As children continue to enter contact sports, concussions will undoubtedly go up — but so does the chance of CTE.
C/O Molly Ferguson Art
Traumatic brain injuries are everywhere, from the workplace to sports. It is estimated that there are nearly 500 TBIs per 100,000 individuals annually in Canada; to narrow that down, one person in Canada would suffer a TBI every three minutes.
A TBI occurs due to shaking of the brain caused by blows to the head. It is the most apparent cause of death among young adults. TBI can range from being either mild, moderate or severe, depending on the results retrieved from neurological assessments. A concussion is often referred to in clinical settings as mild TBI.
Concussions can typically resolve spontaneously after 7-10 days with close monitoring of symptoms but can lead to immediate impairment of neurologic function with subsequent head injuries. Common symptoms present in the diagnosis of a concussion include headaches, dizziness, nausea, lack of concentration, memory impairment and tiredness.
It is estimated that 200,000 concussions occur per year in Canada alone, and of that, children under the age of five were the most prevalent demographic to experience a concussion.
Now, when looking at sports-related concussions, football is the most common sport in which concussions are diagnosed, where a study showed it accounted for more than half of all 2561 concussions reported.
In the NFL, the position played is an important factor for predictions on concussions and brain injuries, where offensive and defensive linemen are more prone to concussions than any other position. However, these concussions may be caused by low impact hits due to the short distance between the hitting and receiving players, whereas a quarterback would receive stronger hits at a lower frequency.
Though as players become sidelined for injuries, the media has a tendency to blow up injury stories and depending on fan support, the player may be ridiculed for not playing, as opposed to receiving empathy. Thus, many players who may indeed have a concussion go undiagnosed to ensure they are not portrayed as “weak” in their own perspective, in addition to the media’s and fans’ perspectives.
Now as players become injured with concussions repeatedly, long-term neurodegenerative effects may result and more specifically, chronic traumatic encephalopathy. Impulsivity, aggression, and suicidal behaviour encompass the clinical presentation for CTE, alongside the loss of memory and muscle spasms. However, a key limitation with the diagnosis of CTE is the requirement for it to be post-mortem.
CTE has gained recent attention from a study in 2017, where the CTE centre in Boston University concluded that CTE was diagnosed in 110 of 111 former deceased NFL players. More specifically, there was global attention on the specific case of Aaron Hernandez.
Hernandez was on route to becoming one of the greatest tight ends at the time. However, his life turned upside down when he was convicted guilty in 2015 and sentenced to life imprisonment without parole for the first-degree murder of Odin Lloyd in 2013.
Just two years after his conviction, Hernandez committed suicide in April 2017. But after further studies by the Boston University CTE centre, it was found that Aaron Hernandez suffered the most extreme case of CTE ever found in anyone of his age.
Ann McKee, director of the BU CTE centre, was shocked to find Aaron being diagnosed with Stage III CTE at only 27 years old, exclaiming that his problem-solving, judgement and impulse control behaviours may have been compromised.
“This would be the first case we’ve ever seen of that kind of damage in such a young individual,” said McKee at the time.
“This would be the first case we’ve ever seen of that kind of damage in such a young individual.”
Ann McKee
When looking at concussion rehabilitation programs, it is never that simple, especially for children and youth; but at McMaster University, the CanChild research centre has a specific attention to youth and children with disabilities, and in this case, concussion education and rehabilitation.
More specifically, the centre developed evidence-based protocols for Return to Activity and Return to School for children and youth, led by Professor Carol DeMatteo. It was found that roughly 50 per cent of children and youth adhered to the protocols, and it is primarily dependent on education and awareness of concussion protocols.
To help with adherence, DeMatteo and her team developed the Back2Play app, where concussion symptoms are regularly monitored with an apple watch and real-time activity data is recorded. With that being said, return to school has happened quicker than return to activity.
As children consistently enter themselves into contact sports leagues, it will be no surprise that the prevalence of concussions will rise. However, with greater emphasis on the education of brain injuries, further concussions can be avoided and prevent the unfortunate cases of CTE.
The McMaster Students Union recognizes over 350 clubs. According to the MSU Clubs page, the purpose of these clubs is to “provide an insightful and meaningful contribution to the McMaster and Hamilton community.”
Being a MSU recognized club affords certain privileges including being eligible for funding from the MSU. This funding comes directly from the MSU organizational fee, a $130.26 fee that all full-time undergraduate students pay. Within this fee, $8.02 are collected per student to support MSU clubs.
As students are paying for the operations of these clubs, the MSU has a responsibility to ensure that these clubs are not deliberately sharing and promoting misinformation that can be harmful to students.
McMaster Lifeline is the pro-life group on campus. Their mission statement is “to advocate with loving care the legal rights and social support of pregnant women and their unborn children.”
While the presence of a pro-life group on campus is already cause for controversy, the issue at hand is not solely the groups’ existence but that they use student space and resources to share information that is factually incorrect.
The group can often be found at a table in the McMaster University Student Centre, a privilege of being a MSU club, spreading scientifically false information on abortions and reproductive health. In addition to misinformation, the group is known for distributing graphic and potentially triggering images.
Groups like McMaster Lifeline should not be given a platform by the MSU to disseminate false information about individuals’ health.
Namely, the group fails to state that abortions are safe, medical procedures that are fully legal in Canada. Instead, they spread the false rhetoric that “abortions are never medically necessary”, which is simply a lie.
In fact, any student-run group on campus does not really have the credentials to provide healthcare information or advice to students. Abortion is a serious topic that should be discussed with a healthcare professional who can provide factual, non-judgemental information, not with students who some of which have “no experience engaging with people on the topic.”
The MSU should be cautious in ratifying clubs that provide this type of information, as the results can be extremely harmful to students.
With over 350 clubs, it can be difficult for the MSU to ensure that operations of each of their clubs are aligned with the core goal of supporting students. However, that is not an excuse for allowing this behaviour to occur.
Multiple students have on many occasions voiced their concerns against these clubs’ actions. The MSU failing to take action blatantly goes against their responsibility towards their student constituents.
The MSU Clubs Operating Policy states that the MSU “will not attempt to censor, control or interfere with any existing MSU club on the basis of its philosophy, beliefs, interests or opinions expressed until these lead to activities which are illegal or which infringe upon the rights and freedoms of others”.
Due to this policy, on March 22, pro-choice students who were protesting McMaster Lifeline’s table in MUSC were removed and not allowed to distribute pro-choice pamphlets. A claimed “victory for free speech on campus” by the MSU only served to help promote the misinformation on campus.
While the actions of McMaster Lifeline may not be illegal, they certainly are harmful to students and may actually be violating the Clubs Judicial Policy, stated under the MSU Clubs Operating Policy.
Specifically, their actions may be considered to “unnecessarily cause a significant nuisance for an individual or group” (5.1.1.3), have “conduct unbecoming of an MSU club” (5.1.2.7) and most importantly, actions that “unnecessarily jeopardize the safety or security of any person or property” (5.1.3.3).
If the MSU truly wishes to provide a meaningful contribution to the McMaster and Hamilton community, it can begin with properly investigating clubs that may be found guilty of any offences described by the Clubs Judicial Policy. Only then can they truly ensure that their clubs support and protect McMaster students.
If students do wish to learn about their options with respect to their reproductive health, the Student Wellness Centre offers birth control counselling. If a student wishes to speak in a more informal setting, the MSU Student Health Education Centre offers relevant literature, referrals and peer support.
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Shloka Jetha is a woman who has always been on the move. After growing up in seven countries, the 23-year old has finally settled in Toronto and is pursuing her dream of working with at-risk youth. Part of what appealed to her about the new Professional Addiction Studies program at McMaster Continuing Education is that it’s online, which means she can set her own schedule and study on-the-go when she’s away from home.
But of course the biggest draw is the way Jetha feels the program will complement and expand upon what she learned in her McMaster degree in sociology, as well as what she is currently learning in a Child and Youth Care program at another school. With the goal of someday working in a clinical setting like the Sick Kids Centre for Brain and Mental Health, Jetha believes the more practical information she has about addiction and mental health, the better.
“I’m learning a lot in my current Child and Youth program,” Jetha enthuses, “but for me there is a bit of a knowledge gap that the McMaster Professional Addiction Studies program will help to close. It’s an incredibly complex field, every situation is new, and you need to be able read between the lines and understand the difference between what a troubled kid is saying and what’s actually going on in their life.”
Jetha believes that having the rich background knowledge the Professional Addiction Studies program will provide, and being able to link that information to her work in the field, will help her excel faster. Most importantly, she feels it will make her better and more effective at helping and healing kids in crisis.
“I’m specifically looking forward to gaining more knowledge about pharmacology, but also about other things as it’s difficult to learn on the job,” Jetha says. “I can learn a tremendous amount from the kids I work with, and that’s invaluable experience, but coming to them with a deeper knowledge base will allow me to talk with them about drugs and alcohol in a way I otherwise couldn’t.”
Jetha has been fortunate not to be personally touched by addiction, but has lost friends and people in her community from overdose. She is also familiar with the impact of this complex issue through the volunteer work she has done.
Even though this is an incredibly demanding career path, it’s one Jetha is proud and honoured to walk. She feels the good outweighs the bad and is determined to continue learning and helping as much as she can. The Professional Addiction Studies program at McMaster Continuing Education is uniquely designed to help her achieve that goal.
Applications for Spring term are open until April 29, 2019. Learn more at mcmastercce.ca/addiction-studies-program
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By: Areej Ali
The Trudeau government has granted over $3.4 million to McMaster researchers to fund a study that aims to identify and combat systemic causes of domestic violence.
Andrea Gonzalez, an assistant professor in psychiatry and behavioural neurosciences at McMaster, is currently overseeing the “Triple P” program, which stands for the positive parenting program.
Triple P is a public health parenting intervention initiative that aims to improve the “knowledge, skills and confidence of parents” while working to reduce the pervasiveness of emotional and behavioural problems in children.
The Triple P program is part of a larger project that originally began in Australia over 30 years ago.
Gonzalez will be evaluating preventative intervention of child maltreatment, leading one of the first Triple P program studies to be conducted in Canada.
“We have a number of main objectives but really we are looking at the impact of the Triple P in promoting family relationships and improving parenting practices and prevention of child maltreatment,” said Gonzalez. “The Triple P has been widely evaluated in multiple countries actually around the world, but it has never been evaluated in Canada.”
According to the Triple P program’s website, the program does not advocate how to be a parent, but rather provides tools and strategies to promote healthy families, focusing on children who are in the age bracket of three to eight years old.
The program is being implemented in Ontario and Manitoba.
It is anticipated to entail a multi-method evaluation network and will most likely also consist of a ‘quasi experimental design’ in Ontario, according to Gonzalez.
This involves choosing various communities and areas that fit the age bracket and particular population sizes.
Community agencies will be asked to participate in the program and the evaluation will be facilitated in these specific communities.
There is one study to date that focused on efficacy of early intervention of child maltreatment. The McMaster researchers will be drawing information from and referring to this particular study.
Gonzalez hopes to study the impact of Triple P in fostering healthy and sustainable family relationships and and preventing child maltreatment at its roots.
McMaster students will have the opportunity to participate in the program.
For instance, Triple P will rely on “environmental scans,” specific type of data collection, regarding existing parental programs in Ontario.
Once the project is launched, there will be opportunities to contribute to the researchers’ collection of questionnaire data.
In addition, there will be opportunities to contribute to behavioural data and to be trained in techniques that will be used in the project.
Many teams on campus that work on family violence prevention, partner violence and other aspects of violence will also be able to aid in the evaluation.
For instance, the Triple P will be partnering with the Institute for Clinical Evaluative, an organization that has a site on the McMaster campus.
“They have all the data linkage,” Gonzalez said. “We will certainly be partnering with those investigators as well as the ones in Toronto.”
For more information about the project, students can contact Gonzalez directly at gonzal@mcmaster.ca. Students can also visit the Triple P website to learn more about the program.
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