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To examine the ways in which sports-related brain injury (concussion and subconcussion) is both similar to and different from other injuries and to set out a sociological understanding of the injury, its manifestation and management.

There is a broad contextualization of the ‘issue’ of concussion and the processes that have brought this to the fore, an examination of the ways in which concussion has been figuratively clouded from plain view, and an outline of the main contributions of the social sciences to understanding this injury – the culture of risk and the mediating effect of social relationships. The chapter concludes by questioning whether the emergence of concerns over chronic traumatic encephalopathy has stimulated a fundamental change in attitudes towards sport injuries, and if this has had a significant impact on the social visibility of concussion.

The two available sociological studies of the lived experiences of concussion are situated within a broader analysis of the politicization of sports medicine and the emergence of a particular social discourse around sports-related brain injury.

The difficulties emanating from the dominance of a biomedical approach to concussion are discussed along with the need for further research, incorporating a more holistic view of concussion, as a bio-psycho-social phenomenon.

Design, implementation, and evaluation are all important for integrated care. However, they miss one critical factor: education. The authors define “integrated care education” as meaningful learning that purposefully supports collaboration and the development of adaptive expertise in integrated care. The ECHO (Extensions for Community Health Outcomes) model is a novel digital health solution that uses technology-enabled learning (TEL) to facilitate, support, and model integrated care education. Using ECHO Concussion as a case study, the authors describe the effects of technology-enabled integrated care education on the micro-, meso-, and macro-dimensions of integrated care.

This case study was constructed using data extracted from ECHO Concussion from video-archived sessions, participant observation, and internal program evaluation memos. The research team met regularly to discuss the development of relevant themes to the dimensions of integrated care.

On the micro-level, clinical integration occurs through case-based learning and the development of adaptive expertise. On the meso-level, professional integration is achieved through the development of the “specialist generalist,” professional networks and empathy. Finally, on the macro-level, ECHO Concussion and the ECHO model achieve vertical and horizontal system integration in the delivery of integrated care. Vertical integration is achieved through ECHO by educating and connecting providers across sectors from primary to quaternary levels of care. Horizontal integration is achieved through the establishment of lateral peer-based networks across sectors as a result of participation in ECHO sessions with a focus on population-level health.

This case study examines the role of education in the delivery of integrated care through one program, ECHO Concussion. Using the three dimensions of integrated care on the micro-, meso-, and macro-levels, this case study is the first explicit operationalization of ECHO as a means of delivering integrated care education and supporting integrated care delivery.

Using the National Football League (NFL) concussion crisis context, the purpose of this paper is to provide sports marketers with a strategic approach to sports crisis management through consideration of crisis media coverage and organizational reputation.

An online experiment assessed the impact of two crisis response strategies, fan involvement and exposure to crisis media coverage on emotional response, corporate message credibility, crisis perception and perceived corporate reputation.

The accident response strategy was associated with more favorable perceptions of the NFL and corporate message credibility. Sports fan involvement facilitated more favorable perceptions of the NFL’s reputation, while exposure to media coverage of the NFL’s crisis created negative perceptions of the NFL’s reputation. Exposure to media coverage of the NFL concussion crisis increased feelings of anger, which in turn decreased perceptions of corporate message credibility.

A limitation for this study is the specific crisis scenario that was used. The NFL concussion crisis is different from other crisis types in that it does not directly impact the audience’s well-being, but instead affects their perceptions of an iconic institution.

In light of study findings, it is suggested that sports marketers consider the following when dealing with crises: carefully determine proper framing methods when crafting a crisis response as different response types affect consumers in different ways; leverage public relations (PR) practices by engaging in media monitoring to inform an appropriate crisis response to control the narrative; and examine forces exernal of the organization that influence consumer emotions, paying special attention to feelings of anger as anger negatively impacts consumer perceptions of corporate credibility.

This paper addresses sports crisis strategy from both marketing and public relations perspectives. It describes how strategic efforts protect a sports organization’s reputation, thus increasing marketing effectiveness.

This paper aims to conduct the first cross-sectional survey on depression, Resilience, well-being, depression symptoms and concussion levels in equestrian athletes and to assess whether past concussion rates were associated with depression, resilience and well-being.

In total, 511 participants from Canada, Republic of Ireland, UK, Australia and USA took part in an international cross-sectional, online survey evaluating concussion history, depression symptoms, resilience and well-being.

In total, 27.1% of athletes met clinically relevant symptoms of major depressive disorder. Significant differences were shown in the well-being and resilience scores between countries. Significant relationships were observed between reported history of concussion and both high depression scores and low well-being scores.

Findings highlight the need for mental health promotion and support in equestrian sport.

Results support previous research suggesting a need for enhanced mental health support for equestrians. There is reason to believe that mental illness could still be present in riders with normal levels of resilience and well-being.

This study examined an understudied athlete group: equestrian athletes and presents important findings with implications for the physical and mental health of this population.

The retrospective diagnosis of concussion is often missed by clinicians. We present a brief scale for retrospective assessment of the immediate concussion symptoms (ICS) to facilitate the diagnosis of patients without visible head injury or full loss of consciousness. We administered the scale to 90 survivors of car accidents (mean age 42.0, SD=13.6; 33 males, 57 females) at 2 to 33 months after their accident. Our scale consists of 6 items and these were endorsed by the following % of our respondents: feeling dazed (64.4% of our 90 respondents), stunned (73.3%), confused (70.0%), disoriented (62.2%), dizzy (57.8%), and loss of consciousness (22.2%). The statistical properties of the scale are satisfactory (Cronbach alpha = 0.74). The scale correlates with post-accident insomnia (r=0.28), depression (r=0.29), and also with Rivermead measure of the chronic post-concussion syndrome (r=0.34). The ICS scale could be used as a starting point in longitudinal research with brain imaging procedures to evaluate the stages of recovery from the initial concussion. Attached are the English, Spanish, French, German, Italian, Russian, and Czech versions of our scale.

This chapter analyzes the campaign against race norming in the 2013 National Football League (NFL) concussion settlement that caregivers of retired players designed, and it considers how their collective action throws new light on activism in sport. While there is a substantial literature on how individual athletes engage in protest, less work has focused on how families – partners, children, siblings, and parents – of athletes organize as a group to answer back to anti-Black racism in professional sport. I argue that a group of spouses used their position as caregivers to shame the NFL, the presiding judge of the settlement, Class Counsel, and even the Department of Justice into acknowledging not only individual suffering from traumatic brain injury but also of the distribution of that suffering across households. Specifically, the wives group expanded definitions of risk and damage to include not only individual illness but also family and group suffering and demanded inclusion of gendered and racialized aspects of social care. Through their campaign, the group recast what is considered protest in the world of sport and who has the ability to access an activist subjectivity.

The purpose of this paper is to better understand how consumers perceive and process danger in American football and why they continue to enjoy watching the sport given society’s increased understanding of the danger to the athletes.

Two studies, one lab study with eye-tracking (N = 152) and one survey study (N = 444), were conducted. Study 1 examines how the perception of danger associated with football mediates the relationship between exposure to violent or nonviolent video clips and enjoyment of watching video clips. Study 2 examines how device type and screen resolution influence perceptions of danger associated with football.

Findings support the role that perceived danger plays in sport viewing enjoyment. The results are in keeping with reversal theory where individuals have a protective frame that allows them to experience negative emotions (e.g. anxiety) as positive (e.g. excitement). The research also shows that for larger devices, the perception of danger associated with football is significantly influenced by high resolution.

The work, through considering the way consumers experience sport, questions societal tolerance for entertainment that is dangerous to sport participants.

The findings of this work corroborate past research that has found that consumers of sport do enjoy danger for athletes in their viewing experience. Reversal theory is utilized to explain how negative emotions are experienced as positive. The work extends past findings by showing that the characteristics of the device used (large size and high resolution) during sport viewing influence perceptions of danger.

This paper aims to conduct a combined Eulerian/Lagrangian fluid/solid transient non‐linear dynamics computational analysis of the interaction between a single planar blast wave and a human head in order to assess the extent of intra‐cranial shock wave generation and its potential for causing traumatic brain injury.

Two levels of blast peak overpressure were selected, one corresponding to the unprotected lung‐injury threshold while the other associated with a 50 percent probability for lung injury caused death. Collision of the head with a stationary/rigid barrier (at an initial collision velocity of 5 m/s) was also analyzed computationally, since blunt‐object impact conditions may lead to mild traumatic brain injury (mTBI), i.e. concussion.

A comparison between the two blast and the single blunt‐object impact cases with the corresponding head‐to‐head‐collision results showed that, while the von Mises stress‐based head‐to‐head collision mTBI thresholds are not exceeded under blast‐loading conditions investigated, the high blast‐induced peak‐pressure levels within the intra‐cranial cavity may lead to mTBI.

While concussion is not generally considered as life altering/threatening, the associated temporary loss of situational awareness or consciousness may have devastating consequences in the case of common military tactical and battle‐field scenarios. This suggests that the head‐protection gear (primarily, the helmet) which are currently designed to withstand blunt‐object and ballistic impacts, should be redesigned in order to obtain the necessary level of head protection with respect to blast impact.

The paper provides a comprehensive computational investigation of impact on a human skull/brain assembly.

While often considered a low incidence disability, traumatic brain injuries (TBIs) among students are anything but low incidence occurrences. Furthermore, educators are often at times not made aware that a student is injured; when informed, the information provided is generally limited or incomplete at best leaving educators unsure regarding what is needed for the student. In this chapter, information on TBI and its effects on students is provided. We also explore the history of inclusion, mechanisms for service delivery, accommodations and modifications for injured students, and transitioning and reintegrating students post-injury. Lastly, we provide a review of common barriers to service delivery and offer both proactive and reactive strategies to overcome those barriers.

Hospital emergency rooms document approximately 500,000 traumatic brain injuries (TBIs) in children and adolescents aged 0–14 annually; these prevalence rates do not include those learners evaluated in primary care facilities nor those never evaluated by medical professionals. In this chapter, information on TBI and its effect on learners is provided with emphasis on the idiosyncratic nature of the injury and, thus, the need for individualized reintegration and educational plans. The role of educators in the identification, assessment, reintegration, disability classification, intervention delivery, and progress monitoring is described. Lastly, specific intervention options are presented with cautions that interventions should not be simply picked from a menu, but rather targeting key observations and reported deficits in the physical, cognitive, emotional, social, and behavioral domains.