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  • Springer (CrossRef)  (13)
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  • 1
    Language: English
    In: Sports medicine (Auckland, N.Z.), July 2018, Vol.48(7), pp.1761
    Description: The article Test-Retest Reliability and Interpretation of Common Concussion Assessment Tools.
    Keywords: Medicine & Public Health ; Sports Medicine ; Medicine;
    ISSN: 01121642
    E-ISSN: 1179-2035
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  • 2
    Language: English
    In: Sports Medicine, 2018, Vol.48(5), pp.1255-1268
    Description: Background Concussion diagnosis is typically made through clinical examination and supported by performance on clinical assessment tools. Performance on commonly implemented and emerging assessment tools is known to vary between administrations, in the absence of concussion. Objective To evaluate the test-retest reliability of commonly implemented and emerging concussion assessment tools across a large nationally representative sample of student-athletes. Methods Participants ( n  = 4874) from the Concussion Assessment, Research, and Education Consortium completed annual baseline assessments on two or three occasions. Each assessment included measures of self-reported concussion symptoms, motor control, brief and extended neurocognitive function, reaction time, oculomotor/oculovestibular function, and quality of life. Consistency between years 1 and 2 and 1 and 3 were estimated using intraclass correlation coefficients or Kappa and effect sizes (Cohen’s d ). Clinical interpretation guidelines were also generated using confidence intervals to account for non-normally distributed data. Results Reliability for the self-reported concussion symptoms, motor control, and brief and extended neurocognitive assessments from year 1 to 2 ranged from 0.30 to 0.72 while effect sizes ranged from 0.01 to 0.28 (i.e., small). The reliability for these same measures ranged from 0.34 to 0.66 for the year 1–3 interval with effect sizes ranging from 0.05 to 0.42 (i.e., small to less than medium). The year 1–2 reliability for the reaction time, oculomotor/oculovestibular function, and quality-of-life measures ranged from 0.28 to 0.74 with effect sizes from 0.01 to 0.38 (i.e., small to less than medium effects). Conclusions This investigation noted less than optimal reliability for most common and emerging concussion assessment tools. Despite this finding, their use is still necessitated by the absence of a gold standard diagnostic measure, with the ultimate goal of developing more refined and sound tools for clinical use. Clinical interpretation guidelines are provided for the clinician to apply with a degree of certainty in application. Electronic supplementary material The online version of this article (10.1007/s40279-017-0813-0) contains supplementary material, which is available to authorized users.
    Keywords: Original Research Article;
    ISSN: 0112-1642
    E-ISSN: 1179-2035
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  • 3
    Language: English
    In: Sports Medicine, 2018, Vol.48(8), pp.1971-1985
    Description: Background Sport-related concussion and repetitive head impact exposure in contact sports continue to receive increased attention in public and medical spheres. The Concussion Assessment, Research and Education (CARE) Consortium, a multicenter cooperative, was established to study the natural history of concussion in National Collegiate Athletic Association (NCAA) collegiate student-athletes across 29 colleges and universities in the United States. The purpose of this investigation is to provide normative data from the CARE Consortium and evaluate for differences between sport categories. Methods NCAA student-athletes were evaluated annually for general demographics and sport-specific characteristics before the start of the competitive season. We collected demographic and medical history information and evaluated each student-athlete's neurocognitive function, neurological status, postural stability, and self-reported symptoms. Sports were categorized by the amount of contact typically associated with the sport (i.e., contact, limited contact, non-contact). Comparisons between the three sport categories for the evaluated variables were made using linear or zero inflated negative binomial regression models adjusted for gender, concussion history, and household income. Results Over a 2-year period (August 2014-July 2016), 15,681 NCAA athletes completed preseason evaluations. Overall, 53% of the athletes were in the contact sport group, 31% were in the limited contact group and 17% were in the non-contact group. After adjusting for covariates, there were statistically significant differences found between athlete groups, although the differences and effect sizes were small and not clinically significant. The contact sport group had better scores on Immediate Post-Concussion Assessment Testing (ImPACT®) visual and verbal memory, Sport Concussion Assessment Tool (SCAT) symptom checklist, and Brief Symptom Inventory-18 (BSI-18), but slower ImPACT reaction time and worse scores on Standardized Assessment of Concussion (SAC). Further, the data indicate that some ImPACT score distributions were noticeably different from those presented in the technical manual. Conclusions In this large, racially and socio-economically diverse cohort of male and female college athletes, we found no evidence that student-athletes participating in contact sports have clinically meaningful deficits in preseason cognitive and balance testing. They also did not report significantly more symptoms of psychological distress when compared with student-athletes in non-contact or limited contact sports. In addition, the data suggest potential limitations when using published ImPACT norms when evaluating injured athletes.
    Keywords: United States–Us ; Gender Differences ; Students ; Cognition ; Consortia ; Colleges & Universities ; Injury Prevention ; Medical Research ; Posture ; Demographics ; Reaction Time ; Brain Research ; Regression Analysis ; Regression Models ; Concussion ; Athletes ; Norms ; Cognitive Ability ; Statistical Analysis ; Contact Sports ; Pediatrics ; Concussion ; Memory ; Ultrasonic Testing ; College Football ; Consortia ; Data Collection ; Demography ; Stability Analysis ; Athletes ; Family Income ; Cognitive Ability ; Sports Injuries ; Traumatic Brain Injury ; Athletes ; Colleges & Universities ; National Collegiate Athletic Association–Ncaa;
    ISSN: 0112-1642
    E-ISSN: 1179-2035
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  • 4
    Language: English
    In: Sports medicine (Auckland, N.Z.), July 2017, Vol.47(7), pp.1437-1451
    Description: The natural history of mild traumatic brain injury (TBI) or concussion remains poorly defined and no objective biomarker of physiological recovery exists for clinical use. The National Collegiate Athletic Association (NCAA) and the US Department of Defense (DoD) established the Concussion Assessment, Research and Education (CARE) Consortium to study the natural history of clinical and neurobiological recovery after concussion in the service of improved injury prevention, safety and medical care for student-athletes and military personnel. The objectives of this paper were to (i) describe the background and driving rationale for the CARE Consortium; (ii) outline the infrastructure of the Consortium policies, procedures, and governance; (iii) describe the longitudinal 6-month clinical and neurobiological study methodology; and (iv) characterize special considerations in the design and implementation of a multicenter trial. Beginning Fall 2014, CARE Consortium institutions have recruited and enrolled 23,533 student-athletes and military service academy students (approximately 90% of eligible student-athletes and cadets; 64.6% male, 35.4% female). A total of 1174 concussions have been diagnosed in participating subjects, with both concussion and baseline cases deposited in the Federal Interagency Traumatic Brain Injury Research (FITBIR) database. Challenges have included coordinating regulatory issues across civilian and military institutions, operationalizing study procedures, neuroimaging protocol harmonization across sites and platforms, construction and maintenance of a relational database, and data quality and integrity monitoring. The NCAA-DoD CARE Consortium represents a comprehensive investigation of concussion in student-athletes and military service academy students. The richly characterized study sample and multidimensional approach provide an opportunity to advance the field of concussion science, not only among student athletes but in all populations at risk for mild TBI.
    Keywords: Athletes ; Athletic Injuries ; Military Personnel ; Students ; Brain Concussion -- Diagnosis ; Universities -- Organization & Administration
    ISSN: 01121642
    E-ISSN: 1179-2035
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  • 5
    Language: English
    In: Journal of General Internal Medicine, 1987, Vol.2(3), pp.168-173
    Description: Nonelective hospitalizations for urgent or emergent reasons are frequent events for patients with diabetes mellitus, and their occurrence is difficult to predict. A model for predicting nonelective hospitalizations is described. It is based on risk factors: prior visits to the emergency room, hypoalbuminemia, cardiomegaly, anemia, systolic hypotension, and hyperglycemia. To test the model, the authors conducted a prospective cohort study in which 429 ambulatory patients with diabetes mellitus were stratified into three risk levels for hospitalization and followed for two years. Patients in higher risk groups were more likely to be hospitalized (high risk, 58.1%; medium risk, 40.2%; low risk, 26.6%, p〈0.01) and had more hospitalizations per patient (1.47 vs. 0.80 vs. 0.46, p〈0.01) and more hospital days per patient (14.6 vs. 8.6 vs. 5.3, p〈0.01). When the two-year study period was divided into four six-month intervals, there was no significant difference across the four periods. This study demonstrates the validity of the model for predicting nonelective hospitalizations of patients with diabetes mellitus over time.
    Keywords: diabetes mellitus ; patient admissions ; ambulatory care ; hospitalization ; appointments and schedules
    ISSN: 0884-8734
    E-ISSN: 1525-1497
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  • 6
    Language: English
    In: Journal of General Internal Medicine, 1987, Vol.2(4), pp.232-238
    Description: An intervention package was examined to determine its effectiveness in increasing office visits and in reducing the incidence of nonelective hospitalizations (those for urgent or emergent reasons). The intervention included mailings of information, appointment reminders, and intense follow-up by telephone of visit failures for rescheduling. Eight hundred fifty-four patients receiving drug therapy for diabetes mellitus were stratified by risk of nonelective hospitalization and randomly assigned to the control group or the intervention group. After two years, the intervention group averaged 9.1 per cent more kept scheduled visits per month than the control group (0.371 vs. 0.340, p=0.02). However, the mean incidence of nonelective hospitalizations per month was not significantly different between intervention and control groups (0.040 vs. 0.041, p=0.9), nor was there a difference in nonelective hospital days per month (0.443 vs. 0.425, p=0.7). The authors conclude that while mailings and telephone calls can increase office visits, the intervention is not sufficient to reduce morbidity necessitating nonelective hospitalizations of diabetic patients.
    Keywords: diabetes mellitus ; patient admissions ; ambulatory care ; hospitalization ; appointments and schedules
    ISSN: 0884-8734
    E-ISSN: 1525-1497
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  • 7
    Language: English
    In: Journal of General Internal Medicine, 1996, Vol.11(12), pp.762-764
    Description: We previously reported a predictive model that identified potentially modifiable risk factors for nonelective readmission to a county hospital. The objectives of this study were to determine if those risk factors were generalizable to a different population. We found that the previously reported risk factors were generalizable, and other potentially modifiable risk factors were identified in this population of veterans. However, further research is needed to establish whether or not the risk factors can be modified and whether or not modification improves outcomes.
    Keywords: patient readmission ; patient discharge ; hospitalization
    ISSN: 0884-8734
    E-ISSN: 1525-1497
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  • 8
    Language: English
    In: Journal of Behavioral Medicine, 1988, Vol.11(4), pp.383-393
    Description: This study evaluates the impact of a pipeline assessment (salivary cotinine determination) on the accuracy of self-reported use of cigarettes and smokeless tobacco by 160 rural seventh-and eighth-grade males ranging in age from 12 to 16. Half of them were randomly assigned to complete a questionnaire on tobacco use prior to revealing the biochemical validation materials and collecting samples. The others had the samples collected prior to receiving and completing the questionnaires. The questionnaire-first group reported significantly greater smokeless tobacco use than did the pipeline-first group. Only for the latter were their self-reports significantly corroborated by the cotinine results. These results suggest that the utilization of a biochemical pipeline not only can improve self-reported tobacco use but also may help identify perceptions about the social desirability of using harmful substances.
    Keywords: bogus pipeline ; smokeless tobacco ; cigarette ; self-reports ; adolescent
    ISSN: 0160-7715
    E-ISSN: 1573-3521
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  • 9
    Language: English
    In: Pediatric Radiology, 1996, Vol.26(11), pp.811-814
    Description: Purpose . The objectives of the study were to document the normal CT appearance and size of the crura of the diaphragm in children. Materials and methods . The CT scans of 80 children (0–15 years) were reviewed. The children were divided into eight age groups. The maximal transverse diameters of the right and left crura were measured. They were normalized by comparison with the transverse and anteriorposterior diameters of the 12th thoracic vertebra (T12) and the transverse abdominal diameter at T12. The crura were also evaluated as to whether their contour was smooth or nodular. . The diaphragmatic crura of smaller children appear large, relative to body size and the diameters of the T12 vertebral body, compared with those in older children. Crural width does not increase significantly with age. Additionally, the crura were found to have a greater tendency to be nodular in appearance in children under the age of 5 years than in older children. . Diaphragmatic crura are more nodular and larger relative to body size in younger children.
    Keywords: Abdomen–Anatomy & Histology ; Adolescent–Anatomy & Histology ; Aging–Diagnostic Imaging ; Anthropometry–Anatomy & Histology ; Body Constitution–Diagnostic Imaging ; Child–Diagnostic Imaging ; Child, Preschool–Diagnostic Imaging ; Diaphragm–Diagnostic Imaging ; Humans–Diagnostic Imaging ; Infant–Diagnostic Imaging ; Radiography, Abdominal–Diagnostic Imaging ; Retrospective Studies–Diagnostic Imaging ; Thoracic Vertebrae–Diagnostic Imaging ; Tomography, X-Ray Computed–Diagnostic Imaging;
    ISSN: 0301-0449
    E-ISSN: 1432-1998
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  • 10
    Language: English
    In: Diseases of the Colon & Rectum, 1986, Vol.29(1), pp.49-51
    Description: Hepatic portal venous gas occurring during an air-contrast bariumenema examination in patients with inflammatory bowel disease is a benign finding. Patients with chronic ulcerative colitis have experienced some morbidity, while those with Crohn's colitis have not. It may not be necessary to treat all of these patients with antibiotics, especially asymptomatic patients with Crohn's colitis.
    Keywords: Portal venous gas ; Crohn's disease ; Barium enema ; Benign
    ISSN: 0012-3706
    E-ISSN: 1530-0358
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