Subcommittee on Sports-Related Concussions in Canada committee  With the stance of no harm done, in most cases, for neck strengthening.... While, again, it's very equivocal, some research is positing that perhaps women and girls have less musculature in the neck, and so potentially that might be an approach for that avenue.

Subcommittee on Sports-Related Concussions in Canada committee  One of the first steps is to create and implement a national surveillance system. I think there are multiple ways one could do that. In the States, for example, the NCAA has the largest collegiate database of injury information. A corollary of that is the High School RIO system, or reporting information online, which is relatively newer and is doing quite well in terms of being sustained since 2005, actually, so more than a decade ago.

Subcommittee on Sports-Related Concussions in Canada committee  To go back to the question of conversations and communication among the federal, provincial, territorial, municipal and other levels, we do think there needs to be communication among all levels. That's because some of the things that are going to be done are going to be under the jurisdiction of education or health, and that can be quite different across the country.

Subcommittee on Sports-Related Concussions in Canada committee  That's one of the reasons we need more research. We don't know for certain what's going on in terms of gender and sex considerations. We do know more than we did, say, a decade ago. It's very encouraging and it's even more motivating to do more research in that area.

Subcommittee on Sports-Related Concussions in Canada committee  In addition to that, there are potentially different mechanisms of the injury. Some research has shown that males tend to have more player-to-player contact as their mechanism of injury than females do. That's because there is a lot less intentional contact in, say, women's hockey or other sports.

Subcommittee on Sports-Related Concussions in Canada committee  We are really encouraged by the creation of this subcommittee, as well as the discussions you've had thus far and the enthusiasm we've seen. Therefore, we're really hopeful for a near future in which we see a comprehensive concussion strategy that is implemented across the country.

Subcommittee on Sports-Related Concussions in Canada committee  The second is a pan-Canadian concussion strategy, including a national centre of excellence for concussion research.

Subcommittee on Sports-Related Concussions in Canada committee  Yes. We recommend looking to the field of knowledge translation and behaviour change for this, because there are strategies that have research behind them in terms of what works for changing behaviour. One of the things we would recommend is having, for example, champions for change, for knowledge translation.

Subcommittee on Sports-Related Concussions in Canada committee  Sure. We have a copy with us today.

Subcommittee on Sports-Related Concussions in Canada committee  We will send one to you. We appreciate that this will be useful to you. The second point here, the second recommendation, is to really promote educational initiatives that explicitly include mental health. The third is to ensure concussion care for all Canadians who need it.

Subcommittee on Sports-Related Concussions in Canada committee  There have been a lot of emerging themes in the field of concussion in recent years. We have four recommendations based on those emerging themes for you to consider, the first of which is to support prospective and well-designed research studies on concussion and gender and sex considerations, as women and girls are often an overlooked population in research.

Subcommittee on Sports-Related Concussions in Canada committee  Our next recommendation about policy research is to address any regional inequities that may exist among rural, suburban and urban areas in terms of access to resources in order to be able to even implement concussion policy. The next recommendation is to ensure regular evaluation of concussion policy wherever it may exist.

Subcommittee on Sports-Related Concussions in Canada committee  We also recommend, for education, the support for research, development and implementation of effective, multimodal, stakeholder-specific and interactive education to improve knowledge outcomes for all of these stakeholders. We also recommend the support and promotion of education for clinical trainees and practising clinicians alike that is competency-based, adequate and consistent, as there is a current knowledge gap among clinicians.

Subcommittee on Sports-Related Concussions in Canada committee  My name is Swapna. Don't worry, you're not seeing double. It's not an April Fool's joke. We are twins. We'll begin with a brief introduction of ourselves just for some context. As was mentioned, we are a Ph.D. candidate and an MD/Ph.D. candidate at the University of Toronto. We've been involved in the field of concussions for just under a decade now.

Subcommittee on Sports-Related Concussions in Canada committee  Concussions are a growing problem in Canada. This image from the Canadian Institute for Health Information shows that it's been reported to have grown most in children and youth in recent years. This represents a lot of sport concussions. This is just the tip of the iceberg. It truly is a public health problem.