Healthy Schools

UNC prof studies concussions in young athletes

Riddell is embedding sensors in its helmets to help researchers study which types of hits are most likely to result in concussion.

Igor Szczyrba’s world is one of abstract mathematical formulae and complex software, not high school locker rooms and football sidelines. Yet from his research may come one key to keeping young athletes safe.

Szczyrba (pronounced “Sturba”) is a professor of mathematical sciences at the University of Northern Colorado and, for the past 10 years, his research has focused on computer modeling of traumatic brain injuries.

Last week, at a supercomputing conference in New Orleans, Intel, working with football helmet manufacturer Riddell, announced that Szczyrba is among a group of researchers whose modeling will be used to predict what sort of on-field hits are most likely to produce dangerous head injuries, and to suggest in which part of the brain such injuries might occur.

“We want to develop some brain injury criteria,” said Szczyrba, who is collaborating with his son, software engineer Rafal Szczyrba, and Martin Burtscher, an associate professor at Texas State University in San Marcos who received his doctorate in computer science from the University of Colorado in 2000.

A better way to detect concussions

“I’m not a physician but my understanding is that right now, at high school and university football games, if a player takes a blow to the head, the coach asks him some questions, based on a questionnaire,” Szczyrba said. “And based on their answers they decide if there’s a chance there’s a concussion.  But we want to do more.

“If it’s a minor concussion, they might not even know it. The problem with minor brain injuries is that they may not be immediately apparent. A brain hematoma may start very slowly, and even if you do an MRI, it might not show up immediately. You cannot judge immediately whether there’s been a concussion based on the behavior of a football player. That’s why it’s important to help physicians predict the probability of an injury.”

Igor Szczyrba is a UNC math professor who has spent the past 10 years researching computer modeling of traumatic brain injuries.

The modeling to be done by Szczyrba and his colleagues will involve data collected from sensors placed inside football helmets. These sensors will measure the acceleration or movement of a player’s head inside the helmet during a hit.

Research indicates that the most dangerous brain injuries appear when the head rotates on the neck. By analyzing the angle and force of each hit, and comparing those hits that cause concussions to those that do not, researchers may be able not only to design helmets that provide better protection, but also imbed chips in those helmets that can alert coaches and physicians when a player has taken a potentially dangerous hit.

“In the past we’ve tried to do similar studies on car accidents,” Szczyrba said. “You can estimate the acceleration of the car, the acceleration of the body, especially the head, but it’s very imprecise because you cannot tell how a body is moving in the car. This is the first time we’re getting the data from football helmets, and data from cars is not as good as data from helmets.”

Szczyrba has just received the first set of data. He hopes that within a year, he and his colleagues will have be able to produce some definitive findings.

Legislation likely to be introduced in Colorado

Meanwhile, expect concussions and how they are treated in school-age athletes to become an increasingly hot topic in Colorado. At least one major conference on the topic is planned for Denver in February, and officials from a number of agencies that deal with brain injuries are working to draft legislation they hope will be introduced in the upcoming Colorado General Assembly.

“Already there are half a dozen states where such legislation has passed or is pending, so it’s not just Colorado,” said Gavin Attwood, executive director of the Brain Injury Association of Colorado. “Part of that wave is because there has been increased research around the effects of concussion on young brains. The brains of high school athletes heal a lot slower than adults. I can’t give you a reason why, but they do.

“The other thing that’s being observed is that if you have several concussions, there can be longterm cognitive issues for the students,” Attwood said. “It could be a lack of concentration, or irritability or depression. So what the country is say is, ‘Hey, we love that our youth play sports and in no way are we trying to put a stop to that, but we’ve got to manage concussions carefully. Otherwise, these kids will potentially have cognitive issues later in life.”

The exact number of sports-related concussions suffered by Colorado students annually isn’t known, but based on extrapolation from national data, officials estimate somewhere between 1,349 and 2,510 such concussions each year that result in emergency room visits.

But the actual number is likely far greater, since many more injured youngsters never make it to the emergency room, and often never receive any sort of treatment at all.

Attwood said the proposed legislation in Colorado will mostly likely address three issues: mandatory education about concussions for all coaches, even volunteer coaches; mandatory removal from the field of play for young athletes suspected of sustaining a concussion; and prohibition from returning to play without the approval of a medical professional with training in treating concussions.

Conference to bring educators, parents, health professionals together

The Brain Injury Association will host a conference, “When Mild Traumatic Brain Injury is Not Really Mild,” on Feb. 4 in Denver. Keynote speaker will be Dr. Ron Savage, chairman and co-founder of the International Pediatric Brain Injury Society and “the guru of all things about disability in the school system,” said Rhonda Rickett, coordinator of the event. “He built the model for brining parents and schools together as very direct partners in educating students with disabilities,” she said.

PHOTO: Nicholas Garcia
The REAP Project (Reduce, Educate, Accommodate, Pace) is a community-based model for concussion management developed in Colorado.

Also speaking will be Dr. Karen McAvoy, a licensed child psychologist and director of the Center for Concussion at the Rocky Mountain Youth Sports Medicine Institute. From 2004 to 2007, McAvoy was manager of a Centers for Disease Control study on concussion in high school athletes. The researchers followed 92 student athletes with concussions over three years.

Based on that study, McAvoy developed the REAP Project (Reduce, Educate, Accommoate, Pace), a model program for concussion management that health officials hope will be adopted throughout Colorado. During its pilot 2009-10 school year, when it was in place in four Colorado school districts, the REAP project received more than 150 referrals of athletes treated in emergency rooms for concussion. The families of those injured athletes were quickly contacted by REAP so that parents could know what to look for and how to gradually ease the youngsters back into activity without further harm or risk.

For more information

To read more about Szczyrba’s Traumatic Brain Injury research and to see animated computer models, go here and select “animations.”

To see a simulation of a collision between football players and how their heads rotate, see this article in geek.com.

Read the latest recommendations for enhancing athlete safety, released in September by the Colorado Youth Sports Concussions Special Interest Group,

Not long for this world

Denver teen pregnancy prevention organization to close its doors at the end of the year

PHOTO: freestocks.org

A Denver-based nonprofit focused on teen pregnancy prevention and youth sexual health will close its doors at the end of 2017 after losing two major grants.

Andrea Miller, executive director of Colorado Youth Matter, announced the news in an email to supporters Monday afternoon.

The organization, begun in the 1980s as a volunteer-run group, provides teacher training and assistance in picking sex education curricula for 10 to 25 Colorado school district a year.

Miller said she’s hopeful other organizations will pick up where Colorado Youth Matter leaves off — possibly RMC Health, the Responsible Sex Education Institute of Planned Parenthood of the Rocky Mountains or the state-run Colorado Sexual Health Initiative.

Colorado Youth Matter’s biggest financial hit came in July when federal officials announced the end of a major teen pregnancy prevention grant mid-way through the five-year grant cycle. That funding made up three-quarters of Colorado Youth Matter’s $1 million annual budget.

“It feels like we’re getting cut off at the knees,” Miller said.

About the same time, the organization lost a family foundation grant that made up another 10 percent of its budget.

Miller, who took the helm of the organization just 10 months ago, said one of her primary goals was to diversify funding, but there wasn’t enough time.

Miller said with a variety of factors playing into the state’s teen pregnancy rates, which have been at record lows in recent years, it’s hard to say what the impact of the organization’s dissolution will be.

She said Colorado Youth Matter has worked successfully with school districts with different political leanings to find the right policies and resources to address the sexual health of their students.

“We have been masters at meeting the school districts where they are,” she said.

Wanna go outside?

Less plastic, more trees: New effort seeks to reinvent preschool playgrounds and capture kids’ imaginations

This play structure at Step By Step Child Development Center in Northglenn will go away under a plan to create a more natural and engaging outdoor play space.

Michelle Dalbotten, the energetic director of a Northglenn child care center called Step by Step, doesn’t like her playground.

Sure, it’s spacious, with a high privacy fence bordering an adjacent strip mall parking lot. It’s also got a brightly colored play structure surrounded by lots of spongy rubber mulch.

But Dalbotten and her staff have long noticed that the kids get bored there. They clump together in the small shady area or on a few popular pieces of equipment. Sometimes, they start throwing trucks off the play structure or shoving their friends down the slide.

Something about it just doesn’t work.

Recently, Dalbotten found a solution in the form of a new grant program called the ECHO initiative, which aims to reinvent more than 100 preschool and child care playgrounds across Colorado over the next few years. Think mud kitchens, looping tricycle trails, vegetable gardens, stages, shady reading nooks and dump truck construction zones.

The idea is to create outdoor spaces that capture kids’ imagination, connect them with nature and keep them active in every season. Such efforts grow out of a recognition in the education field that healthy habits start early and boost learning.

The current preschool playground at Step by Step is covered by rubber mulch.

Step by Step staff members had talked many times about their stagnant play space. But it was hard to envision anything different until they attended a design workshop with experts from ECHO, a partnership between the National Wildlife Federation, Qualistar Colorado and the Natural Learning Initiative at North Carolina State University.

“We knew we were missing the boat somewhere because (the children) weren’t super-engaged and we had a lot of behavioral issues,” Dalbotten said. “But we just couldn’t see past it, I guess.”

For child care providers, it’s a common challenge, said Sarah Konradi, ECHO program director with the regional office of the National Wildlife Federation

“This is a very new idea to a lot of folks,” she said. “It’s hard to sort out as a layperson.”

ECHO, borne out of a decade of research from the Natural Learning Initiative, will hand out $355,000 in grants over the next three years. The initiative prioritizes centers that serve children from low-income families or other vulnerable populations.

Fourteen centers — Step by Step and Wild Plum Learning Center in Longmont are the first two — will get $10,000 awards for serving as demonstration sites willing to host visits for other Colorado providers.

Leaders at Step by Step say kids and teachers often congregate in the limited shady spots.

Around 100 other centers will receive ECHO’s $5,000 seed grants and expert assistance to revamp their outdoor spaces.

Such transformations can have a big impact on children who may spend thousands of hours a year at such centers, said Nilda Cosco, director of programs at the Natural Learning Initiative.

“When we do a renovation of the outdoor learning environments as we call them — not playgrounds — we see increased physical activity … more social interactions among children … less altercations,” she said.

“The teachers have to do less because the children are so engaged. There is so much to do.”

ECHO, which stands for Early Childhood Health Outdoors, is the latest iteration of a program Cosco started a decade ago called “Preventing Obesity by Design.” That effort revamped outdoor space at about 260 child care centers in North Carolina, South Carolina and Texas.

Cosco said such makeovers can ”prevent obesity by counteracting sedentary lifestyles. Children walk more, exercise more, are conversant with healthy eating strategies.”

Dalbotten and her staff have big plans for their play areas, which sit behind a plaza that houses a bingo hall, Dollar Tree and Big D’s Liquor store. They’ll get rid of the colorful play structure and the rubber mulch in favor of a more natural look. There will be trees, shrubs, small grassy hills and a winding trail leading to a wide array of activity areas.

This porch will get new lighting, fencing and foliage to make it a more attractive outdoor space at Step by Step.

The center’s smaller toddler playground will get a similar reboot and its tiny yard for babies — mostly bare except for a couple low-hanging shade sails — will be expanded to include a shaded deck where teachers can sit or play with babies. A barren concrete porch on the side of the building will be remade into a cozy activity area decorated with bird houses, planter gardens and butterfly-attracting foliage.

At the recent design workshop Dalbotten attended, ECHO leaders displayed photos from other centers around the country that have gone through outdoor transformations. She saw one that stuck with her.

“There were kids everywhere,” she said. “It was super cool looking. I was like, ‘Oh look, we can be that. We can have kids everywhere.’”

PHOTO: Natural Learning Initiative
The play space at Johnson Pond Learning Center in Fuquay-Varina, NC, after a makeover.
PHOTO: Natural Learning Initiative
The outdoor play space at Spanish For Fun Academy in Chapel, Hill, NC, after a makeover.