Football participation declines for the second consecutive year nationally

For the second consecutive year, participation in 11-player high school football declined nationwide, according to the annual survey by the National Federation of State High School Associations.

In 2017, there were 1,035,942 high school students participating in 11-player football, a decline of 21,465, or 2 percent, from the previous year. In 2016, the decline was 27,865, or 2.5 percent.

In New Jersey, 23,034 boys played the sport in 2017, down from 24,730 the year prior. Girls participation in 11-player football in New Jersey did increase from 67 to 95, the survey shows.

However, football remains the No. 1 participatory sport for boys by a wide margin. No. 2 for overall nationwide participation is track and field with 600,097. Track and field leads for girls with 488,097.

For the 29th consecutive year, participation in high school sports overall increased, led by an increase of 15,009 in girls sports programs. The total number of participants reached 7,979,986. The number of girls participating reached an all-time high of 3,415,306 and boys were at 4,564,680.

The top 10 states by overall sports participants remained the same. Texas and California topped the list again with 824,619 and 819,625 participants, respectively, followed by New York (378,065), Ohio (347,567), Illinois (338,848), Pennsylvania (319,867), Florida (311,361), Michigan (296,625), New Jersey (281,800) and Minnesota (240,433), according to the National Federal of State High School Associations

Among boys sports, soccer had the largest gain with 6,128 additional participants.

In 2017, 20 fewer schools fielded 11-player football teams, or 14,079 compared with 14,099 in 2016.

“We are encouraged that the decline in high school football was slowed, due in part, to our efforts in reducing the risk of injury in the sport,” said Karissa Niehoff, the NFHS executive director, in a statement. “While there may be other reasons that students elect not to play football, we have attempted to assure student-athletes and their parents that thanks to the concussion protocols and rules in place in every state in the country, the sport of football is as safe as it ever has been.”

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Heart scans for patients with chest pains could save thousands of lives

Heart scans for patients with chest pains could save thousands of lives in the UK, research suggests.

The life-saving scans helped to spot those with heart disease so they could be given treatments to prevent heart attacks.

Researchers say current guidelines should be updated to incorporate the scans into routine care.

The SCOT-HEART study tracked more than 4000 patients who were referred to a hospital clinic with symptoms of angina – a condition that restricts the blood supply to the heart.

Half of the patients were given a scan called a computed tomography angiogram, or CTA, in addition to standard diagnostic tests.

After receiving the scan, the number of patients suffering a heart attack within five years dropped by 40 per cent, the study found.

The number of patients undergoing additional procedures increased within the first year but had leveled out by the end of the five-year period. This suggests that including the scans in routine care would not lead to a surge in costly tests or additional heart surgery, the researchers say.

Patients who are at risk of a heart attack are frequently diagnosed with a test called an angiogram. This involves inserting tubes into the body and heart to check the flow of blood and identify any obstructions that could pose a heart attack risk.

CTA scans enable doctors to look at the blood vessels from the outside the body, without the need to insert tubes into the heart. The scans are cheaper, quicker and safer than angiograms.

The study had previously found that around a quarter of patients had their diagnoses reclassified after receiving the scan, prompting new treatments in many cases.

This is the first study to look at the impact of the scans on long-term survival rates.

Lead researcher Professor David Newby, of the BHF Centre for Cardiovascular Science at the University of Edinburgh, said: “This relatively simple heart scan ensures that patients get the right treatment. This is the first time that CT guided management has been shown to improve patient outcomes with a major reduction in the future risk of heart attacks. This has major implications for how we now investigate and manage patients with suspected heart disease.”

Source:

https://www.ed.ac.uk/

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What colleges want, and how you can boost your chance of admission

The college application process can seem pretty mysterious to the uninitiated.

But what colleges want from their applicants isn’t a secret. Schools telegraph what they’re after in the form of big data that’s available online to anyone.

High-school students can use that data to apply where they will be strong candidates, boosting their chances of admission and financial aid. Here’s what to look for.

Use the data to find your best match

Each year, colleges supply reams of admission and financial aid statistics, known as the Common Data Set, to satisfy the demands of various education publishers, says college consultant Lynn O’Shaughnessy. The information can be found by searching for the college’s name and the phrase “common data set,” or at college comparison sites such as CollegeData.

Among other figures, the statistics for each school include:

• The cost to attend.
• How much student loan debt the average graduate incurs.
• What percentage of applicants are accepted.
• Average grades and test scores of incoming freshmen.

At Stanford University, for example, 75% of incoming students for the 2016-2017 academic year scored 700 or above on their math SATs (the top score is 800), 94% had grade point averages above 3.75 and 95% ranked in the top 10% of their high school class.

Top-flight grades and scores don’t guarantee entrance into any selective school, of course. Stanford accepts just 5% of those who apply. But knowing the stats of the incoming class can help students eliminate long-shot choices and focus on schools where they’re more likely to gain admission.

Target the schools that want you

Having grades and test scores that are above the school’s average can help with both odds of admission and financial-aid packages, college consultants say.

The best financial aid deals may come not from highly selective schools or large public universities but from smaller liberal-arts colleges that are trying harder to attract good applicants, says Vita Cohen, a college consultant in Chicago.

“I tell students, ‘Please consider being the big fish in a smaller pond,’” Cohen says. “Why wouldn’t you want to be at a place where they’re throwing rose petals at your feet?”

Clues to how a school evaluates applicants can be found in the data set’s “admissions factors.” These detail how each school weighs 19 admissions criteria, from class rank to extracurricular activities.

Many schools, for example, rate as “very important” the difficulty of the applicant’s high school courses and his or her academic grade point average. Some heavily weigh standardized tests; others don’t.

“Level of applicant’s interest” is another differentiator. Colleges care about their “yield,” or the percentage of applicants who accept an offer of admission. Some want to see definite signs of interest from applicants, including campus visits and responding to emails from the admissions office.

Need aid? Avoid ungenerous schools

Most colleges don’t fully meet the financial need of their students, even after federal student loans are factored in. Families are expected to come up with the additional money on their own, often through parental or private student loans.

The size of those gaps depends on the generosity of each school.

The cost of attending New York University and the University of Southern California, for example, is roughly the same: about $72,000 a year. USC, however, fully met the financial need of 80.4% of freshmen who received financial aid. NYU fully met the financial need of only 9.1% of its first-year aid recipients.

Families who don’t have financial need can get discounts from many schools in what’s known as “merit” aid. In general, merit aid is less likely at public and highly selective schools that can attract plenty of applicants without it. UCLA, for example, offered merit aid averaging $4,847 to just 2.6% of its freshmen. (UCLA’s cost of attendance is $31,916 for in-state residents and $59,930 for out-of-state students.)

University of Puget Sound, a private liberal arts school in Tacoma, Washington, gave merit aid to 42.2% of its freshmen, knocking an average $16,832 off its $63,510 cost of attendance. Each college has a “net price calculator” on its site to help applicants understand how much they’re likely to pay out of pocket annually.

And costs matter. While a college degree is important, consultants warn students against overdosing on debt to get one.

“You don’t want to be 22 or 23 and saddled with debt that’s going to cripple you,” Cohen says.

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‘One of the tobacco industry’s greatest scams’

Two new studies from the Tobacco Control Research Group at the University of Bath, published in the BMJ journal, Tobacco Control, expose evidence that big tobacco companies are still facilitating tobacco smuggling, while attempting to control a global system designed to prevent it, and funding studies that routinely overestimate levels of tobacco smuggling.

The findings come off the back of a major announcement last week from Bloomberg Philanthropies which makes Bath’s Tobacco Control Research Group one of the leaders of an all-new $20 million global tobacco industry watchdog aiming to counter the negative influences of the tobacco industry on public health. The global partnership aims in particular to highlight tobacco industry activity across low and middle income countries.

The first study, which draws on leaked documents, highlights the elaborate lengths the industry has gone to control a global track and trace system and to undermine a major international agreement—the Illicit Trade Protocol—designed to stop the tobacco industry from smuggling tobacco.

A linked blog and editorial in the BMJ, help explain the findings.

In 2012, off the back of a string of inquiries, court cases and fines all aiming to hold the major tobacco companies to account for their involvement in global tobacco smuggling operations aimed to avoid paying taxes, governments around the world adopted the Illicit Trade Protocol (ITP). Part of a global treaty, the Framework Convention on Tobacco Control, the ITP aims to root out tobacco industry smuggling through an effective track and trace system—a system in which tobacco packs are marked so they can be tracked through their distribution route and, if found on the illicit market, can be traced back to see where they originated.

Fearful of developments, the new study argues that at this point the tobacco industry claimed to have changed, no longer the perpetrators of smuggling, but instead themselves now the victims of smuggled and counterfeited tobacco.

Simultaneously the major tobacco companies developed their own track and trace system, ‘Codentify’, lobbying governments around the world to see it adopted as the global track and trace system of choice. Leaked documents show the four major transnational tobacco companies hatched a joint plan to use front groups and third parties to promote ‘Codentify’ to governments and have them believe it was independent of industry and how these plans were operationalised. For example, the study reveals how a supposedly independent company fronted for British American Tobacco (BAT) in a tender for a track and trace system in Kenya.

Yet, reveal the researchers, growing evidence suggests the tobacco industry is still facilitating tobacco smuggling. Approximately two thirds of smuggled cigarettes may still derive from industry. At best, the authors suggest, this shows the tobacco industry’s failure to control its supply chain, but they point to growing evidence from government investigations, whistleblowers and leaked tobacco industry documents all suggesting ongoing industry involvement.

The study suggests that in order to bolster support for their system and enhance their credibility, Big Tobacco created front groups, poured funding into organisations meant to hold it to account and into initiatives that would curry favour, and paid for misleading data and reports.

Professor Anna Gilmore, Director of the Tobacco Control Research Group, explains: “This has to be one of the tobacco industry’s greatest scams: not only is it still involved in tobacco smuggling, but big tobacco is positioning itself to control the very system governments around the world have designed to stop it from doing so. The industry’s elaborate and underhand effort involves front groups, third parties, fake news and payments to the regulatory authorities meant to hold them to account.”

The second study, published today examines the quality of the data and reports on illicit tobacco that the tobacco industry has funded and raises further concerns about the tobacco industry’s conduct. It finds that industry-funded data routinely overestimates levels of tobacco smuggling.

The first study to systematically identify and review literature that assesses industry-funded data on the illicit tobacco trade, it identifies widespread concerns with the quality, accuracy and transparency of tobacco-industry funded research. Industry-funded data were criticised for a fundamental lack of transparency at every stage of the research process, from sampling and data collection, through analysis to publication of findings.

The authors posit that the consistency with which issues have been identified suggests that the tobacco industry may be intentionally producing misleading data on the topic.

The authors suggest that despite overwhelming evidence of historical complicity in tobacco smuggling and their latest evidence suggesting that tobacco companies are continuing to fuel the illicit trade, the industry now portrays itself as key to solving the problem, presenting its funding of research as an example of its attempts to reduce illicit trade.

Lead author Allen Gallagher from the Tobacco Control Research Group at Bath explains: “Our latest findings fit with the tobacco industry’s long history of manipulating research, including its extensive efforts to undermine and cause confusion on science showing the negative health impacts of smoking and second-hand smoke.”

Second author Dr. Karen Evans-Reeves added: “Despite far-reaching concerns over industry-funded data on this topic, tobacco companies continue to spend millions of pounds funding research into the illicit tobacco trade. As recently as 2016 Philip Morris International’s PMI IMPACT initiative pledged 100 million USD for this purpose. Yet, if industry-funded data consistently fails to reach the expected standards of replicable academic research, we must question if it has any use beyond helping the industry muddy the waters on an important public health issue.”

The team is now calling on governments and international bodies to crack down on Big Tobacco’s tactics, to ensure that systems designed to control tobacco smuggling are truly independent of the industry and its front organisations, and that research on tobacco smuggling is free of industry interests.

Professor Gilmore, senior author on both papers states: “Governments, tax and customs authorities around the world appear to have been hoodwinked by industry data and tactics. It is vital that they wake up and realise how much is at stake. Tobacco industry funded research cannot be trusted. No government should implement a track and trace system linked in any shape or form to the tobacco manufacturers. Doing so could allow the tobacco industry’s involvement in smuggling to continue with impunity.”

Andy Rowell, co-author of the first paper states: “Governments need to be alert to what the tobacco industry is doing and to realise it is now operating via a complex web of front groups and companies. Any track and trace system linked to ‘Codentify’ simply cannot be trusted.”

 Explore further: Global pact to curb illicit tobacco trade to take effect in September

More information: Allen W A Gallagher et al, Tobacco industry data on illicit tobacco trade: a systematic review of existing assessments, Tobacco Control (2018). DOI: 10.1136/tobaccocontrol-2018-054295

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College tours for Chinese teens a rapidly growing market for tourist industry

Growing numbers of families in China are sending their teens on college tours in other countries, creating a potentially lucrative market sector for universities, college towns and tourism-related businesses, a new study suggests.

While the itineraries of these study tours used to concentrate on the Ivy League schools and their peers scattered along the East and West coasts of the U.S., intense competition for admission and rising tuition costs are prompting more Chinese students to look beyond the ivies to the highly ranked public universities in the Midwest, said lead author Joy Huang, a professor of recreation, sport and tourism at the University of Illinois.

“These short-term overseas tours and summer camps are a very important market for the tourist industry in the Midwest,” Huang said. “They are also a very good recruiting tool for universities and a way to ‘audition’ potential foreign students—who usually pay much higher tuition than domestic students.”

In 2013, more than 300,000 young people from China participated in overseas study tours. But by summer 2015, the number of Chinese teens who traveled abroad on these types of trips grew to more than 500,000 annually, according to the study.

Organized by travel agencies and high schools, the two- to four-week trips to the U.S. and other developed countries typically cost Chinese families $5,000-$8,000.

Huang co-wrote the study with Qian Li, then a doctoral student at the U. of I. Their paper appears in the Journal of China Tourism Research.

To learn more about why Chinese teens participate in the tours and the factors that influence families’ decisions to send their children on these excursions, the researchers interviewed 30 Chinese adolescents who had traveled on a group study tour within the prior three years and 20 of their parents.

Similar to the grand tours undertaken by wealthy young men in ancient Europe, the study tours typically include sightseeing and an assortment of educational and cultural enrichment experiences as well as social and recreational activities, Huang said.

China’s integration into the global economy has given rise to a rapidly growing middle class that is curious about other cultures and perspectives and eager to expand their children’s knowledge beyond the Chinese educational system’s test-focused curriculum, she said.

The parents interviewed said they hoped that going on the study trip would enrich their children’s educational and life experience, and foster “global perspectives” that would enhance their competitiveness in the job market after college. Accordingly, the youths said they were motivated by their desire to learn about other cultures, to experience daily life in other countries and improve their English language skills.

With many of the parents’ own college aspirations derailed by China’s Cultural Revolution, they sought to fulfill those dreams vicariously by pushing their children to attend colleges in the U.S. and other countries, which they perceived as being more prestigious than the postsecondary institutions in China, Huang said.

Their children were among the generations born under China’s one-child family planning policy, which began in 1979 and was phased out in 2016.

Among China’s well-educated and more prosperous families, the one-child policy and exposure to Western cultural values has produced child-centered families in which the parent-child relationships are more egalitarian than in traditional Chinese culture, Huang and Li found.

“Several adolescents—and some parents—indicated that they hoped the study tours, which were the youths’ first trips without their parents in tow, would foster greater independence” and prepare them for college life, Huang said. “The teens thought it was important to learn how to socialize and communicate with other people in new environments.”

While much of the research on Chinese outbound tourists takes a “mass-market perspective, viewing all Chinese as a homogenous group, travel agencies and tourist destinations need to recognize the heterogeneity that exists among these travelers and adapt their products and marketing messages to these audience members’ differing perspectives,” Huang said.

She suggested that tourist agencies and universities that want to appeal to college-bound Chinese teens offer diverse itineraries with a mix of educational, social and recreational activities that immerse visiting teens in campus life. The itinerary might include attending classes and sporting events, hosting talks that enable visitors to ask questions of current students and housing the visiting teens in college residence halls.

Marketing campaigns aimed at the parents of these teens, however, should highlight the educational benefits and career opportunities available to students who attend the colleges they will visit, Huang said.

More information: Zhuowei (Joy) Huang et al, The Grand Tour in the Twenty-first Century: Perspectives of Chinese Adolescents and Their Parents, Journal of China Tourism Research (2018). DOI: 10.1080/19388160.2018.1507859

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Post-heart attack: open heart surgery or a stent?

New advice on the choice between open heart surgery and inserting a stent via a catheter after a heart attack is launched today. The European Society of Cardiology (ESC) and European Association for Cardio-Thoracic Surgery (EACTS) Guidelines on myocardial revascularization are published online in European Heart Journal.

Coronary artery disease, also called ischaemic heart disease, is the top cause of death worldwide. Arteries supplying oxygen-rich blood to the heart become narrowed with fatty material, causing chest pain and increasing the risk of heart attacks and death. Patients should stop smoking, be physically active, and consume a healthy diet. They also need lifelong medication which can include a statin to control blood lipids, blood pressure lowering drugs, and aspirin.

Myocardial revascularization can be performed in patients with stable (chronic) coronary artery disease or an acute event (heart attack) to improve blood flow to the heart, reduce chest pain (angina), and improve survival. There are two types of myocardial revascularization: open heart surgery to bypass clogged arteries (coronary artery bypass grafting; CABG) and percutaneous coronary intervention (PCI) to open clogged arteries with a stent.

Patients should be involved in choosing the procedure, state the guidelines. They need unbiased, evidence-based information with terminology they can understand explaining the risks and benefits in the short- and long-term such as survival, relief of chest pain, quality of life, and requirement for a repeat procedure. In non-emergency situations, patients must have time to reflect on the trade-offs and seek a second opinion. Patients have the right to obtain information on the level of experience of the doctor and hospital in performing these procedures.

Outcomes from the two procedures vary according to the anatomical complexity of coronary artery disease. This is graded using the SYNTAX Score, which predicts whether PCI can provide similar survival as bypass. For patients with more simple disease, surgical bypass and PCI provide similar long-term outcomes. For patients with complex disease, long-term survival is better with surgical bypass. Also, patients with diabetes have better long-term outcomes with surgical bypass even with less complex disease.

A heart team of cardiologists, cardiac surgeons and anaesthetists should be consulted for patients with chronic coronary artery disease and a complex coronary anatomy, while respecting the preferences of the patient.

Professor Miguel Sousa-Uva, EACTS Chairperson of the Guidelines Task Force, Santa Cruz Hospital, Carnaxide, Portugal, said: “Despite the development of new stents, studies show that patients with complex coronary artery disease have better survival with bypass surgery and this should be the preferred method of revascularization.”

In patients with stable disease, another aspect to consider when choosing the procedure is whether it is possible to bypass or insert a stent into all blocked arteries, as this improves symptoms and survival. Preference should be given to the procedure most likely to achieve this so-called complete revascularization.

When PCI is chosen, stents that release a drug to prevent clots, heart attacks, and reinterventions should be used in all procedures. Bioresorbable stents, which are absorbed by the body, should only be used in clinical trials.

Professor Franz-Josef Neumann, ESC Chairperson of the Guidelines Task Force, University Heart Centre Freiburg ? Bad Krozingen, Germany, said: “The guidelines aim to help patients and doctors make a logical decision on the type of revascularization based on the scientific evidence. They will also be consulted by governments and health insurers as the standard of care for coronary artery disease.”

 Explore further: Coronary artery bypass surgery effective in patients with type 1 diabetes

More information: 2018 ESC/EACTS Guidelines on myocardial revascularization. European Heart Journal. 2018. DOI: 10.1093/eurheartj/ehy394.

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Do doctors really know how to diagnose a heart attack?

Confusion over how to diagnose a heart attack is set to be cleared up with new guidance launched today. The 2018 Fourth Universal Definition of Myocardial Infarction is published online in European Heart Journal.

“Unless there is clarity in the emergency room on what defines a heart attack, patients with chest pain may be wrongly labelled with heart attack and not receive the correct treatment,” said Professor Kristian Thygesen, Aarhus University Hospital, Denmark.

“Many doctors have not understood that elevated troponin levels in the blood are not sufficient to diagnosis a heart attack and this has created real problems,” continued Professor Thygesen, who is joint chair of the Task Force that wrote the document, together with Professor Joseph S. Alpert, University of Arizona, USA and Professor Harvey D. White, Auckland City Hospital, New Zealand.

The international consensus document spells out that a heart attack (myocardial infarction) has occurred when the heart muscle (myocardium) is injured and has insufficient oxygen. Troponin is a protein normally used by the heart muscle for contraction, but is released into the blood when the muscle is injured. Oxygen shortage (ischaemia) is detected by electrocardiogram (ECG) and symptoms such as pain in the chest, arms, or jaw, shortness of breath, and tiredness.

Myocardial injury on its own is now considered a separate condition. There are numerous situations which can cause myocardial injury, and therefore a rise in troponin. These include infection, sepsis, kidney disease, heart surgery, and strenuous exercise. The first step of treatment is to address the underlying disorder.

As for myocardial infarction, there are different types which require specific treatment. Type 1 is the situation which most people associate with a heart attack. Here a fatty deposit in an artery, called a plaque, ruptures and blocks blood flow to the heart which deprives it of oxygen. Treatment can include antiplatelet medication to stop platelets clumping together and forming a clot, inserting a stent via a catheter to open up the artery, or surgery to bypass the artery.

In type 2, oxygen deprivation is not caused by plaque rupture in an artery but is due to other reasons such as respiratory failure or severe hypertension. Professor Alpert said: “Some doctors have incorrectly called this type 1 and given the wrong treatment, which can be harmful. Treatment should be directed at the underlying condition, for example blood pressure lowering medications for patients with hypertension.”

Efforts by doctors to correctly diagnosis myocardial infarction and its subtypes have not been helped by the lack of diagnosis codes in the International Classification of Diseases (ICD). The subtypes of myocardial infarction were first introduced by the joint Task Force in 2007, but were not incorporated into the ICD until October 2017.3,4

Professor White said: “In the consensus document we have expanded the section on type 2 myocardial infarction and included three figures to help doctors make the correct diagnosis. The incorporation of type 2 into the ICD codes is another step towards accurate recognition followed by appropriate treatment. A code for myocardial injury will be added to the ICD next year.”

The international consensus document was produced by the European Society of Cardiology (ESC), American College of Cardiology (ACC), American Heart Association (AHA), and World Heart Federation (WHF).

 Explore further: New heart attack test better informs of underlying condition

More information: 2018 ESC/ACCF/AHA/WHF Fourth Universal Definition of Myocardial Infarction. European Heart Journal. 2018. doi: 10.1093/eurheartj/ehy462

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