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ByLauranNeergaard TheAssociatedPress WASHINGTON Thereisno concussion-proof football helmet, but manufacturers may soon have to meet new testing standards against certain concussion-caus- ing forces — a step in the quest for more protection. The organization that sets safety standards for athletic equipment was preparing to adopt the test- ing criteria on Friday. Itispartofamovementto try to make contact sports safer, as concern about con- cussions is growing. There's even a new smartphone app to help parents and coaches recognize right away if a player may have a brain in- jury. Football helmets were designed to protect against catastrophic injuries such as skull fractures and bleeding in the brain, and are considered highly effec- tive at that. They're tested for how they withstand di- rect blows, so-called linear forces that can make the brain bump back and forth. The proposed new stan- dard would add an ad- ditional test of how hel- mets perform when an im- pact also makes a player's head suddenly spin, caus- ing the brain to stretch and twist inside the skull as it changes direction. Scien- tists call that rotational ac- celeration, and brain spe- cialists say limiting both kinds of forces is impor- tant. "We're plowing new ground here," Mike Oliver, executive director of the National Operating Com- mittee on Standards for Athletic Equipment, told The Associated Press. The hope is that the standard might eventually spur safer helmet designs. "I don't believe helmets will ever be the sole solu- tion for concussion," said Dr. Robert Cantu, a Bos- ton University neurologist, a leading sports concus- sion expert and vice pres- ident of the athletic equip- ment standards committee. But, "it puts us on the road to developing helmets that will lessen the chance for concussion." Once the standard goes into effect, expected in about a year, it would ap- ply only to new helmets. "We don't foresee any need to replace all the hel- mets that exist with new and different helmets," Oli- ver said. "This is a first step." Concern about concus- sions is growing amid headlines about former professional players who suffered long-term impair- ment after repeated blows to the head. It's not just football; concussions occur in a range of sports, from hockey and lacrosse to soc- cer and wrestling. Children and teens, with their still developing brains, appear at special risk. The Institute of Medi- cine, an independent orga- nization that advises the government, warned last fall that too many young athletes still face a play- at-all-costs culture that discourages reporting the injury and staying on the sidelines until it's healed. Although millions of U.S. children and teens play school or community sports, it's not clear how many suffer concussions, in part because many go undiagnosed. The Institute of Medicine said 250,000 people 19 and younger were treated in emergency rooms for concussions and other sports- or recreation- related brain injuries in 2009. "Parents and coaches need to be prepared and educated about what the nature of this injury is," advised neuropsychologist Gerard Gioia of Children's National Medical Center in Washington and medi- cal adviser to USA Football. The federal Centers for Disease Control and Pre- vention's "heads-up" cam- paign teaches signs of concussion — which may not appear right away — and what steps to take. Symptoms include confu- sion, weakness, appearing dazed or stunned, lack of coordination, mood or be- havior changes and even a brief loss of consciousness. Recent guidelines say any- one suspected of having a concussion should be taken out of play immediately and not allowed back un- til cleared by a trained pro- fessional. Gioia helped turn that advice into the "concussion recognition and response" smartphone app to offer guidance on the field. As for safety gear, last fall's Institute of Medicine report found little scien- tific evidence that current sports helmet designs re- duce the risk of concus- sion. Indeed, football hel- mets have gotten bigger and heavier in recent years but "our concussion prob- lem has not gotten bet- ter," said Dave Halstead, a sports biomechanics spe- cialist at the University of Tennessee and the South- ern Impact Research Cen- ter testing laboratory who advises the athletic equip- ment standards committee. To test rotational ac- celeration, labs will put helmets onto a crash test dummy-like head with a moveable neck. A machine then positions a ram to hit the head from differ- ent directions, at different speeds and as if different- sized players were behind the impact. "It's about time," was the reaction from concussion researcher Steven P. Broglio of the University of Michi- gan and National Athletic Trainers' Association. Broglio wasn't involved in the NOCSAE move but compared it to how car- crash ratings focused first on head-on collisions and then on side impacts. "We're adding another layer to get a better under- standing of what helmets are capable of," he said. It's not clear whether helmet changes really will help, cautioned Dr. Thom Mayer, medical director of the NFL Players Associa- tion. But "we're committed to making sure we look at what are the most cutting- edge helmet testing stan- dards available. This is a step in the right direction," he said. Helmet standards can't affect rotational accelera- tion caused by strong tack- les to the body rather than a hit to the head, Halstead said. Specialists emphasize other steps, such as teach- ing players not to lower their heads during a hit, said USA Football's Gioia. Newtestingfor helmets proposed in concussion fight SAFETY SOUTHERNIMPACTRESEARCHCENTER—THEASSOCIATEDPRESS This handout photo taken June 18shows equipment that can test how football helmets perform against certain concussion-causing forces. DEAR DOCTOR K I'm a healthy 50-year-old woman. Do I need to take a multivitamin/mineral supplement? DEAR READER Following the news on supplements is like watching a ping- pong match. One study finds supplements improve health, then another study questions their benefit. Back and forth they go. One recommendation about vitamin supple- ments is not in dispute: Women of childbearing age should take folic acid supplements. Folic acid (often classified with the B vitamins) reduces the risk of a woman giving birth to a baby with neural tube defects. The most common of these defects is called spina bifida. Neural tube defects can cause perma- nent neurological dam- age: difficulty swallowing, breathing and moving. IF YOU ARE A WOMAN OF CHILDBEARING AGE WHO WANTS CHIL- DREN, AND YOU ARE NOT TAKING DAILY FOLIC ACID SUPPLE- MENTS, TALK TO YOUR DOCTOR: YOU PROBA- BLY SHOULD BE. Did I say that loud enough? Another recommen- dation that is not in dis- pute: If you have osteopo- rosis (thin bones) or os- teopenia (borderline thin bones), you should talk to your doctor about taking vitamin D, along with cal- cium. They protect your bones. Now we get into the controversy. Last year, the U.S. Preventive Services Task Force, a panel of dis- ease prevention experts, reviewed research pub- lished over the past de- cade. The task force con- cluded there isn't enough evidence to support use of vitamin and mineral sup- plements to prevent heart disease, cancer or deaths from these diseases in healthy adults. So does this close the book on sup- plements for disease pre- vention? My colleague Dr. How- ard Sesso, an epidemiolo- gist at Harvard-affiliated Brigham and Women's Hospital, doesn't think so. As an example, he points to the Physician's Health Study. This large, well-de- signed study found tak- ing a daily multivitamin significantly reduced can- cer risk. Individual vitamins and minerals, such as vitamin D, also warrant further study. A number of obser- vational studies suggest vi- tamin D may help prevent chronic diseases, besides its beneficial effect on thin bones. Sesso is working on a large, long-term trial that will study the effects of vitamin D on cancer, heart disease and stroke risks. While the research con- tinues, ask your doctor for an individualized recom- mendation. If you have or are at risk for osteoporo- sis, for example, your doc- tor will likely recommend calcium and vitamin D. You can also consider a daily multivitamin if your diet is less than perfect. It doesn't replace a bal- anced diet, but it can help fill nutritional gaps. And we don't know of health risks from taking a multi- vitamin. If you choose to take a supplement, stick with the major brands. They are well tested and are more likely to fall in line with recommended doses. (I've put tables listing recom- mended amounts of vi- tamins and minerals on my website, AskDoctorK. com.) Avoid specialized mul- tivitamin formulations — for immunity support, heart health, energy, etc. — unless your doctor rec- ommends otherwise. One exception: If you are over age 50, choose a vitamin designed for seniors. It will contain the right vi- tamin and mineral levels for you. Dr. Komaroff is a physi- cian and professor at Har- vard Medical School. To send questions, go to Ask- DoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115. ASK DR. K Jury still out on multivitamins By Lindsey Tanner The Associated Press CHICAGO Women with heart failure are less likely to get a special kind of pace- maker than men, but more likely to benefit from the de- vice, a government analysis suggests. The findings come from the first study of its kind conducted by researchers at the Food and Drug Admin- istration. The FDA has done similar analyses of prescrip- tion drugs, but not of medi- cal devices, said lead author Dr. David Strauss, an FDA medical officer. Relatively few women have been included in stud- ies of pacemakers and other medical devices, which "has made it difficult to assess differences in the safety and effectiveness of these devices for women vs. men," Strauss said. The study authors said it's unclear why women would benefit more from these special pacemakers but possibilities include dif- ferences in physiology and body size. It's also uncer- tain why the pacemakers are used less in women but an editorial published with the study says heart devices in general are more com- monly used in men, possi- bly because of scarce scien- tific evidence that they work in women. Theresearchers pooled re- sults in three previous pace- maker studies, involving more than 4,000 patients, mostly men. Still, there were 878 women included — enough to assess gender dif- ferences in treatment results, the researchers said. Their analysis was pub- lished Monday in JAMA In- ternal Medicine. Pacemakers are small de- vices implanted in the chest that emit electrical signals to regulate the heartbeat. They are often used to treat heart failure, which occurs when the heart muscle has weakened and can't effi- ciently pump blood. 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