Prognostic Utility of Oculomotor Assessments in Determining Return-to-Learn Time in Acutely Concussed College Student-Athletes: A Pilot Study.

We sought to discover which oculomotor test (King-Devick [KD], near point of convergence [NPC], and accommodative facility [AF]) would best produce a prognostic model for an RTL time frame. An observational cohort design was used to longitudinally track division I and III student-athletes with concussion at a private university in New York State. Measurements included pre-RTL oculomotor testing (NPC, KD, and AF), along with daily text messages and phone calls. Participants were considered returned-to-learn once they had returned to baseline symptoms and had attended 2 days of classes. Our data promote KD score and class attendance as the best-fit prognostic model, with every second accrued on the KD test equating to 5.29 h of RTL time. Further, attending class throughout recovery, versus not, shortened RTL time by a mean 170.50 h, or 7.1 days. Five variables produced a significant attenuating association with concussion symptoms: time post-injury (p = 0.01); caffeine (p = 0.05); alcohol (p = 0.01); music (p = 0.01); and physical activity (p = 0.01). Three variables produced a significant worsening association with concussion symptoms: screen time (p = 0.05); music (p = 0.01); and class attendance (p = 0.01). The findings present a preliminary evidence-based model to prognosticate RTL time. To our knowledge, this is the second longitudinal study, and the first overall, to present objective data for guiding and prognosticating RTL, respectively. Correspondingly, these data should assist clinicians with objectively steering RTL in-clinic.

Practical Management: A Standardized Aerobic Exercise Program for Adolescents With Concussion in the Absence of Graded Exercise Testing.

ABSTRACT: Aerobic exercise is safe and beneficial for adolescent athletes recovering from sport-related concussion (SRC). The results of systematic graded exercise testing are used to create individualized, subsymptom heart rate threshold (HRt) aerobic exercise treatment programs for adolescents after SRC. Many clinicians, however, do not have access to graded exercise tests. This article presents a safe, systematic, evidence-based exercise program that clinicians can prescribe, progress, and modify to help manage acute pediatric SRC without the need for formal exercise testing. The exercise prescription accounts for sex and days since injury but not age because our analysis indicates age does not significantly affect the HRt on graded exercise testing. This article provides clinicians without access to graded exercise testing a viable option for prescribing exercise treatment to adolescents in the early phase after SRC.

Seasonal Minimum and Maximum Solar Ultraviolet Exposure Measurements of Classroom Teachers Residing in Tropical North Queensland, Australia.

The risk of keratinocyte skin cancer, malignant melanoma and ultraviolet radiation (UVR)-induced eye disease is disproportionately higher in Australia and New Zealand compared to equivalent northern hemisphere latitudes. While many teachers are aware of the importance of reinforcing sun safety messages to students, many may not be aware of the considerable personal exposure risk while performing outdoor duties in locations experiencing high to extreme ambient UVR year-round. Personal erythemally effective exposure of classroom teachers in tropical Townsville (19.3°S) was measured to establish seasonal extremes in exposure behavior. Mean daily personal exposure was higher in winter (91.2 J m-2 , 0.91 Standard Erythema Dose [SED]) than summer (63.3 J m-2 , 0.63 SED). The range of exposures represents personal exposures that approximate current national guidelines for Australian workers at the study latitude of approximately 1.2 SED (30 J m-2 effective to the International Commission on Non-Ionizing Radiation Protection). Similar proportions of teachers spent more than 1 h outdoors per day in winter (28.6%) and summer (23.6%) as part of their teaching duties with seasonal differences having little effect on the time of exposure. Personal exposures for teachers peaked during both seasons near school meal break times at 11:00 am and 1:00 pm, respectively.

An Inexpensive High-Temporal Resolution Electronic Sun Journal for Monitoring Personal Day to Day Sun Exposure Patterns.

Exposure to natural sunlight, specifically solar ultraviolet (UV) radiation contributes to lifetime risks of skin cancer, eye disease, and diseases associated with vitamin D insufficiency. Improved knowledge of personal sun exposure patterns can inform public health policy; and help target high-risk population groups. Subsequently, an extensive number of studies have been conducted to measure personal solar UV exposure in a variety of settings. Many of these studies, however, use digital or paper-based journals (self-reported volunteer recall), or employ cost prohibitive electronic UV dosimeters (that limit the size of sample populations), to estimate periods of exposure. A cost effective personal electronic sun journal (ESJ) built from readily available infrared photodiodes is presented in this research. The ESJ can be used to complement traditional UV dosimeters that measure total biologically effective exposure by providing a time-stamped sun exposure record. The ESJ can be easily attached to clothing and data logged to personal devices (including fitness monitors or smartphones). The ESJ improves upon self-reported exposure recording and is a cost effective high-temporal resolution option for monitoring personal sun exposure behavior in large population studies.