Digital Commons Network^™

Models Of Shared Care For The Management Of Psychotic Disorder After First Diagnosis In Ontario., Joshua C. Wiener, Rebecca Rodrigues, Jennifer N S Reid, Kelly K. Anderson

Epidemiology and Biostatistics Publications

OBJECTIVE: To describe the provision of care for young people following first diagnosis of psychotic disorder.

DESIGN: Retrospective cohort study using health administrative data.

SETTING: Ontario.

PARTICIPANTS: People aged 14 to 35 years with a first diagnosis of nonaffective psychotic disorder in Ontario between 2005 and 2015 (N=39,449).

MAIN OUTCOME MEASURES: Models of care, defined by psychosis-related service contacts with primary care physicians and psychiatrists during the 2 years after first diagnosis of psychotic disorder.

RESULTS: During the 2-year follow-up period, 29% of the cohort received only primary care, 30% received only psychiatric care, and 32% received both primary and …

Smartphones For Smart Eating: Evaluating The Effectiveness Of Smartphone Applications On Improving Adolescent Food Knowledge, Heather A. Jantzi

Electronic Thesis and Dissertation Repository

Many Canadian adolescents have unhealthy eating habits which are risk factors for developing chronic diseases later in life. Food literacy plays a role in healthy eating habits but teens in Ontario currently lack sufficient nutrition education learning opportunities in home and school environments. Across health research, smartphones have been utilized as a novel medium to promote learning and alter behaviour. This thesis seeks to understand the effectiveness of smartphone applications at improving food knowledge in adolescents through (i) a systematic review of published interventions, and (ii) by investigating the efficacy of a novel location-based smartphone application. Findings from this thesis …

Characterizing And Predicting Canadian Adolescents’ Internalizing Symptoms In The First Year Of The Covid-19 Pandemic, Haley E. Green, Andrew R. Daoust, Matthew R. J. Vandermeer, Pan Liu, Kasey Stanton, Kate L. Harkness, Elizabeth P. Hayden

Psychology Publications

To date, most longitudinal studies of adolescents’ internalizing symptoms during the COVID-19 pandemic include few time points, limiting knowledge about the long-term course of adolescents’ mental health during the pandemic. Moreover, examining intraindividual variability in symptoms, which may have important implications for adolescents’ adjustment beyond mean or “typical” symptoms, requires multiple time points. We examined the course of internalizing symptoms in 271 Ontario adolescents (mean n = 193 across time points) during the first year of the pandemic (March 2020–April 2021) via mixed-effect location scale models, drawing upon established internalizing symptom risk factors as predictors of mean trends and intraindividual …

Lockdown, Bottoms Up? Changes In Adolescent Substance Use Across The Covid-19 Pandemic, Tara M. Dumas, Wendy E. Ellis, Stephen Van Hedger, Dana M. Litt, Madeleine Macdonald

Neuroscience Institute Publications

The COVID-19 pandemic notably altered adolescent substance use during the initial stage (Spring 2020) of the pandemic. The purpose of this longitudinal study is to examine trajectories of adolescent substance use across the pandemic and subsequent periods of stay-at-home orders and re-opening efforts. We further examined differences as a function of current high school student versus graduate status. Adolescents (n = 1068, 14–18 years, Mage = 16.95 years and 76.7% female at T1) completed 4 different self-report surveys, starting during the first stay-at-home order and ending approximately 14 months later. Negative binomial hurdle models predicted: (1) the likelihood of no …

The Prevalence And Impact Of Adolescent Hospitalization To Adult Psychiatric Units., Samantha Mcrae, Jordan Edwards, Kathy N Speechley, Javeed Sukhera, Guangyong Zou, Kelly K. Anderson

Epidemiology and Biostatistics Publications

BACKGROUND: With increasing psychiatric hospitalizations among adolescents and constrained hospital resources, there are times when youth are hospitalized in adult inpatient psychiatry units. Evidence on the prevalence of this practice and associated impacts is lacking.

AIMS: We sought to explore the prevalence, determinants, and outcomes related to the hospitalization of adolescents aged 12-17 years on adult inpatient psychiatry units in Ontario.

METHODS: Using health administrative data, we constructed a cohort of adolescents with an inpatient psychiatric admission in Ontario (2007-2011). We classified adolescents as having an admission to an adult psychiatry unit or to other inpatient units. Multivariable regression models …

Characterizing And Predicting Canadian Adolescents’ Internalizing Symptoms In The First Year Of The Covid-19 Pandemic, Haley Elizabeth Green

Electronic Thesis and Dissertation Repository

Most studies of adolescents’ internalizing symptoms during the COVID-19 pandemic have included few data waves, limiting long-term conclusions about adolescents’ mental health during the pandemic. Collecting only a few waves of data precludes examination of intraindividual symptom variability, which may have implications for adjustment beyond mean symptoms. We characterized mean n = 192 adolescents’ internalizing symptoms from March 2020-April 2021 and used mixed effect location scale models to examine established risk factors as predictors of mean trends and intraindividual variability in adolescents’ internalizing symptoms. Adolescents’ symptoms were relatively stable and low over the first year of the pandemic; severity peaked …

Health Concerns Of Adolescents And Adults With Spina Bifida, Jessica A. Starowicz

Electronic Thesis and Dissertation Repository

The Transitional and Lifelong Care (TLC) program is a multidisciplinary clinical service providing comprehensive, coordinated care to adolescents and adults with spina bifida (SB). This study sought to identify the most common health concerns among this population at initial consultation and identify patient factors related to these concerns to ultimately improve health care delivery. A retrospective chart review was performed. Descriptive analyses were completed and associations between concerns and patient factors were determined using Spearman’s rho correlation coefficients. A multiple linear regression was performed to estimate the relationship between patient factors and total number of concerns reported. Ninety-four patient charts …

“I Am The Expert” : The Process Of Adolescent Transition In The Self-Management Of Hearing Healthcare. A Constructivist Grounded Theory Study, Christine N. Meston

Electronic Thesis and Dissertation Repository

Adolescence is a time when adult behaviours become established and adolescents are more able to manage aspects of their healthcare. Research has examined adolescent transitions to self-manage their personal healthcare needs associated with chronic diseases. Providing children and adolescents with information about their health is an ongoing process and, as they mature, they should be allowed to take on more responsibility for their healthcare management. The purpose of this study was to explore the transition for adolescents who are deaf and hard of hearing toward the self-management of their hearing healthcare. A constructivist grounded theory approach was used to develop …

Automated Office Blood Pressure Measurement For The Diagnosis Of Hypertension, Guido Filler, Maria E Díaz-González De Ferris

Paediatrics Publications

Editorial

High Molecular Weight Adiponectin Levels Are Inversely Associated With Adiposity In Pediatric Brain Tumor Survivors., Rebecca Ronsley, Shahrad Rod Rassekh, Adam Fleming, Brianna Empringham, William Jennings, Carol Portwine, Sarah Burrow, Shayna Zelcer, Donna L Johnston, Lehana Thabane, M Constantine Samaan

Paediatrics Publications

While children with brain tumors are surviving at record rates, survivors are at risk of cardiovascular disease and type 2 diabetes mellitus; these conditions may be driven by excess body fat. Adiponectin in an adipokine that is inversely associated with the fat mass, and has been linked to cardiometabolic risk stratification in the general population. However, adiponectin's profile and determinants in SCBT have not been established. We tested the hypothesis that high molecular weight (HMW) adiponectin levels, the more biologically active form of adiponectin, were associated with adiposity in SCBT similarly to non-cancer controls. Seventy-four SCBT (n = 32 female) …

Breakfast Consumption And Diet Quality Of Teens In Southwestern Ontario, Nicolas Woods

Electronic Thesis and Dissertation Repository

BACKGROUND: Breakfast skipping has previously been associated with worse diet quality among adolescents, although research from Canada is relatively sparse. Additionally, many studies do not consider diet quality as a function of calories, which is problematic as skippers tend to consume less energy than consumers.

PURPOSE: This study investigated breakfast skipping habits and Healthy Eating Index-2015 scores among teens in Southwestern Ontario.

METHODS: Cross-sectional, baseline data were used from the SmartAPPetite project, which is currently ongoing. 24-hour dietary recalls and sociodemographic information were obtained from participants and parents (n=512).

RESULTS: Breakfast skippers had significantly lower diet quality, even when calories …

Student Feedback To Tailor The Card™ System For Improving The Immunization Experience At School, Charlotte Logeman, Anna Taddio, C. Meghan Mcmurtry, Lucie Bucci, Noni Macdonald, Garth Chalmers, Victoria Gudzak, Vibhuti Shah

Paediatrics Publications

Increasing the comfort of vaccine delivery at school is needed to improve the immunization experience for students. We created the CARD™ (C—Comfort, A—Ask, R—Relax and D—Distract) system to address this clinical care gap. Originally designed for grade 7 students, this study examined the perceptions of grade 9 students of CARD™. Grade 9 students who had experience with school-based immunizations, either as recipients or onlookers (n = 7; 100% females 14 years old) participated. Students answered pre–post surveys, reviewed CARD™ educational materials and participated in a semi-structured focus group discussion. The Consolidated Framework for Implementation Research (CFIR) was used as the …

Signs With A Side Of Fries: The Influence Of Outdoor Advertising On Retail Food Outlet Purchases By Adolescents, Alexander Wray

Electronic Thesis and Dissertation Repository

Most Canadian adolescents have diets high in fat, sodium, and free sugar. There are concerns among researchers and policymakers that food and beverage marketing has an adverse impact on adolescent dietary attitudes, knowledge, and behaviours. The food environment plays an important role in shaping diets and health. The food information environment, and more specifically outdoor food and beverage advertising, may have an effect on adolescent food and beverage purchases. This thesis investigates the associations between the availability of, accessibility to, or exposure to outdoor advertising and retail food outlets, coupled with attitudes related to food and beverage consumption, and purchases …

Screening And Treatment Outcomes In Adults And Children With Type 1 Diabetes And Asymptomatic Celiac Disease: The Cd-Diet Study., Farid H Mahmud, Antoine B M Clarke, Kariym C Joachim, Esther Assor, Charlotte Mcdonald, Fred Saibil, Heather A Lochnan, Zubin Punthakee, Amish Parikh, Andrew Advani, Baiju R Shah, Bruce A Perkins, Caroline S Zuijdwijk, David R Mack, Dror Koltin, Emilia N De Melo, Eugene Hsieh, Geetha Mukerji, Jeremy Gilbert, Kevin Bax, Margaret L Lawson, Maria Cino, Melanie D Beaton, Navaaz A Saloojee, Olivia Lou, Patricia H Gallego, Premysl Bercik, Robyn L Houlden, Ronnie Aronson, Susan E Kirsch, William G Paterson, Margaret A Marcon

Paediatrics Publications

OBJECTIVE: To describe celiac disease (CD) screening rates and glycemic outcomes of a gluten-free diet (GFD) in patients with type 1 diabetes who are asymptomatic for CD.

RESEARCH DESIGN AND METHODS: Asymptomatic patients (8-45 years) were screened for CD. Biopsy-confirmed CD participants were randomized to GFD or gluten-containing diet (GCD) to assess changes in HbA

RESULTS: Adults had higher CD-seropositivity rates than children (6.8% [95% CI 4.9-8.2%,

CONCLUSIONS: CD is frequently observed in asymptomatic patients with type 1 diabetes, and clinical vigilance is warranted with initiation of a GFD.

An Examination Of Child And Youth Mental Health Service Urgency In Ontario, Valbona Semovski

Electronic Thesis and Dissertation Repository

Ontario’s capacity to treat children and adolescents in mental health crisis is outweighed by the number and needs of individuals requiring treatment. A lack of standardized assessments for prioritizing individuals has contributed to long wait times for treatment and a paucity of information to help prioritize those requiring urgent services. This study examined whether sector (e.g., school, hospital), sex, age, legal guardianship, interpersonal and school conflict, intellectual disability and comorbid health conditions predicted greater mental health service urgency in 61,448 children (ages 4 to 18 years) assessed using the interRAI Child and Youth Mental Health Screener. Additionally, differences in mental …

Cumulative Purposeful Soccer Heading Can Lead To Compensatory Changes In Brain Activity During Combined Moderate Exercise And Cognitive Load In Female Youth Soccer Players, Alexandra Harriss

Electronic Thesis and Dissertation Repository

Head trauma that occurs during sporting events is responsible for an increasing number of emergency department visits in Canada and is associated with an increased risk of developing neurodegenerative diseases.While head injury in American football has been extensively studied, it cannot be extrapolated to non-helmeted sports. Approximately 265 million people are actively participating in soccer and many are 18 years of age and younger. Soccer is unique in that players use their head to redirect the ball; however, the effects of cumulative purposeful soccer heading on brain health are unknown. Accordingly, the objective of this thesis was to quantify head …

Prevalence And Clinical Features Of Inflammatory Bowel Diseases Associated With Monogenic Variants, Identified By Whole-Exome Sequencing In 1000 Children At A Single Center, Eileen Crowley, Neil Warner, Jie Pan, Sam Khalouei, Abdul Elkadri, Karoline Fiedler, Justin Foong, Andrei L Turinsky, Dana Bronte-Tinkew, Shiqi Zhang

Paediatrics Publications

BACKGROUND & AIMS: A proportion of infants and young children with inflammatory bowel diseases (IBDs) have subtypes associated with a single gene variant (monogenic IBD). We aimed to determine the prevalence of monogenic disease in a cohort of pediatric patients with IBD.

METHODS: We performed whole-exome sequencing analyses of blood samples from an unselected cohort of 1005 children with IBD, aged 0-18 years (median age at diagnosis, 11.96 years) at a single center in Canada and their family members (2305 samples total). Variants believed to cause IBD were validated using Sanger sequencing. Biopsies from patients were analyzed by immunofluorescence and …

Vascular Risk Reduction In Obesity Through Reduced Granulocyte Burden And Improved Angiogenic Monocyte Content Following Bariatric Surgery., David A Hess, Justin Z Trac, Stephen A Glazer, Daniella C Terenzi, Adrian Quan, Hwee Teoh, Mohammed Al-Omran, Deepak L Bhatt, C David Mazer, Ori D Rotstein, Subodh Verma

Physiology and Pharmacology Publications

Bariatric surgery, in addition to the benefit of sustained weight loss, can also reduce cardiometabolic risk and mortality. Lifelong vessel maintenance is integral to the prevention of cardiovascular disease. Using aldehyde dehydrogenase activity, an intracellular detoxifying enzyme present at high levels within pro-vascular progenitor cells, we observed an association between chronic obesity and "regenerative cell exhaustion" (RCE), a pathology whereby chronic assault on circulating regenerative cell types can result in adverse inflammation and diminished vessel repair. We also describe that, at 3 months following bariatric surgery, systemic inflammatory burden was reduced and pro-angiogenic macrophage precursor content was improved in subjects …

Age At Migration And The Risk Of Psychotic Disorders: A Systematic Review And Meta-Analysis., Kelly K. Anderson, Jordan Edwards

Epidemiology and Biostatistics Publications

OBJECTIVE: To conduct a systematic review and meta-analysis of the existing evidence on the association between age at migration and the risk of psychotic disorders.

METHODS: Observational studies were eligible for inclusion if they presented data on the association between age at migration and the risk of psychotic disorders among first-generation migrant groups. We used two random effects meta-analyses to pool effect estimates for each stratum of age at migration relative to (i) a native-born reference category and (ii) the youngest age stratum (0 to 2 years).

RESULTS: Ten studies met inclusion criteria, and five were included in the meta-analysis. …

Predicting Hemolytic Uremic Syndrome And Renal Replacement Therapy In Shiga Toxin-Producing Escherichia Coli-Infected Children., Ryan S Mckee, David Schnadower, Phillip I Tarr, Jianling Xie, Yaron Finkelstein, Neil Desai, Roni D Lane, Kelly R Bergmann, Ron L Kaplan, Selena Hariharan, Andrea T Cruz, Daniel M Cohen, Andrew Dixon, Sriram Ramgopal, Annie Rominger, Elizabeth C Powell, Jennifer Kilgar, Kenneth A Michelson, Darcy Beer, Martin Bitzan, Christopher M Pruitt, Kenneth Yen, Garth D Meckler, Amy C Plint, Stuart Bradin, Thomas J Abramo, Serge Gouin, April J Kam, Abigail Schuh, Fran Balamuth, Tracy E Hunley, John T Kanegaye, Nicholas E Jones, Usha Avva, Robert Porter, Daniel M Fein, Jeffrey P Louie, Stephen B Freedman

Paediatrics Publications

BACKGROUND: Shiga toxin-producing Escherichia coli (STEC) infections are leading causes of pediatric acute renal failure. Identifying hemolytic uremic syndrome (HUS) risk factors is needed to guide care.

METHODS: We conducted a multicenter, historical cohort study to identify features associated with development of HUS (primary outcome) and need for renal replacement therapy (RRT) (secondary outcome) in STEC-infected children without HUS at initial presentation. Children agedeligible.

RESULTS: Of 927 STEC-infected children, 41 (4.4%) had HUS at presentation; of the remaining 886, 126 (14.2%) developed HUS. Predictors (all shown as odds ratio [OR] with 95% confidence interval [CI]) of HUS included younger age …

Physical Activity And Social Connectedness Interventions In Outdoor Spaces Among Children And Youth: A Rapid Review, Alexander Wray, Gina Martin, Emma Ostermeier, Alina Medeiros, Malcolm Little, Kristen Reilly, Jason Gilliland

Paediatrics Publications

Introduction: The rise in sedentary behaviour, coupled with the decline in overall mental health among Canadian children and youth in recent decades, demonstrates a clear need for applied research that focusses on developing and evaluating cross-disciplinary interventions. Outdoor spaces provide opportunities for physical activity and social connectedness, making them an ideal setting to address these critical health concerns among children and youth. Methods: We conducted a rapid review of peer-reviewed (n = 3096) and grey literature (n = 7) to identify physical activity and/or social connectedness outdoor space interventions targeted at children and youth (19 years and under) in Australia …

Pain Squad+ Smartphone App To Support Real-Time Pain Treatment For Adolescents With Cancer: Protocol For A Randomised Controlled Trial., Lindsay Jibb, Paul C Nathan, Vicky Breakey, Conrad Fernandez, Donna Johnston, Victor Lewis, Sarah Mckillop, Serina Patel, Christine Sabapathy, Caron Strahlendorf, J Charles Victor, Myla E Moretti, Cynthia Nguyen, Amos Hundert, Celia Cassiani, Graziella El-Khechen Richandi, Hayley Insull, Rachel Hamilton, Geoffrey Fang, Susan Kuczynski, Jennifer Stinson

Paediatrics Publications

INTRODUCTION: Pain negatively affects the health-related quality of life (HRQL) of adolescents with cancer. The Pain Squad+ smartphone-based application (app), has been developed to provide adolescents with real-time pain self-management support. The app uses a validated pain assessment and personalised pain treatment advice with centralised decision support via a registered nurse to enable real-time pain treatment in all settings. The algorithm informing pain treatment advice is evidence-based and expert-vetted. This trial will longitudinally evaluate the impact of Pain Squad+, with or without the addition of nurse support, on adolescent health and cost outcomes.

METHODS AND ANALYSIS: This will be a …

Circulating Leptin Levels Are Associated With Adiposity In Survivors Of Childhood Brain Tumors., E Danielle Sims, William J. Jennings, Brianna Empringham, Adam Fleming, Carol Portwine, Donna L. Johnston, Shayna M. Zelcer, Shahrad Rod Rassekh, Sarah Burrow, Lehana Thabane, M Constantine Samaan

Paediatrics Publications

Survivors of Childhood Brain Tumors (SCBT) are at a higher risk of developing cardiovascular disease and type 2 diabetes compared to the general population. Adiposity is an important risk factor for the development of these outcomes, and identifying biomarkers of adiposity may help the stratification of survivors based on their cardiovascular risk or allow for early screening and interventions to improve cardiometabolic outcomes. Leptin is an adipokine that positively correlates with the adipose mass in the general population and is a predictor of adverse cardiometabolic outcomes, yet its association with adiposity in SCBT has not been studied. The aim of …

Predictors Of Bicuspid Aortic Valve-Associated Aortopathy In Childhood: A Report From The Mibava Consortium, Michael Grattan, Andrea Prince, Rawan K Rumman, Conall Morgan, Michele Petrovic, Amanda Hauck, Luciana Young, Anders Franco-Cereceda, Bart Loeys, Salah A Mohamed, Harry Dietz, Seema Mital, Chun-Po Steve Fan, Cedric Manlhiot, Gregor Andelfinger, Luc Mertens

Paediatrics Publications

BACKGROUND: Bicuspid aortic valve (BAV) is the most prevalent congenital heart defect affecting 1% to 2% of the population. It is associated with ascending aorta dilatation. Valve morphology, aortic stenosis (AS), and aortic insufficiency (AI) have been proposed as potential risk factors; however, evaluating their role is difficult, as these factors are inherently related. The aim of this study was to determine whether BAV morphology and dysfunction are independent determinants for ascending aorta dilatation in pediatric patients.

METHODS: A multicenter, retrospective, cross-sectional study of pediatric BAV patients followed since 2004 was performed. Imaging data were assessed for BAV morphology, severity …

Osteochondritis Dissecans In Pediatric Patients With Juvenile Idiopathic Arthritis., Bradley C Jackson, Debra L Bartley, Roberta A Berard

Paediatrics Publications

No abstract provided.

Fatigue In Young People With Duchenne Muscular Dystrophy, Basmah El-Aloul, Kathy N Speechley, Yi Wei, Piotr Wilk, Craig Campbell

Paediatrics Publications

AIM: To describe fatigue in Duchenne muscular dystrophy (DMD) from patients' and parents' perspectives and to explore risk factors for fatigue in children and adolescents with DMD.

METHOD: A multicentre, cross-sectional study design was used. Seventy-one patients (all males; median age 12y, age range 5-17y) identified via the Canadian Neuromuscular Disease Registry, and their parents completed questionnaires. Subjective fatigue was assessed using the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale by child self-report and parent proxy-report.

RESULTS: Patients with DMD across ages and disease stages experienced greater fatigue compared to typically developing controls from published data. Sleep disturbance symptoms …

Healthcare Utilization Costs Of Emerging Adults With Mood And Anxiety Disorders In An Early Intervention Treatment Program Compared To A Matched Cohort, Ava A. John-Baptiste, Lihua Li, Wanrudee Isaranuwatchai, Elizabeth Osuch, Kelly K. Anderson

Epidemiology and Biostatistics Publications

AIM: The First Episode Mood and Anxiety Disorder Program (FEMAP) provides treatment to emerging adults with mood and anxiety disorders in an accessible, youth-friendly environment. We sought to investigate FEMAP's impact on the costs of care.

METHODS: We conducted a retrospective observational study of one-year health service costs using linked administrative datasets to compare emerging adults treated at FEMAP (FEMAP users) to propensity-score matched controls (non-users). Costs from the perspective of the Ontario Ministry of Health and Long-Term Care, included drug benefit claims, inpatient, physician and ambulatory care services. We used bootstrapping to perform unadjusted comparisons between FEMAP users and …

Preventing Adolescent Dating Violence: An Outcomes Protocol For Evaluating A Gender-Transformative Healthy Relationships Promotion Program, Deinera Exner-Cortens, Alysia Wright, Debb Hurlock, Roseline Carter, Pam Krause, Claire Crooks

Journal Articles

Adolescent dating violence (ADV) is a pressing public health problem in North America. Strategies to prevent perpetration are needed, and a substantial body of research demonstrates the importance of applying a gender lens to target root causes of adolescent dating violence as part of effective prevention. To date, however, there has been limited research on how to specifically engage boys in adolescent dating violence prevention. In this short communication, we describe the protocol for a longitudinal, quasi-experimental outcome evaluation of a program called WiseGuyz. WiseGuyz is a community-facilitated, gender-transformative healthy relationships program for mid-adolescent male-identified youth that aims to reduce …

Development Of A Teen-Informed Coding Tool To Measure The Power Of Food Advertisements, Drew D. Bowman, Leia M. Minaker, Bonnie J.K. Simpson, Jason A. Gilliland

Paediatrics Publications

The food-related information environment, comprised of food and beverage advertising within one’s surroundings, is a growing concern for adolescent health given that food marketing disproportionately targets adolescents. Despite strong public interest concerning the effects of food marketing on child health, there is limited evidence focused on outdoor food advertising in relation to teenage diets, food purchasing, and perceptions. Further, limited research has considered both the exposure to and influence of such advertisements. This study used a novel multi-method approach to identify and quantify the features of outdoor food and beverage advertisements that are most effective at drawing teenagers into retail …

Impact Of Diagnostic Terminology On Parental Attitudes Toward Concussion And Brain Injury, Naomi Sanderson

Electronic Thesis and Dissertation Repository

Although some have argued that the terms concussion and mild traumatic brain injury (mTBI) should not be used interchangeably, any differences between the diagnoses are subtle. In this study, we recruited 98 individuals through Amazon Mechanical Turk who self-identified as having children between the ages of 13 and 18 (inclusive). Participants were asked questions about a hypothetical injury to their child, related to symptoms, participation in school and physical activity, and recovery prognosis. Roughly half (n = 51) were asked these questions in reference to a “concussion”, and the remainder (n = 47) were asked questions in reference to an …