Snakeskin can inspire to safer buildings

New research shows that it might be a good idea to look for inspiration in nature when designing load-bearing foundations for buildings.

AARHUS UNIVERSITY

Research News

 

Despite human inventiveness and ingenuity, we still lag far behind the elegant and efficient solutions forged by nature over millions of years of evolution.

This also applies for buildings, where animals and plants, have developed extremely effective digging methods, for example, that are far more energy-efficient than modern tunnelling machines, and even self-repairing foundations that are unusually resistant to erosion and earthquakes (yep, we're talking about roots here).

Researchers from all over the world are therefore seeking inspiration in nature to develop the buildings of the future, and researchers from Aarhus University and University of California Davis have now in collaboration published an article in the scientific journal Acta Geotechnica about constructing foundations inspired by the scales on a snake.

"Previous studies have shown that surface geometry inspired by snakeskin can result in different shear strengths, depending on the load direction. We've taken this knowledge one step further in this research and investigated the interaction between different soil types and these snakeskin surfaces," says Assistant Professor Hans Henning Stutz from the Department of Civil and Architectural Engineering at Aarhus University.

Modern pile foundations are usually made by driving, drilling or pushing piles into the ground to achieve sufficient bearing capacity for a building.

Today, the piles are usually prefabricated with quadratic or circular cross-sections and a load-bearing capacity that is isotropic (identical in all shear directions) due to the mainly symmetrical, smooth profile of the surface.

However, in the study, the researchers experimented with asymmetric micro-structural features on the surface, resembling the scales along the underside of a snake. These so-called ventral scales are elongated in shape, relatively smooth, and have cross-section shaped like an elongated, right-angled triangle.

"By experimenting with 'scales' measuring 0.5 mm in height and 20-60 mm in length, we've achieved - in lab conditions - a significantly increased load-bearing capacity in the media we've examined: more specifically different types of sand. The results of the project show that piles with this surface pattern give 25-50 per cent less resistance during installation compared with the pressure they can subsequently support," says Hans Henning Stutz.

According to the assistant professor, there is still a lot be gained from biology when optimising structures and durable foundations, and he believes that future construction will find much more inspiration in biology.

"Evolution has come up with some quite inspiring solutions during the ages, and there's a lot to be gained in a geotechnical perspective. I'm convinced that in the future we'll see major developments in bio-inspired and very effective solutions, especially in areas such as anchoring, tunnels, and marine constructions," he says.

Partners of people with schizophrenia and bipolar disorder have often a mental disorder

THE MAGICK PRINCIPLE OF LIKE ATTRACTS LIKE*

Almost half of the parents who have children together with a parent with schizophrenia or bipolar disorder, are themselves burdened by psychological issues. This can affect family life and the children. This is shown in the research result from the major

AARHUS UNIVERSITY

Research News

 

Almost half of the parents who have children together with a parent with schizophrenia or bipolar disorder, are themselves burdened by psychological issues. This can affect family life and the children. This is shown in the research result from the major Danish psychiatry project iPSYCH.

We typically choose a partner who resembles us in relation to social status, education and, to some extent, also income. Research has previously established this. A new study now shows that almost half of the parents who have children with a partner who suffers from schizophrenia or bipolar disorder themselves meet the criteria for a mental disorder. By comparison, this is 18 percent for parents in the control group.

The results stem from The Danish High-Risk and Resilience Study, which is part of iPSYCH. A total of 872 parents participated in the study. The parental couples were selected such that one of the parents was registered in the National Patient Register with a diagnosis of schizophrenia or bipolar disorder. Their partner and the parents from the control group were not registered with these disorders. At the time of the study, all of the parents had a seven-year-old child.

Met the criteria themselves

"In the Danish registers we used, each child only had one parent registered with a mental disorder, but the diagnostic interview carried out as part of our study showed that almost half of the partners also fulfilled the criteria for such a disorder. In addition, the partners had a lower functional level compared to the control group," says PhD and Psychologist Aja Neergaard Greve, who is behind the study.

"The most frequent diagnosis among the partners was depression. We were surprised that six per cent of the partners to people with schizophrenia also met the diagnostic criteria for schizophrenia themselves. In the control group, it was only one per cent," she says.

Care is often dependent on the other person

According to the researcher, the results - which have been published in the scientific journal Schizophrenia Bulletin - indicate possible risk factors for children who grow up in families with a parent with schizophrenia or bipolar disorder.

"When one of the parents has a severe mental disorder, caring for the child will often be more dependent on the other parent, who perhaps also has much of their attention directed towards the ill parent. If the parent who we thought was healthy and well-functioning also in some cases has a mental disorder, and/or has a lower functional level and is emotionally and practically burdened by the general family situation, then this can have significance for the whole family's well-being," explains Aja Neergaard Greve.

Already at increased risk

Children born to parents with schizophrenia and bipolar disorder have an increased risk of themselves developing mental disorders - in fact, the familial risk is the highest known risk factor for later development of these disorders. If both parents have a mental disorder, the overall risk for the children increases.

"This increased risk is both genetic and environmental. Cognitive functions such as intelligence are e.g. hereditary, but if the parents have cognitive difficulties there will also be an effect on the environment the child grows up in if the parents therefore don't have the opportunity to create good stable routines and predictability or to stimulate the child sufficiently," she says and continues:

"Some of these families are particularly vulnerable and struggle with more than one issue and they therefore need extra help and support. Our study suggests that there is a need for increased attention on some of the families where one or both parents have a mental disorder. There is a need for specialised and targeted efforts for families already early in the child's life," says Aja Neergaard Greve.

The researchers will follow the families from the study up through the child's upbringing and hope to learn more about how the children develop, as well as which factors have greatest importance for the well-being of the families.

Background for the results

The Danish High-Risk and Resilience Study is a nationwide, representative group consisting of 522 children born to parents with schizophrenia, bipolar disorder or parents from the control group. The children and both the child's biological parents have been interviewed and examined. The results of this study stem from data from 872 parents.

###

The study is a collaboration between adult psychiatry in the Central Denmark Region and adult and child and adolescent psychiatry in the Capital Region of Denmark.

The study is financed by the Lundbeck Foundation, Aarhus University, the Central Denmark Region, the Capital Region of Denmark and the Beatrice Surovell Haskell Foundation for Child Mental Health Research of Copenhagen.

The scientific article is published in Schizophrenia Bulletin

* GOLDEN BOUGH; JAMES FRAZIER.

Mobile gaming app enhances HIV care

University of North Carolina at Chapel Hill and Duke University promote better health through gamification

UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL

Research News

 

IMAGE: UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL HEALTH BEHAVIOR SPECIALISTS, FROM LEFT, LISA HIGHTOW-WEIDMAN AND KATE MUESSING INTEGRATE GAMING FEATURES INTO MOBILE GAMING APPLICATION TO IMPROVE HIV CARE. view more 

CREDIT: UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL

Researchers at the University of North Carolina at Chapel Hill and Duke University improved HIV care by gamifying it with a mobile gaming application.

Gaming features - like those used to drive airline loyalty and track daily steps --- helped young men living with HIV achieve viral suppression and doubled their chances for reaching near perfect adherence to medication plans, according to a study in AIDS and Behavior.

Gamification can inspire changes in behavior when a doctor's advice or a patient's good intentions are not enough. In this case, motivating those living with HIV to stick to the antiretroviral therapy (ART) that can keep them healthy by suppressing the HIV virus.

Study authors include Lisa Hightow-Weidman and Kate Muessig, health behavior specialists at the UNC Gillings School of Global Public Health, Alyssa Vecchio of the UNC Institute for Global Health and Infectious Diseases, and Alyssa Platt and Joseph R. Egger of the Duke Global Health Institute.

"The app delivered daily health messages in a digestible form that was more fun than sitting in a class and more consistent than a clinic visit scheduled every three to six months," said lead study author Hightow-Weidman, professor of medicine and health behavior and mHealth researcher who directs the UNC Behavior and Technology Lab in the UNC School of Medicine.

Gamifying health promotion

Researchers teamed up with the web application development company Caktus Group to create a mobile phone app that could help patients to better adhere to HIV medication plans.

Specifically, the app was designed with the goal of improving medication adherence among young men who have sex with men who are living with HIV. It's the population most affected by HIV in the United States.

The app made use of game mechanics and social networking features to improve adherence to HIV medications. In addition to medication reminders and adherence tracking, Epic Allies used gaming elements to create a compelling and engaging experience that could motivate and support behavior change.

Gamers were awarded points and badges for their own successes and providing support and encouragement to others.

Rates of viral suppression and ART adherence increased over the course of the study among its 146 participants, even among those who were randomized to receive the control app -- weekly text-based information about adherence.

At 26 weeks, viral suppression among app users was 62.9% while viral suppression in the control group was 73.5%. When use of the Epic Allies app, which is no longer available, ended, viral suppression leveled out to about 64% for all study participants, who were ages 16-24.

Notably, the app appeared to provide a head start to controlling the HIV virus. Participants who used the app regularly - four or more days a week - had a reported 56% higher likelihood of achieving viral suppression at 13 weeks compared to those who didn't use the app. Regular app users were more than twice as likely to report near perfect ART adherence at both 13 weeks and 26 weeks compared to non-app users.

Digital bridges to care

Study limitations include the small sample size and authors write that issues with app use metrics limit the ability to say that the app was effective in causing behavior changes that improved health.

But Hightow-Weidman said technology is emerging to support high-risk patients who may have life circumstances - homelessness, mental health issues, substance abuse issues - that may make it harder for them to focus on the long term. For young people, it can be especially difficult to connect today's decisions to future health, she said.

And as telehealth and virtual visits gained momentum during COVID-19 shutdowns, lessons were learned about providing needed care for everyone.

"Apps and digital tools are a bridge to care," she said. "They cannot replace a network of doctors and nurses and care management, but they can be a bridge to that real world and inspire change."

The project was supported by a grant from the National Institutes of Health.

Young people and adolescents know too little about pathogens such as COVID-19

Which are reciprocally transmitted from animals to humans

LEIBNIZ INSTITUTE FOR ZOO AND WILDLIFE RESEARCH (IZW)

Research News

 

IMAGE: THE ONE HEALTH CYCLE EXPLAINS HOW THE MANAGEMENT OF A ZOONOTIC SPILLOVER WITH A ONE HEALTH APPROACH WORKS. A ZOONOTIC PATHOGEN FROM WILD ANIMALS MOVES INTO LIVESTOCK, PETS, FUR ANIMALS OR DIRECTLY TO HUMANS. THE ONE... view more 

CREDIT: ZUCCA P ET AL.

The EU-funded BIO-CRIME project - with support from the Leibniz Institute for Zoo and Wildlife Research (Leibniz-IZW) - conducted a scientific investigation on the topic of illegal small animal trade and the associated risk of pathogen transmission.

The study focused on the key areas of "illegal small animal trade" and the level of knowledge and proper behaviours of young people and adolescents with "zoonotic diseases" and the "One Health concept". One Health is an approach that recognises that human health is closely linked to the health of animals and our shared environment.

A total of 656 students from six countries participated in the survey. The students answered an anonymous questionnaire, followed by a theoretical and practical lesson that resolved the correct results of the survey. After four weeks - in the meantime the students had further studied the topic of zoonoses and the One Health approach - a second theoretical-practical lesson was conducted. Immediately afterwards, the same questionnaire was answered anonymously a second time.

The result of the first questionnaire response showed that the percentage of students who did not know that animals can transmit many diseases to humans and vice versa was 28.96 %. The percentage of participants who did not know what a zoonosis is was 32.16 %. Ignorance about the One Health concept was 31.40 % among the young people, respectively was answered incorrectly by 59.91 % of the students, furthermore rabies was considered as a non-dangerous disease by 23.02% of the participants.

After the two theoretical-practical lessons of the first survey, the same questionnaire was filled out again to conclude the knowledge transfer process. The result, the percentage of correct answers (knowledge increase) increased by 21.92 %.

Depending on gender and country, there were different expressions in the correctness of the answered questions. Overall, however, a pronounced lack of knowledge about zoonotic risks and a lack of understanding about the contents of the One Health concept were present in more than one third of the participating students in this study.

"This is a public health problem that needs to be addressed. It means that more than one third of the students participating in the study are not aware of the zoonotic risk they run when they come into contact with animals from the illegal small animal trade. Therefore, I recommend that education about zoonotic diseases and the One Health concept be firmly anchored in school curricula and syllabi by means of theoretical-practical teaching units," explains project leader and first author Paolo Zucca, from the Central Directorate for Health, Social Policies and Disabilities, in Italy.

"In Germany, for the practical part of zoonotic disease education in schools, we used Sir Isaac Newton, a research sniffer dog from the Leibniz-IZW, who showed students how dogs can detect illegally hidden animals in luggage," reports Leibniz-IZW scientist Susanne Holtze.

"Our joint international scientific work emphasises the importance of sharing knowledge about zoonotic diseases and the One Health concept among younger generations. The Covid-19 pandemic shows us all that the transmission of diseases from animals to humans is not just mere theory, but a real threat," explains science communicator and co-author Steven Seet from the Leibniz-IZW.

More than 60% of the 1,700 known infectious diseases transmissible to humans originate from animals. Repeated and frequent zoonotic outbreaks, such as the recent COVID-19 pandemic, are caused by human impact on nature. In particular, the creation of huge intensive domestic animal farms, the frequent use of antibiotics in intensive breeding farms, the destruction of forests, the consumption of wild meat (bushmeat), and the "illegal animal trade" are factors that favor the occurrence and transmission of diseases from animals to humans and vice versa.

"Early education and health prevention programmes in schools that explain the interrelationships of zoonoses within the framework of the One Heath concept are a fundamental prerequisite for the health of the population and the prevention of future pandemics," explains Jeannette Wichert, biology and chemistry teacher at the Robert Havemann Gymnasium in Berlin, Germany.

###

Publication:

Zucca P, Rossmann M-C, Dodic M, Ramma Y, Matsushima T, Seet S, Holtze S, Bremini A, Fischinger I, Morosetti G, Sitzia M, Furlani R, Greco O, Meddi G, Zambotto P, Meo F, Pulcini S, Palei M, Zamaro G (2021): What do adolescents know about One-Health and Zoonotic risks? A school-based survey in Italy, Austria, Germany, Slovenia, Mauritius and Japan. Frontiers in Public Health. Manuscript ID: 658876. https://www.frontiersin.org/articles/10.3389/fpubh.2021.658876/full

Graphic: https://www.frontiersin.org/articles/10.3389/fpubh.2021.658876/full#supplementary-material

Partners, collaborators and stakeholders of the BIO-CRIME Project: https://www.biocrime.org/partners

 

Poor grasp of dating violence in college perpetuates 'boys will be boys' views

Study reveals how college-age women conceptualize violence in dating relationships and the role technology plays

FLORIDA ATLANTIC UNIVERSITY

Research News

 

IMAGE: FIFTY-SEVEN PERCENT OF PARTICIPANTS REPORTED DIFFICULTY IDENTIFYING WHAT CONSTITUTES DATING VIOLENCE. WHILE 100 PERCENT SAID "PHYSICALLY FORCING YOU TO HAVE INTERCOURSE " WAS VIOLENT, ABOUT 25 PERCENT OF PARTICIPANTS FOUND COERCIVE... view more 

CREDIT: ALEX DOLCE, FLORIDA ATLANTIC UNIVERSITY

Dating violence - physical, sexual, psychological or emotional within a relationship, including stalking - is pervasive on college campuses with far-reaching health implications. One in five women experience a sexual assault in college and students living in sorority houses are three times more likely to experience rape. College students are vulnerable to dating violence because of the influence of their social and living environments.

Researchers from Florida Atlantic University's College of Education in collaboration with Sacred Heart University conducted a study to understand the dating violence experience and perpetration of college-age women, as well as how they conceptualize violence in dating relationships. They also wanted to learn more about the role of technology within their lived experiences, which infuses most areas of American life, especially in dating and romantic relationships. Mobile technology allows 24-hour access, which also facilitates stalking and controlling behaviors.

Results of the study, published in the journal Violence Against Women, illuminate the span of dating violence knowledge among the participants and point to a lack of understanding of what constitutes emotional violence. Findings reveal normalization of unhealthy violent behaviors where sexual pressure or sexualized verbal harassment are viewed as an innate part of men, supporting the idea that "boys will be boys."

"Physically forcing you to have intercourse," was endorsed at 100 percent by participants as violent, while "emotionally pressuring you to have intercourse until you give in," was endorsed at 73.9 percent. Both scenarios indicate rape, yet one of them introduced physical dating violence, which was not acceptable to any participant. The other item introduced coercive sex, which was acceptable to about 25 percent of the participants.

Fifty-eight percent of the study participants reported not knowing how to help someone experiencing dating violence, 57 percent reported difficulty identifying what constitutes dating violence, and 38 percent noted not knowing how to get help for themselves if experiencing dating violence.

A substantially lower percentage of participants reported not experiencing in-person violence, but did report the experience of intimate partner "cyber" violence. Almost every respondent who noted having experienced intimate partner sexual, physical and emotional violence also documented experiencing intimate partner cyber violence.

Participants expressed a decreased sense of personal control over impulsivity and retaliatory behaviors when using technology in relationships, while often justifying the use of this form of violence because of the accessibility of technology. They also described ways in which they were controlled and monitored by partners.

"Unfortunately, the college students in our study demonstrated a lack of knowledge of the forms of dating violence and its consequences. They also had a tendency to normalize these behaviors, which led to acceptance, rationalizing and providing excuses for these acts of violence. Furthermore, they lacked awareness of support systems that are available," said Kelly Emelianchik-Key, Ph.D., senior author and an associate professor in the Department of Counselor Education within the College of Education.

Study participants failed to mention any resources for psychological services, therapy, prevention programming or dating violence support groups. Only 21.6 percent endorsed the desire to seek help specifically from a counselor, traditionally one of the primary services provided on most college campuses. Instead, study participants turned to peers for help. However, research has shown that peers do not know how to help and fear intruding into someone's relationship.

"Our study findings underscore the need for education and early prevention programs on campuses that give a clear message that violence - in all forms - is not acceptable or normal in relationships," said Carman S. Gill, Ph.D., co-author, professor and department chair in the clinical mental health program, FAU College of Education. "Moreover, women should recognize emotional violence as a predictor of low quality of life over time and emotional well-being. The importance of understanding emotional abuse cannot be understated, as research findings illustrate that emotional violence is just as detrimental as physical violence."

The researchers say that because it is evident that peers play a critical role in student growth and development, interventions such as peer training initiatives, need to be appropriately targeted across college campuses. They also note that to break this cycle, students could benefit from a university/college statement or policy of zero tolerance for all forms of dating violence perpetration, along with clear definitions of the forms of violence.

"By gaining a critical understanding of college women's unique experiences, we can tailor early intervention to meet the individual needs of this population before the violence becomes pervasive and affects their physical and emotional health," said Emelianchik-Key.

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Co-author of the study is Rebekah Byrd, Ph.D., associate professor of counseling and coordinator of clinical experiences, Sacred Heart University in Fairfield, Connecticut.

About Florida Atlantic University:

Florida Atlantic University, established in 1961, officially opened its doors in 1964 as the fifth public university in Florida. Today, the University serves more than 30,000 undergraduate and graduate students across six campuses located along the southeast Florida coast. In recent years, the University has doubled its research expenditures and outpaced its peers in student achievement rates. Through the coexistence of access and excellence, FAU embodies an innovative model where traditional achievement gaps vanish. FAU is designated a Hispanic-serving institution, ranked as a top public university by U.S. News & World Report and a High Research Activity institution by the Carnegie Foundation for the Advancement of Teaching. For more information, visit http://www.fau.edu.

 

Trends in the Prevalence of Concussion Reported by US Adolescents, 2016-2020

Phil Veliz, PhD¹; Sean Esteban McCabe, PhD¹; James T. Eckner, MD, MS²; et alJohn E. Schulenberg, PhD³

Author Affiliations Article Information

JAMA. 2021;325(17):1789-1791. doi:10.1001/jama.2021.1538

In 2016, 19.5% of US adolescents reported at least 1 concussion during their lifetime.^1,2 While knowledge about concussion and management of these injuries within the adolescent population have increased over the past decade,³ to our knowledge, no national study has tracked whether rates of concussion have declined or increased. This study estimated trends in the lifetime prevalence of self-reported concussion among a national sample of adolescents between 2016 and 2020.

Methods

This study uses national cross-sectional data from the 2016-2020 Monitoring the Future (MTF) initiative.⁴ The MTF initiative is an annual school-based survey of 8th-, 10th-, and 12th-graders conducted between February and June each school year; surveys are administered in classrooms and completed during normal class periods. The MTF stopped data collection for the 2020 survey early on March 14, 2020, due to COVID-19 (a representative sample was still maintained). The student response rates between 2016 and 2020 ranged from 79% to 90%. The University of Michigan institutional review board approved this study. A waiver of informed consent was sent to parents providing them a means to decline their child’s participation.

A measure to assess concussion was added to the MTF in 2016, asking respondents the following: “Have you ever had a head injury that was diagnosed as a concussion?” Response options included “no,” “yes, once,” and “yes, more than once.” The measure did not change across the 5 years.

Binary regression models (using Mplus 8.1) estimated linear trends for self-reported concussion; adjusted models controlled for sex, race/ethnicity, grade level, parental education, and participation in sports. Analyses report the unadjusted prevalence ratios, adjusted prevalence ratios, and 95% CIs. Statistical significance was set at α ≤ .05 for a 2-tailed test when assessing linear trends. Full information maximum likelihood estimation was used to account for item missingness for each of the binary regression models. All analyses take into account the complex multistage sampling design, including clustering of respondents in primary sampling units⁴; weights were incorporated to provide nationally representative estimates along with adjusting for the different sample sizes for 8th-, 10th-, and 12th-graders.

Results

The sample consisted of 52 949 8th-, 10th-, and 12th-graders, of whom 50.3% were girls, and self-reported race/ethnicity was 45.0% White, 11.8% Black, 20.6% Hispanic, and 22.6% other (category included Asian American, American Indian or Alaska Native, and Native Hawaiian or other Pacific Islander) based on predefined categories. Lifetime prevalence of at least 1 self-reported concussion increased from 19.5% (95% CI, 18.5%-20.6%) in 2016 to 24.6% (95% CI, 22.5%-26.7%) in 2020 (adjusted prevalence ratio, 1.05; 95% CI, 1.03-1.08) (Table 1). The increase in lifetime prevalence of only 1 self-reported concussion (adjusted prevalence ratio, 1.05 [95% CI, 1.02-1.08]; 14.0% in 2016 vs 17.7% in 2020) and 2 or more self-reported concussions (adjusted prevalence ratio, 1.05 [95% CI, 1.01-1.11]; 5.5% in 2016 vs 6.8% in 2020) between 2016 and 2020 was statistically significant. Increases in any self-reported concussion were found across both sexes and race/ethnicity categories, among respondents whose parents had a high school diploma or less, and among respondents who participated in competitive sports during the past year (Table 2).

Discussion

Between 2016 and 2020, the estimated percentage of US 8th-, 10th-, and 12th-graders who reported at least 1 diagnosed concussion during their lifetime increased. Although lower prevalence of self-reporting concussions has been found among Hispanic, non-Hispanic other, and non-Hispanic Black adolescents compared with non-Hispanic White adolescents,⁵ these groups saw increases in self-reported concussion during this time period.

The study also found that trends in self-reporting concussion among adolescents who participate in competitive sports increased during this time period, in contrast with emergency department data that showed a decrease in sports/recreation-related traumatic brain injuries among adolescents and children between 2012 and 2018.⁶

The increase in reporting of concussion could be due to an increased incidence or greater recognition of symptoms associated with these injuries. Given greater effort to educate the US population regarding the risks associated with head injuries, more adolescents may be seeking care for these injuries, including care from health care professionals outside the emergency department who have appropriate diagnosis and management skills.³

Limitations of the study include the use of self-reported measures of concussion and the use of cross-sectional data. Continued efforts to monitor and prevent concussion are needed.

Section Editor: Jody W. Zylke, MD, Deputy Editor.

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Article Information

Corresponding Author: Phil Veliz, PhD, School of Nursing, Center for the Study of Alcohol, Smoking and Health, University of Michigan, Ann Arbor, MI 48109 (ptveliz@umich.edu).

Accepted for Publication: January 31, 2021.

Author Contributions: Dr Veliz had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: Veliz, McCabe, Schulenberg.

Drafting of the manuscript: Veliz, McCabe.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Veliz.

Obtained funding: McCabe, Schulenberg.

Administrative, technical, or material support: Schulenberg.

Supervision: McCabe.

Other (contribution of concussion-specific content expertise): Eckner.

Conflict of Interest Disclosures: None reported.

Funding/Support: This work was supported by research grants R01DA001411 and R01DA031160 from the National Institute on Drug Abuse. The Monitoring the Future data were collected under grant R01DA001411.

Role of the Funder/Sponsor: The National Institute on Drug Abuse had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse.

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Veliz  P, McCabe  SE, Eckner  JT, Schulenberg  JE.  Prevalence of concussion among US adolescents and correlated factors.   JAMA. 2017;318(12):1180-1182. doi:10.1001/jama.2017.9087
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Halstead  ME, Walter  KD, Moffatt  K; Council on Sports Medicine and Fitness.  Sport-related concussion in children and adolescents.   Pediatrics. 2018;142(6):e20183074. doi:10.1542/peds.2018-3074PubMedGoogle Scholar

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Miech  RA, Johnston  LD, O’Malley  PM, Bachman  JG, Schulenberg  JE, Patrick  ME,. Secondary school students. In:  Monitoring the Future: National Survey Results on Drug Use, 1975-2018. Vol 1. Institute for Social Research, University of Michigan; 2020.

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Haarbauer-Krupa  J, Lebrun-Harris  LA, Black  LI,  et al.  Comparing prevalence estimates of concussion/head injury in US children and adolescents in national surveys.   Ann Epidemiol. 2021;54:11-20. doi:10.1016/j.annepidem.2020.11.006PubMedGoogle ScholarCrossref

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Waltzman  D, Womack  LS, Thomas  KE, Sarmiento  K.  Trends in emergency department visits for contact sports-related traumatic brain injuries among children—United States, 2001-2018.   MMWR Morb Mortal Wkly Rep.  2020;69(27):870-874. doi:10.15585/mmwr.mm6927a4PubMedGoogle ScholarCrossref