Go online and look at the various meanings of the term ‘security policy’. Why is there so much discrepancy? Provide links to your resources and references.
Minimum 300 Words.
Assignment Instructions
For this assignment, you are going to submit the methods and results section of your final paper. The methods section of your paper should detail the methods the class used to collect the data presented in the results section. Your methods section should be no more than three pages long but may be much shorter. For this section, you need to provide enough detail so someone can repeat the study.
The results section should include text, figures, and tables as needed to present the results of the survey. Your results will come from your created Survey Monkey Survey results which includes figures and the original data for you to do analysis. The text should explain the "bogus" figures and tables and may present data, not in the figures and tables.
Formatting Guidelines for Methods and Results
· Double spaced
· Times New Roman font
· 12 font
· 1" margin all the way around
· References: You may need to use references from your methods section. You do not need references for the results section. Remember your references must be from scholarly and/or primary sources.
This assignment will be graded using the attached rubric.
I targeted the number of concussions reported in youth sports (20 kids) within 24 hours of injury.
https://www.surveymonkey.com/r/NHDD522
https://www.surveymonkey.com/home/?ut_source=header
****another survey
Good afternoon,
Below I have attached my survey link. The target population would be parents, coaches, and adolescents between the ages of 14 to 19 within youth sports. I would like to receive about 400 participants within pinpointed zip codes.
https://www.surveymonkey.com/r/P9D92X5
V/r
AW
****articles at the bottom****
Mitka, Mike. “Reports of Concussions From Youth Sports Rise Along With Awareness of the Problem.” JAMA 304.16 (2010): 1775–1776. Web.
Forum 5b: Qualitative, Quantitative, and Mixed Methods Studies; Types of Study Design
Cited Source: Lee, S. Y. (2018). Analysis of relationship marketing factors for sports centers with mixed methods research. Asia Pacific Journal of Marketing and Logistics, 30(1), 182-197.
The kind of study: This study is a mixed research design. As supported by existing evidence, the mixed methods approach is where the researcher collects, analyzes and interprets both quantitative research- which involves surveys and experiments and qualitative research which may involve interviews and focus groups.
Why is it this type of research? In this research study, Lee (2018) uses both a statistical survey, which is a form of quantitative research and in-depth interviews which is a form of qualitative research method in studying the impact of relationship marketing factors of sports centers on commitment to relationship and recommendation intentions. In its findings, the quantitative ...
Go online and look at the various meanings of the term ‘security p.docx
1. Go online and look at the various meanings of the term ‘security
policy’. Why is there so much discrepancy? Provide links to
your resources and references.
Minimum 300 Words.
Assignment Instructions
For this assignment, you are going to submit the methods and
results section of your final paper. The methods section of your
paper should detail the methods the class used to collect the
data presented in the results section. Your methods section
should be no more than three pages long but may be much
shorter. For this section, you need to provide enough detail so
someone can repeat the study.
The results section should include text, figures, and tables as
needed to present the results of the survey. Your results will
come from your created Survey Monkey Survey results which
includes figures and the original data for you to do analysis.
The text should explain the "bogus" figures and tables and may
present data, not in the figures and tables.
Formatting Guidelines for Methods and Results
· Double spaced
· Times New Roman font
· 12 font
· 1" margin all the way around
· References: You may need to use references from your
methods section. You do not need references for the results
section. Remember your references must be from scholarly
and/or primary sources.
This assignment will be graded using the attached rubric.
I targeted the number of concussions reported in youth sports
(20 kids) within 24 hours of injury.
https://www.surveymonkey.com/r/NHDD522
https://www.surveymonkey.com/home/?ut_source=header
2. ****another survey
Good afternoon,
Below I have attached my survey link. The target population
would be parents, coaches, and adolescents between the ages of
14 to 19 within youth sports. I would like to receive about
400 participants within pinpointed zip codes.
https://www.surveymonkey.com/r/P9D92X5
V/r
AW
****articles at the bottom****
Mitka, Mike. “Reports of Concussions From Youth
Sports Rise Along With Awareness of the Problem.” JAMA
304.16 (2010): 1775–1776. Web.
Forum 5b: Qualitative, Quantitative, and Mixed Methods
Studies; Types of Study Design
Cited Source: Lee, S. Y. (2018). Analysis of relationship
marketing factors for sports centers with mixed methods
research. Asia Pacific Journal of Marketing and
Logistics, 30(1), 182-197.
The kind of study: This study is a mixed research design. As
supported by existing evidence, the mixed methods approach is
where the researcher collects, analyzes and interprets both
quantitative research- which involves surveys and experiments
and qualitative research which may involve interviews and
focus groups.
Why is it this type of research? In this research study, Lee
(2018) uses both a statistical survey, which is a form of
quantitative research and in-depth interviews which is a form of
qualitative research method in studying the impact of
relationship marketing factors of sports centers on commitment
to relationship and recommendation intentions. In its findings,
the quantitative aspect of the research established that the
relationship marketing factors like price, bonding and facility
3. affect commitment to relationship in a positive manner.
References
Lee, S. Y. (2018). Analysis of relationship marketing factors for
sports centers with mixed methods research. Asia Pacific
Journal of Marketing and Logistics, 30(1), 182-197
*******?,Respond to classmate LW
Greetings Class,
The article I have chosen for our forum topic is titled
“Is it Still “In the Game”; or Has Amateurism Left the
Building? NCAA Student-Athletes’ Perceptions of Commercial
Activity and Sports Video Games.” The article discusses a study
of the attitudes of college football and basketball players
regarding the use of their likenesses in video games and towards
the concept of amateurism.
This study was conducted using 5 survey questions
given to Division 1 college football and basketball players. The
survey was given to 50 football players and 7 basketball players
from 2 colleges in every division 1 college conference, totaling
272 players. All players were selected at random and split in
groups based on race, playing time, scholarship status and
divisional affiliation. The survey was designed to gauge
player’s feelings toward seeing their institutions earn money
from the player’s likeliness while they couldn’t profit from it.
What the researchers found was that there is a correlation
between player’s opinions and what group they belong to in the
study.
Results showed that black athletes were more likely to
believe they should be paid for the use of their likeness in video
games. Female athletes showed the least interest in how their
likeness was used. All but 10% of athletes agreed that they
approved of being used in video games. In conclusion, after
looking at the results the researchers believe that the NCAA
4. needs to conduct studies like this one to get opinions from the
people who will be directly affected before making any change
to league policy.
In my opinion this article asked appropriate questions
to bring across the point that athletes opinions should be taken
into consideration in the case of amateurism in college sports. I
personally think athletes should be compensated in some way
for their participation in athletics. The level of compensation
might not be the same for all athletes but with the amount of
money being brought in the athletes should at least see some of
that.
References:
Kaburakis, A., Pierce, D., Cianfrone, B., & Paule, A. (2012). Is
It Still “In the Game”, or Has Amateurism Left the Building?
NCAA Student-Athletes’ Perceptions of Commercial Activity
and Sports Video Games. Journal of Sport Management, 26(4).
Retrieved from
http://search.proquest.com/docview/1032944879/
MEDICAL NEWS & PERSPECTIVES
cine in W inston-S alem , NC, said the
passage of the F ood a n d D rag A dm in-
5. i s tr a tio n A m e n d m e n ts A ct o f 2 007
s h o u ld have giv en th e ag en cy m o re
regulatory am m u n itio n to p u sh com -
panies to com ply w ith conducting post-
m ark etin g studies. “T he problem prio r
to the act’s passage was th a t som e of the
com m itm ents to com plete postm arket-
ing studies h ad no deadlines, so it was
hard to claim they were delinquent. And
clearly there have been no consequences
and no one at the FDA paid attention to
th is p r o b le m ,” F u r b e r g sa id . “T h e
changes in the regulations should help,
b u t w hen I look at the list of studies on
the accelerated approval list, som e have
been conducted and some are pending,
and to m e it is h ard to say the situation
has im proved.”
Nissen remains frustrated w ith the in-
action by FDA leadership to improve the
a c c e le ra te d a p p ro v a l p ro c e s s . “T h e
people at the FDA approving drugs are
very pharm a friendly; they view p h a r-
m aceutical m anufacturers as their p rin -
cipal clients. So we see this lack of en-
forcem ent over and over,” N issen said.
“I do n ot th in k we need tough laws; we
need tougher regulators.” □
Reports of Concussions From Youth Sports
Rise A long W ith Awareness of the Problem
Mike Mitka
A
6. n e w s t u d y h a s d o c u m e n t e d
a g ro w in g n u m b e r o f e m e r -
gency d epartm ent visits by chil-
d r e n a n d a d o le s c e n ts w ith s p o r ts -
related co ncussion, b u t it is u n k n o w n
w h eth er th e increase reflects a true rise
in the n u m b e r of incidents o r better re-
p o rtin g due to greater aw areness.
The study, by researchers from Brown
University in Providence, RI, found that
from 1997 to 2007, US em ergency de-
partm en t visits for concussions occur-
ring in organized team sp o rts h ad al-
m ost doubled (from 3946 to 7791) in
children aged 8 to 13 years and m ore
th a n trip le d (fro m 7 2 7 6 to 23 239)
a m o n g y o u th s ag ed 14 to 19 y e a rs
(BakhosLLet al. P ed ia tric s. doi:10.1542/
peds.2009-3101 [published online Au-
gust 30,2010]. In addition, the research-
ers f o u n d th a t fro m 2001 to 2 0 0 5 ,
children and adolescents aged 8 to 19
years had an estim ated 502 000 em er-
gency d e p a rtm e n t v isits for c o n c u s -
sion, w ith about 35% involving 8- to 13-
y ear-o ld s a n d h a lf o f th e to ta l v isits
related to a sports incident.
The Brown researchers, u sin g data
from the N ational S porting G oods As-
sociation, fo u n d th a t for 2001 to 2005,
the concu ssio n rate was h ig h est for ice
hockey, at 10 per 10 000 participants for
7- to 11-year-olds and 29 per 10 000 par-
7. ticipants for 12- to 17-year-olds. F o o t-
ball acco u n ted for th e seco n d highest
concussion rate, at 8 an d 27 p e r 10 000
for the 2 age groups, respectively.
Lisa L. Bakhos, MD, lead au th o r and
now a pediatric em ergency physician at
Jersey Shore Medical Center in Neptune,
NJ, said a m ajor p art of their retrospec-
tive review of data from the National Elec-
tronic Injury Surveillance System was to
provide solid concussion data for the p re -
high-school population. She said the rea-
son for the high num bers of em ergency
departm ent visits for concussion is u n -
clear. “W e do n o t know if it is an actual
increase; we hope it is increased aware-
ness and reporting,” Bakhos said. “W e do
speculate that youth sports are getting ex-
tremely competitive, and kids, in general,
are getting bigger; so you end up w ith
8-year-olds in 13-year-old bodies but with
the m aturity still o f 8-year-olds.”
Michael A. McCrea, PhD, executive di-
rector of the ProH ealth Care N eurosci-
ence C enter and Research In stitute in
W aukesha, Wis, speculated that m ost of
the increase in re p o rte d con cu ssio n s
could be tied to greater awareness of the
problem by patents, coaches, and train-
ers, b u t he added th at some percentage
of the increase should be attributed sim -
ply to m ore concussions. “It feels evo
8. lutionary and seems natural to me th at
if we saw great speed, s tre n g th , an d
mass— all the requirem ents for a colli-
sion— at the professional level, we natu -
rally saw it trickle do w n to the colle-
giate level, and now it is trickling dow n
to the yo u th sports level.
A n e w r e p o r t r e m i n d s
t h o s e i n v o l v e d in
o r g a n i z e d t e a m s p o r t s
t h a t e v e n t h e
y o u n g e s t p a r t i c i p a n t s
a r e a t r is k f o r
c o n c u s s i o n .
JAMA, October 27, 2010—Vol 304, No. 16 1 7 7 5
MEDICAL NEWS & PERSPECTIVES
Bakhos and colleagues also found that
during the time period w hen reported
concussions increased, participation in
organized team sports decreased. The re-
searchers estim ated that about 385 000
children aged 7 to 17 participated in the
top 5 organized teams posts in 1997, with
the nu m b er falling to ju s t over 330 000
9. participants by 2007.
McCrea does n o t have h ard data, b ut
he speculated that the increasing num ber
of concussions during a tim e of apparent
declining participation in sports m ay be
the result of how those children rem ain-
ing in a sport train and compete. “Partici
pation in sports has become a year-around
commitment; you used to play football for
2 m onths and then m ove onto basketball
and then maybe track and field,” McCrea
said. “So maybe participation is down, but
for those playing, say football, the n u m -
ber o f exposures seems to be certainly
higher than seen a decade ago.”
In August, the American Academy of
P e d ia tric s issu e d its first clin ical re -
p o r t o ffe rin g g u id a n c e in th e tre a t-
m e n t a n d m a n a g e m e n t o f s p o r t s -
re la te d c o n c u s s io n in c h ild r e n a n d
adolescents (H alstead ME, W alter KD;
the Council on Sports Medicine and Fit-
n e ss. Pediatrics. 2 0 1 0 ;1 2 6 [ 3 ] :5 9 7 -
615). M ark E. H alstead, MD, a co au -
th o r o f the clinical re p o rt and assistant
p ro fesso r o f o rth o p e d ic s a n d p e d ia t-
rics at W a s h in g to n U n iv e rsity in St
Louis, said their guidance lays o u t para-
m eters to be used in assessing w h e n an
ath lete can re tu rn to co m p etitio n fol-
low ing a concussion. “Rather th en tell
ing a player to sit o u t for a set p erio d
of tim e, we gradually increase the a th -
10. lete’s activities over a 5-day p erio d to
m ake su re th e ath lete do es n o t d e m -
o n strate sy m p to m s,” H alstead said.
Deciding w hen an athlete is well
enough to return to com petition remains
a bit o f a mystery, McCrea said, because
there is little rigorous evidence to show
w hat w orks best. He said the decision to
retu rn is especially difficult to m ake for
those w ho have had repeated concussions
and that such a determ ination is probably
best m ade by the treating physician.
“No adult signs his or h e r own retum -
to-work slip after they have had a stroke,
b u t retum -to-play for concussion for de-
cades has been m anaged by the injured
ath le te o r n o n m e d ic a l p ro fe ssio n a ls”
su c h as p a re n ts, coaches, or train ers,
McCrea said. “But there has been som e
positive m ovem ent in creating policy re-
quiring medical clearance before one can
re tu rn to an activity.” □
N ational Children's Study Expands
Bridget M. K uehn
W
IT H N E A R L Y 4 0 O F T H E
planned 105 sites across the
U nited States recruiting, the
p ilot phase o f the N ational C h ild ren ’s
Study is well u n d e r way, after years of
11. uncertain ty .
T he stu d y will follow u p m ore than
100 000 infants and their m others from
before c o n cep tio n th ro u g h th e ch ild ’s
21st b irth d a y an d m ay provide critical
in fo rm a tio n a b o u t how e n v iro n m e n -
tal and genetic factors contribute to dis-
ease. U n p reced en ted in its scope and
length, the stu d y has faced b o th logis-
tic an d fu n d in g challenges since it was
a u th o rized by C ongress as p a rt o f the
C h ild ren ’s H ealth Act of 2000.
A lthough the initial estim ate o f the
stu d y ’s co st was $2.7 billio n over 25
years, su b seq u en t m edia rep o rts have
suggested it could cost m ore than twice
as m uch. It is being led by a consortium
o f federal agencies; inclu d in g the E u-
nice K ennedy Shriver N ational In sti-
tute of Child Health and H um an Devel-
o p m e n t, th e N a tio n a l I n s t i t u t e o f
Environm ental Health Sciences, the US
Centers for Disease Control and Preven-
tion, and the US Environm ental Protec-
tion Agency. The planning for the project
began in 2000 and included in p u t from
the National Academy of Sciences. How-
ever, funding fell short of target am ounts
d u rin g the plan n in g phase, leading to
concern about the viability o f the study.
But funding levels have increased su b -
stantially since 2007, w hen the im ple-
m entation phase began, and $414.3 mil-
12. lion has been secured to date.
The payoff of su ch a m assive in vest-
m en t, in term s of u n iq u e in sights on
how the interaction betw een genes and
th e e n v iro n m e n t lead to b o th c h ild -
h o o d an d ad u lt disease, is expected to
be enorm ous. “W e are em barking u p o n
one o f th e ric h e st d ata-co llectio n ef-
forts ever conducted, an d the w ealth of
in fo rm a tio n we ho p e to am ass co u ld
h a v e a m a jo r im p a c t o n th e h e a lth
o f fu tu r e g e n e r a tio n s ,” sa id S tev en
H irschfeld, MD, PhD, the stu d y ’s a ct
ing directo r, in a statem ent.
T he endeavor also m ay provide in -
sights into the best ways to conduct such
a m assive research effort. D uring the
s tu d /s pilot phase, each participating site
will use 1 o f 3 strategies for recruiting
w o m en to p articip ate: referral o f p a-
tients by practitioners; outreach efforts
to contact w om en at hom e (via adver-
tisements) and at com m unity events; and
the mailing of a questionnaire to w om en
to complete and then selection of a group
to participate further. Insights from this
phase will be used to determ ine the most
efficient and cost-effective strategies for
recruitm ent for use during the rest of the
study. C urrently, the sites are recru it-
ing w o m en w ho are p reg n an t o r w ho
m ay s o o n b e c o m e p r e g n a n t fo r th e
study’s pilot phase.
13. Initial resu lts from this phase of the
study sh o u ld be available later this year
o r in early 2011, H irschfeld said. Early
findings from th e s tu d y m ay begin to
filter in som etim e in 2013.
M o re in f o rm a tio n o n th e p r o je c t
is a v a ila b le o n l i n e a t h tt p : / / w w w
.n atio n alchildrensstudy.gov. □
1 7 7 6 JAMA, October 27, 2010—Vol 304, No. 16
http://www
Copyright of JAMA: Journal of the American Medical
Association is the property of
American Medical Association and its content may not be
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or posted to a listserv without the copyright holder's express
written permission. However,
users may print, download, or email articles for individual use.
MEDICAL NEWS & PERSPECTIVES
cine in W inston-S alem , NC, said the
passage of the F ood a n d D rag A dm in-
i s tr a tio n A m e n d m e n ts A ct o f 2 007
s h o u ld have giv en th e ag en cy m o re
regulatory am m u n itio n to p u sh com -
panies to com ply w ith conducting post-
m ark etin g studies. “T he problem prio r
to the act’s passage was th a t som e of the
com m itm ents to com plete postm arket-
14. ing studies h ad no deadlines, so it was
hard to claim they were delinquent. And
clearly there have been no consequences
and no one at the FDA paid attention to
th is p r o b le m ,” F u r b e r g sa id . “T h e
changes in the regulations should help,
b u t w hen I look at the list of studies on
the accelerated approval list, som e have
been conducted and some are pending,
and to m e it is h ard to say the situation
has im proved.”
Nissen remains frustrated w ith the in-
action by FDA leadership to improve the
a c c e le ra te d a p p ro v a l p ro c e s s . “T h e
people at the FDA approving drugs are
very pharm a friendly; they view p h a r-
m aceutical m anufacturers as their p rin -
cipal clients. So we see this lack of en-
forcem ent over and over,” N issen said.
“I do n ot th in k we need tough laws; we
need tougher regulators.” □
Reports of Concussions From Youth Sports
Rise A long W ith Awareness of the Problem
Mike Mitka
A
n e w s t u d y h a s d o c u m e n t e d
a g ro w in g n u m b e r o f e m e r -
gency d epartm ent visits by chil-
d r e n a n d a d o le s c e n ts w ith s p o r ts -
related co ncussion, b u t it is u n k n o w n
w h eth er th e increase reflects a true rise
15. in the n u m b e r of incidents o r better re-
p o rtin g due to greater aw areness.
The study, by researchers from Brown
University in Providence, RI, found that
from 1997 to 2007, US em ergency de-
partm en t visits for concussions occur-
ring in organized team sp o rts h ad al-
m ost doubled (from 3946 to 7791) in
children aged 8 to 13 years and m ore
th a n trip le d (fro m 7 2 7 6 to 23 239)
a m o n g y o u th s ag ed 14 to 19 y e a rs
(BakhosLLet al. P ed ia tric s. doi:10.1542/
peds.2009-3101 [published online Au-
gust 30,2010]. In addition, the research-
ers f o u n d th a t fro m 2001 to 2 0 0 5 ,
children and adolescents aged 8 to 19
years had an estim ated 502 000 em er-
gency d e p a rtm e n t v isits for c o n c u s -
sion, w ith about 35% involving 8- to 13-
y ear-o ld s a n d h a lf o f th e to ta l v isits
related to a sports incident.
The Brown researchers, u sin g data
from the N ational S porting G oods As-
sociation, fo u n d th a t for 2001 to 2005,
the concu ssio n rate was h ig h est for ice
hockey, at 10 per 10 000 participants for
7- to 11-year-olds and 29 per 10 000 par-
ticipants for 12- to 17-year-olds. F o o t-
ball acco u n ted for th e seco n d highest
concussion rate, at 8 an d 27 p e r 10 000
for the 2 age groups, respectively.
Lisa L. Bakhos, MD, lead au th o r and
16. now a pediatric em ergency physician at
Jersey Shore Medical Center in Neptune,
NJ, said a m ajor p art of their retrospec-
tive review of data from the National Elec-
tronic Injury Surveillance System was to
provide solid concussion data for the p re -
high-school population. She said the rea-
son for the high num bers of em ergency
departm ent visits for concussion is u n -
clear. “W e do n o t know if it is an actual
increase; we hope it is increased aware-
ness and reporting,” Bakhos said. “W e do
speculate that youth sports are getting ex-
tremely competitive, and kids, in general,
are getting bigger; so you end up w ith
8-year-olds in 13-year-old bodies but with
the m aturity still o f 8-year-olds.”
Michael A. McCrea, PhD, executive di-
rector of the ProH ealth Care N eurosci-
ence C enter and Research In stitute in
W aukesha, Wis, speculated that m ost of
the increase in re p o rte d con cu ssio n s
could be tied to greater awareness of the
problem by patents, coaches, and train-
ers, b u t he added th at some percentage
of the increase should be attributed sim -
ply to m ore concussions. “It feels evo
lutionary and seems natural to me th at
if we saw great speed, s tre n g th , an d
mass— all the requirem ents for a colli-
sion— at the professional level, we natu -
rally saw it trickle do w n to the colle-
giate level, and now it is trickling dow n
to the yo u th sports level.
17. A n e w r e p o r t r e m i n d s
t h o s e i n v o l v e d in
o r g a n i z e d t e a m s p o r t s
t h a t e v e n t h e
y o u n g e s t p a r t i c i p a n t s
a r e a t r is k f o r
c o n c u s s i o n .
JAMA, October 27, 2010—Vol 304, No. 16 1 7 7 5
MEDICAL NEWS & PERSPECTIVES
Bakhos and colleagues also found that
during the time period w hen reported
concussions increased, participation in
organized team sports decreased. The re-
searchers estim ated that about 385 000
children aged 7 to 17 participated in the
top 5 organized teams posts in 1997, with
the nu m b er falling to ju s t over 330 000
participants by 2007.
McCrea does n o t have h ard data, b ut
he speculated that the increasing num ber
of concussions during a tim e of apparent
declining participation in sports m ay be
the result of how those children rem ain-
18. ing in a sport train and compete. “Partici
pation in sports has become a year-around
commitment; you used to play football for
2 m onths and then m ove onto basketball
and then maybe track and field,” McCrea
said. “So maybe participation is down, but
for those playing, say football, the n u m -
ber o f exposures seems to be certainly
higher than seen a decade ago.”
In August, the American Academy of
P e d ia tric s issu e d its first clin ical re -
p o r t o ffe rin g g u id a n c e in th e tre a t-
m e n t a n d m a n a g e m e n t o f s p o r t s -
re la te d c o n c u s s io n in c h ild r e n a n d
adolescents (H alstead ME, W alter KD;
the Council on Sports Medicine and Fit-
n e ss. Pediatrics. 2 0 1 0 ;1 2 6 [ 3 ] :5 9 7 -
615). M ark E. H alstead, MD, a co au -
th o r o f the clinical re p o rt and assistant
p ro fesso r o f o rth o p e d ic s a n d p e d ia t-
rics at W a s h in g to n U n iv e rsity in St
Louis, said their guidance lays o u t para-
m eters to be used in assessing w h e n an
ath lete can re tu rn to co m p etitio n fol-
low ing a concussion. “Rather th en tell
ing a player to sit o u t for a set p erio d
of tim e, we gradually increase the a th -
lete’s activities over a 5-day p erio d to
m ake su re th e ath lete do es n o t d e m -
o n strate sy m p to m s,” H alstead said.
Deciding w hen an athlete is well
enough to return to com petition remains
19. a bit o f a mystery, McCrea said, because
there is little rigorous evidence to show
w hat w orks best. He said the decision to
retu rn is especially difficult to m ake for
those w ho have had repeated concussions
and that such a determ ination is probably
best m ade by the treating physician.
“No adult signs his or h e r own retum -
to-work slip after they have had a stroke,
b u t retum -to-play for concussion for de-
cades has been m anaged by the injured
ath le te o r n o n m e d ic a l p ro fe ssio n a ls”
su c h as p a re n ts, coaches, or train ers,
McCrea said. “But there has been som e
positive m ovem ent in creating policy re-
quiring medical clearance before one can
re tu rn to an activity.” □
N ational Children's Study Expands
Bridget M. K uehn
W
IT H N E A R L Y 4 0 O F T H E
planned 105 sites across the
U nited States recruiting, the
p ilot phase o f the N ational C h ild ren ’s
Study is well u n d e r way, after years of
uncertain ty .
T he stu d y will follow u p m ore than
100 000 infants and their m others from
before c o n cep tio n th ro u g h th e ch ild ’s
21st b irth d a y an d m ay provide critical
in fo rm a tio n a b o u t how e n v iro n m e n -
20. tal and genetic factors contribute to dis-
ease. U n p reced en ted in its scope and
length, the stu d y has faced b o th logis-
tic an d fu n d in g challenges since it was
a u th o rized by C ongress as p a rt o f the
C h ild ren ’s H ealth Act of 2000.
A lthough the initial estim ate o f the
stu d y ’s co st was $2.7 billio n over 25
years, su b seq u en t m edia rep o rts have
suggested it could cost m ore than twice
as m uch. It is being led by a consortium
o f federal agencies; inclu d in g the E u-
nice K ennedy Shriver N ational In sti-
tute of Child Health and H um an Devel-
o p m e n t, th e N a tio n a l I n s t i t u t e o f
Environm ental Health Sciences, the US
Centers for Disease Control and Preven-
tion, and the US Environm ental Protec-
tion Agency. The planning for the project
began in 2000 and included in p u t from
the National Academy of Sciences. How-
ever, funding fell short of target am ounts
d u rin g the plan n in g phase, leading to
concern about the viability o f the study.
But funding levels have increased su b -
stantially since 2007, w hen the im ple-
m entation phase began, and $414.3 mil-
lion has been secured to date.
The payoff of su ch a m assive in vest-
m en t, in term s of u n iq u e in sights on
how the interaction betw een genes and
th e e n v iro n m e n t lead to b o th c h ild -
h o o d an d ad u lt disease, is expected to
21. be enorm ous. “W e are em barking u p o n
one o f th e ric h e st d ata-co llectio n ef-
forts ever conducted, an d the w ealth of
in fo rm a tio n we ho p e to am ass co u ld
h a v e a m a jo r im p a c t o n th e h e a lth
o f fu tu r e g e n e r a tio n s ,” sa id S tev en
H irschfeld, MD, PhD, the stu d y ’s a ct
ing directo r, in a statem ent.
T he endeavor also m ay provide in -
sights into the best ways to conduct such
a m assive research effort. D uring the
s tu d /s pilot phase, each participating site
will use 1 o f 3 strategies for recruiting
w o m en to p articip ate: referral o f p a-
tients by practitioners; outreach efforts
to contact w om en at hom e (via adver-
tisements) and at com m unity events; and
the mailing of a questionnaire to w om en
to complete and then selection of a group
to participate further. Insights from this
phase will be used to determ ine the most
efficient and cost-effective strategies for
recruitm ent for use during the rest of the
study. C urrently, the sites are recru it-
ing w o m en w ho are p reg n an t o r w ho
m ay s o o n b e c o m e p r e g n a n t fo r th e
study’s pilot phase.
Initial resu lts from this phase of the
study sh o u ld be available later this year
o r in early 2011, H irschfeld said. Early
findings from th e s tu d y m ay begin to
filter in som etim e in 2013.
M o re in f o rm a tio n o n th e p r o je c t
22. is a v a ila b le o n l i n e a t h tt p : / / w w w
.n atio n alchildrensstudy.gov. □
1 7 7 6 JAMA, October 27, 2010—Vol 304, No. 16
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