An exploratory study about the perception and justification of violence in Mixed Martial Arts and kickboxing athletes

THE INFLUENCE of combat sport practice on behaviour, attitude, personality and other factors was, and still remains, a research topic of great interest as well as conflicting points of view. Findings are as yet inconclusive since a direct or causal effect is difficult to establish and other factors external to the individual, such as the instructor’s coaching style, also need to be taken into consideration. Furthermore, the wide range of disciplines pertaining to the category combat sports differ from each other on a number of characteristics, such as the extent of physical contact or competition rules, and in fact, attempts have been made to distinguish between various sub-types (e.g. Trulson, 1986). A common distinction made is that between the traditional martial arts, which place emphasis on the art’s philosophy, its traditions and hierarchy (e.g. traditional karate, aikido) and the modern (or Western) combat sports (e.g. boxing, Mixed Martial Arts). An ongoing debate exists about the potential positive and/or negative influence of combat sport practice in comparison to other sport disciplines that do not include this element of fighting and direct aggression. On the one hand, combat sports have been presented by some researchers and sport practitioners as a means of promoting positive social and individual behavior, such as in Theeboom, De Knop and Wylleman’s (2008) evaluation of a martial arts Programme for socially disadvantaged youths in Belgium. Results revealed a positive effect of this project; however, it also highlighted the crucial role played by the instructors or leaders of such programmes. In another intervention using martial arts, Trulson (1986) reported a positive effect of a six month traditional martial art (Korean Tae Kwon Do) intervention with male juvenile delinquents including a reduction in aggressiveness and anxiety, thus confirming the positive influence of such an activity. Nevertheless, this effect was not observed in the other group participating in a modern Adaptation of this martial art led by the same instructor, where the philosophical aspect of this discipline was not emphasised. Moreover, an opposite effect was ascertained in this case where an increased tendency towards delinquency was reported. These results support the distinction between the various types of combat sports together with the way this sport is presented and taught by the instructor.

In Richtung "Komplexe PTBS": die deutsche Version des Trauma Symptom Inventory (TSI) zur Erfassung komplexer Traumafolgen.

Die Studie überprüfte die deutsche Übersetzung des Trauma Symptom Inventory (TSI) von Briere [1], das die Komplexe PTB-Symptomatik erfassen soll. Das TSI war Teil einer Testbatterie, welche weiter den Childhood Trauma Questionnaire, Short Screening Scale, Short Form Health Survey, Geriatrische Depressionsskala und das Mini International Neuropsychiatric Interview enthielt. Untersucht wurde eine Stichprobe von N=116 älteren Personen (Altersbereich: 59-98 Jahre; 40,5% Frauen) mit einer Häufung potentiell traumatischer Erfahrungen in der Kindheit. Die deutsche Version des TSI zeigte eine adäquate interne Konsistenz, überwiegend gute Trennschärfen und Schwierigkeitsindizes sowie eine gute Kriteriums- und Konstruktvalidität. Hinsichtlich faktorieller Validität konnte ein Validierungsmodell [2] aus dem europäischen Raum tendenziell besser repliziert werden, als das amerikanische Originalmodell von Briere. Das TSI erwies sich als reliables, ökonomisches und teilweise valides Instrument zur Erfassung der Komplexen PTB-Symptomatik.

Childhood Trauma and PTSD symptoms increase the risk of cognitive impairment in a sample of former indetured child laborers in old Age.

A growing body of evidence suggests a link between early childhood trauma, post-traumatic stress disorder (PTSD) and higher risk for dementia in old age. The aim of the present study was to investigate the association between childhood trauma exposure, PTSD and neurocognitive function in a unique cohort of former indentured Swiss child laborers in their late adulthood. To the best of our knowledge this is the first study ever conducted on former indentured child laborers and the first to investigate the relationship between childhood versus adulthood trauma and cognitive function. According to PTSD symptoms and whether they experienced childhood trauma (CT) or adulthood trauma (AT), participants (n = 96) were categorized as belonging to one of four groups: CT/PTSD+, CT/PTSD-, AT/PTSD+, AT/PTSD-. Information on cognitive function was assessed using the Structured Interview for Diagnosis of Dementia of Alzheimer Type, Multi-infarct Dementia and Dementia of other Etiology according to ICD-10 and DSM-III-R, the Mini-Mental State Examination, and a vocabulary test. Depressive symptoms were investigated as a potential mediator for neurocognitive functioning. Individuals screening positively for PTSD symptoms performed worse on all cognitive tasks compared to healthy individuals, independent of whether they reported childhood or adulthood adversity. When controlling for depressive symptoms, the relationship between PTSD symptoms and poor cognitive function became stronger. Overall, results tentatively indicate that PTSD is accompanied by cognitive deficits which appear to be independent of earlier childhood adversity. Our findings suggest that cognitive deficits in old age may be partly a consequence of PTSD or at least be aggravated by it. However, several study limitations need to considered. Consideration of cognitive deficits when treating PTSD patients and victims of lifespan trauma (even without a diagnosis of a psychiatric condition) is crucial. Furthermore, early intervention may prevent long-term deficits in memory function and development of dementia in adulthood.

Clinical findings and diagnostic value of post-traumatic thoracic radiographs in dogs and cats with blunt trauma

Objective: To characterize the clinical findings in dogs and cats that sustained blunt trauma and to compare clinical respiratory examination results with post-traumatic thoracic radiography findings. Design: Retrospective clinical study. Setting: University small animal teaching hospital. Animals, interventions and measurements: Case records of 63 dogs and 96 cats presenting with a history of blunt trauma and thoracic radiographs between September 2001 and May 2003 were examined. Clinical signs of respiratory distress (respiratory rate (RR), pulmonary auscultation) and outcome were compared with radiographic signs of blunt trauma. Results: Forty-nine percent of dogs and 63.5% of cats had radiographic signs attributed to thoracic trauma. Twenty-two percent of dogs and 28% of cats had normal radiographs. Abnormal auscultation results were significantly associated with radiographic signs of thoracic trauma, radiography score and presence and degree of contusions. Seventy-two percent of animals with no other injuries showed signs of thoracic trauma on chest radiographs. No correlation was found between the radiographic findings and outcome, whereas the trauma score at presentation was significantly associated with outcome and with signs of chest trauma but not with the radiography score. Conclusion: Thoracic trauma is encountered in many blunt trauma patients. The RR of animals with blunt trauma is not useful in predicting thoracic injury, whereas abnormal chest auscultation results are indicative of chest abnormalities. Thorough chest auscultation is, therefore, mandatory in all trauma animals and might help in the assessment of necessity of chest radiographs.

Validation and reclassification of MGAP and GAP in hospital settings using data from the Trauma Audit and Research Network.

BACKGROUND Recently, two simple clinical scores were published to predict survival in trauma patients. Both scores may successfully guide major trauma triage, but neither has been independently validated in a hospital setting. METHODS This is a cohort study with 30-day mortality as the primary outcome to validate two new trauma scores-Mechanism, Glasgow Coma Scale (GCS), Age, and Pressure (MGAP) score and GCS, Age and Pressure (GAP) score-using data from the UK Trauma Audit and Research Network. First, an assessment of discrimination, using the area under the receiver operating characteristic (ROC) curve, and calibration, comparing mortality rates with those originally published, were performed. Second, we calculated sensitivity, specificity, predictive values, and likelihood ratios for prognostic score performance. Third, we propose new cutoffs for the risk categories. RESULTS A total of 79,807 adult (≥16 years) major trauma patients (2000-2010) were included; 5,474 (6.9%) died. Mean (SD) age was 51.5 (22.4) years, median GCS score was 15 (interquartile range, 15-15), and median Injury Severity Score (ISS) was 9 (interquartile range, 9-16). More than 50% of the patients had a low-risk GAP or MGAP score (1% mortality). With regard to discrimination, areas under the ROC curve were 87.2% for GAP score (95% confidence interval, 86.7-87.7) and 86.8% for MGAP score (95% confidence interval, 86.2-87.3). With regard to calibration, 2,390 (3.3%), 1,900 (28.5%), and 1,184 (72.2%) patients died in the low, medium, and high GAP risk categories, respectively. In the low- and medium-risk groups, these were almost double the previously published rates. For MGAP, 1,861 (2.8%), 1,455 (15.2%), and 2,158 (58.6%) patients died in the low-, medium-, and high-risk categories, consonant with results originally published. Reclassifying score point cutoffs improved likelihood ratios, sensitivity and specificity, as well as areas under the ROC curve. CONCLUSION We found both scores to be valid triage tools to stratify emergency department patients, according to their risk of death. MGAP calibrated better, but GAP slightly improved discrimination. The newly proposed cutoffs better differentiate risk classification and may therefore facilitate hospital resource allocation. LEVEL OF EVIDENCE Prognostic study, level II.

Trauma, developmental stages, and motivational abilities in indentured Swiss child laborers in old age

OBJECTIVES The study examined the relationship between potential traumatic events in childhood and motivational abilities in old adulthood according to developmental stage. METHODS The motivational abilities of self-efficacy, conscientiousness and impulsivity (self control) were investigated in a sample of 114 formerly indentured Swiss child laborers. Adversities were assessed by the Childhood Trauma Questionnaire (CTQ). The sample was split into four age groups according to the beginning of the potential trauma: infancy (0-2), preschool (3-5), early childhood (6-9), and early adolescence (≥ 10). RESULTS The strongest relationship was found between self-efficacy and CTQ in the group "early adolescence," followed by the relationship between conscientiousness and CTQ in the same group. Impulsivity and CTQ were most strongly associated in the "preschool" group. CONCLUSION Childhood adversities seem to have a negative impact on self-efficacy and conscientiousness after the age of ten. In contrast, self-control seems to be affected by the deleterious effect of trauma or adversity already at an earlier age.

Improvement of research quality in the fields of orthopaedics and trauma: a global perspective.

The international orthopaedic community aims to achieve the best possible outcome for patient care by constantly modifying surgical techniques and expanding the surgeon's knowledge. These efforts require proper reflection within a setting that necessitates a higher quality standard for global orthopaedic publication. Furthermore, these techniques demand that surgeons acquire information at a rapid rate while enforcing higher standards in research performance. An international consensus exists on how to perform research and what rules should be considered when publishing a scientific paper. Despite this global agreement, in today's "Cross Check Era", too many authors do not give attention to the current standards of systematic research. Thus, the purpose of this paper is to describe these performance standards, the available choices for orthopaedic surgeons and the current learning curve for seasoned teams of researchers and orthopaedic surgeons with more than three decades of experience. These lead to provide an accessible overview of all important aspects of the topics that will significantly influence the research development as we arrive at an important globalisation era in orthopaedics and trauma-related research.

Costs and yield of a 15-month preparticipation cardiovascular examination with ECG in 1070 young athletes in Switzerland: implications for routine ECG screening

Background The usefulness and modalities of cardiovascular screening in young athletes remain controversial, particularly concerning the role of 12-lead ECG. One of the reasons refers to the presumed false-positive ECGs requiring additional examinations and higher costs. Our study aimed to assess the total costs and yield of a preparticipation cardiovascular examination with ECG in young athletes in Switzerland. Methods Athletes aged 14–35 years were examined according to the 2005 European Society of Cardiology (ESC) protocol. ECGs were interpreted based on the 2010 ESC-adapted recommendations. The costs of the overall screening programme until diagnosis were calculated according to Swiss medical rates. Results A total of 1070 athletes were examined (75% men, 19.7±6.3 years) over a 15-month period. Among them, 67 (6.3%) required further examinations: 14 (1.3%) due to medical history, 15 (1.4%) due to physical examination and 42 (3.9%) because of abnormal ECG findings. A previously unknown cardiac abnormality was established in 11 athletes (1.0%). In four athletes (0.4%), the abnormality may potentially lead to sudden cardiac death and all of them were identified by ECG alone. The cost was 157 464 Swiss francs (CHF) for the overall programme, CHF147 per athlete and CHF14 315  per finding. Conclusions Cardiovascular preparticipation examination in young athletes using modern and athlete-specific criteria for interpreting ECG is feasible in Switzerland at reasonable cost. ECG alone is used to detect all potentially lethal cardiac diseases. The results of our study support the inclusion of ECG in routine preparticipation screening.

Association between Head Injury and Helmet Use in Alpine Skiers: Cohort Study from a Swiss Level I Trauma Center.

The association between helmet use during alpine skiing and incidence and severity of head injuries was analyzed. All patients admitted to a level 1 trauma center for traumatic brain injuries (TBIs) sustained from skiing accidents during the seasons 2000-2001 and 2010-2011 were eligible. Primary outcome was the association between helmet use and severity of TBI measured by Glasgow Coma Scale (GCS), computed tomography (CT) results, and necessity of neurosurgical intervention. Of 1362 patients injured during alpine skiing, 245 (18%) sustained TBI and were included. TBI was fatal in 3%. Head injury was in 76% minor (Glasgow Coma Scale, 13-15), 6% moderate, and 14% severe. Number and percentage of TBI patients showed no significant trend over the investigated seasons. Forty-five percent of the 245 patients had pathological CT findings and 26% of these required neurosurgical intervention. Helmet use increased from 0% in 2000-2001 to 71% in 2010-2011 (p<0.001). The main analysis, comparing TBI in patients with or without a helmet, showed an adjusted odds ratio (OR) of 1.44 (p=0.430) for suffering moderate-to-severe head injury in helmet users. Analyses comparing off-piste to on-slope skiers revealed a significantly increased OR among off-piste skiers of 7.62 (p=0.004) for sustaining a TBI requiring surgical intervention. Despite increases in helmet use, we found no decrease in severe TBI among alpine skiers. Logistic regression analysis showed no significant difference in TBI with regard to helmet use, but increased risk for off-piste skiers. The limited protection of helmets and dangers of skiing off-piste should be targeted by prevention programs.