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• American Academy of Pediatrics. healthychildren.org. (2019). Soccer-Related Injuries in Kids are Rising – What Can Parents Do?
• American Academy of Pediatrics. (2012, Reaffirmed 2021). Policy Statement: Cheerleading Injuries: Epidemiology and Recommendations for Prevention. Pediatrics; 130(5): 966-971.
• Arbogast, K. B., Curry, A. E., Pfeiffer, M. R., et al. (2016). Point of Health Care Entry for Youth With Concussion Within a Large Pediatric Care Network. JAMA Pediatrics; 170(7): e160294.
• Bryan, M. A., Rowhani-Rahbar, A., Comstock, R. D., & Rivara, F. (2016). Sports- and Recreation-Related Concussion in US Youth. Pediatrics; 138(1), e20154635.
• Carney, N., Ghajar, J., Jagoda, A., Bedrick, S., Davis-O’Reilly, du Coudray, H., . . . Riggio, S. (2014). Concussion Guidelines Step 1: Systematic Review of Prevalent Indicators. Neurosurgery, 75(supplement 1): pS3–S15.
• Centers for Disease Control and Prevention. Traumatic Brain Injury and Concussion. (2018). CDC Pediatric mTBI Guideline.
• Centers for Disease Control and Prevention. Traumatic Brain Injury & Concussion. (2019). Get the Facts About TBI.
• Centers for Disease Control and Prevention. Traumatic Brain Injury & Concussion. (2019). National Concussion Surveillance System.
• Centers for Disease Control and Prevention. What Is A Concussion? video.
• Centers for Disease Control and Prevention. Explore Youth Risk Behavior Survey Questions - United States, 2021.
• Cullum, C. M., Bunt, S., Hicks, C., Didehbani, N., Miller, S., Vargas, B., Sabo, T., Bell, K., & Batjer, H. H. (2020). The North Texas Concussion Registry (ConTex). National Institutes of Health National Library of Medicine. BMJ Open; 10(1): e032345.
• DePadilla, L., Miller, G. F., Jones, S. E., Peterson, A. B., & Breiding, M. J. (2018) Self-Reported Concussions from Playing a Sport or Being Physically Active Among High School Students — United States, 2017. Centers for Disease Control and Prevention, Morbidity & Mortality Weekly Report (MMWR), 67 (24):682–685.
• Echemendia RJ, Ahmed OH, Bailey CM, et al. Introducing the Concussion Recognition Tool 6 (CRT6). British Journal of Sports Medicine. (2023). 57:689-691.
• Echemendia RJ, Burma JS, Bruce JM, et al. Acute evaluation of sport-related concussion and implications for the Sport Concussion Assessment Tool (SCAT6) for adults, adolescents and children: a systematic review. British Journal of Sports Medicine. (2023). 57:722-735.
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• American Academy of Pediatrics. (2022). Policy Statement: Vision and Concussion: Symptoms, Signs, Evaluation, and Treatment. Pediatrics, 150 (2): e2021056047.
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• Maroon, J. C., Winkelman, R., Bost, J., Amos, A., Mathyssek, C., & Miele, V. (2015). Chronic Traumatic Encephalopathy in Contact Sports: A Systematic Review of All Reported Pathological Cases. National Institutes of Health National Library of Medicine. PLoS ONE; 10(2): e0117338.
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Definitions

The medical definitions in this module were obtained or adapted from Columbia University Irving Medical Center, Mayo Clinic and StatPearls.

Continuing Medical Education

The Texas Department of State Health Services, Continuing Education Service is accredited by the Texas Medical Association to provide continuing medical education for physicians. 

The Texas Department of State Health Services, Continuing Education Service designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Nursing Education

The Texas Department of State Health Services, Continuing Education Service is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The Texas Department of State Health Services, Continuing Education Service has awarded 1.00 contact hour(s) of Continuing Nursing Education.

Social Workers

The Texas Department of State Health Services, Continuing Education Service, the continuing education provider, ensures that the education provided is directly related to the practice of social work; and that the individuals presenting the information have the necessary experience and knowledge in the topics presented. The Texas Department of State Health Services, Continuing Education Service has awarded 1.00 hours of credit.

Certificate of Attendance

The Texas Department of State Health Services, Continuing Education Service has designated 1.00 hour(s) for attendance.

Certified Community Health Worker

The Texas Department of State Health Services, Promotor(a)/Community Health Worker Training and Certification Program has certified this course for 1.00 contact hour(s) of continuing education for Certified Community Health Workers and Community Health Worker Instructors.

General Disclosure

One of the requirements of continuing education is disclosure of the following information to the learner:

1. Notice of requirements for successful completion of continuing education activity. To receive continuing education credit the learner must successfully complete the following activities:
   • Create a Texas Health Steps account.
   • Complete on-line registration process.
   • Thoroughly read the content of the module.
   • Complete the on-line examination.
   • Complete the evaluation.
2. Commercial Support.
   The THSTEPS Web-based Continuing Education Series has received no commercial support.
3. Disclosure of Relevant Financial Relationships.
   The THSTEPS Continuing Education Planning Committee and the authors of these modules have no relevant financial relationships to disclose.
4. Non-Endorsement Statement.
   Accredited status does not imply endorsement of any commercial products or services by the Department of State Health Services, Continuing Education Service; Texas Medical Association; or American Nurse Credentialing Center.
5. Off-Label Use.
   Using a disclosure review process, the THSTEPS Continuing Education Planning Committee has examined documents and has concluded that the authors of these modules have not included content that discusses off-label use (use of products for a purpose other than that for which they were approved by the Food and Drug Administration).

The following are policies and definitions of terms related to continuing education disclosure:

The intent of disclosure is to allow Department of State Health Services (DSHS) Continuing Education Service the opportunity to resolve any potential conflicts of interest to assure balance, independence, objectivity and scientific rigor in all of its Continuing Education activities.

All faculty, planners, speakers and authors of Department of State Health Services (DSHS) Continuing Education Service sponsored activities are expected to disclose to the Department of State Health Services (DSHS) Continuing Education Service any relevant financial, relationships with any commercial or personal interest that produces health care goods or services concerned with the content of an educational presentation. Faculty, planners, speakers and authors must also disclose where there are any other potentially biasing relationships of a professional or personal nature.

Glossary of Terms

Conflict of Interest: Circumstances create a conflict of interest when an individual has an opportunity to affect Continuing Education content about products or services of a commercial interest with which she/he has a financial relationship or where there are any other potentially biasing relationships of a professional or personal nature.

Commercial Interest: Any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.

Financial Relationships: Those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected. Relevant financial relationships would include those within the past 12 months of the person involved in the activity and a spouse or partner. Relevant financial relationships of your spouse or partner are those of which you are aware at the time of this disclosure.

Off Label: Using products for a purpose other that that for which it was approved by the Food and Drug Administration (FDA).

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