bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘There’s Got to Be a Better Ending than That’: Enacting Agency in Film Adaptations of Romeo and Juliet for Children
Authors: Rowe Rebecca 
Published: June 2023

Abstract
William Shakespeare’s Romeo and Juliet (1597) is a play that supposedly focuses on young people, yet, when the play is adapted into the family film format, creators make some rather drastic changes for their young audience, changes that are often belittled by scholars and critics alike, especially when the films end happily. The Lion King II (1998) and Gnomeo and Juliet (2011) are perfect examples of how such adaptations can play with genre and audience in significantly more sophisticated ways than scholars often acknowledge. I argue that these films rescript the intergenerational tragedy of Shakespeare’s Romeo and Juliet in order to show how youth hold the power to change their societies, an empowering message that resonates with the family film format. In this article, I note three major changes that work towards empowering young viewers: First, the films free Shakespeare’s Juliet from her confinement so that she can become an active part in her own society. Second, the films highlight the problem with the parents’ over-protectiveness. Finally, the lovers’ survival shifts the result of their romance from stilted love and uneasy peace to societal change. These accumulating elements suggest that the happy endings do more than simply bowdlerize but rather accomplish the films’ systemic goal of fostering youth agency. Ultimately, my analysis of these films suggests a new interpretation of adaptations of canonical texts made for children that places these changes within wider discussions of childhood instead of bemoaning changes to a centuries-old text.
Assessing cognitive function in longitudinal studies of ageing worldwide: some practical considerations
Authors: De Looze Céline , Feeney Joanne , Seeher Katrin M , Amuthavalli Thiyagarajan Jotheeswaran , Diaz Theresa , Kenny Rose Anne 
Published: June 2023

Abstract
Over 55 million people live with dementia worldwide. With 40% of modifiable risk factors estimated to contribute to dementia, the potential for prevention is high, and preventive measures, at an early stage of cognitive decline, are likely to positively influence future dementia trends. Countries need reliable health data and adequate measurement tools to quantify, monitor and track early changes in cognitive capacity in the general population. Many cognitive tests exist; however, there is no consensus to date about which instruments should be employed, and important variations in measurement have been observed. In this narrative review, we present a number of cognitive tests that have been used in nationally representative population-based longitudinal studies of ageing. Longitudinal panel studies of ageing represent critical platforms towards capturing the process of cognitive ageing and understanding associated risk and protective factors. We highlight optimal measures for use at a population level and for cross-country comparisons, taking into consideration instrument reliability, validity, duration, ease of administration, costs, literacy and numeracy requirements, adaptability to sensory and fine motor impairments and portability to different cultural and linguistic milieux. Drawing upon the strengths and limitations of each of these tests, and the experience gained and lessons learnt from conducting a nationally representative study of ageing, we indicate a comprehensive battery of tests for the assessment of cognitive capacity, designed to facilitate its standardised operationalisation worldwide.
Urinary retention and mydriasis secondary to topical glycopyrronium for axillary hyperhidrosis
Authors: Green Holly Hoshall , Ray Lance , Buchanan Jennie , Matsler Nikolaus 
Published: June 2023

Abstract

Purpose
Glycopyrronium, also known as glycopyrrolate, is an antimuscarinic competitive inhibitor of acetylcholine widely utilized topically for its anticholinergic properties in dermatology. A single topical glycopyrronium tosylate (GT) formulation is available on the market, and prescription of this medication has become increasingly popular among dermatologists. This medication has a relatively notable adverse effect profile and carries risks that patients need to be counseled on before initiation.

Summary
A 22-year-old female presented to our emergency department (ED) with a chief complaint of difficulty urinating for 48 hours and blurred vision for 2 weeks. Over the course of a week, she visited the ED once and urgent care multiple times due to complications associated with combination use of GT and cetirizine. Although these clinical effects were reversible, the patient impact in our case was profound given the time, cost, and invasive nature of these visits.

Conclusion
The notable adverse effects of GT should be considered when prescribing this agent.
A-06 Football-playing Youth May Have Lower Baseline TOMM Trial 1 Performance Than Youth In Other Sports
Authors: Baldini D , Ellis-Stockley M , Tupou T A , Steinbaugh A , Flowers J , Alvis W , Hirst R B 
Published: June 2023

Abstract

Purpose
The TOMM assesses whether examinees’ memory performance is valid (Tombaugh, 1996). American football players have increased risk of invalid performance on baseline testing, possibly due to wanting to resume play after injury, and these results have been replicated in collegiate football players. America’s four most popular sports are football, basketball, soccer and baseball. Youth football players remain understudied, and the sports at the highest risk of suboptimal performance are unknown.

Methods
A univariate analysis of covariance examined mean TOMM Trial 1 scores in baseline youth athletes (n=143, 79.9% male), comparing football players (n=79) and non-football players (n=64). Quade’s ANCOVAs also examined soccer, baseball and basketball vs. non-respective sports players, excluding participants who played football (n=42, 23, 23, respectively). Gender was covaried.

Results
Youth athletes in the football group performed significantly worse on TOMM Trial 1 than participants in the non-football group (M=45.96, 47.81, respectively, p=.033). There were no group differences in performance on TOMM Trial 1 in soccer, baseball, and basketball players (p=.33, .35, .38, respectively).

Conclusions
These results indicate that youth athletes who play football may be at a higher risk of suboptimal test performance than other sports, similar to previous findings in older football players. More scrutiny for this population may be necessary during baseline testing in order to ensure the safest return to play possible. Education on concussion effects and the importance of valid baseline testing should also be implemented.
A-07 TOMM Trial 1 Provides Sensitivity Over Rey-15 And Reliable Digit Span In Youth Football Players.
Authors: Baldini D , Flowers J , Eve H , Ellis-Stockley M , Vang L , Steinbaugh A , Hirst R B 
Published: June 2023

Abstract

Purpose
Performance validity testing (PVT) provides information about response bias in neuropsychological testing. Adult football players have increased risk of invalid performance on baseline testing, perhaps due to wanting to resume play following concussion. Youth athletes have shown similar behavior, yet youth football players remain under-studied. This study examined which PVTs have the best utility for youth athletes.

Methods
Three univariate analyses of covariance compared mean baseline test performance on three PVT’s (Rey-15 item test combined, TOMM Trial 1, and Reliable Digit Span) in a youth athlete baseline evaluation sample (n=143, 79.9% male) ages 8-18 (mean=11.94) who played football (n=79) to those who played other sports (n=64). Gender was included as a covariate.

Results
Mean scores on TOMM trial 1 for youth football players were significantly lower than athletes who did not play football (M=45.96, 47.81, respectively, p=.033). There were no group differences on the RDS or Rey-15 item tests (p=.14, .88, respectively). Further, five football players failed TOMM trial 1, compared to one non-football player.

Conclusions
These results may indicate that the TOMM is more sensitive to validity performance in youth football players, compared to RDS and Rey-15. Youth may benefit from increased education on the consequences of premature return to play and importance of optimal performance on baseline testing. Continued research on PVTs for youth may help neuropsychologists make more informed decisions on PVT selection.
A-08 Understanding the relationship between knowledge, beliefs, actions and confidence surrounding concussions among youth hockey coaches
Authors: Banovetz K , Rob J , Benert J , Custer A 
Published: June 2023

Abstract

Purpose
To investigate the effectiveness of mandatory concussion education among youth hockey coaches and to understand if increased knowledge correlates with confidence. Identification of facilitators and barriers to coaches’ beliefs and actions were also assessed.

Methods
Prospective, cross-sectional descriptive pilot study using an electronic survey via REDCap sent to youth coaches within the Minnesota Hockey organization. Quantitative questions were used to investigate knowledge and attitudes, while qualitative questions explored the facilitators and barriers to concussion management in youth hockey.

Results
98.8% of the 177 participants (M=150; F=22, NB=5), aged 18–65+ years completed the mandatory concussion training, with majority completing it in the last year (79%). 95% endorsed concussion education as beneficial with only 8 coaches reporting it was not helpful and 10 coaches requesting more educational materials. Over half of the participants (96; 54%) denied legislation impacting their attitude toward concussion. Confidence in concussion knowledge (3.07±1.09; 77%) and attitudes towards concussions (7.62±1.63; 85%) were positive. 39 (26%) coaches considered athlete and parent input most valuable for return to play. This may be related 72% of participants who reported no trained medical staff were present at games or practices. Concerningly, 20% of coaches may not encourage an athlete with loss of consciousness to seek emergent care.

Conclusions
Current mandatory concussion education produces increased knowledge, confidence, and appropriate action among majority of youth coaches. Coach reliance on athlete and parent report for clearance to play increases with no medical staff present for practices and games, which could have negative consequences.
A-09 Youth Athlete Concussion-Related Anxiety Perceptions
Authors: Beidler E , Bretzin A C , Schmitt A J 
Published: June 2023

Abstract

Purpose
To describe the prevalence of concussion-related anxiety in youth athletes, and determine what factors (e.g., sex, sport, concussion history, concussion education, parental concussion anxiety) were associated with greater anxiety.

Methods
Youth athletes participating in football, soccer, ice hockey, lacrosse (n=411; males=185, females=282; age=11.04±1.8 years) completed a cross-sectional survey. Participants completed demographic items and the Illness Perception Questionnaire, altered to be concussion-specific. We focused on the following four anxiety perception items scored on a Likert scale from 1 (strongly disagree) to 5 (strongly agree): “The thought of getting a concussion is upsetting to me.”, “I am afraid of getting a concussion.”, “The thought of me having a concussion makes me feel anxious.”, and “Concussions do not worry me [reverse].” The sum of items produced an overall anxiety composite score (20 possible points) with higher values indicating greater anxiety.

Results
Overall, 46.72% (n=192/411) of youth athletes were upset, 46.72% (n=196/411) afraid, or 29.0% (n=119/453) anxious at the thought of sustaining a concussion. Additionally, 49.9% (n=205/411) indicated concussions worry them. The sample mean anxiety perception composite score was 12.48±3.84. Participating in soccer (β: 1.49, 95% CI: 0.35, 2.62), being a girl (β: 1.40, 95% CI: 0.55, 2.26), and having a parent with higher concussion anxiety (β: 0.2, 95% CI: 0.82, 0.32) were associated with greater youth athlete concussion-related anxiety perceptions.

Conclusions
Concussion-related anxiety perceptions are fairly prevalent in youth athletes. More research is needed to determine how these beliefs may influence avoidance of risky sport behavior, intention to report a suspected concussion, and post-injury recovery outcomes.
A-11 Sex Differences in Performance Validity Testing in the Immediate Post-Concussion Assessment and Cognitive Test
Authors: Bouchard H C , Higgins K L 
Published: June 2023

Abstract

Purpose
Sex differences have frequently been investigated in concussion and poor effort is a known confound in baseline testing. However, research has yet to investigate if insufficient effort is different or has differential effects on baseline cognitive scores between male and female athletes.

Methods
Collegiate athletes (n=1,505; 43% female) completed ImPACT during their baseline concussion evaluation. Research has identified four embedded effort indicies in ImPACT which were used to estimate effort across a continuum. We evaluated the relationship between effort, sex, memory performance and speed performance using linear regression models.

Results
We found that athletes who failed one, two, or three+ effort indicators performed worse on all cognitive domains compared to athletes who failed zero effort indicators (p&lt;0.05). More male athletes failed two or three+ effort indicators compared to female athletes (p&lt;0.001). Female athletes performed faster overall on visual-motor speed tasks (p=0.001), but there was no interaction between sex and failed effort indicators. Female athletes also performed faster on reaction time and better verbal memory tasks compared to male athletes, but only when they failed three+ effort indicators (p&lt;0.01).

Conclusions
These results suggest that as expected, athletes performed worse when they failed more effort indicators. Insufficient or poor effort appears to be different between male and female athletes, with male athletes demonstrating more indicators of poor effort than female athletes. Poor effort also appears to differentially effect cognitive scores with differences in reaction time and verbal memory only identified between groups when athletes failed three or more effort measures.
A-13 Concussion history is related to performance on executive functioning tasks in youth
Authors: Brower R 
Published: June 2023

Abstract

Purpose
Pediatric traumatic brain injuries (TBIs) are among the most common acquired disabilities in youth. They occur when the brain is rapidly developing and therefore many impact the child into adulthood and can impact executive functioning (EF) skills that are vital to everyday tasks, like maintaining attention, organizing, and inhibiting behaviors. It is important to understand the impact of childhood TBIs to learn how to best intervene.

Methods
11,224 children aged 9-10 years old (mean age=9.91, 49.4% male) at baseline completed an extensive battery of interviews and neuropsychological tasks through the Adolescent Brain Cognitive Development (ABCD) study. Based on parent reports on the Ohio State TBI screening measure, children were classified into No/Unlikely TBI, Possible Mild, Mild, Moderate, and Severe TBI. 153 children met criteria for possible mild TBI or higher. They also completed an array of neurocognitive measures, including Matrix Reasoning and several NIH Toolbox executive functioning tasks.

Results
There were small significant correlations between TBI status and a language task (Picture Vocab, r=.03, p=.002), attention task (Flanker, r=.02, p=.04), set shifting (Dimensional Change Card Sort, r=.02, p=.04), and with the crystallized cognition (r=.03, p=.005) and cognition composite (r=.03, p=.005) scores. Trend-level correlations were found for an oral reading task and fluid cognition composite score. However, when children with no TBI history were removed, no correlations held.

Conclusions
A history of even a mild TBI may be related to impaired functioning across several domains of executive functioning skills in youth.
A-14 Athletic Trainers' Perceptions of High School Athlete's Concussion Reporting Behaviors
Authors: Bunker N , Breitmeyer A , MacNeil B 
Published: June 2023

Abstract

Purpose
The purpose of this study was to evaluate athletic trainers’ (AT) perspectives of high school athletes overreporting concussion symptoms and evaluate their willingness to incorporate a neuropsychologist or licensed mental health professional on the sports medicine team.

Methods
This study was completed via electronic survey sent to 1,000 ATs employed in secondary schools across the United States. A total of 64 participants (17 male, 45 female, 2 non-binary) completed the survey. Participants were selected based on age greater than 21 years old employment in a secondary school. Frequencies and descriptive statistics were obtained for each variable, including AT experience level, AT confidence in diagnosis of SRC, school division, concern of overreporting, and willingness to add a mental health professional or neuropsychologist to the sports medicine team.

Results
Results of this study revealed 75% (n=64) of the participants endorsed concerns with athletes overreporting concussion symptoms, while 96.9% expressed interest in adding a neuropsychologist or mental health professional to the consultation team. Furthermore, 67.2% believe athletes view concussion as a way to discontinue playing their sport. Additionally, study results yielded a negative correlation between ATs’ school division and the rate of concern for overreporting concussion symptoms, r(62)=-.21, p=.047.

Conclusions
Overall, results indicated a growing concern regarding the validity of self-report symptoms associated with SRCs in high school athletes. Our findings highlight the need for valid and reliable screening measures and neuropsychological consultation. Future research is also needed to identify factors associated with concussion overreporting.
A-15 Predictive Utility of Risk Factors Associated with Vestibular and Oculomotor Outcomes Following Sport-Related Concussion
Authors: Burley C , Trbovich A , Patel S , French J , Collins M W , Kontos A P 
Published: June 2023

Abstract

Purpose
The purpose of the present study was to determine the ability of these risk factors to predict vestibular/oculomotor symptom provocation on the Vestibular/Oculomotor Screening (VOMS). It was hypothesized that both pre- and post-injury risk factors would predict symptom provocation on the VOMS.

Methods
This was a retrospective chart review of patients (n=78; 41 male) aged 15.2±1.7 years (range 12-18 years) seeking care at a concussion specialty clinic. Participants were seen 5.1±3.2 days (range 1-14 days) post-injury and completed a clinical interview, history questionnaire, symptom inventory, and VOMS as part of routine clinical care. Data analysis included chi-square tests with odds ratios to examine the association between identified risk factors and VOMS outcomes. An alpha value of .05 was used for all analyses.

Results
Personal history of motion sickness (χ2=7.6, p=.006, OR=11.4), personal history of oculomotor dysfunction (Fisher’s exact test, p=.01, OR=1.2), post-traumatic migraine (PTM) symptoms (χ2=11.7, p&lt;.001, OR=5.4), and post-injury fogginess (χ2=10.1, p=.001, OR=4.8), were associated with presence of one or more post-injury VOMS individual item scores above clinical cutoff (i.e., symptom elevation &gt;2). History of oculomotor dysfunction (Fisher’s exact test p=.013, OR=6.6) and PTM symptoms (χ2=5.0, p=.025, OR=3.3) were associated with obtaining a post-injury near-point convergence (NPC) distance &gt;5 cm. Gender, loss of consciousness status, concussion history, history of migraine, and psychiatric history were not associated with VOMS symptom provocation or abnormal NPC.

Conclusions
Findings indicate that both pre-injury risk factors (i.e., personal history of motion sickness and history of oculomotor dysfunction) and post-injury risk factors (i.e., fogginess, PTM symptoms) were associated with clinically meaningful symptom provocation on the VOMS. In addition, history of oculomotor dysfunction and PTM symptoms were both associated with abnormal NPC distance. These results reinforce the importance of a comprehensive evaluation including a clinical history and vestibular and oculomotor screening following SRC. Consistent with prior research, loss of consciousness status and concussion history were not associated with increased risk for vestibular/oculomotor outcomes.
A-17 Predictors of Concussion Clinical Profiles and Prolonged Recovery
Authors: Choi D M , Kontos A P , Foster E , Goldberg K B 
Published: June 2023

Abstract

Purpose
This study examined relationships among concussion clinical profiles with patient demographic and clinical factors and the prognostic utility of the CP Screen tool at initial visit for prolonged recovery (&gt;28 days).

Methods
297 participants with concussion were selected through convenience sampling for this retrospective cohort study (9-68 years old, 59.3% males, 71.7% sport-related concussion). At initial visit in UPMC clinics, participants of the original study completed the CP Screen along with the ImPACT, PCSS, VOMS, as part of standard care. Clinical profiles (anxiety/mood, cognitive/fatigue, posttraumatic migraine, vestibular, ocular) were endorsed via CP Screen criteria. Participants’ demographic (age, sex, mechanism of injury) and clinical (psychiatric, migraine, ADHD/LD, concussion histories) factors were examined.

Results
Females endorsed more clinical profiles (M=1.20, SD=1.54) than males (M=.60, SD=1.13) (p&lt;.001). Psychiatric history predicted endorsement of anxiety/mood profile (OR=3.29, 95% CI [1.41, 7.69], p&lt;.01), controlling for migraine, ADHD/LD, and concussion histories. Vestibular profile, controlling for other clinical profiles, predicted prolonged recovery (OR=3.93, 95% CI [1.52, 10.22], p&lt;.01). Exploratory analysis for cognitive/fatigue profile as predictor of prolonged recovery revealed statistical significance (OR=2.16, 95% CI [1.01, 4.62], p&lt;.05).

Conclusions
At initial visit, clinicians may anticipate females to present more symptomatic with clinical profiles than males and expect anxiety/mood profile endorsement by those with pre-existing psychiatric problems. Clinicians may also need to closely monitor patients initially endorsing vestibular or cognitive/fatigue profiles as they are more likely to experience an extensive recovery.