Expert consensus document: Mind the gaps—advancing research into short-term and long-term neuropsychological outcomes of youth sports-related concussions

Sports-related concussions and repetitive subconcussive exposure are increasingly recognized as potential dangers to paediatric populations, but much remains unknown about the short-term and long-term consequences of these events, including potential cognitive impairment and risk of later-life dementia. This Expert Consensus Document is the result of a 1-day meeting convened by Safe Kids Worldwide, the Alzheimer\u27s Drug Discovery Foundation, and the Andrews Institute for Orthopaedics and Sports Medicine. The goal is to highlight knowledge gaps and areas of critically needed research in the areas of concussion science, dementia, genetics, diagnostic and prognostic biomarkers, neuroimaging, sports injury surveillance, and information sharing. For each of these areas, we propose clear and achievable paths to improve the understanding, treatment and prevention of youth sports-related concussions

Doping in two elite athletics competitions assessed by randomized-response surveys

BACKGROUND: Doping in sports compromises fair play and endangers health. To deter doping among elite athletes, the World Anti-Doping Agency (WADA) oversees testing of several hundred thousand athletic blood and urine samples annually, of which 1-2% test positive. Measures using the Athlete Biological Passport suggest a higher mean prevalence of about 14% positive tests. Biological testing, however, likely fails to detect many cutting-edge doping techniques, and thus the true prevalence of doping remains unknown. METHODS: We surveyed 2167 athletes at two sporting events: the 13th International Association of Athletics Federations Word Championships in Athletics (WCA) in Daegu, South Korea in August 2011 and the 12th Quadrennial Pan-Arab Games (PAG) in Doha, Qatar in December 2011. To estimate the prevalence of doping, we utilized a "randomized response technique," which guarantees anonymity for individuals when answering a sensitive question. We also administered a control question at PAG assessing past-year use of supplements. RESULTS: The estimated prevalence of past-year doping was 43.6% (95% confidence interval 39.4-47.9) at WCA and 57.1% (52.4-61.8) at PAG. The estimated prevalence of past-year supplement use at PAG was 70.1% (65.6-74.7%). Sensitivity analyses, assessing the robustness of these estimates under numerous hypothetical scenarios of intentional or unintentional noncompliance by respondents, suggested that we were unlikely to have overestimated the true prevalence of doping. CONCLUSIONS: Doping appears remarkably widespread among elite athletes, and remains largely unchecked despite current biological testing. The survey technique presented here will allow future investigators to generate continued reference estimates of the prevalence of doping

Prevalence of Use of Performance-Enhancing Substances Among United States Adolescents

Adolescents may regard the use of performance-enhancing substances as an easy means to gain self-esteem through improved body appearance and athletic performance. The use of performance-enhancing substances by adolescents is particularly troubling because safety data are largely lacking. This poses a dilemma for the pediatrician who needs correct information, including the potential efficacy and negative health effects of such substances, to identify the patients in need of counseling and to find the best way to help adolescent patients make informed decisions to promote healthy behaviors. This article is intended to assist pediatricians by providing a summary of the current state of knowledge regarding the prevalence of use of performance-enhancing substances by United States adolescents

How Healthy Is Camp? Exploring Early Results From the Surveillance Study of Injuries and Illness

This article explores what was learned from the Healthy Camp Study during the first two years of the study (summers of 2006 and 2007). Although we\u27ll have a more complete picture after the next three years of the study, we are already gaining important information about where camps might target prevention efforts. Before you read about these results, think about how your camp currently benefits from this exciting study. Have you participated in either or both of the past two summers? Did you know that participation is free and that you can still enroll for next summer? Did you know that you don\u27t have to be ACA accredited or be affiliated in any particular way in order to participate? Did you know that participating camps receive a detailed injury-illness report that they can use as a risk-management tool

Epidemiology of Injuries in United States High School Track and Field: 2008-2009 Through 2013-2014

Background: Track and field is one of the most popular high school sports among boys and girls, but epidemiological research on the sport and its individual events has been limited. Purpose: To describe injury rates and patterns in boys’ and girls’ high school track and field. Study Design: Descriptive epidemiology study. Methods: A retrospective epidemiological analysis of injury and exposure data from a longitudinal national high school sports injury surveillance system was conducted. Results: From 2008-2009 through 2013-2014, 2485 track and field injuries occurred during 2,962,308 athlete exposures (0.84 injuries per 1000 athlete exposures). Injury rates were higher in competition versus practice for both sexes. Girls had higher injury rates than boys overall (rate ratio, 1.37; 95% CI, 1.27-1.48) and in practice (rate ratio, 1.60; 95% CI, 1.46-1.76), but competition injury rates did not differ. Overuse/chronic injuries accounted for 27.5% and 36.2% of boys’ and girls’ track and field injuries, respectively. The majority of injuries were to the lower extremity. Sprints, distance running, and jumps accounted for over 65% of all track injuries. Boys sustained a greater proportion of injuries in relay events (injury proportion ratio, 2.02; 95% CI, 1.69-2.36) but fewer in hurdle events (injury proportion ratio, 0.51; 95% CI, 0.23-0.78). Conclusion: Injury rates varied by event, sex, and competition versus practice exposure. To increase effectiveness, targeted strategies for injury prevention should be driven by an understanding of such differences. Because many track and field injuries are overuse/chronic across sexes and for both competitions and practices, coaches and athletic trainers should be adept at recognizing early injury symptoms, intervene to treat minor injuries in order to prevent severe injuries, and ensure the prompt diagnosis and management of all injuries

Epidemiology Of Meniscal Injuries In US High School Boys' Football, Ice Hockey, and Lacrosse

Describe the epidemiology of meniscal injuries in US high school boys' football, ice hockey, and lacrosse. High school sports-related injury data was collected from 2008/09-2010/11 for boys' football, ice hockey, and lacrosse. We calculated overall injury rates, meniscal injury rates, and rate ratios. From 2008/09-2010/11, certified athletic trainers reported a total of 7902 football, 528 ice hockey, and 758 lacrosse injuries during 2,065,536 football athlete exposures [AEs], 220,974 ice hockey AEs, and 339,971 lacrosse AEs. Overall injury rates were 3.83 per 1000 AEs in football, 2.39 in ice hockey, and 2.23 in lacrosse. Competition injury rates were significantly higher than practice for football (12.3 vs. 2.12 per 1000 AEs; RR 5.79, 95% CI 5.54-6.05), ice hockey (5.84 vs. 0.75 per 1000 AEs; RR 7.81, 95% CI 6.34-9.62), and lacrosse (4.40 vs. 1.27 per 1000 AEs; RR 3.47, 95% CI 3.00-4.01). Knee injuries accounted for 15.4% of all injuries in these sports, and 8.3% of all knee injuries involved the meniscus