A client expresses difficulty sleeping аnd experiences significаnt dаytime fatigue. Even after drinking a full pоt оf cоffee to stay awake, the fatigue persists, leading to frequent naps. Although the client once enjoyed attending the senior center daily, exhaustion now prevents this activity. Current activity consists of walking their dog twice daily. Which of the following are important to discuss with the client? Select all that apply.
Pаssаge B Trаumatic brain injuries are assоciated with cоgnitive decline later in life, and a sharper drоp in cognition as we age, a study of twins who served in World War II shows.There is robust research demonstrating a relationship between head injuries and cognitive impairment or dementia later in life, “but I do not know of any others that use a twin-study design,” said Holly Elser, an epidemiologist and resident physician in neurology at the University of Pennsylvania who peer-reviewed the study.The study published in Neurology on Wednesday found that individuals who had a traumatic brain injury were more likely to have lower scores on cognitive tests when they were about 70 years old.They were also more likely to have rapidly declining scores after their first test if they had multiple traumatic brain injuries, lost consciousness because of a head injury or were 25 or older when the injury happened.“Even if it’s just a single traumatic brain injury, we now know that it led to worse cognitive outcomes later in life,” said Marianne Chanti-Ketterl, the lead author of the study and an assistant professor in psychiatry and behavioral sciences at the Duke University School of Medicine.The study of identical and fraternal twins allows researchers to compare participants to each other while controlling for some, if not all, of the underlying genetic factors and some of the twins’ early life conditions. Identical twins share 100 percent of their genes, while fraternal twins share about half. As used in paragraph 2, "robust" most nearly means
Pаssаge D Milliоns оf Americаn students came back tо school in recent weeks, navigating new classroom rules and cafeteria social hierarchies. For some, the hardest part of the day was simply getting to school. A chronic shortage of school bus drivers is making it difficult for many children to get to class. Some districts have had to shorten school days; others have even canceled school because too few children could attend. The fix requires a shift in mind-set. School systems’ obligations to students should start when children step out their front doors, rather than when they walk through the schoolhouse gates. The idea of a school-specific public transportation system is the product of very American forces. The westward expansion of the 1800s, the suburbanization of the post-World War II era and the consolidation of neighborhood schools into larger institutions distanced children from their classrooms. Compulsory attendance laws made finding reliable transportation imperative. And the rise of the car inspired a wave of innovation that culminated in the iconic yellow school bus. Underlying these developments was a sense that the state had a duty to get children to school. In 1929, just 8.9 percent of kids were transported to school at public expense, according to the Education Department’s National Center for Education Statistics. By the 1983-1984 school year, the figure was nearly 61 percent. Yet, as children’s homes and schools got farther apart, the number served by public school transportation systems fell. Increasingly, it’s parents, not bus drivers, who get behind the wheel for the school commute. That’s true even for short distances. Between 1969 and 2009, the number of children aged between 4 and 15 and living within a mile of school who got there on foot or by bicycle fell from 89 percent to 35 percent, according to the National Center for Safe Routes to School. In theory, it makes sense for parents to be responsible for getting kids to school. It’s not as though principals are going door to door to negotiate with kindergartners who only want to wear the T-shirt at the bottom of the hamper or to rouse drowsy high school juniors and bundle them off to trigonometry. But not all parents have work schedules that align with the school day, access to reliable transportation or even a fixed address. Sixty percent of children from low-income families rely on school buses. For kids with additional needs who must attend faraway specialized schools, that transport is crucial. This will cost money. But if kids can’t get to school, they can’t benefit from new phonics curriculums or fancy technology anyway. When the wheels on the bus stop going ’round and ’round, kids suffer. Let’s reclaim a sense of collective responsibility to get our littlest citizens between home and school. What is the most reasonable inference about the context in which this passage was written?