Association Between Head Impact Exposure, Psychological Needs, and Indicators of Mental Health Among U.S. High School Tackle Football Players.

PURPOSE: Age of first exposure to tackle football and head impact kinematics have been used to examine the effect of head impacts on mental health outcomes. These measures coupled with retrospective and cross-sectional designs have contributed to conflicting results. The purpose of this study was to identify the effect of one season of head impact exposure, age of first exposure to football, and psychological need satisfaction on acute mental health outcomes in adolescent football players. METHODS: This prospective single-season cohort study used sensor-installed mouthguards to collect head impact exposure along with surveys to assess age of first exposure to football, psychological satisfaction, depressive symptoms, anxiety symptoms, and thriving from football players at four high schools (n = 91). Linear regression was used to test the association of head impact exposure, age of first exposure, and psychological satisfaction with acute mental health outcomes. RESULTS: A total of 9,428 impacts were recorded with a mean of 102 ± 113 impacts/player. Cumulative head impact exposure and age of first exposure were not associated with acute mental health outcomes at postseason or change scores from preseason to postseason. Greater psychological satisfaction was associated with fewer depressive symptoms (ß = -0.035, SE = 0.008, p = < .001), fewer anxiety symptoms (ß = -0.021, SE = 0.008, p = .010), and greater thriving scores (ß = 0.278, SE = 0.040, p = < .001) at postseason. DISCUSSION: This study does not support the premise that greater single-season head impact exposure or earlier age of first exposure to tackle football is associated with worse acute mental health indicators over the course of a single season in adolescent football players.

Sex Differences in Paediatric and Adult Asthma.

Asthma is the most common chronic condition in Western countries. Affecting 1 in 7 children and 1 in 12 adults, asthma is responsible for >350,000 avoidable deaths every year. While most children who develop symptoms of asthma are <5 years of age, the disease is frequently misdiagnosed or not suspected in infants and toddlers. In addition, the prevalence of asthma is different in males and females throughout their lifespan. While boys are more likely to develop asthma than girls, this pattern is reversed after puberty. This indicates that sex-specific factors, such as fluctuations in hormone levels, play a role in the disease's pathogenesis. In this review, the authors discuss recent advances in diagnostic tools for asthma in both adults and children, as well as the influences of BMI, environmental exposures, socioeconomic factors, and sex hormones in the disease's pathogenesis. The review will show that both experimental and epidemiological evidence suggest that circulating sex hormone levels are important contributors to asthma symptoms in post-pubertal females, while their role in males and children has not been yet established. In addition, the mechanisms associated with these hormonal influences on airway inflammation and hyper-reactivity have not been yet elucidated. The authors conclude that different factors affect asthma rates and severity in children and adults, and that more research needs to be conducted to identify the specific contributions of sex hormones. These will allow the development of more personalised asthma treatment strategies for men and women at different stages of life.