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Examine pre-existing learning disorders (LD) and attention deficit/hyperactivity disorders (ADHD) as risk factors for prolonged recovery and increased symptomology following pediatric mild traumatic brain injury (mTBI).
We conducted a retrospective cohort study of children/adolescents (5-17 years) with mTBI who presented to a Children’s Minnesota Concussion Clinic between April 2018 and March 2019. Differences across strata of pre-existing conditions (present vs. absent) in time to recovery measures were estimated via Kaplan–Meier and Cox proportional hazards analyses and differences in symptom trajectories were examined via linear mixed-effects regression models. Regression models were adjusted for age, sex and other confounders.
In our cohort of 680 mTBI patients, those with LD (n = 70) or ADHD (n = 107) experienced significantly longer median durations of symptoms (58 and 68 days, respectively) than those without (43 days). Accordingly, LD was significantly associated with delayed symptom recovery (adjusted hazard ratio (aHR) = 1.63, 95% CI: 1.16–2.29), return to school (1.47, 1.08–2.00), and return to physical activity (1.50, 1.10–2.04). Likewise, ADHD was associated with delayed recovery (1.69, 1.28–2.23), return to school (1.52, 1.17–1.97) and physical activity (1.55, 1.19–2.01). Further, patients with LD or ADHD reported, on average, significantly more concussion symptoms and higher vision symptom scores throughout recovery versus those without. There was no evidence that concussion or vision symptom recovery trajectories varied over time between those with/without LD or ADHD (joint P-interactions > 0.05).
Pre-existing LD and ADHD are risk factors for prolonged and more symptomatic mTBI recovery in youth. These results can inform clinical concussion management and recovery expectations.
Recognizing the need for organizational change in a transition setting, we specify a research model entailing the effects of two important workplace variables on the relationship between dispositional resistance to change and organizational commitment. Organizational commitment is important because of its relationship with a host of considerations relevant to successful organizational change and development. We test the model with samples from four Ukrainian firms undergoing comparable substantive change, including in their human resource systems. The results indicate that the negative relationship between resistance to change and organization commitment is moderated by trust in management. Specifically, it is the lack of trust that exacerbates the negative influence of resistance to change on commitment. Also, high procedural justice strengthens the negative relationship, thereby reducing organizational commitment, an interesting divergence from the Western literature. These indigenous findings in a markedly different context from the West hold potential for theory that is richer and more comprehensive in its explanatory reach. The findings also provide useful insights for managers in Ukraine in their efforts to change organizational practices.
Gravitational waves from coalescing neutron stars encode information about nuclear matter at extreme densities, inaccessible by laboratory experiments. The late inspiral is influenced by the presence of tides, which depend on the neutron star equation of state. Neutron star mergers are expected to often produce rapidly rotating remnant neutron stars that emit gravitational waves. These will provide clues to the extremely hot post-merger environment. This signature of nuclear matter in gravitational waves contains most information in the 2–4 kHz frequency band, which is outside of the most sensitive band of current detectors. We present the design concept and science case for a Neutron Star Extreme Matter Observatory (NEMO): a gravitational-wave interferometer optimised to study nuclear physics with merging neutron stars. The concept uses high-circulating laser power, quantum squeezing, and a detector topology specifically designed to achieve the high-frequency sensitivity necessary to probe nuclear matter using gravitational waves. Above 1 kHz, the proposed strain sensitivity is comparable to full third-generation detectors at a fraction of the cost. Such sensitivity changes expected event rates for detection of post-merger remnants from approximately one per few decades with two A+ detectors to a few per year and potentially allow for the first gravitational-wave observations of supernovae, isolated neutron stars, and other exotica.
The non-medical use of prescription stimulants (NMUPS) is a common habit among American college students; It refers to the use of stimulant medications by students who do not qualify for prescription or in higher quantities or manners other than prescribed in order to improve their academic performance. To the best of our knowledge, no studies have examined the role of specific affective, biologically determined and inherited traits that might predict misuse of stimulants for neuroenhancement in graduate education.
To examine the role for individual temperament traits on non-medical use of prescription stimulants (NMUPS) in medical college students.
We investigated 181 students using the short form of the Temperament Evaluation of the Memphis, Pisa, Paris and San Diego Auto-questionnaire (TEMPS-A). Furthermore, we assessed the association of demographic variables and health risk behaviors (drinking, smoking, use other illicit drugs) with NMUPS. Predictors were investigated using logistic regression.
The prevalence of NMUPS was 30.06% with 7.1% users being previously diagnosed with ADHD. NMUPS users had higher scores on the hyperthymic scale. The main reason for taking NMUPS was to “Increase ability to stay alert during studying” (80.1%) followed by “Allow studying for longer periods of time” (19.9%). The hyperthymic temperament score and being a user of other illicit drugs increased the odds of becoming NMUPS.
Our results suggest that personality profiles can be used to identify students with an increased risk for NMUPS for early personalized counseling and behavioral intervention based on their temperament profile.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Mixed-methods designs, especially those in which case selection is regression-based, have become popular across the social sciences. In this paper, we highlight why tools from spatial analysis—which have largely been overlooked in the mixed-methods literature—can be used for case selection and be particularly fruitful for theory development. We discuss two tools for integrating quantitative and qualitative analysis: (1) spatial autocorrelation in the outcome of interest; and (2) spatial autocorrelation in the residuals of a regression model. The case selection strategies presented here enable scholars to systematically use geography to learn more about their data and select cases that help identify scope conditions, evaluate the appropriate unit or level of analysis, examine causal mechanisms, and uncover previously omitted variables.
To determine the burden of skin and soft tissue infections (SSTI), the nature of antimicrobial prescribing and factors contributing to inappropriate prescribing for SSTIs in Australian aged care facilities, SSTI and antimicrobial prescribing data were collected via a standardised national survey. The proportion of residents prescribed ⩾1 antimicrobial for presumed SSTI and the proportion whose infections met McGeer et al. surveillance definitions were determined. Antimicrobial choice was compared to national prescribing guidelines and prescription duration analysed using a negative binomial mixed-effects regression model. Of 12 319 surveyed residents, 452 (3.7%) were prescribed an antimicrobial for a SSTI and 29% of these residents had confirmed infection. Topical clotrimazole was most frequently prescribed, often for unspecified indications. Where an indication was documented, antimicrobial choice was generally aligned with recommendations. Duration of prescribing (in days) was associated with use of an agent for prophylaxis (rate ratio (RR) 1.63, 95% confidence interval (CI) 1.08–2.52), PRN orders (RR 2.10, 95% CI 1.42–3.11) and prescription of a topical agent (RR 1.47, 95% CI 1.08–2.02), while documentation of a review or stop date was associated with reduced duration of prescribing (RR 0.33, 95% CI 0.25–0.43). Antimicrobial prescribing for SSTI is frequent in aged care facilities in Australia. Methods to enhance appropriate prescribing, including clinician documentation, are required.
To establish the prevalence of hypocalcaemia following laryngectomy and demonstrate that total thyroidectomy is a risk factor.
A retrospective cohort study was conducted that included all patients who underwent total laryngectomy from 1st January 2006 to 1st August 2017. Exclusion criteria were: pre-operative calcium derangement, previous thyroid or parathyroid surgery, concurrent glossectomy, pharyngectomy, or oesophagectomy.
Ninety patients were included. Sixteen patients had early hypocalcaemia (18 per cent), seven had protracted hypocalcaemia (8 per cent) and six had permanent hypocalcaemia (10 per cent). Exact logistic regression values for hypocalcaemia following total thyroidectomy compared to other patients were: early hypocalcaemia, odds ratio = 15.5 (95 per cent confidence interval = 2.2–181.9; model p = 0.002); protracted hypocalcaemia, odds ratio = 13.3 (95 per cent confidence interval = 1.5–117.1; model p = 0.01); and permanent hypocalcaemia, odds ratio = 22.7 (95 per cent confidence interval = 1.9–376.5; model p = 0.005).
This is the largest study to investigate the prevalence of hypocalcaemia following laryngectomy and the first to include follow up of longer than three months. Total thyroidectomy significantly increased the risk of hypocalcaemia at all time frames and independent of other variables.
Mixed-methods designs, especially those where cases selected for small-N analysis (SNA) are nested within a large-N analysis (LNA), have become increasingly popular. Yet, since the LNA in this approach assumes that units are independently distributed, such designs are unable to account for spatial dependence, and dependence becomes a threat to inference, rather than an issue for empirical or theoretical investigation. This is unfortunate, since research in political science has recently drawn attention to diffusion and interconnectedness more broadly. In this paper we develop a framework for mixed-methods research with spatially dependent data—a framework we label “geo-nested analysis”—where insights gleaned at each step of the research process set the agenda for the next phase and where case selection for SNA is based on diagnostics of a spatial-econometric analysis. We illustrate our framework using data from a seminal study of homicides in the United States.
The Brazilian Supreme Court (Supremo Tribunal Federal, STF) is widely regarded as one of the more powerful high, constitutional tribunals in Latin America (Brinks 2005; Taylor 2008; Nunes 2010; Kapiszewski 2012). This power is often understood in terms of the effects of court decisions, effects which have been expanding to be more general and binding since the 1990s, giving the STF increasing policy-making authority (Desposato et al. 2015). The STF is also generally regarded as a very visible high court, due in large part to the media attention it has drawn in deciding major issues of national importance, including racial quotas and affirmative action, family status for same-sex couples, stem-cell research, land invasions, pension and tax reform, and political corruption (Taylor 2008; Kapiszewski 2012; Falcão and de Oliveira 2013; Desposato et al. 2015). However, with few exceptions (e.g., Falcão and de Oliveira 2013), an underexamined feature of the court is its unusually high transparency. Indeed, compared with its regional peers, and even with the US Supreme Court, the Brazilian STF can reasonably be called the most transparent high, constitutional court in the Americas.
This chapter offers three main contributions: (1) a descriptive documentation of this high transparency, (2) an examination of some of the sources of this transparency, including media relations, and (3) an examination of some of the implications of this transparency, especially regarding public opinion of the court. In documenting the STF's uncommon transparency, I draw on existing data on the openness of national courts across Latin America, specifically, a study of the web-based access to judicial information conducted by the Center for Judicial Studies of the Americas (Centro de Estudios Judiciales de las Americas, CEJA (N.d.)), which is an organ of the Organization of American States (OAS). In examining the sources of this transparency, I build on recent scholarship on the rising media coverage of the STF (Falcão and de Oliveira 2013), and also on the STF's data and documents on its own public relations operations and internal, intrainstitutional efforts to generate media coverage of itself.
Existing research shows that the ideas of judges shape their behaviour. A natural next question to ask is, where do these ideas come from? Yet, there is little empirical evidence regarding the content and distribution of these ideas and even less evidence regarding the sources of these ideas, especially how ideas transfer or diffuse among judges. In this article, a survey of judges in the Mexican state of Michoacán generates original data on the attitudes and professional ties among these legal elites, and a mixed-methods design examines the diffusion of these attitudes along these ties, sequencing quantitative network analyses and interviews with judges to strengthen causal inferences. The core finding that the social structure of judges influences the attitudes judges hold contributes a valuable analytic complement to scholarship on comparative judicial behaviour, and clarifies our understanding of the role of judicial networks in strengthening democracy and the rule of law.
Why have some Mexican states proceeded faster than others in the revolutionary transformation of overhauling criminal procedure? Contributing an original index of criminal procedure reform across Mexico's 32 states from 2002 to 2011 and building on existing research on policy diffusion, this article seeks to answer this question. It finds that the 2008 constitutional reform at the federal level exerts a strong positive effect (federal mandate); being situated in a neighborhood of states that have reformed has a counterintuitive negative effect (spatial proximity); and having a governor from the same party as governors of other states that have reformed has a positive influence (network affinity). These findings yield a better understanding of the vertical, cross-level and horizontal, cross-unit diffusion of reform, with implications for understanding how to overcome challenges to criminal justice reform in Mexico, Latin America, and elsewhere.