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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
Support for this project was provided by an endowed gift from Rhoda and Bernard G. Sarnat and by the Institute of Medicine and the National Research Council. The views presented in this report are not necessarily those of the funding agencies.
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The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.
THE NATIONAL ACADEMIES
National Academy of Sciences
National Academy of Engineering
Institute of Medicine
National Research Council
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M. Alberts is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Wm. A. Wulf is president of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. Wm. A. Wulf are chairman and vice chairman, respectively, of the National Research Council.
BOARD ON NEUROSCIENCE AND BEHAVIORAL HEALTH
Kenneth B. Wells, MD, MPH, (Chair),
Neuropsychiatric Institute, University of California, Los Angeles, California
Nancy E. Adler, PhD,
University of California, San Francisco, California
Paul Appelbaum, MD,
University of Massachusetts, Boston, Massachusetts
William E. Bunney, MD,
(emeritus) University of California, Irvine, California
Howard Fields, MD, PhD,
University of California, San Francisco, California
Richard G. Frank, PhD,
Harvard Medical School, Boston, Massachusetts
Sid Gilman, MD,
University of Michigan, Ann Arbor, Michigan
Jerome Kagan, PhD,
Harvard University, Cambridge, Massachusetts
Herbert D. Kleber, MD,
Columbia University and New York State Psychiatric Institute, New York, New York
Beverly B. Long, MS, MPH,
World Federation for Mental Health, Atlanta, Georgia
Karen Matthews, PhD,
University of Pittsburgh, Pittsburgh, Pennsylvania
Bruce McEwen, PhD,
Rockefeller University, New York, New York
Kathleen R. Merikangas, PhD,
Yale University, New Haven, Connecticut
David Reiss, MD,
George Washington University Medical Center, Washington, D.C.
Rhonda J. Robinson-Beale, MD,
Blue Cross/Blue Shield of Michigan, Southfield, Michigan
Charles Zorumski, MD,
Washington University, St. Louis, Missouri
Terry C. Pellmar, PhD, Board Director,
Janet E. Joy, PhD, Project Director
John Rockwell, MS, Research Assistant (until May 2001)
Amanda Hunt, PhD,
NBH intern (June–August 2001)
Joah Iannotta (until September 2001)
Brian McQuillan, Senior Project Assistant (from December 2001)
Catherine Paige, Administrative Assistant (from October 2001)
Michelle Kipke, PhD,
Board Director, BCYF (until August 2001)
The Board on Neuroscience and Behavioral Health thank Dr. and Mrs. Sarnat for providing the funds to supplement the National Academies’ support for this workshop. With their generous endowment, we were able to disseminate the content of the workshop through this report.
We also thank each of the workshop speakers for their thoughtful, informative, and lively presentations. Their work has been and will continue to be instrumental in protecting our children’s futures by promoting safe sports policies. We extend special appreciation to the workshop chairs, Linda Cowan and Michael Johnston, for keeping the lively discussions focused and moving forward throughout the day. Many of the workshop participants responded frequently and faithfully to the fact-checking inquiries we sent during the preparation of the summary of the workshops, and we especially thank Jon Almquist, Trey Crisco, Ruben Echemendia, Kevin Guskiewicz, Albert Hergenroeder, David Hovda, James Kelly, Don Kirkendall, and Muriel Lezak for helping sort out the details.
This project would not have been completed without the excellent and much-appreciated assistance of the Institute of Medicine staff. Amanda Hunt and John Rockwell did much of the background research for the project. Brian McQuillan was the White Knight who stepped in at the last minute to do a terrific job of handling the meeting logistics.
This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the NRC’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:
Julie Gilchrist, M.D., National Center for Injury Prevention and Control, Centers for Disease Control, Atlanta, Georgia
Stephen H. Hauser, M.D., Department of Neurology, University of California at San Francisco, San Francisco, California
Mark R. Lovell, M.D., Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the final draft of the report before its release. The review of this report was overseen by Richard Frank, Harvard Medical School. Appointed by the National Research Council and Institute of Medicine, he was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authors and the institution.