The diagnostic and prognostic utility of the dual-task tandem gait test for pediatric concussion

Background:The tandem gait test has gained interest recently for assessment of concussion recovery.The purpose of our study was to determine the prognostic and diagnostic use of the single-and dual-task tandem gait test,alongside other clinical measures,within 10 days of pediatric concussion.Methods:We assessed 126 patients post-concussion(6.3§2.3 days post-injury,mean§SD)at a pediatric sports medicine clinic and compared them to 58 healthy controls(age:15.6§1.3 years;43%female).We also compared the 31 patients with concussion who developed persistent post-concussion symptoms(PPCS)(age=14.9§2.0 years;48%female)to the 81 patients with concussion who did not develop PPCS following the initial assessment(age:14.1§3.0 years;41%female).All subjects completed a test battery,and concussion patients were monitored until they experienced concussion-symptom resolution.The test battery included tandem gait(single-task,dual-task(performing tandem gait while concurrently completing a cognitive test)conditions),modified Balance Error Scoring System(mBESS),and concussion symptom assessment(Health and Behavior Inventory).We defined PPCS as symptom resolution time>28 days post-concussion for the concussion group.Measurement outcomes included tandem gait time(single-and dual-task),dual-task cognitive accuracy,mBESS errors(single/double/tandem stances),and symptom severity.Results:The concussion group completed the single-task(mean difference=9.1 s,95%confidential interval(95%CI):6.1-12.1)and dual-task(mean difference=12.7 s,95%CI:8.7
16.8)tandem gait test more slowly than the control group.Compared to those who recovered within 28 days of concussion,the PPCS group had slower dual-task tandem gait test times(mean difference=7.9 s,95%CI:2.0-13.9),made more tandem-stance mBESS errors(mean difference=1.3 errors,95%CI:0.2-2.3),and reported more severe symptoms(mean difference=26.6 Health and Behavior Inventory rating,95%CI:21.1-32.6).Conclusion:Worse dual-task tandem gait test time and mBESS tandem stance performance predicted PPCS in pediatric patients evaluated within 10 days of concussion.Tandem gait assessments may provide valuable information augmenting common clinical practices for concussion management.     

Slowed driving-reaction time following concussion-symptom resolution

Background: Concussed patients have impaired reaction time (RT) and cognition following injury that may linger and impair driving performance. Limited research has used direct methods to assess driving-RT post-concussion. Our study compared driving RT during simulated scenarios between concussed and control individuals and examined driving-RT''s relationship with traditional computerized neurocognitive testing (CNT) domains.MethodsWe employed a cross-sectional study among 14 concussed (15.9 ± 9.8 days post-concussion, mean ± SD) individuals and 14 healthy controls matched for age, sex, and driving experience. Participants completed a driving simulator and CNT (CNS Vital Signs) assessment within 48 h of symptom resolution. A driving-RT composite (ms) was derived from 3 simulated driving scenarios: stoplight (green to yellow), evasion (avoiding approaching vehicle), and pedestrian (person running in front of vehicle). The CNT domains included verbal and visual memory; CNT-RT (simple-, complex-, Stroop-RT individually); simple and complex attention; motor, psychomotor, and processing speed; executive function; and cognitive flexibility. Independent t tests and Hedge d effect sizes assessed driving-RT differences between groups, Pearson correlations (r) examined driving RT and CNT domain relationships among cohorts separately, and p values were controlled for false discovery rate via Benjamini-Hochberg procedures (α = 0.05).ResultsConcussed participants demonstrated slower driving-RT composite scores than controls (mean difference = 292.86 ms; 95% confidence interval (95%CI): 70.18–515.54; p = 0.023; d = 0.992). Evasion-RT (p = 0.054; d = 0.806), pedestrian-RT (p = 0.258; d = 0.312), and stoplight-RT (p = 0.292; d = 0.585) outcomes were not statistically significant after false-discovery rate corrections but demonstrated medium to large effect sizes for concussed deficits. Among concussed individuals, driving-RT outcomes did not significantly correlate with CNT domains (r-range: –0.51 to 0.55; p > 0.05). No correlations existed between driving-RT outcomes and CNT domains among control participants either (r-range: –0.52 to 0.72; p > 0.05).ConclusionSlowed driving-RT composite scores and large effect sizes among concussed individuals when asymptomatic signify lingering impairment and raise driving-safety concerns. Driving-RT and CNT-RT measures correlated moderately but not statistically, which indicates that CNT-RT is not an optimal surrogate for driving RT.     

灾难性创伤事件后青少年危机应对问卷的编制

本研究以＂5.12汶川地震＂为研究背景,在文献综述、抗震救灾心理援助个案分析以及专家探讨的基础上,提出灾难性创伤事件后青少年危机应对的理论构想,并形成了初始问卷;随后对位于极重灾区的1 000名青少年进行预测,通过项目分析、探索性因素分析、验证性因素分析对问卷的项目和结构进行验证,结果显示实证模型与理论模型基本吻合。     

Do parents' own school memories contribute to their satisfaction with their child's school?

In the present study a group of parents with a child in preschool were asked to give evaluative recollections of their own primary school and then to indicate the level of their satisfaction with the functioning of their child's school repeatedly in the course of the child's compulsory education. Across the follow‐up, the parents with positive recollections showed more satisfaction than those with negative recollections did. Over the years, the level of satisfaction decreased in all other groups but the fathers with positive recollections. Parents' recollections may be seen as an experience‐based component of their attitudes towards education.     

‘I’m not a “maths‐person”!’ Reconstituting mathematical subjectivities in aesthetic teaching practices

In this study I have investigated how alternative ways of teaching mathematics influence and affect Early Childhood Education (ECE) students’ attitudes towards maths and how they understand their own subjectivities as more or less mathematical during a 10‐week alternative maths course. The investigated course adopts a feminist post‐structural approach based on critical pedagogy and deconstructive theory and includes an interdisciplinary approach to investigative mathematics. The data used include the memory/narrative writings and process‐writings of 75 female teacher‐education students, collected from three different cohorts, in which the students describe their learning processes throughout the maths course. The study shows that, in the main, the students became much more positively inclined to the subject of mathematics after the maths course and agreed that this course had changed their understanding of their own mathematical subjectivity, albeit in different and varying ways.     

汶川地震灾后儿童心理创伤的表现、评估及重建

汶川地震造成儿童不同程度的心理创伤,形成儿童创伤后应激障碍,并在身心、精神、认知以及行为方面均有所表现。因此需要给予儿童更多的心理照顾以帮助他们度过危机。本文考察了地震灾后儿童心理创伤的阶段性和年龄性特征,提出灾后儿童心理的康复与重建需要开展多层面心理评估,并着重分析了开展地震灾后儿童心理康复与重建的基本原则、辅导策略、活动方式以及服务技巧。     

运动相关颅脑创伤流行病学调查

目的：研究我国华东地区运动相关颅脑创伤的流行病学特征,了解运动相关颅脑创伤的伤情特点,为预防与治疗提供科学依据。方法：从“20（14年华东六省一市颅脑创伤住院患者”数据库中整群抽取运动伤患者．用SPSS13．0统计软件包分析。结果：689例运动相关颅脑创伤患者中男女之比为5．06：1。平均年龄（21．49±7．98）岁.21～30岁年龄组所占比例最大,为45．0％。颅脑创伤多发生于足球、拳击等对抗性运动,其中足球所占比例最大,为16．0％。689例患者大多数为轻型颅脑创伤（GCS13分～15分）,占81．6％。脑震荡是最常见的损伤类型,占299例。患者最常见合并有颌面部损伤。所有住院病人中无死亡病例,植物生存占5．2％,重度残疾占3．9％,中度残疾占10．9％,恢复良好占80．0％。spearman等级相关分析显示,患者的出院GOS评分与入院GCS评分和运动类型显著相关（P〈0．001）;而年龄与GOS无显著相关性。结论在我国华东地区,运动相关颅脑创伤高发于参与对抗性运动的中青年男性,脑震荡是最常见的损伤类型,患者多伴有颌面部损伤。我国相关机构应针对运动相关颅脑创伤的发病特点,制定有针对性的预防措施,以降低其发生率。     

Maslow and Team Organization

Many middle schools use the Web to disseminate and gather information. Online barriers often limit the accessibility of the Web for students with disabilities. The purpose of this study was to evaluate the accessibility of home pages of a sample of middle schools. The authors located 165 Web sites using a popular online directory and evaluated the sites for accessibility. A software program quantified the number of accessibility errors at each site. Most middle school home pages had accessibility problems, and the majority of them represented severe concerns that should be given a high priority for improvement. The good news is that the majority of the errors can easily be corrected. The work reflects a need for middle schools to continuously examine the accessibility of their home pages. Direction for improving accessibility is provided.     

Multicultural education as an emotional situation: practice encountering the unexpected in teacher education

Juxtaposing the concepts of screen memory, counter-transference and the holding environment within psychoanalytic theory, this essay explores the author’s emotional experience, who begins the exploration by asking several questions. What happens to a teacher’s emotional world and her consciousness in the process of trying to shift students’ consciousness in multicultural education? What is the psychical consequence for teachers of colour who must listen to racist discourse as a precondition to convincing those to do otherwise? How does a teacher’s emotional world influence student learning and development of critical consciousness? In working through her emotional response aroused by the students’ questions in her multicultural education classes, the author discusses the importance of a conversation between psychoanalysis and critical multicultural pedagogies and why the conversation matters.     

创伤性肩关节损伤分析及疗效观察

通过分析创伤性肩关节损伤的发病原因及其与运动项目的关系，观察采用电针加红外线及运动针综合疗法，治疗本院85例该病患，结果显示有效率达97、6％。提示该疗法是运动卫生保健工作一项有效治疗方法。同时提出预防损伤的重要性及预防措施，避免因损伤造成的功能、精神、财力等多方面的伤害。