Stakeholder perceptions of a tackle law variation to reduce concussion incidence in community rugby union: A qualitative study

This study aimed to investigate the perceptions of key stakeholder groups, i.e. coaches, players, and referees, of a reduced maximum legal tackle height law variation trial in a collegiate amateur rugby competition. A pragmatic qualitative approach was used. Eighteen semi-structured interviews were performed. Thematic analysis was used to analyse the data. Three main law trial-related themes and four additional contextual themes were identified. The most important contextual factors include perceptions of resource scarcity of the implementation context, deficient concussion knowledge and lack of education among all stakeholder groups, tackle technique deficiencies, and an entrenched culture of a dismissive attitude towards serious injuries and non-disclosure of concussion by players. Real-world challenges such as inconsistent sanctioning during gameplay, multi-tackler tackles, and player fatigue underscore the gap between the theoretical knowledge of the law and the complex, dynamic nature of its execution. Furthermore, deeply ingrained issues like entrenched tackle techniques, the quality of coaching, and prevailing attitudes towards concussion compounded these challenges, indicating a need for a more comprehensive approach to bridge the divide between understanding and implementation. Despite these challenges, several participants felt the law variation was still more effective than the existing law; and that it created more awareness around concussion, while sending a clear message that player welfare is being taken seriously. Collectively these factors indicate the difficulty of addressing a complex problem such as concussion, with a law variation intervention in a challenging (resource-constrained) setting

Tackling sport-related concussion: effectiveness of lowering the maximum legal height of the tackle in amateur male rugby - a cross-sectional analytical study

OBJECTIVE: Rugby union ('rugby') is popular globally, with most of its participants being amateur. Concern regarding sport-related concussion (SRC) sustained during rugby is increasing. SRC occurs most frequently in the tackle, yet few interventions have aimed to mitigate this risk factor. This study investigated the influence of a lowered legal tackle height on SRC incidence in amateur rugby. DESIGN: Cross-sectional analytical study: 2018 (control-standard tackle height) and 2019 (intervention-lowered legal tackle height) seasons. SETTING: South African collegiate student rugby competition. PARTICIPANTS: Between 800 and 900 male amateur student players (age: 20±1.6 years) in each year. INTERVENTION: Maximum legal tackle height lowered from line of the shoulder on the ball carrier to the line of the armpit. OUTCOME MEASURES: Number of overall (medical attention) and time-loss (≥1 day lost) injuries, head injuries and SRCs in 2018 and 2019 (dependent variables); events associated with injury incidents (independent variables). RESULTS: There was no statistically significant difference in incidences of time-loss injuries (IRR: 0.79; 95% CI: 0.6 to 1.1; p=0.13), head injuries (IRR: 0.83; 95% CI: 0.5 to 1.3; p=0.42) and SRC (IRR: 0.69; 95% CI: 0.4 to 1.2; p=0.20). In 2018 and 2019, most time-loss head injuries (57%, n=43) and SRCs (55%, n=26) occurred during the tackle. CONCLUSIONS: Despite a trend towards reducing injuries, head injuries and SRC, lowering maximum legal tackle height to armpit level did not change SRC incidence in this amateur male rugby cohort. Most time-loss head injuries and SRCs occurred during the tackle. Further tackle-related interventions to reduce SRC incidence require investigation

Adaptive Evolution of the Myo6 Gene in Old World Fruit Bats (Family: Pteropodidae)

PMCID: PMC3631194This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Identification of Streptococcus pneumoniae by a real-time PCR assay targeting SP2020.

Real-time PCR targeting lytA (the major autolysin gene) and piaB (permease gene of the pia ABC transporter) are currently used as the gold-standard culture-independent assays for Streptococcus pneumoniae identification. We evaluated the performance of a new real-time PCR assay - targeting SP2020 (putative transcriptional regulator gene) - and compared its performance with the assays previously described. A collection of 150 pneumococci, 433 non-pneumococci and 240 polymicrobial samples (obtained from nasopharynx, oropharynx, and saliva; 80 from each site) was tested. SP2020 and lytA-CDC assays had the best performance (sensitivity of 100% for each compared to 95.3% for piaB). The specificity for lytA and piaB was 99.5% and for SP2020 was 99.8%. Misidentifications occurred for the three genes: lytA, piaB and SP2020 were found in non-pneumococcal strains; piaB was absent in some pneumococci including a serotype 6B strain. Combining lytA and SP2020 assays resulted in no misidentifications. Most polymicrobial samples (88.8%) yielded concordant results for the three molecular targets. The remaining samples seemed to contain non-typeable pneumococci (0.8%), and non-pneumococci positive for lytA (1.7%) or SP2020 (8.7%). We propose that combined detection of both lytA-CDC and SP2020 is a powerful strategy for the identification of pneumococcus either in pure cultures or in polymicrobial samples

Outcome of hospitalization for COVID-19 in patients with interstitial lung disease. An international multicenter study

Rationale: The impact of coronavirus disease (COVID-19) on patients with interstitial lung disease (ILD) has not been established. Objectives: To assess outcomes in patients with ILD hospitalized for COVID-19 versus those without ILD in a contemporaneous age-, sex-, and comorbidity-matched population. Methods: An international multicenter audit of patients with a prior diagnosis of ILD admitted to the hospital with COVID-19 between March 1 and May 1, 2020, was undertaken and compared with patients without ILD, obtained from the ISARIC4C (International Severe Acute Respiratory and Emerging Infection Consortium Coronavirus Clinical Characterisation Consortium) cohort, admitted with COVID-19 over the same period. The primary outcome was survival. Secondary analysis distinguished idiopathic pulmonary fibrosis from non–idiopathic pulmonary fibrosis ILD and used lung function to determine the greatest risks of death. Measurements and Main Results: Data from 349 patients with ILD across Europe were included, of whom 161 were admitted to the hospital with laboratory or clinical evidence of COVID-19 and eligible for propensity score matching. Overall mortality was 49% (79/161) in patients with ILD with COVID-19. After matching, patients with ILD with COVID-19 had significantly poorer survival (hazard ratio [HR], 1.60; confidence interval, 1.17–2.18; P = 0.003) than age-, sex-, and comorbidity-matched controls without ILD. Patients with an FVC of <80% had an increased risk of death versus patients with FVC ≥80% (HR, 1.72; 1.05–2.83). Furthermore, obese patients with ILD had an elevated risk of death (HR, 2.27; 1.39−3.71). Conclusions: Patients with ILD are at increased risk of death from COVID-19, particularly those with poor lung function and obesity. Stringent precautions should be taken to avoid COVID-19 in patients with ILD

Tackling the tackle 2: Evaluation of referee and player behavioural change as measures of implementation of a law variation in community-level male amateur rugby union.

OBJECTIVES: To evaluate player and referee behaviour during a lower tackle height law variation trial in community rugby union ('rugby'). DESIGN: Prospective observational cohort study. METHODS: In a law variation trial in male amateur community rugby, coded match video surveillance data were analysed. Referee (sanctioning rate) and player (tackler body position) behaviour changes over one season (under the lowered, armpit-level maximum legal tackle height condition) were analysed in three approximately equal periods of the season. Secondarily, an independent professional referee reviewed illegal high tackle sanctioning data. RESULTS: Overall, 108 matches with 14,780 tackles were filmed and coded. Sanctioned illegal high tackle propensity was significantly higher in the mid-season (41 sanctioned high tackles/1000 tackle events; 95 % CI: 35-47), compared with first and last periods. Upright tacklers in tackles decreased significantly in the final vs. middle period of the season (rate ratio: 0.69; 95 % CI: 0.54-0.88; p < 0.01). Of all the coder-determined high tackles also assessed as high under the new law by the independent referee, 51 % were sanctioned by the on-field referee. CONCLUSIONS: Positive player and referee behavioural changes were observed during a lowered legal tackle height law variation in this community rugby setting. Increased mid-phase high tackle sanctioning by referees was followed by fewer tackles with upright tacklers in the subsequent (last) phase of the season. Encouraging positive behaviour changes of this nature, particularly if sustained (beyond trial study periods), may contribute to overall injury risk reduction, and hold considerable importance to inform future injury prevention strategies in rugby

PLEISTOCENE FOSSIL ELEPHANT TRACKS IN ADDO ELEPHANT NATIONAL PARK

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Tackling the tackle 1: a descriptive analysis of 14,679 tackles and risk factors for high tackles in a community-level male amateur rugby union competition during a lowered tackle height law variation trial

Objective In rugby union (rugby), the tackle is the most frequent cause of concussion and thus a target for intervention to reduce concussion incidence. The aim of this study is to describe tackle characteristics and factors associated with illegal high tackles in amateur community-level rugby during a lowered (arm-pit level) tackle height law variation trial. Design Prospective observational cohort study. Methods Video surveillance of a single season, four-league competition with coding of video data according to a predefined coding framework. Descriptive statistics of tackle detail and logistic regression was performed to analyse factors associated with high tackles. Results One hundred and eight matches with 14,679 tackles and a mean of 137 (± 30) tackles per match were analysed. High tackles (above armpit-level) had significantly greater odds of occurring in the lower (2nd-4th) leagues (OR: 1.95; 95 % CI: 1.6–2.4; p < 0.001), front-on tackles (OR: 1.61; 95 % CI: 1.3–2.0; p < 0.001), arm tackles (OR: 1.65; 95 % CI: 1.3–2.1; p < 0.001), bent-at-waist ball carrier (OR: 1.93; 95 % CI: 1.6–2.4; p < 0.001), falling/diving ball carrier (OR: 2.21; 95 % CI: 1.6–3.1; p < 0.001), and an upright tackler (OR: 3.38; 95 % CI: 2.7–4.2; p < 0.001). A falling/diving tackler had significantly lower odds of being associated with a high tackle (OR: 0.44; 95 % CI: 0.3–0.6; p < 0.001). Conclusions Overall mean tackles per match was similar to that of senior amateur and elite rugby. League, tackle type, tackle aspect, and player body positions were associated with high tackles. These findings reiterate the need for ongoing efforts to identify and implement mitigating strategies to reduce tackle-related injury risk

Elephant seismicity: Ichnological and rock art perspectives from South Africa

An association between round or oval features and linear features has been noted in South African Pleistocene coastal deposits, in apparent association with elephant tracks. The round or oval features sometimes exhibit concentric rings, and the latter often comprise near-parallel grooves and ridges. In one case the concentric rings and parallel grooves are closely connected. Such an association requires interpretation, even if this remains hypothetical until further sites are identified. Elephants are the heaviest extant land mammals, and their capacity to impart substantial forces onto the substrates on which they tread is well documented. Such forces include a seismic component, and seismic communication between elephants has received considerable attention in recent decades. Comparisons with dinosaur tracks are instructive in interpreting the available ichnological evidence. In the absence of plausible alternatives, the possibility that the noted features represent an ichnological signature of elephant seismicity or seismic communication needs to be considered. The rock art record in southern Africa suggests that ancestral humans were aware of elephant seismic communication. A comprehensive approach to elephant seismicity can involve not just research into the habits of extant elephants, but also the rock art record and the trace fossil record. To illustrate these concepts, findings from South African trace fossil sites and rock art sites are presented