Timing and Reasons Behind Single-Sport Specialization in Soccer: A Survey of 64 Major League Soccer Athletes

Background: Single-sport specialization at the exclusion of other sports has become increasingly popular in youth sporting culture. The purpose of this study was to survey Major League Soccer (MLS) athletes to examine factors influencing the timing of single-sport specialization in soccer. Hypothesis: The majority of surveyed athletes will have participated in multiple sports prior to specialization and specialized primarily as a result of a coach’s recommendation, with no significant impact on specialization timing stemming from birth or high school location, obtaining a collegiate scholarship, MLS experience, or position. Study Design: Cross-sectional study. Level of Evidence: Level 4. Methods: Anonymous surveys were distributed to 3 MLS organizations and completed by MLS athletes during preseason physicals. Surveys evaluated the age and reason(s) behind an athlete’s decision to specialize in soccer, birth location, geographic high school location for US-born athletes, participation in a developmental league, college scholarship, years in the MLS, and position played. Results: Approximately 74% (64/86) of athletes returned completed surveys. Athletes reported beginning soccer at a mean age of 5.1 ± 2.1 years and specializing at age 12.6 ± 4.3 years. Athletes who participated in no other sports prior to specialization ( P < 0.001), athletes reporting soccer to be their first sport played at an advanced level ( P < 0.001), and athletes receiving a college scholarship ( P = 0.02) specialized at a significantly younger age. Internationally born athletes specialized at significantly younger ages when compared with US-born athletes ( P < 0.001). Conclusion: The majority of athletes participated in multiple sports prior to specialization and eventually specialized to focus exclusively on soccer. The timing of sport specialization in professional MLS athletes was not associated with multisport participation prior to specialization, playing soccer at an advanced level prior to other sports, receiving a college scholarship, or being born outside the United States. Clinical Relevance: Timing of sport specialization is associated with multiple factors prior to athlete promotion to the MLS that warrant further investigation to better understand the impact of specialization on injury incidence, performance, and career length.

Download Full-text

Game-Related Impacts in High School Boys’ Lacrosse

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119835587 ◽

2019 ◽

Vol 7 (4) ◽

pp. 232596711983558 ◽

Cited By ~ 2

Author(s):

Shane V. Caswell ◽

Patricia Kelshaw ◽

Andrew E. Lincoln ◽

Lisa Hepburn ◽

Reginald Dunn ◽

...

Keyword(s):

High School ◽

Rotational Velocity ◽

Linear Acceleration ◽

The United States ◽

Head Impact ◽

Level Of Evidence ◽

Cross Sectional ◽

Head Impacts ◽

Direct Head ◽

The Impact

Background: The rate of concussions in boys’ lacrosse is reported to be the third highest among high school sports in the United States, but no studies have described game-related impacts among boys’ lacrosse players. Purpose: To characterize verified game-related impacts, both overall and those directly to the head, in boys’ varsity high school lacrosse. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 77 male participants (mean age, 16.6 ± 1.2 years; mean height, 1.77 ± 0.05 m; mean weight, 73.4 ± 12.2 kg) were instrumented with sensors and were videotaped during 39 games. All verified game-related impacts ≥20 g were summarized in terms of frequency, peak linear acceleration (PLA), and peak rotational velocity (PRV). Descriptive statistics and impact rates per player-game (PG) with corresponding 95% CIs were calculated. Results: Overall, 1100 verified game-related impacts were recorded (PLA: median, 33.5 g [interquartile range (IQR), 25.7-51.2]; PRV: median, 1135.5 deg/s [IQR, 790.0-1613.8]) during 795 PGs. The rate for all verified game-related impacts was 1.38 impacts per PG (95% CI, 1.30-1.47). Of these, 680 (61.8%) impacts (PLA: median, 35.9 g [IQR, 26.7-55.5]; PRV: 1170.5 deg/s [IQR, 803.2-1672.8]) were directly to the head (impact rate, 0.86 impacts/PG [95% CI, 0.79-0.92]). Overall, midfielders (n = 514; 46.7%) sustained the most impacts, followed by attackers (n = 332; 30.2%), defenders (n = 233; 21.2%), and goalies (n = 21; 1.9%). The most common mechanisms for overall impacts and direct head impacts were contact with player (overall: n = 706 [64.2%]; head: n = 397 [58.4%]) and stick (overall: n = 303 [27.5%]; head: n = 239 [35.1%]), followed by ground (overall: n = 73 [6.6%]; head: n = 26 [3.8%]) and ball (overall: n = 15 [1.4%]; head: n = 15 [2.2%]). Direct head impacts were associated with a helmet-to-helmet collision 31.2% of the time, and they were frequently (53.7%) sustained by the players delivering the impact. Nearly half (48.8%) of players delivering contact used their helmets to initiate contact that resulted in a helmet-to-helmet impact. Players receiving a head impact from player contact were most often unprepared (75.9%) for the collision. Conclusion: The helmet is commonly used to initiate contact in boys’ high school lacrosse, often targeting defenseless opponents. Interventions to reduce head impacts should address rules and coaching messages to discourage intentional use of the helmet and encourage protection of defenseless opponents.

Download Full-text

Catastrophic High School and Collegiate Cheerleading Injuries in the United States: An Examination of the 2006-2007 Basket Toss Rule Change

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738118807122 ◽

2018 ◽

Vol 11 (1) ◽

pp. 32-39 ◽

Cited By ~ 2

Author(s):

Rebecca K. Yau ◽

Savannah G. Dennis ◽

Barry P. Boden ◽

Robert C. Cantu ◽

James A. Lord ◽

...

Keyword(s):

United States ◽

High School ◽

Case Series ◽

Injury Rate ◽

The United States ◽

Level Of Evidence ◽

Injury Rates ◽

Rule Change ◽

Before And After ◽

The Impact

Background: Cheerleading is a specialized athletic activity that can lead to catastrophic injuries. Cheerleading rules are in place to maximize safety of participants. The purpose of this study was to describe catastrophic cheerleading injuries among high school and collegiate-level participants in the United States and to explore whether the 2006-2007 basket toss rule change was effective at reducing the number of catastrophic injuries. Hypothesis: The 2006-2007 basket toss rule change contributed to a reduction in the number of catastrophic injuries among high school and collegiate cheerleaders. Study Design: Case series. Level of Evidence: Level 4. Methods: Data on catastrophic cheerleading injuries were collected by the National Center for Catastrophic Sport Injury Research from July 2002 to June 2017. Information collected included cheerleader, event, and injury characteristics. The impact of the 2006-2007 rule change banning the basket toss on any hard surfaces was assessed by comparing injury rates and 95% CIs before and after the rule change. Results: There were 54 catastrophic cheerleading injuries, or 3.6 injuries per year. From July 2002 through June 2017, the injury rate was 2.12 per 1,000,000 cheerleaders (95% CI, 1.56-2.69). Most cheerleaders sustained serious injuries (n = 27; 50%) during practice (n = 37; 69%) to the head (n = 28; 52%) and cervical spine (n = 17; 32%). From July 2002 through June 2017, basket tosses were the stunt that accounted for the highest proportion of injuries (n = 19; 35%). The basket toss injury rate decreased from 1.55 to 0.40 per 1,000,000 cheerleaders among both high school and collegiate cheerleaders after the rule change. Conclusion: Catastrophic injury rates in cheerleading decreased dramatically after the 2006-2007 rule change banning basket tosses from being performed on any hard surfaces. In particular, there was a nearly 4-fold reduction in the rate of catastrophic basket toss injuries.

Download Full-text

Impact of temperature and relative humidity on the transmission of COVID-19: a modelling study in China and the United States

BMJ Open ◽

10.1136/bmjopen-2020-043863 ◽

2021 ◽

Vol 11 (2) ◽

pp. e043863

Author(s):

Jingyuan Wang ◽

Ke Tang ◽

Kai Feng ◽

Xin Lin ◽

Weifeng Lv ◽

...

Keyword(s):

Regression Analysis ◽

Relative Humidity ◽

Human Mobility ◽

The United States ◽

Reproductive Number ◽

Cross Sectional ◽

The Usa ◽

Higher Temperature ◽

Potential Impact ◽

The Impact

ObjectivesWe aim to assess the impact of temperature and relative humidity on the transmission of COVID-19 across communities after accounting for community-level factors such as demographics, socioeconomic status and human mobility status.DesignA retrospective cross-sectional regression analysis via the Fama-MacBeth procedure is adopted.SettingWe use the data for COVID-19 daily symptom-onset cases for 100 Chinese cities and COVID-19 daily confirmed cases for 1005 US counties.ParticipantsA total of 69 498 cases in China and 740 843 cases in the USA are used for calculating the effective reproductive numbers.Primary outcome measuresRegression analysis of the impact of temperature and relative humidity on the effective reproductive number (R value).ResultsStatistically significant negative correlations are found between temperature/relative humidity and the effective reproductive number (R value) in both China and the USA.ConclusionsHigher temperature and higher relative humidity potentially suppress the transmission of COVID-19. Specifically, an increase in temperature by 1°C is associated with a reduction in the R value of COVID-19 by 0.026 (95% CI (−0.0395 to −0.0125)) in China and by 0.020 (95% CI (−0.0311 to −0.0096)) in the USA; an increase in relative humidity by 1% is associated with a reduction in the R value by 0.0076 (95% CI (−0.0108 to −0.0045)) in China and by 0.0080 (95% CI (−0.0150 to −0.0010)) in the USA. Therefore, the potential impact of temperature/relative humidity on the effective reproductive number alone is not strong enough to stop the pandemic.

Download Full-text

Financial Returns in Major League Soccer

Journal of Sports Economics ◽

10.1177/15270025211022733 ◽

2021 ◽

pp. 152700252110227

Author(s):

John Charles Bradbury

Keyword(s):

United States ◽

Ownership Structure ◽

North American ◽

Consumer Demand ◽

Professional Sports ◽

The United States ◽

Professional Soccer ◽

Major League Soccer ◽

Major League ◽

Sports Leagues

Major League Soccer (MLS) is the top-tier professional soccer league serving the United States and Canada. This study examines factors hypothesized to impact consumer demand for professional sports on team revenue in this nascent league. The estimates are consistent with positive returns to performance, novelty effects from newer teams, and varying impacts from roster quality and composition. Other factors hypothesized to be important for MLS teams (e.g., stadium quality and market demographics) are not associated with team revenue. The estimates are similar to findings in other major North American sports leagues, even though MLS operates with a unique single-entity ownership structure that has the potential to disincentivize individual team investments by league owners.

Download Full-text

OHNS Residency Program and Applicant Social Media Presence During the COVID-19 Pandemic

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489420987977 ◽

2021 ◽

pp. 000348942098797

Author(s):

Shadi Ahmadmehrabi ◽

Deborah X. Xie ◽

Bryan K. Ward ◽

Paul C. Bryson ◽

Patrick Byrne

Keyword(s):

Social Media ◽

The United States ◽

Cross Sectional Study ◽

Application Process ◽

Cross Sectional ◽

Residency Programs ◽

Social Media Presence ◽

Residency Application ◽

The Impact ◽

Residency Match

Objectives: In addition to clinical and social disruption, the Coronavirus Disease 2019 (COVID-19) pandemic has affected many aspects of the otolaryngology residency application process. With delays in the 2021 Electronic Residency Applications Service (ERAS) timeline, students and programs have had more time to interact prior to the formal application process. This communication will report recent trends in social media presence by OHNS residency programs, and discuss mechanisms to compensate for decreased applicant-program interactions using social media ahead of the 2021 Match. Methods: In a cross-sectional study of the accredited otolaryngology residency programs in the United States, the number of social media profiles on Twitter, Instagram, and Facebook from 2009 to 2019 were recorded and compared. Results: Most programs (61%) have at least 1 social media profile. Over the past 10 years, the number of programs on social media has increased. During the COVID-19 pandemic, Twitter and Instagram showed higher rates of growth compared to Facebook. With the reduction of in-person opportunities for interactions, both applicants and programs are utilizing social media to showcase their values and their research. Twitter, in particular, also serves as a platform for professional networking. Conclusion: Both Twitter and Instagram are growing in popularity among programs and applicants to enhance networking. Social media is a powerful tool for networking and may help compensate for limitations imposed on the residency match process by the COVID-19 pandemic while maintaining professionalism considerations. The impact of social media on the 2021 otolaryngology residency match is an evolving phenomenon.

Download Full-text

Physician beliefs about the impact of meaningful use of the EHR

Applied Clinical Informatics ◽

10.4338/aci-2014-05-ra-0050 ◽

2014 ◽

Vol 05 (03) ◽

pp. 789-801 ◽

Cited By ~ 13

Author(s):

D.Y. Ting ◽

M. Healey ◽

S.R. Lipsitz ◽

A.S. Karson ◽

J. S. Einbinder ◽

...

Keyword(s):

Quality Of Care ◽

Primary Care Physicians ◽

Meaningful Use ◽

The United States ◽

Improve Quality ◽

Cross Sectional ◽

Incentive Program ◽

Physician Beliefs ◽

The Impact

SummaryBackground: As adoption and use of electronic health records (EHRs) grows in the United States, there is a growing need in the field of applied clinical informatics to evaluate physician perceptions and beliefs about the impact of EHRs. The meaningful use of EHR incentive program provides a suitable context to examine physician beliefs about the impact of EHRs.Objective: Contribute to the sparse literature on physician beliefs about the impact of EHRs in areas such as quality of care, effectiveness of care, and delivery of care.Methods: A cross-sectional online survey of physicians at two academic medical centers (AMCs) in the northeast who were preparing to qualify for the meaningful use of EHR incentive program.Results: Of the 1,797 physicians at both AMCs who were preparing to qualify for the incentive program, 967 completed the survey for an overall response rate of 54%. Only 23% and 27% of physicians agreed or strongly agreed that meaningful use of the EHR will help them improve the care they personally deliver and improve quality of care respectively. Physician specialty was significantly associated with beliefs; e.g., 35% of primary care physicians agreed or strongly agreed that meaningful use will improve quality of care compared to 26% of medical specialists and 21% of surgical specialists (p=0.009). Satisfaction with outpatient EHR was also significantly related to all belief items.Conclusions: Only about a quarter of physicians in our study responded positively that meaningful use of the EHR will improve quality of care and the care they personally provide. These findings are similar to and extend findings from qualitative studies about negative perceptions that physicians hold about the impact of EHRs. Factors outside of the regulatory context, such as physician beliefs, need to be considered in the implementation of the meaningful use of the EHR incentive program.Citation: Emani S, Ting DY, Healey M, Lipsitz SR, Karson AS, Einbinder JS, Leinen L, Suric V, Bates DW. Physician beliefs about the impact of meaningful use of the EHR: A cross-sectional study. Appl Clin Inf 2014; 5: 789–801http://dx.doi.org/10.4338/ACI-2014-05-RA-0050

Download Full-text

Prevalence and quality of life in high school pupils with acne in Serbia

Vojnosanitetski pregled ◽

10.2298/vsp1310935p ◽

2013 ◽

Vol 70 (10) ◽

pp. 935-939 ◽

Cited By ~ 4

Author(s):

Jelena Peric ◽

Natasa Maksimovic ◽

Janko Jankovic ◽

Biljana Mijovic ◽

Vesna Reljic ◽

...

Keyword(s):

Quality Of Life ◽

High School ◽

Cross Sectional Study ◽

Cross Sectional ◽

Demographic Questionnaire ◽

Study Population ◽

Serbian Version ◽

The Impact ◽

Spearman’S Correlation

Background/Aim. Acne is a common problem in adolescent children with considerable emotional and psychological effects. The aim of this study was to determine the self-reported prevalence of acne and to assess its impact on the quality of life in high school pupils in Serbia. Methods. The cross-sectional study was conducted in May 2011 in two medical high schools in Serbia. Only pupils who gave a written informed consent to participate in the study (n = 440) were asked to fill in two questionnaires: short demographic questionnaire and Cardiff Acne Disability Index (CADI), a disease-specific questionnaire measuring disability induced by acne. Internal consistency (tested by Cronbach?s alpha) and item-total score correlations (Spearman's correlation analysis) were used for reliability analyses. Results. The study population consisted of 440 pupils, 281 from Belgrade and 159 from Uzice. Among them 371 (84.3%) were girls and 69 (15.7%) boys, with similar sex distribution in Belgrade and Uzice. The total mean age of pupils was 16.48 years (SD = 0.55). Out of 440 pupils 228 (51.8%) self-reported their acne. The acne prevalence was significantly higher in pupils from Uzice (73.6%) than in those from Belgrade (39.6%). The overall mean CADI score for the whole sample was 2.87 ? 2.74, with the similar quality of life impairment in adolescents from Belgrade and from Uzice. The mean Cronbach?s alpha was 0.82. Conclusion. This study shows that the quality of life impairment due to acne is mild for the majority of the affected pupils. The Serbian version of the CADI is a reliable, valid, and valuable tool for assessing the impact of acne on the quality of life.

Download Full-text

Perspectives in Treatments of End-Stage Ankle Arthritis Among Orthopaedic Surgeons

Foot & Ankle Orthopaedics ◽

10.1177/2473011418779976 ◽

2018 ◽

Vol 3 (3) ◽

pp. 247301141877997

Author(s):

Phinit Phisitkul ◽

Natalie Glass ◽

Patrick B. Ebeling ◽

Sandra E. Klein ◽

Jeffrey E. Johnson

Keyword(s):

United States ◽

The United States ◽

Total Ankle Replacement ◽

Ankle Arthritis ◽

Cross Sectional Survey ◽

Level Of Evidence ◽

Cross Sectional ◽

Orthopaedic Surgeons ◽

Ankle Replacement ◽

End Stage

Background: This study aimed to assess the preferred operative treatment for patients over the age of 60 with end-stage ankle arthritis and perspectives on total ankle replacement (TAR) among American Orthopaedic Foot & Ankle Society (AOFAS) members. Associated factors were analyzed for potential contraindications among members with different levels of experience. Method: A questionnaire containing 6 questions was designed and sent to 2056 members of the AOFAS. Responses were received from 467 orthopaedic surgeons practicing in the United States (76%), Canada (5%), and 26 other countries (20%). Participants were grouped for response comparisons according to country as well as experience level. Differences in contraindications were compared using χ2 tests or exact tests. Results: Respondents practicing in the United States and surgeons who perform 11 or more TARs per year tended to recommend operative treatments favoring TAR and displayed recognition of its increasing role ( P < .05). Overall, respondents felt that 41% of typical patients over 60 years old with end-stage arthritis would be best treated with TAR. Talus avascular necrosis, morbid obesity (body mass index >40 kg/m2), and poorly controlled diabetes with neuropathy were most recognized as the absolute contraindications to TAR. Surgeon’s experience affected the consideration of these clinical factors as contraindications. Conclusions: Total ankle replacement has a substantial and increasing role in the treatment of end-stage ankle arthritis in patients over the age of 60. Absolute and potential contraindications of the procedures were indicated from a cross-sectional survey of AOFAS members. Surgeons more experienced with total ankle replacement felt more comfortable employing it in a wider range of clinical settings. Level of Evidence: Level III, therapeutic.

Download Full-text

Concussion Epidemiology in Youth Sports: Sports Study of a Statewide High School Sports Program

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738120932570 ◽

2020 ◽

Vol 13 (1) ◽

pp. 18-24

Author(s):

Benjamin J. Chun ◽

Troy Furutani ◽

Ross Oshiro ◽

Casey Young ◽

Gale Prentiss ◽

...

Keyword(s):

High School ◽

Student Athletes ◽

Sports Participation ◽

Management Program ◽

Level Of Evidence ◽

High School Sports ◽

School Sports ◽

Relative Risks ◽

Injury Reporting ◽

The Impact

Background: Current research on concussion incidence in youth athletes (age <18 years) is small and limited by variability in injury reporting and diagnostic methodology. Hypothesis: Concussion injuries commonly occur in high school sports programs. The likelihood of concussion among student-athletes (aged 13-18 years) depends on the sport they are participating in as well as the sex of the athlete. Study Design: Descriptive epidemiology study. Level of Evidence: Level 4. Methods: A retrospective analysis of all Hawaii high school athletes aged 13 to 18 years participating in 14 sports from 2011 through 2017 was performed as part of a statewide standardized concussion assessment and management program. Results: A total of 5993 concussions were identified among 92,966 athletes. The overall concussion rate was 0.96 (95% CI, 0.94-0.99). Girls’ judo had the highest concussion rate (1.92; 95% CI, 1.68-2.17) followed by football (1.60; 95% CI, 1.53-1.66). The concussion rate for boys (1.0; 95% CI, 0.97-1.03) was higher than that for girls (0.91; 95% CI, 0.87-0.95); however, in 4 of the 5 sports in which both girls and boys participated, girls had a higher rate of concussion injury. Conclusion: The likelihood of concussion among student-athletes aged 13 to 18 years may be higher than previously thought and varies depending on sport and sex. Clinical Relevance: Epidemiologic data on concussion injury in children and adolescents are useful in accurately determining the relative risks of high school sports participation and may be valuable in determining the appropriate allocation of health care and scholastic resources for student-athletes, as well as the impact of rule and training modifications designed to improve participant safety.

Download Full-text

Identifying the Most Common CrossFit Injuries in a Variety of Athletes

Rehabilitation Process and Outcome ◽

10.1177/1179572719897069 ◽

2020 ◽

Vol 9 ◽

pp. 117957271989706

Author(s):

Kirill Alekseyev ◽

Alex John ◽

Andrew Malek ◽

Malcolm Lakdawala ◽

Nikhil Verma ◽

...

Keyword(s):

Risk Factors ◽

Large Scale ◽

The United States ◽

Cross Sectional Study ◽

Musculoskeletal Injuries ◽

Online Forums ◽

Cross Sectional ◽

Advanced Level ◽

Expertise Level ◽

Associated Risk Factors

Background: CrossFit is an increasingly popular, rapidly growing exercise regimen. Few studies have evaluated CrossFit-associated musculoskeletal injuries on a large scale. This study explores such injuries and associated risk factors in detail. Objective: To identify the most common musculoskeletal injuries endured during CrossFit training among athletes at different levels of expertise. Design: Survey-based retrospective cross-sectional study. Setting: Distribution at CrossFit gyms in the United States and internationally. Also published on active online forums. Participants: A total of 885 former and current CrossFit athletes. Methods: Institutional review board-approved 33-question Web-based survey focused on CrossFit injuries and associated risk factors. Survey submissions were accepted for a period of 6 months. Main outcome measurements: Specific injuries with associated workouts, risk factors that affected injury including (1) basic demographics, (2) regional differences in reported injuries, (3) training intensity, and (4) expertise level at time of injury. Results: Of the 885 respondents, 295 (33.3%) were injured. The most common injuries involved the back (95/295, 32.2%) and shoulder (61/295, 20.7%). The most common exercises that caused injury were squats (65/295, 22.0%) and deadlifts (53/295, 18.0%). Advanced-level (64/295, 21.7%) athletes were more significantly injured than beginner-level (40/295, 13.6%) athletes. International participants were 2.2 times more likely than domestic US participants to suffer injury. Individuals with 3+ years of CrossFit experience were 3.3 times more likely to be injured than those with 2 or less years of experience. Participants who trained for 11+ h/week were significantly more likely to be injured than those who trained less than or equal to 10 h/week. Conclusions: As CrossFit becomes more popular, it is important to monitor the safety of its practitioners. Further studies are needed to explore how to lower this injury prevalence of 33.3%. Areas to focus on include factors that have caused the regional (international vs US states) differences, level of expertise/experience differences (advanced level vs intermediate and beginner levels), and stretching routine modifications.

Download Full-text