J Natl Med Assoc
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: Despite the increase in studies and media coverage, concussion continues to threaten the futures of young athletes and cause a great deal of concern among parents and practitioners. Questions continue regarding the management and return to play for injured adolescents and young adults, and regarding the long term consequences of repeated concussion in our youth. There appears to be a huge disparity between what health care professionals know and understand about concussion and what the average athlete and parent understands about what concussion is and the real risks involved. ⋯ We recommend athletes be assessed at their yearly physical in order to properly determine their baseline function and readiness to return to play after concussion. Additionally, we recommend providing anticipatory guidance and a simple concussion evaluation tool to be used by parents and guardians to also annually assess a young person's baseline functional status and subsequent alterations. The goal of this review is to create an evidence-based, simple, cost-effective parental survey; increase awareness, understanding and diagnosis of concussion; and finally, expedited proper treatment and facilitate return to play.
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The authors wish to acknowledge the support and assistance of Dr. William Lawrence for his contribution to the M.A.UT model used in the decision aid, Making Your Wishes Known: Planning Your Medical Future (MYWK), Dr. Cheryl Dellasega for her leadership in focus group activities, Charles Sabatino for his review of legal aspects of MYWK, Dr. Robert Pearlman and his collaborative team for use of the advance care planning booklet "Your Life, Your Choices," Megan Whitehead for assistance in grant preparation and project organization, and the Instructional Media Development Center at the University of Wisconsin as well as JPL Integrated Communications for production and programming of MYWK. ⋯ Preliminary evidence suggests that an interactive computer program can help African Americans engage in effective advance care planning, including creating an accurate advance directive document that will be shared with loved ones.
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This work was funded by HRSA grants D16HP00067 and D08PE50097. ⋯ Self-efficacy and skills gained through web-based and faculty-led curricula were retained at graduation. Data from items at graduation support targeted curricular improvement.
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The authors are grateful to the men and women who participated in our Focus Groups and shared with us their very personal cancer experience. Their insight is valuable, and will inform and improve cancer care for future generations. The authors thank the Greensboro area Community Research Advocates - especially April Durr, Elvira Mebane, Marie McAdoo, Kathy Norcott, and Cindy Taylor - who assisted in the conduct of the study, including interpretation of results. They also thank Gratia Wright of First Research Group for her expertise in moderating and executing all of the focus groups, and Lindsey Haynes-Maslow for her assistance in responding to reviewer comments. The study was funded as a part of the Carolina Community Network program, funded by a grant from the National Cancer Institute (U01-CA114629). This study was reviewed and approved by the Institutional Review Board (IRB) at the University of North Carolina at Chapel Hill. ⋯ Findings indicate the importance of clinical trial education in both traditional provider referral to trials and also in general patient navigation. To dispel pervasive misapprehension regarding placebos, clinical trial information should emphasize the role of standard care in modern cancer treatment trials. Many participants described willingness to participate in a trial upon physician recommendation, suggesting merit in improving patient-physician communication through culturally competent terminology and trial referral systems.