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Buckley TA, Passalugo SW, Gallo CA, Bodt B, Evans KM, Munkasy BA. Collegiate student-athletes concussion knowledge and attitudes: what a difference a decade Makes. Brain Inj 2024; 38:288-294. [PMID: 38369869 PMCID: PMC10911450 DOI: 10.1080/02699052.2024.2314549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 01/31/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVE The purpose of this study was to assess changes in concussion knowledge and attitudes amongst incoming intercollegiate student-athletes over the course of a decade (2010-2012 vs 2021-2023). METHODS There were 592 student-athletes from 2 cohorts (2010-2012, 2021-2023) who completed the Rosenbaum Concussion Knowledge and Attitudes Survey (ROCKaS) questionnaire which is comprised of a concussion knowledge index (CKI, 0-24) and attitude index (CAI, 15-75) with higher scores reflecting better performance. A three factor ANOVA (Group, Sex, Concussion History) compared performance on the CKI and CAI. Individual questions were compared between groups with a Chi-Square analysis. RESULTS For the CKI, there was a significant main effect for Group (2010-2012: 18.5 ± 2.6, 2021-2023: 19.4 ± 2.5, p < 0.001, η 2 = 0.032 ) . For the CAI, there was also a significant main effect for group (2010-2012: 52.9 ± 6.0, 2021-2023: 62.2 ± 6.5, p < 0.001, η 2 = 0.359 ) . CONCLUSIONS The results of this study show a modest increase in concussion knowledge; however, large improvements in concussion attitudes were observed between groups. These results suggest a continued improvement in student-athlete concussion awareness and provide specific areas to continue addressing persistent misconceptions.
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Affiliation(s)
- Thomas A Buckley
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, USA
- Interdisciplinary Program in Biomechanics and Movement Science, University of Delaware, Newark, Delaware, USA
| | - Scott W Passalugo
- Interdisciplinary Program in Biomechanics and Movement Science, University of Delaware, Newark, Delaware, USA
| | - Caitlin A Gallo
- Interdisciplinary Program in Biomechanics and Movement Science, University of Delaware, Newark, Delaware, USA
| | - Barry Bodt
- College of Health Sciences, University of Delaware, Newark, Delaware, USA
| | - Kelsey M Evans
- Department of General Surgery, Orlando Health, Orlando, Florida, USA
| | - Barry A Munkasy
- School of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, Georgia, USA
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2
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Gordon KE, Kuhle S. Canadians Reporting Sport-Related Concussions: Increasing and Now Stabilizing. Clin J Sport Med 2022; 32:313-317. [PMID: 32956100 DOI: 10.1097/jsm.0000000000000888] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/10/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Canada is currently engaged in a national harmonization of strategies to prevent and manage sport-related concussions. OBJECTIVE To examine the annual incidence rates of reported sport-related concussions or other brain injuries by participants in the Canadian Community Health Survey, a national public health survey which provides nearly 2 decades of serial data using consistent methodology. DESIGN Serial cross-sectional survey. SETTING Population-based Canadian survey from 2000 to 2018 that collects data on "concussions or other brain injuries." PARTICIPANTS Respondents 12 years and older. INDEPENDENT VARIABLES Sex and age categorized 12 to 14 years, 15 to 19 years, 20 to 29 years, and 30+ years. OUTCOME MEASURES National incidence rates of participants reporting concussions or other brain injuries occurring within the previous year while engaged in "organized sports/leisure sports or physical exercise." RESULTS Data were available for 2000/01, 2003, 2005/6, 2009/10, 2013/4, and 2017/8 (N = 757 383). A previously stable annual incidence of reported sport-related concussions or other brain injuries increased nearly 2 and a half-fold from 2005/06 through 2013/14 (P < 0.0001) but seems to have stabilized recently (2013/14 vs 2017/8, P = 0.35). This trend is similar for both men and women but is manifest primarily within youth (12-19 years) as opposed to adults (>19 years). Approximately 1 in 450 Canadians 12 years and older report sport-related concussions or other brain injuries as their most significant injury associated with disability in the previous year (2017-2018: 221 per 100 000 population, 95% confidence interval: 179-264). CONCLUSIONS In Canada, the annual incidence rates of reported sport-related concussions or other brain injuries is changing and may reflect improved reporting and recognition.
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Affiliation(s)
- Kevin E Gordon
- Division of Pediatric Neurology, Department of Pediatrics; and
| | - Stefan Kuhle
- Perinatal Epidemiology Research Unit, Department of Pediatrics and Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, Nova Scotia
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3
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Risk Factors Based on Analysis of Injury Mechanism and Protective Equipment for Ice Hockey Amateur Players. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074232. [PMID: 35409913 PMCID: PMC8998423 DOI: 10.3390/ijerph19074232] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/21/2022] [Accepted: 03/31/2022] [Indexed: 02/04/2023]
Abstract
Considering the increasing popularity of ice hockey in South Korea, types of injuries and protective equipment for amateur club members need to be further studied. The purpose of the study is to investigate various injuries and protective equipment used by amateur players and to analyze different risk factors by collecting information on areas of injury and their mechanisms. The online survey for 102 participants was designed to address the general information of participants, types of injuries, information about ice hockey equipment, and open-ended questions about injuries and equipment. We conducted in-depth face-to-face interviews with five players about their experiences with injury and opinions about the protective equipment. In total, 60% of the survey participants had experienced injuries, including to the knee (22.6%), shoulder (21.6%), ankle (20.6%), and wrist (14.7%), in order of frequency. Types of injury included sprain (33.3%), contusion (31.4%), fracture (17.7%), abrasion (10.8%), and concussion (0.9%). Injury mechanisms included instances in which those with less proficiency in skating would be injured initially from player-to-player contact, and from landing on the ice or crashing into the fence afterward. We acknowledged how important wearing correctly sized equipment is for protection, and we highlighted the need to develop protective gear that accommodates Asian body measurements.
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Neurotrophins Time Point Intervention after Traumatic Brain Injury: From Zebrafish to Human. Int J Mol Sci 2021; 22:ijms22041585. [PMID: 33557335 PMCID: PMC7915547 DOI: 10.3390/ijms22041585] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 01/25/2021] [Accepted: 02/02/2021] [Indexed: 12/14/2022] Open
Abstract
Traumatic brain injury (TBI) remains the leading cause of long-term disability, which annually involves millions of individuals. Several studies on mammals reported that neurotrophins could play a significant role in both protection and recovery of function following neurodegenerative diseases such as stroke and TBI. This protective role of neurotrophins after an event of TBI has also been reported in the zebrafish model. Nevertheless, reparative mechanisms in mammalian brain are limited, and newly formed neurons do not survive for a long time. In contrast, the brain of adult fish has high regenerative properties after brain injury. The evident differences in regenerative properties between mammalian and fish brain have been ascribed to remarkable different adult neurogenesis processes. However, it is not clear if the specific role and time point contribution of each neurotrophin and receptor after TBI is conserved during vertebrate evolution. Therefore, in this review, I reported the specific role and time point of intervention for each neurotrophic factor and receptor after an event of TBI in zebrafish and mammals.
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5
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Lawrence DW, Sharma B, Griffiths RR, Carhart-Harris R. Trends in the Top-Cited Articles on Classic Psychedelics. J Psychoactive Drugs 2021; 53:283-298. [PMID: 33535907 DOI: 10.1080/02791072.2021.1874573] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study was designed to identify trends in the top-cited classic psychedelic publications. The top 50 publications on classic psychedelics with the greatest total of number of citations and annual citation rate were identified and pooled. Unique articles (n = 77) were dichotomized by median year of publication (2010); the differential distribution of study characteristics between the "Recent Cohort" (n = 40) and "Older Cohort" (n = 37) were documented. The Recent Cohort had a greater annual citation rate (median 76.5, IQR 43.8 to 103.3) compared to the Older Cohort (median 8.8, IQR 4.2 to 17.2, p < .001). The Recent Cohort included a greater number of clinical studies (n = 27 [67.5%] vs. n = 10 [27.0%]) while the Older Cohort included more basic science and preclinical studies (n = 22 [59.5%] vs. n = 3 [7.5%], p < .001). Psilocybin was the predominant psychedelic studied in the Recent Cohort (n = 26 [40.6%] vs. n = 8 [17.4%]) while lysergic acid diethylamide (LSD) was predominantly studied in the Older Cohort (n = 26 [56.5%] vs. n = 19 [29.7%], p = .028). The Recent Cohort included more studies examining affective disorders (n = 16 [25.8%] vs. n = 1 [2.7%]) and substance use disorders (n = 6 [9.7%] vs. n = 1 [2.7%]), while the Older Cohort included a greater number of pharmacological outcomes (n = 26 [70.3%] vs. n = 11 [17.7%], p < .001). This study identified and documented trends in the top-cited classic psychedelic publications. The field is continuing to form a foundational understanding of the pharmacological effects of psychedelics and is now advancing with the identification of therapeutic uses within clinical populations.
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Affiliation(s)
- David Wyndham Lawrence
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada.,Mount Sinai Hospital, Sinai Health System, Toronto, Canada.,Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Canada
| | - Bhanu Sharma
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada.,Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Roland R Griffiths
- Departments of Psychiatry and Neuroscience, Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Robin Carhart-Harris
- Centre for Psychedelic Research, Faculty of Medicine, Imperial College London, London, UK
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6
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Szymski D, Achenbach L, Krutsch V, Alt V, Meffert R, Krutsch W, Fehske K. Injury epidemiology in men's professional team sports: is media analysis helpful? Arch Orthop Trauma Surg 2021; 141:655-661. [PMID: 33426608 PMCID: PMC7966138 DOI: 10.1007/s00402-020-03743-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 12/19/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Epidemiological injury surveillance in professional sports is often based on online media analysis in order to collect necessary data. However, the validation of this study protocol is lacking. Therefore, this study aimed to identify the validity of injury surveillance in men's professional team sports based on media reports. METHODS In a retrospective cohort study, the validity of media-data-relating injuries was investigated in participating teams of the highest two German divisions in men's professional basketball (BB) and handball (HB) in the season 2018/2019. Injury protocols completed by the team physicians were compared to those of sports media injury reports. RESULTS The study population was composed of 133 athletes (54 BB and 79 HB). Of 343 injuries reported by the team physicians, 151 (44%) could be identified by means of sports media reports. Severe injuries (n = 75, 72%) were reported more likely in sports media compared to less severe injuries (n = 76, 32%, p < 0.00001). Odds ratio (OR) was 5.33 (95% CI 3.22-8.82). No differences regarding injury reporting could be seen between the two team sports. CONCLUSION For severe injuries, media analysis may be a sufficient method for data collection in popular men's professional ball sports. An underestimation of true injury prevalence lies within the range of previous reported investigations concerning the validation of injury surveillance methods. Non-severe injuries could not be verified via media analysis in professional handball and basketball.
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Affiliation(s)
- Dominik Szymski
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Leonard Achenbach
- Department of Trauma-, Hand-, Plastic- and Reconstructive Surgery, Julius-Maximilians University Wuerzburg, Josef-Schneider-Strasse 2, 97080 Wuerzburg, Germany
| | - Volker Krutsch
- Department of Otorhinolaryngology, Paracelsus Medical University Nuremberg, Nuremberg, Germany
| | - Volker Alt
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Rainer Meffert
- Department of Trauma-, Hand-, Plastic- and Reconstructive Surgery, Julius-Maximilians University Wuerzburg, Josef-Schneider-Strasse 2, 97080 Wuerzburg, Germany
| | - Werner Krutsch
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany ,SportDocsFranken, Nuremberg, Germany
| | - Kai Fehske
- Department of Trauma-, Hand-, Plastic- and Reconstructive Surgery, Julius-Maximilians University Wuerzburg, Josef-Schneider-Strasse 2, 97080 Wuerzburg, Germany
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Robidoux MA, Kendall M, Laflamme Y, Post A, Karton C, Hoshizaki TB. Comparing concussion rates as reported by hockey Canada with head contact events as observed across minor ice-hockey age categories. JOURNAL OF CONCUSSION 2020. [DOI: 10.1177/2059700220911285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Head injuries in elite and youth sport have garnered growing public attention in part because of high-profile cases of professional athletes suffering career-ending/threatening concussions and because of the increase in medical studies identifying how repeated concussive events can lead to long-term health problems, most notably degenerative brain disease. Public concerns around youth ice hockey are intensifying in light of recent evidence which suggests that effects of head injury are worse for youth than they are for athletes in later stages of life. To better understand concussion injury rate trends across all levels of youth hockey, this paper provides a retrospective analysis of concussion related hockey injury as recorded in Hockey Canada’s Injury Reporting System from the period covering 2009 to 2016, combined with two years of observational research documenting head contact events in minor hockey in the Ottawa and Gatineau regions of Ontario and Quebec. By comparing two different data sets through different methodological designs, it provides important insight into the levels of head contact in youth hockey, how head contact is occurring, and offers commentary about the levels of risk players are exposed to in minor hockey in Canada.
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Affiliation(s)
| | | | | | - Andrew Post
- School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Clara Karton
- School of Human Kinetics, University of Ottawa, Ottawa, Canada
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The Potential of Specialized Media in Public Health: Analysis of Health-Related Content in Sports Newspapers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071202. [PMID: 30987152 PMCID: PMC6479661 DOI: 10.3390/ijerph16071202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 03/30/2019] [Indexed: 12/05/2022]
Abstract
Sports-specialized newspapers are one of the print media with the highest number of readers in Spain. However, little is known about the health coverage in this type of print press. The aim of the study was to analyze any health-related material in sports newspaper coverage and describe the main characteristics. This is an observational and cross-sectional study, performed in relation to the three most read daily Spanish sports newspapers (MARCA, AS, SPORT). A descriptive analysis was conducted to assess the health-related materials selected after a careful search over a period of 30 days. During this time, a total of 815 units of analysis were identified. On average, 14.79% (n = 645 pages) of the full content (n = 4362) included health-related material. The Liga BBVA section was the most frequent to contain health-related content by a significant margin (p = 0.01). The main covered topics were injuries to soccer players (52%), doping (21%), and other diseases in athletes or their relatives (8.6%) with no significant differences (p = 0.10). Photographs (87.4%) were the most frequent visual material used in the health content, followed by infographics (12.6%). Press releases were the most frequent source of information (58%). Spanish sports newspapers include a high proportion of health-related material, especially in terms of providing detailed descriptions of athletes’ sport injuries, mainly related to soccer.
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9
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Gordon KE, Kuhle S. ‘Reported concussion’ time trends within two national health surveys over two decades. Brain Inj 2018; 32:843-849. [DOI: 10.1080/02699052.2018.1463105] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Kevin E. Gordon
- Division of Pediatric Neurology, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Stefan Kuhle
- Perinatal Epidemiology Research Unit, Department of Pediatrics, Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, Nova Scotia, Canada
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10
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Zhang J, Knight R, Wang Y, Sawyer TW, Martyniuk CJ, Langlois VS. Comprehensive assessment of shockwave intensity: Transcriptomic biomarker discovery for primary blast-induced mild traumatic brain injury using the mammalian hair follicle. Brain Inj 2017; 32:123-134. [DOI: 10.1080/02699052.2017.1342000] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Jing Zhang
- Chemistry and Chemical Engineering Department, Royal Military College of Canada, Kingston, ON, Canada
| | - Rosalinda Knight
- University of New Brunswick and Canadian River Institute, Fredericton, NB, Canada
| | - Yushan Wang
- Defence Research and Development Canada, Suffield Research Centre, Medicine Hat, AB, Canada
| | - Thomas W Sawyer
- Defence Research and Development Canada, Suffield Research Centre, Medicine Hat, AB, Canada
| | - Christopher J Martyniuk
- University of New Brunswick and Canadian River Institute, Fredericton, NB, Canada
- University of Florida, Center for Environmental and Human Toxicology & Department of Physiological Sciences, Gainesville, FL, USA
| | - Valerie S Langlois
- Chemistry and Chemical Engineering Department, Royal Military College of Canada, Kingston, ON, Canada
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Cusimano MD, Zhu A. Systematic Review of Traumatic Brain Injuries in Baseball and Softball: A Framework for Prevention. Front Neurol 2017; 8:492. [PMID: 29163326 PMCID: PMC5670156 DOI: 10.3389/fneur.2017.00492] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 09/01/2017] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Traumatic brain injuries (TBIs) are an important public health challenge. The classification of baseball and softball as low contact sports and their association with extremity injuries cause individuals to overlook the risk of TBI in baseball and softball. PURPOSE To summarize our knowledge of the epidemiology and risk factors of TBIs associated with baseball and softball with an aim to better design and implement preventive strategies. METHODS A search algorithm containing keywords that were synonymous to the terms "TBI," "baseball" was applied to the following nine databases: MEDLINE, Scopus, PubMed, EMBASE, CINAHL, Healthstar, PsychINFO, AMED, Cochrane library. Cited reference lists of identified articles were also consulted yielding a total of eighty-eight articles for full review. The search was concluded on November 14, 2016. The level of evidence was evaluated according to the guidelines from Strengthening the Reporting of Observational Studies in Epidemiology statement. RESULTS Twenty-nine articles published between 2000 and 2016 met the criteria for analysis. Collectively, they examined the years 1982-2015 and identified 242,731 baseball-and softball-related TBIs. The most explored outcome of TBI was concussion. The average injury rate per 1,000 athletic exposures was 0.13 (range 0.03-0.46). The most common mechanism of injury was being struck by bat for younger players and being struck by ball for older athletes (adolescent and beyond). Rates of TBI were on average 4.17 times greater in games compared to practices. Females were on average 2.04 times more likely to sustain a TBI than males. Severity of TBIs varied considerably from mild and returning to the field on the same day, to immediate death. Generally, there is poor compliance with helmet use and return-to-play post-concussion guidelines. An increase TBI rates was observed over time. Multifaceted preventive strategies must be implemented to reduce the frequency and burden of these injuries. CONCLUSION It is difficult to compare the epidemiologic trends of TBI in baseball and softball due critical differences in the methods employed across the studies. Additional research is needed to provide a greater understanding of baseball- and softball-related TBI and to aid in the development of prevention and management modules.
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Affiliation(s)
- Michael D. Cusimano
- Division of Neurosurgery, Department of Surgery, St. Michael’s Hospital, Injury Prevention Research Office, Li Ka Shing Knowledge Institute, Keenan Research Centre, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Alice Zhu
- Division of Neurosurgery, Department of Surgery, St. Michael’s Hospital, Injury Prevention Research Office, Li Ka Shing Knowledge Institute, Keenan Research Centre, University of Toronto, Toronto, ON, Canada
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12
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Workewych AM, Ciuffetelli Muzzi M, Jing R, Zhang S, Topolovec-Vranic J, Cusimano MD. Twitter and traumatic brain injury: A content and sentiment analysis of tweets pertaining to sport-related brain injury. SAGE Open Med 2017; 5:2050312117720057. [PMID: 28890783 PMCID: PMC5574478 DOI: 10.1177/2050312117720057] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 06/16/2017] [Indexed: 11/21/2022] Open
Abstract
Objectives: Sport-related traumatic brain injuries are a significant public health burden, with hundreds of thousands sustained annually in North America. While sports offer numerous physical and social health benefits, traumatic brain injuries such as concussion can seriously impact a player’s life, athletic career, and sport enjoyment. The culture in many sports encourages winning at all costs, placing athletes at risk for traumatic brain injuries. As social media has become a central part of everyday life, the content of users’ messages often reflects the prevailing culture related to a particular event or health issue. Methods: We hypothesized that Twitter data might be useful for understanding public perceptions and misperceptions of sport-related traumatic brain injuries. We performed a content and sentiment analysis of 7483 Twitter® tweets related to traumatic brain injuries in sports collected during June and July 2013. Results: We identified five major themes. Users tweeted about personal traumatic brain injuries experiences, reported traumatic brain injuries in professional athletes, shared research about sport-related concussions, and discussed policy and safety in injury prevention, such as helmet use. We identified mixed perceptions of and sentiment toward traumatic brain injuries in sports: both an understanding that brain injuries are serious and disregard for activities that might reduce the public burden of traumatic brain injuries were prevalent in our Twitter analysis. Conclusion: While the scientific and medical community considers a concussion a form of traumatic brain injuries, our study demonstrates a misunderstanding of this fact among the public. In our current digital age, social media can provide useful insight into the culture around a health issue, facilitating implementation of prevention and treatment strategies.
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Affiliation(s)
- Adriana M Workewych
- Injury Prevention Research Office, Division of Neurosurgery, Li Ka Shing Knowledge Institute and Trauma and Neurosurgery Program, St. Michael's Hospital, Toronto, ON, Canada
| | | | - Rowan Jing
- Injury Prevention Research Office, Division of Neurosurgery, Li Ka Shing Knowledge Institute and Trauma and Neurosurgery Program, St. Michael's Hospital, Toronto, ON, Canada
| | - Stanley Zhang
- Injury Prevention Research Office, Division of Neurosurgery, Li Ka Shing Knowledge Institute and Trauma and Neurosurgery Program, St. Michael's Hospital, Toronto, ON, Canada
| | - Jane Topolovec-Vranic
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Michael D Cusimano
- Injury Prevention Research Office, Division of Neurosurgery, Li Ka Shing Knowledge Institute and Trauma and Neurosurgery Program, St. Michael's Hospital, Toronto, ON, Canada.,Faculty of Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Surgery, University of Toronto, Toronto, ON, Canada
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13
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Abstract
OBJECTIVE Although the importance of traumatic brain injury has gained public attention in recent years, relatively little attention has been paid to head injuries among women who have experienced intimate partner violence (IPV). The present study screened for lifetime exposure to mild traumatic brain injuries (mTBIs) among a sample of women who had experienced recent IPV (median days since target incident = 26). METHOD Participants included ethnically diverse women whose IPV experiences were reported to law enforcement. Women (n = 225) were asked about injuries to the head sustained during the target IPV incident as well as over the lifetime, and related symptoms. RESULTS The vast majority of women (80%) reported a lifetime head injury. More than half (56%) screened positive for mTBI, defined as at least one instance in which they experienced a change in consciousness or a period of being dazed and confused as a result of a head injury. A minority of women (13%) reported injuries to the head during the target IPV incident. Most women who had experienced a lifetime head injury reported frequent and current cognitive difficulties. CONCLUSION These findings highlight the importance of assessing head injuries and related symptoms among women who have experienced IPV, pointing to important implications for policy and practice.
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Affiliation(s)
- Kerry L Gagnon
- a Department of Psychology , University of Denver , Denver , Colorado , USA
| | - Anne P DePrince
- a Department of Psychology , University of Denver , Denver , Colorado , USA
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14
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Factors Influencing the Underreporting of Concussion in Sports: A Qualitative Study of Minor Hockey Participants. Clin J Sport Med 2017; 27:375-380. [PMID: 28653965 DOI: 10.1097/jsm.0000000000000372] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The present study is to identify factors contributing to underreporting of concussion in adolescent athletes. DESIGN Qualitative interviews. SETTING Participants were interviewed in an office environment. PARTICIPANTS Interviews were conducted with 31 minor hockey players, 10 parents, 6 coaches, 4 trainers, 2 managers, and one game official. Players were 13 to 15 year old. With selective sampling, an inductive approach of analyzing the interviews was undertaken and themes were identified and analyzed. ASSESSMENT OF RISK FACTORS Underreporting is a complex phenomenon. A number of risk factors related to hockey culture, players, reference others, and rules of play were assessed. MAIN OUTCOME MEASURES Reasons not reporting concussion is accepted in minor hockey. RESULTS Aspects of hockey culture such as an overemphasis on winning games and upheld misperceptions about the risks associated with concussion were identified as relevant to the underreporting of concussions. Various factors relevant to the underreporting of concussions include player's motivation to win, group membership dynamics such as a player's role as the team's "enforcer," coaches' own motivation to win to further their own opportunities in the sport, and parents' personal financial interest or alternative agenda in terms of time commitments and their child's future career prospects. CONCLUSIONS Our findings indicate that underreporting of concussion among those players interviewed appears to be prevalent and associated with misconceptions about injury risk, and a culture that both reinforces and encourages underreporting with tacit or overt complicity of parents and coaches. Our findings support the need to alter the culture of violence and tough play in hockey by education, rule changes, economic measures, and changes in governance of the sport. Interviewing more stakeholders and policy makers would shed light on such potential interventions.
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15
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The accuracy and reproducibility of video assessment in the pitch-side management of concussion in elite rugby. J Sci Med Sport 2017; 20:246-249. [DOI: 10.1016/j.jsams.2016.07.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 06/17/2016] [Accepted: 07/09/2016] [Indexed: 11/23/2022]
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Zemek RL, Grool AM, Rodriguez Duque D, DeMatteo C, Rothman L, Benchimol EI, Guttmann A, Macpherson AK. Annual and Seasonal Trends in Ambulatory Visits for Pediatric Concussion in Ontario between 2003 and 2013. J Pediatr 2017; 181:222-228.e2. [PMID: 27843008 DOI: 10.1016/j.jpeds.2016.10.067] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 09/14/2016] [Accepted: 10/19/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate annual and seasonal trends in physician office and emergency department (ED) visit rates for pediatric concussion in Ontario between 2003 and 2013. STUDY DESIGN A retrospective, population-based study was conducted using linked health administrative data from all concussion-related visits to ED and physician office by children aged 5 through 18 years. Time series analysis was used to assess whether periodic components exist in the monthly number of concussion-related visits. RESULTS Over the 11-year study period, there were 176 685 pediatric visits for concussion in EDs and physician offices in Ontario. Standardized concussion-related visits showed a 4.4-fold (95% CI 4.37-4.45) increase per 100 000 from 2003 to 2013, with nearly 35 000 total visits in 2013. Concussion-related visits demonstrated a steep increase from 2010 onward. The greatest increases in standardized visits were in females (6.3-fold, 95% CI 6.23-6.46 vs 3.6-fold, 95% CI 3.56-3.64 in males) and 13-18.99 year olds (5.0-fold, 95% CI 4.93-5.08 vs 4.1-fold, 95% CI 3.99-4.27 in 9-12 years and 2.3-fold, 95% CI 2.23-2.42 in 5-8 years). A strong seasonal variability (R2autoreg = 0.87, P < .01) in the number of concussion-related visits was present, with most occurring in fall and winter. CONCLUSIONS Pediatric concussion-related ED and physician office visit rates have greatly increased in the last decade, particularly since 2010. Prevention strategies may be targeted at those most at risk and at seasonal-related activities carrying the greatest risk of concussion.
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Affiliation(s)
- Roger L Zemek
- Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
| | - Anne M Grool
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | | | - Carol DeMatteo
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Linda Rothman
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario, Canada
| | - Eric I Benchimol
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Astrid Guttmann
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Alison K Macpherson
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario, Canada
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Ilie G, Mann RE, Boak A, Adlaf EM, Hamilton H, Asbridge M, Rehm J, Cusimano MD. Cross-sectional examination of the association of co-occurring alcohol misuse and traumatic brain injury on mental health and conduct problems in adolescents in Ontario, Canada. BMJ Open 2016; 6:e011824. [PMID: 28186929 PMCID: PMC5129005 DOI: 10.1136/bmjopen-2016-011824] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE This study describes the impact of traumatic brain injury (TBI) and hazardous drinking on mental health and behavioural issues among Ontario adolescents. In particular, we assessed the incremental co-occurrence of hazardous drinking with a history of TBI, in comparison to experiencing just one of these conditions. METHODS A cross-sectional subsample of 3130 Ontario adolescents attending grades 9-12, and aged 10-21 were surveyed in 2013 as a part of the Centre for Addiction and Mental Health's Ontario Student Drug Use and Health Survey. Recent (past year) and former (lifetime and excluding the last year) TBI were defined as trauma to the head that resulted in loss of consciousness for at least 5 min or overnight hospitalisation. Current hazardous drinking was derived using the Alcohol Use Disorders Identification Test (AUDIT). RESULTS An estimated 11.8% of Ontario adolescents (95% CI 10.1% to 13.8%) reported a history of former TBI and were not hazardous drinkers; 4.0% (95% CI 2.9% to 5.5%) reported recent TBI and were not hazardous drinkers; 13.7% (95% CI 12.3% to 15.3%) were hazardous drinkers who never had a TBI; 4.1% (95% CI 2.9% to 5.8%) had former TBI with co-occurring hazardous drinking; and 2.2% (95% CI 1.6% to 3.0%) had recent TBI with co-occurring hazardous drinking. Most odds increased significantly and were two to three times higher for reporting compromised mental health, violent and non-violent conduct behaviours, and reported victimisation for classifying as a hazardous drinker at the time of testing with co-occurring either former or recent TBI compared to classifying as not having either of these conditions. Adolescents classified as hazardous drinkers with former TBI had numerous and higher ORs for conduct behaviours than those with recent TBI. CONCLUSIONS Results emphasise the strong interplay between TBI and hazardous drinking and point to the need for integrating prevention efforts to reduce these conditions and their co-occurrence among adolescents.
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Affiliation(s)
- Gabriela Ilie
- Department of Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Robert E Mann
- Department of Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Angela Boak
- Department of Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Edward M Adlaf
- Department of Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Hayley Hamilton
- Department of Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Mark Asbridge
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jürgen Rehm
- Department of Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Michael D Cusimano
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Division of Neurosurgery and Injury Prevention Research Office, St. Michael's Hospital, Toronto, Ontario, Canada
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Building Statewide Infrastructure for the Academic Support of Students With Mild Traumatic Brain Injury. J Head Trauma Rehabil 2016; 31:397-406. [DOI: 10.1097/htr.0000000000000205] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Substance Use and Related Harms Among Adolescents With and Without Traumatic Brain Injury. J Head Trauma Rehabil 2016; 30:293-301. [PMID: 25427256 DOI: 10.1097/htr.0000000000000101] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The relationship between self-reported lifetime traumatic brain injury (TBI) and drug and alcohol use and associated harms was examined using an epidemiological sample of Canadian adolescents. SETTINGS AND DESIGN Data were derived from a 2011 population-based cross-sectional school survey, which included 6383 Ontario 9th-12th graders who self-completed anonymous self-administered questionnaires in classrooms. Traumatic brain injury was defined as loss of consciousness for at least 5 minutes or a minimum 1-night hospital stay due to symptoms. RESULTS Relative to high schoolers without a history of TBI, those who acknowledged having a TBI in their lifetime had odds 2 times greater for binge drinking (5+ drinks per occasion in the past 4 weeks), 2.5 times greater for daily cigarette smoking, 2.9 times greater for nonmedical use of prescription drugs, and 2.7 times greater for consuming illegal drug in the past 12 months. Adolescents with a history of TBI had greater odds for experiencing hazardous/harmful drinking (adjusted odds ratio [aOR] = 2.3), cannabis problems (aOR = 2.4), and drug problems (aOR = 2.1), compared with adolescents who were never injured. CONCLUSION There are strong and demographically stable associations between TBI and substance use. These associations may not only increase the odds of injury but impair the quality of postinjury recovery.
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Cusimano MD, Ilie G, Mullen SJ, Pauley CR, Stulberg JR, Topolovec-Vranic J, Zhang S. Aggression, Violence and Injury in Minor League Ice Hockey: Avenues for Prevention of Injury. PLoS One 2016; 11:e0156683. [PMID: 27258426 PMCID: PMC4892613 DOI: 10.1371/journal.pone.0156683] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 05/18/2016] [Indexed: 11/18/2022] Open
Abstract
Background In North America, more than 800,000 youth are registered in organized ice hockey leagues. Despite the many benefits of involvement, young players are at significant risk for injury. Body-checking and aggressive play are associated with high frequency of game-related injury including concussion. We conducted a qualitative study to understand why youth ice hockey players engage in aggressive, injury-prone behaviours on the ice. Methods Semi-structured interviews were conducted with 61 minor ice hockey participants, including male and female players, parents, coaches, trainers, managers and a game official. Players were aged 13–15 playing on competitive body checking teams or on non-body checking teams. Interviews were manually transcribed, coded and analyzed for themes relating to aggressive play in minor ice hockey. Results Parents, coaches, teammates and the media exert a large influence on player behavior. Aggressive behavior is often reinforced by the player’s social environment and justified by players to demonstrate loyalty to teammates and especially injured teammates by seeking revenge particularly in competitive, body-checking leagues. Among female and male players in non-body checking organizations, aggressive play is not reinforced by the social environment. These findings are discussed within the framework of social identity theory and social learning theory, in order to understand players’ need to seek revenge and how the social environment reinforces aggressive behaviors. Conclusion This study provides a better understanding of the players’ motivations and environmental influences around aggressive and violent play which may be conducive to injury. The findings can be used to help design interventions aimed at reducing aggression and related injuries sustained during ice hockey and sports with similar cultures and rules.
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Affiliation(s)
- Michael D. Cusimano
- Division of Neurosurgery, Department of Surgery, Injury Prevention Research Office, Saint Michael’s Hospital, Toronto, Ontario, Canada
- * E-mail:
| | - Gabriela Ilie
- Dalhousie University Faculty of Medicine, Department of Community Health and Epidemiology, Halifax, Nova Scotia, Canada
| | - Sarah J. Mullen
- Division of Neurosurgery, Department of Surgery, Injury Prevention Research Office, Saint Michael’s Hospital, Toronto, Ontario, Canada
| | - Christopher R. Pauley
- Division of Neurosurgery, Department of Surgery, Injury Prevention Research Office, Saint Michael’s Hospital, Toronto, Ontario, Canada
| | | | - Jane Topolovec-Vranic
- Faculty of Medicine (Occupational Science and Occupational Therapy), University of Toronto, Toronto, Canada
| | - Stanley Zhang
- Division of Neurosurgery, Department of Surgery, Injury Prevention Research Office, Saint Michael’s Hospital, Toronto, Ontario, Canada
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Buckley TA, Oldham JR, Caccese JB. Postural control deficits identify lingering post-concussion neurological deficits. JOURNAL OF SPORT AND HEALTH SCIENCE 2016; 5:61-69. [PMID: 30356901 PMCID: PMC6191989 DOI: 10.1016/j.jshs.2016.01.007] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 05/26/2015] [Accepted: 11/20/2015] [Indexed: 05/20/2023]
Abstract
Concussion, or mild traumatic brain injury, incidence rates have reached epidemic levels and impaired postural control is a cardinal symptom. The purpose of this review is to provide an overview of the linear and non-linear assessments of post-concussion postural control. The current acute evaluation for concussion utilizes the subjective balance error scoring system (BESS) to assess postural control. While the sensitivity of the overall test battery is high, the sensitivity of the BESS is unacceptably low and, with repeat administration, is unable to accurately identify recovery. Sophisticated measures of postural control, utilizing traditional linear assessments, have identified impairments in postural control well beyond BESS recovery. Both assessments of quiet stance and gait have identified lingering impairments for at least 1 month post-concussion. Recently, the application of non-linear metrics to concussion recovery have begun to receive limited attention with the most commonly utilized metric being approximate entropy (ApEn). ApEn, most commonly in the medial-lateral plane, has successfully identified impaired postural control in the acute post-concussion timeframe even when linear assessments of instrumented measures are equivalent to healthy pre-injury values; unfortunately these studies have not gone beyond the acute phase of recovery. One study has identified lingering deficits in postural control, utilizing Shannon and Renyi entropy metrics, which persist at least through clinical recovery and return to participation. Finally, limited evidence from two studies suggest that individuals with a previous history of a single concussion, even months or years prior, may display altered ApEn metrics. Overall, non-linear metrics provide a fertile area for future study to further the understanding of postural control impairments acutely post-concussion and address the current challenge of sensitive identification of recovery.
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Affiliation(s)
- Thomas A. Buckley
- Department of Kinesiology and Applied Physiology, Interdisciplinary Program in Biomechanics and Movement Science, 150 Human Performance Laboratory, University of Delaware, Newark, DE 19716, USA
- Interdisciplinary program in Biomechanics and Movement Science, University of Delaware, Newark, DE 19716, USA
| | - Jessie R. Oldham
- Department of Kinesiology and Applied Physiology, Interdisciplinary Program in Biomechanics and Movement Science, 150 Human Performance Laboratory, University of Delaware, Newark, DE 19716, USA
| | - Jaclyn B. Caccese
- Department of Kinesiology and Applied Physiology, Interdisciplinary Program in Biomechanics and Movement Science, 150 Human Performance Laboratory, University of Delaware, Newark, DE 19716, USA
- Interdisciplinary program in Biomechanics and Movement Science, University of Delaware, Newark, DE 19716, USA
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Ilie G, Boak A, Mann RE, Adlaf EM, Hamilton H, Asbridge M, Rehm J, Cusimano MD. Energy Drinks, Alcohol, Sports and Traumatic Brain Injuries among Adolescents. PLoS One 2015; 10:e0135860. [PMID: 26375286 PMCID: PMC4572704 DOI: 10.1371/journal.pone.0135860] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 07/27/2015] [Indexed: 11/23/2022] Open
Abstract
Importance The high prevalence of traumatic brain injuries (TBI) among adolescents has brought much focus to this area in recent years. Sports injuries have been identified as a main mechanism. Although energy drinks, including those mixed with alcohol, are often used by young athletes and other adolescents they have not been examined in relation to TBI. Objective We report on the prevalence of adolescent TBI and its associations with energy drinks, alcohol and energy drink mixed in with alcohol consumption. Design, Settings and Participants Data were derived from the Centre for Addiction and Mental Health’s 2013 Ontario Student Drug Use and Health Survey (OSDUHS). This population-based cross-sectional school survey included 10,272 7th to 12th graders (ages 11–20) who completed anonymous self-administered questionnaires in classrooms. Main Outcome Measures Mild to severe TBI were defined as those resulting in a loss of consciousness for at least five minutes, or being hospitalized for at least one night. Mechanism of TBI, prevalence estimates of TBI, and odds of energy drink consumption, alcohol use, and consumption of energy drinks mixed with alcohol are assessed. Results Among all students, 22.4% (95% CI: 20.7, 24.1) reported a history of TBI. Sports injuries remain the main mechanism of a recent (past year) TBI (45.5%, 95% CI: 41.0, 50.1). Multinomial logistic regression showed that relative to adolescents who never sustained a TBI, the odds of sustaining a recent TBI were greater for those consuming alcohol, energy drinks, and energy drinks mixed in with alcohol than abstainers. Odds ratios were higher for these behaviors among students who sustained a recent TBI than those who sustained a former TBI (lifetime but not past 12 months). Relative to recent TBI due to other causes of injury, adolescents who sustained a recent TBI while playing sports had higher odds of recent energy drinks consumption than abstainers. Conclusions and Relevance TBI remains a disabling and common condition among adolescents and the consumption of alcohol, energy drinks, and alcohol mixed with energy drinks further increase the odds of TBI among adolescents. These associations warrant further investigation.
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Affiliation(s)
- Gabriela Ilie
- Injury Prevention Research Office, St. Michael’s Hospital, Toronto, Canada
- Department of Psychology, University of Toronto, Toronto, Canada
- * E-mail:
| | - Angela Boak
- Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Robert E. Mann
- Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Edward M. Adlaf
- Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Hayley Hamilton
- Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | | | - Jürgen Rehm
- Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Michael D. Cusimano
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Division of Neurosurgery, University of Toronto, Toronto, Canada
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Sharma B, Lawrence DW. Top-cited articles in traumatic brain injury. Front Hum Neurosci 2014; 8:879. [PMID: 25414657 PMCID: PMC4220681 DOI: 10.3389/fnhum.2014.00879] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 10/12/2014] [Indexed: 11/13/2022] Open
Abstract
A review of the top-cited articles in a scientific discipline can identify areas of research that are well established and those in need of further development, and may, as a result, inform and direct future research efforts. Our objective was to identify and characterize the top-cited articles in traumatic brain injury (TBI). We used publically available software to identify the 50 TBI articles with the most lifetime citations, and the 50 TBI articles with the highest annual citation rates. A total of 73 articles were included in this review, with 27 of the 50 papers with the highest annual citation rates common to the cohort of 50 articles with the most lifetime citations. All papers were categorized by their primary topic or focus, namely: predictor of outcome, pathology/natural history, treatment, guidelines and consensus statements, epidemiology, assessment measures, or experimental model of TBI. The mean year of publication of the articles with the most lifetime citations and highest annual citation rates was 1990 ± 14.9 years and 2003 ± 6.7 years, respectively. The 50 articles with the most lifetime citations typically studied predictors of outcome (34.0%, 17/50) and were specific to severe TBI (38.0%, 19/50). In contrast, the most common subject of papers with the highest annual citation rates was treatment of brain injury (22.0%, 11/50), and these papers most frequently investigated mild TBI (36.0%, 18/50). These findings suggest an intensified focus on mild TBI, which is perhaps a response to the dedicated attention these injuries are currently receiving in the context of sports and war, and because of their increasing incidence in developing nations. Our findings also indicate increased focus on treatment of TBI, possibly due to the limited efficacy of current interventions for brain injury. This review provides a cross-sectional summary of some of the most influential articles in TBI, and a bibliometric examination of the current status of TBI research.
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Affiliation(s)
- Bhanu Sharma
- Toronto Rehabilitation Institute, University of Toronto , Toronto, ON , Canada
| | - David Wyndham Lawrence
- Department of Family and Community Medicine, St. Michael's Hospital, University of Toronto , Toronto, ON , Canada
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Ilie G, Adlaf EM, Mann RE, Boak A, Hamilton H, Asbridge M, Colantonio A, Turner NE, Rehm J, Cusimano MD. The moderating effects of sex and age on the association between traumatic brain injury and harmful psychological correlates among adolescents. PLoS One 2014; 9:e108167. [PMID: 25268238 PMCID: PMC4182663 DOI: 10.1371/journal.pone.0108167] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 08/19/2014] [Indexed: 11/27/2022] Open
Abstract
Background Although it is well established that sex is a risk factor in acquiring a traumatic brain injury (TBI) among adolescents, it has not been established whether it also moderates the influence of other TBI psychological health correlates. Methods and Findings Data were derived from a 2011 population-based cross-sectional school survey, which included 9,288 Ontario 7th–12th graders who completed anonymous self-administered questionnaires in classrooms. Response rate was 62%. Preliminary analyses found no evidence of nonresponse bias in the reporting of TBI. TBI was defined as a hit or blow to the head that resulted in a 5 minutes loss of consciousness or at least one overnight hospitalization due to symptoms associated with it. Reports of lifetime TBI were more common among males than females (23.1%, 95% CI: 20.5, 25.8 vs. 17.1%, 95% CI: 14.7, 19.8). Thirteen correlates were examined and included cigarette smoking, elevated psychological distress, suicide ideation, bully victimization (at school, as well as cyber bullying), bullying others, cannabis use, cannabis dependence and drug use problems, physical injuries, daily smoking, drinking alcohol, binge drinking, use of cannabis, and poor academic performance. Among the outcomes examined, sex moderated the relationship between lifetime TBI and cigarette smoking. In addition, sex and age jointly moderated the relationship between lifetime TBI and daily smoking, alcohol use and physical injuries. Late adolescent males who reported lifetime TBI, relative to females, displayed elevated daily smoking and injuries, whereas their females counterparts displayed elevated past year drinking. Possible bias related to self-report procedures and the preclusion of causal inferences due to the cross-sectional nature of the data are limitations of this study. Conclusions TBI differences in outcomes need to be assessed for potential moderating effects of sex and age. Results have important implications for more tailored injury prevention efforts.
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Affiliation(s)
- Gabriela Ilie
- Division of Neurosurgery and Injury Prevention Research Office, St. Michael's Hospital, Toronto, Canada
- * E-mail:
| | - Edward M. Adlaf
- Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Robert E. Mann
- Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Angela Boak
- Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Hayley Hamilton
- Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Mark Asbridge
- Department of Community Health and Epidemiology and Department of Emergency Medicine, Dalhousie University, Halifax, Canada
| | - Angela Colantonio
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, Toronto Rehabilitation Institute, Toronto, Canada
| | - Nigel E. Turner
- Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Jürgen Rehm
- Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Michael D. Cusimano
- Division of Neurosurgery and Injury Prevention Research Office, St. Michael's Hospital, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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