Concussion knowledge and attitudes among amateur South African rugby players

Background: The South African Rugby Union's BokSmart programme currently educates coaches and referees on concussion. Rugby players are often more familiar with their teammates than the coach or referee. Therefore they are well-positioned to play a pivotal role in rugby safety if they have adequate knowledge to identify subtle signs and abnormal behaviour displayed by a concussed teammate. However, no programme focuses on concussion education among South African rugby players and there is a dearth of literature on concussion education programmes among rugby players which could lead to safer return to play (RTP) habits.Objectives: To evaluate South African rugby players' concussion knowledge and attitudes/behaviours regarding RTP following a concussion.Methods: A descriptive, cross-sectional study was used. Participants (n=294) were divided into junior amateur high school (JAHS) (n=216) and senior amateur club (SAC) (n=78) players. The modified RoCKAS-ST questionnaire was used to evaluate their concussion knowledge index (CKI) and concussion attitudes/behaviours index (CAI) regarding RTP.Results: On average, 62% (JAHS) and 60% (SAC) of the CKI questions were answered correctly. JAHS participants correctly identified 66% of concussion symptoms, similarly to the SAC participants (63%), rendering similar (p=0.37) overall CKI scores when comparing the two groups. The CAI questions yielded similar (p=0.98) results between the groups, reporting safe responses in 66% (JAHS) and 67% (SAC) of the items.Discussion and conclusion: Junior and senior South African amateur rugby players lacked approximately one-third of essential concussion knowledge, which may lead to a display of unsafe attitudes/ behaviours to concussion and RTP. Further research is warranted to inform educational programmes on concussion among rugby players

Health; Well-Being and Wellness: an Anthropological Eco-Systemic Approach

More than two decades ago; Fritjof Capra commended - and indeed advocated - a paradigm shift in health science and care. In his book The Turning Point (1982) he talks of a major shift from the preoccupation with micro-organisms to a careful study of the `host organism and its environment'; of `significant attempts to develop a unified approach to the mind/body system' in Western medicine; of `a new holistic paradigm' (as opposed to `the old biomedical paradigm') regarding the problem of health and healing; of `a holistic and humanistic approach to primary care'; and of `a holistic therapy' as opposed to `the traditional biochemical practice of associating a physical disease with a specific physical cause'. Our concern in this article is with the paradigm shift advocated by Capra in this book and the progress that has since been made