Serious problem of concussions in professional soccer

Striking one's head against a hard ball over and over again never seemed like a good idea.  But of course there are also all the accidental falls and hits to the head.  Here is an interesting article in the journal Neurology entitled: "Chronic traumatic brain injury in professional soccer players."

Methods: Fifty-three active professional soccer players from several professional Dutch soccer clubs were compared with a control group of 27 elite noncontact sport athletes. All participants underwent neuropsychological examination. The main outcome measures were neuropsychological tests proven to be sensitive to cognitive changes incurred during contact and collision sports.
Results: The professional soccer players exhibited impaired performances in memory, planning, and visuoperceptual processing when compared with control subjects. Among professional soccer players, performance on memory, planning, and visuoperceptual tasks were inversely related to the number of concussions incurred in soccer and the frequency of "heading" the ball. Performance on neuropsychological testing also varied according to field position, with forward and defensive players exhibiting more impairment.
Conclusion: Participation in professional soccer may affect adversely some aspects of cognitive functioning (i.e., memory, planning, and visuoperceptual processing).

For college, women's soccer appears to have a higher rate of concussions than men's football or soccer: 6.3 per 10,000 exposures in women’s soccer versus 4.9 for men’s soccer and 6.1 per 10,000 for men’s football.   Indeed, for college sports, women's soccer has the highest rate of concussions.  

For high school, girls' soccer has the second highest rate of concussions behind football, but when concussions do occur girls and boys' high school soccer have worst concussions than do football (click on figure to make it larger).



Girls' high school basketball might not have a lot of concussions, but their concussions tend to be pretty bad.  The most severe concussions requiring 22+ days to recuperate from appear to be twice the percentage for both boys and girls' soccer.  More is available here.

There is another study on college players, but the survey method used here is fairly problematic.  The survey indicates that soccer players are much less likely than football players to even realize that they have had a concussion.  If the rate of perceived concussions is related to the rate that people answer the survey, you will get relatively more underreporting of concussions among soccer players.  The questionnaires indicated that "70.4% of the football playersand 62.7% of the soccer players had experienced symptoms of a concussion during theprevious year."  But much of that difference could be explained by differences in reporting rates. 

Here is another academic article of interest:
British Journal of Sports Medicine: The Effect of Protective Headgear on Head Injuries and Concussions in Adolescent Football (Soccer) Players: "In the population studied, 47.8% had experienced symptoms of a concussion during the current football year. 26.9% of athletes who wore headgear (HG) and 52.8% of those who did not wear headgear (No-HG) had concussions."

Here is something else that a reader sent me.

SOCCER CONCUSSIONS: GET THE FACTS
-- 92,505 Concussions in High School Soccer

National High School Sports-Related Injury Surveillance Study 2011/2012. http://www.nationwidechildrens.org/cirp-rio
-- Players NOT wearing protective soccer headgear are 2.65 times more likely to suffer a concussion than those who did wear headgear
Al-Kashmiti, Delaney, et al “The Effect of Protective Headgear on Head Injuries and Concussions in Adolescent Football (Soccer) Players,” British Journal of Sports Medicine (2007). http://bjsm.bmj.com/content/early/2007/07/05/bjsm.2007.037689 .abstract - Dr. J. Scott Delaney, jscott.delaney@mcgill.ca
-- Concussions in soccer are not commonly caused by heading the ball
Boden, Kirkendall et al, “Concussion Incidence in Elite College Soccer Players,” American Journal of Sports Medicine (1998), 26:238-41. http://ajs.sagepub.com/content/26/2/238.short
-- “Head to head impacts posed high concussion risk”
Withnall, Shewchenko et al., “Effectiveness of Headgear in Soccer,” British Journal of Sports Medicine (2005), 39(supp1):i40-i48. http://bjsm.bmj.com/content/39/suppl_1/i40.full
-- In a peer-reviewed study, 62.7% of college-level soccer players had concussion symptoms in a single year
Delaney, Lacroix et al., “Concussions Among University Football and Soccer Players,” Clinical Journal of Sports Medicine (2002), 12(6):331-38. http://www.ncbi.nlm.nih.gov/pubmed/12466687
-- The number of sports concussions is believed to be under-reported by 90%
NIH Consensus Development Panel, “Rehabilitation of Persons with Traumatic Brain Injury,” Journal of the American Medical Association (1999), 282:974-83. http://jama.jamanetwork.com/article.aspx?articleid=191465 mediarelations@jamanetwork.org
-- The concussion rate in soccer is similar to that in American football
Baroff, “Is Heading a Soccer Ball Injurious to Brain Function?” Journal of Head Trauma Rehabilitation (1998), 13(2):45-52. http://journals.lww.com/headtraumarehab/Abstract/1998/04000/I s_Heading_a_Soccer_Ball_Injurious_to_Brain.7.aspx

-- After the first concussion, the risk of a second one increases by a factor of four
Gerberich, Priest et al., “Concussion Incidences and Severity in Secondary School Varsity Football Players,” American Journal of Public Health (1973), 73:1370-75. http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.73.12.13 70
-- Subsequent concussions are usually more serious than the first one, even if the impacts are similar
Collins, Lovell et al., “Cumulative Effects of Concussion in High School Athletes,” Neurosurgery (2002), 51(5):1175-81. http://journals.lww.com/neurosurgery/Abstract/2002/11000/Cum ulative_Effects_of_Concussion_in_High_School.11.aspx
-- Second Impact Syndrome (rapid swelling of the brain, potentially catastrophic outcome) may occur if the head is impacted before the brain has recovered from a concussion
Cantu, “Recurrent Athletic Head Injury: Risks and When to Retire,” Clinics in Sports Medicine (2003), 22(3):593-603. http://www.sportsmed.theclinics.com/article/S0278- 5919(02)00095-9/fulltext
-- Younger players require more time to recover from a concussion than older players
Field, Collins et al., “Does Age Play a Role in Recovery from Sports-Related Concussion? A Comparison of High School and Collegiate Athletes,” Journal of Pediatrics (2003), 142(5):546- 53. http://www.jpeds.com/article/S0022-3476(03)00116- 1/abstract - journal.pediatrics@cchmc.org
-- Girls are more likely to be concussed than boys
Fuller, Junge et al., “A Six Year Prospective Study of the Incidence and Causes of Head and Neck Injuries in International Football,” British Journal of Sports Medicine (2005), 39(supp1):i3-i8. http://bjsm.bmj.com/content/39/suppl_1/i3.full.pdf 

Here is an interesting blog on soccer concussions.

Finally, a real solution to hangovers

From the New York Post:

. . . It could be in a drug called ampelopsin, aka dihydromyricetin, found in oriental raisin trees. It’s a traditional Chinese cure that may actually work, and is now being sold over the counter as BluCetin.
UCLA researcher Richard Olsen, who has been studying the effects of low to moderate drinking, thinks the drug may bind to an ethanol receptor called delta-GABA-R — and deflect booze.
Then again, do we really want a society in which heavy drinking occurred without automatic retribution? College students might binge-drink themselves into a collective stupor. Drunk driving could see an uptick. And, alarming as it is to think about, “The Hangover, Part IV” could be even more boring than III. . . .

Why humans have an Appendix

As someone who had their appendix burst a few years ago, I have wondered why we have these organs.  The traditional view has been that the appendix was a residual organ that was no longer used.  From ABC News:

The researchers say it acts as a safe house for good bacteria, which can be used to effectively reboot the gut following a bout of dysentery or cholera. 

The conventional wisdom is that the small pouch protruding from the first part of the large intestine is redundant and many people have their appendix removed and appear none the worse for it. 

Scientists from the Duke University Medical Centre in North Carolina say following a severe bout of cholera or dysentery, which can purge the gut of bacteria essential for digestion, the reserve good bacteria emerge from the appendix to take up the role. . . .

Mexico has "world's fattest" people, US second fattest

This article claims that the obesity is due to poverty, but has the percentage of the population that is obese increased over time?  No.  Just like increased poverty can't explain the increased obesity in the US over time.  From the New York Post:

The United States no longer holds the title of the world’s most populous, obese nation; that designation has been passed on to Mexico.
According to a new report from the United Nations, nearly 70 percent of Mexican adults are overweight, and childhood obesity in the country has tripled within the past decade, Medical Daily reported. One-third of Mexican teenagers are also obese, and experts believe that four out of every five obese children will remain overweight for the rest of their lives.
Overall, 32.8 percent of Mexican adults are considered obese, compared to 31.8 percent of adults in the United States. Nearly 70,000 deaths in Mexico each year are caused by weight-related diabetes, and more than 400,000 new cases of diabetes are diagnosed annually. . . .
One researcher also believes the increase can be attributed to more Mexicans moving from rural to urban areas, where food prices are much higher and sedentary lifestyles are easier.

Ugh?  Higher food prices cause obesity?

WSJ: "Extra Pounds Mean Lower Chance of Death"

This is too funny.

"Conservatives are more thoughtful than liberals in processing emotions like fear"

Researchers at London University College found differences in brain structure for liberals and conservatives.  From Reuters:

"The brains of liberals tend to be more active in situations involving conflict or uncertainty.  Whereas Conservatives are more thoughtful than liberals in processing emotions like fear."

Banning sodas is a lot different than refusing to let government money subsidize their purchase

5% of food stamps supposedly go to sodas.  Instead of regulating everyone's intake of sodas, why not ban letting food stamp dollars being spent on them?

food stamps, makes up about $80 billion of the $100 billion a year cost of the farm bill, providing aid to some 46 million people. . . .

From the Washington Post:

The 42 million Americans receiving federal food stamps use those benefits to buy $4 billion of soda every year, according to the Center for Science in the Public Interest. . . .

Newest piece at National Review Online: Bloomberg’s Soda Ban

My newest piece starts this way:

Mayor Michael Bloomberg wants to ban sugary soft drinks larger than 16 ounces. He believes that by this measure he can reduce obesity. But plenty of evidence indicates that he will fail. The ban will inconvenience people and waste their time, but it will not make them thinner.  
Bloomberg didn’t originate this type of idea. Public schools, which hold their students captive for much of their day, have tried a similar approach to making students lose weight. And some have gone further than Bloomberg’s limit on cup size and have banned such drinks completely. But even complete bans haven’t worked. Students simply drink more sugary drinks after school. According to an article in the Journal of Nutrition Education and Behavior analyzing data for Maine, “keeping such drinks out of teenagers’ reach during school hours may not be enough.” . . .

Michelle Obama supports Bloomberg's ban. 

she said, "We applaud anyone who's stepping up to think about what changes work in their communities. New York is one example." . . .

"New York Plans to Ban Sale of Big Sizes of Sugary Drinks"

So you ban large soft drinks. Will that reduce the amount that people drink of soft drinks?  Probably.  Sure, there are substitute ways of drinking it -- get two drinks (though not as easy to carry).  Will it get people to switch large milk shakes?  What is next?  Limits on portion size?  Mayor Bloomberg strikes again.  From the NY Times:

The proposed ban would affect virtually the entire menu of popular sugary drinks found in delis, fast-food franchises and even sports arenas, from energy drinks to pre-sweetened iced teas. The sale of any cup or bottle of sweetened drink larger than 16 fluid ounces — about the size of a medium coffee, and smaller than a common soda bottle — would be prohibited under the first-in-the-nation plan, which could take effect as soon as next March.
The measure would not apply to diet sodas, fruit juices, dairy-based drinks like milkshakes, or alcoholic beverages; it would not extend to beverages sold in grocery or convenience stores.
“Obesity is a nationwide problem, and all over the United States, public health officials are wringing their hands saying, ‘Oh, this is terrible,’ ” Mr. Bloomberg said in an interview on Wednesday in the Governor’s Room at City Hall. . . .

Liberals want to keep out of people's bedrooms?

Go drink that coffee

From MSNBC:

men who drank at least six cups of coffee a day had a 10 percent lower chance of dying during the 14-year study period than those who drank none. For women, the risk was 15 percent lower, according to Freedman’s work, published in the latest issue of the New England Journal of Medicine. . . .

"Mad Men" and drinking

Anyone who has seen an episode of the TV series "Mad Men" knows about how much these creative advertising types are depicted as drinking alcohol. Well, there is now some research that indicates that drinking enhances creativity.

Drinking alcohol may enhance a person’s problem solving skills, according to a new study. Scientists found that men who either drank two pints of beer or two glasses of wine before solving brain teasers not only got more questions right, they also were quicker in delivering correct answers, compared to men who answered the questions sober. While the latest findings go against the traditional beliefs that alcohol impairs analytical thinking and rational thoughts, lead author Professor Jennifer Wiley of the University of Illinois at Chicago discovered that alcohol may enhance creativity problem solving by reducing the mind’s working memory capacity, which is the ability to concentrate on something in particular. “Working memory capacity is considered the ability to control one’s attention,” Wiley told the Federation of Associations in Behavioral and Brain Sciences (FABBS). “It’s the ability to remember one thing while you’re thinking about something else.” While the latest study found that alcohol may enhance creative problem solving, previous research found that increased working memory capacity actually led to better analytical problem-solving performance. . . .

So are short high intensity workouts as good as long more leisurely ones?

That is what a growing body of research seems to indicate. From Fox News:

Many health groups have drummed into our heads that we need to do 30 minutes or more of moderate intensity exercise five days a week, totaling at least 150 minutes. But according to the Physical Activity Guidelines published by the National Institutes of Health, 75 minutes a week of high intensity physical activity can significantly lower your risk of heart disease, stroke, hypertension, diabetes and depression. That’s only 15 minutes a day, five days a week. If going all out for 15 minutes doesn’t sound like your thing, you can get the same improvements by doing 10 short, 60-second intervals. According to researchers at McMaster University in Hamilton, Ontario, young men who did high-intensity interval training, or HIIT, which involved 30 seconds of all-out effort at 100 percent of their maximum heart rate, saw similar improvements in their leg muscles as those who did multiple, hour-long sessions of steady cycling, and spent 90 percent more time exercising. . . .

A 'Universal' Cancer Vaccine?

From the UK Telegraph:

The therapy, which targets a molecule found in 90 per cent of all cancers, could provide a universal injection that allows patients' immune systems to fight off common cancers including breast and prostate cancer. Preliminary results from early clinical trials have shown the vaccine can trigger an immune response in patients and reduce levels of disease. The scientists behind the vaccine now hope to conduct larger trials in patients to prove it can be effective against a range of different cancers. They believe it could be used to combat small tumours if they are detected early enough or to help prevent the return and spread of disease in patients who have undergone other forms of treatment such as surgery. Cancer cells usually evade patient's immune systems because they are not recognised as being a threat. While the immune system usually attacks foreign cells such as bacteria, tumours are formed of the patient's own cells that have malfunctioned. . . .

What happens when shortages of organs make doctors desparate

The shortage of organs makes people to undesirable things. In particular, doctors will ignore signs of recovery. Wouldn't it be better if we let patients get paid for their organs? From the WSJ:

But what are you giving up when you check the donor box on your license? Your organs, of course—but much more. You're also giving up your right to informed consent. Doctors don't have to tell you or your relatives what they will do to your body during an organ harvest operation because you'll be dead, with no legal rights. . . . .

The current criteria on brain death were set by a Harvard Medical School committee in 1968, at a time when organ transplantation was making great strides. In 1981, the Uniform Determination of Death Act made brain death a legal form of death in all 50 states.

The exam for brain death is simple. A doctor splashes ice water in your ears (to look for shivering in the eyes), pokes your eyes with a cotton swab and checks for any gag reflex, among other rudimentary tests. It takes less time than a standard eye exam. Finally, in what's called the apnea test, the ventilator is disconnected to see if you can breathe unassisted. If not, you are brain dead. (Some or all of the above tests are repeated hours later for confirmation.)

Here's the weird part. If you fail the apnea test, your respirator is reconnected. You will begin to breathe again, your heart pumping blood, keeping the organs fresh. Doctors like to say that, at this point, the "person" has departed the body. You will now be called a BHC, or beating-heart cadaver. . . .

In a 1999 article in the peer-reviewed journal Anesthesiology, Gail A. Van Norman, a professor of anesthesiology at the University of Washington, reported a case in which a 30-year-old patient with severe head trauma began breathing spontaneously after being declared brain dead. The physicians said that, because there was no chance of recovery, he could still be considered dead. The harvest proceeded over the objections of the anesthesiologist, who saw the donor move, and then react to the scalpel with hypertension. . . . .

If Florida Gov Signs bill, Doctors won't be able to grill patients about gun ownership

I have run into these types of doctors myself in the past. My book The Bias Against Guns has a discussion of what happened when I took some of my kids to the medical clinic at Yale University. Michael Graham has a similar story here.

With a stroke of the governor's pen, Florida is positioned to become the first state in the nation to prohibit physicians from asking patients if they have guns in their homes, a move some doctors say will interfere with health care.
The Florida Senate passed House Bill 155 last month by a 27-10 vote and the measure now awaits the signature of Republican Gov. Rick Scott. If signed, it would ban doctors from asking about the presence of guns or ammunition in the home.
Republican State Rep. Jason Brodeur, a sponsor of the bill, proposed the legislation following an incident in which a Florida pediatrician told a mother to find another doctor when she refused to answer questions about guns in her home.
Supporters of the legislation, including the National Rifle Association, say they're seeking to stop doctors from invading their privacy. Critics of the bill, however, claim that doctors need to ask patients about guns to ensure their safety and to make sure they remain out of the reach of children.
"The [bill], if enacted, would limit pediatricians’ capacity to do what they do best -- compassionately and effectively care for children," read a March 30 statement released by The American Academy of Pediatrics. "Because unintentional injuries continue to be the leading cause of death in children older than 1 year, pediatricians play a key role in injury prevention by providing anticipatory guidance to parents during office visits to help minimize the risk of injury in the child’s everyday environment." . . .

A copy of the law is available here. Note that other states first tried to force doctors to ask patients about gun ownership.

Here is what I wrote on this topic a few years ago. Given the costs of gunlocks, there isn't much of a problem to solve in Florida or other states.


Here are what doctors are saying about the law.

The American Academy of Pediatrics' position on firearm-related injuries states "the absence of guns from children's homes and communities is the most reliable and effective measure to prevent firearm-related injuries" to them.
Timothy Wheeler, a retired surgeon in Upland, Calif., founder and director of Doctors for Responsible Gun Ownership, cites the position statement as proof that pediatricians want to ban firearms. Pediatric residents "think it's normal to ask about guns in the home," he says. "They don't understand that it is an ethical boundary violation."
Louis St. Petery, a Tallahassee pediatric cardiologist and executive vice president of the Florida Pediatric Society, says prevention, not politics, drives children's doctors to inquire about firearms. . . .

Six simple things that increase life expectancy

Fox News as a useful summary available here. I had one issue to raise:

In fact, studies suggest that daily exercise can add up to three years to your life. . . .

Assuming one works out one hour a day, that you are awake for 16 hours a day, and a zero interest rate, in 48 years you would have spent an amount of time exercising to the increase in life expectancy. Discounting by even a small interest rate would dramatically reduce the number of years that one would have to exercise before the work canceled out the benefit.

Stimulus dollars spent on anti-obesity campaign

So much for the claim that the Stimulus was being spent on what the Democrats called jobs programs.

A stimulus-funded anti-obesity campaign has spread throughout the country. And the $650 million Recovery Act program called Communities Putting Prevention to Work (CPPW) is funding not just anti-obesity campaigns in New York City, but campaigns throughout the country.

Thirty-one localities — from cities in Hawaii to Maine to South Carolina — have received grants to combat the effects of sugary drinks and trans fats on residents’ waistlines.

The state of California was by far the biggest beneficiary, receiving $55.1 million to do things like “reduce sugar-sweetened beverage consumption and promote healthy eating” and “implement physical education policies in schools.” Of that grant, $32.1 million went to Los Angeles, $16.1 million went to San Diego, and $6.9 million went to Santa Clara. Yet California is one of the country’s slimmest states.

Washington State received $25.5 million in taxpayer dollars to fight obesity. The grant went directly to the Seattle and King County Department of Public Health. However, according to Forbes rankings, Seattle is one of the top ten fittest cities in America. Nonetheless, in 2010, Seattle announced a campaign to reduce consumption of sugary drinks, modeled after “materials developed in New York City.”

The Philadelphia Department of Public Health received $25.4 million to “make healthy foods more available and affordable” and remove “unhealthy food” from schools.

Cook County and the City of Chicago in Illinois received $15.9 million and $11.6 million, respectively, to promote healthy living and anti-smoking campaigns.

Pima County in Arizona received $15.8 million. And in Texas, San Antonio got $15.6 million while the city of Austin, which is ranked as one of the fittest cities in America, got $7.5 million.

The affluent city of Boston, Massachusetts, where lawmakers are considering a ban on soft drinks, received $12.5 million in grants. In return, the city promised to decrease consumption of sugary beverages, increase active transit, and infuse more physical activity and health education into the school system. . . .

May Cell Phones Prevent Alzheimer's?

After all the lack of findings that cell phones cause cancer, it is interesting to see this work that indicates a benefit from cell phones.

A study in mice suggests using cellphones may help prevent some of the brain-wasting effects of Alzheimer's disease, U.S. researchers said on Wednesday.

After long-term exposure to electromagnetic waves such as those used in cell phones, mice genetically altered to develop Alzheimer's performed as well on memory and thinking skill tests as healthy mice, the researchers wrote in the Journal of Alzheimer's Disease.

The results were a major surprise and open the possibility of developing a noninvasive, drug-free treatment for Alzheimer's, said lead author Gary Arendash of the University of South Florida.

He said he had expected cell phone exposure to increase the effects of dementia.

"Quite to the contrary, those mice were protected if the cell phone exposure was stared in early adulthood. Or if the cellphone exposure was started after they were already memory- impaired, it reversed that impairment," Arendash said in a telephone interview.

Arendash's team exposed the mice to electromagnetic waves equivalent to those emitted by a cellphone pressed against a human head for two hours daily over seven to nine months.

At the end of that time, they found cellphone exposure erased a build-up of beta amyloid, a protein that serves as a hallmark of Alzheimer's disease.

The Alzheimer's mice showed improvement and had reversal of their brain pathology, he said.

"It (the electromagnetic wave) prevents the aggregation of that bad protein of the brain," Arendash said. "The findings are intriguing to us because they open up a whole new field in neuroscience, we believe, which is the long-term effects of electromagnetic fields on memory."

Arendash said his team was modifying the experiment to see if they could produce faster results and begin testing humans. . . .

Young Children who are spanked end up being happier and more successful

As far as these types of studies go, this sample of 2,600 people is relatively large.

Young children spanked by their parents may grow up to be happier and more successful than those who have never been hit, a study has found.

According to the research, children spanked up to the age of 6 were likely as teenagers to perform better at school and were more likely to carry out volunteer work and to want to go to college than their peers who had never been physically disciplined.

But children who continued to be spanked into adolescence showed clear behavioral problems.

Children’s groups and lawmakers in the UK have tried several times to have physical chastisement by parents outlawed, the Times of London reported. They claim it is a form of abuse that causes long-term harm to children and say banning it would send a clear signal that violence is unacceptable.

However, Marjorie Gunnoe, professor of psychology at Calvin College in Grand Rapids, Michigan, said her study showed there was insufficient evidence to deny parents the freedom to choose how they discipline their children.

“The claims made for not spanking children fail to hold up. They are not consistent with the data,” said Gunnoe. “I think of spanking as a dangerous tool, but there are times when there is a job big enough for a dangerous tool. You just don’t use it for all your jobs.” . . .

Calorie Posting Laws at NYC restaurants don't alter what people eat

Calorie posting laws in NYC haven't been altering what people eat. This might not be a big cost for large chains per dollar of food that they serve, but what about fancy "Foodie" restaurants? No change in today's menu because the food hasn't been tested yet for its calorie count. If you only serve food once as an experiment and you are a small restaurant, how can it pay to send the food off for testing? It will surely reduce innovation in food.

A study of New York City’s pioneering law on posting calories in restaurant chains suggests that when it comes to deciding what to order, people’s stomachs are more powerful than their brains.

The study, by several professors at New York University and Yale, tracked customers at four fast-food chains – McDonald’s, Wendy’s, Burger King and Kentucky Fried Chicken – in poor neighborhoods of New York City where there are high rates of obesity.

It found that about half the customers noticed the calorie counts, which were prominently posted on menu boards. About 28 percent of those who noticed them said the information had influenced their ordering, and nine out of 10 of those said they had made healthier choices as a result.

But when the researchers checked receipts afterward, they found that people had, in fact, ordered slightly more calories than the typical customer had before the labeling law went into effect, in July 2008.

The findings, to be published Tuesday in the online version of the journal Health Affairs, come amid the spreading popularity of calorie-counting proposals as a way to improve public health across the country.

“I think it does show us that labels are not enough,” Brian Elbel, an assistant professor at the New York University School of Medicine and the lead author of the study, said in an interview. . . . .