Violence in youth sports: hazing, brawling and foul play.

By separating hazing, brawling, and foul play and failing to recognise that their connection to sport binds them together into a cohesive subset of sport injury and youth violence, past research has failed to show how sports-related violence is a broad example of interpersonal violence. The acceptance of violence within the sporting culture may, in part, explain why sports-related violence has not yet been widely recognised as a public health concern. This review shows that sports-related violence, including hazing, brawling and foul play, occurs among youth athletes of all ages and in a variety of different sports. The few studies to address this issue have all acknowledged the dangers of sports-related violence; however, no incident tracking method has been developed. Future research must provide accurate national estimates of the incidence of sports-related violence among youth, identify associated risk factors, evaluate preventive interventions and identify effective methods of distributing and implementing evidence-based interventions. Monitoring the magnitude and distribution of the burden of sports-related violence and building the scientific infrastructure necessary to support the development and widespread application of effective sports-related prevention interventions are essential first steps toward a reduction in the incidence of sports-related violence.

Injury patterns at US and Canadian overnight summer camps: first year of the Healthy Camp study.

OBJECTIVE: To describe injury patterns at overnight summer camps in 2006, and identify risk factors for more significant injury. DESIGN: Surveillance data obtained from Healthy Camp Study from 2006 were analyzed from 71 overnight camps, representing 437,541 camper-days and 206,031 staff-days. RESULTS: Injuries were reported in 218 campers and 81 staff. 51.8% of injured campers were male versus 34.6% of staff. Among campers, 60.1% were evaluated off-site; 2.3% required hospital admission. 43.9% of injuries required >24 h activity restriction (deemed "significant injury"). Among campers, significant injury was associated with camp sessions > or =14 days (RR 1.48); among staff, with male sex (RR 1.85) and camper-to-staff ratio (RR 0.67). There were no associations with age, time of day, setting, or level of supervision. CONCLUSIONS: Significant injuries are uncommon at overnight summer camps. Rates appear similar to those in comparable activities. Targeted interventions may further reduce injury risk.

When the rules of the game are broken: what proportion of high school sports-related injuries are related to illegal activity?

OBJECTIVES: To compare sport and gender differences in injury rates and proportions of injuries related to illegal activity and to describe the epidemiology of injuries related to illegal activity. DESIGN: Descriptive epidemiology study. SETTING: 100 US high schools. SUBJECTS: Athletes participating in nine sports: boys' football, soccer, basketball, wrestling, and baseball plus girls' soccer, volleyball, basketball, and softball. MAIN OUTCOME MEASURES: Illegal activity-related injuries were analyzed using data from the 2005-06 and 2006-07 National High School Sports-Related Injury Surveillance Study. RESULTS: Nationally, an estimated 98 066 injuries were directly related to an action that was ruled illegal activity by a referee/official or disciplinary committee, giving an injury rate of 0.24 injuries per 1000 athletic competition-exposures. Boys' and girls' soccer had the highest rates of injuries related to illegal activity, and girls' volleyball, girls' softball, and boys' baseball had the lowest. Overall, 6.4% of all high school sports-related injuries were related to illegal activity, with the highest proportion in girls' basketball (14.0%), girls' soccer (11.9%), and boys' soccer (11.4%). A greater proportion of injuries related to illegal activity were to the head/face (32.3%) and were concussions (25.4%) than injuries not related to illegal activity (13.8% (injury proportion ratio 2.35; 95% CI 1.82 to 3.04; p<0.001) and 10.9% (injury proportion ratio 2.35; 95% CI 1.71 to 3.22; p<0.001), respectively). CONCLUSIONS: Illegal activity is an overlooked risk factor for sports-related injury. Reducing illegal activity through enhanced enforcement of sports' rules and targeted education about the dangers of illegal activity for players, coaches, and referees/officials may reduce sports-related injuries.

A comparison of pediatric freestyle and Greco-Roman wrestling injuries sustained during a 2006 US national tournament.

The purpose of this study was to compare the epidemiology of freestyle and Greco-Roman wrestling injuries sustained during a 2006 United States (US) national tournament. A prospective injury surveillance study was conducted at the US 2006 ASICS/Vaughan Cadet and Junior National Championships. There were 83 freestyle- and 55 Greco-Roman-related injuries sustained, with the rate of injury per 1000 athlete-matches higher in freestyle (7.0) compared with Greco-Roman (4.6) wrestling [Rate ratio (RR)=1.51, 95% confidence interval (CI): 1.07-2.12]. Compared with Greco-Roman wrestling, there was a greater proportion of knee injuries in freestyle wrestling [injury proportion ratio (IPR)=4.17, 95% CI: 1.30-13.41]. In GrecoRoman wrestling, there were greater proportions of elbow (IPR=9.11, 95% CI: 1.13-73.59) and head/face/neck (IPR=1.72, 95% CI: 1.10-2.67) injuries and a greater proportion of concussions (IPR=1.95, 95% CI: 0.92-4.12), although the latter was statistically insignificant. Greco-Roman wrestlers sustained a greater proportion of injuries from being driven into the mat (IPR=2.97, 95% CI: 1.72-5.14). There were no statistically significant differences in injury outcome by wrestling style. The differing injury rates and patterns of injury between freestyle and Greco-Roman wrestling are likely due to the different rules between these styles that allow lower leg attacks in freestyle wrestling and encourage the use of throws in Greco-Roman wrestling.

Video analysis of falls experienced by paediatric iceskaters and roller/inline skaters.

OBJECTIVES: To evaluate differences in the way iceskaters and roller/inline skaters fall. METHODS: Children's falls related to skating were videotaped and categorised based on type of skating activity, child's estimated age, direction of fall, whether the child attempted to break the fall, and whether the head struck the skating surface. RESULTS: In total, 216 iceskating and 201 roller/inline skating falls were captured on videotape. In both iceskating and roller/inline skating, the majority of falls were forward in direction. The skaters attempted to break the falls with their arms or hands in over 90% of falls in both iceskating (93.1%) and roller/inline skating (94.5%). A greater proportion of falls in iceskating resulted in the head striking the skating surface (13.0%) than did those in roller/inline skating (3.0%) (odds ratio = 4.8; 95% confidence interval 1.9 to 13.3; p<0.001). CONCLUSIONS: This study found that paediatric iceskaters and roller/inline skaters fall similarly and that both types of skaters try to break their falls with their arms or hands; however, because iceskating takes place on a low friction surface, attempts to break falls with the arms or hands are often unsuccessful, leading to head and face injuries. The development of a new type of protective gear, a wrist guard with a non-slip palm, should stop iceskaters from striking the head, protect against upper extremity fractures, and unlike a bulky helmet, should not discourage children from skating.

The fair sex? Foul play among female rugby players.

Rugby, a full contact sport, exposes participants to a high risk of injury. While several studies have explored injuries among male rugby players, few have investigated injuries among females. We conducted a cross-sectional study of United States of America (USA) female rugby players to assess the players' perception of foul play and the referee response to foul play and to evaluate the association between players' perception of foul play and injury. An anonymous, self-administered questionnaire reporting injury status, history of player perceived foul play and referee response was administered to 258 players recruited at a women's rugby tournament. The overall rate of injury was 4.4 injuries/100 matches, 0.2 injuries/100 practices and 1.4 injuries/100 total rugby exposures (matches and practices), with 107 (41.5%) players classified as injured. While 16.5% of players admitted to perpetrating foul play without an assessed penalty and 13.8% to being penalised for foul play, a smaller proportion reported being sent to the 'sin bin' (temporarily removed from play) or being ejected from a match (3.3% and 1.3% respectively). Of the 107 injured, 24.3% believed they had been injured as a result of foul play. Among all 258 players, self-perception of having been hurt due to unpenalised foul play was associated with study-defined injury (OR = 2.4, 95% CI = 1.0-5.9, p = 0.046). To make the sport safer, efforts should be made to minimise foul play. Suggested preventive methods include educating referees, coaches and players about the prevalence of foul play in women's rugby and the association between foul play and injury.

A comparison of two surveillance systems for deaths related to violent injury.

OBJECTIVE: To compare violent injury death reporting by the statewide Medical Examiner and Vital Statistics Office surveillance systems in Oklahoma. METHODS: Using a standard study definition for violent injury death, the sensitivity and predictive value positive (PVP) of the Medical Examiner and Vital Statistics violent injury death reporting systems in Oklahoma in 2001 were evaluated. RESULTS: Altogether 776 violent injury deaths were identified (violent injury death rate: 22.4 per 100 000 population) including 519 (66.9%) suicides, 248 (32.0%) homicides, and nine (1.2%) unintentional firearm deaths. The Medical Examiner system over-reported homicides and the Vital Statistics system under-reported homicides and suicides and over-reported unintentional firearm injury deaths. When compared with the standard, the Medical Examiner and Vital Statistics systems had sensitivities of 99.2% and 90.7% (respectively) and PVPs of 95.0% and 99.1% for homicide, sensitivities of 99.2% and 93.1% and PVPs of 100% and 99.0% for suicide, and sensitivities of 100% and 100% and PVPs of 100% and 31.0% for unintentional firearm deaths. CONCLUSIONS: Both the Vital Statistics and Medical Examiner systems contain valuable data and when combined can work synergistically to provide violent injury death information while also serving as quality control checks for each other. Preventable errors within both systems can be reduced by increasing training, addressing sources of human error, and expanding computer quality assurance programming. A standardized nationwide Medical Examiners' coding system and a national violent death reporting system that merges multiple public health and criminal justice datasets would enhance violent injury surveillance and prevention efforts.

Bacteriostatic and bactericidal activities of gentamicin alone and in combination with clarithromycin against Mycobacterium avium.

The inhibitory activity of gentamicin against Mycobacterium avium depended on the pH of the medium, and the broth-determined MICs for 90% of strains were 5.0 micrograms/ml at pH 7.4, 9.5 micrograms/ml at pH 6.8, and greater than 16.0 micrograms/ml at pH 5.0. The MBCs were two- to eightfold higher than the MICs. The combined effect of gentamicin and clarithromycin was additive, and the MICs and MBCs of each drug were either the same as those in the single-drug tests or reduced twofold.

Clarithromycin minimal inhibitory and bactericidal concentrations against Mycobacterium avium.

Minimal inhibitory and bactericidal concentrations (MIC and MBC) of clarithromycin were determined with 49 Mycobacterium avium strains isolated from patients with acquired immunodeficiency syndrome. The inhibitory activity depended on the pH of the medium: the drug was more active at pH 7.4 and less active at pH 5.0, with activity at pH 6.8 in an intermediate position. The broth-determined MIC found at pH 7.4 were 0.25 and 0.5 micrograms/ml for most strains. The agar-determined MIC for most strains ranged from 1.0 to 4.0 micrograms/ml. The MBC of the drug were 8- to 64-fold higher than the MIC, which indicates that the efficacy of clarithromycin can be associated with its inhibitory rather than its bactericidal activity.

Persistent viral DNA synthesis associated with an avian osteopetrosis-inducing virus.

Bone and red blood cell DNA was obtained from MAV-2(O) infected, osteopetrotic chickens and analyzed for the presence of integrated and unintegrated viral DNA. Results indicate that unintegrated MAV-2(O) DNA did not appear until after osteopetrotic lesions were well established. These observations lead us to conclude that, unlike some retroviral diseases, unintegrated viral DNA may not play a significant role in the pathogenesis of MAV-2(O) osteopetrosis. In addition, there was no evidence of a clonally derived tumor in the bone.