A targeted neuropsychological examination of children with a history of sport-related concussion.

Experimental research suggests that sport-related concussion can lead to persistent alterations in children's neurophysiology and cognition. However, the search for neuropsychological tests with a similar ability to detect long-term deficits continues. PRIMARY OBJECTIVE: The current study assessed whether a target battery of neuropsychological measures of higher cognition and academic achievement would detect lingering deficits in children 2 years after injury. RESEARCH DESIGN: Cross-sectional. METHODS AND PROCEDURE: A total of 32 pre-adolescent children (16 concussion history, 16 control) completed a targeted battery of neuropsychological and academic tests. MAIN OUTCOMES AND RESULTS: Children with a history of concussion exhibited selective deficits during the Raven's Coloured Progressive Matrices, Comprehensive Trail-Making Test, and the mathematics sub-section of the WRAT-3. Deficit magnitude was significantly related to age at injury, but not time since injury. CONCLUSIONS: The current results suggest that neuropsychological measures of higher cognition and academic achievement may be sensitive to lingering deficits, and that children injured earlier in life may exhibit worse neuropsychological and academic performance.

Understanding stroke survivors' and informal carers' experiences of and need for primary care and community health services--a systematic review of the qualitative literature: protocol.

INTRODUCTION: Despite the rising prevalence of stroke, no comprehensive model of postacute stroke care exists. Research on stroke has focused on acute care and early supported discharge, with less attention dedicated to longer term support in the community. Likewise, relatively little research has focused on long-term support for informal carers. This review aims to synthesise and appraise extant qualitative evidence on: (1) long-term healthcare needs of stroke survivors and informal carers, and (2) their experiences of primary care and community health services. The review will inform the development of a primary care model for stroke survivors and informal carers. METHODS AND ANALYSIS: We will systematically search 4 databases: MEDLINE, EMBASE, PsycINFO and CINAHL for published qualitative evidence on the needs and experiences of stroke survivors and informal carers of postacute care delivered by primary care and community health services. Additional searches of reference lists and citation indices will be conducted. The quality of articles will be assessed by 2 independent reviewers using a Critical Appraisal Skills Programme (CASP) checklist. Disagreements will be resolved through discussion or third party adjudication. Meta-ethnography will be used to synthesise the literature based on first-order, second-order and third-order constructs. We will construct a theoretical model of stroke survivors' and informal carers' experiences of primary care and community health services. ETHICS AND DISSEMINATION: The results of the systematic review will be disseminated via publication in a peer-reviewed journal and presented at a relevant conference. The study does not require ethical approval as no patient identifiable data will be used.

Effects of strength and aerobic-based training on functional fitness, mood and the relationship between fatness and mood in older adults.

AIM: Physical independence and positive mood states contribute to successful aging. The aim of this study was to analyze the effects of aerobic and strength-based training programs on functional fitness and mood in older adults, and to assess the relationship between adiposity and mood states. METHODS: Seventy eight participants (age 65 to 95 year old) were randomly assigned to a control group, aerobic training (AT), or strength training group (ST). Functional fitness was assessed using dimensions of the Senior Fitness Test battery relating to lower and upper body strength and flexibility, velocity, agility and dynamic balance, and aerobic endurance. Mood states (depression, tension, fatigue, vigour, anger, and confusion) were determined using the POMS-SF questionnaire. Participants were evaluated at the baseline and at the end of a 16-week exercise programme. RESULTS: Both the ST and AT groups improved their functional fitness following the 16 week training. Body Mass Index (BMI) was positively associated with tension (r=0.30; P<0.01), fatigue (r=0.31; P<0.01) and confusion (r=0.24; P<0.05). At 16-week evaluation, control group reported increased levels of confusion, and the ST group reported increases in vigour (P<0.05). CONCLUSION: Results support the idea that strength-based training can be as effective as aerobic-based training in improving physical skills that contribute to functional mobility in later years. Positive associations between increased BMI and mood disturbance were also found. Physical training also contributed to some improvements in mood.