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Describe concussion education perceptions among secondary school athletic trainers and determine the relationship between education program characteristics and perceived effectiveness. Two hundred and three participants completed at least one survey item (age = 35.2 ± 9.4 years; male = 27.6%). We used descriptive statistics to describe concussion education characteristics and point out biserial correlations to determine if relationships existed between concussion education characteristics and perceived effectiveness. The most frequently used mandated concussion education programs were informational handouts created by the state interscholastic association, the Centers for Disease Control and Prevention's (CDC) Heads Up materials, and the National Federation of State High School Athletic Association's materials. The CDC's Heads Up materials, handouts created by the state interscholastic association, and in-person presentations created by respondents were the most frequent concussion educational programs utilized by respondents who indicated no specific program mandated. Educational programs that were engaging increased perceived effectiveness (n = 131, rpb = 0.31,p < 0.001). Our results highlight that materials created by state interscholastic association and the CDC's Heads Up program among others are utilized to satisfy mandates and are perceived to be moderately effective, especially when perceived to be engaging. These results can help guide future studies to examine specific educational tools and administration strategies to determine effectiveness on concussion disclosure. [ABSTRACT FROM AUTHOR]

Teachers play an important role in supporting students' return to school after concussion. This online cross sectional survey examined teachers' beliefs and practices regarding concussion and academic support strategies, or academic adjustments (AA). Most teachers (99.1%) agreed-to-strongly agreed concussions affect school performance, and many (71.6%) have worked with a student who received AA after concussion. Teachers who participated in concussion education and observed a decline in a student's academic performance after concussion were more familiar with and recommended AA more often. Professional development is recommended to provide teachers with practical and timely resources to enhance support for students after concussion. [ABSTRACT FROM AUTHOR]

Following a concussion, both cognitive and physical rest are imperative aspects of injury management. The inclusion of academic adjustments and the formation of an interprofessional concussion management team (ICMT) provide a mechanism to manage academic issues following a concussion. As one of the sole healthcare providers presents during school hours, the school nurse may offer unique insight regarding the infrastructure of an ICMT in the secondary school setting. The purpose of this study was to explore school nurses’ perceptions of and experiences with an ICMT for adolescents following a concussion in the secondary school setting. The consensual qualitative research approach was used to guide this study. Semi-structured individual telephone interviews were conducted with 15 school nurses employed in the secondary school setting across the United States. During data analysis, themes and categories were established based on a consensus process by the research team. Study findings indicated that school nurses identified several stakeholders regarding the concussion management team that are essential to include in the concussion management process. In addition to the school nurse, participants perceived an ICMT should include a physician, athletic trainer, school counsellor, teachers, and other stakeholders such as the patient and their parents. Additionally, participants discussed their perceptions of their own role as a member of an ICMT in the secondary school setting. The inclusion of an ICMT to aid the recovery following a concussion is vital to ensure proper care for the adolescent patient. Furthermore, the school nurse and athletic trainer must effectively collaborate, when possible, to ensure that concussed adolescents are allowed sufficient cognitive rest via the incorporation of academic adjustments during the recovery process. [ABSTRACT FROM PUBLISHER]

Background: Concussions present significant public health concerns and associated medical costs, especially for those with persisting concussion symptoms. Purpose: To compare direct costs of care for adolescent patients managed within the secondary school setting with and without persisting concussion symptoms. Methods: Our study was a retrospective analysis of medical records using the Athletic Training Practice-Based Research Network which included records from 59 secondary schools in the United States. Participants included 282 adolescent patients following a concussion (male=199, female=83, age=15.5 years, 95% CI:15.3, 15.6). Complete patient cases were identified using International Classification of Diseases and Related Health Problems diagnostic codes for concussion between 2010-2017. We calculated summary statistics for common services and direct costs of care, calculated based on reimbursement rates for Current Procedural Terminology codes. Patients were grouped as with (symptoms experienced 28 days; n=38) and without (symptoms experienced <28 days; n=238) persisting concussion-related symptoms. A Mann-Whitney U test was used to determine if direct cost of care differed between groups (n=276, α=0.05). We used a linear regression to determine cost for each additional day of care. Results: The most common service was an athletic trainer re-evaluation (n=1012/1560, 64.9%). The average total direct costs of care was US $286.30 per adolescent patient (95% CI: US $260.14-312.45). Significantly higher direct costs of care were reported for patients with persisting symptoms (p <0.001; persisting: median=US $471.07, IQR=US $281.21-564.93, 95% CI: US $367.05-528.11; without persisting: median=US $210.95; IQR=US $117.45-337.52, 95% CI: US $234.28-286.82). The concussion base price was US $174.42 (95%CI: US $129.75-219.10) and each additional day cost US $5.99 (95% CI: $3.99-7.99). Conclusions: Our findings provide insight to potential costs associated with adolescent patients who are managed within the secondary school setting following a concussion. These results highlight the potential economic value of sports medicine professionals within the school setting. Other health care professionals not in the school setting may advise patients to first be evaluated and managed by the site athletic trainer if able and in accordance with state law, prior to an office visit to also reduce care costs as many athletic trainers do not charge for their services. Future research should examine how to decrease the economic burden for patients. [ABSTRACT FROM AUTHOR]

The article discusses a study on the knowledge of U.S. youth sports coaches concerning first-aid and injury prevention. It mentions that while young athletes tend to benefit from organized sports, they are also at risk of sports-related injuries. It is said that the country lacks as mandated program for certification of youth coaches in which reports show that an estimated 85% do not possess adequate knowledge in areas such as basic safety. The study indicates that only 3.2% of 156 youth coach respondents were able to pass the First-Aid Assessment (FAA).

Objective: This paper provides an overview of the state of evidence-based practice (EBP) in nursing and selected allied health professions and a synopsis of current trends in incorporating EBP into clinical education and practice in these fields. This overview is intended to better equip librarians with a general understanding of the fields and relevant information resources, Included Professions: Professions are athletic training, audiology, health education and promotion, nursing, occupational therapy, physical therapy, physician assisting, respiratory care, and speech-language pathology. Approach: Each section provides a description of a profession, highlighting changes that increase the importance of clinicians' access to and use of the profession's knowledge base, and a review of each professions efforts to support EBP. The paper concludes with a discussion of the librarian's role in providing EBP support to the profession. Conclusions: EBP is in varying stages of growth among these fields. The evolution of EBP is evidenced by developments in preservice training, growth of the literature and resources, and increased research funding. Obstacles to EBP include competing job tasks, the need for additional training, and prevalent attitudes and behaviors toward research among practitioners. Librarians' skills in searching, organizing, and evaluating information can contribute to furthering the development of EBP in a given profession. [ABSTRACT FROM AUTHOR]

The article discusses the postural control deficits in participants with functional ankle instability as measured by the Balance Error Scoring System (BESS), in the U.S. The study involved a between-groups design to assess postural control among participants, conducted in a university athletic training facility. The test battery of BESS requires participants to stand unsupported on two different surfaces and in different stances. Based from the results, subjects with functional ankle instability scored more errors or having poorer balance on the single stancefirm condition, tandem stancefoam condition, and total BESS score. Therefore, using the BESS, postural control deficits were identified in participants with functional ankle instability.

Provides information on the management of sport-related concussion recommended for certified athletic trainers (ATC), physicians and other medical professionals caring for athletes as detailed under the position statement of the National Athletic Trainers' Association of the U.S. Factors that attributed to the decrease in number of incidence of fatalities and nonfatal catastrophic injuries among high school and collegiate football players between 1976 and 1980 in the country; Mechanisms and presentation of traumatic brain injury; Action that should be taken by ATC to detect deteriorating signs and symptoms that may indicate a more serious head injury.

Context: Gymnastics trains fundamental movement skills but has high rates of early sport specialization. Early specialization is associated with increased injury risk. Gymnasts devote time to developing technical skill, but whether specialization status influences performance is unknown., Objective: To describe the participation and specialization characteristics of youth club gymnastics participants and determine whether the level of specialization is associated with fitness and functional task performance., Design: Retrospective cross-sectional study., Setting: A single gymnastics facility., Patients or Other Participants: Data on youth gymnasts (n = 131; 84 females, 47 males; age = 10.9 ± 2.9 years, height = 142.14 ± 16.23 cm, mass = 38.15 ± 12.93 kg) were reviewed., Main Outcome Measure(s): Specialization was assessed using a 3-tiered classification. Fitness measurements consisted of the Gymnastics Functional Measurement Tool, Men's Gymnastics Functional Measurement Tool, and core strength. Functional tasks evaluated hop performance, dynamic balance, and jump-landing technique. Separate analyses of covariance, covaried by age, hours of training, and years of gymnastics participation, were used to identify differences in fitness and functional performance among specialization groups. Pearson product correlations were calculated to evaluate the relationships between training hours per week and years in gymnastics with fitness and functional performance., Results: Most gymnasts were classified as moderately (50.4%, n = 66) or highly (35.1%, n = 46) specialized. Only 14.5% (n = 19) were classified as having a low level of specialization. Weak to moderate correlations were present between years in gymnastics and most fitness tasks. Moderate to strong correlations were noted between training hours per week and most fitness tasks. Low-specialization gymnasts scored lower on right lower extremity Y-balance ( P = .004), upper left extremity Y-balance ( P = .033), and right hop performance ( P = .039) tests., Conclusions: Gymnasts reported high proportions of moderate to high specialization, and many exceeded guidelines for hours participating in gymnastics per week. We did not observe clinically meaningful group differences among specialization status and fitness or functional movement tasks, indicating no clear benefit of gymnastics training to the exclusion of other sports for increased performance.

Objective: To assess the influence of psychosocial determinants from the Theory of Reasoned Action and Planned Behaviour (TRA/TPB) on concussion-reporting intentions., Methods: The present study employed the TRA/TPB to develop a cross-sectional survey to examine contributors to intention to report concussion symptoms. High school athletes (n = 167, age = 15.7 ± 1.4) completed this survey. The TRA/TPB constructs of attitude (perceptions about concussion reporting), subjective norm (perception of important social referents beliefs about concussion reporting), perceived behavioural control (perceived control over concussion reporting) and intention to report concussion symptoms served as the independent variables. Linear regression models were used to predict intention to report concussion symptoms. Binomial regression models were used to predict concussion-reporting behaviours from intention., Results: Direct attitude, subjective norm and direct perceived behavioural control were all associated with intention to report concussion. Intention was associated with decreased prevalence of participating in practices and games while symptomatic from concussion., Conclusions: Favourable attitudes toward reporting and social referents' beliefs have the greatest impact on intention to report concussion symptoms. Reporting intention may not always be an indicator of concussion-reporting behaviours. Concussion education initiatives should focus on improving attitudes and beliefs among athletes, coaches and parents to promote better care-seeking behaviours among young athletes.

This article aims to examine pediatric concussion literature with respect to epidemiology, etiology, return to play, and recurrent concussions, and to provide recommendations for future research. We conducted a review of pediatric concussion literature regarding incidence, etiology, return to play, and recurrent concussive injury by using MEDLINE, CINAHL, Sport-Discus, and PsychInfo databases from 1995-2010. A review of reference lists in the aforementioned articles was also performed. We discovered that the research on sports-related concussion specific to children and adolescents is rather limited. Results of existing studies of concussion incidence in this population indicate that concussion is relatively rare compared with most musculoskeletal injuries; however, the potential consequences of mismanagement and of subsequent injury warrant significant attention regarding injury recognition and recovery, and the challenge of determining readiness to return to play. Evidence exists that children and adolescents take longer to recover than adults after a concussion, which underscores the need for a more conservative approach to management and return to physical and cognitive activities. Concussion in the young athlete is of specific concern because of the continuing cognitive maturation, therefore, the recovery may be more difficult to track when using the standard assessment tools currently available. Until future studies can better delineate the mechanisms of, response to, and recovery from concussion in the young athlete, it is prudent to act in a conservative manner when dealing with pediatric athletes with concussion., (Copyright © 2011 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.)

Context: Clinicians often rely on the self-report symptoms of patients in making clinical decisions; hence it is important that these scales be reliable., Objective: To determine the test-retest reliability of healthy youth in completing a graded symptom scale (GSS), modified from the Head Injury Scale Self-Report Concussion Symptoms Scale (HIS)., Design: Repeated-measures., Setting: Middle school classroom., Patients or Other Participants: 126 middle school students., Intervention: A survey consisting of a demographic and life events questionnaire and a GSS asking about symptom severity and duration., Main Outcomes Measures: Score for each symptom on the severity and duration scale and a total symptom score (TSS) and the total number of symptoms endorsed (TSE) from the severity scale. Responses on a life events questionnaire were also recorded., Results: We found excellent reliability for TSS (ICC=.93) and TSE (ICC=.88) for the severity scale. We found moderate to excellent reliability on the individual symptoms of both the severity (ICC=.65-.89) and duration (ICC=56-.96) scales., Conclusions: Healthy youth can reliably self-report symptoms using a GSS. This patient-oriented outcome measure should be incorporated into more investigations in this age group.