Does Increasing the Severity of Penalties Assessed in Association With the "Zero Tolerance for Head Contact" Policy Translate to a Reduction in Head Impact Rates in Youth Ice Hockey?

OBJECTIVE: The risk of concussion is high in Canadian youth ice hockey. Aiming to reduce this burden, in 2011, Hockey Canada implemented a national "zero tolerance for head contact (HC)" policy mandating the penalization of any player HC. In 2018 to 2020, Hockey Canada further amended this HC policy including stricter enforcement of severe HCs. This study aimed to compare HC rates, head impact location, and HC enforcement prepolicy, postpolicy, and after policy amendments in elite U15 Canadian youth ice hockey. DESIGN: This is a prospective cohort study. SETTING: A collection of events with the video camera located at the highest point near center ice in public ice hockey arenas in Calgary, Alberta. PARTICIPANTS: A convenience sample of 10 AA U15 games prepolicy (2008-2009), 8 games postpolicy (2013-2014), and 10 games after policy amendments (2020-2021). INDEPENDENT VARIABLES: An analysis of 3 cohort years regarding the HC-policy implementation and amendments. MAIN OUTCOME MEASURES: Using Dartfish video-analysis software, all player contacts and HCs [direct (HC1), indirect (eg, boards, ice) (HC2)] were tagged using validated criteria. Univariate Poisson regression clustering by team-game offset by game length (minutes) was used to estimate incidence rates (IR) and incidence rate ratios (IRR) between cohorts. RESULTS: With additional rule modifications, a 30% reduction in HC1s emerged (IRR 2013-2020 = 0.70, 95% CI, 0.51-0.95). Since the HC-policy implementation, HC1s decreased by 24% (IRR 2008-2020 = 0.76, 95% CI, 0.58-0.99). The proportion of HC1s penalized was similar across cohorts (P 2008-2009 = 14.4%; P 2013-2014 = 15.5%; P 2020-2021 = 16.2%). CONCLUSIONS: The HC-policy amendments have led to decreased HC1 rates. However, referee enforcement can further boost the HC-policy effectiveness. These findings can help future referee training and potential rule modifications to increase player safety nationally.

Evaluating the Effect of Policy Prohibiting Body Checking on Physical Contacts in U15 and U18 Youth Ice Hockey Leagues.

OBJECTIVE: To compare physical contacts (PCs) and head contacts (HCs) in nonelite U15 (ages 13-14) and U18 (ages 15-17) ice hockey players in body checking (BC) and non-BC leagues. DESIGN: Cohort video analysis study. SETTING: Ice hockey arenas in Calgary, Canada. PARTICIPANTS: Players from 13 BC and 13 non-BC games at the nonelite U15 and U18 levels (n = 52 total games). ASSESSMENT OF RISK FACTORS: Games were videotaped and analyzed to compare PC variables between leagues allowing and prohibiting BC. MAIN OUTCOME MEASURES: Validated methodology for PC type (trunk PC and other types of PC with limb/stick/head), intensity (low and high intensity), and HC. Incidence rate ratios (IRRs) were estimated using Poisson regression (controlling for cluster by team game and offset by player minutes) to compare the incidence of PCs in BC and non-BC games. RESULTS: The rate of trunk PCs was lower in the non-BC leagues for both U15 (IRR = 0.50, 99% confidence interval [CI]: 0.43-0.58) and U18 (IRR = 0.56, 99% CI: 0.46-0.67) players. This was most significant for BC contacts (U15: IRR = 0.18, 99% CI: 0.11-0.29; U18: IRR = 0.16, 99% CI: 0.08-0.34), although also significant for body contacts (U15: IRR = 0.54, 99% CI: 0.46-0.64; U18: IRR = 0.58, 99% CI: 0.48-0.70), other PCs, (U15: IRR = 0.60, 99% CI: 0.45-0.78; U18: IRR = 0.71, 99% CI: 0.58-0.88), and HCs (U15: IRR = 0.40, 99% CI: 0.22-0.71; U18: IRR = 0.37, 99% CI: 0.25-0.57). CONCLUSIONS: The incidence of BC was 82% lower in the U15 and 84% lower in U18 levels not allowing BC, with lower HC and other PC rates also in non-BC leagues. These findings demonstrate high adherence with BC policy change in youth ice hockey.

The potential for entomophagy to address undernutrition.

The use of insects as food for humans has the potential to substantially reduce undernutrition worldwide. The Food and Agriculture Organization of the United Nations estimates that 805 million people are undernourished, with a total food energy deficit of 67.6 billion kcal/day (84 kcal/day/person). Calculations in this article suggest that this deficit could theoretically be reduced or eliminated through edible insect rearing, utilizing organic side streams as feed, on 15,586 to 92,976 ha.

Incidence of Head Contacts, Penalties, and Player Contact Behaviors in Youth Ice Hockey: Evaluating the "Zero Tolerance for Head Contact" Policy Change.

BACKGROUND: To reduce the risk of concussion in youth ice hockey, Hockey Canada implemented a national "zero tolerance for head contact" (HC) policy in 2011. A previous cohort study revealed higher concussion rates after this implementation in players aged 11 to 14 years. However, it is unknown whether the elevated risk was due to higher HC rates or factors such as increased concussion awareness and reporting. PURPOSE: To compare the rates of primary and secondary HCs and HC policy enforcement in elite U15 ice hockey leagues (players <15 years) before (2008-2009) and after (2013-2014) the zero-tolerance policy change. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A total of 32 elite U15 games before (n2008-2009 = 16; 510 players) and after (n2013-2014 = 16; 486 players) HC policy implementation were video recorded. Videos were analyzed with validated criteria for identifying HC types (primary/direct contact by players [HC1], secondary/indirect contact via boards, glass, or ice surface [HC2]) and other player-to-player contact behavior. Referee-assessed penalties were cross-referenced with the official Hockey Canada casebook, and penalty types were displayed using proportions. Univariate Poisson regression (adjusted for cluster by team game, offset by game length [minutes]) was used to estimate HC incidence rates (IRs) and incidence rate ratios (IRRs) between cohorts. RESULTS: A total of 506 HCs were analyzed, 261 before HC policy implementation (IR, 16.6/100 team minutes) and 245 after implementation (IR, 15.5/100 team minutes). The HC1 rate (IRR, 1.05; 95% CI, 0.86-1.28) and HC2 rate (IRR, 0.74; 95% CI, 0.50-1.11) did not significantly differ before versus after implementation. Only 12.0% and 13.6% of HC1s were penalized pre- and postimplementation, respectively. Before implementation, HC1s were commonly penalized as roughing or elbowing penalties (59%), while after implementation, HC1s were penalized with the HC penalty (76%), and only 8% as roughing or elbowing. CONCLUSION: Despite implementation of the "zero tolerance for HC" policy, there was no difference in the rate of HC1s and HC2s or the proportion of HC1 penalized from before to after implementation. This research is instrumental in informing Hockey Canada's future referee training and rule enforcement modifications.

The Role of the Teacher in the Implementation of a School-Based Intervention on the Physical Activity Practice of Children.

Medium- or long-term intervention strategies for physical activity practice (PAP) need to be more effective in terms of their implementation by practitioners. The aim of this study was to evaluate the role of a teacher to implement the Team Pentathlon (TP) in order to improve the PAP in primary children. TP is a health education program made to improve PAP of children through individual and collective achievements. In this study, 203 children (age: 10-13 years) in grades 5 and 6 (intervention group (IG) N = 104, control group (CG) N = 99) were guided to increase their PAP during an eight-week period by five elementary school teachers (physical education or classroom) who had received four training sessions. Levels of PAP (self-reported) were compared between groups (IG/CG), sex, socioeconomic status of the schools and between teachers: baseline and during TP. Several teachers noted significant increases in PAP in the IG for both boys and girls (p ≤ 0.05 or p < 0.01), whereas others found only small improvements in PAP. One teacher even observed higher PAP in the CG. Training session records revealed that the teacher himself, how the TP is implemented, and proper resources were the three elements that explained the successful implementation of the TP program. The implementation of the TP significantly increased the PAP in primary children. Training sessions helped teachers to implement the TP program but personal engagement, motivation, respecting protocol, and an adequate environment are also necessary in improving the PAP of children.

The Effectiveness of A School-Based Nutrition Intervention on Children's Fruit, Vegetables, and Dairy Product Intake.

BACKGROUND: Most Canadian children do not meet daily recommendations for consumption of vegetables and fruits (V/F) and dairy products (DP). The aim of this study was to evaluate the impact of Team Nutriathlon on V/F and DP consumption of children. METHODS: Participants were 404 children from grades 5 and 6 (intervention group [IG] N = 242, control group [CG] N = 162). Teams of children were guided to increase their consumption and variety of V/F and DP over an 8-week period. Daily servings of V/F and DP were compared between groups at 4 time points: baseline (week 0), during (week 6), immediately after (week 9 or 10), and a follow-up 10 weeks after (week 20) the intervention. RESULTS: During and after the program and at follow-up, children in the IG consumed more servings of V/F and DP compared to the CG (group × time, p < .0001). Sex, baseline consumption levels, and school socioeconomic status did not influence the results (p > .05). CONCLUSIONS: Team Nutriathlon is an innovative school-based nutrition program that can help to increase the V/F and DP consumption of children.

The Incidence and Types of Physical Contact Associated with Body Checking Regulation Experience in 13-14 Year Old Ice Hockey Players.

BACKGROUND: Ice hockey has one of the highest sport participation and injury rates in youth in Canada. Body checking (BC) is the predominant mechanism of injury in leagues in which it is permitted. The objectives of this study were to determine whether the incidence and types of physical contact differ for Bantam players (aged 13-14 years) who were exposed to BC at Pee Wee level (aged 11-12 years) in Calgary, Alberta versus Bantam players who were not exposed to BC at Pee Wee level in Québec City, Québec. All teams were exposed to BC at bantam level; METHODS: A cohort study was conducted in Québec City and Calgary. Sixteen games for Calgary and 15 for Québec City were randomly selected and analysed with a validated observation system to quantify five intensities of physical contact and to observe different types of physical contact such as slashing and holding; RESULTS: A total of 5610 incidences of physical contact with the trunk and 3429 other types of physical contact were observed. Very light intensity trunk contact was more frequent in Calgary (adjusted incidence RR (ARR): 1.71; 95% CI: 1.28-2.29). Holding (ARR: 1.04; 95% CI: 1.02-1.07) and slashing (ARR: 1.38; 95% CI: 1.07-1.77) were more frequent in Calgary; CONCLUSION: RESULTS suggest that players' physical contacts differ between Bantam leagues in which BC was permitted at Pee Wee level and leagues in which it was not permitted until Bantam level.

The incidence of behaviours associated with body checking among youth ice hockey players.

OBJECTIVES: To determine if a difference exists between the incidence and intensity of the physical contacts of Pee Wee (aged 11-12 years) ice hockey players according to whether the players participate in a league in which body checking is permitted (Calgary, Canada) compared to a league in which body checking is not permitted (Québec City, Canada). DESIGN: Cohort study conducted in Québec City and Calgary during the 2007-2008 Pee Wee ice hockey season. METHODS: Ten games were randomly selected for each city (n=20) and analysed. Games were videotaped and subsequently analysed with a validated observation system allowing quantification of the intensity of the various physical contacts. Incidence rate ratios (RR) based on multivariate Poisson regression were used to compare the physical contacts between provinces. All analyses were controlling for game period, score difference, and zone on the playing surface. RESULTS: A total of 2418 physical contacts with the trunk and 757 other physical contacts were observed. Very light intensity trunk physical contacts were more frequent in Québec City (adjusted incidence RR [ARR]: 0.68; 95% CI: 0.48-0.97). Very high intensity trunk physical contacts were more frequent in Calgary (ARR: 12.72; 95% CI: 4.48-36.14). Hooking (ARR: 0.89; 95% CI: 0.84-0.95) and slashing (ARR: 0.91; 95% CI: 0.85-0.97) were more frequent in Québec City. CONCLUSIONS: Results suggest that players' behaviours are different in leagues where body checking is permitted compared to leagues where it is not permitted. Policy allowing body checking in Pee Wee ice hockey increases the frequency and intensity of physical contacts.