Background/Purpose: Reducing the incidence and negative consequences of concussion among youth athletes is a public health priority. Fifty states have adopted legislation addressing the problem of sports-related concussions among youth-athletes. In 2010, Massachusetts adopted legislation based on Washington State’s Lystedt Law, enacting state-wide requirements for high school athletic programs. This study explored how the legislation has been implemented within Massachusetts schools and school-districts and identified factors influential to local implementation. Methods: A qualitative multiple-case study approach was utilized. US Census data concerning the household median income and population size of the school-district’s representative town(s) were used to purposively recruit cases. Semi-structured interviews with a breadth of school-district actors in the Commonwealth of Massachusetts and archival records associated with participating schools were used for analysis. Interview data were analyzed using a conventional content analysis approach. Written documents were subjected to an archival analysis. Results: 19 participants from 5 schools were interviewed. Interviewed school personnel included 5 athletic directors, 5 coaches, 4 athletic trainers, 4 school nurses, and 1 health and wellness coordinator. Eight case-level themes related to how the regulation was implemented were identified, and 6 influential factors related to the regulation’s implementation emerged. All participating cases decided to utilize neurocognitive baseline testing programs to assist in diagnosing concussions. Cases also decided to place the decision making authority of removal-from-play and return-to-play situations in the hands of athletic trainers. Primary care physicians were expected to provide medical clearance for concussed student athletes. Funding and man-power emerged as a threat to schools’ ability to implement the regulation with high fidelity. Conclusions: At the local level, provisions of the Massachusetts regulation were implemented with high fidelity. However, differences and similarities regarding local-level implementation decisions existed across cases. Conducting the study qualitatively allowed the study to obtain rich detail and identify implementation decisions made within cases. However, the knowledge generated may not be generalizable to other school districts or other states. The study’s findings speak to the variability often found when implementation is relegated to the local-level.

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Bakgrund: Hjärnskakning i idrott är vanligt och det finns etablerade riktlinjer för identifiering, hantering och rehabilitering. För tidig återgång till idrott kan medföra risker. Kvalitativ forskning om idrottares upplevelser och erfarenheter av och om idrottsrelaterad hjärnskakning har ej påträffats. Syfte: Att undersöka hjärnskakningsdrabbade idrottares upplevelser och erfarenheter om hjärnskakning inom idrott samt återgång till idrottsaktivitet efter skadehändelsen. Metod: Data insamlades från fem idrottare med hjälp av semistrukturerade intervjuer som analyserades med hjälp av innehållsanalys. Resultat: I studien framkom tre teman; ”Föranledd vårdkontakt”, ”Motiverande och hindrande faktorer för återgång till idrott”, samt ”Resonemang kring hjärnskakning” som innefattade bland annat att idrottarna upplevde undermålig information från vården gällande återgång till idrott efter hjärnskakning och att tränare hade bristande kunskap om omhändertagande vid idrottsskada. Idrottarna uppfattade ett behov av ökad kunskap. Stöttning och förståelse för idrottarens situation från omgivningen påverkade positivt för återgång medan press och rädsla för en ny hjärnskakning hämmade. Konklusion: Föreliggande studie har uppnått syftet att undersöka hjärnskakningsdrabbade idrottares upplevelser och erfarenheter om hjärnskakning samt återgång. Resultaten ökar förståelsen för idrottare som råkar ut för hjärnskakning i idrottssammanhang. Ytterligare forskning behövs för att bilda uppfattning om läget av idrottsrelaterad hjärnskakning i Sverige. / Background: Concussion in sport is common and there are established guidelines for identification, management and rehabilitation. Premature return to play may be dangerous. Qualitative research on athletes' experiences on sport-related concussion has not been found. Objective: To examine concussed athletes' perceptions and experiences about concussion in sports and return to play after their concussion. Method: Data was collected from five athletes using semi-structured interviews and was analyzed through content analysis. Results: Three themes emerged; "Cause for health care", "Motivations and hindrances on return to play", and "Reasoning about concussion”. They included for instance that athletes experienced poor information from health institutions regarding return to play, and coaches had insufficient knowledge of sport-injury management. The athletes perceived a need for increased knowledge. Support and understanding for the athlete's situation had a positive impact on the return to play while pressure and fear of a new concussion inhibited return to play. Conclusion: The objective to examine concussed athletes' perceptions and experiences about concussion in sports and return to play, has been achieved. The results increase our understanding for athletes who sustain concussions in sports. Further research is needed to form an estimation of ​​the extent of sports-related concussions in Sweden.

Incidents and awareness of sports-related concussion have grown in recent years, attracting attention in both the academic and popular press. These concussions can lead to the rapid onset of neurological dysfunctions, as well as a variety of subjective symptoms. Although concussive sequelae are typically considered transient, debate remains about the persistent effects of repeated traumatic contact during sport participation. Although research has examined the complications of head trauma found in traditionally popular sports (e.g., football, soccer, boxing), little research has focused on the growing sport of mixed-martial-arts (MMA). Research specifically pertaining to MMA is in nascent stages, but to-date studies suggest that concussive injuries for this sport are prevalent and the training regimens of these athletes may place them at a high risk for concussive or subconcussive head traumas—as well as the accompanying neurological difficulties. The current study is the first to assess cognitive profiles of MMA athletes using an objective neuropsychological assessment instrument. Among 56 athletes (28 MMA athletes and 28 athletes not exposed to head traumas), no neuropsychological differences were found between groups of athletes. Additionally, no aspects of MMA training regimen shared a reliable relationship with neuropsychological performance or subjective concussive symptoms. This suggests non-professional participation in MMA may not typically pose a significant risk for cumulative concussions and associated adverse neuropsychological consequences.

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Syftet med studien är att ta reda på om det finns förutsättningar att skapa ett idrottsrelaterat plagg som kan få liknande genomslagskraft som en välkänd tidlös symbol inom modevärlden, "den lilla svarta" (Coco Chanel). Begrepp som tidlöshet och genomslag är svårdefinierade visar genomgången litteratur. En ansats är att tillämpa filosofiska begrepp för att kartlägga modefenomenet. Förutom de filosofiska begreppen, litteraturstudier och erfarenheter från "den lilla svarta" innehåller studien utarbetade frågor till tre personer med stor branschvana. I analysen förs ett resonemang som visar att det utefter dessa förutsättningar är möjligt att skapa plagget. / The purpose of the study is to find out if there are prerequisites for creating a sports-related garment that can have a similar impact to a well-known timeless symbol in the fashion world, "the little black dress" (Coco Chanel). Concepts such as timelessness and impact are difficult to define, the review shows literature. One approach is to apply philosophical concepts to map the fashion phenomenon. In addition to the philosophical concepts, literature studies and experiences from "the little black", the study includes elaborate questions for three people with great industry experience. The analysis provides a reasoning that shows that it is possible to create the garment according to these conditions.

Background: To reduce the reliance on clinical judgment for the regulation of sports-related traumatic brain injury, identifying and measuring objective to biofluid biomarkers can provide important insight into the diagnosis (Determining the type and origin of a disorder) and prognosis (Determining the chance of survival of a disorder) of SR-TBIs. A biomarker is a qualitative or quantitative measurement that provides a measure of a subject’s physiological or pathological condition at a specific time or during a disease state. Recent literature has suggested that biomarkers can help in the screening of patients exhibiting symptoms of mild traumatic brain injury (mTBI). Despite insights from recent research, it is not clear whether biomarkers and assessments of sports-related TBI are well-aligned. The objective of this study sought to review the current literature on predictive values of biomarkers: glial fibrillary acidic protein (GFAP), calcium channel binding protein S100 subunit beta (S100β), total-tau and neuron-specific enolase (NSE) for sports-related Traumatic Brain Injuries (SR-TBIs) to improve comprehension of biological and clinical contexts that can help evaluate the use of these biomarkers in sports-related TBIs and their potential function. Methods: The study was reported based on guidelines recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA: 2020 Edition) of 8 studies related to the assessment of biomarkers concerning SR-TBI. Literature searches were carried out on PubMed, Google Scholar, ScienceDirect, and ResearchGate. With an evidentiary table, the characteristics of the studies included in the meta-analysis (n = 14 studies) were presented. A significant role for biomarkers in the management of mild traumatic brain injury is suggested by the results of this analysis. From the literature, the significance of biomarkers in SR-TBI was identified along with the biomarkers that can facilitate more accurate clinical decision-making. Results:The initial search resulted in 73 articles, and the application of exclusion criteria and removal of duplicates resulted in the inclusion of 14 articles. Eight of the included studies were ([26], [27], [28], [30], [34], [39], [40], [41]), three were cohort studies ([25], [37], [45]) one was a pilot study [32], one interview, and an observational study [44]. The review was carried out to determine the efficacy of Biomarkers GFAP, S100β, Total-tau, and NSE to help in the screening of mild traumatic brain injury (mTBI) in patients showing symptoms. The focus is on athletes presenting at an emergency department with possible mTBI requiring a CT scan based on the application of a clinical algorithm. A forest plot was utilized, and the studies had low heterogeneity or variability (P Conclusions: It was established that the utility of biofluid biomarkers in the prediction of mild traumatic brain injury due to SRC is significant when the markers are used in large combinations. The four biofluid biomarkers (S100β, total-tau, GFAP, NSE) under study have strong predictive ability for mTBI, and their use can reduce the number of CT scans among TBI patients participating in athletic activities. Although preliminary evidence shows that other diagnostic treatments may help to mitigate traumatic brain injury sequelae, clinical trials are needed to further test their efficacy, specifically with diverse and high-risk populations. Luckily, the research on mTBI biomarkers is rapidly advancing, and should these biomarkers be better established clinically, they could easily hold many important roles.

Objectives To examine the relationship between Concussion Symptom Clusters (CSCs) and return-to-play time using a representative sample of U.S. college athletes with sports-related concussions. Background Recent evidence regarding concussion symptoms have been observed to be an important element of concussion severity, and potentially a predictor of return-to-play time. However, there is a paucity of data examining the associations between Concussion Symptom Clusters (CSCs) and return-to-play time in the U.S. college athlete population. Methods Data from the 2009-2010 to 2013-2014 academic years (n=1670) were obtained from the Datalys Center for Sports Injury and Prevention Inc. database. Exploratory factor analytic methods were applied, and the resulting factors were used in multinomial regression modeling to identify associations between CSCs and return-to-play time. ResultsA 4-factor solution accounted for 48.8% of the variance and included: audio-vestibular, somatic, amnesic, and affective factor structure. Audio-vestibular symptoms were associated with increased odds of prevented participation at 7-13 days, 14-29 days, greater than 30 days, and out for remainder of season, respectively (p Conclusion Specific CSCs were significantly associated with return-to-play time in college athletes, (p<0.05).