When the brain is in this low energy state, it has been well established that the brain is extremely vulnerable to additional trauma, where even smaller
impacts can lead to another concussion; and these second concussions can cause severe brain injuries with
potentially permanent or fatal outcomes.
Fewer than half the districts carried out all required components of the grant,
potentially indicating implementation challenges with pay - for - performance systems.85 The relative
impact of the programs evaluated depended on program design elements such as the amount of compensation provided, the link between individual efforts and rewards, and whether the funding is perceived as temporary or permanent (see sidebar on Washington D.C.'s IMPACT sy
impact of the programs evaluated depended on program design elements such as the amount of compensation provided, the link between individual efforts and rewards, and whether the funding is perceived as temporary or
permanent (see sidebar on Washington D.C.'s
IMPACT sy
IMPACT system).