Assessing injuries with proxies: implications for understanding concurrent relations and behavioral antecedents of pediatric injuries

Sex Differences in the Relation Between Supervision and Injury Risk Across Motor Development Stages: Transitioning From Infancy Into Toddlerhood

Rationale

Addressing a notable gap in research on injuries during infancy, this longitudinal study examined sex differences in the relationship between parents’ typical levels of supervision and infants’ injuries across motor development stages.

Method

Parents were recruited and completed biweekly phone calls about their infant’s motor skills. Once the infant was able to sit up independently, then a home visit was scheduled. Applying a participant-event monitoring method, parents were taught to complete diary forms (injury, supervision), which they started doing once the child could move from their seated location on the floor in some way (e.g., roll, crawl). Recordings continued until a month after the child could walk independently. Data (injury, supervision) were averaged within each motor development stage (low, high), and associations across stages were examined.

Results

Model testing indicated that supervision level moderated the relation between injury rate across motor development stages, but the strength of this association varied by sex of the child. More intense supervision predicted lower injury rates for girls more so than for boys.

Conclusions

Although the emergence of motor milestones has been associated with increased risk of injury during infancy, the current findings indicate that greater supervision can reduce this risk. However, supervision alone is not as effective to moderate injury risk for boys as it is for girls. Thus, for boys, additional strategies (e.g., hazard removal) may also be warranted to maximize reduction in their risk of injury as they acquire increasing motor skills.

Exercise-Based Training Strategies to Reduce the Incidence or Mitigate the Risk Factors of Anterior Cruciate Ligament Injury in Adult Football (Soccer) Players: A Systematic Review

Anterior cruciate ligament (ACL) is one of the most concerning injuries for football players. The aim of this review is to investigate the effects of exercise-based interventions targeting at reducing ACL injury rate or mitigating risk factors of ACL injury in adult football players. Following PRISMA guidelines, a systematic search was conducted in CINAHL, Cochrane Library, PubMed, Scopus, SPORTDiscus and Web of Science. Studies assessing the effect of exercise-based interventions in ACL injury incidence or modifiable risk factors in adult football players were included. 29 studies evaluating 4502 male and 1589 female players were included (15 RCT, 8 NRCT, 6 single-arm): 14 included warm-up, 7 resistance training, 4 mixed training, 3 balance, 1 core stability and 1 technique modification interventions. 6 out of 29 studies investigated the effect of interventions on ACL injury incidence, while the remaining 23 investigated their effect on risk factors. Only 21% and 13% studies evaluating risk of injury variables reported reliability measures and/or smallest worthwhile change data. Warm-up, core stability, balance and technique modification appear effective and feasible interventions to be included in football teams. However, the use of more ecologically valid tests and individually tailored interventions targeting specific ACL injury mechanisms are required.

Understanding Infants' In-Home Injuries: Context and Correlates

RATIONALE

Infancy is a time of elevated risk of injury. Past research has focused mostly on the type of injuries, leaving many gaps in knowledge about contextual information that could aid in injury prevention planning.

METHODS

In this longitudinal study, a participant-event recording method was used in which mothers tracked their infants' home injuries through three motor development stages (sitting up independently, crawling, and walking). A contextual analysis elucidated where injuries occurred, their type and severity, the infant's and parent's behaviors at the time, if the infant had done the risk behavior before and been injured, the level of supervision, and the nature of any safety precautions parents implemented following these injuries.

RESULTS

Injuries occurred as often in play as in nonplay areas and were due to physically-active nonplay activities more so than play activities; mothers were often doing chores. Bumps and bruises were the most common types of injuries. As infants became more mobile, supervision scores declined and injury severity scores increased. Infants had done the risk behavior leading to injury previously about 60% of the time, with higher scores associated with parents implementing fewer preventive actions in response to injury. When mothers did implement a safety precaution, greater injury severity was associated with more modifications to the environment and increased supervision; teaching about safety was infrequent.

CONCLUSION

Implications of these results for injury prevention messaging are discussed.

Evidence-based assessment of childhood injuries and physical risk-taking behaviors

OBJECTIVE

To offer a critical evidence-based review and summary of assessment methods of childhood injuries and physical risk-taking behaviors.

METHODS

A literature review was conducted to identify methodologies for assessing injury events and physical risk-taking behaviors. Methodologies reviewed included self- or parent-report scales, behavioral observations, and participant event monitoring. We classified methodologies according to published criteria of "well-established," "approaching well-established," or "promising."

RESULTS

7 methodologies were classified as "well-established", 9 were classified as "approaching well-established", and 8 were classified as "promising."

CONCLUSIONS

Several approaches to assessing injuries or physical risk-taking behaviors have strong psychometric properties. Opportunities for further psychometric validation of techniques are noted. It is hoped that this review inspires researchers throughout the fields of pediatric and clinical child psychology to adopt assessments of injury and physical risk-taking in their ongoing research efforts.

The mediating role of hyperactivity and inattention on sex differences in paediatric injury risk

BACKGROUND

Extensive research suggests that risk of injury is higher among young boys versus young girls. The present study examined a mediational model to identify mechanisms that may explain differences in injury risk.

METHODS

Reports of child behaviour and two indices of injury risk among 114 children in early childhood were obtained from parents in community-based paediatric medical centres.

RESULTS

Regression analyses and post-hoc examination of indirect effects supported a mediation model in which the relationship between child sex and child injury risk was explained by hyperactivity and inattention.

CONCLUSIONS

Interventions that promote child well-being by targeting constellations of externalizing behaviour problems may simultaneously decrease paediatric injury risk.