Studying Contact Replays: Investigating Mechanisms, Management and Game Exposures (SCRIMMAGE) for brain health in the Australasian National Rugby League: a protocol for a database design
Andrew J. GardnerGrant L. IversonPaul BloomfieldSharron FlahiveJames BrownSuzi EdwardsGordon FullerMazdak GhajariP. JhalaBen JonesChristopher LeviWarren McDonaldShreya McLeodCameron OwenGeorgia PageKenneth L. QuarrieOliver J. SmithPeter StanwellDaniel TadmorTimana TahuDouglas P. TerryClint ThomsonRoss TuckerLauren V. Fortington
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Concussions in contact sports are challenging for athletes, health professionals and sporting bodies to prevent, detect and manage. Design of interventions for primary prevention, early recognition of concussion and continuing to improve postconcussion management are essential for protecting athletes and promoting brain health. Over the last decade, there have been advancements in video technology for analysing head impact events and improvements in the clinical management of concussions. This study protocol describes how researchers, clinicians and staff from the Australasian National Rugby League (NRL) have brought these advancements together and developed a database of videos with head impact events and clinical outcomes. The intended outputs from this work will enhance the understanding of head impact events in NRL, from biomechanical and gameplay factors to concussion and return to play outcomes. Publishing this protocol increases the transparency of this large-scale effort to better identify head impacts and their relationship to concussions and player movement behaviour to contextualise these variables to generate new knowledge and support the reproducibility of these emerging findings. Between 2017 and 2023, over 5250 head contact cases were recorded in the database, from which >1700 head injury assessments were performed, and >600 concussions were diagnosed. Future studies using these data are planned to inform both primary and secondary injury prevention initiatives, such as risk analysis and prediction of game scenarios that result in concussion, as well as investigation of features and factors that help to inform the duration of recovery and return to play.Recognizing that injuries and violence kill more than five million people worldwide annually and cause harm to millions more, the World Health Assembly (WHA) has repeatedly called on governments du...
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Pediatric firearm-related deaths and injuries are a national public health crisis. In this Special Review Article, we characterize the epidemiology of firearm-related injuries in the United States and discuss public health programs, the role of pediatricians, and legislative efforts to address this health crisis. Firearm-related injuries are leading causes of unintentional injury deaths in children and adolescents. Children are more likely to be victims of unintentional injuries, the majority of which occur in the home, and adolescents are more likely to suffer from intentional injuries due to either assault or suicide attempts. Guns are present in 18% to 64% of US households, with significant variability by geographic region. Almost 40% of parents erroneously believe their children are unaware of the storage location of household guns, and 22% of parents wrongly believe that their children have never handled household guns. Public health interventions to increase firearm safety have demonstrated varying results, but the most effective programs have provided free gun safety devices to families. Pediatricians should continue working to reduce gun violence by asking patients and their families about firearm access, encouraging safe storage, and supporting firearm-related injury prevention research. Pediatricians should also play a role in educating trainees about gun violence. From a legislative perspective, universal background checks have been shown to decrease firearm homicides across all ages, and child safety laws have been shown to decrease unintentional firearm deaths and suicide deaths in youth. A collective, data-driven public health approach is crucial to halt the epidemic of pediatric firearm-related injury.
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Helmet use protects against head injury. Our objective was to assess whether parental knowledge of helmet safety is associated with helmet use in children, and whether a relationship exists between helmet ownership and other safety behaviors. Three hundred forty-one surveys were distributed to parents of third through fifth graders; 97% of parents believed that a helmet confers protection; 49% of parents reported that their child owns a helmet. Of the helmet owners, 27% reported that the child wears it more than 75% of the time. Seat belt usage was associated with helmet ownership (p=0.02) and frequency of wearing a helmet (p=0.04). Although parents are aware of the benefits, a barrier between helmet ownership and usage exists.
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