Causes of childhood concussion in rural versus urban areas

A study of causes of childhood concussions in rural versus urban areas shows that children living in rural areas get concussions from motorized vehicles and children living in urban areas get concussions from sports.

Researchers at Western University (London, Canada) have found youth living in rural areas are more likely to sustain concussions from injuries involving motorized vehicles such as all-terrain vehicles and dirt bikes, whereas youth living in urban areas suffer concussions mostly as a result of sports. Hockey accounts for 40 per cent of those injuries. The study which reveals where and how children are receiving concussions is published in the Journal of Trauma and Acute Care Surgery.

Dr. Doug Fraser, a scientist with the Children's Health Research Institute at Lawson Health Research Institute and Tanya Charyk Stewart, the Injury Epidemiologist for the Trauma Program at Children's Hospital, London Health Sciences Centre (LHSC) and their team tracked all the youth under the age of 18 who presented to the LHSC emergency departments with a concussion over a six year period. There were 2,112 paediatric concussions, with a steady increase in number treated each year.

"It was important for us to learn about who is getting injured, where they're getting injured, and why they're getting injured. Once you answer those questions, then you can implement targeted injury prevention programs," says Dr. Fraser, an associate professor in the Departments of Paediatrics, Physiology & Pharmacology and Clinical Neurological Sciences at Western's Schulich School of Medicine & Dentistry.

Concussions are a particular concern for children and adolescents because their brains are still developing and they are more susceptible to effects of a head injury. The goal following this research is to create injury prevention programs that target and educate those at high risk of sustaining a concussion.

Concussions can often be predictable. Along with properly following the rules of the sport and wearing the protective equipment, Charyk Stewart suggests, "In sports, if you have been hit, then just get off the field immediately and stop play. If you are experiencing any symptoms, be seen by a doctor."

Dr. Fraser explained what to look for in a child who has experienced a head injury, "Watch the person carefully. In young children look for symptoms like, irritability or an inability to console the child. If the care giver has any concerns at all; if a person has any symptoms whatsoever in conjunction with an injury, they should immediately go and be seen by a doctor. Better safe than sorry, so be seen."

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Tips for a Better Night's Sleep if You're Sleepy on the Job

There's no denying that sleep deprivation, and the health issues that result, are becoming more prevalent in our go-go, techno society. But a recent sleep study by the National Sleep Foundation (NSF) grabbed my attention as particular cause for concern.

Every year, the NSF releases a Sleep in America® poll. For its 2012 survey, the NSF examined the specific sleep habits and work performances of transportation workers -- pilots, train operators, and truck, bus, taxi and limousine drivers. The transportation workers were asked about the duration and quality of their sleep, specifically on work nights, and how it affects their work performance.

Some of the results of the survey were:

• About one-fourth of the train operators and pilots polled said that sleepiness has affected their job performance at least once a week.

• One in five pilots polled -- about 20 percent -- said they have made a "serious error" as a result of on-the-job sleepiness.

• One in five pilots and one in six train operators admit to a "near miss" due to on-the-job sleepiness.

• Pilots and train operators are more likely than non-transportation workers to have been involved in a sleep-related car accident while commuting.

• Among all workers surveyed, train operators and pilots report the most work day sleep dissatisfaction.

• Almost two-thirds of train operators and one-half of pilots say they rarely or never get a good night's sleep on work nights.

• About one-third of bus, taxi, and limo drivers said they rarely or never get a good night's sleep on work nights.

The results of the poll are some cause for alarm and reinforce the growing problem of sleep disorders and the potential risks they pose, such as commuter car accidents and errors by public transportation drivers responsible for many people.

Persistent sleep problems left untreated can also lead to myriad health problems, including memory and concentration problems, increased risk of high blood pressure, hypertension, stroke and heart attacks, depression, diabetes and sexual dysfunction. Severe cases of sleep apnea can even be fatal.

Besides these sobering health risks, an untreated sleep disorder can also be the root cause of poor performance at work or school, car accidents and other activities that require focus and concentration.

Common Symptoms of Sleep Disorders

Many people experience some occasional difficulty sleeping and/or daytime fatigue. But how does a person know if he or she has a temporary sleep problem that can be remedied with some simple behavioral changes or if it is a legitimate disorder, such as snoring, sleep apnea, sinusitis or nasal obstruction that should be diagnosed and treated properly?

The first step is to be aware of some common symptoms of sleep disorders. Keep in mind that symptoms vary between disorders, such as snoring, sleep apnea, insomnia, restless leg syndrome, nasal obstruction, and narcolepsy, so it pays to do some research based on what you are personally experiencing.

Some common symptoms of sleep disorders include:

• Trouble falling asleep at night

• Waking throughout the night

• Chronic snoring

• Morning headaches

• Poor memory

• Daytime sleepiness/falling asleep during the day/low energy

• Bad moods/ irritability

• Increased depression

• Trouble concentrating/driving/making decisions

The Link Between Lifestyle and Sleep Problems

If you or someone you know is experiencing some of the above common symptoms of sleep disorders, the next step is to examine if lifestyle habits are contributing to the difficulty sleeping, fatigue and irritability during the day and other symptoms.

Some behavioral and lifestyle questions to ask include:

• Am I watching TV or using the computer late at night and too close to bedtime?

• Am I consuming too much caffeine during the day?

• Am I taking a medication that may be affecting my sleep quality and duration?

• Is there something particularly stressful going on in my life that is causing me worry and anxiety?

• Am I exercising enough to help alleviate some of that stress and tension?

See a Specialist -- And Be Specific

Many sleep problems can be remedied by making some common-sense behavioral changes. However, if you or someone you know is experiencing one or more of the above symptoms on a regular basis, see a qualified ear, nose and throat doctor or otolaryngologist to get diagnosed and treated properly. There are multiple options and minimally-invasive techniques available today to treat your sleep disorder.

When you see a specialist, be specific about the symptoms you are experiencing. Many times, sleep apnea and other sleep disorders can be misdiagnosed as chronic fatigue, insomnia, depression, or some other non-specific condition. Some doctors, for example, still associate sleep apnea more with men than women, and are too quick to prescribe a medication, rather than do a full sleep disorder work up.

It may help to keep a sleep log (or, more accurately, lack-of-sleep log) next to your bed to write down what you are experiencing, when you wake and some symptoms you experience. Again, to try and avoid misdiagnosis, go to a qualified sleep specialist and be specific about your symptoms. Don't wait -- it could save your life.

To read the full report, see "Sleepy Pilots, Train Operators and Drivers" on the National Sleep Foundation website.

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25% of Pilots are Sleepy on the Job

The people we trust to take us or our loved ones from place to place struggle with sleep, according to the National Sleep Foundation's (NSF) 2012 Sleep in America^® poll. It is the first poll to ask transportation professionals, including pilots, train operators,* truck, bus, taxi and limo drivers about their sleep habits and work performance.

Pilots and train operators are most likely to report sleep-related job performance and safety problems

The results of the poll are striking. About one-fourth of train operators (26%) and pilots (23%) admit that sleepiness has affected their job performance at least once a week, compared to about one in six non-transportation workers (17%).

Perhaps more disturbingly, a significant number say that sleepiness has caused safety problems on the job. One in five pilots (20%) admit that they have made a serious error and one in six train operators (18%) and truck drivers (14%) say that they have had a "near miss" due to sleepiness.

Sleepiness has also played a role in car accidents commuting to and from work. Pilots and train operators are significantly more likely than non-transportation workers (6% each, compared to 1%) to say that they have been involved in a car accident due to sleepiness while commuting.

"Driving home from work after a long shift is associated with crashes due to sleepiness," says Dr. Sanjay Patel, a sleep researcher at Brigham and Women's Hospital and Harvard Medical School. "We should all be concerned that pilots and train operators report car crashes due to sleepiness at a rate that is six times greater than that of other workers."

Train operators and pilots report most sleep dissatisfaction

Among all workers surveyed, train operators and pilots report the most work day sleep dissatisfaction. Almost two-thirds of train operators (57%) and one-half of pilots (50%) say they rarely or never get a good night's sleep on work nights, compared to 44% of truck drivers and 42% of non-transportation workers. Bus, taxi, and limo drivers report the best work day sleep satisfaction, with about one-third (29%) saying they rarely or never get a good night's sleep on work nights.

"The margin of error in these professions is extremely small. Transportation professionals need to manage sleep to perform at their best," says David Cloud, CEO of the National Sleep Foundation. "As individuals and employers, we need to know more about how sleep improves performance."

Sleepiness is common for all workers

Roughly one in ten Americans say they are likely to fall asleep at an inappropriate time and place, such as during a meeting or while driving. The poll included a validated assessment tool used by doctors to determine whether a person is "sleepy." Anyone who suffers from excessive sleepiness should seek professional help to identify underlying conditions. This study finds that 11% of pilots, train operators, bus, taxi, and limo drivers and 8% of truck drivers as well as 7% of non-transportation workers are "sleepy."

"We found that although pilots are especially focused on obtaining adequate sleep, one in ten can still be classified as 'sleepy.' This is not acceptable. Who among us wants to take a one in ten chance of flying on a plane with a sleepy pilot?" says CPT Edward Edens, PhD of the Walter Reed Army Institute of Research.

A sleepy transportation worker is far more prone to mistakes: sleepy transportation workers report job performance problems about three times more often and report averaging about 45 minutes less sleep per night than their non-sleepy peers.

Significant number of transportation workers say their schedules do not allow enough time for sleep

Many transportation workers cite their schedule as a major contributor to sleep problems. Almost one-half of train operators (44%) and more than one-third of pilots (37%) report that their current work schedule does not allow adequate time for sleep, compared to about one-fourth of non-transportation workers and truck drivers (27% each) and one-fifth of bus, taxi and limo drivers (20%).

In general, transportation professionals work more varied shifts than other workers, which may play a role in their sleep problems. Only 6% of pilots and 47% of train operators say they work the same work schedule each day, compared to 76% of non-transportation workers.

Time off between shifts may play a role in transportation workers' sleepiness. Non-transportation workers report having an average of 14.2 hours off between shifts, compared to 12.9 hours for pilots; 12.5 for train operators; 12.1 for truck drivers; and 11.2 hours for bus, taxi, and limo drivers. If given one more hour off between work shifts, over one-half of pilots (56%) and train operators (54%) report that they would use that hour for sleep.

Long commutes cut into transportation workers' already shortened time between shifts. Pilots report the longest commutes with 37% saying it takes more than an hour to get to work from home. Pilots and train operators have the highest average commute time of 45.5 minutes and 31 minutes, respectively, compared to a 23.8 minute average for non-transportation workers. Other research has consistently found that longer commute times have been associated with shorter individual sleep times.

"Transportation workers experience considerable variability in the days they work, the times they work, and the amount of time off between shifts. This makes it difficult for such workers to maintain regular sleep/wake schedules, which can, in turn, make it difficult for these workers to maintain alertness on the job. Employers should put more effort into designing work/rest schedules that facilitate sleep and minimize workers exposure to irregular, variable schedule changes," says Patrick Sherry, PhD, a sleep researcher and professor from theUniversity of Denver Intermodal Transportation Institute.

Pilots and train operators nap twice as frequently

The poll shows that transportation professionals are taking more naps than other workers. More than one-half of pilots (58%) and train operators (56%) take at least one nap on work days, compared to about one-fourth of non-transportation workers (27%). About one in five pilots (20%), bus, taxi and limo drivers (20%), truck drivers (16%) and train operators (16%) say they take 3-5 naps during the work week. Among those who report napping on work days, one-half of pilots (50%), almost one-half of truck drivers (42%), one-third of train operators (33%) and nearly one-fourth of bus, taxi and limo drivers (24%) say they actually napped during work hours in the past two weeks, compared to about one in five non-transportation workers (19%).

"Transportation workers have challenging schedules that compete with the natural need for sleep. While I'm impressed that transportation professionals nap when they are off duty, we need to better understand how to use naps to reduce sleep deprivation and overcome scheduling issues," says Thomas Balkin, PhD, a sleep researcher from the Walter Reed Army Institute of Research.

Read more: http://www.sciencedaily.com/releases/2012/03/120304141858