of education delivered through text or phone call at 14 days. The primary outcome compared the change in short term knowledge between groups and the secondary outcome was long term knowledge at 1 month. Results: Forty-three patients were included. Scores improved significantly ( P < .05) in the pharmacist group from 54.1% to 85.9% and from 64.3% to 86.1% in the video education group, although there was no difference between groups (31.8% vs 22.9%, P = .13). At 30 days, scores were significantly higher than baseline (difference 16.5%, P < .05) although did decrease from the posttest (difference 7.4%, P < .05). There was no difference at 30 days between those that received text messages versus phone calls (−10% vs −5.5%, respectively; P = .36). Conclusion: We saw improvements in both short term and long term knowledge for patients receiving education through pharmacist or video education. Neither approach was more effective than the other. Clinicians can use either approach based on patient preference.

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Availability and Use of Mobile Health Technology for Disease Diagnosis and Treatment Support by Health Workers in the Ashanti Region of Ghana: A Cross-Sectional Survey

Diagnostics ◽

10.3390/diagnostics11071233 ◽

2021 ◽

Vol 11 (7) ◽

pp. 1233

Author(s):

Ernest Osei ◽

Kwasi Agyei ◽

Boikhutso Tlou ◽

Tivani P. Mashamba-Thompson

Keyword(s):

Healthcare Professionals ◽

Healthcare Delivery ◽

Disease Diagnosis ◽

Text Messages ◽

Diagnosis And Treatment ◽

Cross Sectional Survey ◽

Mobile Wireless ◽

Ashanti Region ◽

Phone Calls ◽

Treatment Support

Mobile health (mHealth) technologies have been identified as promising strategies for improving access to healthcare delivery and patient outcomes. However, the extent of availability and use of mHealth among healthcare professionals in Ghana is not known. The study’s main objective was to examine the availability and use of mHealth for disease diagnosis and treatment support by healthcare professionals in the Ashanti Region of Ghana. A cross-sectional survey was carried out among 285 healthcare professionals across 100 primary healthcare clinics in the Ashanti Region with an adopted survey tool. We obtained data on the participants’ background, available health infrastructure, healthcare workforce competency, ownership of a mobile wireless device, usefulness of mHealth, ease of use of mHealth, user satisfaction, and behavioural intention to use mHealth. Descriptive statistics were conducted to characterise healthcare professionals’ demographics and clinical features. Multivariate logistic regression analysis was performed to explore the influence of the demographic factors on the availability and use of mHealth for disease diagnosis and treatment support. STATA version 15 was used to complete all the statistical analyses. Out of the 285 healthcare professionals, 64.91% indicated that mHealth is available to them, while 35.08% have no access to mHealth. Of the 185 healthcare professionals who have access to mHealth, 98.4% are currently using mHealth to support healthcare delivery. Logistic regression model analysis significantly (p < 0.05) identified that factors such as the availability of mobile wireless devices, phone calls, text messages, and mobile apps are associated with HIV, TB, medication adherence, clinic appointments, and others. There is a significant association between the availability of mobile wireless devices, text messages, phone calls, mobile apps, and their use for disease diagnosis and treatment compliance from the chi-square test analysis. The findings demonstrate a low level of mHealth use for disease diagnosis and treatment support by healthcare professionals at rural clinics. We encourage policymakers to promote the implementation of mHealth in rural clinics.

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The Wheel of Change Moves On: Assessing the Severity of Stalking Behavior

Journal of Interpersonal Violence ◽

10.1177/08862605211015216 ◽

2021 ◽

pp. 088626052110152

Author(s):

Ewa B. Stefanska ◽

Nicholas Longpré ◽

Rekayla S. Harriman

Keyword(s):

Social Issue ◽

Item Response ◽

Text Messages ◽

Severity Scale ◽

Communication Behaviors ◽

Phone Calls ◽

Ranking Order ◽

Minimal Work ◽

Work Done ◽

The Continuum

Stalking is a significant social issue. The inconsistency as to what defines stalking has resulted in the creation of different methods to measure the crime. However, there has been minimal work done that assesses the severity of individual stalking behaviors. The aim of the present study was to assess the level of stalking behavior in terms of severity within a randomly selected sample of 924 cases from the database of the National Stalking Helpline. Item response theory analyses were used to assist in developing a scale that displays the ranking order of each stalking behavior. These analyses were also used to examine whether the stalking behavioral items created a single continuum of severity of stalking. Results indicated that 16 stalking behavioral items of the 28 items present in the National Stalking Helpline, best represented the severity of stalking. Unwanted communication behaviors such as text messages and phone calls were located at the lower end of the severity scale, whereas criminal damage and death threats were mapped on the higher end of the continuum. The findings also revealed that the 16 items categorized under 6 factors. The findings of the present study provide many implications for stalking agency professionals and criminal justice responses.

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Comparison Between Short Text Messages and Phone Calls to Reduce No-Show Rates in Outpatient Medical Appointments

Journal of Ambulatory Care Management ◽

10.1097/jac.0000000000000388 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Rogério Cortecioni Lance ◽

Antônio Pazin-Filho ◽

Fábio Fernandes Neves

Keyword(s):

Text Messages ◽

Short Text ◽

Phone Calls

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Feasibility of digital life coaching during stem cell transplantation for multiple myeloma.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e24103 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e24103-e24103

Author(s):

Rahul Banerjee ◽

Chiung-Yu Huang ◽

Lisa Dunn ◽

Jennifer Knoche ◽

Kelly Jean Brassil ◽

...

Keyword(s):

Multiple Myeloma ◽

Stem Cell ◽

Stem Cell Transplantation ◽

Cell Transplantation ◽

Sleep Disturbances ◽

Text Messages ◽

High Dose ◽

Life Coaching ◽

Phone Calls ◽

Patient Reported

e24103 Background: Patients with multiple myeloma (MM) experience acute quality of life (QOL) exacerbations following autologous stem cell transplantation (ASCT) that can lead to long-term complications. Life coaching can improve QOL in a structured & personalized manner. We investigated the feasibility of a digital life coaching (DLC) platform, where coaching is accomplished through phone calls and text messages, for patients with MM during ASCT. Methods: Our pilot study (clinicaltrials.gov ID: NCT04432818) enrolled adult patients with MM, English proficiency, and cellphone ownership (smartphone not required). The 16-week DLC program, beginning at Day -5 before ASCT, included unlimited digital access to a certified life coach to help with identifying and accomplishing wellness-related goals. Our primary outcome was ongoing DLC engagement (≥ 1 bidirectional conversation every 4 weeks). Secondary outcomes were ePRO assessments of QOL (PROMIS Global Health), insomnia (PROMIS Sleep Disturbances), and distress (NCCN DT). Electronic patient-reported outcome (ePRO) assessments were delivered via automated REDCap emails every 1-2 weeks. Results: Of 18 screened patients, 15 (83%) enrolled in our study; 2 patients dropped out before initiating DLC (including 1 who was unable to connect with her coach between Day -5 and 0). Of 13 remaining patients, median age was 65 (range 50-81) and 23% had an ECOG performance status of 1 (remainder 0). DLC conversations occurred a mean of every 7.6 days (range 3-28) overall and every 6.5 days (range 2.8-14) during the initial 28-day period including high-dose melphalan and hospitalization. 80% of patients maintained ≥ 1 conversation every 4 weeks. Selected ePRO results (mean ± standard error) are shown in the table. Conclusions: Certain MM patients are able to engage digitally with a life coach and complete email-based ePRO assessments during and after ASCT. Limitations of our study include selection bias and the Day -5 start date, which may be too late logistically and symptom-wise (given our ePRO findings suggestive of peak distress pre-ASCT). DLC may play an innovative and scalable role given the emphasis on remotely delivered care during the COVID-19 pandemic. A Phase II randomized study of DLC versus usual care is under way (clinicaltrials.gov ID: NCT04589286). Clinical trial information: NCT04432818. [Table: see text]

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A-13 Return-to-Learn: Academic Accommodations for Concussion Recovery

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acaa036.13 ◽

2020 ◽

Vol 35 (5) ◽

pp. 609-609

Author(s):

B Davis ◽

K Creed ◽

C Keshvnani ◽

D Blueitt ◽

C Garrison

Keyword(s):

Primary Care ◽

Sports Medicine ◽

Care Center ◽

Care Physician ◽

Cognitive Symptoms ◽

Academic Accommodations ◽

School Work ◽

Medicine Physician ◽

Return To Learn ◽

Concussion Recovery

Abstract Objective To evaluate academic accommodations offered to student athletes following a concussive injury. Method Participants were identified during regularly scheduled visits to the participating fellowship-trained, board-certified primary care sports medicine physician (D.B.). A total of 127 participants (mean ± SD age, 14.8 ± 1.5 years [range, 12–18 years]) diagnosed with a concussion from December 2018 to October 2019 were surveyed. The participants were provided a questionnaire in which the following information was collected: age at injury, date of injury, locations of treatment, cognitive symptoms experienced, academic accommodations received, implementation of accommodation by educators, and school related problems. Results Cognitive symptoms were reported by 117 (92.1%) participants with trouble concentrating (81.2%), and feeling “slow” (78.7%) being the most common. Participants treated at the participating, sports-medicine concussion center had the highest rate of receiving academic accommodations (95.3%), while those also treated at an emergency or acute care center, primary care physician, or pediatrician’s office had significantly lower rates (<5%). Participants reported their accommodations as helpful (94.5%), with extra time (88.2%), and ability to take breaks (80.3%) having the highest frequency of recommendation. While symptomatic, 110 (86.6%) participants reported having difficulty completing school work and tests, 58 (45.7%) reported experiencing anxiety about completing their school work, and 55 (43.3%) reported a decline in their grades. Conclusions These data display the high frequency of cognitive symptoms and hindered academic performance associated with concussion recovery. The implementation of academic accommodations was demonstrated to be beneficial; however, not all medical centers are providing accommodations.

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SOCIAL NETWORK SIZE AND FREQUENCY OF ELECTRONIC COMMUNICATION: THE RELATIONSHIP TO INTERPERSONAL STRESS

Innovation in Aging ◽

10.1093/geroni/igz038.618 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S174-S174

Author(s):

Xin Yao Lin ◽

Margie E Lachman

Keyword(s):

Social Network ◽

Network Size ◽

Text Messages ◽

Interpersonal Stress ◽

Electronic Communications ◽

Daily Diary Study ◽

Social Network Size ◽

Phone Calls ◽

Video Chat ◽

The Relationship

Abstract Social relationships are beneficial for psychological wellbeing, but they are also associated with interpersonal stress. With the growing usage of multiple forms of electronic communications (EC) including phone calls, text messages, video chat, and internet among adults of all ages, it was of interest to explore the relationship between social network size (SNS), in-person communication (PC), and EC, and whether the relationship between SNS and frequency of communication is associated with interpersonal stress. A daily diary study was conducted over seven days for 142 participants ages 22 to 94. SNS was assessed with the social convoy model. Frequency of PC and EC, along with interpersonal stress, were assessed daily. As expected, multiple regression analysis results showed that older adults had smaller SNS and less frequent technology communication (text messages, video chat, internet) compared to younger adults. With regard to effects on interpersonal stress, there were no main effects for frequency of PC, EC, or SNS. However, the frequency of EC moderated the relationship between SNS and interpersonal stress, controlling for amount of PC. Among those with a smaller SNS, having more frequent EC was associated with less interpersonal stress compared to those with less frequent EC. For those with a larger SNS, having more frequent EC was associated with more interpersonal stress compared to those with less EC, but PC was not related to interpersonal stress. The discussion will consider implications of the findings for developing interventions to minimize stress from interpersonal communications, especially those that involve EC.

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