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PBS NewsHour

Is soccer safe for kids? Amid concussion fears, a parent searches for answers


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WILLIAM BRANGHAM: Dr. Richard Flyer has been my family’s pediatrician for thirteen years, and to be totally honest: I love the guy. I admire him and I trust him. But three years ago — when my son, Jack was ten — Flyer said something that floored us. He told Jack he wanted him to stop playing soccer, completely.

Flyer argued that the dozens and dozens of kids he’d seen with serious, sometimes life-altering concussions – some of them from heading the ball — had convinced him that soccer itself was not safe.

DR. RICHARD FLYER: We need to look at these sports realistically and say, “Are they really something we want our children to do?” Do we want to, in the name of sport, put a child’s brain in harm’s way?

WILLIAM BRANGHAM: Flyer’s warning got me and my wife Tory to take a long, uncomfortable look at whether the sport our three kids love is safe. The benefits they get out of the game? Those are obvious, but are they worth the risks of serious injury? For the last few years, we’ve been struggling with a dilemma that’s facing really millions of parents across the country.

TORY BRANGHAM: I just feel really confused and worried and just unsure what we’re supposed to do now.

WILLIAM BRANGHAM: It’s important to say that we became a soccer family partly by design. Our three kids are Jack, who’s 13, Gavin is 11, and Ally is nine. When they were little, they all tried a lot of different sports, but when it came time to officially join a team, we really steered them to soccer, which we thought was a ‘safe’ sport, compared to something like football.

NFL ANNOUNCER: Lot of Dolphins sidelined today, including Donald Brown out with a concussion.

TORY BRANGHAM: I think I knew enough and this is now ten years ago to know that football wasn’t really an option for our kids.

WILLIAM BRANGHAM: Because it wasn’t safe.

TORY BRANGHAM: Because it was considered unsafe.

WILLIAM BRANGHAM: Then in 2008, that idea was driven home by an awful tragedy in our town. A 16 year-old football player at Montclair high school, Ryne Dougherty, died from a brain hemorrhage he got tackling during a game.

Three weeks before — he’d had another hard hit and a concussion. The whole town was really shaken up by his death. Did we console ourselves, thinking, well, that couldn’t happen to our kids? I don’t know. Maybe. But we kept signing the kids up — and they were playing – and loving – soccer.

ALLY BRANGHAM: I really like playing– how there are positions, cause there’s, like, a special thing that you have to do when you’re doing it so you feel like you’re an important part of it.

GAVIN BRANGHAM: You get to move around a lot, and you have to be a good team, not just composed of good players.

JACK BRANGHAM: Soccer is just the best sport there is. Period.

WILLIAM BRANGHAM: That said, I can’t pretend that Dr. Flyer’s warnings weren’t always somewhere in the back of our minds. In 2012, one of jack’s soccer mates, a boy named nick graham, went up for a header, fell to the ground, and suffered such a severe concussion that his headaches and dizziness didn’t get better for months. Nick left the team and hasn’t played since.

Within the last year, at least three of his teammates have suffered concussions. Did that make us think about taking jack or any of our kids out of soccer? Honestly, no. Seeing them learn the value of hard work and dedication, how to handle the successes and the failures, it all seemed worth it to us.

TORY BRANGHAM: In this day and age, there’s so many warnings — parental warnings. It’s not safe to walk to school, it’s not safe to drink that drink, it’s not safe to look at that screen. There’s so many “No’s.” And quite frankly some of the things in life that are the most fun and are most rewarding have some risk involved.

And I’m not encouraging my kids to skydive or to cliff jump. What I’m saying is soccer is fun and it’s thrilling and it’s exciting.

WILLIAM BRANGHAM: And it gives them so much.

TORY BRANGHAM: And it gives them a lot of pleasure. So I wasn’t prepared to take that away from them.

WILLIAM BRANGHAM: But then, during the 2014 world cup, which we loved, but also where we saw some of those really brutal blows to the head, I read this story about a movement to take heading out of kid’s soccer because of concern over concussions.

I raised this question with a friend who’s spent his entire life around the game. Declan Carney was born in Ireland. He manages my son Jack’s team and our sons have played together for several years.

DECLAN CARNEY: There’s no question that concussions need to be dealt with and need to be taken very seriously whenever they happen.

But if soccer, heading a soccer ball was actually a real danger of some sort of brain injury, I think it would’ve exhibited itself somewhere in medical history in Europe or in South America or in Asia, where people play soccer pretty much all their life and have done for the last 80, 100 years.

And I don’t think the science says it’s there.

WILLIAM BRANGHAM: I checked, and Declan is right: there aren’t any large-scale, long term studies connecting soccer to brain injury among the millions of soccer players in Europe or South America or Asia.

But that article I read cited one small American study showing that adult amateur soccer players who headed the ball a lot – between about 900 and 1,500 times a year — showed abnormalities in their brains — represented here by the red and yellow sections. These are effects similar to what you’d see in concussions

But many of these players said they hadn’t had concussions. The suggestion being that brain trauma might be occurring from a lot of heading without obvious symptoms. Keep in mind, 900 to 1500 headers is far more than any kid I know ever heads the ball, even with regular practice.

But that article also quoted this man — Dr. Robert Cantu — he’s a neurosurgeon, co-directs a brain study center at Boston University, and is one of the nation’s top experts on youth concussions.

Cantu acknowledges the science connecting soccer with brain injury is limited. He’s in fact called for much more research, but even so he thinks it’s better to be safe than sorry and not allow young kids to head the ball.

DR. ROBERT CANTU: If you took heading out of soccer, it wouldn’t be behind football in the incidence of concussion. It wouldn’t even be in the high-risk group. It would be in a low-risk group.

Cantu told me that heading the ball as well as the collisions and hard falls to the ground that often accompany them are problematic for kids because unlike adult brains kid’s brains are still developing.

DR. ROBERT CANTU: The young brain is largely not myelinated. Myelin is the coating of nerve fibers that connect nerve cells, similar to coating on a telephone wire, it helps transmission but it also gives strength. And so when you violently shake the young brain, you have a much greater chance to disrupt nerve fibers and their connections than you do an adult brain.

WILLIAM BRANGHAM: And there’s this: a kid’s head sits on a less developed neck and torso than an adult’s. So the same blow might cause more damage to a kid than a grownup.

DR. ROBERT CANTU: So, you’ve got a bobble head doll effect with our youngsters, so that the very minimal impact is now gonna set their brain in much more motion than it would an adult brain with a strong neck.

WILLIAM BRANGHAM: Cantu says strengthening kid’s neck muscles can help, but those soccer helmets and headgear don’t really offer much protection, so he says there’s only one thing left to do.

DR. ROBERT CANTU: Take the most injurious activity for head injury out of it, but let the rest of the sport go on. And that’s playing soccer without heading.

WILLIAM BRANGHAM: Some others who know far more about the game than I do are listening to Cantu. One of whom you might recognize. Brandi Chastain’s dramatic penalty shot against China won the 1999 World Cup for the U.S. She also helped win gold for the U.S at two different Olympics.

She now lives in northern California with her husband and her 8 year-old son Jaden. She coaches his team, and helps coach a Division 1 team at Santa Clara University. She, along with several of her former teammates from the U.S. National team, have joined forces with Dr. Cantu’s organization.

BRANDI CHASTAIN: We don’t need to have heading in youth soccer, 14 and under.

WILLIAM BRANGHAM: The interesting thing is just a few years ago Chastain was on NBC saying that heading was safe for kids, as long as they were trained correctly.

BRANDI CHASTAIN: [NBC News clip] It’s a part of the game, it’s an important part, and it’s a beautiful part of the game.

WILLIAM BRANGHAM: At the time, were saying, “I think that it can be taught to kids, and it should stay in the game for kids.” Now you think differently. I wonder what was it in particular that changed your mind?

BRANDI CHASTAIN: I think it was hearing the information that Dr. Cantu was putting out. The more I started hearing about it, and the more research that has come out, I just thought, you know, I have to protect them, and this doesn’t need to exist at this young age.

WILLIAM BRANGHAM: Chastain admitted that so far — their campaign really hasn’t taken off. Just a handful of programs have removed heading. She says the lead really has to come from the top, from the international governing body of soccer, FIFA and the U.S. Soccer Federation.

Those organizations are currently being sued by a group of soccer parents in California who say the groups haven’t done enough to protect kids from head injury.

We reached out to FIFA and to the U.S. Soccer Federation for comment. While neither would go on the record, citing the litigation, they both said that player safety is a priority. And the Federation indicated heading and concussions are among the topics regularly reviewed by its policy makers.

Back in New Jersey, the soccer season goes on. We see a fair amount of heading, especially in my older son’s games. The boys take hard ones, soft ones. They score goals with them.

Our soccer club, Montclair United, says it’s very concerned about concussions and trains our coaches thoroughly but they say they don’t make the rules, and so heading remains a part of our game.

And quite frankly, there’s a lot of doubt on a lot of people’s minds that heading is a problem at all.

DECLAN CARNEY: I have a 13 year old son that I wanna protect as much as anybody wants to protect their son. But I will let my son head a ball because I see no evidence whatsoever that there is a danger for anybody in youth soccer playing, heading a ball.

WILLIAM BRANGHAM: But then our pediatrician, Dr. Flyer says taking heading out doesn’t go far enough in his opinion. He says what he’s sees in his own patients is evidence enough that the sport isn’t safe for kids.

DR. RICHARD FLYER: We had this 30-year experiment. The results are coming in. It’s not safe for children to do this. It’s a contact sport. That and, you know, that’s also a euphemism. It’s a brain-injuring sport. And if I don’t get this information across, even the risk of upsetting people, I’ve failed.

WILLIAM BRANGHAM: So where does all this leave us? My wife and kids and I still get up every Saturday and Sunday and get ready for another long weekend of soccer.

But full disclosure: after all the interviews I’ve done tory and I recently told our kids not to head the ball anymore. So far, it’s not been an issue in their games or with their coaches.

Even so, when we go out there and cheer them on… our pediatrician’s voice is still in the back of our minds.

WILLIAM BRANGHAM: Do you feel like we’re doing the right thing by letting them play?

TORY BRANGHAM: We are sort of punting the ball down the field and avoiding a decision. Which in and of itself is a decision. Our decision is that we’ve let our kids continue to play soccer.

WILLIAM BRANGHAM: And are you okay with that?

TORY BRANGHAM: Well, you know, I sort of just sit there secretly hoping at the end of every game that they walk off the field in one piece. I just want them to be whole.

The post Is soccer safe for kids? Amid concussion fears, a parent searches for answers appeared first on PBS NewsHour.

Officials try to ease worries about NYC’s first Ebola case


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JUDY WOODRUFF: The governors of New York and New Jersey announced today that all travelers coming from Ebola-affected countries will face a new mandatory quarantine when they arrive at airports in those two states.

Governors Andrew Cuomo and Chris Christie said the existing federal standards were not enough. It came just hours after New York City officials tried to tamp down concerns over that city’s first Ebola case.

Hari Sreenivasan has the story from New York.

MAYOR BILL DE BLASIO, New York: We have the finest public health system not only anywhere in this country, but anywhere in the world. Its a public health system that has been developed over decades. It is ready for extraordinary challenges, and it’s proving it as we speak.

HARI SREENIVASAN: New York City Mayor Bill de Blasio sought to reassure citizens this afternoon, a day after Dr. Craig Spencer was diagnosed with the Ebola virus and his fiancee and two friends were placed in quarantine.

Spencer, isolated and in stable condition at a New York hospital, had recently returned from treating Ebola patients in Guinea. But city health commissioner Dr. Mary Bassett said the 33-year- old was symptom-free during his travels.

DR. MARY TRAVIS BASSETT, Commissioner, New York City Health Department:  So, he was feeling well, had no fever at the time that he left Guinea, which was on the 14th. He continued to feel well with his onward travel from Europe to the United States, where he arrived at JFK on the 17th. And he continued to check his temperature daily.

HARI SREENIVASAN: Officials said Spencer visited the High Line Park, a coffee shop and restaurant in Manhattan on Tuesday as fatigue symptoms appeared. On Wednesday, he went running and rode the subway to a bowling alley in Brooklyn.

It was at his apartment Thursday morning that Spencer reported having a 100.3 degree fever, and emergency workers moved him to Bellevue Hospital for treatment. Health officials are now retracing Spencer’s steps in the days leading up to his hospital admission. They have cleared the bowling alley and the coffee shop, and maintain that the odds of virus transmission in public spaces remains very low.

Meanwhile, doctors declared Nina Pham, one of two nurses who contracted the disease while treating Ebola patient Thomas Eric Duncan, free of the virus today. She was released from the National Institutes of Health this morning.

NINA PHAM, Ebola Survivor: I feel fortunate and blessed to be standing here today. I first and foremost would like to thank God, my family, and friends. Throughout this ordeal, I have put my trust in God and my medical team. I’m on my way back to recovery, even as I reflect on how many others have not been so fortunate.

HARI SREENIVASAN: Pham later met with President Obama at the Oval Office. Her release is the latest in a series of recoveries by Americans who have contracted the disease. Pham colleague and fellow nurse Amber Vinson, NBC cameraman Ashoka Mukpo, and three missionary workers, Dr. Kent Brantly, Nancy Writebol, and Dr. Rick Sacra have all been declared Ebola-free after receiving treatment at U.S. facilities.

Still, on Capitol Hill today, National Nurses United co-president Deborah Burger said the Ebola response from U.S. hospitals and governmental agencies has been inconsistent.

DEBORAH BURGER, Co-President, National Nurses United: Eighty-five percent of the nurses say they are not adequately trained. Give us the tools we need. All we ask from President Obama and Congress is not one more infected nurse.

HARI SREENIVASAN: But John Roth, an inspector general at the Department of Homeland Security, said an audit of previous DHS pandemic preparedness revealed questionable spending practices.

JOHN ROTH, Inspector General, Department of Homeland Security: We found that DHS has a stockpile of about 350,000 white coverall suits and 16 million surgical masks, but hasn’t been able to demonstrate how either fits into their pandemic preparedness plans.

HARI SREENIVASAN: Meanwhile, in Switzerland, the World Health Organization announced plans to ramp up development of Ebola vaccines.

WHO assistant director-general of health systems and innovation Marie-Paule Kieny:

MARIE-PAULE KIENY, Assistant Director-General for Health Systems and Innovation, World Health Organization: All is put in place by all partners to start efficacy trials in affected countries in December, as early as in December 2014. Of course, the protocols will be adapted to take into consideration safety and immunogenicity results of the phase one trial as they become available.

HARI SREENIVASAN: They said hundreds of thousands of doses could be ready for use in West Africa by the middle of next year. The WHO also announced it was sending experts to Mali, where a 2-year-old girl has died with Ebola, the first known case in that country; 43 others are being monitored for symptoms.

JUDY WOODRUFF: The World Health Organization said today there are already more than 9,900 cases of Ebola in Africa during this outbreak and close to 4,900 deaths. Nine cases of Ebola have been seen in the United States since the beginning of August. Only Thomas Eric Duncan, the man from Liberia, died.

The post Officials try to ease worries about NYC’s first Ebola case appeared first on PBS NewsHour.

Saving lives and bearing witness in hot spots around the world


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JUDY WOODRUFF: As we reported earlier, the doctor in New York City with Ebola, Craig Spencer, contracted the virus while on a mission for Doctors Without Borders in Guinea.

Tonight, special correspondent Fred de Sam Lazaro brings us a closer look at that organization and its oftentimes life-risking and lifesaving work.

A version of the story aired on the PBS program “Religion & Ethics Newsweekly.”

FRED DE SAM LAZARO: They have been front and center, not just in the fight against Ebola, but in every humanitarian crisis in recent memory.

Widely known by its French acronym, MSF, Doctors Without Borders is in hot spots of disease, natural disaster and war around the world, and on the front lines to get the international community to wake up to some of the world’s crises.

DR. JOANNE LIU, Medicins Sans Frontiers: Medicins Sans Frontiers has been ringing alarm bells for months, but the response has been too late, too little.

FRED DE SAM LAZARO: That’s MSF president Joanne Liu, who has been expressing growing frustration on Ebola to world leaders.

DR. JOANNE LIU: Today, Ebola is winning. The isolation center you have promised must be established now. There is today a political momentum the world has rarely, if ever, seen. As world leaders, you will be judged — you will be judged by how you use it.

FRED DE SAM LAZARO: Beyond medicine, MSF’s mission is to bear witness, to speak out. It goes back to its founding in 1971 by a group of French Red Cross volunteers working amid grave violence in Nigeria’s civil war.

Sociologist Renee Fox wrote of their frustration in a book about the group.

RENEE FOX, University of Pennsylvania: They pledged their commitment to not speak of what they saw in the field, very much in keeping with the professional confidentiality that physicians keep vis-a-vis their individual patients, and when they saw these abuses taking place came together with the conviction that there was something wrong with not speaking out.

FRED DE SAM LAZARO: Four decades later, MSF calls itself a movement. It has chapters in 24 mostly wealthy countries, and 25,000 people deployed around the world.

Ninety percent are hired locally. Most are not doctors and nurses. They are construction, experts in logistics, in water, in sanitation. The teams move swiftly, as we saw in this 2008 report from a hurricane-ravaged Haiti.

The construction workers aren’t finished yet, but the hospital work is already in full swing since it’s the only hospital now in Gonaives, a city of more than 200,000 people.

One reason it can move quickly is MSF raises over a billion dollars a year, critically, with few strings attached.

RENEE FOX: Ninety percent of their finances come from people like you and me who make modest contributions or more than modest contributions to MSF.

SOPHIE DELAUNAY, MSF USA: We don’t need to wait for funding from a government to be able to react to a crisis.

FRED DE SAM LAZARO: And MSF USA’s Sophie Delaunay adds they don’t accept money from governments heavily involved in events, no U.S. funds work in Afghanistan, for example.

But she admits the thinking has shifted in the Ebola epidemic, where MSF supports the U.S. military’s aid.

SOPHIE DELAUNAY: In principle, we really try to take as much distance as possible from military, but in these particular circumstances, we don’t want to be dogmatic. And we feel there is a value in taking a different position.

FRED DE SAM LAZARO: MSF’s reputation Drew Dr. Benjamin Levy to sign on for a six-month stint in 2011 in a field hospital in Ethiopia. Thousands of refugees were fleeing famine and civil war from neighboring Somalia.

DR. BENJAMIN LEVY, Centers for Disease Control and Prevention: It was a place where sort of the idealism of medicine came to practice.

FRED DE SAM LAZARO: Levy, who now works for the Centers for Disease Control and Prevention, remembers a culture of debate.

DR. BENJAMIN LEVY: There was healthy debate as to what diseases we could treat, what diseases we didn’t have the capacity to treat, and where to take the programs that we were running as the emergency ended.

FRED DE SAM LAZARO: And before it begins working an emergency, particularly in war zones, MSF works to gain safety assurances from all factions.

SOPHIE DELAUNAY: You’re going to treat their brothers, their cousins, their family, et cetera. It’s a very good protection, actually. The second criteria that we use is, we want to be able to have an evacuation route.

FRED DE SAM LAZARO: MSF has evacuated from Afghanistan in 2004 for five years after two workers were killed, and from Somalia after two were kidnapped.

It pulled foreign staff and closed a hospital in Syria after five workers were kidnapped. However, in recent conflicts like Burma, Sri Lanka and Yemen, MSF stayed on, agreeing not to criticize government policies it acknowledged were repressive.

Bearing witness is complicated by the reality on the ground, says author Fox.

RENEE FOX: When they were young, they thought witnessing was an unmitigated virtue. As they matured, they came to see how complex the ramifications of witnessing might be.

FRED DE SAM LAZARO: They have learned to be politically pragmatic, she says, without being political.

JUDY WOODRUFF: Fred’s reporting is a partnership with the Under-Told Stories Project at Saint Mary’s University in Minnesota.

The post Saving lives and bearing witness in hot spots around the world appeared first on PBS NewsHour.

Dallas Nurse declared Ebola free, released from hospital


Nina Pham, a 26-year-old Dallas nurse, contracted Ebola while caring for patient Eric Thomas Duncan. Video still by PBS NewsHour

The first nurse in the U.S. diagnosed with Ebola, Nina Pham, is now free of the virus and was released from the hospital earlier today.

Pham is one of two nurses to contract Ebola in Dallas while caring for infected patient Thomas Eric Duncan, who succumbed to the virus earlier this month. She was transferred to Bethesda, Md., where she was treated at the National Institutes of Health hospital.

“I feel fortunate and blessed to be standing here today,” said Pham, addressing reporters outside the hospital, before adding that “it may be a while before I have my strength back.”

Still, Dr. Anthony Fauci, infectious disease chief at the NIH, that Pham represents no threat to the public. “She is cured of Ebola, let’s get that clear,” Fauci said, explaining that Pham had passed five consecutive tests that showed there was no virus left in her blood.

The news of Pham’s release comes amid mixed news on the broader fight against Ebola. Yesterday, the second nurse afflicted by Ebola in Texas – Amber Vinson – was declared free of the life threatening virus. But, today, officials in New York confirmed the city’s first case of Ebola.

Craig Spencer, a Doctors Without Borders physician who returned from treating patients in Africa last week, began showing symptoms (fever, nausea, pain and fatigue) Thursday morning and was promptly admitted to the Bellevue Hospital Center.

Spencer is currently being held in isolation but investigators who reconstructed his movements since arriving back in the US say that he did ride the subway, go for a jog and visit a bowling alley. His fiancé, along with his two friends, are under quarantine and the bowling alley has been temporarily closed.

Like in previous cases, officials in New York have been working to stem public panic. “”There is no cause for alarm,” said Mayor Bill de Blasio. “New Yorkers who have not been exposed to an infected person’s bodily fluids are simply not at risk.”

Elsewhere, Ebola has spread to yet another West African country, Mali. It was carried by a two-year old girl who crossed the border from neighboring Guinea.

A press briefing on Pham’s discharge is scheduled for 11:30 a.m. EDT. Watch the live NIH stream here.

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