Purpose Academic difficulty is reported in children with prolonged post-concussive symptoms. Despite growing evidence that vestibular-ocular and vision-specific dysfunction are common in children following concussion, vision is rarely mentioned in return-to-learn protocols. The purpose of this project was to evaluate a cohort of children with prolonged post-concussive symptoms to determine if vision symptoms are associated with those reporting academic difficulty. Methods Data was obtained from the Children’s of Alabama Concussion Clinic REDCap dataset from the period January 2007 to October 2013. From this dataset of 1,033 concussion events, a cohort of 276 children aged 5–18 years with three or more concussion-related symptoms present for 10 days or more was identified. A cross-sectional cohort study was undertaken to evaluate the association of concussion symptoms, SCAT2 scores, demographic and concussion severity markers to reported educational difficulty among children with prolonged post-concussive symptoms. Univariate and multivariate logistic regression techniques were used to model the association of reported educational difficulty to self-reported vision abnormalities. Results Mean age was 13.8 years. Median time since the concussive event was 21 days, with 33% (95/276) reporting their concussion more than thirty days prior to data collection. Academic difficulty was reported by 29% (79/270) and vision abnormalities in 46% (128/274). After model reduction, vision symptoms (OR 2.17, 95% CI 1.02, 4.62), hearing disturbance (OR 2.39, 95% CI 1.06, 5.36) and concentration difficulty (OR 21.62, 95% CI 9.50, 44.47) remained associated with academic difficulty. For those with symptoms 30 days or more after concussion, only vision (OR 3.15, 95% CI 1.06, 9.38) and concentration difficulty (OR 15.33, 95% CI 4.99, 47.05) remained statistically significant. Conclusions Vision problems were commonly reported in children with concussions and were independently associated with those reporting academic difficulty. Comprehensive vision assessment should be considered in children reporting academic difficulty and in the development of return-to-learn protocols.

Successful interprofessional teams are essential when caring for older adults with multiple complex medical conditions that require ongoing management from a variety of disciplines across healthcare settings. To successfully integrate interprofessional education into the healthcare professions curriculum, the most effective learning experiences should utilize adult learning principles, reflect real-life practice, and allow for interaction among trainees representing a variety of health professions. Interprofessional clinical experiences are essential to prepare future healthcare professionals to provide quality patient care and understand the best methods for utilizing members of the healthcare team to provide that care. To meet this need, the University of Alabama at Birmingham Geriatric Education Center has developed an Interprofessional Clinical Experience (ICE) to expose future healthcare providers to an applied training experience with older adults in the nursing home setting. This paper outlines how this program was developed, methods used for program evaluation, and how the outcome data influenced program revisions.

Significance.-Oculomotor tests in concussion commonly show impairment in smooth pursuit and saccadic function. Honing in on the systems likely to be affected by concussion will streamline use of oculomotor function as a supplemental diagnostic and prognostic tool, as well as improve our understanding of the pathophysiology of concussion. Purpose.-This study investigates oculomotor function between concussed and healthy collegiate athletes, as well as determines measurement test-retest reliability of those tools. Methods.-Eighty-seven healthy athletes were recruited from a US Division 1 sports university and completed a 30-minute vestibular ocular testing battery in an enclosed rotary chair system equipped with 100Hz eye-tracking goggles. Forty-three individuals completed the battery twice. Twenty-eight individuals with a current diagnosis of concussion also completed the battery. All participants were ages 18-24. Bivariate statistical tests examined differences in scores across groups, and intraclass coefficients were computed to test reliability. Results.-Concussed individuals had significantly longer saccadic, visual, and dual-task reaction times and reduced saccadic accuracy. There was no difference in optokinetic reflex gain, but few

Participants were tested in a Neuro Kinetics Inc. I-Portal® Neuro Otologic Test Center system (NOTC) by an experienced trained examiner. The I-Portal® NOTC is a chair attached to a high-torque motor driven by a computer and contained inside a lightproof enclosure. The testing protocol took approximately 30 minutes. Participants sat in the NOTC, were secured for safety, and the head was restrained. A binocular infrared

Vision had an impact on all ADLs and IADLs evaluated, with greater impact on self-reported function for younger adults. This suggests that younger adults perceive limitations associated with visual disability differently than do older adults.

IMPORTANCEThe prevalence of irreversible vision impairment in the United States is expected to increase by 2050. Vision rehabilitation is the primary treatment option. Clinical trials have established its efficacy in improving quality of life. Yet studies indicate that patients experience many barriers to accessing low-vision care.OBJECTIVES To examine the rate of referral for low-vision rehabilitation services by resident and attending ophthalmologists for adults with irreversible vision impairment and to assess the knowledge, attitudes, and beliefs of patients about vision rehabilitation.

Four demographic variables, age, socioeconomic status, age-gender interaction, and socioeconomic status-education interaction, defined those likely to be using contact lens on any given day in the United States. Together, these four variables identify almost 9 of 10 contact lens users.

Purpose To compare the prevalence of attention deficit/hyperactivity disorder (ADHD) in children with normal vision and with vision problems not correctable with glasses or contact lenses (vision problems) as determined by parent report in a nationwide telephone survey. Methods This cross-sectional study included 75,171 children without intellectual impairment ages 4 to 17 participating in the 2011-12 National Survey of Children's Health (NSCH), conducted by the United States Centers for Disease Control and Prevention. Demographic information and information regarding vision and ADHD status was obtained by parent interview. Questions asked whether they had ever been told by a doctor or health care provider that the child had a vision problem not correctable with glasses or contact lenses, ADHD, intellectual impairment or one of 13 other common chronic conditions of childhood. A follow-up question asked about condition severity. The main outcome measure was current ADHD. Results The prevalence of current ADHD was greater (p<0.0001) among children with vision problems (15.6%) compared to those with normal vision (8.3%). The odds of ADHD compared to that of children with normal vision was greatest for those with moderate vision problems (odds ratio (OR) 2.6 (95% CI 1.7, 4.4)) and mild vision problems (OR 1.8, 95% CI1.1, 2.9). Children with severe vision problems had similar odds of ADHD to that of children with normal vision, perhaps owing to the small numbers in this group (OR 1.6, 95% CI 0.8, 3.1). In multivariable analysis adjusting for confounding variables, vision problems remained independently associated with current ADHD (OR 1.8, 95% CI 1.2, 2.7). Conclusions In this large nationally representative sample, the prevalence of ADHD was greater among children with vision problems not correctable with glasses or contacts. The association between vision problems and ADHD remains even after adjusting for other factors known to be associated with ADHD.