The cautioned that, while existing research provides useful information, much is still unknown about the extent of the problem, how to diagnose, manage and prevent concussions, and their short- and long-term effects. These areas remain confusing and controversial for parents, coaches,physicians and policy-makers alike.

91探花injury expert Dr. Frederick Rivara, a professor who holds the Seattle Children鈥檚 Endowed Chair in Pediatrics, was vice-chair of the committee, which was chaired by Dr. Robert Graham, director of the National Program Office of Aligning Forces for Quality at George Washington University.

The committee examined current findings on sports-related concussions in youth from elementary school age through young adulthood. They looked at studies, too, of concussions in military personnel and their dependents.

Several sponsors supported the Institute of Medicine and the National Research Council in convening the committee. They included the Centers for Disease Control and Prevention and the CDC Foundation, which received funding for the study from the National Football League. Other sponsors were the Department of Defense, Department of Education, U.S. Health Resources and Services Administration, National Academies, National Athletic Trainers Association Research and Education Foundation, and National Institutes of Health.

The data available on the incidence of sports concussions suggest that, among male athletes at in high school and college sports, football, ice hockey, lacrosse, wrestling and soccer led in the incidence of concussions. Among female high school and college students, soccer, lacrosse, basketball and ice hockey were linked with the highest rates of concussions. The frequency of concussions among younger athletes, or those in intramural and club sports, is not known.

The lack of data on the overall incidence of sports-related concussions in youth prompted the Institute of Medicine committee to call for the Centers of Disease Control and Prevention to establish a national surveillance to collect information on concussive injuries, including those in youth age 5 to 21.

The committee observed that little research has been conducted on changes in the brain after concussions in youth, or on the differences in brain effects between males and females.聽 The diagnosis and treatment of concussions, and measurements of recovery, have also not been settled, the report said.聽 In addition, the effects of repetitive brain injuries and multiple concussions are still unclear.

The committee recommended that the National Institutes of Health and the Department of Defense conduct studies of the short- and long-term effects of concussions on quality of life and daily activities. The committee said it believes it is critical to include predictors and modifiers of these outcomes, including the influences of socioeconomic status, race and ethnicity, gender, and co-existing conditions.

Better-designed safety equipment, they noted, might also protect youth from concussions.聽 The committee found only limited evidence that current helmet designs reduce the risk of sports-related concussion.

In its other recommendations, the committee called for enforcing standards for safe play and for teaching of age-appropriate techniques in youth sports. They also asked for national college and high school athletic governing bodies to evaluate how playing standards might affect the incidence of concussions.聽 The group suggested that the Department of Defense conduct similar research for sports and physical training at military academies and for military personnel.

The committee cited data showing that, among military personnel, mild traumatic brain injuries, of which include concussions, represent about 85 percent of all traumatic brain injuries, About 80 percent of their mild traumatic brain injuries did not occur in battle, but were commonly the result of automobile accidents and falls or happened during sports and recreational activities or military training.

The experts emphasized changing sports and military cultures that make injured young people reluctant to report their injuries. The serious nature of concussions and the health threats they post, the committee believes, needs to be heeded.

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The Institute of Medicine announced Oct. 21 that three 91探花 faculty members have been newly elected into its membership ranks, one of the most prestigious honors in the fields health and medicine.

They are:

Dr. Janis L. Abkowitz, the Clement A. Finch Professor of Medicine, head of the Division of Hematology in the Department of Medicine. She is also a leader of the Hematology Clinic at the Seattle Cancer Care Alliance, where she sees patients who have blood disorders.聽 In addition, she is a physician at 91探花Medical Center.

Dr. Frederick Appelbaum, executive vice president and deputy director, Fred Hutchinson Cancer Research Center; and president and executive director, Seattle Cancer Care Alliance, Seattle. He is also a 91探花professor of medicine, Division of Oncology.

Dr. Bruce M. Psaty, professor of medicine in the 91探花School of Medicine and professor of epidemiology and health services in the 91探花School of Public Health and an investigator at Group Health Research Institute, Group Health Cooperative.聽 He co-directs the Cardiovascular Health Research Unit, a joint program of the 91探花and Group Health Research Institute. Psaty practices general internal medicine at the Adult Medicine Clinic at Harborview Medical Center.

Their election brings 91探花faculty membership in the Institute of Medicine to 58. New members are elected by current members and are chosen for advancing medical science, healthcare and public health.聽 About a fourth of the members are neither health professionals nor biomedical scientists, but come from law, economics, sociology, geography, political science and other areas.

Founded in 1970, the Institute of Medicine is the health arm of the National Academy of Sciences.聽 As both an honorific organization and an advisory group, it acts as a national resource for independent, scientifically informed analysis and recommendations on health issues.

During the past year, its expert panels have addressed many public concerns, including elder abuse, violence around the world, population health implications of the Affordable Care Act, vaccine development priorities, commercial sexual exploitation of minors, pregnancy weight gain guidelines, birth settings, and the growing demand for cancer care.

The three new 91探花members of the Institute of Medicine bring a wide range of talents and experience to their new national advising responsibilities.

As the president of the American Society of Hematology, Abkowitz has issued statements on the likely effects on medical progress posed by instability in federal fiscal planning. She has also commented on the impact of other health care policies on hematology science and practice. Her own research is geared to understanding the biological mechanisms behind the blood cancers and blood- forming disorders many of her patients face.聽 Some of these conditions are leukemia, lymphoma, red cell aplasia, aplastic anemia, and polycythemia vera and other myeloproliferative syndromes.

Abkowitz studies stem cells residing in the bone marrow. These are the precursors of a variety of different blood cells.聽 Her work has improved knowledge of how blood production resumes after a bone marrow transplant.聽 It has also elucidated some of the reasons for marrow failure syndrome and for the expansion of cancer stem cells.聽 Abkowitz also researches imbalances that lead to red blood cell problems, such as the faulty coordination of heme and globin production. These two substances make hemoglobin, which is essential to the oxygen-carrying role of red blood cells.

She has received both a Clinical Oncology Career Development Award and a Faculty Research Award from the American Cancer Society. She has received many research grants from the National Institutes of Health, has served as Councilor to the National Institute of Diabetes and Digestive and Kidney Diseases, and has published more than 100 research papers. 聽Abkowitz is also dedicated to the education of new scientists and academic physicians, and advocates for national policies that support the entry of talented students into these careers.

Dr. Frederick Appelbaum, an expert in blood cancers, served for the past two decades as senior vice president and director of the Clinical Research Division of Fred Hutchinson Cancer Research Center. Last month he was named the executive vice president and deputy director of the Center. In his new post he is working on scientific strategies and research partnerships. These include a joint UW/Fred Hutch program in cancer molecular diagnostics currently under development.聽 From 1998 until his new appointment at Fred Hutch he served as head of the Division of Medical Oncology at the 91探花School of Medicine. He remains president of Seattle Cancer Care Alliance, the cancer-treatment arm of Fred Hutch, 91探花and Seattle Children鈥檚.

He was recruited to Seattle by the late Nobel Prize winner Dr. E. Donnall Thomas to advance bone marrow transplantation. Appelbaum鈥檚 research is on the biology and treatment of leukemias, lymphomas and other blood cancers. He was the lead author of the first paper to describe the successful use of autologous bone marrow transplantation, a therapy now used in more than 30,000 patients annually. He was also a key contributor to the discovery and development of gemtuzumab ozogamicin, known commercially as Mylotarg, the first monoclonal antibody approved by the Food and Drug Administration to treat acute myeloid leukemia.

Psaty has had major roles as an epidemiologist at the coordinating centers of National Institutes of Health-funded multi-center studies, including the Cardiovascular Health Study, the Multi-Ethnic Study of Atherosclerosis and the Women鈥檚 Health Initiative.聽 His research interests include heart attacks, stroke, high blood pressure, diabetes, drug safety, and genetics.

He is known for his work evaluating the risks and benefits of a variety of medications, including hormone therapy, non-steroidal anti-inflammatory agents, and drugs to treat high blood pressure, diabetes, lipid disorders, asthma, heart failure, atrial fibrillation, osteoporosis and chronic pain. He is also interested in drug-gene interactions that may influence individual reactions to medications.

Recently, Psaty has worked with other investigators to establish the Cohorts for Heart and Aging Research in Genomic Epidemiology, or CHARGE Consortium.聽 He has been named a Distinguished Scientist of the American Heart Association.

Psaty has served as chair of the National Institutes of Health鈥檚 Cardiovascular Disease and Sleep Epidemiology Study Section, as a member of the Institute of Medicine鈥檚 Committee on the Assessment of the U.S. Drug Safety System and its Committee on Ethical and Scientific Issues in Studying the Safety of Approved Drugs. He has also served on the Executive Committee of the National Heart, Lung and Blood Institute鈥檚 Strategic Planning Effort and on the Scientific Advisory Board of the Netherlands Biobank Infrastructure.

Currently he is a member of the U.S. Food and Drug Administration鈥檚 Science Board, its Mini-Sentinel Initiative鈥檚 Safety Science Committee, and the National Heart, Lung and Blood Institute鈥檚 Advisory Council.

A prolific researcher and the author of numerous papers, he also is a frequent contributor to editorial and commentary sections of medical and scientific journals, and a member of several editorial boards.聽 He is a teacher and mentor to students, fellows, and junior faculty in medicine and in epidemiology.