High School Football Players Suffer More Symptoms After Concussion: Study

By Steven Reinberg
HealthDay Reporter

MONDAY, May 2, 2016 (HealthDay News) — High school football players are more likely to suffer more symptoms after a concussion, and to need more recovery time than their college counterparts, a new study finds.

But those who play in youth football leagues are the most likely to get back on the field less than 24 hours after a concussion, the researchers discovered.

“The finding related to return-to-play under 24 hours being the highest in the youth level is surprising, but may be the result of young football players struggling to identify concussion symptoms and express how they feel [to coaches or trainers],” explained lead researcher Zachary Kerr, from the Datalys Center for Sports Injury Research and Prevention, in Indianapolis.

With mounting evidence suggesting that concussions that happen earlier in life have a cumulative effect on the developing brain, finding ways to better spot and treat these serious head injuries in younger players is more pressing than ever.

For the study, Kerr and his colleagues analyzed data from three injury programs. They found that more than 1,400 sports-related concussions were reported among youth, high school and college football players from 2012 to 2014. The most common symptoms reported were headache, dizziness and difficulty concentrating.

Overall, about 15 percent of players did not return to play for at least 30 days after a concussion, while 3 percent returned to play less than 24 hours after being injured, the researchers found.

The study found that high school football players had the highest average number of reported symptoms of concussion (5.60), followed by college athletes (5.56) and younger players (4.76).

For high school players, the likelihood of returning to play at least 30 days after concussion was higher (19.5 percent) than younger players (just over 16 percent), or college football players (7 percent), the researchers found.

The researchers suggested biological factors, such as puberty and brain development, may explain the differences in recovery time among the age groups.

Meanwhile, the youngest players were the most likely to return to play less than 24 hours after suffering a concussion (10 percent), followed by college (close to 5 percent) and high school players (just under 1 percent), Kerr added.

It’s vital to educate young football players about concussions, as well as parents, coaches and officials on recognition and management of these head injuries, Kerr said. “Appropriate medical care includes managing and returning players to the game at the appropriate time,” he said.

Most colleges have an athletic trainer on the field during football games and practices to help spot and treat injuries, Kerr said. “However, a number of high schools do not have access to a full-time athletic trainer, and many youth football leagues do not have any access. An investment in an athletic trainer at these games and practices is an investment in the health and safety of our adolescent and children athletes,” he said.

The study findings were published online May 2 in the journal JAMA Pediatrics.

About 3 million young kids, 1 million high school students and 100,000 college athletes play football each year, the researchers said. Sports-related concussions, which can cause emotional, mental and sleep-related symptoms, are gaining more attention among players, coaches and parents, the researchers added.

Many factors influence how concussions are managed at different age levels, said Dr. John Kuluz, director of traumatic brain injury and neurorehabilitation at Nicklaus Children’s Hospital in Miami.

For example, “college coaches are all over these kids in terms of monitoring, treating and taking them out of class and seeing that they rest,” he said.

High school and middle school is a different story, where “it’s a chore trying to get these kids accommodations to recover from a concussion,” Kuluz said.

High school teachers have academic demands and players are often reluctant to admit they have symptoms, he added.

“Some kids are high achievers. They don’t want any accommodations. They want to play so badly they don’t admit to having symptoms,” Kuluz explained.

“In many cases, high school students are ridiculed or not believed when they report symptoms of a concussion,” he said. “I see that all the time.”

High schools have to allow these athletes time to recover, Kuluz said.

Luckily, students are becoming savvier, he added: “My hope is that athletes are going to get even smarter about concussions. It’s all up to the athletes reporting the symptoms.”

More information

For more information on concussion, visit the American Association of Neurological Surgeons.

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Does TV Influence Which Alcohol Teens Favor?

MONDAY, May 2, 2016 (HealthDay News) — The more teens see alcohol brands on TV shows, the greater the chances they’ll choose those brands, a new study finds.

Researchers looked at alcohol product placement on 10 popular TV shows. They found an average of two placements per episode. Some shows had more than 13 alcohol brand placements per episode, the study noted.

“Given the significant health implications of underage drinking, the Federal Trade Commission needs to place more emphasis on monitoring and limiting alcohol brand placement of alcohol in media,” study author Joy Gabrielli said in an American Academy of Pediatrics news release. Gabrielli is a clinical child psychologist at Dartmouth College and Dartmouth-Hitchcock Medical Center.

Placements featured a number of brands. Budweiser was the most frequent at 12 percent. Heineken appeared in 7 percent of placements, while Dos Equis was in 6 percent of placements, researchers said.

The researchers then surveyed more than 2,600 teens between the ages of 15 and 20. They asked the teens how much they watched the 10 shows. They also asked the teens about their drinking behavior and favorite alcohol brand. The brands that appeared most often in the shows tended to be the brands preferred by the teens in the study.

Teens who spent more time watching shows with more prominent alcohol brand placement had higher levels of problem drinking, the study revealed.

Tobacco companies haven’t been allowed to buy TV show product placement since 2000. But, alcohol makers have been allowed to self-regulate when it comes to product placement, the researchers noted.

“Despite alcohol company reports in a 2012 Federal Trade Commission summary that they pay little for brand placement of their products, highly advertised brands appeared commonly in some TV shows popular with underage youth,” Gabrielli said.

“This raises the question of whether companies are accurately reporting such payments to government regulators,” she added.

Gabrielli said the current approach to alcohol placements on TV represents a failure of the government to protect children from alcohol industry marketing.

“Parents should be aware that it is highly likely their children will be exposed to alcohol brand placements if they watch TV shows rated TV-PG or higher, and that this could affect their drinking behavior,” Gabrielli advised.

The TV ratings system (TV-PG, TV-14, TV-MA) should address the level of alcohol brand placement in each episode, the researchers suggested.

Findings from the study were to be presented Saturday at the Pediatric Academic Societies annual meeting in Baltimore. Meeting findings are typically viewed as preliminary until they appear in a peer-reviewed journal.

More information

The U.S. Centers for Disease Control and Prevention has more on underage drinking.

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Even in Taxis, Kids Belong in Safety Seats

MONDAY, May 2, 2016 (HealthDay News) — Small children riding in taxis often aren’t in a car safety seat, putting them at risk for injury and death in an accident, U.S. researchers warn.

All 50 states require young children to be in car safety seats when traveling in a motor vehicle. But, many municipalities exempt taxis from this safety rule, the researchers said.

Study senior investigator Dr. Ruth Milanaik is with Cohen Children’s Medical Center in New Hyde Park, N.Y. “Given that car safety seats have been shown to significantly decrease the risk of death or injury from motor vehicle collisions, there should be no exemptions in car seat safety laws for taxi services. When it comes to child safety, even one preventable injury calls for a change in policy,” she said said in an American Academy of Pediatrics (AAP) news release.

The researchers monitored places in New York City such as airports, train stations, shopping malls and tourist locations and observed 69 taxis picking up or dropping off passengers. More than 100 children were among those passengers. Only 11 percent of small children — no taller than the taxi’s side view mirror — were properly restrained while in the taxi. And, almost all of the children in that group were secured in an infant carrier, according to the researchers.

The researchers also called 97 taxi companies in the New York City area. Almost four out of 10 said they had car safety seats available. Of those companies, 18 percent said they had a limited number of seats or that a reservation was required for a seat. Only 8 percent charged extra for a seat, the researchers said.

Health code restrictions and allergy and hygiene concerns were some of the reasons cited by taxi companies for not having child safety seats available, the researchers noted.

Motor vehicle accidents are a leading cause of death among children in the United States. There’s a 70 percent increased risk of death or injury for 7- and 8-year-olds who aren’t properly restrained in vehicles, the researchers said.

Infants and toddlers should be secured in rear-facing child safety seats. Children should continue to be placed in car safety seats or belt-positioning booster seats until they reach the height of 4 feet, 9 inches, the AAP advises.

The study was to be presented Sunday at the Pediatric Academic Societies annual meeting, in Baltimore. Findings presented at meeting are generally viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. Centers for Disease Control and Prevention has more about child passenger safety.

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Could Talk Therapy Ease Chemo-Related Memory Issues?

MONDAY, May 2, 2016 (HealthDay News) — A type of psychotherapy might help cancer survivors deal with the long-term thinking problems some experience after chemotherapy, researchers say.

It’s estimated that about half of those who undergo chemotherapy for cancer develop what’s often called “chemo brain.” For instance, they may have trouble following conversations or remembering the steps in a project, according to background notes with the new study.

Although usually mild, these changes can affect quality of life, job performance and relationships, said the researchers from the Eastern Maine Medical Center and Lafayette Family Cancer Center in Bangor, Maine.

The researchers developed a cognitive-behavioral therapy (CBT) program called Memory and Attention Adaptation Training to help cancer survivors prevent or manage these memory problems.

Their study involved 47 breast cancer survivors who underwent chemotherapy an average of four years earlier. Some were assigned to receive eight CBT sessions that lasted about 30 to 45 minutes each.

The rest received supportive talk therapy sessions.

For both groups, the sessions were conducted via videoconference to minimize patients’ travel time. Participants also completed thinking tests and answered questionnaires about their memory issues and related anxiety. Verbal memory and processing speed was also tested.

Participants were retested after completing all eight sessions and again two months later.

The CBT participants reported significantly fewer memory problems and better processing speed than those who received supportive therapy, according to the study published online May 2 in the journal CANCER. They also reported much less anxiety about mental problems two months after their psychotherapy ended.

“This is what we believe is the first randomized study with an active control condition that demonstrates improvement in cognitive symptoms in breast cancer survivors with long-term memory complaints,” said study leader Robert Ferguson in a journal news release. He is currently at the University of Pittsburgh Cancer Institute.

“Participants reported reduced anxiety and high satisfaction with this cognitive-behavioral, non-drug approach,” Ferguson said. Also, because treatment was delivered via videoconference device, he said the study demonstrates it’s possible “to improve access to survivorship care.”

More information

The National Alliance on Mental Illness provides more information on cognitive-behavioral therapy.

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Even Non-Obese Report Better Mood, Sex Drive After Dieting

By Dennis Thompson
HealthDay Reporter

MONDAY, May 2, 2016 (HealthDay News) — Dieting might help improve your health, mood, sex drive and stress levels even if you’re not obese, a new clinical trial reports.

A group of either healthy weight or mildly overweight people who followed a calorie-restricted diet for two years lost nearly 17 pounds on average and enjoyed significant quality-of-life improvement, said lead author Corby Martin. He is director for behavioral sciences and epidemiology with the Pennington Biomedical Research Center in Baton Rouge, La.

“Even among people who are relatively healthy, you see these positive biological and physiological changes occurring with calorie restriction,” Martin said.

Participants felt better and lost weight even though they fell short by half of their original calorie-cutting goal, Martin noted.

Researchers had asked study participants to restrict their calorie intake by 25 percent, but over two years they only achieved an average 12 percent calorie reduction.

“A 25 percent reduction in caloric intake for most people is going to be very challenging,” said Dr. Scott Kahan, director of the National Center for Weight and Wellness in Washington, D.C. “Despite only achieving 12 percent, you still see the really big benefits of that degree of caloric decrease, and we have lots of data from other studies showing even smaller changes lead to very impressive outcomes.”

Until now, studies have shown that cutting calories can make a big difference in the health and well-being of obese people, but it’s been an open question whether dieting would help or harm people at or near a healthy weight, Martin said.

For their clinical trial, Martin and his colleagues recruited 220 people with a body mass index (BMI) between 22 and 28. Average age was nearly 38, and 70 percent were women.

Healthy weight runs from 18.5 to 24.9 BMI, while overweight runs from 25 to 29.9 BMI, according to the U.S. Centers for Disease Control and Prevention. Obesity is defined as a BMI of 30 or higher.

Almost two-thirds of the participants were asked to restrict their daily calories by 25 percent for two years, while the other third could eat whatever they wanted.

By the end of the second year, people on the calorie-restricted diet had lost nearly 17 pounds on average, or 10.4 percent of their initial weight, the researchers found. There was no significant weight change among the people eating whatever they liked.

Compared with the no-diet group, the investigators found that people restricting their calories experienced: improved mood, including less depression; better quality of life; improved sleep; and enhanced sexual drive and better relationships.

The biological changes that accompany weight loss — lower blood sugar, improved cholesterol, better blood pressure — appear to translate into a happier life for people who cut calories, even if those people are in good shape, Martin said.

“The presumption is that these general health improvements that are really kind of biologically based are reflected in how we subjectively feel,” he said. “We feel as if we have more energy. It’s easier to move around and be more active and not have sore knees or a sore back.”

Another expert said the weight loss, not the calorie restriction, caused the improved mood, well-being and sex drive. “When people lose weight they feel happier, healthier, more satisfied with their appearance and even sexier,” said Lauri Wright. She is an assistant professor in the University of South Florida’s College of Public Health in Tampa.

Martin and Kahan agreed that to successfully reduce calorie intake, you should find the diet that feels best for you and fits best into your daily lifestyle.

Some people may respond well to a traditional low-fat diet, while others might find that a low-carb diet is easier to follow, they said. The goal should be to lower daily energy intake in a way that is sustainable.

“If one way fits for you better than another, don’t listen to the noise out there that says it has to be one way or the other way,” Kahan said. “We have good data suggesting the opposite. Everyone is different in terms of their bodies, their tastes and their need for convenience.”

The trial results are published in the May 2 online issue of JAMA Internal Medicine.

More information

For more on healthy eating, visit the U.S. Centers for Disease Control and Prevention.

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More Kids Burned, Hospitalized as Fireworks Sales Rules Ease

MONDAY, May 2, 2016 (HealthDay News) — There has been a sharp increase in the number of U.S. children who have been hospitalized with fireworks-related burns since sales restrictions on fireworks have been eased, a new study finds.

Researchers analyzed national data and found a slight increase since 2006 in the number of patients younger than 21 with fireworks-related burn injuries who were treated and released by U.S. emergency departments.

But the investigators found a much larger increase in the percentage of patients in that age group who were admitted to the hospital for their burn injuries, rising from 29 percent of cases in 2006 to 50 percent in 2012.

The findings are scheduled for presentation Tuesday at the Pediatric Academic Societies annual meeting, in Baltimore. Research presented at meetings should be viewed as preliminary until published in a peer-reviewed journal.

“The increase in fireworks-related injuries and the severity of these injuries in children since 2006 are very concerning,” study author Dr. Charles Woods said in an American Academy of Pediatrics news release.

“Although our findings do not prove a direct link to relaxations in state laws governing fireworks sales, it may be time for lawmakers to reassess this issue,” said Woods, associate chair of the department of pediatrics at the University of Louisville.

“Parents and caregivers of children also should be aware of these increasingly serious injuries and the potential dangers involved in allowing young children to handle and play with fireworks,” Woods added.

More information

The U.S. Consumer Product Safety Commission has more on fireworks safety.

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Obamacare Buyers Could Have Fewer Choices in 2017

By Karen Pallarito
HealthDay Reporter

MONDAY, May 2, 2016 (HealthDay News) — With the nation’s largest health insurer exiting all but a few Affordable Care Act exchanges next year, some Americans may be left with fewer choices and some might see higher monthly premiums.

Experts say that will be the upshot of UnitedHealth Group Inc.’s recent announcement that it will pull out of most of the 34 states where it offers health plans on the public health insurance exchanges.

The public health insurance exchanges are online marketplaces where people can shop for and enroll in a health plan. This is the third year of operation for the exchanges, a key component of the Affordable Care Act, also known as Obamacare.

Meanwhile, health insurers stung by the high cost of covering public health exchange enrollees, are expected to request sharply higher rates for 2017.

In Virginia alone, nine insurers have proposed average rate hikes ranging from more than 9 percent to 37 percent, the Associated Press reported.

In 2016, about 12.7 million people enrolled in a health plan through HealthCare.gov or state-based insurance exchanges, according to the U.S. Department of Health and Human Services. And more than eight in 10 enrollees qualified for federal tax credits to make their monthly insurance premiums more affordable.

While most consumers can choose from three or more insurers, UnitedHealth’s departure could curtail choices to one or two in a handful of southern and midwestern states, a recent Kaiser Family Foundation analysis suggests.

But UnitedHealth’s withdrawal is expected to have a minimal effect on the average “benchmark” premium nationwide, the foundation said. It would likely have the largest effect in Alabama, Arizona, Iowa, Nebraska and North Carolina, the foundation noted.

UnitedHealth, which covers 795,000 exchange customers, has said it expects to lose $650 million on its exchange business in 2016.

The company is not the only insurer that has reported that it is struggling to turn a profit on the state and federal health insurance exchanges.

In a February call with investors, Aetna Inc. said the company’s public exchange business remains unprofitable.

And some Blue Cross Blue Shield insurance plans, including those in Alabama and North Carolina, also have reported red ink on plans sold on the Affordable Care Act exchanges, according to news reports.

One notable exception is Anthem Inc., the nation’s largest for-profit Blues plan.

Anthem officials said last week that the company remains on target to post a slim profit this year on its public exchange business.

Gail Wilensky, an economist and head of Medicare and Medicaid under former President George H.W. Bush, said UnitedHealth’s pullback highlights, in a very public way, difficulties insurers are having in the fledgling exchanges.

“We are not yet in a period of stability,” she said.

For one thing, insuring people who signed up for health plans on the exchanges has been more costly than insurers anticipated.

People newly enrolled in those plans have higher rates of chronic conditions, such as high blood pressure, diabetes, depression, heart disease, HIV and hepatitis C, according to a recent Blue Cross Blue Shield Association analysis.

The analysis also found that these newly insured Americans use more medical services and had medical costs that were 22 percent higher, on average, in 2015, than Blue Cross Blue Shield members with private health insurance.

Wilensky, a senior fellow at Project HOPE, an international health foundation, said health plans were “flying blind” in the first two years under the public exchanges because they didn’t know how sick these new members would be.

Special enrollment periods offered by the Obama administration in 2014 and 2015 to boost the number of insured individuals also played havoc with rate-setting, Wilensky added. Many of these people used medical care and then dropped their insurance; health plans, in turn, incurred the expense but lost whatever premium would have been paid the rest of the year, she explained.

Sorien Schmidt, state director for the advocacy group Enroll America, doesn’t know how it will all shake out, but she said people still have choices. And she cautioned the public not to panic when they hear about rate increases, since many exchange buyers receive federal subsidies.

“A rate increase does not equal a premium increase,” she explained.

And because plans and premiums change annually, Schmidt said it’s in consumers’ best interest to shop around each year. Open enrollment for 2017 begins Nov. 1.

“Check to make sure that you’re picking the best plan for your needs, both your budget and your health needs,” Schmidt said.

More information

To learn more about the insurance exchanges, go to HealthCare.gov.

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Playground-Related Brain Injuries on Rise in U.S.

By Kathleen Doheny
HealthDay Reporter

MONDAY, May 2, 2016 (Healthday News) — For some kids, playgrounds aren’t all fun and games. Playground-related brain injuries have risen significantly in the United States over the last decade, health officials say.

Despite improvements in playground safety and design, between 2001 and 2013, emergency rooms treated an average of 21,000 playground-related traumatic brain injuries annually among kids 14 and younger.

The statistics were compiled for a new report from the U.S. Centers for Disease Control and Prevention.

“It’s not just sports. This study highlights the importance of other causes of traumatic brain injuries and concussion among children,” said study researcher Dr. Jeneita Bell. She is a medical officer at the CDC’s National Center for Injury Prevention and Control.

The researchers can’t explain why serious head injuries are increasing. “We can only make assumptions,” Bell said.

“It may be that there is increased awareness about concussions as a whole,” she suggested. In recent years, researchers have focused on the dangers of concussions among children, especially in sports.

Monkey bars, playground gyms and swings were the pieces of equipment cited most often in connection with these head injuries. And about two-thirds of the injuries occurred at schools and recreational sports facilities, according to the study.

Th researchers looked at national injury-surveillance data and found that ERs treated more than 29,000 children for concussions and other serious head injuries in 2013, up from 18,000 in 2001. The numbers started rising notably in 2009, the study authors said.

Boys accounted for nearly six out of 10 of these ER visits. And more than half of the children treated were aged 5 to 9, Bell’s team found. Most of the injuries happened in April, May and September.

In recent years, industry standards for playgrounds have improved, with surfacing better able to reduce the risk of injury and death from falls, the researchers said, suggesting even better safety strategies are needed.

The study findings don’t surprise Dr. Barbara Pena, research director of the emergency department at Nicklaus Children’s Hospital in Miami. She, too, cited increased awareness of the dangers of head injuries as one probable reason for the uptick.

Adult supervision is crucial to reduce the injury rate, agreed Pena and Bell. Pena also suggested recognizing that some pieces of equipment are more hazardous than others.

“I would advise them to stay away from the monkey bars,” Pena said. If that’s not possible, parents and teachers should warn children that hanging upside down from monkey bars is dangerous, because they’ll likely land on their head if they fall, she added.

Parents should also inspect playgrounds.

“Check the surfacing to make sure there is soft surfacing in place,” Bell said. Be sure your child is playing on equipment appropriate for his or her age. And, look at the equipment to be certain it’s in good condition, Bell advised.

The study should not discourage playground use, Pena said. “It’s fun and it’s needed, and kids can be outside,” she said. But paying attention to the equipment and the supervision can go a long way to reducing injuries, the experts agreed.

The study results were published online May 2 in the journal Pediatrics.

More information

To learn more about playground safety, visit the National Program for Playground Safety.

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WH&F Head Trainer Sheena-Lauren shares her 10 minute workout to kickstart your mornings.

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WH&F Head Trainer Sheena-Lauren shares her 10 minute workout to kickstart your mornings.

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