Despite the adoption of several RTS and RTA protocols in clinical practice there is little evidence to determine their efficacy in the paediatric population. Summary The current data support the recommendation that children in the acute stage postconcussion should undergo 1-2 days physical and cognitive rest as they initiate graduated RTA/RTS protocols.  https://www.selleckchem.com/  Prolonged rest may increase reported symptoms and time to recovery. Further interventional studies are needed to evaluate the effectiveness of RTA/RTS protocols in youth with concussion. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.Objectives We compared the ability of physical activity and sitting time questionnaires (PAQ) for ranking individuals versus continuous volume calculations (physical activity level (PAL), metabolic equivalents of task (MET), sitting hours) against accelerometry measured physical activity as our criterion. Methods Participants in a cohort from the Tromsø Study completed three questionnaires; (1) The Saltin-Grimby Physical Activity Level Scale (SGPALS) (n=4040); (2) The Physical Activity Frequency, Intensity and Duration (PAFID) questionnaire (n=5902)) calculated as MET-hours·week-1 and (3) The International Physical Activity questionnaire (IPAQ) short-form sitting question (n=4896). We validated the questionnaires against the following accelerometry (Actigraph wGT3X-BT) estimates vector magnitude counts per minute, steps∙day-1, time (minutes·day-1) in sedentary behaviour, light physical activity, moderate and vigorous physical activity (MVPA) non-bouted and ≥10 min bouted MVPA. Results Ranking of physical actimmercial re-use. See rights and permissions. Published by BMJ.Objectives To assess awareness of external auditory exostosis (EAE) among Australian surfers. Methods This is a cross-sectional observational study, assessing professional and recreational Australian surfers. Currently, active surfers over 18 years of age, surfing year-round, were eligible to participate. After initial screening, individuals were asked to complete a questionnaire. All included volunteers underwent bilateral otoscopic examination, to assess the presence and severity of EAE. Results A total of 113 surfers were included in the study and were divided into two groups, based on surfing status 93 recreational surfers and 20 professional surfers. Recreational surfers were significantly older (p less then 0.005), more experienced (greater years surfing; p less then 0.005), with lower prevalence of otological symptoms (p less then 0.05). The most common symptoms were water trapping, impacted wax and hearing loss. Prevalence of EAE was high for both groups (95% in the professional surfers and 82.8% in the recreational surfers); however, recreational surfers had mild grade EAE (grade 1) as the most common presentation, as opposed to professionals who had severe grade EAE (grade 3) as the most common presentation (p less then 0.05 between groups). Awareness of the term 'surfer's ear' was high for both groups, as was knowledge of prevention options. However, fewer considered the condition to be preventable, and an even lower number reported regular use of prevention methods. Conclusion Australian surfers had a high level of awareness of EAE; however, few reported using prevention methods, despite having a high prevalence of the condition. Health practitioners should screen susceptible individuals in order to recommend appropriate preventive measures. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.Background Stunting is defined as a child with a height for-age Z-score less than minus two standard deviations. Globally, 162 million less than 5 years were stunted. In Ethiopia, Nationally the prevalence of stunting among under five children was 38.4% and in Afar it is above the national average (41.1%). This study was aimed to identify determinants of stunting among children aged 6 to 59 months in rural Dubti district, Afar region, North East Ethiopia, 2017. Methods Community based unmatched case-control study design was conducted among 322 (161 cases and 161 controls) children aged 6 to 59 months from March 2-30/ 2017. Simple random method was used to select 5 kebelles from 13 kebelles. Training was given for data collectors and supervisors. Data were entered to EPI data version 3.02 and exported to SPSS version 20 for analysis. Binary logistic regression analysis was used and variables with p-value less then  0.25 on univariable binary logistic regression analysis were further analyzed on multivariable binary logistic regression analysis and statistical significance was declared at 95% CI. Results Being from a mother with no education (AOR = 4.92, 95%CI (1.94, 12.4), preceding birth interval less than 24 months (AOR = 4.94, 95% (2.17, 11.2), no ANC follow-up (AOR = 2.81, 95% (1.1.46, 5.38), no access to latrine (AOR =3.26, 95% CI (1.54-6.94), children born from short mother less then  150 cm (AOR = 3.75, 95%CI (1.54, 9.18), not fed colostrum (AOR = 4.45, 95% CI (1.68, 11.8), breast fed for less than 24 months (AOR = 3.14, 95% CI (1.7, 5.79) and non-exclusive breast feeding (AOR = 6.68, 95% (3.1, 14.52) were determinants of stunting at 95% CI. Conclusion No maternal education, preceding birth interval less than 24 months, no ANC follow-up, no access to latrine, short maternal height, not feeding colostrum, duration of breast feed less than 24 months and non- exclusive breast feeding were determinants of stunting at 95% CI. © The Author(s) 2020.Background Some of the recently piloted innovative approaches for the management of acute malnutrition in children use the "expanded MUAC-only" approach, with Mid Upper Arm Circumference (MUAC) less then  125 mm as the sole anthropometric criterion for screening and admission, classification of cases as severe using the 115 mm cut-off, and use Ready-to-Use-Therapeutic-Food (RUTF) for the management of both moderate (MAM) and severe (SAM) cases of acute malnutrition. Our study aimed at exploring the potential consequences of this "expanded MUAC-only" program scenario on the eligibility for treatment and RUTF allocation, as compared with the existing WHO normative guidance. Methods We analyzed data from 550 population representative cross-sectional cluster surveys conducted since 2007. We retrieved all children classified as SAM and MAM according to currently used case definitions, and calculated the proportions of SAM children who would be excluded from treatment, misclassified as MAM, or whose specific risks (because of having both MUAC and weight-for height deficits) would be ignored.