They smirk ‘but you're not dying’ and other (mis)understandings about communication and concussion navigated by youth: An arts-based reflexive collective case study

Concussion and communication researchers have yet to study how post-concussion communication changes affect youths' daily lives. The lack of attention paid to how young people respond to communication changes during concussion recovery constitutes a significant gap in current concussion management research and practices. To explore how youth respond to the effects of post-concussion communication changes in their daily life, including (1) daily routines, (2) relationships with family members, (3) relationships with peers and (4) participation in school/work and community activities. Five youths (16-25 years) and three family members participated in this arts-based reflexive collective case study. Ecocultural theory provided the theoretical framework for study design, data collection and analysis. Cases consist of (1) pre-interview demographic information, (2) three 60-90-min virtual interviews, (3) optional family member interviews, (4) multi-media arts-based participant-generated materials representing participants' experiences of communication change and concussion, and (5) researcher observations, discussions and reflexive journal entries. Reflexive thematic analysis was used to analyse the data. Analysis yielded four themes that illustrate the ways youth navigated and adapted to post-concussion communication changes: (1) navigating changes in communication tasks, daily roles, and identity; (2) re-negotiating relationships and emotional reactions; (3) seeking control and learning to let go during recovery; and (4) helping youth adapt to post-concussion communication changes. The study findings deepen our understanding of the impact of post-concussion communication changes on youths' daily lives and underscore considerations critical to the development ofcommunication-focused concussion education programs and interventions tailored specifically for youth. What is already known on the subject Youth is a critical period of social and emotional development. Communication is integral to identity, relationships, participation in daily activities and well-being. Concussions can affect speech clarity, fluency, understanding and use of language, and social interactions. Re-engaging in routine activities and pre-injury roles can be challenging for youth experiencing communication changes as part of complex concussion recoveries. What this paper adds to the existing knowledge Findings from this research illuminate how youth navigate and adapt to communication changes post-concussion and support the development of youth-focused communication education programs, assessments and interventions. Youth participants actively managed their recoveries by developing innovative strategies to support their communication during daily activities, learning about communication, practicing communication tasks sequentially, and facing fears. Youth also reframed and challenged narrow views of 'normal communication'. What are the potential or actual clinical implications of this work? Findings highlight the need for more youth- and communication-focused education materials and programs within youth concussion management protocols. Information about the specific ecological and sociocultural factors youth encounter during concussion recovery is needed to develop targeted communication-focused education and intervention programs for youth and their families to mitigate risks of isolation, loneliness, and mental health concerns and increase youths' participation in family, community and cultural life. By learning from youth about how communication changes affected their participation in daily activities, identity and relationships, clinicians can provide information and interventions to reduce adverse listener reactions and help young people feel supported and understood.

IntroductionAdolescents with concussion will typically experience symptom resolution within 4‐weeks of injury; however, persistent post‐concussion symptoms (PPCS) may develop in approximately 30% of adolescents. Concussion management guidelines currently recommend a brief (24‐48 hour) rest period followed by sub‐symptom exercise to facilitate recovery. Additionally, poor sleep is associated with longer recovery, and early physical activity (PA) may accelerate symptom resolution. By understanding the individual association of both sleep and PA with symptom recovery, a basis can be provided for future recommendations on concussion intervention. Therefore, the purpose of this study was to determine whether sleep characteristics (duration, timing) and/or PA (steps/day, exercise frequency, duration, exercise intensity) in the first month after concussion are associated with PPCS.MethodsWe performed a prospective study of adolescent athletes who sustained a concussion and were evaluated within 14 days of injury. Participants received a Fitbit Charge 3TM to track PA and sleep parameters during recovery. The Post‐Concussion Symptom Inventory (PCSI) was used to determine symptom severity at the initial visit and the clearance visit. Participants were followed until symptom resolution, and the main outcome interest was development of PPCS (symptom duration ≥ 28 days). We then used a logistic regression model to examine associations between PA and sleep parameters with PPCS.ResultsOf the 49 patients included in the analysis, 47% (n=23, symptom resolution=57±23 days post‐injury) developed PPCS and 53% (n=26, symptom resolution=15±7 days post‐injury) did not. There was a significant difference between the PPCS and no PPCS groups in three different variables: steps/day (7526±2975 vs. 9803±3786; p=0.02), exercise days/week (2.5±2.2 vs. 4.4±2.1; p=0.005), and time in bed awake (1.2±0.3 hours/night vs. 0.8±0.3 hours/night; p=0.03). In our multivariable model, the risk of developing PPCS decreased by 1.6x with each additional exercise session/week (adjusted odds ratio=0.616, 95% confidence interval=0.389, 0.974, p=0.038).ConclusionsThe results suggest that participating in multiple exercise sessions per week during concussion recovery is associated with a lower risk of developing PPCS. Furthermore, taking more steps/day and spending less time awake in bed are associated with a shorter recovery period. Counseling patients on optimizing sleep and PA during concussion recovery may be one method for clinicians to promote recovery for their patients.

The stories behind stories: Reflections on the role of voice in research with unaccompanied refugee youth

A rejuvenated approach to urban development and inequality: Young people's perceptions and experiences in Rio de Janeiro

Fibromyalgia (FM) is a pain disorder that involves a variety of symptoms including painful joints, fatigue, muscle stiffness, and sleep disturbances. Cognitive symptoms are also a hallmark of FM, which result in difficulties with thought articulation, concentration, and mental fatigue. There is a gap in research substantiating increased levels of sensory defensiveness symptoms in individuals with FM and the effects in daily life. Currently, only one research study has provided evidence of increased sensory sensitivity across multiple modalities in individuals with FM. The purpose of this research was to determine whether women with FM had increased levels of sensory defensiveness in daily life when compared to pain free age matched women. This research also examined whether women with FM had decreased quality of life (QOL) and participation in daily occupations. Lastly, this study investigated if there was a relationship between sensory defensiveness, participation in typical patterns of daily activities, and QOL. This study was a quantitative, multi-group, quasi-experimental comparison design. Participants were recruited from South Central Wisconsin and Northern California. A total of 20 women participated in the study, 11 in the control group and 9 in the FM group. The data was collected through the following three distinct questionnaires and one activity: Medical Outcome Survey-Short Form 36 (SF-36), Adult/Adolescent Sensory Profile (AASP), Fibromyalgia Impact Questionnaire (FIQ), and the Activity Card Sort (ACS). Data was analyzed using two-tailed t-Test and Pearson's r Correlations. Women in the FM group reported significantly more symptoms for sensory defensiveness and participation in fewer daily activities than the control group. Women with FM reported decreased QOL when compared to the control group. Symptoms of sensory defensiveness were moderately, but not significantly, correlated with participation in daily activities. Increased symptoms of sensory defensiveness were strongly correlated with reports of poorer mental health scores in women with FM.

Concussions are common among children and youth. To date, the pediatric concussion literature has focused on quantitative reports of the effects of concussion and return-to-activity guidelines. However, the subjective experiences of children and youth returning to occupations postconcussion have largely been ignored. An understanding of these experiences is critical to inform effective concussion management. To investigate the experiences of children and youth returning to occupations after sustaining a concussion and the impacts on their future engagement in occupation. Qualitative interpretive description was used for data analysis and interpretation. Community. Children and youth ages 11 to 18 yr from a cohort study were recruited to be interviewed about their experiences of engaging in occupations postconcussion. Interviews were conducted 3 to 24 mo postconcussion, transcribed verbatim, and analyzed using interpretive description to identify themes. Eight children and youth (5 male, 3 female) were included. Analyses revealed three themes of the experiences of children and youth returning to occupations after concussion: diverse experiences of concussion, knowledge is key to concussion management, and concussions affect occupational engagement. This study highlights the importance of considering a person's needs to enable effective concussion treatment plans. The results suggest the need for an occupation-based framework to guide interventions in pediatric concussion management. What This Article Adds: Our findings indicate that children and youth report variable recovery patterns, a lack of knowledge about concussion recovery, and a negative effect of concussion on occupational engagement.

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.

Sexual and reproductive health (SRH) is recognised as a fundamental human right in South Africa. The study explores the underlying reasons and motivations for service hesitancy among youth in Mutale Village, even when they are aware that those services are available. This study analyses the knowledge, perceptions and experiences of young people in Mutale Village, Thulamela Municipality. Utilising a mixed-method approach, the study employed both snowball and purposive sampling to gather data from 126 participants via semi-structured interviews and questionnaires. Qualitative data underwent thematic analysis while quantitative data was analysed using descriptive statics via SPSS version 19.0. key findings reveal young people encounter numerous challenges accessing SRH services due to minimal awareness of available options. Service use is significantly hampered by prevailing social norms, religious beliefs that view SRG as improper for youth, and misconceptions regarding contraceptives side effects (e.g. fear of infertility). Furthermore, the negative attitude of local healthcare workers was found to discourage young people from using the facilities. The concludes that social barriers and healthcare worker attitudes are major impediments to the utilisation of essential SRH services. The study recommends that clinics in rural areas should expand youth-friendly corners with trained staff who respect confidentiality and provide non-judgmental services. Regular refresher training for healthcare providers on adolescent SRH needs is essential

The assessment of paranoia in young people: Item and test properties of the Bird Checklist of Adolescent Paranoia

It has been proven that the development and implementation of educational programs that shape the educational space and the possibilities of ensuring territorial development at various levels are of particular importance for training a qualified specialist. In this context, the characterization of the educational components of the implementation of PhD programs in geodesy and land management is a relevant and timely issue. The implementation of the PhD educational program is aimed at training a highly qualified, competitive specialist in the field of geodesy and land management by deepening and improving theoretical knowledge and practical skills, professional skills in the field of architecture and construction in the field of geodesy and land management, improving language and philosophical competences, forming the ability to conduct research and creation of modern systems of geospatial support and land use for the development of cities and regions. As a result of the study, the educational components of the implementation of the PhD program in geodesy and land management were characterized. Within the framework of the educational and scientific program, it is proposed to additionally characterize the components of the territorial development of land use in the regions. In particular, geospatial components are defined, where cartographic support, directions and possibilities of application of geoinformation systems and technologies are characterized, territorial, functional, socio-economic factors are distinguished. Urban planning, investment and ecological factors of territorial development of land use in the region are characterized. The educational components of the implementation of the PhD program in geodesy and land management are characterized. Competences are defined, which allows for the formation of a systematic approach to the training of specialists. It should be noted that the implementation of the educational program is formed through a range of issues related to the training of highly qualified specialists who are able to formulate and solve complex scientific and practical tasks in the field of geodesy and land management and implement the results of scientific research. Features of the application of the program include the possibility of taking into account the directions and features of territorial development and the efficiency of land use at the regional level. Mastering the presented program allows you to form an educational environment that takes into account the possibilities of using modern geodetic and geospatial tools, the provisions of the theoretical and methodological platform, and is aimed at ensuring the territorial development of the region and increasing the efficiency of land use. Keywords: educational components, PhD, educational programs, geodesy and land management, territorial development of the region, land use, geodetic and geospatial support.

Introduction. Modern compre- hension of the existing problems and mechanisms for their resolution, based on the best national-level practices, is a critical prerequisite for the preparation and implementation of corresponding programs in Ukraine. The Aim of This Study: to examine the features of developing and implementing educational programs in countries with highly effective anti-doping systems in sports. Research Methods: the study employs theoretical analysis of scientific literature, online information resources, and documentary materials, along with comparative analysis. Results. An analysis of the successful implementation of the UNESCO International Convention against Doping in Sport and the Council of Europe’s Anti-Doping Convention in various countries revealed that the United Kingdom, France, Germany, and Poland rank among the nations with highly efficient anti-doping systems. In these countries, national anti-doping organizations play a leading role in the development and implementation of relevant educational programs. These organizations work closely with government bodies, sports federations, research institutions, and educational institutions. Such educational programs are aimed at fostering a "clean sport" culture and preventing athletes from using doping by promoting moral resilience and awareness of the consequences of violations. In the current context, anti- doping educational programs combine both offline and online training through dedicated internet platforms and mobile applications. Gamification and real-life scenario simulations have become dominant methods to ensure the interactivity of learning. Indicators of successful program implementation include a reduction in anti-doping rule violations and an increase in awareness among athletes. Conclusion. The advanced international experience in the development and implementation of educational programs in the anti-doping system in sports is characterized by its multidimensional nature and shares common features to ensure the integrity of sport. The application of this experience in Ukraine holds great promise and requires further research.

The creation of advanced engineering schools at universities to improve the quality of human capital is becoming increasingly relevant. This paper examines the relationship between the development of economics, engineering education, the results of intellectual activity and the scale of launching new educational programs in universities.The analysis demonstrates that activities in the field of engineering education will develop in the interests of knowledge transfer in areas of technological sovereignty with large amounts of investment. However, so far, the educational activity of advanced engineering schools correlates with the level of development of industries in the regions, which creates challenges and opportunities for expanding cooperation and introducing technologies beyond their borders throughout the industry.The study shows that the scale of launching new educational programs is interconnected with the general culture of research and the creation of professional education programs at the university. The high potential of research activities, in general, is a prerequisite for the development and implementation of engineering educational programs in demand in the real sector. At the same time, the results of scientific and intellectual activity are often the source of their creation. The high level of launching additional professional education programs at the university makes it possible to expand the involvement of university teams in the development and implementation of educational programs and engineering orientation.The authors offer practical recommendations aimed at further development of engineering education for both students in educational institutions and current specialists in the interests of ensuring the technological sovereignty of the Russian Federation, the development of the university’s third mission, as well as to stimulate sales of educational programs, innovative solutions and projects.

PurposeThis paper aims to contribute to growing efforts to “contextualise” young people's experiences of sexual and intimate relationships in research and sex and relationships education (SRE). The study reports on which explored factors young people identified as influencing their relationships – in the past, present and future.Design/methodology/approachAn exploratory, qualitative investigation was conducted using focus groups and in‐depth interviews to elicit young people's attitudes to, and experiences of, intimate relationships. A diverse group of young men and women (N=52) were purposively sampled from a range of agencies, including supported accommodation units, a young offenders' institution and two boarding schools.FindingsPeer groups, a need for protection and companionship, and previous negative relationships variously influenced young people's experiences in early youth. Access to potential partners, other priorities, and the degree to which young people could offer a critical assessment of a relationship played a role in explaining current relationship attitudes and experiences. Future aspirations for sexual and intimate relationships were largely influenced by young people's broader plans for their education and transition into adulthood.Practical implicationsAge‐appropriate and personally relevant forms of SRE need to be developed which focus on the various factors influencing relationships at different points in time for groups of young people.Originality/valueContextualising young people's sexual and intimate relationships in terms of the specific factors influencing attitudes, experiences in the past and present, together with future aspirations can usefully inform the development of SRE programmes.

The purpose of a review article is the systematization and analysis of the existing legal framework of joint educational programs at both local and state level, identifying the stages of their development and implementation that require additional regulation. Despite the experience of the Russian universities, the key risks of development and implementation of joint educational programs are still the following - incomplete regulatory base and significant differences in its interpretation. The article clarifies the nature and classification of joint educational programs, as one of the types of network educational programs. Authors propose key features of joint educational programs: poly-subject nature, unified curriculum, synchronicity, complementarity, legal basis and parity. The article presents the results of the analysis of the regulatory framework for the development and implementation of joint educational programs in Russian universities on the basis of a comparison with the European experience, in which they are an instrument of formation and development of the European higher education area. Systematization of the stages of development and implementation of joint educational programs and normative documents of the local and state levels helped to identify that the following processes are still not regulated: the formation of the consortium of joint educational programs partners, program management and quality assurance. Taking into account the peculiarities of the Russian system of higher education additional regulation is required concerning admission of students to joint educational programs, funding rules and state accreditation requirements and procedures. However, universities are granted considerable academic freedom in the development and implementation of joint educational programs, ensuring their quality conforms to the European approach to the regulation of higher education and it requires a certain maturity of local normative systems of the universities. The findings can be used by higher educational institutions in the field of improvement of local normative systems for joint educational programs. At the state level, improvement of the legal regulation of such programs has important conceptual value, as they are an example of the transition from the concept of «value chain» to «value network» when a partnership of competitors in the market is no longer a resource but a mechanism for providing services and manufacturing products. Therefore, the development of regulations of joint educational programs is a necessary step for the development of new types of educational products and technology in the higher education of Russia.

Substantiation of the educational program that provides training of highly competitive professionals who are able to actively operate in a market economy and social partnership; development of scientific priorities and innovation component. Improving the published educational and professional program within thecyclical process of development and implementation of educational and professional programs in accordance with the methodology of student-centered learning.In the process of development and further implementation of the educational program applied definition, generalization, identification, analysis, synthesis, induction and deduction, idealization, analogy, selective and continuous observations, control measurements, inventory, systematization, expertise, technological research, method of hypotheses, experiment and modeling.The structure and features of the standard of higher education approved by the Ministry of Education and Science of Ukraine at the first (bachelor's) level of knowledge 19 –Architecture and Construction, specialty 193 "Geodesy and Land Management" are analyzed. The current level of information and methodological support for the development of educational programs has been clarified. The peculiarities and essence of each of the stages of development of the educational program inaccordance with the methodology of student-centered learning are considered.The author's educational program that ensures the achievement of additional learning outcomes is proposed and measures to achieve them are justified. The spheres of use and potential users of the educational-professional program are presented. The educational and professional program is published on the official website, and the features of its components –in this publication in order to share experiences, receive recommendations, comments, suggestions on its content, components, specifics of implementation and optimization.The article is review and informative