Age has a Minimal Effect on the Impact Performance of Field-Used Bicycle Helmets

Helmet manufacturers recommend replacing a bicycle helmet after an impact or after anywhere from 2 to 10 years of use. The goal of this study was to quantify the effect of helmet age on peak headform acceleration during impact attenuation testing of field-used bicycle helmets. Helmets were acquired by donation from consumers and retail stores, and were included in the study if they were free of impact-related damage, had a legible manufacture date label, and were certified to at least one helmet standard. Helmets (n = 770) spanning 0–26 years old were drop tested to measure peak linear headform acceleration during impacts to the right and left front regions of the helmets at two impact speeds (3.0 and 6.2 m/s). General linear mixed models were used to assess the effect of age and three covariates (helmet style, size and certification impact speed) on peak acceleration. Overall, age was related to either no difference or a statistically significant but small increase (≤0.76 g/year of helmet age) in peak headform acceleration. Extrapolated across 20 years, age-related differences were less than both style- (traditional vs. BMX) and size-related differences. The age-related differences were also less than the variability observed between different helmets after accounting for style, size and certification effects. These findings mean that bicycle helmets (up to 26-year-old traditional helmets and 13-year-old BMX helmets) do not lose their ability to attenuate impacts with age; however, other helmet features that may change with age were not evaluated in this study.     

气囊式头盔防护下的两轮车骑车人头部损伤风险分析

目的 提出一种气囊式头盔缓冲内衬结构,并分析其对两轮车骑车人头部损伤的防护效果。方法 将气囊式内衬应用于自行车（半盔）和摩托车（全盔）两款典型的两轮车骑车人头盔,通过标准GB 24429-2009和法规ECE R22.05测试工况下的有限元碰撞仿真,获得人体头部模型运动学和生物力学响应,从颅骨骨折和颅脑损伤风险角度对比常规聚苯乙烯泡沫塑料（expanded polystyrene, EPS）头盔,综合评价气囊式头盔的防护性能。结果 当气囊压力为0.06 MPa时,气囊式头盔（半盔/全盔）防护下的人体头部颅骨骨折相关量分别小于120 g和150 g,颅骨骨折风险基本低于40%;颅脑最大主应变均小于0.3,轻度脑损伤风险均低于25%;气囊式头盔防护下的人体颅骨骨折和颅脑损伤风险均低于EPS头盔。结论 本文设计的气囊式头盔具有较好的防护效果,能兼顾颅骨骨折和颅脑损伤防护,可以为新型头盔的设计提供基础示例。损伤风险分析也可为骑车人头部损伤应急诊断提供初步参考。     

Increasing the use of bicycle helmets: lessons from behavioral science

Bicycle helmet purchase, use, consistent use, and correct use are determined by a complex set of factors. Behavioral theory suggests that they are influenced by the reciprocal association between individual characteristics such as, expectations, skills, attitudes, and beliefs; social influences such as social norms and peer pressure; and environmental factors such as availability, accessibility, and cost. These factors can be influenced through counseling and other interventions. While a review of the literature suggests that many bicycle helmet programs have not been planned using behavioral models and knowledge from the behavioral sciences, many studies include information that supports behavioral principles. This paper describes the behavioral principles and their application to the problem of increasing bicycle helmet use. Recommendations for practitioners are included.     

Maternal Intervention Strategies in Enforcing Children's Bicycle Helmet Use

We investigated maternal methods of enforcing helmet usage in children. Although the American Academy of Pediatrics recently called for stronger parenting strategies to increase bicycle-helmet use, there has been virtually no study of typical parenting strategies to influence children to wear their helmets. In the present study, mothers of second- and eighth-grade children responded to 12 vignettes portraying typical excuses children give for not wearing a helmet. Even after continued child refusal, mothers reported they would try to persuade, discuss or command their child to wear the helmet, more often than they would use consequences. Initially, there were no age or gender effects, but as the vignettes portrayed the child protesting, mothers of second-grade girls suggested the use of consequences more often than mothers of eighth-graders. The reverse was true for mothers of second-grade boys, although these differences typically did not reach statistical significance. Overall, the data support the American Academy of Pediatrics' suggestion for more effective parenting strategies, especially for children at highest risk for bicycle injury.     

Comparison of Ice Hockey Goaltender Helmets for Concussion Type Impacts

Concussions are among the most common injuries sustained by ice hockey goaltenders and can result from collisions, falls and puck impacts. However, ice hockey goaltender helmet certification standards solely involve drop tests to a rigid surface. This study examined how the design characteristics of different ice hockey goaltender helmets affect head kinematics and brain strain for the three most common impact events associated with concussion for goaltenders. A NOCSAE headform was impacted under conditions representing falls, puck impacts and shoulder collisions while wearing three different types of ice hockey goaltender helmet models. Resulting linear and rotational acceleration as well as maximum principal strain were measured for each impact condition. The results indicate that a thick liner and stiff shell material are desirable design characteristics for falls and puck impacts to reduce head kinematic and brain tissue responses. However for collisions, the shoulder being more compliant than the materials of the helmet causes insufficient compression of the helmet materials and minimizing any potential performance differences. This suggests that current ice hockey goaltender helmets can be optimized for protection against falls and puck impacts. However, given collisions are the leading cause of concussion for ice hockey goaltenders and the tested helmets provided little to no protection, a clear opportunity exists to design new goaltender helmets which can better protect ice hockey goaltenders from collisions.     

Impact Performance of Modern Football Helmets

Linear impact tests were conducted on 17 modern football helmets. The helmets were placed on the Hybrid III head with the neck attached to a sliding table. The head was instrumented with an array of 3-2-2-2 accelerometers to determine translational acceleration, rotational acceleration, and HIC. Twenty-three (23) different impacts were conducted on four identical helmets of each model at eight sites on the shell and facemask, four speeds (5.5, 7.4, 9.3, and 11.2 m/s) and two temperatures (22.2 and 37.8 °C). There were 1,850 tests in total; 276 established the 1990s helmet performance (baseline) and 1,564 were on the 17 different helmet models. Differences from the 1990s baseline were evaluated using the Student t test (p < 0.05 as significant). Four of the helmets had significantly lower HICs and head accelerations than the 1990s baseline with average reductions of 14.6–21.9% in HIC, 7.3–14.0% in translational acceleration, and 8.4–15.9% in rotational acceleration. Four other helmets showed some improvements. Eight were not statistically different from the 1990s baseline and one had significantly poorer performance. Of the 17 helmet models, four provided a significant reduction in head responses compared to 1990s helmets.     

Spatial differences in sensible and latent heat losses under a bicycle helmet

This research aims at quantifying spatial gradients in skin temperature and sweat production under a bicycle helmet. Distribution of sweat production, skin temperature and air temperature was measured at different positions under a bicycle helmet on five male and four female test persons. Effort level was 100 and 150 watt for men (low and high effort level) and 80 and 120 W for women (low and high effort level). Skin temperatures were found to be spatially different (P < 0.05): frontal and lateral region varied 4.6°C at low effort level and 5.3°C at high effort level. Sweat production was found to be not significantly different (P > 0.05). Finally, air temperature variations were found to be spatially different (P < 0.05). Average air temperature differed 2.3°C between lateral and frontal region at high effort level and 2.7°C at low effort level. The results of this research can be used to help designing helmets with better thermal comfort.     

Change in Size and Impact Performance of Football Helmets from the 1970s to 2010

Linear impactor tests were conducted on football helmets from the 1970s–1980s to complement recently reported tests on 1990s and 2010s helmets. Helmets were placed on the Hybrid III head with an array of accelerometers to determine translational and rotational acceleration. Impacts were at four sites on the helmet shell at 3.6–11.2 m/s. The four generations of helmets show a continuous improvement in response from bare head impacts in terms of Head Injury Criterion (HIC), peak head acceleration and peak rotational acceleration. Helmets of 2010s weigh 1.95 ± 0.2 kg and are 2.7 times heavier than 1970s designs. They are also 4.3 cm longer, 7.6 cm higher, and 4.9 cm wider. The extra size and weight allow the use of energy absorbing padding that lowers forces in helmet impacts. For frontal impacts at 7.4 m/s, the four best performing 2010s helmets have HIC of 148 ± 23 compared to 179 ± 42 for the 1990s baseline, 231 ± 27 for the 1980s, 253 ± 22 for the 1970s helmets, and 354 ± 3 for the bare head. The additional size and padding of the best 2010s helmets provide superior attenuation of impact forces in normal play and in conditions associated with concussion than helmets of the 1970s–1990s.     

Dynamic Response Due to Behind Helmet Blunt Trauma Measured with a Human Head Surrogate

A Human Head Surrogate has been developed for use in behind helmet blunt trauma experiments. This human head surrogate fills the void between Post-Mortem Human Subject testing (with biofidelity but handling restrictions) and commercial ballistic head forms (with no biofidelity but ease of use). This unique human head surrogate is based on refreshed human craniums and surrogate materials representing human head soft tissues such as the skin, dura, and brain. A methodology for refreshing the craniums is developed and verified through material testing. A test methodology utilizing these unique human head surrogates is also developed and then demonstrated in a series of experiments in which non-perforating ballistic impact of combat helmets is performed with and without supplemental ceramic appliques for protecting against larger caliber threats. Sensors embedded in the human head surrogates allow for direct measurement of intracranial pressure, cranial strain, and head and helmet acceleration. Over seventy (70) fully instrumented experiments have been executed using this unique surrogate. Examples of the data collected are presented. Based on these series of tests, the Southwest Research Institute (SwRI) Human Head Surrogate has demonstrated great potential for providing insights in to injury mechanics resulting from non-perforating ballistic impact on combat helmets, and directly supports behind helmet blunt trauma studies.     

Measurement of Gamma Knife helmet factors using MOSFETs

The relative dose rate for the different Gamma Knife helmets (4, 8, 14, and 18 mm) is characterized by their respective helmet factors. Since the plateau of the dose profile for the 4 mm helmet is at most 1 mm wide, detector choices are limited. Traditionally helmet factors have been measured using 1 x 1 x 1 mm3 thermoluminescent dosimeters (TLDs). However, these are time-consuming, cumbersome measurements. This article investigates the use of metal-oxide-semiconductor field effect transistors (MOSFETs) (active area of 0.2 x 0.2 mm2) as a more accurate and convenient dosimeter. Their suitability for these measurements was confirmed by basic characterization measurements. Helmet factors were measured using both MOSFETs and the established TLD approach. A custom MOSFET cassette was designed in analogy to the Elekta TLD cassette (Elekta Instruments AB) for use with the Elekta dosimetry sphere. Although both dosimeters provided values within 3% of the manufacturer's suggestion, MOSFETs provided superior accuracy and precision, in a fraction of the time required for the TLD measurements. Thus, MOSFETs proved to be a reasonable alternative to TLDs for performing helmet factor measurements.     

Analysis of cerebral concussion frequency with the most commonly used models of football helmets

Data on helmet models used and occurrence of cerebral concussions over five seasons were collected from a representative sample of college football teams including a total of 8,312 player-seasons and 618,596 athlete-exposures to the possibility of being injured in a game or practice. Results showed that players with a history of concussion any time during the previous 5 years were six times as likely to suffer a new concussion as those with no previous history. In light of previous studies showing cognitive deficits for up to 30 days following even minor head injuries, and the growing awareness of “second impact” fatalities, these data support a need for reconsideration of the common practice of immediate return to play following non-loss-of-consciousness head injuries. Results on concussion frequency in ten models of football helmets indicated a significantly lower than expected frequency in the Riddell M155 and a significantly higher frequency in the Bike Air Power. All other models performed within expectations. This study demonstrates the need for monitoring on-the-field performance of football helmets through continuing epidemiological studies to supplement laboratory test data, which cannot duplicate all the factors involved in actual helmet performance.     

Methodology to determine skull bone and brain responses from ballistic helmet-to-head contact loading using experiments and finite element analysis

The objective of the study was to obtain helmet-to-head contact forces from experiments, use a human head finite element model to determine regional responses, and compare outputs to skull fracture and brain injury thresholds. Tests were conducted using two types of helmets (A and B) fitted to a head-form. Seven load cells were used on the head-form back face to measure helmet-to-head contact forces. Projectiles were fired in frontal, left, right, and rear directions. Three tests were conducted with each helmet in each direction. Individual and summated force- and impulse-histories were obtained. Force-histories were inputted to the human head–helmet finite element model. Pulse durations were approximately 4 ms. One-third force and impulse were from the central load cell. 0.2% strain and 40 MPa stress limits were not exceeded for helmet-A. For helmet-B, strains exceeded in left, right, and rear; pressures exceeded in bilateral directions; volume of elements exceeding 0.2% strains correlated with the central load cell forces. For helmet-A, volumes exceeding brain pressure threshold were: 5–93%. All elements crossed the pressure limit for helmet-B. For both helmets, no brain elements exceeded peak principal strain limit. These findings advance our understanding of skull and brain biomechanics from helmet–head contact forces.     

A film technique for the determination of output factors and end effect times for the Leksell Gamma Knife

The relative output factors of the four helmets for a model B Leksell Gamma Knife and the end effect times for each helmet have been measured. For the three helmets with the smallest-diameter collimators a technique employing Kodak XV-2 film was used. The measured output factors are in good agreement with the values recommended by the manufacturer. The end effect times vary with the collimator size, with the shorter time occurring with the smaller collimator.     

COMMUNITY READINESS AS A MULTIDIMENSIONAL CONSTRUCT

Both the organizational studies literature and the community psychology literature discuss the importance of readiness when implementing change. Although each area emphasizes different characteristics, several common themes are present within the literature. The current study integrates and applies organizational and community psychology literature in evaluating community readiness in the context of a school-community-university collaborative prevention model. Results demonstrate (a) that there is substantial agreement between members of community prevention teams on the level of readiness of a community; (b) that readiness is a cohesive, but multidimensional, construct related to hypothesized community and individual characteristics; and (c) that there is small to moderate agreement between members of prevention teams and their "agency directors." These results support the notion that clear "theories of change" need to be formulated before deciding how to assess community readiness, as assessments will vary due to several factors: the type of respondent, the level in which analyses are conducted, and the specific community domain (i.e., school, workplace collaboration, collaboration experience) investigated.     

DEPRESSION STIGMA, RACE, AND TREATMENT SEEKING BEHAVIOR AND ATTITUDES

This study examined the relationship between internalized and public stigma on treatment-related attitudes and behaviors in a community sample of 449 African American and white adults aged 18 years and older. Telephone surveys were administered to assess level of depressive symptoms, demographic characteristics, stigma, and treatment-related attitudes and behaviors. Multiple regression analysis indicated that internalized stigma mediated the relationship between public stigma and attitudes toward mental health treatment. Within group analyses indicated that the mediating effect of internalized stigma was significant for whites only. Among African Americans, internalized stigma did not mediate public stigma; it was directly related to attitudes toward mental health treatment. The internalization of stigma is key in the development of negative attitudes toward mental health treatment, and future research should focus on this aspect of stigma in both individual and community-based efforts to reduce stigma.     

Football face-mask removal with a cordless screwdriver on helmets used for at least one season of play

Context: The Inter-Association Task Force for the Appropriate Care of the Spine-Injured Athlete recommends leaving a football player''s helmet in place and removing the face mask from the helmet “as quickly as possible and with as little movement of the head and neck as possible.” Although 2 groups have studied face-mask removal from new equipment, to our knowledge no researchers have investigated equipment that has been previously used. A full season of play may have a significant effect on football equipment and its associated hardware. Countless impacts, weather, playing surfaces, sweat, and other unforeseen or unknown variables might make the face-mask removal process more difficult on equipment that has been used.Objective: To determine the percentage of face masks that we could unscrew, with a cordless screwdriver, from football helmets used for a full season.Design: Cross-sectional.Setting: Three New England high schools.Patients or Other Participants: All football helmets used at 3 local high schools were tested (n = 222, mean games, 9.7 ± 1.2; mean practice weeks, 13.7 ± 1.2).Intervention(s): Each helmet was secured to a board, and a cordless screwdriver was used to attempt to remove all 4 screws attaching the face mask to the helmet.Main Outcome Measure(s): Variables included overall success or failure, time required for face-mask removal, and success by screw location. Data were analyzed with χ², analysis of variance, and Tamhane post hoc tests.Results: Overall, 832 (94%) of 885 screws were unscrewed, and 183 (82.4%) of 222 face masks were removed. Mean removal time was 26.9 ± 5.83 seconds. Face-mask removal success was significantly different between school 1 (24 [52.2%] of 46) and schools 2 (84 [91.3%] of 92) and 3 (75 [89.3%] of 84; F_2,219 = 24.608; P < .001). The removal success rate was significantly higher at top screws (98%) than at screws adjacent to ear holes (90%) (P < .001).Conclusions: Based on our results and previous findings that demonstrated quicker access time and reduced head movement associated with the use of the screwdriver compared with cutting tools, the former may be a good tool for face-mask removal. However, an appropriate cutting tool must be immediately available should the screwdriver fail. Helmet hardware adjacent to ear holes was more vulnerable to failure, perhaps because it is protected by less padding than the top hardware. Possible causes of the higher failure rate at school 1 are the use of hardware materials subject to rust and corrosion and differences in helmet brand; these areas warrant future research and rules consideration.     

Order in The Court? The Association Between Substance Use,Exposure to Violence,Risky Sexual Behaviors & Observed Court Behaviors Among Women Involved in the Criminal Justice System

Drug courts, therapeutic justice programs for individuals charged with drug offenses, have sub-optimal completion rates. The Courtroom Behavior Checklist (CRBCL), an assessment that quantifies readiness for drug court and drug court behaviors, was developed to predict female offenders who may be at-risk for non-compliance and termination. Data derived from 264 mainly urban women recruited from a Municipal Drug Court System in St. Louis, MO, were used to evaluate the association between substance use, victimization, HIV/AIDS risk behaviors, and observed drug court behaviors. Results showed that women who reported recent substance use or were categorized as at risk for HIV/AIDS were significantly more likely to have scores indicative of unfavorable drug court behaviors, while women who experienced victimization had scores indicative of favorable drug court behaviors. Other factors significantly associated with unfavorable drug court behaviors included greater lifetime arrests, lower education, and being less religious or spiritual. Our findings suggest that the CRBCL may have added utility in identifying women in drug court with recent substance use and risky sexual behaviors. However, further studies on other samples of offenders are needed to support these findings.     

The combined tool approach for face mask removal during on-field conditions

CONTEXT: An effective approach to emergency removal of the face mask (FM) from a football helmet should include successful removal of the FM and limitation of both the time required and the movement created during the process. Current recommendations and practice are to use a cutting tool to remove the FM. Researchers recently have suggested an alternate approach that combines the use of a cordless screwdriver and a cutting tool. This combined tool approach has not been studied, and FM removal has not been studied in a practical setting. OBJECTIVE: To investigate the effectiveness and speed of using a combined tool approach to remove the FMs from football helmets during on-field conditions throughout the course of a football season. DESIGN: Randomized multigroup design. SETTING: Practice field of 1 National Collegiate Athletic Association Division II football college. PATIENTS OR OTHER PARTICIPANTS: Eighty-four members of 1 football team. INTERVENTION(S): We used a battery-operated screwdriver for FM removal and resorted to using a cutting tool as needed. MAIN OUTCOME MEASURE(S): We tracked FM removal success and failure and trial time and compared results based on helmet characteristics, weather variables, and the seasonal timing of the removal trial. RESULTS: Of the 84 players, 76 were available for data-collection trials. Overall, 98.6% (75/76) of FM removal trials were successful and resulted in a mean removal time of 40.09 +/- 15.1 seconds. We found no differences in FM removal time throughout the course of the season. No differences in effectiveness or trial time were found among helmet characteristics, weather variables, or the timing of the trial. CONCLUSIONS: Combining the cordless screwdriver and cutting tool provided a fast and reliable means of on-field FM removal in this Division II setting. Despite the excellent overall result, 1 FM was not removed in a timely manner. Therefore, we recommend that athletic trainers practice helmet removal to be prepared should FM removal fail.     

Nano-Composite Foam Sensor System in Football Helmets

American football has both the highest rate of concussion incidences as well as the highest number of concussions of all contact sports due to both the number of athletes and nature of the sport. Recent research has linked concussions with long term health complications such as chronic traumatic encephalopathy and early onset Alzheimer’s. Understanding the mechanical characteristics of concussive impacts is critical to help protect athletes from these debilitating diseases and is now possible using helmet-based sensor systems. To date, real time on-field measurement of head impacts has been almost exclusively measured by devices that rely on accelerometers or gyroscopes attached to the player’s helmet, or embedded in a mouth guard. These systems monitor motion of the head or helmet, but do not directly measure impact energy. This paper evaluates the accuracy of a novel, multifunctional foam-based sensor that replaces a portion of the helmet foam to measure impact. All modified helmets were tested using a National Operating Committee Standards for Athletic Equipment-style drop tower with a total of 24 drop tests (4 locations with 6 impact energies). The impacts were evaluated using a headform, instrumented with a tri-axial accelerometer, mounted to a Hybrid III neck assembly. The resultant accelerations were evaluated for both the peak acceleration and the severity indices. These data were then compared to the voltage response from multiple Nano Composite Foam sensors located throughout the helmet. The foam sensor system proved to be accurate in measuring both the HIC and Gadd severity index, as well as peak acceleration while also providing additional details that were previously difficult to obtain, such as impact energy.