Sleep Parameters and Overnight Urinary Melatonin Production in Children With Persistent Post-concussion Symptoms.

BACKGROUND: Sleep disturbance is common after a mild traumatic brain injury (mTBI) in children, yet its biology is poorly understood. We aimed to explore sleep-related problems (SRPs), sleep-activity patterns, and endogenous melatonin production in children with different recovery trajectories following mTBI. We hypothesized that children with delayed recovery would have more SRPs and abnormal sleep-activity patterns, which would correlate with lower overnight melatonin production. METHODS: In this prospective controlled cohort study, we enrolled 83 children with persistent symptoms, 26 children who had clinically recovered following mTBI, and 25 healthy controls. SRPs were evaluated using the sleep subscale of the Post-Concussion Symptom Inventory. Sleep actigraphy was performed for five to seven days at 37 (S.D. 7) days post-injury. Health-related quality of life and mood disturbance was assessed using the Child Health Questionnaire and the Behavior Assessment System for Children, respectively. Endogenous melatonin production was assessed using overnight urine collection. RESULTS: The groups were similar in age (13.9 [S.D. 2.6] years) and sex (52% female). Regression analysis demonstrated increased SRP in the symptomatic group (9.0; 95% confidence interval: 7.6, 11.1) compared with the recovered group (1.6; 95% confidence interval: 1.0, 2.4) and controls (2.0; 95% confidence intervals: 1.2, 3.2). Actigraphy parameters and urinary melatonin levels were not significantly different between groups. Neither SRPs nor actigraphy parameters correlated with anxiety and depression scores. CONCLUSIONS: Although children with persistent post-concussion symptoms reported more SRPs, this was not related to actigraphy sleep parameters or melatonin production. Further research is warranted to understand the pathophysiology of post-traumatic sleep disturbance.

Design, Development, and Content Creation for an Open Education Physics Website for MRT Education.

BACKGROUND: As health care technologies continue to advance rapidly, resulting in improved standards of practice, it is essential for health care professionals to continually expand on their current skills and knowledge. We describe here an initiative to use open education resources to provide ongoing education in radiation medical sciences and imaging. AIMS: The aim of this study to design an interactive, engaging, multilevel radiation medical physics resource, which is fully open to the public, and functional on all types of computing devices. Our primary target audiences are students and workers in medical radiation technology and other health care professionals as part of their continuing professional development. DESIGN AND DEVELOPMENT: The three tasks of design, development, and content creation were most efficiently performed in parallel wherever possible. A modern responsive web design was adopted to target all desktop and mobile devices. Only open-source tools and libraries were used in developing the OpenPhys website. OVERALL WEBSITE DESIGN AND NAVIGATION: The homepage is a modern tile-based design containing one coloured tile for each lesson. Clicking anywhere on a coloured lesson tile will open up a two-dimensional interactive concept map linking to content pages. Currently, 10 lessons are available online ranging from the electronic structure of the atom to MRI basics: "NMR" and "Inside a Pixel". Lesson pages include text, images, graphics, equations, quizzes, and interactive animations. USER FEEDBACK: An online questionnaire was emailed to current radiation therapy students at the University of Alberta and alumni regarding the functionality and navigation of the website. DISCUSSION/CONCLUSION: To our knowledge, OpenPhys is the first open education resource specializing in radiation physics and medical imaging. We believe OpenPhys will fill existing gaps in the realm of physics education delivery and could be a component of a blended learning initiative. Future steps will include a formal evaluation of the website and content.