A Systematic Review of the Effectiveness of Concussion Education Programs for Coaches and Parents of Youth Athletes.

Coach and parent concussion education programs are essential for the prevention, diagnosis, management, and return to play of youth athletes. This systematic review examined the content and efficacy (changes in knowledge, impact on concussion incidence) of concussion education programs for coaches and parents of youth and high school athletes. Six databases were searched: SPORTDiscus, Academic Search Premiere, CINAHL, PsycINFO, PubMed, and Google Scholar. Studies evaluated the use and/or efficacy of concussion education programs among coaches or parents of youth athletes. A total of 13 articles (out of 1553 articles) met selection criteria. Although different concussion education programs exist, only three have been evaluated in the literature: ACTive Athletic Concussion Training™, USA Football's Heads Up Football, and the Center for Disease Control and Prevention's HEADS UP. These programs are well liked among coaches and parents and the suggested practices are easily implemented by coaches. These programs increased concussion knowledge among coaches and parents and promoted behavioral changes among coaches to reduce the concussion risk in high school sports. Few studies have assessed the efficacy of concussion education programs on youth athlete health outcomes. No studies included a longitudinal follow up to determine the degree of knowledge retention following the intervention. While online educational programs are sufficient to improve coach knowledge, in-person training may be a more effective educational tool for reducing the incidence of youth sport concussion. Future studies addressing the efficacy of concussion education programs should include a longitudinal follow up to assess knowledge retention and fidelity.

Effects of Protective American Football Headgear on Peripheral Vision Reaction Time and Visual Target Detection in Division I NCAA Football Players.

The purpose of this study was to examine the effects of protective football headgear on peripheral vision reaction time and visual target detection. Twenty-five Division I NCAA football players (age = 20.5 yrs ± 0.9, height = 185.9 cm ± 6.8, body mass = 99.2 kg ± 19.2, BMI = 29.6 ± 4.5) participated. In a crossover counterbalanced study design, subjects participated in one visit with three conditions: Baseline (BL) without headgear, helmet only (HO), helmet with an eye shield (HE). Subjects completed a 1-min peripheral vision reaction time test for each condition separated by 3-min recovery periods. Tests were administered using a 64 light Dynavision D2 Visuomotor board. Target detection (total hit score) was higher during BL than HO (p < 0.001) and HE (p < 0.001). Average (p < 0.001), peak (p < 0.001), minimum (p < 0.001), and median (p < 0.001) peripheral reaction times were faster during BL than HO and HE. No significant differences were observed for any measures between HO and HE conditions (p > 0.05). Findings indicate that protective football headgear impaired reaction time to peripheral visual stimuli. The addition of an eye shield to the helmet had a small non-significant effect on reaction time and target detection. These results may hold important implications in helmet design and player safety.

A systematic review of acute concussion assessment selection in research.

Background: Several organisations developed guidelines and assessments for aiding in the diagnosis of concussions. The growing number of concussion assessments increases the difficulty for researchers and clinicians to determine the best method of concussion diagnosis. Purpose: To systematically review the current assessments selected for acute sports-related concussion. Methods: Academic Search Premier, CINHAL, MEDLINE, PsycINFO and SPORTDiscus were searched. English-language, peer-review published studies of acute (<72 h) concussion assessments were included. Results: A total of 31 studies met inclusion criteria (of 291 evaluated); 27 studies provided sufficient information to be included in the descriptive statistics of the assessments. Six of these assessments were used in at least three studies. Only 12 percent of the population studied was female. The age range for these assessments was 9-67 years, although most participants ranged in age between 18 and 35 years. Conclusion: There is a need for a 'gold' standard concussion assessment to enable consistency across research and clinical outcomes. We found a large discrepancy between the number of males and females assessed, suggesting that future studies are needed to determine if these current assessments identify concussion signs and symptoms unique to females. Further studies are needed to determine which assessments are appropriate and valid for youth athletes.

Regarding the fitness to ride a bicycle under the acute influence of alcohol.

To determine the threshold for the absolute inability to ride a bicycle, practical cycling tests and medical examinations at different blood alcohol concentrations were performed. Special attention was given to additional medical examinations, reaction tests and alcohol consumption under real-life conditions. Seventy-eight test subjects were included in the trials (37 females, 41 males). Five test subjects participated twice; thus, there were a total of 83 evaluable trials. Alcohol-related deficits were already identifiable at very low BACs. A significant increase in gross motoric disturbances compared to the soberness state did not regularly occur until a BAC of at least 0.8 g/kg was reached. At the BAC of 1.4 g/kg and above, no test subjects were able to achieve or surpass their sober driving results. Isolated highly alcoholised test subjects rode the bike in a manner that was not conspicuously different than the other sober test persons. Contrary to the assumptions of current German legal practise, it cannot be stated that all people are 'absolutely impaired' to the point of being incapable of riding bicycle at BACs of at least 1.6 g/kg.

Synthesis of internal fluorinated alkenes via facile aryloxylation of substituted phenols with aryl trifluorovinyl ethers.

Nucleophilic addition-elimination of ortho- or para-substituted phenols to aryl trifluorovinyl ethers (TFVEs) in N,N-dimethylformamide was studied. Using sodium hydride as a base afforded vinyl substitution products R-Ar-O-CF=CF-O-Ar-R', where R or R' = H, Br, OMe, tert-Bu, or Ph. The vinyl substitution products produced mixtures of (Z)/(E)-isomers and this isomer ratio was influenced by substitution with more sterically encumbered phenol nucleophiles. Reactions using caesium carbonate afforded addition products R-Ar-O-CHFCF(2)-O-Ar-R' whereas upon dehydrofluorination using sodium hydride produced vinyl substitution products. The preparation of vinyl substituted and addition products proceeded in overall good isolated yields and were elucidated using (1)H and (19)F NMR, GC-MS, and X-ray analysis. Vinyl substituted products were inert to UV light and chemical reactivity using common polymerization promoters. Thermal activation of the (Z)/(E)-fluoroolefin (-CF=CF-) was observed at an onset of 310 °C in nitrogen using differential scanning calorimetry (DSC) producing insoluble network material. The synthesis, characterization, and mechanism for stereoselectivity are discussed.