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The utility of injury characteristics for predicting the severity of post-concussion outcomes remains equivocal. The purpose of this meta-analysis was to quantify the predictive relationship between these variables to inform classification of acute injury severity. Thirty-one empirical samples of concussed athletes, for which rates of loss of consciousness and/or amnesia were reported, were included in a meta-analysis evaluating acute outcomes following sports-related concussion. Outcome measures of interest were neuropsychological tests first administered 1–10 days post-injury. Loss of consciousness and anterograde amnesia significantly predicted more severe neuropsychological deficits within 10 days of concussion in studies using pre-injury baseline, but not control group, comparisons. Retrograde amnesia significantly predicted acute neuropsychological dysfunction (d = -1.03) irrespective of comparison group. Although small sample sizes require conservative interpretation and future replication, the evidence suggests that retrograde amnesia, rather than loss of consciousness, may be used to classify the acute severity of concussion. (JINS, 2014, 20, 81–87) [ABSTRACT FROM AUTHOR]

The objective of this study is to determine which pre-existing athlete characteristics, if any, are associated with greater deficits in functioning following sports-related concussion, after controlling for factors previously shown to moderate this effect (e.g., time since injury). Ninety-one independent samples of concussion were included in a fixed+systematic effects meta-analysis (n = 3,801 concussed athletes; 5,631 controls). Moderating variables were assessed using analogue-to-ANOVA and meta-regression analyses. Post-injury assessments first conducted 1–10 days following sports-related concussion revealed significant neuropsychological dysfunction, postural instability and post-concussion symptom reporting (d = −0.54, −1.10, and −1.14, respectively). During this interval, females (d = −0.87), adolescent athletes competing in high school competitions (d = −0.60), and those with 10 years of education (d = −1.32) demonstrated larger post-concussion neuropsychological deficits than males (d = −0.42), adults (d = −0.25), athletes competing at other levels of competition (d = −0.43 to −0.41), or those with 16 years of education (d = −0.15), respectively. However, these sub-groups’ differential impairment/recovery beyond 10 days could not be reliably quantified from available literature. Pre-existing athlete characteristics, particularly age, sex and education, were demonstrated to be significant modifiers of neuropsychological outcomes within 10 days of a sports-related concussion. Implications for return-to-play decision-making and future research directions are discussed. (JINS, 2013, 19, 1–17). [ABSTRACT FROM AUTHOR]

The experiment outlined in this paper investigated the effect of interference on everyday dynamic risk-taking judgments. Two questions were addressed. First, can highly practised dynamic risk-taking decisions become automated, such that they are not affected by the presence of a demanding secondary task? Second, if risk-taking decisions are interfered with by a secondary task, what is the direction of the effect? Do people take more risks when they are distracted or do they compensate for the interference and take fewer risks? Drivers (N = 121) were required to perform video-simulation tests measuring driving-related, risk-taking decisions. Participants were required to carry out the tasks while either performing a concurrent verbal task or not. It was found that those in the dual-task condition took more risks. This suggests that dynamic risk-taking decisions in this context are not automatic and also that interference increases individuals' propensity to take risks., It has been suggested in the literature that some highly practised human skills become automatic. There are a number of conflicting definitions of automaticity in the literature (Bargh, 1992), but [...]

Aim: Although individuals recovering from mild traumatic brain injury (MTBI) could pose a risk to road safety, little is known about their intentions regarding return-to-driving. Reported are the expectations of a sample of emergency department patients with MTBI regarding their recovery and return-to-driving. Method: Eighty-one patients with MTBI were recruited from an emergency department. Participants completed an 11-item questionnaire measuring expectations regarding recovery from injury; five of the items addressed return-to-driving. Results: Only 48% of the sample intended to reduce their driving following their injury. However, those that did intend to reduce their driving nominated a mean duration of 16.59 days (SD = 31.68) of reduced exposure. A logistic regression found that previous head injury experience and an interaction between pain and previous head injury experience predicted intentions to reduce driving. Similarly, a multiple regression revealed that pain level contributed significantly to the variance in time estimates of return-to-driving. Conclusion: The finding that half the individuals recovering from MTBI do not intend to moderate their driving exposure post-injury is cause for concern, as another study has shown that driving performance is compromised in this group immediately after injury. [ABSTRACT FROM AUTHOR]

Background and study aims: Prior research supports the validity of performance measures derived from the use of a physical model colonoscopy simulator - the Kyoto Kagaku Colonoscope Training Model (Kyoto Kagaku Co. Ltd., Kyoto, Japan) - for assessing insertion skill. However, its use as a training tool has received little research attention. We assessed the efficacy of a brief structured program to develop basic colonoscope insertion skill through unsupervised practice on the model. Participants and methods: This was a training study with pretesting and post-testing. Thirty-two colonoscopy novices completed an 11-hour training regime in which they practiced cases on the model in a colonoscopy simulation research laboratory. They also attempted a series of test cases before and after training. For each outcome measure (completion rates, time to cecum and peak force applied to the model), we compared trainees' post-test performance with the untrained novices and experienced colonoscopists from a previously-reported validation study. Results: Compared with untrained novices, trained novices had higher completion rates and shorter times to cecum overall ( Ps  < .001), but were out-performed by the experienced colono-scopists on these metrics ( Ps  < .001). Nevertheless, their performance was generally closer to that of the experienced group. Overall, trained novices did not differ from either experience-level comparison group in the peak forces they applied ( P  > .05). We also present the results broken down by case. Conclusions: The program can be used to teach trainees basic insertion skill in a more or less self-directed way. Individuals who have completed the program (or similar training on the model) are better prepared to progress to supervised live cases.