WHAT'S KNOWN ON THIS SUBJECT: Shoulder injuries are common among high school athletes. These injuries, both traumatic and overuse, contribute to significant time loss from athletic activity. Understanding sport-specific injury patterns is critical for development of targeted injury prevention programs. WHAT THIS STUDY ADDS:This study is the most comprehensive analysis of high school shoulder injuries to date, providing national injury estimates while examining injury rates, diagnoses, severity, and mechanisms of injury in 9 interscholastic sports. abstract OBJECTIVES: The objective of this study was to describe shoulder injuries in a nationally representative sample of high school athletes playing 9 sports. A national estimate of shoulder injuries among high school athletes was subsequently calculated.METHODS: Injury data were collected in 9 sports (boys' football, soccer, basketball, wrestling, and baseball; girls ' soccer, volleyball, basketball, and softball) high school athletes in this study sustained 2798 shoulder injuries during 13 002 321 athlete exposures, for an injury rate of 2.15 per 10 000 athlete exposures. This corresponds to a nationally estimated 820 691 injuries during this time period. Rates of injury were higher in competition as compared with practice (rate ratio = 3.17 [95% confidence interval: 2.94-3.41]). The highest rate of injury was in football (4.86) and the lowest in girls' soccer (0.42). The most common types of injury were strain/sprain (37.9%) and dislocation/separation (29.2%). Boys were more likely than girls to sustain their injuries after contact with another person or with the playing surface. Surgical repair was required for 7.9% of the injuries. Time loss from athletic participation varied among sports, with 40.7% of athletes returning within 1 week, whereas 8.2% were medically disqualified for their season/career. CONCLUSIONS:High school shoulder injury rates and patterns varied by sport and gender. Prospective epidemiologic surveillance is warranted to discern trends and patterns to develop evidence-based interventions to prevent shoulder injuries. Pediatrics 2014;133:272-279

Spanking is common in the United States but less common in many European countries in which it has been outlawed. Being spanked has been associated with child abuse victimization, poor self-esteem, impaired parent–child relationships, and child and adult mental health, substance abuse, and behavioral consequences. Being spanked as a child has also been shown to increase the likelihood of abusing one's own children or spouse as an adult. Spanking of very young children less than two is almost never recommended even among experts that consider spanking as reasonable in some circumstances. Using a cross-sectional anonymous telephone survey, we describe spanking rates among a representative sample of North Carolina mothers of children less than 2 years old and the association of spanking with demographic characteristics. A substantial proportion of mothers admit to spanking their very young children. The rate of spanking in the last year among all maternal respondents was 30%. Over 5% of the mothers of 3-month olds reported spanking. Over 70% of the mothers of 23-month olds reported spanking. Increased spanking was associated with higher age of the child and lower maternal age. With every month of age, a child had 27% increased odds of being spanked. Early spanking has been shown to be associated with poor cognitive development in early childhood. Further, early trauma has been shown to have significant effects on the early developing brain. It is therefore critical that health and human services professionals address the risk of corporal punishment as a method of discipline early in the life of the child. The spanking of very young children may be an appropriate locus for policy and legislative debates regarding corporal punishment.