Aggression, Violence and Injury in Minor League Ice Hockey: Avenues for Prevention of Injury

Does sports participation affect the mediating role of impulsivity in the association between adverse childhood experiences and aggression?

Introduction

Adverse childhood experiences (ACEs) and self-reported aggression have often been associated, however, the mediating and moderating mechanisms underlying this association are not fully understood. In addition, less is known about potential factors that could serve as protection against the development of aggressive behavior. In this study, we investigated a moderated mediation model of sports participation and five impulsivity traits including positive and negative urgency, sensation seeking, and lack of premeditation and perseverance, in the association between ACEs and two forms of aggression.

Methods and results

The sample comprised 651 (68.5% females) individuals from a Dutch community ranging in age from 18 to 82 years (M = 34.08). Contrary to our expectations, sports participation did not affect the associations of ACEs, the five impulsivity traits, and reactive and proactive aggression, except the association between ACEs and lack of premeditation. Specifically, the detrimental effect of ACEs on the propensity to act without thinking, increases among individuals with lower levels of sports participation. In addition, it was also found that sports participation directly contributed to higher levels of sensation seeking. Finally, after controlling for sociodemographic variables, the positive association between ACEs and reactive aggression was significantly mediated by negative urgency, lack of perseverance, and lack of premeditation, while the positive association between ACEs and proactive aggression was significantly mediated by lack of premeditation and positive urgency.

Conclusion

The findings of this study add to the body of knowledge about the role of sports participation and impulsivity traits in the development of both forms of aggression, however, replication studies among multiple populations are needed before firm conclusions can be drawn.

Characteristics of Parents Who Feel a Lack of Communication with Coaches of Youth Sports

Communication between parents and their children's coaches is important for children's sports activities, but the relationship between parents and coaches is not well understood. It is possible that parents feel a lack of communication with coaches, which could be due to parents' experience with sports activities or the social environment of the team. This study aimed to elucidate the characteristics of parents who feel a lack of communication with their children's coaches of youth sports. A cross-sectional study was conducted on parents of young athletes (n = 6,641) and multivariate logistic regression analyses were performed to assess factors related to parents' feeling of a lack of communication with their children's coaches. Among the respondents, 29.4% of parents felt a lack of communication with their children's coaches. The factors related to the parents' feeling were a shorter duration of their children playing the present sport, an absence of experience playing the same sport as their children or playing in a team with high competition level, dissatisfaction with their children's attitude towards sports activities, and an awareness of verbal and/or physical abuse by the coaches and bullying by the teammates in their children's team. Parents' previous sports experience and awareness of interpersonal violence in their children's team were associated with their feeling of a lack of communication with coaches. Educating parents on the sport and their roles in youth sport is necessary to make appropriate mutual communication between parents and coaches, which could lead to better circumstances for young athletes.

Machine Learning Outperforms Logistic Regression Analysis to Predict Next-Season NHL Player Injury: An Analysis of 2322 Players From 2007 to 2017

Background:

The opportunity to quantitatively predict next-season injury risk in the National Hockey League (NHL) has become a reality with the advent of advanced computational processors and machine learning (ML) architecture. Unlike static regression analyses that provide a momentary prediction, ML algorithms are dynamic in that they are readily capable of imbibing historical data to build a framework that improves with additive data.

Purpose:

To (1) characterize the epidemiology of publicly reported NHL injuries from 2007 to 2017, (2) determine the validity of a machine learning model in predicting next-season injury risk for both goalies and position players, and (3) compare the performance of modern ML algorithms versus logistic regression (LR) analyses.

Study Design:

Descriptive epidemiology study.

Methods:

Professional NHL player data were compiled for the years 2007 to 2017 from 2 publicly reported databases in the absence of an official NHL-approved database. Attributes acquired from each NHL player from each professional year included age, 85 performance metrics, and injury history. A total of 5 ML algorithms were created for both position player and goalie data: random forest, K Nearest Neighbors, Naïve Bayes, XGBoost, and Top 3 Ensemble. LR was also performed for both position player and goalie data. Area under the receiver operating characteristic curve (AUC) primarily determined validation.

Results:

Player data were generated from 2109 position players and 213 goalies. For models predicting next-season injury risk for position players, XGBoost performed the best with an AUC of 0.948, compared with an AUC of 0.937 for LR (P < .0001). For models predicting next-season injury risk for goalies, XGBoost had the highest AUC with 0.956, compared with an AUC of 0.947 for LR (P < .0001).

Conclusion:

Advanced ML models such as XGBoost outperformed LR and demonstrated good to excellent capability of predicting whether a publicly reportable injury is likely to occur the next season.

Comparing concussion rates as reported by hockey Canada with head contact events as observed across minor ice-hockey age categories

Head injuries in elite and youth sport have garnered growing public attention in part because of high-profile cases of professional athletes suffering career-ending/threatening concussions and because of the increase in medical studies identifying how repeated concussive events can lead to long-term health problems, most notably degenerative brain disease. Public concerns around youth ice hockey are intensifying in light of recent evidence which suggests that effects of head injury are worse for youth than they are for athletes in later stages of life. To better understand concussion injury rate trends across all levels of youth hockey, this paper provides a retrospective analysis of concussion related hockey injury as recorded in Hockey Canada’s Injury Reporting System from the period covering 2009 to 2016, combined with two years of observational research documenting head contact events in minor hockey in the Ottawa and Gatineau regions of Ontario and Quebec. By comparing two different data sets through different methodological designs, it provides important insight into the levels of head contact in youth hockey, how head contact is occurring, and offers commentary about the levels of risk players are exposed to in minor hockey in Canada.

Losing the identity of a hockey player: the long-term effects of concussions

AIM

To describe what suffering multiple concussions meant for former semi-professional or professional hockey players who were forced to end their career.

RESULTS

Nine former Swedish hockey players, who once played on national or professional teams were interviewed. The interviews were analyzed with reference to hermeneutic phenomenology to interpret and explain their experiences. The theme of losing one's identity as a hockey player was constructed from five subthemes: being limited in everyday life, returning to the hockey stadium as soon as possible, forming a post career identity, lacking understanding and support, and preventing injuries by respecting other players.

CONCLUSION

The former hockey players struggled with developing their off-the-ice identities and with finding other sources of meaning for their lives.

Prevention of Concussion

Concussion is a common pediatric problem, and the best point of intervention would be to prevent a concussion from occurring. Unfortunately, information in this area has inconsistent support for the various methods that have been attempted. In infants, concussions are typically related to safety hazards in the environment and attempts to make the environment safer have resulted in decreased injuries over time. Toddlers also face environmental hazards that are slightly different in light of their increased mobility. School-aged children and adolescents primarily sustain concussions in the course of participation in organized contact sports. Although much research has been devoted to protective equipment, there is not a clearly effective piece of equipment that prevents concussions. Some effect has been demonstrated with changes in rules and policy that limit or eliminate certain kinds of dangerous contact. Research is still being performed to adequately evaluate methods that are already being used, as well as to find new methods in the future that may help protect today's children from concussions.

The characteristics of coaches that verbally and physically abuse young baseball players using a self-reported questionnaire

BACKGROUND

Because the relationship between coaches and athletes is unequal, verbal and physical abuse remains a common problem among sports coaches. We aimed to elucidate the characteristics of baseball coaches who verbally/physically abuse young baseball players.

METHODS

A cross-sectional study was conducted on youth sports team coaches in Miyagi prefecture, Japan (n = 380), using a self-reported questionnaire. Multivariate logistic regression models were used for the analyses, evaluating the following variables: sex, age, educational level, smoking habits, years of coaching, level of baseball-playing experience, personal experience with verbal/physical abuse by former coaches, satisfaction with athletes' attitudes, number of athletes on the team, team competition level, awareness of the recommendations of the Japanese Society of Clinical Sports Medicine, limitations in the total pitch count, difficulty in coaching in other positions, number of games per year, and acceptance of former verbal/physical abuse.

RESULTS

The prevalence of verbal/physical abuse toward young athletes was 74.5% (n = 283) and 6.6% (n = 25), respectively. Verbal abuse was significantly associated with personal experience of verbal abuse by former coaches (odds ratio [OR]: 2.00, 95% confidence interval [95% CI]: 1.04-3.85), and acceptance of verbal/physical abuse (OR: 2.61, 95% CI: 1.34-5.10). Physical abuse was significantly associated with greater than 10 years of coaching experience (OR: 7.16, 95% CI: 1.36-37.78), personal experience with physical abuse by former coaches (OR: 4.25, 95% CI: 1.23-14.70), and acceptance of verbal/physical abuse (OR: 3.85, 95% CI: 1.51-9.84).

CONCLUSIONS

Coaches' experiences with verbal/physical abuse by former coaches negatively affected young athletes. Breaking this cycle is necessary to keep athletes active and interested in playing baseball.

LEVEL OF EVIDENCE

Level III.

The Relationship Between Self-Efficacy and Aggressive Behavior in Boxers: The Mediating Role of Self-Control

Aggressive behavior has been one of the core issues in sports psychology, whereas boxers' aggressive behavior has received limited attention. Although some literature reported that self-efficacy is related to aggressive behavior, the mechanism whereby self-efficacy affects aggressive behavior remains unclear. The present study investigated the relationship between self-efficacy and aggressive behavior, as well as the effect of self-control as a mediating factor. This study uses the Self-efficacy Scale for Athletes, the Self-control Questionnaire for Athletes, and the Buss-Perry Aggression Questionnaire. This relationship is explored through self-reported measures from N = 414 Chinese professional boxers, n = 243 were male and n = 171 were female, the average age was M = 17.72 years (SD = 3.147), the participants, the average number of years of exercise was M = 3.89 years (SD = 2.734); Results showed that male boxers reported greater aggression than female boxers; It was found that the self-efficacy and self-control improved as age of the participants increased; The higher the level of competition, the higher levels of self-efficacy and self-control; Self-efficacy was negatively related with aggressive behavior and positively correlated with self-control. Self-control was also negatively correlated with aggressive behavior among boxers. Self-control had a full mediating effect on the relationship between self-efficacy and aggressive behavior.

Understanding the resistance to creating safer ice hockey: essential points for injury prevention

Introduction

Despite the known negative health outcomes of concussions in minor level boys’ hockey, there has been significant resistance to creating a safer game with less body checking.

Methods

To better understand cultural barriers that prevent making the sport safer for youth and adolescents, semistructured interviews, with 20 ice hockey stakeholders, were conducted and analysed using thematic analysis.

Results

Through this analysis, two primary concepts arose from respondents. The first concept is that body checking, despite the harm it can cause, should be done in a respectful sportsmanlike fashion. The second concept is the contradiction that the game of ice hockey is both dynamic and unchangeable.

Discussion

Using structural functionalist theory, we propose an argument that the unfortunate perpetuation of violence and body checking in youth ice hockey serves to maintain the social order of the game and its culture. Any strategies aimed at modifying and promoting healthy behaviour in the game should take these concepts into account.

Twitter and traumatic brain injury: A content and sentiment analysis of tweets pertaining to sport-related brain injury

Objectives:

Sport-related traumatic brain injuries are a significant public health burden, with hundreds of thousands sustained annually in North America. While sports offer numerous physical and social health benefits, traumatic brain injuries such as concussion can seriously impact a player’s life, athletic career, and sport enjoyment. The culture in many sports encourages winning at all costs, placing athletes at risk for traumatic brain injuries. As social media has become a central part of everyday life, the content of users’ messages often reflects the prevailing culture related to a particular event or health issue.

Methods:

We hypothesized that Twitter data might be useful for understanding public perceptions and misperceptions of sport-related traumatic brain injuries. We performed a content and sentiment analysis of 7483 Twitter^® tweets related to traumatic brain injuries in sports collected during June and July 2013.

Results:

We identified five major themes. Users tweeted about personal traumatic brain injuries experiences, reported traumatic brain injuries in professional athletes, shared research about sport-related concussions, and discussed policy and safety in injury prevention, such as helmet use. We identified mixed perceptions of and sentiment toward traumatic brain injuries in sports: both an understanding that brain injuries are serious and disregard for activities that might reduce the public burden of traumatic brain injuries were prevalent in our Twitter analysis.

Conclusion:

While the scientific and medical community considers a concussion a form of traumatic brain injuries, our study demonstrates a misunderstanding of this fact among the public. In our current digital age, social media can provide useful insight into the culture around a health issue, facilitating implementation of prevention and treatment strategies.

Cross-sectional examination of the association of co-occurring alcohol misuse and traumatic brain injury on mental health and conduct problems in adolescents in Ontario, Canada

OBJECTIVE

This study describes the impact of traumatic brain injury (TBI) and hazardous drinking on mental health and behavioural issues among Ontario adolescents. In particular, we assessed the incremental co-occurrence of hazardous drinking with a history of TBI, in comparison to experiencing just one of these conditions.

METHODS

A cross-sectional subsample of 3130 Ontario adolescents attending grades 9-12, and aged 10-21 were surveyed in 2013 as a part of the Centre for Addiction and Mental Health's Ontario Student Drug Use and Health Survey. Recent (past year) and former (lifetime and excluding the last year) TBI were defined as trauma to the head that resulted in loss of consciousness for at least 5 min or overnight hospitalisation. Current hazardous drinking was derived using the Alcohol Use Disorders Identification Test (AUDIT).

RESULTS

An estimated 11.8% of Ontario adolescents (95% CI 10.1% to 13.8%) reported a history of former TBI and were not hazardous drinkers; 4.0% (95% CI 2.9% to 5.5%) reported recent TBI and were not hazardous drinkers; 13.7% (95% CI 12.3% to 15.3%) were hazardous drinkers who never had a TBI; 4.1% (95% CI 2.9% to 5.8%) had former TBI with co-occurring hazardous drinking; and 2.2% (95% CI 1.6% to 3.0%) had recent TBI with co-occurring hazardous drinking. Most odds increased significantly and were two to three times higher for reporting compromised mental health, violent and non-violent conduct behaviours, and reported victimisation for classifying as a hazardous drinker at the time of testing with co-occurring either former or recent TBI compared to classifying as not having either of these conditions. Adolescents classified as hazardous drinkers with former TBI had numerous and higher ORs for conduct behaviours than those with recent TBI.

CONCLUSIONS

Results emphasise the strong interplay between TBI and hazardous drinking and point to the need for integrating prevention efforts to reduce these conditions and their co-occurrence among adolescents.