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Background: Technological advances provide an opportunity to refine tools that assess central nervous system performance. This study aimed to assess the test-retest reliability and convergent and ecological validity of a newly developed, virtual-reality, concussion assessment tool, 'CONVIRT', which uses eye-tracking technology to assess visual processing speed, and manual reaction time (pushing a button on a riding crop) to assess attention and decision-making. CONVIRT was developed for horse jockeys, as of all sportspersons, they are most at risk of concussion. Methods: Participants (N = 165), were assessed with CONVIRT, which uses virtual reality to give the user the experience of riding a horse during a horserace. Participants were also assessed with standard Cogstate computer-based concussion measures in-between two completions of the CONVIRT battery. The physiological arousal induced by the test batteries were assessed via measures of heart rate and heart rate variability (LF/HF ratio). Results: Satisfactory test-retest reliability and convergent validity with Cogstate attention and decision-making subtests and divergent validity in visual processing speed measures were observed. CONVIRT also increased heart rate and LF/HF ratio, which may better approximate participant arousal levels in their workplace. Conclusions: CONVIRT may be a reliable and valid tool to assess elements of cognition and CNS disruption. The increased ecological validity may also mean better informed 'return-to-play' decisions and stronger industry acceptance due to the real-world meaningfulness of the assessment. However, before this can be achieved, the sensitivity of the CONVIRT battery needs to be demonstrated.

This study aimed to explore the use of a contemporary workplace stress model, the Job Demands-Resources model, with direct-care workers using a qualitative approach. The JD-R model has successfully been used to predict health outcomes across different occupations using quantitative methods. However, the use of the generic questionnaire developed for this model may not always be appropriate. Direct-care workers (n = 19) attended two focus groups and reported on their job demands, job resources and personal resources. Six themes relating to demands across the two groups: funding insecurity, time pressure, hindrance demands, poor systems, emotional engagement and dealing with client crises were identified. Participants identified clinical supervision, social support and progressive workplace resources as job resources. Finally, the personal resources identified by participants were professional behaviours, disposition and self-care. The JD-R model and its standard questionnaire captures some of these aspects of direct-care work, but many were not assessed. As such, future investigations with direct-care workers should ensure items related to poor systems, progressive workplace resources, disposition and professional behaviours are included. Alternatively, a qualitative approach should be used as a first step in the development of valid questionnaires when investigating workplace stress with this group to ensure their experience is accurately quantified.