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AdChoices HTTP/1.1 301 Moved Permanently Date: Mon, 21 Dec 2015 08:11:11 GMT Server: gwiseguy/2.0 Location: /watch?vO9ZUy461Kh0 Content-Length: 0 Content-Type: text/html X-XSS-Protection: 1; modeblock X-Frame-Options: SAMEORIGIN HTTP/1.1 301 Moved Permanently Date: Mon, 21 Dec 2015 08:11:11 GMT Server: gwiseguy/2.0 Expires: Tue, 27 Apr 1971 19:44:06 EST Cache-Control: no-cache Content-Type: text/html; charsetutf-8 Content-Length: 0 X-Content-Type-Options: nosniff Location: /watch?vO9ZUy461Kh0 X-XSS-Protection: 1; modeblock; /appserve/security-bugs/log/youtube X-Frame-Options: SAMEORIGIN Visit /10766 to get additional information about this book, to purchase it in publications, or download becoming a free PDF. Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Improving the Science, Changing the Culture Board on Children, Youth, and Families Robert Graham, Frederick P. Rivara, Morgan A. Ford, and Carol Mason Spicer, Editors Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001 NOTICE: The project that may be the subject in this report was authorized by the Governing Board from the National Research Council, whose members are drawn from your councils on the National Academy of Sciences, the National Academy of Engineering, along with the Institute of Medicine. The members from the committee to blame for the report were chosen for his or her special competences is actually regard for appropriate balance. This study was based on contracts relating to the National Academy of Sciences plus the Centers for Disease Control and Prevention CDC 200-2011-38807; the CDC Foundation Unnumbered Award with support in the National Football League; the Department of Defense HT0011-12-C-0023; the Department of Education ED-OSE-12-P-0049; the Health Resources and Services Administration HHSH250200976014I; the National Athletic Trainers Association Research and Education Foundation 0512SETGRANT; as well as the National Institutes of Health HHSN263201200074I. Any opinions, findings, conclusions, or recommendations expressed on this publication are those from the authors , nor necessarily reflect the views in the organizations or agencies that provided support with the project. Additional copies in this report are for sale to sale through the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; 800 624-6242 or 202 334-3313; For more specifics of the Institute of Medicine, look at the IOM home-page at: Copyright 2014 through the National Academy of Sciences. All rights reserved. The serpent is a symbol of longevity, healing, and knowledge among virtually all cultures and religions since the beginning of recorded history. The serpent adopted like a logotype through the Institute of Medicine can be a relief carving from ancient Greece, now held from the Staatliche Museen in Berlin. Suggested citation: Institute of Medicine IOM and National Research Council NRC. 2014. Sports-related concussions in youth: Improving the science, changing the culture. Washington, DC: The National Academies Press. Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Advisers towards the Nation on Science, Engineering, and Medicine The National Academy of Sciences is usually a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated on the furtherance of technology and science and to their use with the general welfare. Upon the authority from the charter granted to it from the Congress in 1863, the Academy includes a mandate that really needs it to advise government entities on scientific and technical matters. Dr. Ralph J. Cicerone is president from the National Academy of Sciences. The National Academy of Engineering was established in 1964, beneath the charter with the National Academy of Sciences, like a parallel organization of outstanding engineers. It is autonomous rolling around in its administration as well as in the selection of its members, sharing using the National Academy of Sciences the load for advising government entities. The National Academy of Engineering also sponsors engineering programs geared towards meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. C. D. Mote, Jr., is president from the National Academy of Engineering. The Institute of Medicine was established in 1970 with the National Academy of Sciences to secure the help of eminent folks appropriate professions from the examination of policy matters pertaining towards the health in the public. The Institute acts beneath the responsibility given on the National Academy of Sciences by its congressional charter for being an adviser to your federal government and, upon a initiative, to recognize issues of health care bills, research, and education. Dr. Harvey V. Fineberg is president from the Institute of Medicine. The National Research Council was organized with the National Academy of Sciences in 1916 to associate the broad community of technology with the Academy s reasons like furthering knowledge and advising the government. Functioning relative to general policies determined with the Academy, the Council is one of the principal operating agency of the National Academy of Sciences plus the National Academy of Engineering in providing services on the government, the general public, along with the scientific and engineering communities. The Council is administered jointly by both Academies plus the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. C. D. Mote, Jr., are chair and vice chair, respectively, from the National Research Council. Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 This page intentionally left blank. Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 ROBERT GRAHAM Chair, Director, National Program Office, Aligning Forces for Quality, and Research Professor of Health Policy, School of Public Health and Health Services, George Washington University, Washington, DC FREDERICK P. RIVARA Vice Chair, Seattle Children s Guild Endowed Chair in Pediatrics and Professor, Pediatrics, School of Medicine, University of Washington, Seattle KRISTY B. ARBOGAST, Engineering Core Director, Center for Injury Research and Prevention, Children s Hospital of Philadelphia, and Associate Professor of Pediatrics, University of Pennsylvania DAVID A. BRENT, Academic Chief, Child and Adolescent Psychiatry, Western Psychiatric Institute and Clinic, and Professor of Psychiatry, Pediatrics, and Epidemiology, School of Medicine, University of Pittsburgh B. J. CASEY, Sackler Professor of Developmental Psychobiology and Director, Sackler Institute for Developmental Psychobiology, Weill Medical College of Cornell University, New York, New York TRACEY COVASSIN, Associate Professor of Kinesiology and Undergraduate Athletic Training Program Director, Michigan State University, Lansing JOE DOYLE, former Regional Manager, American Development Model, Rocky Mountain and Pacific Districts, USA Hockey, Colorado Springs, Colorado ERIC J. HUANG, Professor of Pathology and Neuropathology, Department of Pathology, School of Medicine, University of California, San Francisco ARTHUR C. MAERLENDER, Director, Pediatric Neuropsychological Services, and Assistant Professor, Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire SUSAN S. MARGULIES, George H. Stephenson Professor in Bioengineering, Department of Bioengineering, University of Pennsylvania, Philadelphia DENNIS L. MOLFESE, Mildred Francis Thompson Professor and Director, Center for Brain, Biology, and Behavior, Department of Psychology, University of Nebraska, Lincoln MAYUMI L. PRINS, Associate Professor in Residence and Director, Brain Injury Research Center Education Program, David Geffen School of Medicine, University of California, Los Angeles Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 NEHA P. RAUKAR, Assistant Professor of Emergency Medicine, and Director, Division of Sports Medicine, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island NANCY R. TEMKIN, Professor, Departments of Biostatistics and Neurological Surgery, University of Washington, Seattle KASISOMAYAJULA VISWANATH, Associate Professor of Social and Behavioral Sciences, Harvard School of Public Health, and Director, Health Communication Core, Dana-Farber/Harvard Cancer Center, Boston, Massachusetts KEVIN D. WALTER, Associate Professor, Departments of Orthopaedic Surgery and Pediatrics, Medical College of Wisconsin, Milwaukee JOSEPH L. WRIGHT, Senior Vice President, Community Affairs, Children s National Medical Center, and Professor of Pediatrics Vice Chair, Emergency Medicine and Health Policy, George Washington University, Washington, DC MORGAN A. FORD, Study Director CAROL MASON SPICER, Associate Program Officer WENDY KEENAN, Program Associate through April 2013 SAMANTHA ROBOTHAM, Senior Program Assistant PAMELLA ATAYI, Administrative Assistant KIMBER BOGARD, Director, Board on Children, Youth, and Families Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 This report is reviewed in draft form by individuals chosen for his or her diverse perspectives and technical expertise, according to procedures licensed by the National Research Council s Report Review Committee. The purpose on this independent review would be to provide candid and critical comments that may assist the institution for making its published report as sound as possible and also to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness on the study charge. The review comments and draft manuscript remain confidential to shield the integrity in the deliberative process. We wish saying thanks to the following individuals because of their review in this report: Gordon Bloom, McGill University R. Dawn Comstock, University of Colorado, Denver Joseph J. Trey Crisco, Brown University John DiFiori, University of California, Los Angeles Corey S. Goodman, venBio LLC Michael V. Johnston, Johns Hopkins University Matthew W. Kreuter, Washington University Brad G. Kurowski, University of Cincinnati Karen McAvoy, Rocky Mountain Youth Sports Medicine Institute Tamara C. Valovich McLeod, Still University Barclay Morrison, Columbia University Cara Camiolo Reddy, University of Pittsburgh Thomas L. Schwenk, University of Nevada Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 CAPT Jack W. Tsao, Uniformed Services University on the Health Sciences Keith O. Yeates, Nationwide Children s Hospital Although the reviewers in the above list have provided many constructive comments and suggestions, these were not motivated to endorse the conclusions or recommendations nor did they view the final draft from the report before its release. The review with this report was overseen by Bradford H. Gray, The Urban Institute, and Floyd E. Bloom, The Scripps Research Institute. Appointed with the National Research Council as well as the Institute of Medicine, they were accountable for making certain that the independent examination with this report was carried out prior to institutional procedures and this all review comments were carefully considered. Responsibility with the final content in this report rests entirely while using authoring committee along with the institution. Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 The Institute of Medicine-National Research Council IOM-NRC Committee on Sports-Related Concussions in Youth and it is supporting staff thank the colleagues, organizations, and agencies that shared their expertise and data during the committee s information-gathering meetings see Appendix A to the names in the speakers. Their contributions informed the committee s deliberations and enhanced the quality with this report. The study sponsors gladly provided information and answered questions. The committee also thanks the National Collegiate Athletic Association along with the Datalys Center for Sports Injury Research and Prevention, Inc., and Dawn Comstock University of Colorado, Denver for answering and adjusting questions and providing concussion incidence data for use inside committee s report. The IOM-NRC staff, including board director Kimber Bogard, study director Morgan Ford, associate program officer Carol Mason Spicer, and also Wendy Keenan, Samantha Robotham, Pamella Atayi, Colin Fink, and Daniel Bearss, were central in shepherding the report though all of its stages. The committee would also like saying thanks to study consultant Stefan Duma Virginia Tech Wake Forest University, for preparing experience paper to tell the committee s deliberations about the effectiveness of helmets to cut back sports-related concussions in youth. The committee and staff extend their gratitude to Laura DeStefano, Nicole Joy, and Abbey Meltzer, IOM Office of Reports and Communications, and Jennifer Walsh, Office of News and Public Information, for his or her assistance with report release and communication activities. Last but not least, the committee and staff thank Clyde Behney, Interim Leonard D. Schaeffer Executive Officer with the IOM, for that guidance he provided throughout this important study. Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 This page intentionally left blank. Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 This page intentionally left blank. Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Boxes, Figures, and Tables Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 This page intentionally left blank. Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 Suggested Citation: Front Matter. Institute of Medicine and National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: The National Academies Press, 2014. doi:10.17226/18377 500 Fifth St., NW Washington, DC 20001 2015 National Academy of Sciences. All rights reserved. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture Get This Book MyNAP members save 10% online. In the last decade, few subjects for the intersection of drugs and sports have generated the maximum amount of public interest as sports-related concussions - especially among youth. Despite growing understanding sports-related concussions and campaigns to coach athletes, coaches, physicians, and parents of young athletes about concussion recognition and management, confusion and controversy persist in several areas. Currently, diagnosis is reliant primarily for the symptoms reported through the individual instead of on objective diagnostic markers, then there is little empirical evidence with the optimal degree and amount of physical rest was required to promote recovery or best timing and way for returning to full physical exercise. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture looks at the science of sports-related concussions in youth from elementary school through young adulthood, together with in military personnel along with their dependents. This report recommends actions which might be taken with a range of audiences - including research funding agencies, legislatures, state and school superintendents and athletic directors, military organizations, and equipment manufacturers, along with youth who get involved in sports along with their parents - to further improve what is known about concussions as well as reduce their occurrence. Sports-Related Concussions in Youth finds that while some studies provide useful information, much remains unknown in regards to the extent of concussions in youth; how you can diagnose, manage, and forestall concussions; along with the short- and long-term consequences of concussions and also repetitive head impacts which do not result in concussion symptoms. The culture of sports negatively influences athletes self-reporting of concussion symptoms along with their adherence to return-to-play guidance. Athletes, their teammates, and, occasionally, coaches and parents would possibly not fully appreciate the threats resulting from concussions. Similarly, military recruits are immersed within a culture that has devotion to duty and service before self, and also the critical nature of concussions may often go unheeded. According to Sports-Related Concussions in Youth, should the youth sports community can adopt the reality that concussions are serious injuries and emphasize look after players with concussions until they're fully recovered, then your culture through which these athletes perform and compete will end up much safer. Improving understanding on the extent, causes, effects, and prevention of sports-related concussions is vitally important for your health and well-being of youth athletes. The findings and recommendations within this report set a direction for research to attain this goal. Youre investigating OpenBook, s online reading room since 1999. Based on feedback within you, our users, weve made some improvements which render it easier than ever to read countless publications on our website. Do you would like to take an instant tour on the OpenBooks features? Show this books table of contents, where you are able to jump to your chapter by name. Jump up towards the previous page or down on the next one. Also, you are able to type in the page number and press to go instantly to that page within the book. Switch involving the Original Pages, where it is possible to read the report the way it appeared on the web, and Text Pages for your web version, where it is possible to highlight and check the text. To search your entire text of the book, enter your search term here and press Share a hyperlink to this book page on the preferred online community or via email. View our suggested citation with this chapter. Ready to look at your reading offline? Click here to get this book on the web or download it as a a free PDF, if available. Giants wide receiver Odell Beckham should be expecting a letter on the league inside the mail soon. The question is whether or not it will include greater than a fine and price him a game title check with an opportunity to play next Sunday night. A suspension can be a possibility after Beckham ran across this line of business and slammed There was obviously a lot of talking and fighting between Josh Norman and Odell Beckham within the field over the Panthers conquer the Giants. OBJ didn t would like to talk about it afterwards, but Norman was plenty willing to consider some shots with the press and via Twitter. To the victor goes the spoils. The Carolina After seeing their team blow a 28-point lead inside a quarter, some quarterbacks could be nervous about having to travel back for the field to win the experience with a last-minute drive. Not Cam Newton. The Carolina Panthers quarterback is very poised which he welcomes task. 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