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Inaccurate dosing of children’s liquid medication is a major problem that causes adverse effects for children every year. In order to prevent these errors, education for at risk parents is essential. A survey and observational study was done in order to identify parents/caregivers who make dosing errors when measuring out liquid medication for their children. A total of 25 parents/caregivers with children admitted to Arnold Palmer Hospital were included in this study. Study participants completed a survey that included demographic data as well as parenting experience. The parents were directly observed measuring a dose of corn syrup using Children’s liquid Tylenol® dosing instructions. The research participants were offered a variety of common measuring devices and they chose the one they most often used at home. Data indicated a high incidence of dosing errors made by a variety of participants. Of the 25 research participants, 13 (52%) made an error greater than 20% when measuring out the dose based on the provided instructions and their child’s weight. This data suggests nurses need to include dosing education for all parents at discharge. This study has shown that many parents are at risk for making errors when measuring medication. Effective discharge education on the importance of measuring medication accurately can prevent these errors and the adverse effects they cause.

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The purpose of the current study was threefold: 1) to assess youths' and parents' perceptions of their competency in managing diabetes, 2) to assess family flexibility and cohesiveness, and 3) to assess the utility of self-efficacy and family factors as predictors of adherence and metabolic control. Participants included 62 youths with insulin-dependent diabetes mellitus (IDDM) and their parents. Parents' and youths' perceptions of their abilities in diabetes and related situations, family cohesion and adaptability, and perceptions of the family's ability to integrate the demands of the diabetes regimen into general family routines were assessed. Results suggested that both social learning factors and general family relations were important in the prediction of youths' adherence to the treatment regimen for diabetes and metabolic control. Moreover, family efficacy and family cohesion were related, suggesting the need for models of assessment and intervention that include both social learning and general family functioning variables. / Ph. D.

As many as 1.9 million sports-related concussions occur annually in youth sports in the United States (U.S.). Often considered a transient injury, research has begun to relate sports-related concussions to long-term neurodegeneration. Youth athletes are considered to be more vulnerable to concussion than their adult counterparts. The research presented in this dissertation was aimed at promoting player safety in youth football as it relates to concussion. Balance dysfunction is often cited as one of the most common symptoms associated with a concussion. Several postural control assessments were assessed in order to develop a youth-specific testing protocol. A cognitive, dual-task assessment was presented for clinician use in the management of sports-related concussion. On-field data collected from youth football players wearing instrumented helmets allowed for characterization of the biomechanics of head impacts and concussions for this population. A youth concussion risk function was developed using head impact data collected from youth football players with medically diagnosed concussions. The proposed testing standard for youth football helmets was assessed in the laboratory and related to on-field head impact data to determine how representative the standard is of youth football head impacts. Helmet safety standards and certifications operate on a pass-fail threshold that does not allow consumers to weigh the relative performance of helmets. A modification of the Summation of Tests for the Analysis of Risk (STAR) evaluation system was developed for youth football helmets. Data presented in this dissertation have direct application to the development of future helmet safety standards and potentially other safety applications as well. / Doctor of Philosophy / As many as 1.9 million sports-related concussions occur annually in youth sports in the United States (U.S.). Often considered a short-term injury, research has begun to relate sports-related concussions to long-term breakdowns in neurological processes. Youth athletes are considered to be more vulnerable to concussion than their adult counterparts. The research presented in this dissertation was aimed at informing player safety in youth football as it relates to concussion. Abnormal balance is often cited as one of the most common symptoms associated with a concussion. Several balance assessments were assessed in order to develop a youth-specific testing protocol. An assessment involving quiet standing while being subjected to a cognitive task was presented for clinician use in the management of sports-related concussion. On-field data collected from youth football players wearing instrumented helmets allowed for characterization of the biomechanics of head impacts and concussions for this youth population. A youth concussion risk function was developed that related linear and rotational head acceleration to risk of concussion. The proposed testing standard for youth football helmets was assessed in the laboratory and observed to assess the most severe head impacts a youth player may experience during participation in football. A modification of the Summation of Tests for the Analysis of Risk (STAR) evaluation system was developed for youth football helmets in order to give consumers more information about helmet performance beyond the pass-fail criteria of the helmet standards. Data presented in this dissertation have direct application to the development of future helmet safety standards and potentially other safety applications as well.

The research presented in this thesis focuses on head impact exposure in youth football. The on-field portion of this research investigated high magnitude head impacts that youth football players experience in games and practices. With previously validated data collection methods, linear and rotational head accelerations from head impacts were collected. Over the course of two seasons, 79 total player-seasons resulted in over 13,000 impacts. A small subset of these, 979 impacts exceeding 40 g, represented the focus of this research as these impacts pose the greatest risk of injury to individuals. Some tackling drills in practice were found to have higher acceleration severities than those observed in games. How practice activities are conducted also contributes towards the overall high magnitude head impact exposure for practice, not just the practice drill itself. Within games, players who are running backs and linebackers played most frequently and experienced higher magnitude impacts more often than their teammates. Data were also collected from all players off the field. Each player completed balance assessments at the beginning and end of the season to allow for comparison, even in absence of a clinically-diagnosed concussion. Current balance assessments were observed to fall short for detecting postural control differences in this youth population. Modifications to these assessments were recommended that might allow for further insights. Research presented in this thesis will inform youth football organizations as they continue to develop strategies to enhance player safety and mitigate head impact exposure. / Master of Science / The research presented in this thesis focuses on head impact exposure in youth football. The on-field portion of this research investigated high magnitude head impacts, which are associated with heightened risk of concussion, that youth football players experience in games and practices. With previously validated data collection methods, the specific causation for high risk head impacts in youth football practices and games was determined for the first time. In some practice drills, players were observed to hit harder and more frequently than they would in games. As youth practices occur more often than games do, limiting the time spent in these types of practice drills is recommended. How practice activities are conducted also contributes towards the overall high magnitude head impact exposure for practice, not just the practice drill itself. Events where players had the opportunity to get up to speed prior to impact were more likely to be high risk than events where players essentially impacted from a standstill. Data were also collected from all players off the field. Each player completed balance assessments at the beginning and end of the season to allow for comparison, even in absence of a clinically-diagnosed concussion. Current balance assessments were observed to fall short for detecting balance differences in this youth population. Modifications to these assessments were recommended that might allow for further insights. Research presented in this thesis will inform youth football organizations as they continue to develop strategies to enhance player safety and mitigate head impact exposure.