Online youth concussion resources for Canadian teachers and school staff: A systematic search strategy.

INTRODUCTION: Teachers and school staff (i.e., principals, coaches, trainers, educational assistants, guidance counselors, school healthcare professionals, etc.) are well positioned to support students' return-to-school post-concussion. Teachers and school staff may access concussion resources online as they are readily available; however, their quality and accuracy are unknown. OBJECTIVE: To identify accurate online concussion resources suitable for Canadian teachers and school staff. METHODS: A five-phased systematic search strategy was conducted: 1) initial identification of resources; 2) consultation of pediatric concussion experts; 3) inclusion and exclusion criteria; 4) content review; and, 5) material evaluation. RESULTS: A total of 837 resources were identified initially and 40 resources were included in the final list. Across all resources, 310 (37%) resources were excluded as they were not designed primarily for teachers and school staff. Thirty-four (43%) of 80 resources reviewed for content accuracy were excluded. Among resources reviewed for readability, usability and suitability, six (13%) were excluded. CONCLUSIONS: The 40 resources identified in this study can enable teachers and school staff to educate themselves about concussion and how to optimally support a student's return-to-school post-concussion.

Assessment of scoliotic deformity using spinous processes: comparison of different analysis methods of an ultrasonographic system.

OBJECTIVE: The purpose of this study was to evaluate the performance of 5 analysis methods in quantifying scoliotic deformity, using the spatial positions of SP tips acquired by a custom-developed ultrasound-based system, with different curve fitting methods and angle metrics in terms of their correlation with Cobb angle, test-retest reliability, vulnerability to digitization errors, and accuracy of identifying end vertebrae and convexity direction. METHODS: Three spinal column dry bone specimens were randomly configured to 30 different scoliotic deformities. Raw spatial data of the SP tips were processed by the following 3 methods: (1) fifth-order polynomial fitting, (2) locally weighted polynomial regression (LOESS) with smoothing parameter (α) = .25, and (3) LOESS with α = .4. Angle between the 2 tangents along the spinal curve with the most positive and negative slopes (ie, posterior deformity angle) and summation of the angles formed by every 2 lines joining 3 neighboring SPs between the end vertebrae (ie, accumulating angle) were computed to quantify scoliotic deformity. Their performances were compared in terms of their correlation with Cobb angle, test-retest reliability, vulnerability to digitization errors, and accuracy of identifying end vertebrae. RESULTS: Posterior deformity angle calculated from the spinal curve constructed by LOESS with α = .4 excelled in every aspect of the comparison (ie, Cobb angle, test-retest reliability, vulnerability to digitization errors, and accuracy of identifying end vertebrae and convexity direction), making it the method of choice of those tested for processing the spatial data of the SP tips in this ultrasonography study using dry bone specimens. CONCLUSIONS: The ultrasound-based system and the LOESS (0.4)-posterior deformity angle method developed for this study offer a viable technology for quantifying scoliotic deformity in a reliable and radiation-free manner. However, further validation using scoliosis subjects is needed before they can be used to quantify spinal deformity in the clinical setting.

Perspectives on and Experiences With Bullying From Youth With Neuromuscular Conditions.

Aim: To understand the bullying experiences of youth with neuromuscular conditions. Method: Fourteen participants with neuromuscular conditions (10 male; 10-19 years old) participated in semistructured interviews that were analyzed using inductive thematic analysis. Results: Four overarching themes were identified: (1) participants experienced stigma-based bullying; (2) participants exhibited resilience despite bullying victimization; (3) participants identified personally and theoretically helpful and unhelpful supports with regard to bullying; and (4) participants proposed bullying interventions. Interpretation: Individuals with neuromuscular conditions had unique experiences and perspectives on bullying. This qualitative study provides health care professionals with insight into the bullying experiences of patients with neuromuscular conditions. Findings highlight the role for formal and informal education to mitigate stigma-based bullying and increased opportunities for peer support as a protective factor against bullying.

Twice-Weekly Outpatient Rehabilitation Intervention for Young Children With Spinal Muscular Atrophy Treated With Genetic-Based Therapies: Protocol for a Feasibility Study.

BACKGROUND: Spinal muscular atrophy (SMA) is a progressive neuromuscular disorder that causes muscle weakness and is the leading genetic cause of infant mortality worldwide. While no definitive cure exists, the approval of 3 genetic-based therapies in Canada since 2018 has led to significant improvements in muscle function for children with SMA. With that, there are no evidence-based rehabilitation interventions and minimal evidence on the combined effects of genetic-based therapies and rehabilitation. OBJECTIVE: This protocol describes the methodology to assess the feasibility of a twice-weekly outpatient rehabilitation intervention focusing on gross and fine motor function to inform the methodology and sample size of a definitive clinical trial. METHODS: We will conduct a single-center nonrandomized pilot and feasibility trial to explore an outpatient rehabilitation intervention for children aged 6 months to 3 years with SMA treated with genetic-based therapies. Participation in the study will occur over a 25-week period, with a baseline assessment visit followed by a 12-week intervention period and a 12-week nonintervention period. The rehabilitation intervention comprises weekly physical and occupational therapy for 11 weeks. Assessments will occur at baseline (week 0), end of intervention or early withdrawal (week 12), and follow-up (week 24). Predetermined feasibility indicators will evaluate study feasibility across process (recruitment rates, eligibility criteria, adherence rates, retention rates, questionnaire suitability, and acceptability), resource (time, implementation, and execution), management (materials and data), and scientific (safety, tolerability, and preliminary efficacy) domains. RESULTS: This project was funded in March 2022, and data will be collected between March 2023 and December 2023. Data analysis will occur between January 2024 and March 2024, with publication expected in the fall of 2024. The protocol for the feasibility trial will be considered successful if it meets the success criteria set out for the feasibility indicators. Indicators of specific interest include all process indicators, as well as time. Exploratory indicators will be reported. Pragmatically, the results of the feasibility trial will inform changes to the protocol and the start-up of a definitive multisite trial. CONCLUSIONS: This novel twice-weekly outpatient rehabilitation intervention will be the first step toward filling the need for an evidence-based rehabilitation intervention for children with SMA treated with genetic-based therapies. It is expected that consistent and intensive rehabilitation therapy will augment functional gains being observed in this population. In the future, a definitive trial will measure the efficacy of the intervention. TRIAL REGISTRATION: ClinicalTrials.gov NCT05638750; https://clinicaltrials.gov/study/NCT05638750. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/46363.

Delivering concussion education to pre-service teachers through the SCHOOLFirst website: Evaluating usability and satisfaction.

BACKGROUND: Return-to-school processes indicate 'when' to initiate activities and 'what' activities should be accomplished, but are missing 'how' to implement the process. The SCHOOLFirst website provides the 'how' through building concussion knowledge, creating a supportive culture, and defining roles. Due to the involvement of pre-service teachers in schools during training and imminent transition to becoming teachers, it is important that pre-service teachers are trained in concussion and can optimally support current and future students. OBJECTIVE: To determine: 1) pre-service teachers' knowledge and confidence surrounding the return-to-school process before and after using the SCHOOLFirst website; 2) the usability, intended use and satisfaction of the SCHOOLFirst website from the perspective of pre-service teachers. METHODS: Thirty pre-service teachers completed the demographic survey, knowledge and confidence survey, System Usability Scale, and satisfaction and intended use survey after participating in a workshop. RESULTS: Significant increases in concussion knowledge (Z = -4.093, p < 0.001) and confidence in helping students return-to-school (Z = -4.620, p < 0.001) were measured after using the SCHOOLFirst website. Participants were satisfied with the SCHOOLFirst website (93.4%) and intend to use it in the future when supporting a student post-concussion (96.4%). CONCLUSION: The SCHOOLFirst website is a valuable tool for pre-service teachers to support students' return-to-school post-concussion.

Influences of temperature and salinity on holistic network performability of multi-AUV cooperative systems.

This study proposes holistic network performability as a reliability index of multiple autonomous underwater vehicle (AUV) (multi-AUV) cooperative systems and deduces the reliability of communication links. Temperature and salinity vary in different areas of the sea. The influence mechanism of temperature and salinity on holistic network performability is discussed. An example is provided to show the influences of temperature and salinity on holistic network performability. Corresponding trends of holistic network performability with the influences of temperature and salinity can be obtained. The trends show that the holistic network performability of multi-AUV cooperative systems exhibit ladder-like increases with temperature and salinity. In each ladder, the value of holistic network performability changes rapidly at high salinity or low temperature. The study on the change of the reliability of multi-AUV cooperative systems under different temperatures and salinities provides a theoretical basis for the reliability research of multi-AUV cooperative systems and provides reference for future practical application of multi-AUV cooperative systems and other network systems.