Athletes perceive sports fans as a source of concussion nondisclosure pressure. Sports fans are exposed to injury depictions from the media that could lead them to underestimate its seriousness. This study examined the concussion knowledge of non-sports fans, sports fans, and wagering sports fans, as knowledge is a modifiable factor that can influence injury disclosure.

A convenience sample of 443 Australian adults completed an online survey.

Cross-sectional.

Self-rated and actual concussion knowledge (the Rosenbaum Concussion Knowledge and Attitudes Survey; RoCKAS).

There was no significant difference in the concussion knowledge of self-identified sports (n = 157) and non-sports (n = 286) fans; but sports fans rated their knowledge as significantly higher than non-sports fans (p < .05). Wagering sports fans (n = 24) had significantly less concussion knowledge than non-wagering sports fans (η2 = .03, small effect).

Athletes who feel nondisclosure pressure from sports fans may be influenced by people with incomplete concussion knowledge, particularly wagering sports fans. Sports fans over-estimated their knowledge, and this could contribute to the nondisclosure pressure felt by athletes. Programmes to increase injury disclosure by athletes should take these factors into consideration.

Early reporting of atypical symptoms following a mild traumatic brain injury (mTBI) may be an early indicator of poor prognosis. This study aimed to determine the percentage of people reporting atypical symptoms 1-month post-mTBI and explore links to recovery 12 months later in a community-dwelling mTBI sample.

Adult participants (>16 years) who had experienced a mTBI were identified from a longitudinal incidence study (BIONIC). At 1-month post-injury, 260 participants completed the Rivermead Post-Concussion Symptoms Questionnaire (typical symptoms) plus four atypical symptom items (hemiplegia, difficulty swallowing, digestion problems and difficulties with fine motor tasks). At 12 months post-injury, 73.9% (n = 193) rated their overall recovery on a 100-point scale. An ordinal regression explored the association between atypical symptoms at 1 month and recovery at 12 months post-injury (low = 0–80, moderate = 81–99 and complete recovery = 100), whilst controlling for age, sex, rehabilitation received, ethnicity, mental and physical comorbidities and additional injuries sustained at the time of injury.

At 1-month post-injury <1% of participants reported hemiplegia, 5.4% difficulty swallowing, 10% digestion problems and 15.4% difficulties with fine motor tasks. The ordinal regression model revealed atypical symptoms were not significant predictors of self-rated recovery at 12 months. Older age at injury and higher typical symptoms at 1 month were independently associated with poorer recovery at 12 months, p < 0.01.

Atypical symptoms on initial presentation were not linked to global self-reported recovery at 12 months. Age at injury and typical symptoms are stronger early indicators of longer-term prognosis. Further research is needed to determine if atypical symptoms predict other outcomes following mTBI.

Antibiotics are widely used in very low-birth-weight infants (VLBW, <1500 g), and excess exposure, particularly to broad-spectrum antibiotics, is associated with significant morbidity. An antibiotic spectrum index (ASI) quantifies antibiotic exposure by relative antimicrobial activity, adding information to exposure measured by days of therapy (DOT). We compared ASI and DOT across multiple centers to evaluate differences in antibiotic exposures.

We extracted data from patients admitted to 3 level-4 NICUs for 2 years at 2 sites and for 1 year at a third site. We calculated the ASI per antibiotic days and DOT per patient days for all admitted VLBW infants <32 weeks gestational age. Clinical variables were compared as percentages or as days per 1,000 patient days. We used Kruskal-Wallis tests to compare continuous variables across the 3 sites.

Demographics were similar for the 734 VLBW infants included. The site with the highest DOT per patient days had the lowest ASI per antibiotic days and the site with the highest mortality and infection rates had the highest ASI per antibiotic days. Antibiotic utilization varied by center, particularly for choice of broad-spectrum coverage, although the organisms causing infection were similar.

An antibiotic spectrum index identified differences in prescribing practice patterns among 3 NICUs unique from those identified by standard antibiotic use metrics. Site differences in infection rates and unit practices or guidelines for prescribing antibiotics were reflected in the ASI. This comparison uncovered opportunities to improve antibiotic stewardship and demonstrates the utility of this metric for comparing antibiotic exposures among NICU populations.

This qualitative study aimed to identify the service and support needs of people with a recent history of traumatic brain injury (TBI) living in the community.

A postal survey was sent to 662 people 6–18 months after hospital admission for a mild-to-severe TBI. The survey included an open-ended item (‘wish-basket’) for collecting ideas about important unmet needs.

Responses from 53 individuals were coded and processed using thematic analysis. Five themes (n = 39) were identified, three of which were related to personal needs. These personal wishes were about being symptom-free, independent and emotionally supported by, and connected to, loved ones. The remaining themes were about the wished-for changes to the health system and society, such as wishing for health care continuity (as opposed to being abandoned), and for greater understanding and support by society.

There is scope to improve the services and support for people living with TBI in the community. This includes reconsidering the way that discharge occurs, addressing the personal needs that remain when living in the community and promoting greater social awareness of TBI to counteract disadvantage.

Best practice management for medically cleared concussion is to commence a graded return to activity, as tolerated, and within 24–48 h of the injury. Patients may encounter this or other advice if they search the Internet, or when they are discharged from care. It is not yet known how patients would interpret this advice, particularly for specific activities. This study compared the effect of two forms of concussion advice on physical activity plans. It was expected that compared to the advice to gradually return to activity, the advice to ‘rest’ would lead to reduced activity plans.

Concussion simulators received the generic advice to undertake 1 week of (i) rest (no physical activity [NPA], n = 115) or (ii) graded physical activity (GPA, n = 104). Activity plans were recorded using items from the Mild Traumatic Brain Injury Rest-Activity Questionnaire (MTBI-RAQ).

There was a significant group difference in activity plans (NPA < GPA, total score and for all MTBI-RAQ items, p’s ≤ 0.001, medium-to-large effects). The average NPA response was for a significant reduction from pre-injury for 14 activities, with no planned change for 2 activities (walking, household chores). In the GPA group, there were plans to reduce (nitems = 7), continue (nitems = 5) or increase activities (nitems = 4; e.g., swimming). Both groups proposed to decrease ‘high-risk’ activities (e.g., heavy lifting).

As expected, there was a significant effect of the type of advice on physical activity plans. Compared to the GPA advice, the NPA advice led to a significant reduction of planned physical activity. If concussed patients seek or receive advice that recommends NPA, it may prompt activity plans that are unnecessarily restrictive. If GPA advice is given, it leads to varied plans, with fewer restrictions overall, and avoidance of higher risk physical activities. Generic GPA advice has the potential to facilitate active recovery for concussion; however, patients would still likely benefit from a professional consultation about their plan and support to safely implement it, and this should be investigated in future research.