Search Results for: concussion
A recent report from the Institute of Medicine found that young athletes in the United States face a "culture of resistance" to reporting when they might have a concussion and to complying with treatment decisions. That culture can result in students heading back to school too quickly—when they should be resting their brains to prevent short- and long-term complications.
"The findings of our report justify the concerns about sports concussions in young people," said Robert Graham, chair of the committee and director of the national program office for Aligning Forces for Quality, at George Washington University, Washington, D.C. (Aligning Forces is a program of the Robert Wood Johnson Foundation.) "However,” says Graham, “there are numerous areas in which we need more and better data. Until we have that information, we urge parents, schools, athletic departments, and the public to examine carefully what we do know, as with any decision regarding risk, so they can make more informed decisions about young athletes playing sports."
Recently, Righttime Medical Care, a chain of urgent care centers in Maryland, opened a number of HeadFirst sports injury and concussion centers in the state, staffed with health professionals who can assess injuries for concussions as well as evaluate students for return to play—in consolation with a team of experts who work with HeadFirst staff. HeadFirst will this year be presenting and publishing data on the more than 10,000 youth it has examined and treated for concussion in just the past two years.
NewPublicHealth recently spoke with Robert Graw, MD, head of Righttime and HeadFirst, about the need for better prevention, evaluation and treatment of concussions to prevent long-term health problems and disability.
NewPublicHealth: Why did Righttime add concussion care to the services provided?
Robert Graw: My son is an orthopedic surgeon and talked to me about the number of injuries he was seeing. We decided a few years ago that we’d learn as much as we could about preventing head injury and the consequences of head injury, and then promote that information through Righttime’s call center and through the visits that people made to our sites.
In the process of learning as much as we could we realized that the knowledge base of how people evaluate and manage concussions had changed drastically in the last five years as people have done more research. So, we then gathered together a group of consultant physicians and neuropsychologists to determine best practices. We met with them frequently, and then had them train our provider staff so that all of them became much more informed about what a concussion really is, the best way to evaluate them and the guidelines for management going forward.
Telehealth Technology Could Help Obese Youth Get Better Treatment, Lose Weight
Telehealth technology—a secure computer system that enables patients to speak “face-to-face” with doctors who are far away—could be an effective strategy to help obese youth who are trying to lose weight, according to new research from UCLA. With a multidisciplinary approach often the prescribed for treating obesity, telehealth services would reduce travel time while giving patients access to expertise that might not be available in their area. This would be especially helpful for low-income families. The UCLA study linked UCLA health care providers with patients at their local health clinics, finding that 80 percent of the 45 study subjects were happy with the technology and would use it again. "One surprise was how natural it was to talk with each other through the telehealth system, even though we never met the patients in person," said lead author Wendy Slusser, MD, medical director of the Fit for Healthy Weight program at Mattel Children's Hospital UCLA and director of pediatric wellness programs at the Venice Family Clinic. "The interaction was very much like being in the same room together. Some kids even thought it was fun to see themselves on the screen." Read more on access to health care.
Study: Psychiatrists Less Likely than Other Doctors to Accept Insurance
Psychiatrists are less likely than other doctors to accept private insurance, according to a new study in JAMA Psychiatry. Researchers analyzed government data from 2005 to 2010, which surveyed approximately 1,250 doctors each year, finding that from 2005 to 2010 the percentage of psychiatrists who accepted private insurance dropped from 72 percent to 55 percent. In comparison, over that same time the rate for doctors in other areas only dropped from 93 percent to 89 percent. While the study does not explain the vast difference, Jeffrey Lieberman, MD, president of the American Psychiatric Association, said reimbursement is a major concern, according to Reuters. "Many doctors can't afford to accept insurance because (insurance companies) don't pay them for the time," he said. "It involves taking more time with the patient and often treating them with psychotherapy.” Read more on mental health.
Even Mild Hits to the Head Can Cause Brain Damage
Even mild hits to the head that don’t cause concussion can still lead to problems with memory and thinking, according to a new study in the journal Neurology. Researchers equipped 80 football and ice hockey players with special helmets that gathered data on mild hits; while none of the players were diagnosed with a concussion, they still showed signs of deficits in thinking after the season. "This suggests that concussion is not the only thing we need to pay attention to," said Tom McAllister, MD, chairman of the department of psychiatry at the Indiana University School of Medicine. "These athletes didn't have a concussion diagnosis in the year we studied them ... and there is a subsample of them who are perhaps more vulnerable to impact. We need to learn more about how long these changes last and whether the changes are permanent." Read more on injury prevention.
New York City Council Votes to Raise Tobacco-purchasing Age to 21
With studies repeatedly showing that the earlier someone begins smoking, the more likely they are to become addicted, the New York City Council has voted to raise the age minimum required to buy tobacco products from to 21 years, up from 18 years. The bill passed 35-11. Mayor Michael R. Bloomberg has already announced he will sign the bill. The law would apply to all tobacco products, including cigarettes, electronic cigarettes, cigars and cigarillos. “This is literally legislation that will save lives,” said Christine C. Quinn, the Council speaker, according to The New York Times. The Council also voted to increase the penalties for retailers who evade tobacco taxes; for a prohibition on discounts for tobacco products; and for a minimum price of $10.50 a pack for cigarettes and little cigars. Read more on tobacco.
Analysis: Sports-related Youth Concussion Diagnoses Climbing
The growing number of diagnosed concussions in young athletes and their reluctance to admit when they have suffered a head injury—despite ever-growing awareness of the dangers of concussions—demonstrates the need for sports leagues and government agencies to become more active in preventing traumatic brain injuries, according to a new report from the Institute of Medicine and the National Research Council. In 2009, about 250,000 youth ages 5-21 were treated for sports-related concussions and other brain injuries in U.S. hospitals, up from approximately 150,000 in 2001. The analysis pointed to Hannah Steenhuysen, a high school soccer goalie in Rehoboth, Massachusetts, as an example of why relying on youth to report their head injuries on their own is not always an effective strategy. "You don't tell anyone usually when you get a headache because you don't want to be out of the game," she said. "I couldn't watch TV or text or even read—it was really tough. When I tried to go back to school, I couldn't keep up and everything got jumbled in my head." Read more on injury prevention.
Tips for Kids with Food Allergies on Halloween
Trick-or-treating and Halloween parties can be difficult for kids with food allergies. However, there are steps both kids and parents can take to make sure kids with food allergies still have a full night of fun, according to Joyce Rabbat, MD, a pediatric allergy specialist with the Loyola University Health System, in Chicago. "The key is education,” she said. “Make sure your child knows what he or she can eat. When in doubt, throw it out." Among her tips:
- Plan parties and events that do not include food, candy or other edible treats.
- Inform the host of any Halloween party if your child has a food allergy. You can also provide a list of foods that may trigger an allergic reaction.
- Clean all cooking utensils, pans or other dishes if they have been in contact with a food allergen. Also make sure to wipe down surfaces.
- Read labels to find out whether foods contain allergens or have been made on the same machine as other products that contain an allergen.
- Carry self-injectable epinephrine.
Read more on food safety.
Pediatricians: Parent’s Religion Should Not Stand in the Way of Child’s Medical Care
While noting that parents have the right to determine a child’s medical care, a parent’s religious beliefs should not stand in the way of necessary medical care when the child is at risk for serious disability or death, according to a new policy statement from the American Academy of Pediatrics Committee on Bioethics. The organization is also calling for a repeal of all state exemptions to child abuse and neglect laws, as well as an end to funding for any religious or spiritual healing. "I think it's important that all children get appropriate medical care, that state policies should be clear about the obligations to provide this care and that state monies directed toward medical care should be used for established and effective therapies," said Armand Antommaria, MD, directors of the Ethics Center at Cincinnati Children's Hospital Medical Center in Ohio and one of the statement’s lead authors. Many religious groups currently decline mainstream and proven medical treatments. For example, Christian Scientists advocate prayer over medical treatment, and Jehovah’s Witnesses opposed blood transfusions. Read more on pediatrics
Study: Low-cost Football Gear as Effective as High-tech, High-cost Equipment at Preventing Head Injuries
A group of experts has performed an extensive study to determine which football helmets and mouth guards are best at preventing youth concussions: none of them. The researchers compared high-tech and custom equipment to low-cost, off-the-shelf equipment, finding no difference in the number of concussions for 1,300 players at 36 high schools during the 2012 football season. There are approximately 40,000 sports-related concussions in U.S. high schools every year. "We're certainly not saying that helmets and mouth guards aren't important. They do what they are supposed to do. Mouth guards prevent dental injuries, and helmets prevent skull fractures and scalp and face lacerations," said Margaret Alison Brooks, MD, the study's lead co-investigator. "But I don't think the manufacturing companies have the data to support [the claim that] if a parent buys a specific model, their child will have a reduced risk of concussion." The findings will be presented today at an American Academy of Pediatrics meeting in Orlando, Fla. Read more on injury prevention.
FDA: Recall of Certain Kraft and Polly-O String Cheese Products
Kraft Foods Group has announced a voluntary recall of some varieties of Kraft and Polly-O String Cheese and String Cheese Twists products because they might spoil before their “Best When Use By” code dates. Approximately 735,000 cases of the product will be affected throughout the United States, each with code dates between October 25, 2013 and February 11, 2014. Kraft announced the recall after receiving several reports of premature spoilage and ceasing the production and distribution of the questionable products. For full refunds, customers can return the products to the store where they were purchased or call Kraft Foods Consumer Relations at 1-800-816-9432 between 9 am and 6 pm (Eastern). Read more on food safety.
FDA Recommends Tighter Regulations for Hydrocodone
The U.S. Food and Drug Administration (FDA) is recommending that products that contain hydrocodone be reclassified more restrictively, possibly putting them in the Schedule II category that already includes other opioid painkillers such as oxycodone and morphine. Products that contain less than 15 milligrams of hydrocodone, such as Vicodin, are currently classified as Schedule III controlled substances. The change would mean patients would need to present a written prescription at a pharmacy and could not get as many refills before returning to their doctors for a new prescription. While this would help limit access by addicts, these greater restrictions would also affect people with legitimate chronic pain, potentially placing undue hardship on their already painful conditions. The Drug Enforcement Agency (DEA) is pushing for the restrictions in an effort to combat the increasing problem of prescription drug abuse;
the change must be approved by the U.S. Department of Health and Human Services and the DEA, which will make a final scheduling decision. This Saturday is also National Prescription Drug Take-Back Day, sponsored by the DEA, when people can anonymously and safely dispose of expired or unused prescription medicines. Read more on prescription drugs.
ONC Releases New Online Security Tool for Disaster Preparedness
The Office of the National Coordinator for Health Information Technology (ONC), part of the U.S. Department of Health and Human Services, has released a new online security training tool to help health care providers and staff with contingency planning in the case of power outages, floods, fires, hurricanes or other events. Such events can damage important patient information, or even make it unavailable. "We know from recent experiences such as Hurricane Sandy, that these events can very adversely impact the delivery of health care," said ONC Chief Privacy Officer Joy Pritts. "We hope that this video game will raise awareness of contingency planning and help practices begin to develop their own disaster plans, backup and recovery processes and other vital activities." The "CyberSecure: Your Medical Practice” tool is available here. Read more on disasters.
Study: Kids with Concussion at Higher Risk for Depression
Children with concussions or other head injuries are at increased risk of later being diagnosed with depression, according to new findings to be presented today at the American Academy of Pediatrics national conference in Orlando, Fla. Researchers found that about 15 percent of children and teenagers who ever suffered a brain injury were later diagnosed with depression, compared to the national average of 4 percent. While the findings did not determine causation, they do suggest that doctors should make assessments or mood and behavior problems part of and follow-up treatment for head injuries. Read more on mental health.
New NIH Study to Look at House-to-House HIV Testing, Other Measures, to Reduce HIV Burden in Africa
A study in South Africa and Zambia is assessing whether house-to-house voluntary HIV testing and prompt treatment of HIV infection, along with other proven HIV prevention measures, can substantially reduce the number of new HIV infections across communities. The trial is funded primarily by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), administered by the Office of the Global AIDS Coordinator. “Through this new study, we aim to learn whether the treatment of HIV-infected individuals as a form of HIV prevention, an approach previously tested in roughly 1,800 heterosexual couples where one partner was infected, will be just as effective when implemented across an entire adult population,” said NIAID Director Anthony S. Fauci, MD. “The study also will tell us whether this method of delivering population-wide HIV treatment as prevention is feasible and cost-effective.” The trial is being conducted in South Africa and Zambia because the HIV prevalence in those countries is among the highest in the world. An estimated 12.5 percent of adults in Zambia and 17.3 percent of adults in South Africa are infected. The study team will measure the impact of the two HIV prevention packages by determining the number of new HIV infections among a representative sample of 52,500 adults drawn from the 21 study communities and followed for three years. The study is expected to end in 2019. Read more on AIDS.
Study: Better Awareness Likely Reason for Increase in ER Visits for Youth Concussions
Improved awareness of the signs and symptoms of traumatic brain injuries (TMI)—such as concussions—is likely the cause of a noticeable increase in TMI-related emergency department visits by children, according to a new study from doctors at the Cincinnati Children's Hospital Medical Center. The study appeared in the journal pediatrics. Visits for these types of injuries climbed about 92 percent from 2002 to 2011, while the overall severity of the injuries decreased and the hospitalization rate remained at around 10 percent. "We are doing a better job at educating ourselves and educating the public about concussion," said Dr. Holly Hanson, lead study author and an emergency medicine fellow. "People and doctors are recognizing sports-related concussions more. People are recognizing the signs and symptoms. People are more aware of the complications. So people are coming in more." According to the U.S. Centers for Disease Control and Prevent, each year TMI accounts for about 630,000 emergency department visits, 67,000 hospitalizations and 6,100 deaths in children and teens annually. Read more on injury prevention.
HHS Developing New Burn Treatments to Improve Disaster Response, Daily Care
Through its Biomedical Advanced Research and Development Authority (BARDA), the U.S. Department of Health and Human Services (HUD) is working to develop five new types of burn treatments for disaster response and daily emergency medical care. The thermal burn medical countermeasures—which could take the form of drugs, vaccines or medical products—will be for chemical, radiological or nuclear incidents. Developing new measures is critical, because with only 127 burn centers in the country, a mass casualty event could quickly overwhelm the public health response. “Sustainability of these medical countermeasures for thermal burns is critical for their availability when they are needed most,” said BARDA Director Robin Robinson, PhD. “Our repurposing and multi-purpose strategy facilitates development, ensures availability, and reduces overall costs for thermal burn medical countermeasures.” Read more on disasters.
Public Health Law Research’s (PHLR) LawAtlas is a comprehensive content management tool that enables users to track and analyze key laws aimed at improving health and access to health care. From interactive law maps to policy surveillance reports to “reams” of digital data, it offers an expansive view of how health and the law are intersecting throughout the country. In fact, LawAtlas just today released two new data sets, one on Child Restraint Systems and one on Dental Hygienist Scope of Practice Laws.
NewPublicHealth spoke with Scott Burris, Director of PHLR’s National Program Office, and Damika Barr, Legal Analyst and LawAtlas Manager, about what LawAtlas means for the public health community—and their hopes for its future.
NewPublicHealth: What are you learning about the value of LawAtlas to the public health and law communities?
Scott Burris: I think there are two things that people really like about this. One is getting law as data. So, we take law and it’s a bunch of words that people in health often don’t want to cope with or don’t really appreciate. It’s not what they do. We turn it into data that they understand, that they can use, that fits right into their broader lifestyle, as it were. Meeting the needs of people doing epidemiology and science, that’s one part of it. The other part is just a great demand to see law laid out in this geographical way so that everyone can see what states have what laws and how any particular policy is progressing across the states.
Damika Barr: We’re finding that this is eye opening because you can finally see the dimensions of the law across jurisdictions over time with your own eyes, and it’s really easier for our researchers or the public health law communities and providers to see the dimensions as compared to looking at a long table with many columns. Researchers can start to ask more detailed questions or about more dimensions of the law than they would have if they were just limited to a table.
NPH: We’ve seen a couple of the ways that LawAtlas is being used already, including the study by Hosea Harvey that looked at youth sports concussion laws. What are some other innovative ways you’re seeing LawAtlas being used in research?
Burris: I think it’s not so much “innovative ways" as what important things can LawAtlas show us? LawAtlas in itself was an innovation in that it allows people to more efficiently code the characteristics of the law and more easily publicize it, but what we’ve learned in recent research is how you can answer important questions with it.
FDA Uses ‘Substantial Equivalence’ Standard to Authorize Two New Tobacco Products, Deny Four Others
The U.S. Food and Drug Administration (FDA) has, for the first time, utilized the substantial equivalence pathway to deny the marketing of four new tobacco products and allow the marketing of two new ones. FDA was granted the authority under the Family Smoking Prevention and Tobacco Control Act of 2009. Manufacturers can seek approval of new products by showing they are substantially equivalent to other tobacco products currently on the market. “Today’s decisions are just the first of many forthcoming product review actions to be issued,” said Mitch Zeller, JD, director of the FDA's Center for Tobacco Products. “The FDA is committed to making science-based decisions on all product applications and providing the agency’s scientific rationale behind its actions to ensure the most transparent and efficient process possible for all involved parties, according to the law.” Read more on tobacco.
Daily Contacts Leave Kids, Teachers, Health Care Workers at Highest Flu Risk
Children, teachers and health care workers are at the greatest risk of catching and transmitting influenza, according to a new study in the journal Proceedings of the Royal Society B. The study utilizes online and mail surveys to analyze the daily social contacts of more than 5,000 people. "People working as teachers or health professionals are no doubt already aware that they have higher risks of picking up bugs like colds and flu. But before this study there was very little data mapping out the contact patterns humans have in their daily life," said Leon Danon, from the Mathematics Institute at the University of Warwick, England, in a release. "By quantifying those social interactions, we can better predict the risks of contracting and spreading infections and ultimately better target epidemic control measures in the case of pandemic flu, for example.” Researchers recommend the people at greatest risk be especially careful to wash their hands with soap and water; maintain clean surfaces; and use tissues when needed. Read more on influenza.
New Study Paints Larger Picture on Adolescent Concussions
New research on youth concussions gives a broader picture of the “silent epidemic” and shows that kids who smoke and drink are at increased risk. The study appears in the Journal of the American Medical Association. Canadian researchers found that about 20 percent of approximately 9,000 Ontario adolescents who were surveyed had suffered from a concussion. About half were related to sports, but they also found that teens who smoked marijuana or consumed alcohol were at three-to-five times higher risk. "This is the first study I'm aware of that looked at the general population," said Kenneth Podell, co-director of the Methodist Concussion Center at the Methodist Hospital System in Houston. U.S. emergency departments treat about 173,000 adolescents annually for traumatic brain injuries, which includes concussions, according to the U.S. Centers for Disease Control and Prevention. Read more on injury prevention.
Racial and Ethnic Minorities Face Greater Subtle Housing Discrimination
Blatant acts of housing discrimination faced by minority prospective home buyers are declining in the United States, but more subtle forms of housing denial persist, according to a new study by the U.S. Department of Housing and Urban Development (HUD) and the Urban Institute. The study found that African-Americans, Hispanics and Asians learn about fewer housing options than equally qualified whites. According to the study, which sent out pairs of “mystery home buyers” — one white and one minority — to contact real estate agents and rental housing providers, the minority pairs were recommended and shown fewer available homes and apartments, which can increase their costs and restrict housing options, according to HUD. “Fewer minorities today may be getting the door slammed in their faces, but we continue to see evidence of housing discrimination that can limit a family’s housing, economic and educational opportunities,” said HUD Secretary Shaun Donovan. Read more on housing.
After Second or Third Concussion Kids Take Longer to Recover
Children and adolescents who suffer a concussion have a much longer recovery time if they have had a concussion in the past, according to a new study in Pediatrics. The study authors evaluated 280 patients between the ages of 11 and 22 who were treated for concussion symptoms in emergency departments. Children who had a second concussion within a year had nearly three times the average duration of symptoms compared to children whose concussions occurred more than one year apart. The number of previous concussions also affected recovery time. Two or more prior concussions resulted in a much longer duration of symptoms compared to those who experienced no or one previous concussion. Other factors that resulted in a longer recovery time included being age 13 or older and having more severe symptoms at the time of the emergency room visit. Read more on injury prevention.
Hearing Loss in Seniors Can Increase Hospitalizations and Poor Health
A new study published in JAMA finds that seniors with hearing loss are at increased risk for hospitalization, illness, injury and depression. The study authors reviewed records of more than 1,000 men and women age 70 and older with hearing loss, finding that over a four-year period they were 32 percent more likely to have been admitted to the hospital than a comparison group the same age with normal hearing. The hearing-impaired seniors in the study were also 36 percent more likely to have extended stretches of illness or injury and 57 percent more likely to have extended episodes of stress, depression or bad mood. According to the researchers, hearing loss affects two-thirds of men and women aged 70 and older. Among their recommendations to reduce the health burdens of hearing loss are expanding Medicare and Medicaid reimbursement for hearing-related services; increased installation of amplification technology in more facilities; and more accessible and affordable approaches for treating hearing loss. Read more on aging.
As we learn more about the long-term effects of traumatic brain injuries (TBI), the public health focus is increasingly on prevention in youth sports. A recent study funded by the Robert Wood Johnson Foundation and published in the American Journal of Public Health found that while 44 states and Washington, D.C., have enacted youth sport TBI laws, they all deal with identifying and responding to the injuries—not preventing them.
NewPublicHealth recently spoke with Robert Faherty, VP and Commissioner of the Babe Ruth League Inc., about what the baseball league in particular—and youth sports in general—are doing to improve the prevention of and response to traumatic brain injuries. The league includes about 1 million players across its Cal Ripken and Babe Ruth divisions.
>>Read more in a related Q&A with the author of the youth sports TBI law study.
NewPublicHealth: How is the Babe Ruth League working to prevent primary traumatic brain injuries in youth baseball?
Robert Faherty: One of the things that we really pride ourselves on— and, first of all, our organizations are entirely made up of volunteers, from the league administration level right down to the coach—is providing that league with the best insurance program we possibly can. Through Babe Ruth League, you have the opportunity to buy accident, or liability insurance. That's because we wanted to make sure that there would be no reason that a player wouldn’t go get checked out or a league wouldn’t send a player to a doctor or to an emergency room. We weren’t worried about the parents having insurance, we weren’t worried about somebody’s liability being in question—you can go to the doctor and have it covered.
The second part of that would be our ongoing attempt to educate and prevent injuries right down to the simplest practices. In our coaching certification and coaching education courses, which are mandated, not only are there safety issues that we include that in our score books that we provide to the teams, but it’s also the smallest things about how to run a practice. One of the most common injuries is being hit by a baseball, but it’s not the batter being hit by a baseball or a fielder being hit by a baseball—it’s an overthrow by kids warming up improperly, and not throwing all in the same direction.