Impaired motor control after sport-related concussion could increase risk for musculoskeletal injury: Implications for clinical management and rehabilitation

This review presents a conceptual framework and supporting evidence that links impaired motor control after sport-related concussion(SRC)to increased risk for musculoskeletal injury.Multiple studies have found that athletes who are post-SRC have higher risk for musculoskeletal injury compared to their counterparts.A small body of research suggests that impairments in motor control are associated with musculoskeletal injury risk.Motor control involves the perception and processing of sensory information and subsequent coordination of motor output within the central nervous system to perform a motor task.Motor control is inclusive of motor planning and motor learning.If sensory information is not accurately perceived or there is interference with sensory information processing and cognition,motor function will be altered,and an athlete may become vulnerable to injury during sport participation.Athletes with SRC show neuroanatomic and neurophysiological changes relevant to motor control even after meeting return to sport criteria,including a normal neurological examination,resolution of symptoms,and return to baseline function on traditional concussion testing.In conjunction,altered motor function is demonstrated after SRC in muscle activation and force production,movement patterns,balance/postural stability,and motor task performance,especially performance of a motor task paired with a cognitive task(i.e.,dual-task condition).The clinical implications of this conceptual framework include a need to intentionally address motor control impairments after SRC to mitigate musculoskeletal injury risk and to monitor motor control as the athlete progresses through the return to sport continuum.     

Impact of sports participation on mortality rates among Brazilian adults

Objective: To analyze the possible dose-response association between components of sports participation (intensity, volume and previous engagement) and 4-year mortality rates among Brazilian adults.

Methods: 679 males and females (mean age among men = 66.7 ± 9.3 years old and mean age among women = 64.8 ± 8.9 years old) composed the study sample. Sports participation was assessed using Baecke’s questionnaire, which considers intensity, duration and previous engagement. Medical records were used to identify the cause of the death. Cox regression analysis was performed to determine the independent associations of exercise components and mortality.

Results: Participants that reported exercising at moderate-vigorous intensity (Moderate/vigorous: 4.1% versus None/light: 10.3% [p-value = 0.012]; HR = 0.42 [0.1 to 0.94)] and for more than four months (≥4 months: 5.3% versus <4 months: 10.2% [p-value = 0.038]; HR = 0.47 [0.24 to 0.94]) had lower mortality risk. The percentage of survival according to all-cause mortality was significantly higher for participants engaged in sports at moderate-vigorous intensity (p-value = 0.014), as well as for those engaged in sports for periods superior than four months (p-value = 0.036).

Conclusion: We found higher percentage of survival among adults engaged in sports at moderate-vigorous intensity and with at least four months of previous engagement.     

Influence Strategies in the Supervisory Dyad: An Investigation Into the Effects of Gender and Age

A content analysis of audiotapes from 42 counseling supervisory dyads examined the effects of supervisor and supervisee gender on the influence strategies used in the session. Gender of the supervisor was not related to influence strategy. Supervisors of both genders were significantly more likely to accept or build upon the ideas generated by female supervisees and asked for more opinions from male supervisees. Male supervisees gave significantly more suggestions than did female supervisees, and female supervisees praised their supervisors more often than did male supervisees. Also, age differences between supervisor and supervisee interacted with gender to affect influence strategies used in the supervisory dyad.     

Starting with a clean slate: An analysis of member identification with a new sports team

Soccer in Australia underwent a series of changes following a Federal Government inquiry into its future. A report into the Structure, Governance and Management of Soccer in Australia (2003) recommended a process of structural change, aimed at repositioning and re-branding soccer as association football. The restructure yielded the replacement of the National Soccer League with the A-League, five new Australian teams and a concerted attempt to separate soccer from its ethnic ties in the antipodes. This paper examines member identification in relation to a specific A-League club’s members. Using the Sports Spectator Identity Scale (Wann & Branscombe, 1993) to measure sport fan identity in a new team context, a survey of club members of Sydney FC (n = 510), was undertaken. Survey findings indicated that members of Sydney FC reported relatively strong team identification in the first year of the new competition, with some nuanced differences based on age and income. The SSIS demonstrated a good level of fit in relation to a new sports team, although it is evident that rivalries and identification with a new team need time to develop fully.     

Ecological principle meets cancer treatment: treating children with acute myeloid leukemia with low-dose chemotherapy

Standard chemotherapy regimens for remission induction of pediatric acute myeloid leukemia (AML) are associated with significant morbidity and mortality. We performed a cohort study to determine the impact of reducing the intensity of remission induction chemotherapy on the outcomes of selected children with AML treated with a low-dose induction regimen plus granulocyte colony stimulating factor (G-CSF) (low-dose chemotherapy (LDC)/G-CSF). Complete response (CR) after two induction courses was attained in 87.0% (40/46) of patients receiving LDC/G-CSF. Post-remission therapy was offered to all patients, and included standard consolidation and/or stem cell transplantation. During the study period, an additional 94 consecutive children with AML treated with standard chemotherapy (SDC) for induction (80/94 (85.1%) of the patients attained CR after induction II, P = 0.953) and post-remission. In this non-randomized study, there were no significant differences in 4-year event-free (67.4 vs. 70.7%; P = 0.99) and overall (70.3 vs. 74.6%, P = 0.69) survival in the LDC/G-CSF and SDC cohorts, respectively. After the first course of induction, recovery of white blood cell (WBC) and platelet counts were significantly faster in patients receiving LDC/G-CSF than in those receiving SDC (11.5 vs. 18.5 d for WBCs (P < 0.001); 15.5 vs. 22.0 d for platelets (P < 0.001)). To examine the quality of molecular response, targeted deep sequencing was performed. Of 137 mutations detected at diagnosis in 20 children who attained hematological CR after two courses of LDC/G-CSF (n = 9) or SDC (n = 11), all of the mutations were below the reference value (variant allelic frequency <2.5%) after two courses, irrespective of the treatment group. In conclusion, children with AML receiving LDC/G-CSF appear to have similar outcomes and mutation clearance levels, but significantly lower toxicity than those receiving SDC. Thus, LDC/G-CSF should be further evaluated as an effective alternative to remission induction in pediatric AML.     

Lifelong learning policies supporting young adults in two Portuguese regions

ABSTRACT

Precarious jobs and unemployment have become common issues for many young adults due to the unfavourable labour market situation in Portugal. Against this background, lifelong learning (LLL) policies have been called in to play a role in creating economic growth and supporting the social inclusion of young adults in vulnerable educational and economic circumstances. These policies are defined at the national level; however, their implementation depends on the action of local actors who face specific challenges. This paper explores disparities in the definition and implementation of LLL policies targeting young adults in two Portuguese regions. Specifically, we analyse professional courses in Vale do Ave (North) and adult education and training courses in Alentejo Litoral (South). These regions were selected due to their dissimilar economic structure. This study adopted a qualitative approach through interviews with LLL experts and policy roundtables with local stakeholders and decision-makers in both regions. Data were transcribed and analysed using NVivo 10. The study shows that the two regions have different cooperation networks between local stakeholders, and that these impact the opportunities to influence the regional skills formation system differently. Also, the study shows that LLL policies are not designed to address destandardised life courses.     

Promoting Student Cognitive Development in Counselor Preparation: A Proposed Expanded Role for Faculty Advisers

The development of cognitively complex counselors has been identified as an important component of counselor education. However, there are no models to provide direction for programs to systematically promote student cognitive growth over the entire course of their graduate education. In many counseling programs, the faculty adviser is the one professor who has interactions with a student from admission through graduation and, thus, could serve an important role in coordinating efforts to facilitate student cognitive development. Toward that end, the authors propose a structured advising model to assist faculty advisers in facilitating the cognitive growth of their advisees.