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Relevance, credibility and plain covers 

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a reputable author, enough information/ evidence, relevance 

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Jenna Burl

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JM

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1) Specifically long titles                                2) Credibility from the author(s)               3) No advertisement nor decor                                                             -DB

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1) Specifically long titles                                2) Credibility from the author(s)               3) No advertisement nor decor                                                             -DB

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Concussions (Head injury)
college student athletes
prevention

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Concussions
Concussion prevention
Long term concussion impacts
College student athletes
Student athletes

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concussions
college athletes
long term impact
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JM

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concussions
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Psychology of student athletes
Student attitudes
Concussions

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Association between Altered Cortisol Profiles and Neurobehavioral Impairment after Mild Traumatic Brain Injury in College Students

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Mind, Body and Sport: Post-concussion syndrome

https://www.ncaa.org/sports/2014/11/5/mind-body-and-sport-post-concussion-syndrome.aspx

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Mind, Body and Sport: Post-concussion syndrome

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Mind, Body and Sport: Post-concussion syndrome An excerpt from the Sport Science Institute’s guide to understanding and supporting student-athlete mental wellness

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concusssions
college student athletes
prevention

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long term impacts
concussions on college students
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Athlete
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concussions, brain damage; wearing helmets and protective gear

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concussions, brain damage; wearing helmets and protective gear

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Concussions
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The Influence of Socioeconomic Status and Academic Standing on Concussion-Reporting Intentions and Behaviors in Collegiate Athletes

The Influence of Socioeconomic Status and Academic Standing on Concussion-Reporting Intentions and Behaviors in Collegiate Athletes - Landon B. Lempke, Michelle L. Weber Rawlins, Melissa N. Anderson, L. Stephen Miller, Robert C. Lynall, Julianne D. Schmidt, 2021 (sagepub.com)

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Physicians' perspectives on Extreme Risk Protection Orders (ERPOs) in the clinical setting: Challenges and opportunities for gun violence prevention.

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Information backed up with sources

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Preliminary evidence from a prospective DTI study suggests a posterior‐to‐anterior pattern of recovery in college athletes with sports‐related concussion.

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Predicting Recovery Patterns After Sport-Related Concussion.

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Concussion
Head injury
Prevention
College Athlete
Student athlete

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Risk factors associated with concussions in a college student population

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https://www.mayoclinic.org/diseases-conditions/post-concussion-syndrome/symptoms-causes/syc-20353352

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Overview

Persistent post-concussive symptoms, also called post-concussion syndrome, occurs when concussion symptoms last beyond the expected recovery period after the initial injury. The usual recovery period is weeks to months. These symptoms may include headaches, dizziness, and problems with concentration and memory.

Concussion is a mild traumatic brain injury that usually happens after a blow to the head. It can also occur with violent shaking and movement of the head or body. You don't have to lose consciousness to get a concussion or experience persistent post-concussive symptoms. In fact, the risk of developing persistent post-concussive symptoms doesn't appear to be associated with the severity of the initial injury.

In most people, symptoms occur within the first seven to 10 days and go away within three months. Sometimes, they can persist for a year or more.

The goal of treatment after concussion is to effectively manage your symptoms.

Symptoms

Persistent post-concussive symptoms include:

Headaches

Dizziness

Fatigue

Irritability

Anxiety

Insomnia

Loss of concentration and memory

Ringing in the ears

Blurry vision

Noise and light sensitivity

Rarely, decreases in taste and smell

Post-concussion headaches can vary and may feel like tension-type headaches or migraines. Most often, they are tension-type headaches. These may be associated with a neck injury that happened at the same time as the head injury.

When to see a doctor

See a doctor if you experience a head injury severe enough to cause confusion or amnesia - even if you never lost consciousness.

If a concussion occurs while you're playing a sport, don't go back in the game. Seek medical attention so that you don't risk worsening your injury.

Causes

Some experts believe persistent post-concussive symptoms are caused by structural damage to the brain or disruption of the messaging system within the nerves, caused by the impact that caused the concussion.

Others believe persistent post-concussive symptoms are related to psychological factors. The most common symptoms - headache, dizziness and sleep problems - are similar to those often experienced by people diagnosed with depression, anxiety or post-traumatic stress disorder.

In many cases, both physical damage of brain trauma and emotional reactions to these effects play a role in the development of symptoms.

However, some research shows that certain factors are more common in people who develop persistent post-concussive symptoms compared with those who don't. These factors include a history of depression, anxiety, post-traumatic stress disorder, significant life stressors, a poor social support system and lack of coping skills.

More research is still needed to better understand how and why persistent post-concussive symptoms happen after some injuries and not others.

Risk factors

Risk factors for developing persistent post-concussive symptoms include:

Age. Studies have found increasing age to be a risk factor for persistent post-concussive symptoms.

Sex. Women are more likely to be diagnosed with persistent post-concussive symptoms, but this may be because women are generally more likely to seek medical care.

Prevention

The only known way to prevent the development of persistent post-concussive symptoms is to avoid the head injury in the first place.

Avoiding head injuries

Although you can't prepare for every potential situation, here are some tips for avoiding common causes of head injuries:

Fasten your seat belt whenever you're traveling in a car, and be sure children are in age-appropriate safety seats. Children under 13 are safest riding in the back seat, especially if your car has air bags.

Use helmets whenever you or your children are bicycling, roller-skating, in-line skating, ice-skating, skiing, snowboarding, playing football, batting or running the bases in softball or baseball, skateboarding, or horseback riding. Wear a helmet when riding a motorcycle.

Take action at home to prevent falls, such as removing small area rugs, improving lighting and installing handrails.

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Persistent post-concussive symptoms (Post-concussion syndrome) - Symptoms and causes

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Persistent post-concussive symptoms, also called post-concussion syndrome, occurs when concussion symptoms last beyond the expected recovery period after the initial injury. The usual recovery period is weeks to months. These symptoms may include headaches, dizziness, and problems with concentration and memory. Concussion is a mild traumatic brain injury that usually happens after a blow to the head.

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Traumatic Brain and Spinal Cord Fatalities Among High School and College Football Players - United States, 2005-2014.

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THE TWIN CRUSADES AGAINST DRUGS AND GUNS.

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Concussion Biomarkers Assessed in Collegiate Student - Athletes
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https://journals.lww.com/acsm-msse/Fulltext/2022/09002/Collegiate_Student_athletes__Initial_Perceptions.1339.aspx

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Collegiate Student-athletes’ Initial Perceptions Of An... : Medicine & Science in Sports & Exercise

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When Can Teens Go Back to Sports After a Concussion?

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As long as people play sports, there will be concussions from time to time. Find out how to protect yourself and when it's safe to return to sports after a concussion.

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https://www.thenationshealth.org/content/45/8/1.3

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NFL rookie Chris Borland made headlines this spring when the San Francisco 49ers linebacker announced he was quitting professional football after just one season, citing his concerns about the potential health risks of repetitive head injuries.

This summer, the University of Minnesota Golden Gophers announced that Olympic silver medalist Amanda Kessel would miss her final year of women's ice hockey due to a concussion she sustained playing for the women's national team.

More and more, head injuries and their long-term effects on athletes are at the forefront of the discussions surrounding sports and the implications for children who play them.

In 2010, the Centers for Disease Control and Prevention reported that traumatic brain injury, whether mild or severe, caused about 2.5 million emergency department visits, hospitalizations or deaths. Since then, that number has increased, though head injuries themselves might not have, said Steve Broglio, PhD, ATC, associate professor of kinesiology at the University of Michigan.

"The rates aren't going up; the reporting is going up, and the economic cost is growing, too," said Broglio, who is on staff at the University of Michigan Injury Center.

Traumatic brain injury, a disruption of normal brain function caused by a bump or blow to the head, often called a concussion, already has a significant cost. According to a study published in the May/June issue of the Journal of Head Trauma Rehabilitation, 2009 estimates showed that the lifetime cost of fatal, hospitalized and non-hospitalized traumatic brain injuries was about $221 billion. Those costs do not factor in lost days at school or work, or extended time spent on either due to long-term effects of head injury.

Public health advocates are stepping up to prevent traumatic brain injuries, or at least prevent their side effects, which include difficulty concentrating or thinking clearly, headaches, irritability, anxiety or sadness. Such injuries have also been linked to sleep issues, lethargy, vision problems and sensitivity to light. And they can include long-term risks for depression, epilepsy, Parkinson's disease, Alzheimer's disease and other health issues. According to the Boston University's Chronic Traumatic Encephalopathy Center, which conducts research through the university's Brain Bank in collaboration with U.S. Veterans Affairs and Sports Legacy Institute, the vast majority of former NFL players whose brains were donated for research showed signs of the degenerative disease linked to repeated concussions.

Part of the issue surrounding concussions, however, is the relative lack of research on them. Researchers do not know how many or which head injuries can lead to early-onset Alzheimer's disease, for example. High-profile cases have led the NFL, NHL and even NBA to enact concussion guidelines for players, but very few adults are professional athletes. However, millions of children play sports while growing up, said Larry Cohen, MSW, executive director of the Prevention Institute and an APHA member.

"While we need more research and more information, we can't let our kids be the guinea pigs while we figure it out," Cohen told The Nation's Health. "Kids' heads can't just be collateral damage."

To prevent serious injuries in student athletes, CDC launched Heads Up, a campaign to help parents, coaches, school professionals and health care providers recognize the signs of head injuries in young athletes. For example, the campaign provides fact sheets for the adults involved in children's sports, each targeting what adults can do to spot possible head injuries, particularly coaches, who have the most contact with children during games. The fact sheets are also broken up by children's ages, highlighting the importance of healing for young brains.

The campaign also outlines the importance of head injury prevention and the healing of concussions, as young athletes who have had one concussion are more likely to have another, according to CDC.

Heads Up campaign resources include online training courses, customizable materials, an app and public service announcements to share, as well as traumatic brain injury survivor stories.

Other programs are working to educate the players themselves. University of New Hampshire researcher Erik Swartz, PhD, ATC, won an NFL Head Health Challenges grant, part of a $3.5 million initiative to fight brain injuries, to study how helmetless practices could teach the school's football players to hit without using their heads.

The technique, called the Helmetless Tackle Training Technique, teaches players to hit while protecting their own heads, a practice that then carries over to games. The two-year research program will document the decrease in head injuries, as well as where impacts occur on players' heads.

Laws keep injured players off field

Over the past six years, head injury prevention has left the field and landed in the legislature. Washington was the first state to enact a Lystedt Law, named after Zackery Lystedt, a high school football player who was left with permanent disabilities after sustaining a concussion in 2006 and returning to the field too soon. Lystedt laws are designed to prohibit young athletes who sustain concussions from returning to the field until they get an all-clear from a medical professional.

Since Washington's law was enacted in 2009, every state in the U.S. has adopted some form of student-athlete concussion laws, said Teresa Gibson, PhD, senior director at Truven Health Analytics and faculty research associate at Harvard Medical School. Gibson, who has studied the effects of the laws and published her findings in research published online in December in JAMA Pediatrics, said that so far, the laws seem to be doing their job.

"The biggest thing that we found is that it seems like the legislation worked," Gibson said. "We saw an increase in office visits and neurologist visits. I think we're seeing a promising trend here with practices that pull kids out when they have a head injury, and making sure they're not going back in too early."

Broglio, who worked on the study with Gibson, also noted that changing the rules of contact sports could help decrease players' risks for head injury at any age. For example, the American Association of Pediatrics has called for hockey to ban body checking in players younger than 15. USA Hockey, the national governing body of the sport, raised the minimum age for checking from 11 to 13 for the 2011-12 season.

That is just a start for Cohen, who sees a need to change rules for professional athletes first. Some sports have already taken action. For example, while basketball has a low incidence of head injuries, the NBA enacted its concussion policy in the 2011-12 season.

The trickle-down effect from such rule changes will protect not only the relatively small number of professional athletes who play for a living, but the millions of young people who play sports across the country as well. Possible changes could include reducing or eliminating heading in soccer, Cohen suggested.

"If everybody plays the same way, it's still competitive," he said. "It wouldn't change the sport that much, but it would probably have a much more positive impact."

Many brain injury steps are reactive, meaning they protect players after they have already had a concussion. But some steps are being taken to stop head injuries before they happen.

Samuel Browd, MD, PhD, an APHA member, said better helmets could be the answer. Browd, an associate professor of neurological surgery at the University of Washington, attending pediatric neurosurgeon at Seattle Children's Hospital and medical director of Seattle Children's Sports Concussion Program, sees many childhood head injuries in his practice. Part of his job includes making decisions on when to recommend players give up a sport after a traumatic brain injury. Sometimes the end of a student athlete's career means scholarships are lost - and with them, access to a college education.

Helmet changes may be able to prevent head injuries, Browd suggested. It has been awhile since major innovations have been made in helmet equipment, he noted.

Browd has teamed up with Per Reinhall, PhD, the chair of the University of Washington's Department of Mechanical Engineering, and Dave Marver, MBA, a medical technology entrepreneur, to form Vicis, a company focused on building a better football helmet. By improving the foam and other materials to make a helmet, Browd said their product is now in prototype trials. Their helmets will be used in the NFL in the 2016-17 season, he added, and they hope to reduce concussion rates by 50 percent in a few years.

"If you reduce the force by 5 percent, you reduce risk by 40 percent," Browd said. "With pretty small reductions in force, you could have a pretty dramatic drop in the concussion rate."

For more information about CDC's Heads Up campaign, visit www.cdc.gov/headsup.
Editor's note: This article was corrected post-publication.

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Health advocates working to prevent athlete concussions: Student, professional players at risk

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NFL rookie Chris Borland made headlines this spring when the San Francisco 49ers linebacker announced he was quitting professional football after just one season, citing his concerns about the potential health risks of repetitive head injuries.

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https://uri-primo.hosted.exlibrisgroup.com/permalink/f/10nopmq/01URI_ALMA2141497550002396

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Mind, Body and Sport: Post-concussion  syndrome JB

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Mind, Body and Sport: Post-concussion  syndrome JB

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https://www.ncaa.org/sports/2014/11/5/mind-body-and-sport-post-concussion-syndrome.aspx

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Mind, Body and Sport: Post-concussion syndrome

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Mind, Body and Sport: Post-concussion syndrome An excerpt from the Sport Science Institute’s guide to understanding and supporting student-athlete mental wellness

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https://www.uofmhealth.org/conditions-treatments/brain-neurological-conditions/concussion-athletes-neurosport

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Concussions in athletes are extremely common. In fact, about 3.8 million concussions occur each year in the U.S. from sports-related injuries. The Center for Disease Control estimates that 5-10% of athletes will experience a concussion in any given sports season. Many of these injuries go unreported and undiagnosed, leading to mismanagement and premature return to activity. The mismanagement of concussion can lead to prolonged symptoms and long-term consequences. To learn about myths related to concussion see Concussion Myths below.

NeuroSport: Dedicated to Concussion in Athletes

The University of Michigan is one of only a handful of comprehensive programs in the country dedicated to the neurological concerns of athletes through its multidisciplinary NeuroSport program. The mission of U-M NeuroSport is to provide individualized care for athletes of all levels with an emphasis on acute concussion care and potential long-term consequences of mild head trauma. Visit the NeuroSport page to learn more about NeuroSport services and the Sports Neurology Fellowship and research.

For information about the Understanding Sport Related Concussion Teach-Out or the Michigan Concussion Training Certification (MOOC) offered in affiliation with the Michigan Concussion Center and NeuroSport, visit our Concussion Education page. You may also read the news release about the two programs on the University of Michigan News website.

For Athletes: What to Do if You Suspect a Concussion

It is important to be evaluated by a health care professional trained in the diagnosis and management of concussion. Do not try to judge the seriousness of the injury yourself. If an athlete is participating in sports at the time of the injury they should be removed from their game or practice and should be seen by a health care provider who is trained in the care of concussion. They should avoid any activities that would put them at risk of another head injury.

Before a youth athlete can return to sports they must be symptom-free and cleared by a healthcare provider as required by Michigan law. Learn more about Michigan Sports Concussion Law.

If you suspect a concussion, please contact NeuroSport at 734-930-7400 to be evaluated.

When to Go to the Emergency Room

Seek immediate medical attention or call 911 if you experience or witness any of the following symptoms:

Look drowsy or cannot be woken up

Headaches that severely worsen

Seizures

Slurred speech

Increasing confusion

Difficulty recognizing people or places

Loss of consciousness

Weakness or numbness

Persistent vomiting

Unusual behavior changes

Concussion Treatment and Recovery for Athletes

Recovery from concussion is a complex and dynamic process and includes three phases:

1. Acute symptomatic phase

2. Recovery phase

3. Recovered

If recovery is not properly managed it can lead to unnecessarily prolonged recovery. Management of recovery should be individualized and directed by a healthcare provider with expertise in concussion care who has ready access to treatment resources. For more detailed information about these phases and concussion recovery management, visit our Concussion Treatment and Recovery page.

Return-to-Play for Sport-Related Concussion

Return to physical activity and sports play should be gradual and determined by your doctor.

Once you are symptom-free without medications, you can start a Return-to-Play process (see below).A Return-to-Play evaluation should be completed before a full return to your sport. Making Return-to-Play decisions can be complex; therefore, it is essential to understand the sport in question as well as the risks it carries.

This progression should only be started with the guidance of a health care provider trained in the evaluation and management of concussion. The purpose of the process is to gradually place more difficult demands on the brain to help determine if you are ready to return to sport. Each stage of the Return-To-Play process must be completed without symptoms before moving to the next stage.
Graduated Return-to-Play Process by Stage

1. Relative Rest
Activity: Symptom-limited activities of daily living; light walking

Goal: Gradual reintroduction of activities involved with daily living and school or work

2. Sport-Specific Non-Contact Exercise

Activity: Progressive aerobic exercise with sports-specific activity (drills) without head impact. May start progressive resistance training.

Goal: Interval training by adding fluctuations in heart rate and adding cognitive activity while increasing movement

Note: An initial period of 24-48 hours of both relative physical rest and cognitive (thinking) rest is recommended before beginning the Return-to-Sport process. There should be at least 24 hours (or longer) for each step of the progression. If any symptoms get worse during exercise, you should go back to the previous step. Resistance training should be added only in the later stages (stage 3 or 4 at the earliest). If symptoms are persistent (10-14 days in adults or more than one month in children), you should go to a health care professional who is an expert in the management of concussion.

What Kind of Exercise Counts As Return-to-Play Activity?

Exercise performed while you are still experiencing symptoms from concussion should not be considered part of the Return-to-Play process. However, exercise you have performed without experiencing any symptoms can be used as a guide as to where to begin the Return-to-Play protocol. This should be determined by your doctor. Your ability to perform intense, supervised, sport-specific activities without symptoms can be used:

To help determine your progress in recovering from concussion

For guidance in the Return-to-Play protocol

Prolonged Recovery

About 10% to 30% of individuals have a recovery period that is considered a longer than normal (prolonged recovery). Many factors likely play a role in the development of prolonged recovery. One main factor may be the lack of recognition and treatment of causes of symptoms. In those suffering from prolonged recovery, it is critical to identify the factors causing symptoms and begin treatment for them.

Long-Term Complications of Repeated Mild Brain Trauma

There is a growing concern that concussions, or sub-concussive blows (repeated head impacts not severe enough to cause concussion), may cause or be a risk factor for developing complications later in life. It is clear, primarily from studies of retired boxers, that some people seem to have developed neurological problems secondary to repetitive mild head trauma in their athletic careers.

Researchers have also discovered microscopic brain changes in people exposed to repetitive mild head trauma. This condition is called CTE, or chronic traumatic encephalopathy. CTE is a pathologic diagnosis, meaning it can only be diagnosed after someone dies and their brain has been examined. The consequences of CTE in a person's life are unknown.

The Risk to Children Who Participate in Contact Sports

Studies have been done that have looked at the risk of long-term consequences in children who participate in contact and collision sports, but no long-term neurologic or psychiatric consequences have yet been identified.

Make an Appointment

To request an appointment or to get more information about Michigan NeuroSport, please call 734-930-7400 or send an email request to [email protected] , with your name and phone number, and a team member will get back to you within two business days to schedule an appointment for evaluation and treatment of your athlete.

Concussion Myths

Remember that healing takes time and that it is important to get adequate sleep, eat healthy, and drink plenty of water during your recovery. After a period of rest for 24-48 hours patients can gradually become more active, however, this should be directed by your physician.

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The University of Michigan is one of only a handful of comprehensive programs in the country dedicated to the neurological concerns of athletes through its multidisciplinary NeuroSport outpatient clinic.

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THE DAMAGE DONE. (cover story)

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https://yourteenmag.com/health/physical-health/an-updated-look-at-concussions

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Back to school means back to sports - and a risk for concussion. Your Teen asked Dr. Richard Figler, co-executive director of Cleveland Clinic's Concussion Center, for the latest on treating the condition.

Q: What has changed in concussion treatment in the past five years?

Figler: Probably the single biggest change is that there is much greater awareness, not only on the parts of athletes themselves but also parents and coaches. All fifty states now have laws to protect young athletes and to educate parents and coaches so that they can recognize concussion symptoms and remove those athletes from practice or competition. These laws have improved everyone's understanding of concussions and helped to educate athletes, parents, and coaches on how to recognize and respond to a potential brain injury.

Q: What early detection efforts are most effective?

Figler: Education and awareness are the best we have for early detection of the signs and symptoms of a concussion. Perhaps the most important tool is a symptom checklist that helps to monitor symptom recovery and guide treatment options. Another tool that can help is baseline testing-now standard in high schools-which helps to keep a record of an athlete's history with concussions.

We know that nearly every high school has an athletic trainer-but that trainer can't be at every practice for every sport. So coaches really are the key component for early detection. Studies show that sometimes kids are unaware they've been injured, or will intentionally hide symptoms because they don't want to leave the field or let their teammates down. We know that the brain begins the healing process right after injury, but there is a window of time immediately after an injury, when you can either assist in recovery, or potentially delay or lengthen recovery time depending upon how you respond. When a coach is aware of symptoms consistent with a concussion and pulls a kid from the field when they observe these symptoms, we typically see much less severe injuries and faster recovery times.

Q: Has there been an increase in the number of concussions in teenage athletes?

Figler: Well, the number of reported injuries has definitely increased because awareness is greater, but in all likelihood the number of injuries is probably about the same. People are simply more aware of symptoms now than in previous years and more likely to recognize when they have been injured.

Q: Have there been any changes in concussion treatment?

Figler: There has been a fairly big shift in treatment. The pendulum has swung away from completely shutting down all brain stimulation and avoiding noise, light, television, and reading because we have found that a completely inactive brain that receives no stimulation just stagnates. The model now is what we call "relative rest." We want these athletes to slow down or stop their activities to the point where they are symptom-free. If you stimulate the brain a little, while avoiding over-stimulating it, we find a more effective, faster recovery. So our new treatment model is: (1) recognize activities causing symptoms; (2) stop or slow down that activity; (3) rest and recover; and (4) return to activity when you are symptom-free.

Q: So concussed athletes no longer need to miss weeks of schools?

Figler: Hopefully not, but each case is treated individually. We want them to be as symptom-free as possible while they are doing their schoolwork at home. Once they can do this for about an hour or so with minimal to no symptoms, they can go back to school with some accommodations. They monitor their symptoms during the school day and take breaks as needed when they become symptomatic. We have found that the social isolation of the student athlete when they are away from school and their team for such a long period of time can cause increased stress and potentially delay their recovery. Remember, they are student athletes. We need to get them back in the classroom first as students. Then they can get back out to compete as athletes.

Q: What advice do you have for parents of concussed athletes?

Figler: Educate yourself. See a physician who is well-versed in managing symptoms of a concussion if there are any concerns. If you can recognize symptoms and catch injuries as soon as possible, your teen will typically recover more quickly.

Common Concussion Symptoms In Teenage Athletes

The most common symptom of a concussion is a headache. This is an especially serious symptom if the headache gets worse over time, which might mean that there is bleeding in the skull.

Other symptoms include:

nausea

balance problems/dizziness

double or blurry vision

sensitivity to light and noise

fatigue or drowsiness

changes in sleep patterns

trouble comprehending and/or concentrating

depression

irritability, nervousness, or sadness

feelings of being "just not right" or in a "fog"

Other danger signs are:

seizures

not knowing people or places

unusual behavior

Source: Cleveland Clinic

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Back to school means back to sports - and a risk for concussion. Your Teen asked Dr. Richard Figler, co-executive director of Cleveland Clinic's Concussion Center, for the latest on treating the condition. Q: What has changed in concussion treatment in the past five years?

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