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  1. Article ; Online: Improving Employee Safety Through a Comprehensive Patient Behavioral Program.

    Laprime, Amanda / Kanaley, Rebecca / Keller, Amy / Stephen, Steve J / Schriefer, Jan / Fallon, Anne / Sosa, Tina

    Hospital pediatrics

    2024  Volume 14, Issue 5, Page(s) 356–363

    Abstract: Background: Health care workers in the United States are facing increasing rates of exposure to aggressive behavior, resulting in an increase in employee injuries related specifically to patient behavioral events. By leveraging interprofessional ... ...

    Abstract Background: Health care workers in the United States are facing increasing rates of exposure to aggressive behavior, resulting in an increase in employee injuries related specifically to patient behavioral events. By leveraging interprofessional collaboration and system-level innovation, we aimed to reduce the rate of employee injuries related to patient behavioral events at a children's hospital by 50% over a 3-year period.
    Methods: An interdisciplinary quality improvement team comprising physicians, behavior analysts, nursing, and other key stakeholders developed a comprehensive behavior program in our children's hospital. The team developed 5 key pillars: aggression mitigation tools, clinical resources, advanced training, screening and management, and behavior emergency response. The outcome measure was rate of reported employee safety events related to patient behavioral events. This was tracked via prospective time series analysis statistical process control chart using established rules to detect special cause variation.
    Results: The average rate of employee injuries resulting from patient behavioral events decreased from 0.96 to 0.39 per 1000 adjusted patient-days, with special cause variation observed on a statistical process control U-chart. This improvement has been sustained for 16 months. Staff members who experienced injuries included nurses and patient technicians, with common antecedents to injuries including medical interventions or patient requests that could not be safely met.
    Conclusions: A unified and multimodal system aimed to address pediatric patient behavioral events can reduce employee injuries and foster a culture of employee safety in the pediatric inpatient setting.
    MeSH term(s) Humans ; Quality Improvement ; Hospitals, Pediatric ; Occupational Health ; Aggression ; Occupational Injuries/prevention & control
    Language English
    Publishing date 2024-04-30
    Publishing country United States
    Document type Journal Article
    ISSN 2154-1671
    ISSN (online) 2154-1671
    DOI 10.1542/hpeds.2023-007714
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: 7T MRI Versus 3T MRI of the Brain in Professional Fighters and Patients With Head Trauma.

    Lee, Jonathan K / Bernick, Charles / Stephen, Steve / Ritter, Aaron / Bullen, Jennifer / Mangat, Arvindpaul / Joyce, Jennifer / Jones, Stephen E

    Neurotrauma reports

    2023  Volume 4, Issue 1, Page(s) 342–349

    Abstract: Many studies have investigated the imaging sequelae of repetitive head trauma with mixed results, particularly with regard to the detection of intracranial white matter changes (WMCs) and cerebral microhemorrhages (CMHs) on ≤3 Tesla (T) field magnetic ... ...

    Abstract Many studies have investigated the imaging sequelae of repetitive head trauma with mixed results, particularly with regard to the detection of intracranial white matter changes (WMCs) and cerebral microhemorrhages (CMHs) on ≤3 Tesla (T) field magnetic resonance imaging (MRI). 7T MRI, which has recently been approved for clinical use, is more sensitive at detecting lesions associated with multiple neurological diagnoses. In this study, we sought to determine whether 7T MRI would detect more WMCs and CMHs than 3T MRI in 19 professional fighters, 16 patients with single TBI, versus 82 normal healthy controls (NHCs). Fighters and patients with TBI underwent both 3T and 7T MRI; NHCs underwent either 3T (
    Language English
    Publishing date 2023-05-18
    Publishing country United States
    Document type Journal Article
    ISSN 2689-288X
    ISSN (online) 2689-288X
    DOI 10.1089/neur.2023.0001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Short-Term Neurologic Manifestations of Repetitive Head Impacts Among Athletes: A Scoping Review.

    Stephen, Steve J / Hasman, Linda / Goldenberg, May / Merchant-Borna, Kian / Kawata, Keisuke / Mannix, Rebekah / Bazarian, Jeffrey J

    The Journal of head trauma rehabilitation

    2022  Volume 37, Issue 5, Page(s) 318–325

    Abstract: Objective: To summarize the evidence linking contact sports-related repetitive head impacts (RHIs) and short-term declines in neurologic function.: Methods: A scoping review following the guidelines in the Preferred Reporting Items for Systematic ... ...

    Abstract Objective: To summarize the evidence linking contact sports-related repetitive head impacts (RHIs) and short-term declines in neurologic function.
    Methods: A scoping review following the guidelines in the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and searching 3 databases (PubMed, EMBASE, and Web of Science) was performed. Peer-reviewed research articles were eligible for inclusion if they were full-length English language articles published between 1999 and 2019 examining athletes between the ages of 14 and 40 years exposed to RHIs, and reporting cognitive, vestibular, and/or oculomotor outcomes within 4 weeks of last head hit exposure.
    Results: Fifty-two articles met criteria for review: 14 reported oculomotor outcomes, 23 reported vestibular outcomes, and 36 reported cognitive function. Short-term RHI-related declines in neurologic function were reported in 42.9% of oculomotor studies, in 20.8% of vestibular studies, and in 33.3% of cognitive studies. Most of the 52 studies involved American football, soccer, or ice hockey athletes at the collegiate ( n = 23) or high school ( n = 14) level. Twenty-four (46%) studies involved only male athletes. Wearable sensors were used to measure RHIs in 24 studies (46%), while RHIs were not measured in 26 studies (50%). In addition, many studies failed to control for attention-deficit/hyperactivity disorder/learning disability and/or concussion history.
    Conclusion: The results of this scoping review suggest that the evidence linking RHIs to short-term declines in neurologic function is relatively sparse and lacking in methodological rigor. Although most studies failed to find a link, those that did were more likely to use objective measures of RHIs and to control for confounders. More careful trial design may be needed to definitively establish a causal link between RHIs and short-term neurologic dysfunction.
    MeSH term(s) Humans ; Infant ; Male ; Athletes ; Athletic Injuries ; Brain Concussion/psychology ; Football ; Hockey ; Soccer ; Head Injuries, Closed
    Language English
    Publishing date 2022-03-15
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S. ; Review
    ZDB-ID 639221-0
    ISSN 1550-509X ; 0885-9701
    ISSN (online) 1550-509X
    ISSN 0885-9701
    DOI 10.1097/HTR.0000000000000767
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2278: Show issues Location:
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    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
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  4. Article: Sex Moderates the Relationship That Number of Professional Fights Has With Cognition and Brain Volumes.

    Bennett, Lauren L / Stephen, Steve J / Bernick, Charles / Shan, Guogen / Banks, Sarah J

    Frontiers in neurology

    2020  Volume 11, Page(s) 574458

    Abstract: Objective: ...

    Abstract Objective:
    Language English
    Publishing date 2020-10-29
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2564214-5
    ISSN 1664-2295
    ISSN 1664-2295
    DOI 10.3389/fneur.2020.574458
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: The Relationship Between Fighting Style, Cognition, and Regional Brain Volume in Professional Combatants: A Preliminary Examination Using Brief Neurocognitive Measures.

    Stephen, Steve J / Shan, Guogen / Banks, Sarah J / Bernick, Charles / Bennett, Lauren L

    The Journal of head trauma rehabilitation

    2019  Volume 35, Issue 3, Page(s) E280–E287

    Abstract: Objective: Repetitive head impacts (RHIs) in combat sports are associated with cognitive decline and brain volume reduction. While fighting style differences between boxers, mixed martial artists (MMAs), and martial artists (MAs) have resulted in a ... ...

    Abstract Objective: Repetitive head impacts (RHIs) in combat sports are associated with cognitive decline and brain volume reduction. While fighting style differences between boxers, mixed martial artists (MMAs), and martial artists (MAs) have resulted in a broader spectrum of injury, the effects of RHIs on MAs relative to other fighters have not yet been explored. This study aimed to determine a differential effect of fighting style on cognition and brain.
    Setting: A large outpatient medical center specializing in neurological care.
    Participants, design, and main measures: In total, 40 MAs, 188 boxers, and 279 MMAs were compared on baseline measures of subcortical regional brain volumes, after controlling for total brain volumes, and cognitive performance.
    Results: Significant differences between MAs, MMAs, and boxers were observed in subcortical brain structure volumes and cognitive measures. MMAs and MAs consistently had larger volumes and higher scores than boxers. Fighting style significantly moderated the relationship between the number of professional fights and the volumes of various subcortical brain structures and performance on a measure of processing speed at baseline.
    Conclusions: Differences in RHIs across fighting styles may be of clinical significance. Exploring changes over time within the MA, boxer, and MMA cohorts may provide insight into longer-term discrepancies in subcortical regional brain volumes and cognitive functioning across fighting styles.
    MeSH term(s) Boxing/classification ; Brain/diagnostic imaging ; Cognition ; Cognitive Dysfunction ; Humans ; Martial Arts/classification ; Organ Size
    Language English
    Publishing date 2019-12-11
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 639221-0
    ISSN 1550-509X ; 0885-9701
    ISSN (online) 1550-509X
    ISSN 0885-9701
    DOI 10.1097/HTR.0000000000000540
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2278: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  6. Article ; Online: Effects of Physical Exertion on Early Changes in Blood-Based Brain Biomarkers: Implications for the Acute Point of Care Diagnosis of Concussion.

    Bazarian, Jeffrey J / Abar, Beau / Merchant-Borna, Kian / Pham, Dzung L / Rozen, Eric / Mannix, Rebekah / Kawata, Keisuke / Chou, Yiyu / Stephen, Steve / Gill, Jessica M

    Journal of neurotrauma

    2022  Volume 40, Issue 7-8, Page(s) 693–705

    Abstract: Blood-based brain biomarkers (BBM) such as glial fibrillary acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) have potential to aid in the diagnosis of concussion. Recently developed point-of-care test devices would enable BBMs ... ...

    Abstract Blood-based brain biomarkers (BBM) such as glial fibrillary acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) have potential to aid in the diagnosis of concussion. Recently developed point-of-care test devices would enable BBMs to be measured in field settings such military and sport environments within minutes of a suspicious head hit. However, head hits in these environments typically occur in the setting of vigorous physical exertion, which can itself increase BBMs levels. Thus, efforts to develop BBMs as acute concussion aids in field settings need to account for the effects of physical exertion. To determine the acute effects of physical exertion on the BBMs, we measured GFAP, UCH-L1, tau, and neurofilament light chain (NF-L) immediately before, immediately after, and 45 min after a single workout session consisting of aerobic and resistance exercises in 30 collegiate football players. Subjects wore body sensors measuring several aspects of exertion and underwent diffusion tensor imaging 24 h before and 48 h after exertion. All subjects were male with a mean age of 19.5 ± 1.2 years. The mean duration of activity during the workout session was 94 ± 31 min. There was a significant decrease in serum GFAP immediately after (median decrease of 27.76%,
    MeSH term(s) Humans ; Male ; Adolescent ; Young Adult ; Adult ; Female ; Physical Exertion ; Point-of-Care Systems ; Diffusion Tensor Imaging ; Brain Concussion/diagnosis ; Biomarkers ; Ubiquitin Thiolesterase ; Glial Fibrillary Acidic Protein ; Football ; Brain/diagnostic imaging
    Chemical Substances Biomarkers ; Ubiquitin Thiolesterase (EC 3.4.19.12) ; Glial Fibrillary Acidic Protein
    Language English
    Publishing date 2022-11-17
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 645092-1
    ISSN 1557-9042 ; 0897-7151
    ISSN (online) 1557-9042
    ISSN 0897-7151
    DOI 10.1089/neu.2022.0267
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2016: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
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