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We know wearing mouthguards during sports is a good practice, and that not all mouthguards are alike. But which ones are the best, and how are we to rate them? This article proposes a 10 grade scale for sports mouthguards, taking into account the type of material, the age of the mouthguard and whether it is custom made, stock, or “boil and bite”. Now, the next steps are to create a simple chart that can be disseminated to dentists, physicians, coaches, and players so that the scale can be put into widespread use. Patrick DG, van Noort R, Found MS. Scale of protection and the various types of sports mouthguard.

Another recent article examines the models used to describe the etiology of sports injuries by focusing on anterior cruciate ligament (ACL) injuries. These can be described on the level of joint and tissue biomechanics, whole body biomechanics, via the behavior of the individual athlete and opponent, or within the playing situation. For each level, one can detail the elements and factors involved that “created” the injury, whether the shear forces on the joint, the speed of the impact, the technical foul, or the jump height achieved. The authors argue for expanding the traditional biomechanical approach to describe the inciting event if our aim is injury prevention. Bahr R, Krosshaug T. Understanding injury mechanisms: a key component of preventing injuries in sport.

Not only are smokers at higher risk of dying from fires, a new study from Taiwan finds that they are at higher risk of mortality from falls and occupational injuries as well. The heaviest smokers had the highest risk and the lightest smokers the lowest risk. Smokers also had more motor vehicle deaths, which in Taiwan were primarily due to motorcycles. This study followed more than 64 000 male smokers for a period of 12–18 years, and adjusted for alcohol use and social class. Wen CP, Tsai SP, Cheng TY, et al. Excess injury mortality among smokers: a neglected tobacco hazard.

A study in Israel also examined risks to motorcyclists, this time in Tel Aviv. More than 10 000 patients were studied, of whom 28% were drivers of motorcycles, while the rest were drivers of other vehicles. Although the risk of injury decreases as age increases, the population of injured cyclists in this busy city was significant older than those elsewhere in the country. Also, the proportion of cyclists who were injured while working was twice that in other regions. Peleg K, Kluger Y, Giveon A, Aharonson-Daniel L, Israel Trauma Group. Risk for motorcyclists in a busy metropolitan city: the example of Tel Aviv.

In the US, programs to screen youth for depression and suicide risk have been proliferating in recent years. Several national initiatives have called for increased screening, but concerns have also been expressed that such programs may create harm by increasing suicidal thoughts or behaviors. For the first time, a randomized controlled study compares high school students’ distress level and suicidal ideation to measure the potential harm of suicide screening. The researchers found no evidence of iatrogenic effects. Gould MS, Marrocco FA, Kleinman M, et al. Evaluating iatrogenic risk of youth suicide screening programs: a randomized controlled trial.

Residential injuries to toddlers were examined over three months through a variety of methods: questionnaires, parent observations, diaries, and interviews. As you might expect, boys were injured more often and more severely than girls, but girls reacted more to their injuries. The researchers also examined parental strategies for preventing injuries and found that they often varied room by room within the home. They found that transitioning too early from environmental strategies to rule based ones increases the risk of injury to young children in the home. Morrongiello BA, Ondejko L, Littlejohn A. Understanding toddlers’ in-home injuries: I. Context, correlates and determinants.

and II. Examining parental strategies, and their efficacy, for managing child injury risk.

Most firearms owned in the US are concentrated in the hands of a relatively small percentage of the population: 20% of gun owners possess 55% of the guns. Firearms are marketed to consumers primarily through gun magazines. A new study examines the themes and characteristics of firearm ads in these magazines and estimates the costs of advertising spending relative to production costs for each firearm. Among their findings: “manufacturers depict firearms as tools, sports equipment, or lifestyle accessories”. Not surprisingly, safety considerations were infrequently mentioned in ads, with the emphasis primarily being on attributes of the gun, such as design, performance, or functioning. The ads tended to portray guns as part of an active lifestyle involving hunting and shooting sports and evocative of the American West. Saylor EA, Vittes KA, Sorenson SB. Firearm advertising: product depiction in consumer gun magazines.

Did you ever get into a taxicab and buckle your seat belt, only to realize that the driver had not buckled his? Some locations require taxi drivers to buckle up, but a dozen states in the US do not. This article found a prevalence of seat belt use among Boston cab drivers of 6.8%, nearly tenfold lower than for local drivers overall (and this in a state without primary enforcement laws). In Washington DC, taxi drivers are assigned points as penalty for non-compliance with belt laws and their use rate is 74%. S&F readers might be interested to note that in some locations, such as Singapore, drivers can also be fined if their passengers do not buckle. Fernandez WG, Park JL, Olshaker J. An observational study of safety belt use among taxi drivers in Boston.

Have you read—or published—an interesting article recently? Please send the citation, and copy if possible, to the editor of Splinters & Fragments: Anara Guard, 44 King Street, Auburndale MA 02466, USA (fax +1 617 969 9186; email