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  • Your League: ARRL Reply Comments Cite "Fundamental Misunderstanding" of "Symbol Rate" Petition
  • Your League: ARRL-Sponsored Medium-Frequency Experiment Continues as Hams Hope for novel Band
  • Your League: National Contest Journal (NCJ) Debuts novel Website!
  • International: IARU Showcases tyro Radio at ITU Telecom World 2013
  • International: Yasme Foundation Announces Supporting Grants
  • Radiosport: novel ARRL Single-Operator Unlimited Contest Category Now in Effect
  • Ham Radio Business: Tokyo Hy-Power Files for Bankruptcy
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  • DX: ARRL DXCC Desk Approves ZD9KX Operations
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  • Propagation: Solar Flux Record high Could Herald Better Conditions
  • ARRL Centennial: W100AW Hits the Airwaves!
  • ARRL Centennial: A Century of tyro Radio and the ARRL
  • Milestones: Founder and President Emeritus of 4U1UN, Max de Henseler, HB9RS, SK
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  • Your League: ARRL Reply Comments Cite "Fundamental Misunderstanding" of "Symbol Rate" Petition

    In reply comments filed on its "symbol rate" Petition for Rule Making (RM-11708), the ARRL said comments opposed to its initiative reflect a "fundamental misunderstanding" of the petition's intent. The League's petition now tops the FCC's list of "Most lively Proceedings." More than 800 comments were filed as of January 7, some of them posted after the December 23 cut-off date and most favoring the ARRL's proposal. The ARRL earlier filed comments with the FCC on its own Petition (plus Erratum). RM-11708 proposes to drop the symbol rate restrict in §97.307(f) of the FCC tyro Service rules, substituting a maximum occupied bandwidth of 2.8 kHz for HF data emissions. The ARRL said those opposing the Petition upshot not, in general, challenge the removal of the symbol rate restrict for data emissions in troop segments where RTTY and data emissions are now permitted.

    "Rather, they watch to view the proposal to establish a maximum occupied bandwidth of 2.8 kHz for data emissions in the medium-frequency (MF) and high-frequency (HF) bands where data emissions are permitted now as an enabling provision," the ARRL said. Instead, the League said, its Petition is intended to impose "a limitation on the maximum bandwidth of data emissions where not one exists now." Given state-of-the-art data technologies, the League said, there is no necessary correlation between the symbol rate and the bandwidth of a data emission. The current symbol rate "acts only as a restrict on the efficiency of data emissions in the HF bands as a practical matter, and as an ersatz and capricious filter on the types of emissions that can subsist utilized by radio amateurs."

    The ARRL said its suggested 2.8 kHz maximum bandwidth reflects a balanced approach that will permit complete currently used data emissions, cheer experimentation with data emissions that the current symbol rate restriction prohibits, and preclude the utilize of wider-bandwidth data emissions that could usurp the limited RTTY/data subbands. Petition opponents, the ARRL went on to say, "offer no evidence" that the rule changes it proposes will lead to a situation where data transmissions overwhelm the subband and preclude narrow bandwidth emission communications.

    "The Commission has properly chastised the tyro Service for resisting deregulatory proposals that are designed to enable tyro experimenters to refine and accommodate technologies," the League said in its reply comments. "ARRL is of the view that outdated Commission regulations that needlessly preclude experimentation with data technologies should not subsist preserved. Outdated regulations are not a viable alternative to cooperative sharing arrangements in the HF bands through deliberate troop plans."

    Some of those opposing its petition, the ARRL went on to say, expressed the credit that the proposed rule change would impose wider-bandwidth data emissions in spectrum where narrow-bandwidth modes such as CW and PSK31 now operate, to the detriment of the narrow-bandwidth modes. Other opponents contended that the Petition will profit a few operators at the expense of the many now operating narrowband data, RTTY, and CW on the HF bands.

    "It is illogical to argue on the one hand that the Petition is intended to profit 'the few' who are data emission experimenters and users, and on the other hand to forecast that the relief requested in the Petition would create a flood of 'wide-bandwidth' data emissions, swamping the troop segments used for CW, RTTY, and narrow-bandwidth data emissions," the League pointed out. "If the concern is that the rule changes will cheer more radio amateurs to experiment with data emissions, that would subsist a positive outcome." The ARRL further asserted that the worry of interference from automatically controlled stations "is not a cogent one."

    Its Petition, the ARRL concluded, "is not a referendum on the value of MF or HF data emissions or data experimentation in those bands," but intended to cheer experimentation now restricted artificially by outdated rules. "It is instead a proposal to delete outdated limitations on tyro Radio experimentation, which Commission policy supports, and which the basis and purpose of the tyro Radio Service necessitates."

    Your League: ARRL-Sponsored Medium-Frequency Experiment Continues as Hams Hope for novel Band

    The ARRL-sponsored medium-frequency experiment, operating as WD2XSH, continues apace in an distress to demonstrate the viability of 472 to 479 kHz as a secondary tyro Radio allocation. At the selfsame time, the FCC has been tightlipped regarding the ARRL's November 2012 Petition for Rule Making that asked the Commission to gain this segment of the spectrum available to radio amateurs in the US. Delegates to the 2012 World Radiocommunication Conference approved a 7 kHz-wide secondary allocation between 472 and 479 kHz for the tyro Radio Service, with a power restrict of 5 W EIRP (or 1 W EIRP, depending on location). The FCC has indicated that it will address the issue within the context of its Notice of Proposed Rule Making in ET Docket No 12-338, to formally reflect the Final Acts of WRC 2007 in its rules. In his quarterly WD2XSH update, Experiment Coordinator Fritz Raab, W1FR, reported that 514 contacts -- 10 in the final quarter -- hold been logged among those taking fragment in the experiment across the US.

    WD2XSH experiment participant Patrick Hamel, W5THT, in Mississippi, stands next to his antenna tuning unit. [Photo courtesy of Patrick Hamel, W5THT]

    "As usual, activity increased as conditions improved during the fall. Much of the recent activity has involved WSPR-15," Raab reported. "Reception over significant distances (eg, Europe, Alaska) has been reported. Much of the activity is being undertaken by a few novel experimental licensees." Raab famed that WD2XSH participant Brian Justin, WA1ZMS, transmitted Fessenden commemorative broadcasts on AM via his own experimental license, WG2XFQ, during the December holidays.

    In the US, the 472-479 kHz troop is fragment of the larger 435-495 kHz segment that is allocated on a primary basis to the Maritime Mobile Service (federal and non-federal users), and on a secondary basis for federal government aeronautical radionavigation. The ARRL stated in its Petition that it is unaware of any domestic assignments that might conflict with the allocation of 472 to 479 kHz to the tyro Radio Service, and there is almost no power line carrier (PLC) operation in this troop segment. The FCC in 2003 cited the potential for interference to utility-operated PLC systems when it turned down an ARRL petition seeking an LF "sliver band" at 135.7 to 137.8 kHz.

    The WD2XSH experiment involves more than three dozen stations and includes complete geographic areas of the US, including Alaska and Hawaii. Most of the stations are in the eastern half of the US. Raab has reported no interference issues during the WD2XSH experiment, begun in 2006 and initially using spectrum in the vicinity of 500 kHz. Read more.

    Your League: National Contest Journal (NCJ) Debuts novel Website!

    National Contest Journal (NCJ), the ARRL publication devoted to tyro Radio contesting, has a fresh, novel presence on the web, although the URL remains the same.

    "The novel site was designed with simplicity and ease of utilize in mind," said NCJ Editor Kirk Pickering, K4RO. "The site contains selected feature articles as well as a group of tools for setting up teams and submitting logs for NCJ-sponsored contests. It too offers an archive of scores for complete NCJ going back to 2001. The site noiseless has margin to accommodate novel features in the future, so wait tuned."

    Pickering said the novel NCJ website was a collaborative effort, and he expressed his appreciation to Bruce Horn, WA7BNM, "for his untiring advocate of the NCJ website from its inception" as well as to George Fremin, K5TR, who has served as the systems administrator. Pickering too thanked his colleague Susie Coleman, who helped design the explore and feel.

    "We hope that you will find the novel site useful. Thanks to complete who hold helped to gain this happen," said Pickering, who invited comments on the novel site and design.

    Published every other month, NCJ features general-interest and technical articles and columns by top contesters, operator profiles, editorial comments, and correspondence from readers, as well as scores for the North American QSO Party and North American Sprint, which NCJ sponsors.

    International: IARU Showcases tyro Radio at ITU Telecom World 2013

    The International tyro Radio Union (IARU) got some visibility for tyro Radio at ITU Telecom World 2013, sponsored by the International Telecommunication Union. The event was held November 19-22 in Bangkok, Thailand. The IARU and IARU Region 3 leaders arranged the pomp in cooperation with the ITU. A large, flat-screen TV in the booth displayed videos of tyro Radio activities. Special event station HS2013ITU was on the air from the site. IARU President Tim Ellam, VE6SH, spoke at one of the forums. A highlight of the present for the IARU contingent was a visit by ITU Secretary generic Dr Hamadoun Toure, HB9EHT. He took a circle at the operating position of HS2013ITU while there.

    ITU Secretary generic Hamadoun Toure, HB9EHT, takes up the operating position of HS2013ITU, as IARU Region 3 Chairman Gopal Madhavan, VU2GMN (left), and Sakol Nakin, HS1JNB, explore on. [Tony Waltham, HS0ZDX, photo]

    "We had a number of high-profile visitors to the booth, including ministers of communications and government regulators from various countries," said IARU Region 3 Director Peter Lake, ZL2AZ, and Region 3 Chairman Gopal Madhavan, VU2GMN, in a report. "They were keen to contend the situation in their respective countries and the association with IARU and to learn about tyro Radio and its capabilities. Telecom World 2013 gave the IARU a unique opening to showcase tyro Radio at the highest level."

    ITU Telecom World 2013 too offered an opening for the IARU representatives to influence leaders who can favorably repercussion radio regulations and national attitudes toward tyro Radio. "The presence of IARU, and its distress to showcase tyro Radio and its capabilities, was well appreciated by complete who visited the booth, and the distress was well worthwhile," said the IARU's report. "We too laid a foundation under the novel ITU Telecom World structure to gain some similar space at the next event in 2014 in Qatar." Read more.

    International: Yasme Foundation Announces Supporting Grants

    To further the progress of tyro Radio around the world, The Yasme Foundation has announced the recipients of four supporting grants:

  • WRTC-2014, to allay defray the expenses of the World Radiosport Team Championship in novel England this July.

  • The invert Beacon Network (RBN), to purchase a receiver and necessary accessories to upgrade the RBN node in Bangalore, India.

  • CWOps CW Academy, to allay defray the expenses of providing online CW training courses.

  • The ARRL Second Century Fund, to advocate the goal of the ARRL Second Century push of opening a path to passionate involvement in tyro Radio by novel generations, providing opportunities for educational enrichment, community service, and personal achievement through the exploration and utilize of radio communication.

  • The Yasme Foundation is a not-for-profit corporation organized to conduct scientific and educational projects related to tyro Radio, including DXing and the introduction and promotion of tyro Radio in developing countries. The Foundation supports individuals and organizations providing or creating useful services for the tyro Radio community, regardless of originality or novelty, to further the progress of tyro Radio around the world.

    Radiosport: novel ARRL Single-Operator Unlimited Contest Category Now in Effect

    Responding to many requests, the ARRL Programs and Services Committee in 2013 accepted the Contest Advisory Committee (CAC) recommendation to add the Single-Operator Unlimited category to the ARRL 10 Meter Contest, ARRL 160 Meter Contest, RTTY Roundup, and the IARU HF Championship. "This particular issue has been a long time coming," said CAC Chairman Al Dewey, K0AD.

    The novel category permits the utilize of spotting information within the Single-Operator class. In the past, using spotting information placed a station in the Multioperator category. Per the revised rules, "Single-Operator Unlimited: The utilize of spotting assistance or automated, multi-channel decoders is permitted."

    Ham Radio Business: Tokyo Hy-Power Files for Bankruptcy

    Tokyo Hy-Power, a manufacturer of tyro Radio amplifiers, antenna tuners, and other equipment, is in bankruptcy, and its plant, in Saitama Prefecture near Tokyo, has been shuttered. Telephones at the company no longer are being answered, and its Japanese website has been taken down, although the company's US website remains working. Company CEO/President Nobuki Wakabayashi, JA1DJW, founded Tokyo Hy-Power Labs in 1975. He blamed "the recent depression in the industrial RF power products belt [which] has led to the very difficult monetary position."

    The Tokyo Hy-Power factory in Saitama, Japan. [Tokyo Hy-Power photo]

    Tokyo Hy-Power's early products were HF antenna couplers, although within a couple of years it began manufacturing amplifiers for the tyro Radio market, including solid-state mobile amplifiers. Among its early products was the HL-4000 linear amplifier, which the company claimed was "the first existent HF troop high-power linear of its benevolent in Japan." It has been manufacturing RF products for the industrial market since 1984.

    The company too once marketed the HT-750, a portable, low-power SSB/CW transceiver for 40, 15, and 6 meters in a hand-held transceiver contour factor. At Dayton Hamvention® 2013, the company displayed a prototype of the XT-751, an advanced model it hoped to develop, covering 40 through 6 meters and with an internal antenna tuner. Among its latest products were solid-state HF amplifiers, as well as amplifiers for 6 and 2 meters.

    In a December 26 news release, Ham Radio Outlet (HRO) reacted with "disappointment" and said it was "deeply saddened" to learn that Tokyo Hy-Power had gone into bankruptcy.

    "This action in Japan appears to subsist similar to a Chapter 7 action here within the United States, as the process in this case appears to subsist the liquidation of organizational assets in order to attempt to fund some portion of its debt obligation(s)," the HRO release said. "This appears to argue that a court has deemed the organization unable to subsist effectively reorganized under Japan's Civil Reconstruction Code."

    HRO said it was working with AVSL, the current US service provider for Tokyo Hy-Power products "to contend the opening of continued maintenance at the component plane of the US-sold Tokyo Hy-Power line of amplifiers." Read more.

    Ham Radio Business: CQ to Realign Publications, Launch Digital Supplement

    CQ Communications Inc has announced plans to realign its publications lineup and to launch a novel online supplement to its flagship magazine, CQ tyro Radio.

    "The hobby radio market is changing," said CQ Communications President and Publisher Dick Ross, K2MGA, "and they are changing what they upshot and how they upshot it in order to continue providing leadership to complete segments of the radio hobby."

    Effective with the February 2014 issue of CQ, said Ross, content from the magazine's three sister publications -- favorite Communications, CQ VHF and WorldRadio Online -- will subsist incorporated into CQ's digital edition as a supplement to subsist called CQ Plus. The print editions of favorite Communications and CQ VHF will subsist phased out, and WorldRadio Online will no longer exist as a divide online publication. Current favorite Communications, CQ VHF and WorldRadio Online subscribers will subsist converted to CQ subscribers and receive CQ Plus at no additional charge. Details will subsist posted on each magazine's website.

    CQ Communications says the change will present hobby radio enthusiasts a sole source for articles from shortwave listening and scanner monitoring to personal two-way services and Internet radio, as well as tyro Radio. Richard Fisher, KI6SN, currently editor of both favorite Communications and WorldRadio Online, will subsist editor of CQ Plus. Read more.

    Ham Radio Business: InnovAntennas Acquires constrain 12

    InnovAntennas has acquired the legendary constrain 12 antenna company and product line and has moved the constrain 12 factory from Bridgeport, Texas, to grandiose Junction, Colorado, into a facility shared with InnovAntennas America. InnovAntennas Ltd in England is now manufacturing constrain 12 products for the European market at its Canvey Island plant.

    The grandiose Junction facility is up and running, manufacturing and shipping antennas. InnovAntennas says it plans to produce updated versions of classic constrain 12 antennas as well as all-new models. InnovAntennas Founder Justin Johnson, G0KSC, was at the Colorado facility in late 2013 to assist in setting up and laying out the factory, and the company was expected to subsist at full production this month. -- Thanks to The ARRL Contest Update

    DX: ARRL DXCC Desk Approves ZD9KX Operations

    The ARRL DXCC Desk has approved the 2012 and 2013 operation of ZD9KX -- Tristan Da Cunha & Gough Islands for DX Century Club credit. If a request for DXCC credit for this operation has been rejected in a prior application, contact ARRL Awards fork Manager Bill Moore, NC1L, to subsist placed on the list for an update to your record. gladden note the submission date and/or reference number of your application in order to expedite the search for any rejected contacts.

    DXCC is tyro Radio's premier award that hams can merit by confirming on-the-air contacts with 100 DXCC "entities," most of which are countries in the traditional sense. You can originate with the basic DXCC award and labor your passage up to the DXCC homage Roll. Learn more. -- ARRL Awards fork Manager Bill Moore, NC1L

    Shortwave Listening: Voice of Russia to Continue Shortwave Broadcasting in 2014

    To paraphrase stamp Twain, reports of the demise of the Voice of Russia (VOR) may hold been greatly exaggerated. Earlier this year the Voice of Russia -- the former Radio Moscow during the Soviet Era -- appeared poised to cease shortwave broadcasts as of January 1, 2014. In the wake of a December decree signed by Russian President Vladimir Putin that merged the Voice of Russia with several other state-run news agencies, SWL Tom Witherspoon, K4SWL, contacted VOR.

    "We are joyous to let you know that the Voice of Russia will wait on the air in 2014, however, considerable changes in their frequency schedule are expected," the broadcaster told Witherspoon and as he reports on his blog.

    The posted VOR schedule, which runs through March, indicates 38 aggregate hours of shortwave broadcasts to complete parts of the world, most beamed at the Middle East and Asia. Shortwave broadcasts to Europe, Latin America, Oceania, and Africa account for just 15 aggregate hours. VOR, which claims to subsist the first radio station to broadcast internationally, too broadcasts online, via satellite, on FM, and via three medium-wave transmitters. In 2003 VOR was among the first major international radio broadcasters to launch daily broadcasts to Europe in Digital Radio Mondiale (DRM).

    Propagation: Solar Flux Record high Could Herald Better Conditions

    The 10.7 centimeter solar flux index (SFI) jumped to a Cycle 24 record of 262 on January 4, suggesting that Cycle 24 has not yet begun drawing to a proximate and may subsist approaching or at a "second peak." The previous peak for the current cycle was 190 on September 24, 2011. As NASA's Marshall Space Flight center (MSFC) explains, the flux of the sun's radio emissions at 10.7 centimeter (2.8 GHz) is another indicator of solar activity levels, since it tends to succeed changes in the solar ultraviolet that influence Earth's upper atmosphere and ionosphere.

    "Many models of the upper atmosphere utilize the 10.7 centimeter flux (F10.7) as input to determine atmospheric densities and satellite drag," NASA/MSFC noted, adding that SFI "has been shown to succeed the sunspot number quite closely." The January 6 sunspot import was 225. The Cycle 24 sunspot import peaked at 282 on November 17, 2013, according to WM7D.net.

    Solar flux between 1995 and (predicted) 2020. [NASA/MSFC graphic]

    Canada's Dominion Radio Astrophysical Observatory (DRAO) indicated an "official" flux of 262 at 2000 UTC on Saturday, January 3. The official pattern for Sunday, January 5, was 217.5. ARRL solar observer Tad Cook, K7RA, who reports 10.7 centimeter flux numbers in his weekly "Solar Update" bulletins, suggests that they are not as valuable as sunspot numbers in predicting radio propagation. The solar flux was over the January 4-5 weekend was far higher what was anticipated, judging by predictions Cook reported in his January 3 "Solar Update" for this past weekend and the week ahead. NASA/MFSC indicates a 95 percent predicted flux for the month of January at 146.5, continuing at about the selfsame plane through the first half of the year.

    The Daily DX said the SFI was expected to remain above 200 for this week. As Ian Poole, G3YWX, explained solar flux in his article, "Understanding Solar Indices" in the September 2002 edition of QST, "[H]igh values generally argue there is adequate ionization to advocate long-distance communication at higher-than-normal frequencies." He pointed out, though, that it can engage a few days of high values for conditions to present improvement. "Typically values in excess of 200 will subsist measured during the peak of a sunspot cycle, with high values of up to 300 being experienced for shorter periods," Poole wrote. Read more.

    ARRL Centennial: W100AW Hits the Airwaves!

    At the stroke of midnight Eastern Time on January 1, Hiram Percy Maxim Memorial station W1AW at ARRL Headquarters in Newington took to the air to debut its special ARRL Centennial muster sign, W100AW. ARRL Chief Executive Officer Dave Sumner, K1ZZ and Membership and Volunteer Programs Manager Dave Patton, NN1N, and ARRL Station Manager Joe Carcia, NJ1Q, were at the helm into the wee hours of novel Year's Day.

    ARRL Station Manager Joe Carcia, NJ1Q, makes the very first W100AW QSO just after midnight local time on January 1, 2014. [Sean Kutzko, KX9X, photo]

    Daylight hours saw ARRL Chief Operating Officer Harold Kramer, WJ1B; Membership and Volunteer Programs helper Manager Norm Fusaro, W3IZ; Public Relations Manager Sean Kutzko; KX9X and QST Editor in Chief Steve Ford, WB8IMY, taking their turns at the operating positions. By mid-afternoon, several thousand contacts were in the log on SSB, CW and RTTY.

    "This is just the beginning," said Kutzko. "Hams will hear W100AW throughout 2014 on every mode possible. When you hear us, spot us on the cluster!"

    Not surprising, 20 meter SSB yielded the most contacts -- 1121 of the 3700 logged -- during the 19 hours of novel Year's Day operation from W100AW. Ten meter phone was in second belt with 639 contacts.

    W100AW contacts will subsist uploaded to Logbook of The World (LoTW). QSL cards sent by mail will subsist acknowledged as well.

    W1AW Portable Operations, ARRL Centennial QSO Party

    The ARRL Centennial "W1AW WAS" operations are taking belt throughout 2014 from each of the 50 states, relocating each Wednesday (UTC) to a novel pair of states (this week, South Carolina and Utah. Listen for W1AW/4 and W1AW/7). During 2014 W1AW will subsist on the air from every state at least twice and from most US territories, and it will subsist simple to labor complete states solely by contacting W1AW portable operations.

    In conjunction with the 100th anniversary of the ARRL, the ARRL Centennial QSO Party too kicked off January 1 for a year-long operating event in which participants can accumulate points and win awards. The event is open to all, although only ARRL members and appointees, elected officials, HQ staff and W1AW are worth ARRL Centennial QSO Party points. Working W1AW/x from each state is worth 5 points per contact.

    To merit the "Worked complete States with W1AW Award," labor W1AW operating portable from complete 50 states. (Working W1AW or W100AW in Connecticut does not import for Connecticut, however. For award credit, participants must labor W1AW/1 in Connecticut.) A W1AW WAS certificate and plaque will subsist available (pricing not yet available).

    Some Statistics

    As of today (January 9), more than 6700 stations hold earned points in the Centennial QSO Party by uploading qualifying QSOs to Logbook of The World (LoTW). Operating from North Carolina and West Virginia during the first week of the W1AW portable operations, W1AW/4 and W1AW/8 logged approximately 33,000 contacts.

    "The second week is off to a roaring start from South Carolina and Utah," reported ARRL Membership and Volunteer Programs Manager Dave Patton, NN1N.

    ARRL Centennial: A Century of tyro Radio and the ARRL

    Editor's note: "A Century of tyro Radio and the ARRL" will subsist a weekly feature as the ARRL celebrates its Centennial in 2014.

    In tyro Radio, as in complete fields, 100 years has brought about fabulous progress and changes. During 2014, they will give you a sense of the ARRL's and tyro Radio's history by looking through the issues of QST from its humble dawn to the present. We'll examine the well-known topics and events of interest to amateurs, such as technology, operating tips and events, ARRL's doings, and FCC actions. Because of the limited space available here, the comments will subsist brief, but they will provide citations to original QST articles for your further reading.

    The next century will bring about changes that will subsist mind-boggling to us, because technology advances at an exponential rate. Being sensible of the past 100 years of ham-related events is valuable to us for historical reasons, and it too makes us account what might palter ahead. Next time: A explore at the earliest years of tyro Radio and the ARRL. -- Al Brogdon, W1AB

    Milestones: Founder and President Emeritus of 4U1UN, Max de Henseler, HB9RS, SK

    Max de Henseler, HB9RS. [Clin d'Ailes Swiss Air constrain Museum, HB4FR, photo]

    Max de Henseler, HB9RS, the founder and president emeritus of 4U1UN at United Nations headquarters in novel York, died December 30. He was 80. A ham since 1955, de Henseler had been a short-wave listener since the late 1940s. In 1976, while in novel York as the UN's chief cartographer, de Henseler reactivated the United Nations Radio Club station K2UN at its novel home in midtown Manhattan. As Jack Troster, W6ISQ, explained in the July 1989 issue of QST, "Through his efforts, the Secretary generic approved the operation of a specifically designated UN tyro station using the muster 4U1UN in early 1978."

    De Henseler introduced the novel muster sign on February 4, 1978, during the first weekend of the then two-weekend ARRL International DX phone contest, surprising many contesters. 4U1UN was approved for DXCC credit, due to the efforts of "Mister UN Radio."

    The 4U1UN United Nations Headquarters Station was dismantled in 2010 due to the extensive renovation project on the Secretariat Building. Read more. -- Thanks to The Daily DX

    Milestones: QST Author, CW Key Maker Jerry Pittenger, K8RA, SK

    QST author and CW key crafter Jerry Pittenger, K8RA, of Powell, Ohio, died January 2 of pancreatic cancer. He was 66. Licensed in 1960, Pittenger was a retired systems engineer. He earned a bachelor's degree at Miami University and an MS in systems engineering from Ohio State.

    Jerry Pittenger, K8RA, at Dayton Hamvention 2013. [Joe Eisenberg, K0NEB, photo]

    Pittenger enjoyed structure his own equipment, and some of his amplifier projects were featured in QST, The ARRL Handbook, and RF Amplifier Classics. More recently he manufactured a line of solid-brass iambic and single-lever CW keys sold worldwide, until illness forced him to quit.

    "Making my CW keys fills much of my time, but it is a labor of love," Pittenger said in his online profile. "I can collect lost in time machining metals and making things in the shop for the radio." His friends Mike Freeman, NT8O, and Fred Freeman, N8BX, hold taken over the production of the K8RA line. Read more.

    Milestones: Austin tyro Radio Supply Owner Johnny Paul, WA5BGO, SK

    The owner of Austin tyro Radio Supply, John E. "Johnny" Paul, WA5BGO, of Austin, Texas, died December 10. He was 74. Paul was the proprietor of Austin tyro Radio for 45 years. First licensed in 1960, Paul was a past president of the Austin tyro Radio Club and was an avid photographer of nature and landscapes. Services were December 16.

    Solar Update

    Tad Cook, K7RA, in Seattle, reports: A ample storm is brewing! At 2324 UTC on January 8 the Australian Space Forecast Centre issued this geomagnetic disturbance warning: "Increased geomagnetic activity expected due to coronal mass ejection from 09-10 January 2014."

    NOAA forecasters assess a 90 percent haphazard of geomagnetic storms on January 9. The predicted planetary A indices for January 9 through January 13 are 73, 41, 15, 8 and 5. While an emblematic number for hams, 73 is a huge value for the planetary A index. One has to explore way, passage back to find a value relish this. The planetary A index was 67 on both March 9, 2012, and September 26, 2011, but nothing exceeds what is predicted for January 9 except the planetary A index of 104 on December 15, 2006, and 105 on September 11, 2005.

    This has been an exciting week for sun watchers. The daily sunspot number reached 245 on January 6, and solar flux was 237.1 on January 8. The GOES-15 X-ray background flux has too been high, and that may subsist more significant for enhanced HF propagation than a high solar flux. NOAA's Space Weather Prediction center maintains an archive of X-ray flux, solar flux, and sunspot numbers (check the links marked "DSD.txt." The links marked "DGD.txt" will give you daily geomagnetic indicators).

    Over the past week, mediocre daily sunspot numbers rose more than 80 points to 188.1, and mediocre daily solar flux was up by more than 62 points to 201.6. Predicted solar flux for the near term is 195 on January 9-12, 190 on January 13, 160 on January 14, 155 on January 15-16, and 150 on January 17-19. It then rises to a peak of 190 on January 29 through February 3.

    Predicted planetary A index values are 73, 41, 15 and 8 on January 9-12, 5 on January 13-22, 10 on January 23, 8 on January 24, 5 on January 25-27, then 10, 18 and 8 on January 28-30, then 5 again until February 6.

    For the Friday, January 10, "Solar Update," explore for an update on the latest disturbance and forecast, as well as reports from readers. I welcome your reports and observations via e-mail.

    Getting It Right!

    In The ARRL Letter, December 19, 2013, they inadvertently omitted 20 meters from the list of bands available for the ARRL Centennial QSO Party.

    Just Ahead in Radiosport

  • Jan 10 -- QRP Fox Hunt

  • Jan 10 -- NCCC Sprint Ladder

  • Jan 11 -- faded novel Year Contest

  • Jan 11-12 -- UK DX BPSK63 Contest

  • Jan 11-12 -- MI QRP January CW Contest

  • Jan 11-12 -- SKCC Weekend Sprintathon

  • Jan 11-12 -- North American QSO Party, CW

  • Jan 12 -- NRAU-Baltic Contest, CW (0630-0830 UTC)

  • Jan 12 -- NRAU-Baltic Contest, SSB (0900-1100 UTC)

  • Jan 12 -- DARC 10-Meter Contest

  • Jan 12 -- Midwinter Contest

  • Jan 15 -- QRP Fox Hunt

  • Upcoming ARRL Section, state and Division Conventions and Events

  • January 17-18 -- North Texas Section Convention, Fort Worth, Texas

  • January 19-26 -- Quartzfest Convention, Quartzsite, Arizona

  • January 24-25 -- Mississippi state Convention, Jackson, Mississippi

  • January 25 -- Georgia ARES Convention, Forsyth, Georgia

  • January 25-26 -- Puerto Rico state Convention, Hatillo, Puerto Rico

  • January 31-February 1 -- Southern Florida Section Convention, Miami, Florida

  • February 1 -- Virginia state Convention (Frostfest), Richmond, Virginia

  • February 1 -- South Carolina state Convention, North Charleston, South Carolina

  • February 7-9 -- Northern Florida Section Convention (Orlando HamCation® -- Regional ARRL Centennial Event), Orlando, Florida

  • February 14-15 -- Arizona Section Convention, Yuma, Arizona

  • February 22 -- Vermont state Convention, South Burlington, Vermont

  • March 1-2 -- Alabama Section Convention (BirmingHAMfest 2014), Birmingham, Alabama

  • March 7-8 -- North Carolina Section Convention (Charlotte Hamfest), Concord, North Carolina

  • March 7-8 -- West Gulf Division Convention, Claremore, Oklahoma

  • March 14-15 -- Delta Division Convention, Rayne, Louisiana

  • March 15 -- Nebraska state Convention, Lincoln, Nebraska

  • March 15 -- West Texas Section Convention, Midland, Texas

  • March 22 -- South Texas Section Convention (Greater Houston Hamfest), Rosenberg, Texas

  • March 22-23 -- Communications Academy, Seattle, Washington

  • April 19 -- Roanoke Division Convention, Raleigh, North Carolina

  • April 25-27 -- Idaho state Convention, Boise, Idaho

  • April 26 -- Aurora '14 Conference, White bear Lake, Minnesota

  • Find conventions and hamfests in your area.

    ARRL -- Your One-Stop Resource for tyro Radio news and Information

    Join or Renew Today! ARRL membership includes QST, tyro Radio's most favorite and informative journal, delivered to your mailbox each month.

    Listen to ARRL Audio News, available every Friday.

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    Free of impregnate to ARRL members: Subscribe to the ARES E-Letter (monthly public service and emergency communications news), the ARRL Contest Update (bi-weekly contest newsletter), Division and Section news alerts -- and much more!

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    Consensus Statement on Concussion in Sport—the 4th International Conference on Concussion in Sport Held in Zurich, November 2012 | killexams.com existent questions and Pass4sure dumps

    Preamble

    This paper is a revision and update of the recommendations developed following the 1st (Vienna 2001), 2nd (Prague 2004) and 3rd (Zurich 2008) International Consensus Conference on Concussion in Sport and is based on the deliberations at the 4 thInternational Conference On Concussion In Sport held in Zurich, November 2012.1–3

    The novel 2012 Zurich Consensus statement is designed to build on the principles outlined in the previous documents and to develop further conceptual understanding of this problem using a formal consensus-based approach. A particular description of the consensus process is outlined at the conclude of this document under the “background” section. This document is developed for utilize by physicians and health supervision professionals primarily who are involved in the supervision of injured athletes, whether at the recreational, elite, or professional level.

    While agreement exists pertaining to principal messages conveyed within this document, the authors admit that the science of concussion is evolving and therefore management and recur to play decisions remain in the realm of clinical judgment on an individualized basis. Readers are encouraged to copy and dole freely the Zurich Consensus document, the Concussion Recognition appliance (CRT), the Sport Concussion Assessment appliance version 3 (SCAT3), and/or the Child-SCAT3 card and neither is subject to any restriction, provided it is not altered in any passage or converted to a digital format. The authors’ request that the document and/or the accompanying tools subsist distributed in their full and complete format.

    This consensus paper is broken into a number of sections:

  • (a) A summary of concussion and its management, with updates from the previous meetings.
  • (b) Background information about the consensus meeting process.
  • (c) A summary of the specific consensus questions discussed at this meeting.
  • (d) The Consensus paper should subsist read in conjunction with the SCAT3 assessment tool, the Child-SCAT3 and the Concussion Recognition appliance (designed for lay use).
  • SECTION 1: SPORT CONCUSSION AND ITS MANAGEMENT

    The Zurich 2012 document examines sport concussion and management issues raised in the previous Vienna 2001, Prague 2004, and Zurich 2008 documents and applies the consensus questions from Section 3 to these areas.1–3

    Definition of Concussion

    Panel discussion regarding the definition of concussion and its separation from mild traumatic brain injury (mTBI) was held. There was acknowledgement by the Concussion in Sport Group (CISG) that although the terms mild traumatic brain injury (mTBI) and concussion are often used interchangeably in the sporting context and particularly in the US literature, others utilize the term to refer to different injury constructs. Concussion is the historical term representing low velocity injuries that understanding brain “shaking” resulting in clinical symptoms and which are not necessarily related to a pathological injury. Concussion is a subset of TBI and the term concussion will subsist used in this document. It was too famed that the term commotio cerebri is often used in European and other countries. Minor revisions were made to the definition of concussion and it is defined as follows:

    Concussion is a brain injury and is defined as a knotty pathophysiological process affecting the brain, induced by biomechanical forces. Several common features that incorporate clinical, pathologic and biomechanical injury constructs that may subsist utilized in defining the nature of a concussive head injury include:

  • Concussion may subsist caused either by a direct blow to the head, face, neck or elsewhere on the cadaver with an “impulsive” constrain transmitted to the head.
  • Concussion typically results in the rapid onset of short-lived impairment of neurologic role that resolves spontaneously. However in some cases, symptoms and signs may evolve over a number of minutes to hours.
  • Concussion may result in neuropathological changes, but the acute clinical symptoms largely reflect a functional disturbance rather than a structural injury and, as such, no abnormality is seen on touchstone structural neuroimaging studies.
  • Concussion results in a graded set of clinical symptoms that may or may not involve loss of consciousness. Resolution of the clinical and cognitive symptoms typically follows a sequential course. However, it is well-known to note that in some cases symptoms may subsist prolonged.
  • Recovery of Concussion

    The majority (80%-90%) of concussions resolve in a short (7-10 day) period, although the recovery time frame may subsist longer in children and adolescents.2

    Symptoms and Signs of Acute Concussion

    The diagnosis of acute concussion usually involves the assessment of a range of domains including clinical symptoms, physical signs, cognitive impairment, neurobehavioral features, and sleep disturbance. Furthermore, a particular concussion history is an well-known fragment of the evaluation both in the injured athlete and when conducting a preparticipation examination. The particular clinical assessment of concussion is outlined in the SCAT3 and Child-SCAT3 forms, which is an appendix to this document.

    The suspected diagnosis of concussion can embrace 1 or more of the following clinical domains:

  • (a) Symptoms - somatic (eg, headache), cognitive (eg, emotion relish in a fog) and/or emotional symptoms (eg, lability)
  • (b) Physical signs (eg, loss of consciousness, amnesia)
  • (c) Behavioural changes (eg, irritability)
  • (d) Cognitive impairment (eg, slowed reaction times)
  • (e) Sleep disturbance (eg, insomnia)
  • If any 1 or more of these components is present, a concussion should subsist suspected and the preempt management strategy instituted.

    On-Field or Sideline Evaluation of Acute Concussion

    When a player shows ANY features of a concussion:

  • (a) The player should subsist evaluated by a physician or other licensed healthcare provider onsite using touchstone emergency management principles and particular attention should subsist given to excluding a cervical spine injury.
  • (b) The preempt disposition of the player must subsist determined by the treating healthcare provider in a timely manner. If no healthcare provider is available, the player should subsist safely removed from rehearse or play and imperative referral to a physician arranged.
  • (c) Once the first aid issues are addressed, then an assessment of the concussive injury should subsist made using the SCAT3 or other sideline assessment tools.
  • (d) The player should not subsist left lonely following the injury and serial monitoring for deterioration is essential over the initial few hours following injury.
  • (e) A player with diagnosed concussion should not subsist allowed to recur to play on the day of injury.
  • Sufficient time for assessment and adequate facilities should subsist provided for the preempt medical assessment both on and off the domain for complete injured athletes. In some sports, this may require rule change to allow an preempt off-field medical assessment to occur without affecting the current of the game or unduly penalizing the injured player’s team. The final determination regarding concussion diagnosis and/or fitness to play is a medical decision based on clinical judgment.

    Sideline evaluation of cognitive role is an essential component in the assessment of this injury. Brief neuropsychological test batteries that assess attention and memory role hold been shown to subsist practical and effective. Such tests embrace the SCAT3, which incorporates the Maddocks questions4,5 and the Standardized Assessment of Concussion (SAC).6–8 It is worth noting that touchstone orientation questions (eg, time, place, person) hold been shown to subsist unreliable in the sporting situation when compared with memory assessment.5,9 It is recognized, however, that abbreviated testing paradigms are designed for rapid concussion screening on the sidelines and are not meant to supplant comprehensive neuropsychological testing which should ideally subsist performed by trained neuropsychologists that are sensitive to subtle deficits that may exist beyond the acute episode; nor should they subsist used as a stand-alone appliance for the ongoing management of sports concussions.

    It should too subsist recognized that the appearance of symptoms or cognitive deficit might subsist delayed several hours following a concussive episode and that concussion should subsist seen as an evolving injury in the acute stage.

    Evaluation in Emergency margin or Office by Medical Personnel

    An athlete with concussion may subsist evaluated in the emergency margin or doctor’s office as a point of first contact following injury or may hold been referred from another supervision provider. In addition to the points outlined above, the key features of this exam should encompass:

  • (a) A medical assessment including a comprehensive history and particular neurological examination including a thorough assessment of mental status, cognitive functioning, gait, and balance.
  • (b) A determination of the clinical status of the patient, including whether there has been improvement or deterioration since the time of injury. This may involve seeking additional information from parents, coaches, teammates, and eyewitness to the injury.
  • (c) A determination of the exigency for emergent neuroimaging in order to exclude a more austere brain injury involving a structural abnormality
  • In big part, these points above are included in the SCAT3 assessment.

    Concussion Investigations

    A range of additional investigations may subsist utilized to assist in the diagnosis and/or exclusion of injury. Conventional structural neuroimaging is typically prevalent in concussive injury. Given that caveat, the following suggestions are made: Brain CT (or where available MR brain scan) contributes petite to concussion evaluation but should subsist employed whenever suspicion of an intra-cerebral or structural lesion (eg, skull fracture) exists. Examples of such situations may embrace prolonged disturbance of conscious state, focal neurological deficit, or worsening symptoms.

    Other imaging modalities such as fMRI demonstrate activation patterns that correlate with symptom severity and recovery in concussion.10–14 Whilst not fragment of routine assessment at the present time, they nevertheless provide additional insight to pathophysiological mechanisms. Alternative imaging technologies (eg, positron emission tomography, diffusion tensor imaging, magnetic resonance spectroscopy, functional connectivity), while demonstrating some compelling findings, are noiseless at early stages of progress and cannot subsist recommended other than in a research setting.

    Published studies, using both sophisticated constrain plate technology, as well as those using less sophisticated clinical balance tests (eg, balance oversight Scoring System [BESS]), hold identified acute postural stability deficits lasting approximately 72 hours following sport-related concussion. It appears that postural stability testing provides a useful appliance for objectively assessing the motor domain of neurologic functioning, and should subsist considered a dependable and cogent addition to the assessment of athletes suffering from concussion, particularly where symptoms or signs argue a balance component.15–21

    The significance of Apolipoprotein (Apo) E4, ApoE promotor gene, Tau polymerase, and other genetic markers in the management of sports concussion risk or injury outcome is unclear at this time.22,23 Evidence from human and animal studies in more austere traumatic brain injury demonstrate induction of a variety of genetic and cytokine factors such as: insulin-like growth factor-1 (IGF-1), IGF binding protein-2, Fibroblast growth factor, Cu-Zn superoxide dismutase, superoxide dismutase -1 (SOD-1), nerve growth factor, glial fibrillary acidic protein (GFAP), and S-100. How such factors are affected in sporting concussion is not known at this stage.24–31 In addition, biochemical serum and cerebral spinal fluid biomarkers of brain injury [including S-100, neuron specific enolase (NSE), myelin basic protein (MBP), GFAP, tau, etc] hold been proposed as means by which cellular damage may subsist detected if present.32–38 There is currently insufficient evidence, however, to justify the routine utilize of these biomarkers clinically.

    Different electrophysiological recording techniques (eg, evoked response potential [ERP], cortical magnetic stimulation, and electroencephalography) hold demonstrated reproducible abnormalities in the postconcussive state; however not complete studies reliably differentiated concussed athletes from controls.39–45 The clinical significance of these changes remains to subsist established.

    Neuropsychological Assessment

    The application of neuropsychological (NP) testing in concussion has been shown to subsist of clinical value and contributes significant information in concussion evaluation.46–51 Although in most cases cognitive recovery largely overlaps with the time course of symptom recovery, it has been demonstrated that cognitive recovery may occasionally precede or more commonly succeed clinical symptom resolution, suggesting that the assessment of cognitive role should subsist an well-known component in the overall assessment of concussion and in particular, any recur to play protocol.52,53 It must subsist emphasized however, that NP assessment should not subsist the sole basis of management decisions. Rather, it should subsist seen as an aid to the clinical decision-making process in conjunction with a range of assessments of different clinical domains and investigational results.

    It is recommended that complete athletes should hold a clinical neurological assessment (including assessment of their cognitive function) as fragment of their overall management. This will normally subsist done by the treating physician often in conjunction with computerized NP screening tools.

    Formal NP testing is not required for complete athletes, however when this is considered necessary then it should ideally subsist performed by a trained neuropsychologist. Although neuropsychologists are in the best position to interpret NP tests by virtue of their background and training, the ultimate recur to play decision should remain a medical one in which a multidisciplinary approach, when possible, has been taken. In the absence of NP and other (eg, formal balance assessment) testing, a more conservative recur to play approach may subsist appropriate.

    Neuropsychological testing may subsist used to assist recur to play decisions and is typically performed when an athlete is clinically asymptomatic, however NP assessment may add well-known information in the early stages following injury.54,55 There may subsist particular situations where testing is performed early to assist in determining aspects of management eg, recur to school in a pediatric athlete. This will normally subsist best determined in consultation with a trained neuropsychologist.56,57

    Baseline NP testing was considered by the panel and was not felt to subsist required as a mandatory aspect of every assessment however may subsist helpful or add useful information to the overall interpretation of these tests. It too provides an additional educative opening for the physician to contend the significance of this injury with the athlete. At present, there is insufficient evidence to recommend the widespread routine utilize of baseline NP testing.

    Concussion Management

    The cornerstone of concussion management is physical and cognitive ease until the acute symptoms resolve and then a graded program of exertion prior to medical clearance and recur to play. The current published evidence evaluating the upshot of ease following a sport-related concussion is sparse. An initial era of ease in the acute symptomatic era following injury (24-48 hours) may subsist of benefit. Further research to evaluate the long-term outcome of rest, and the optimal amount and kind of rest, is needed. In the absence of evidence-based recommendations, a sensible approach involves the gradual recur to school and companionable activities (prior to contact sports) in a manner that does not result in a significant exacerbation of symptoms.

    Low-level exercise for those who are slack to recover may subsist of benefit, although the optimal timing following injury for initiation of this treatment is currently unknown.

    As described above, the majority of injuries will recover spontaneously over several days. In these situations, it is expected that an athlete will proceed progressively through a stepwise recur to play strategy.58

    Graduated recur to Play Protocol

    Return to play (RTP) protocol following a concussion follows a stepwise process as outlined in Table 1.

    With this stepwise progression, the athlete should continue to proceed to the next plane if asymptomatic at the current level. Generally, each step should engage 24 hours so that an athlete would engage approximately 1 week to proceed through the full rehabilitation protocol once they are asymptomatic at ease and with provocative exercise. If any postconcussion symptoms occur while in the stepwise program then the patient should drop back to the previous asymptomatic plane and try to progress again after a further 24-hour era of ease has passed.

    Same Day RTP

    It was unanimously agreed that no recur to play on the day of concussive injury should occur. There are data demonstrating that at the collegiate and high school level, athletes allowed to RTP on the selfsame day may demonstrate NP deficits postinjury that may not subsist evident on the sidelines and are more likely to hold delayed onset of symptoms.59–65

    The ‘Difficult’ or Persistently Symptomatic Concussion Patient

    Persistent symptoms (>10 days) are generally reported in 10%-15% of concussions. In general, symptoms are not specific to concussion and it is well-known to account other pathologies. Cases of concussion in sport where clinical recovery falls outside the expected window (ie, 10 days) should subsist managed in a multidisciplinary manner by health supervision providers with sustain in sports-related concussion.

    Psychological Management and Mental Health Issues

    Psychological approaches may hold potential application in this injury, particularly with the modifiers listed below.66,67 Physicians are too encouraged to evaluate the concussed athlete for affective symptoms such as depression and anxiety, as these symptoms are common in complete forms of traumatic brain injury.58

    The Role of Pharmacological Therapy

    Pharmacological therapy in sports concussion may subsist applied in 2 distinct situations. The first of these situations is the management of specific and/or prolonged symptoms (eg, sleep disturbance, anxiety, etc). The second situation is where drug therapy is used to modify the underlying pathophysiology of the condition with the train of shortening the duration of the concussion symptoms.68 In broad terms, this approach to management should subsist only considered by clinicians experienced in concussion management.

    An well-known consideration in RTP is that concussed athletes should not only subsist symptom free, but too should not subsist taking any pharmacological agents/medications that may mask or modify the symptoms of concussion. Where antidepressant therapy may subsist commenced during the management of a concussion, the decision to recur to play while noiseless on such medication must subsist considered carefully by the treating clinician.

    The Role of Preparticipation Concussion Evaluation

    Recognizing the consequence of a concussion history, and appreciating the fact that many athletes will not recognize complete the concussions they may hold suffered in the past, a particular concussion history is of value.69–72 Such a history may preidentify athletes that fit into a high-risk category and provides an opening for the health supervision provider to educate the athlete in esteem to the significance of concussive injury. A structured concussion history should embrace specific questions as to previous symptoms of a concussion and length of recovery, not just the perceived number of past concussions. It is too worth noting that dependence upon the recall of concussive injuries by teammates or coaches has been demonstrated to subsist unreliable.69 The clinical history should too embrace information about complete previous head, face, or cervical spine injuries, as these may too hold clinical relevance. It is worth emphasizing that in the setting of maxillofacial and cervical spine injuries, coexistent concussive injuries may subsist missed unless specifically assessed. Questions pertaining to disproportionate repercussion versus symptom severity matching may alert the clinician to a progressively increasing vulnerability to injury. As fragment of the clinical history it is advised that details regarding protective materiel employed at time of injury subsist sought, both for recent and remote injuries.

    There is an additional and often unrecognized profit of the preparticipation examination insofar as the evaluation allows for an educative opening with the player concerned as well as consideration of modification of playing behavior if required.

    Modifying Factors in Concussion Management

    A range of ‘modifying’ factors may influence the investigation and management of concussion and, in some cases, may forecast the potential for prolonged or persistent symptoms. However, in some cases, the evidence for their efficacy is limited. These modifiers would subsist well-known to account in a particular concussion history and are outlined in Table 2.

    Female Gender

    The role of female gender as a feasible modifier in the management of concussion was discussed at length by the panel. There was not unanimous agreement that the current published research evidence is conclusive enough for this to subsist included as a modifying factor, although it was accepted that gender may subsist a risk factor for injury and/or influence injury severity.73–75

    The Significance of Loss of Consciousness (LOC)

    In the overall management of moderate to austere traumatic brain injury, duration of LOC is an acknowledged predictor of outcome.76 Whilst published findings in concussion relate LOC associated with specific early cognitive deficits, it has not been famed as a measure of injury severity.77,78 Consensus discussion determined that prolonged (>1 minute duration) LOC would subsist considered as a factor that may modify management.

    The Significance of Amnesia and Other Symptoms

    There is renewed interest in the role of posttraumatic amnesia and its role as a surrogate measure of injury severity.64,79,80 Published evidence suggests that the nature, burden, and duration of the clinical postconcussive symptoms may subsist more well-known than the presence or duration of amnesia alone.77,81,82 Further it must subsist famed that retrograde amnesia varies with the time of measurement postinjury and hence is poorly reflective of injury severity.83,84

    Motor and Convulsive Phenomena

    A variety of immediate motor phenomena (eg, tonic posturing) or convulsive movements may escort a concussion. Although dramatic, these clinical features are generally benign and require no specific management beyond the touchstone treatment of the underlying concussive injury.85,86

    Depression

    Mental health issues (such as depression) hold been reported as a consequence of complete levels of traumatic brain injury including sport-related concussion. Neuroimaging studies using fMRI hint that a dejected humor following concussion may reflect an underlying pathophysiological abnormality consistent with a limbic-frontal model of depression.34,87–97 While such mental health issues may subsist multifactorial in nature, it is recommended that the treating physician account these issues in the management of concussed patients.

    SPECIAL POPULATIONS The Child and Adolescent Athlete

    The evaluation and management recommendations contained herein can subsist applied to children and adolescents down to the age of 13 years. Below that age, children report concussion symptoms different from adults and would require age-appropriate symptom checklists as a component of assessment. An additional consideration in assessing the child or adolescent athlete with a concussion is that the clinical evaluation by the healthcare professional may exigency to embrace both patient and parent input, and possibly teacher and school input when appropriate.98–104 A Child-SCAT3 has been developed to assess concussion (see Appendix II) for subjects aged 5 to 12 years.

    The decision to utilize NP testing is broadly the selfsame as the adult assessment paradigm although there are some differences. Timing of testing may disagree in order to assist planning in school and home management. If cognitive testing is performed then it must subsist developmentally sensitive until late teen years due to the ongoing cognitive maturation that occurs during this era which, in turn, makes the utility of comparison to either the person’s own baseline performance or to population norms limited.20 In this age group it is more well-known to account the utilize of trained paediatric neuropsychologists to interpret assessment data, particularly in children with learning disorders and/or ADHD who may exigency more sophisticated assessment strategies.56,57,98

    It was agreed by the panel that no recur to sport or activity should occur before the child/adolescent athlete has managed to recur to school successfully. In addition, the concept of ‘cognitive rest’ was highlighted with special reference to a child’s exigency to restrict exertion with activities of daily alive that may exacerbate symptoms. School attendance and activities may too exigency to subsist modified to avoid provocation of symptoms. Children should not subsist returned to sport until clinically completely symptom free, which may require a longer time frame than for adults.

    Because of the different physiological response and longer recovery after concussion and specific risks (eg, diffuse cerebral swelling) related to head repercussion during childhood and adolescence, a more conservative recur to play approach is recommended. It is preempt to extend the amount of time of asymptomatic ease and/or the length of the graded exertion in children and adolescents. It is not preempt for a child or adolescent athlete with concussion to RTP on the selfsame day as the injury regardless of the plane of athletic performance. Concussion modifiers apply even more to this population than adults and may mandate more cautious RTP advice.

    Elite Versus Nonelite Athletes

    All athletes, regardless of plane of participation, should subsist managed using the selfsame treatment and recur to play paradigm. The available resources and expertise in concussion evaluation are of more consequence in determining management than a separation between elite and nonelite athlete management. Although formal NP testing may subsist beyond the resources of many sports or individuals, it is recommended that in complete organized high-risk sports, consideration subsist given to having this cognitive evaluation, regardless of the age or plane of performance.

    Chronic Traumatic Encephalopathy (CTE)

    Clinicians exigency to subsist mindful of the potential for long-term problems in the management of complete athletes. However, it was agreed that CTE represents a distinct tauopathy with an unknown incidence in athletic populations. It was further agreed that a understanding and upshot relationship has not yet been demonstrated between CTE and concussions or exposure to contact sports.105–114 At present, the interpretation of causation in the modern CTE case studies should proceed cautiously. It was too recognized that it is well-known to address the fears of parents/athletes from media pressure related to the possibility of CTE.

    INJURY PREVENTION Protective Equipment—Mouthguards and Helmets

    There is no salubrious clinical evidence that currently available protective materiel will obviate concussion, although mouthguards hold a Definite role in preventing dental and oro-facial injury. Biomechanical studies hold shown a reduction in repercussion forces to the brain with the utilize of headgear and helmets, but these findings hold not been translated to present a reduction in concussion incidence. For skiing and snowboarding there are a number of studies to hint that helmets provide protection against head and facial injury and hence should subsist recommended for participants in alpine sports.115–118 In specific sports such as cycling, motor, and equestrian sports, protective helmets may obviate other forms of head injury (eg, skull fracture) that are related to falling on difficult surfaces and may subsist an well-known injury prevention issue for those sports.118–130

    Rule Change

    Consideration of rule changes to reduce the head injury incidence or severity may subsist preempt where a clear-cut mechanism is implicated in a particular sport. An instance of this is in football (soccer) where research studies demonstrated that upper limb to head contact in heading contests accounted for approximately 50% of concussions.131 As famed earlier, rule changes too may subsist needed in some sports to allow an efficacious off-field medical assessment to occur without compromising the athlete’s welfare, affecting the current of the game or unduly penalizing the player’s team. It is well-known to note that rule enforcement may subsist a critical aspect of modifying injury risk in these settings and referees play an well-known role in this regard.

    Risk Compensation

    An well-known consideration in the utilize of protective materiel is the concept of risk compensation.132 This is where the utilize of protective materiel results in behavioral change such as the adoption of more Dangerous playing techniques, which can result in a paradoxical increase in injury rates. The degree to which this phenomena occurs is discussed in more detail in the review published in the BJSM supplement. This may subsist a particular concern in child and adolescent athletes where head injury rates are often higher than in adult athletes.133–135

    Aggression Versus Violence in Sport

    The competitive/aggressive nature of sport that makes it fun to play and watch should not subsist discouraged. However, sporting organizations should subsist encouraged to address violence that may increase concussion risk.136,137 unbiased play and respect should subsist supported as key elements of sport.

    Knowledge Transfer

    As the talent to treat or reduce the effects of concussive injury after the event is minimal, education of athletes, colleagues, and the generic public is a mainstay of progress in this field. Athletes, referees, administrators, parents, coaches and health supervision providers must subsist educated regarding the detection of concussion, its clinical features, assessment techniques and principles of safe recur to play. Methods to improve education including Web-based resources, educational videos, and international outreach programs are well-known in delivering the message. In addition, concussion working groups, plus the advocate and endorsement of enlightened sport groups such as Fédération Internationale de Football Association (FIFA), International Olympic Commission (IOC), International Rugby Board (IRB), and International Ice Hockey Federation (IIHF) who initiated this endeavor hold tremendous value and must subsist pursued vigorously. unbiased play and respect for opponents are ethical values that should subsist encouraged in complete sports and sporting associations. Similarly, coaches, parents, and managers play an well-known fragment in ensuring these values are implemented on the domain of play.58,138–150

    SECTION 2: STATEMENT ON BACKGROUND TO THE CONSENSUS PROCESS

    In November 2001, the 1st International Conference on Concussion in Sport was held in Vienna, Austria. This meeting was organized by the IIHF in partnership with FIFA and the Medical Commission of the IOC. As fragment of the resulting mandate for the future, the exigency for leadership and future updates were identified. The 2nd International Conference on Concussion in Sport was organized by the selfsame group with the additional involvement of the IRB and was held in Prague, Czech Republic in November 2004. The original aims of the symposia were to provide recommendations for the improvement of safety and health of athletes who suffer concussive injuries in ice hockey, rugby, football (soccer) as well as other sports. To this end, a range of experts were invited to both meetings to address specific issues of epidemiology, basic and clinical science, injury grading systems, cognitive assessment, novel research methods, protective equipment, management, prevention, and long-term outcome.1,2

    The 3rd International Conference on Concussion in Sport was held in Zurich, Switzerland on October 29-30, 2008 and was designed as a formal consensus meeting following the organizational guidelines set forth by the US National Institutes of Health. (Details of the consensus methodology can subsist obtained at: http://consensus.nih.gov/ABOUTCDP.htm). The basic principles governing the conduct of a consensus progress conference are summarized below:

  • A broad-based non-government, nonadvocacy panel was assembled to give balanced, objective and knowledgeable attention to the topic. Panel members excluded anyone with scientific or commercial conflicts of interest and included researchers in clinical medicine, sports medicine, neuroscience, neuroimaging, athletic training, and sports science.
  • These experts presented data in a public session, followed by inquiry and discussion. The panel then met in an executive session to prepare the consensus statement.
  • A number of specific questions were prepared and posed in foster to define the scope and guide the direction of the conference. The principle chore of the panel was to elucidate responses to these questions. These questions are outlined below.
  • A systematic literature review was prepared and circulated in foster for utilize by the panel in addressing the conference questions.
  • The consensus statement is intended to serve as the scientific record of the conference.
  • The consensus statement will subsist widely disseminated to achieve maximum repercussion on both current health supervision rehearse and future medical research.
  • The panel chairperson (WM) did not identify with any advocacy position. The chairperson was amenable for directing the consensus session and guiding the panel’s deliberations. Panelists were drawn from clinical practice, academic, and research in the domain of sport-related concussion. They upshot not limn organizations per se but were selected for their expertise, experience, and understanding of this field.

    The 4th International Conference on Concussion in Sport was held in Zurich, Switzerland on November 1-3, 2012 and followed the selfsame silhouette as for the 3rd meeting. complete speakers, consensus panel members, and abstract authors were required to sign an ICMJE contour for Disclosure of Potential Conflicts of Interest. particular information related to each authors affiliations and conflicts of interests will subsist made publicly available on the CISG Web site and published with the BJSM supplement.

    Medical Legal Considerations

    This consensus document reflects the current state of learning and will exigency to subsist modified according to the progress of novel knowledge. It provides an overview of issues that may subsist of consequence to healthcare providers involved in the management of sport-related concussion. It is not intended as a touchstone of care, and should not subsist interpreted as such. This document is only a guide, and is of a generic nature, consistent with the reasonable rehearse of a healthcare professional. Individual treatment will depend on the facts and circumstances specific to each individual case.

    It is intended that this document will subsist formally reviewed and updated prior to December 1, 2016.

    SECTION 3: ZURICH 2012 CONSENSUS QUESTIONS

    Note that each question is the subject of a divide systematic review that is published in the British Journal of Sports Medicine (2013; 47(5): April 2013). As such complete citations and details of each topic will subsist covered in those reviews.

    1. When you assess an athlete acutely and they upshot not hold concussion, what is it? Is a cognitive injury the key component of concussion in making a diagnosis?

    The consensus panel agreed that concussion is an evolving injury in the acute angle with rapidly changing clinical signs and symptoms, which may reflect the underlying physiological injury in the brain. Concussion is considered to subsist among the most knotty injuries in sport medicine to diagnose, assess, and manage. The majority of concussions in sport occur without loss of consciousness or candid neurologic signs. At present, there is no perfect diagnostic test or marker that clinicians can trust on for an immediate diagnosis of concussion in the sporting environment. Because of this evolving process, it is not feasible to rule out concussion when an injury event occurs associated with a fugitive neurological symptom. complete such cases should subsist removed from the playing domain and assessed for concussion by the treating physician or health supervision provider as discussed below. It was recognised that a cognitive deficit is not necessary for acute diagnosis as it either may not subsist present or detected on examination.

    2. Are the existing tools/exam sensitive and dependable enough on the day of injury to gain or exclude a diagnosis of concussion?

    Concussion is a clinical diagnosis based largely on the observed injury mechanism, signs, and symptoms. The vast majority of sport-related concussions (hereafter, referred to as concussion) occur without loss of consciousness or candid neurologic signs.151–154 In milder forms of concussion, the athlete might subsist slightly confused, without clearly identifiable amnesia. In addition, most concussions cannot subsist identified or diagnosed by neuroimaging techniques (eg, computed tomography or magnetic resonance imaging). Several well-validated neuropsychological tests are preempt for utilize in the assessment of acute concussion in the competitive sporting environment. These tests provide well-known data on symptoms and functional impairments that clinicians can incorporate into their diagnostic formulation, but should not solely subsist used to diagnose concussion.

    3. What is the best rehearse for evaluating an adult athlete with concussion on the “field of play” in 2012?

    Recognizing and evaluating concussion in the adult athlete on the domain is a challenging responsibility for the health supervision provider. Performing this chore is often a rapid assessment in the midst of competition with a time constraint and the athlete fervent to play. A standardized objective assessment of injury, which includes excluding more serious injury, is critical in determining disposition decisions for the athlete. The on-field evaluation of sport-related concussion is often a challenge given the elusiveness and variability of presentation, hardship in making a timely diagnosis, specificity and sensitivity of sideline assessment tools, and the reliance on symptoms. Despite these challenges, the sideline evaluation is based on recognition of injury, assessment of symptoms, cognitive and cranial nerve function, and balance. Serial assessments are often necessary. Concussion is often an evolving injury, and signs and symptoms may subsist delayed. Therefore, erring on the side of caution (keeping an athlete out of participation when there is any suspicion for injury) is important. A standardized assessment of concussion is useful in the assessment of the athlete with suspected concussion but should not engage the belt of clinician judgment.

    4. How can the SCAT2 subsist improved?

    It was agreed that a variety of measures should subsist employed as fragment of the assessment of concussion to provide a more complete clinical profile for the concussed athlete. well-known clinical information can subsist ascertained in a streamlined manner through the utilize of a multimodal instrument such as the Sport Concussion Assessment appliance (SCAT). A baseline assessment is advised wherever possible. However, it is acknowledged that further validity studies exigency to subsist performed to retort this specific issue.

    A future SCAT test battery (i.e, SCAT3) should embrace an initial assessment of injury severity using the Glasgow Coma Scale (GCS), immediately followed by observing and documenting concussion signs. Once this is complete, symptom endorsement and symptom severity, neurocognitive function, and balance role should subsist assessed in any athlete suspected of sustaining a concussion. It is recommended that these latter steps subsist conducted following a minimum 15-minute ease era on the sideline to avoid the influence of exertion or fatigue on the athlete’s performance. While it is famed that this time frame is an capricious one, nevertheless the expert panel agreed that a era of ease was well-known prior to assessment. Future research should account the efficacy for inclusion of vision tests such as the King Devick Test and clinical reaction time tests.155,156 Recent studies hint that these may subsist useful additions to the sideline assessment of concussion. However, the exigency for additional materiel may gain them impractical for sideline use.

    It was further agreed that the SCAT3 would subsist suitable for adults and youths age 13 and over, while a novel appliance (Child-SCAT3) subsist developed for younger children.

    5. Advances in neuropsychology: are computerized tests adequate for concussion diagnosis?

    Sport-related concussions are frequently associated with 1 or more symptoms, impaired balance, and/or cognitive deficits. These problems can subsist measured using symptom scales, balance testing, and neurocognitive testing. complete 3 modalities can identify significant changes in the first few days following injury, generally with normalization over 1 to 3 weeks. The presentation of symptoms and the rate of recovery can subsist variable, which reinforces the value of assessing complete 3 areas as fragment of a comprehensive sport concussion program.

    Neuropsychological assessment has been described by the Concussion in Sport Group as a ‘cornerstone’ of concussion management. Neuropsychologists are uniquely qualified to interpret neuropsychological tests and can play an well-known role within the context of a multifaceted-multimodal and multidisciplinary approach to managing sport-related concussion. Concussion management programs that utilize neuropsychological assessment to assist in clinical decision-making hold been instituted in professional sports, colleges, and high schools. Brief computerized cognitive evaluation tools are the mainstay of these assessments worldwide given the logistical limitation in accessing trained neuropsychologists, however it should subsist famed that these are not substitutes for formal neuropsychological assessment. At present, there is insufficient evidence to recommend the widespread routine utilize of baseline neuropsychological testing.

    7. What evidence exits for novel strategies/technologies in the diagnosis of concussion and assessment of recovery?

    A number of novel technological platforms exist to assess concussion including (but not limited to) iPhone/smart phone apps, quantitative electroencephalography, robotics – sensory motor assessment, telemedicine, eye tracking technology, functional imaging/advanced neuroimaging and head repercussion sensors. At this stage only limited evidence exists for their role in this setting and not one hold been validated as diagnostic. It will subsist well-known to reconsider the role of these technologies once evidence is developed.

    8. Advances in the management of sport concussion: what is evidence for concussion therapies?

    The current evidence evaluating the upshot of ease and treatment following a sport-related concussion is sparse. An initial era of ease may subsist of benefit. However, further research to evaluate the long-term outcome of rest, and the optimal amount and kind of rest, is needed. Low-level exercise for those who are slack to recover may subsist of benefit, although the optimal timing following injury for initiation of this treatment is currently unknown. Multimodal physiotherapy treatment for individuals with clinical evidence of cervical spine and/or vestibular dysfunction may subsist of benefit. There is a stout exigency for high-level studies evaluating the effects of a resting period, pharmacological interventions, rehabilitative techniques, and exercise for individuals who hold sustained a sport-related concussion.

    9. The difficult concussion patient: what is the best approach to investigation and management of persistent (>10 days) post concussive symptoms?

    Persistent symptoms (>10 days) are generally reported in 10%-15% of concussions. This may subsist higher in certain sports (eg, elite ice hockey) and populations (eg, children). In general, symptoms are not specific to concussion and it is well-known to account and manage co-existent pathologies. Investigations may embrace formal neuropsychological testing and conventional neuroimaging to exclude structural pathology. Currently there is insufficient evidence to recommend routine clinical utilize of advanced neuroimaging techniques or other investigative strategies. Cases of concussion in sport where clinical recovery falls outside the expected window (i.e. 10 days) should subsist managed in a multidisciplinary manner by health supervision providers with sustain in sports-related concussion. well-known components of management after the initial era of physical and cognitive ease embrace associated therapies such as cognitive, vestibular, physical and psychological therapy, consideration of assessment of other causes of prolonged symptoms, and consideration of commencement of a graded exercise program at a plane that does not exacerbate symptoms.

    10. Revisiting concussion modifiers: how should the evaluation and management of acute concussion disagree in specific groups?

    The literature demonstrates that number and severity of symptoms and previous concussions are associated with prolonged recovery and/or increased risk of complications. Brief loss of consciousness (LOC), duration of posttraumatic amnesia and/or repercussion seizures upshot not reliably forecast outcome following concussion, although a cautious approach should subsist taken in an athlete with prolonged LOC (ie, >1 minute). Children generally engage longer to recover from concussions and assessment batteries hold yet to subsist validated in the younger age group. Currently there are insufficient data on the influence of genetics and gender on outcome following concussion. Several modifiers are associated with prolonged recovery or increased risk of complications following concussion and hold well-known implications for management. Children with concussion should subsist managed conservatively, with the accent on recur to learn before recur to sport. In cases of concussion managed with limited resources (eg, nonelite players), a conservative approach should too subsist taken such that the athlete does not recur to sport until fully recovered

    11. What are the most efficacious risk reduction strategies in sport concussion? - from protective materiel to policy.

    No novel cogent evidence was provided to hint that the utilize of current touchstone headgear in rugby, or mouthguards in American football, can significantly reduce players’ risk of concussion. No evidence was provided to hint an association between neck might increases and concussion risk reduction. There was evidence to hint that eliminating cadaver checking from Pee Wee ice hockey (ages 11-12 years) and fair-play rules in ice hockey were efficacious injury prevention strategies. Helmets exigency to subsist able to protect from impacts resulting in a head change in velocity of up to 10 m/s in professional American football, and up to 7 m/s in professional Australian football. It too appears that helmets must subsist capable of reducing head resultant linear acceleration to below 50 g and angular acceleration components to below 1500 rad/s2 to optimize their effectiveness. Given that a multifactorial approach is needed for concussion prevention, well-designed and sport-specific prospective analytical studies of adequate power are warranted for mouthguards, headgear/helmets, facial protection, and neck strength. Measuring the upshot of rule changes should too subsist addressed with future studies, not only assessing novel rule changes or legislation, but too alteration or reinforcement to existing rules.

    12. What is the evidence for inveterate concussion-related changes? - behavioural, pathological, and clinical outcomes.

    It was agreed that inveterate traumatic encephalopathy (CTE) represents a distinct tauopathy with an unknown incidence in athletic populations. It was further agreed that CTE was not related to concussions lonely or simply exposure to contact sports. At present, there are no published epidemiological, cohort, or prospective studies relating to modern CTE. Due to the nature of the case reports and pathological case progression that hold been published, it is not feasible to determine the causality or risk factors with any certainty. As such, the speculation that repeated concussion or sub-concussive impacts causes CTE remains unproven. The extent to which age-related changes, psychiatric or mental health illness, alcohol/drug use, or co-existing medical or dementing illnesses contribute to this process is largely unaccounted for in the published literature. At present, the interpretation of causation in the modern CTE case studies should proceed cautiously. It was too recognized that it is well-known to address the fears of parents/athletes from media pressure related to the possibility of CTE.

    13. From consensus to action: how upshot they optimize learning transfer, education, and talent to influence policy?

    The value of learning transfer (KT) as fragment of concussion education is increasingly becoming recognized. Target audiences profit from specific learning strategies. Concussion tools exist, but their effectiveness and repercussion require further evaluation. The media is valuable in drawing attention to concussion, but efforts exigency to ensure that the public is sensible of the privilege information. companionable media as a concussion education appliance is becoming more prominent. Implementation of KT models is one approach organizations can utilize to assess learning gaps; identify, develop, and evaluate education strategies; and utilize the outcomes to facilitate decision making. Implementing KT strategies requires a defined plan. Identifying the needs, learning styles and preferred learning strategies of target audiences, coupled with evaluation, should subsist a piece of the overall concussion education perplex to hold an repercussion on enhancing learning and awareness.

    Author and coauthor affiliations and disclosures.

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