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Işın A, Peden AE. The burden, risk factors and prevention strategies for drowning in Türkiye: a systematic literature review. BMC Public Health 2024; 24:528. [PMID: 38378496 PMCID: PMC10877921 DOI: 10.1186/s12889-024-18032-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 02/07/2024] [Indexed: 02/22/2024] Open
Abstract
INTRODUCTION Drowning is a public health problem in Türkiye, as in the rest of the world. This study aims to systematically review the literature on drowning in Türkiye with a focus on data sources, epidemiology, risk factors and prevention strategies. METHODS Literature searches were conducted using PubMed, SPORTSDiscus, Scopus, Web of Science, Turk MEDLINE, Google Scholar and Google Akademik (Turkish language). Studies (limited to original research written in English and Turkish) reporting drowning (unintentional and intentional; fatal and non-fatal) of residents and tourists in Türkiye were independently dual screened at the title and abstract and full text stages. Study quality was assessed using JBI checklists and evidence level assessed based on study design. RESULTS From a total of 917 studies, 49 met the inclusion criteria. Most (51%) focused on unintentional fatal drowning. Included studies were most commonly analytical cross-sectional studies (n = 23) and case series (n = 20) meaning the evidence level was low or very low for 48 (98%) studies. Fifteen studies examined drowning at the national level, while sub-national studies (n = 30) focused on urban areas across three provinces: Antalya (n = 6), Istanbul (n = 6), Izmir (n = 4). There was little consensus on risk factors beyond male drowning risk, and no data reported on implemented or evaluated drowning prevention interventions. DISCUSSION There is a need for more national-level studies to identify the causes of drowning and to guide intervention implementation and evaluation to inform policy makers and donors. Currently official data is limited in its detail, providing age and gender data only, hampering efforts to identify, and thus address, causal factors for drowning. PRACTICAL APPLICATIONS There is currently very little evidence to inform investment in effective drowning prevention interventions in Türkiye. To improve this, data collection systems on drowning in Türkiye need to be strengthened via the development a national drowning registry. TRIAL REGISTRATION #CRD42022382615.
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Affiliation(s)
- Ali Işın
- Department of Coaching Education, Faculty of Sports Sciences, Akdeniz University, 07070, Antalya, Türkiye.
| | - Amy E Peden
- School of Population Health, UNSW Sydney, Kensington, NSW, 2052, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia
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Hunter MA, Sylvester K, Rencken C, White RE, Harrington DT, Vivier PM, Parker RK. Strategies and Challenges of a Safe Fireplace Program in Rural Kenya: A Qualitative Study. J Burn Care Res 2024:irae022. [PMID: 38366041 DOI: 10.1093/jbcr/irae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Indexed: 02/18/2024]
Abstract
There is a lack of information on effective burn prevention strategies. The objective of this study was to examine a safe fireplace program, as a method of burn prevention, in a resource-limited setting. We conducted a qualitative, phenomenological study at a community health and development program for a rural population in Kenya. Semi-structured, in-depth interviews were conducted with a purposive sample of community health workers involved with the safe fireplace program. Data were reviewed iteratively and coded independently by two researchers using NVivo 12. The study included five participants. Reflections from participants fell into three main domains: (1) effective methods of education, (2) strategies to incorporate stakeholders, and (3) implementation challenges. The results of this study emphasize the importance of community engagement in implementing a successful burn injury prevention program in a resource-limited setting. The participants involved in this study reported that rather than focusing on resources outside the community, effective methods of education and strategies for incorporating stakeholders depended on involving peers and community leaders. The challenges to the program were similarly specific to community concerns about resources and maintenance. These findings provide information to guide future community health programs in creating successful models for burn prevention strategies in resource-limited areas.
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Affiliation(s)
- Mary A Hunter
- Department of Surgery, Brown University/Rhode Island Hospital, Providence, RI, United States
| | - Kimutai Sylvester
- Department of Surgery, Tenwek Hospital, 3Brown University School of Public Health, Bomet, Kenya
| | - Camerin Rencken
- Department of Surgery, Brown University/Rhode Island Hospital, Providence, RI, United States
| | - Russell E White
- Department of Surgery, Brown University/Rhode Island Hospital, Providence, RI, United States
- Department of Surgery, Tenwek Hospital, 3Brown University School of Public Health, Bomet, Kenya
| | - David T Harrington
- Department of Surgery, Brown University/Rhode Island Hospital, Providence, RI, United States
| | - Patrick M Vivier
- Hassenfeld Child Health Innovation Institute/Brown University, Providence, RI, United States
| | - Robert K Parker
- Department of Surgery, Tenwek Hospital, 3Brown University School of Public Health, Bomet, Kenya
- Department of Surgery, Alpert Medical School of Brown University, Providence, RI, United States
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Chaabeni A, Kalai A, Dhouibi J, Ben Saad H, Jellad A. Designing a study on footballers' injuries in the 2024 African cup of nations competition (Ivory Coast). Tunis Med 2024; 102:70-73. [PMID: 38567470 DOI: 10.62438/tunismed.v102i2.4815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 01/29/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION To enhance players' performance and implement effective injury prevention protocols and surveillance programs in football, it is essential to conduct epidemiological studies. Since significant disparities in injury rates across various football competitions were reported, it is important to characterize injuries in the context of the African cup of nation (AFCON) competition. AIM To determine the incidence and factors associated with injuries among African footballers during the 2024 AFCON competition, which will be held in Ivory Coast from January 13 to February 11, 2024. METHODS Two expert physician in sports medicine will perform an analytical study (i.e.; a video-based analysis) of the 52 matches that will be played during the 2024 AFCON. The following parameters will be noted: i) Injury incidence, ii) Characteristics of injured players such as age, on-field position, and player league continent, iii) Characteristics ofinjuries such as mechanism, body location, moment of injury in terms of the minute of play and the round of the match, place of the injury in term of stadium zone, replacement consequent to the injury, absence next match, re-injury, recurrence of the injury with the same location during the competition, referee decision, and stoppage time for on-field injury, and iv) Characteristics of matches such as the match' schedule, ambient temperature, humidity, and wind speed. CONCLUSION This study will allow enriching the existing literature with additional data regarding the injuries and the players' characteristics in the African context.
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Affiliation(s)
- Amr Chaabeni
- Department of physical medicine and rehabilitation, Faculty of medicine, University of Monastir, Tunisia
| | - Amine Kalai
- Department of physical medicine and rehabilitation, Faculty of medicine, University of Monastir, Tunisia
- Research laboratory of technology and medical imaging - LR12ES06, Center for musculoskeletal biomechanics research, Faculty of medicine, University of Monastir, Tunisia
| | - Jaouher Dhouibi
- Department of physical medicine and rehabilitation, Faculty of medicine, University of Monastir, Tunisia
| | - Helmi Ben Saad
- University of Sousse, Farhat Hached Hospital, Research laboratory LR12SP09 "Heart Failure", Sousse, Tunisia
| | - Anis Jellad
- Department of physical medicine and rehabilitation, Faculty of medicine, University of Monastir, Tunisia
- Research laboratory of technology and medical imaging - LR12ES06, Center for musculoskeletal biomechanics research, Faculty of medicine, University of Monastir, Tunisia
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Bunstine JL, Yang J, Kistamgari S, Collins CL, Smith GA. Differences in Overuse Injuries in Gender-Comparable Sports: A Nationally Representative Sample of High School Athletes. J Athl Train 2024:498562. [PMID: 38243736 DOI: 10.4085/1062-6050-0040.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
CONTEXT Participation in high school sports has physical, physiological, and social development benefits, while increasing the risk of acute and overuse injuries. Risk of sports-related overuse injury differs between boys and girls. OBJECTIVE To investigate differences in overuse injuries among United States high school athletes participating in the gender-comparable sports of soccer, basketball, and baseball/softball. DESIGN Descriptive epidemiology study using a nationally representative sample from the High School Reporting Information Online (RIOTM) database. SETTING High schools. PATIENTS OR OTHER PARTICIPANTS Athletes with overuse injuries during the 2006-2007 through 2018-2019 academic years. MAIN OUTCOME MEASURES National estimates and rates of overuse injuries were extrapolated from weighted observed numbers (with the independent variables: sport, gender, academic year, class year, event type, body site, diagnosis, recurrence, activity, and position). RESULTS Among an estimated 908, 295 overuse injuries nationally, 43.9% (n=398,419) occurred in boys' soccer, basketball, and baseball, while 56.1% (n=509,876) occurred in girls' soccer, basketball, and softball. When comparing gender across sports, girls were more likely to sustain an overuse injury than boys (soccer: IRR: 1.37; 95% CI: 1.20-1.57; basketball: IRR: 1.82; 95% CI: 1.56-2.14; and baseball/softball: IRR: 1.21; 95% CI: 1.04-1.41). Most overuse injuries in soccer and basketball for both genders occurred to a lower extremity (soccer: 83.9% [175,369/209,071] for boys, 90.0% [243,879/271,092] for girls; basketball: 77.0% [59,239/76,884] for boys, 80.5% [81,826/101,709] for girls), while most overuse injuries in baseball and softball were to an upper extremity (72.5% [81,363/112,213] for boys, 53.7% [73,557/136,990] for girls). For boys' baseball, pitching (43.5% [47,007/107,984]) was the most common activity associated with an overuse injury, which differed from the most common activity of throwing (31.7% [39,921/126,104]) for girls' softball. CONCLUSIONS Gender differences observed in this study can help guide future strategies that are more specific to gender and sport to reduce overuse injuries among high school athletes.
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Affiliation(s)
- Josie L Bunstine
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Lincoln Memorial University DeBusk College of Osteopathic Medicine Knoxville, Knoxville, TN, USA
| | - Jingzhen Yang
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Sandhya Kistamgari
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Christy L Collins
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN, USA
| | - Gary A Smith
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
- Child Injury Prevention Alliance, Columbus, OH, USA
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Duan L, Yu M, Zhao M, Wu J. Enhancing Injury Prevention and Control in China: Establishment of Evidence System. China CDC Wkly 2023; 5:1063-1066. [PMID: 38047246 PMCID: PMC10689963 DOI: 10.46234/ccdcw2023.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 11/22/2023] [Indexed: 12/05/2023] Open
Affiliation(s)
- Leilei Duan
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Min Yu
- Center for Disease Control and Prevention of Zhejiang, Hangzhou City, Zhejiang Province, China
| | - Ming Zhao
- Center for Disease Control and Prevention of Zhejiang, Hangzhou City, Zhejiang Province, China
| | - Jing Wu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Malekpour MR, Ghamari SH, Ghasemi E, Hejaziyeganeh S, Abbasi-Kangevari M, Bhalla K, Rezaei N, Shahraz S, Dilmaghani-Marand A, Taghi Heydari S, Rezaei N, Lankarani KB, Farzadfar F. The effect of Real-Time feedback and incentives on speeding behaviors using Telematics: A randomized controlled trial. Accid Anal Prev 2023; 191:107216. [PMID: 37429155 DOI: 10.1016/j.aap.2023.107216] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 06/16/2023] [Accepted: 07/04/2023] [Indexed: 07/12/2023]
Abstract
Speeding behaviour of drivers is highly correlated to their tangible consequence. Therefore, this study aimed to evaluate the effectiveness of telematics-based feedback and financial incentives in reducing speeding behaviors through a randomized controlled field trial. This randomized controlled trial included four groups of (1) control, (2) information-only, (3) gain-of-reward, and (4) loss-of-reward. While drivers of the control group were unobtrusively monitored using telematics devices, drivers of the information-only group received real-time, weekly, and monthly feedback via text message. In both groups with financial incentives, in addition to receiving feedback, drivers could receive payments at the end of each month based on observed speeding. The primary outcome was the distance traveled at speeds more than 10% (S10 + ) above the posted speed limit as a proportion of the total traveled distance. A total of 397 male taxi drivers consented to participate in the study. After the stratified randomization, the mean age of the participant was 46.0 (95% Confidence Interval: 43.8 to 48.2), 47.0 (44.7 to 49.3), 46.1 (43.7 to 48.5), and 48.8 (46.5 to 51.1) years for the control, the information-only, the gain-of-reward, and the loss-of-reward groups, respectively. The mean S10 + rate per 100 km was 0.9 (0.5 to 1.2) for the control, 0.8 (0.4 to 1.1) for the information-only, 0.7 (0.3 to 1.1) for the gain-of-reward, and 1.3 (0.4 to 2.2) for the loss-of-reward group at the start of intervention. During the intervention phase, the loss-of-reward group with 0.6 (0.5 to 0.7) had the lowest mean of S10 + rate, followed by the gain-of-reward group with 0.8 (0.7 to 0.8). The loss-of-reward and gain-of-reward groups were the most influenced groups by the intervention, with 38.0% (13.2 to 55.7; p-value < 0.01) and 29.4% (2.0 to 49.2; p-value = 0.04) less S10 + rate than the control group, respectively. It was figured out that providing information regarding drivers' behavior without appropriating motives or penalties would have a minuscule impact.In addition, the group of drivers who were treated with instant punishment was the most influenced group by the intervention.
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Affiliation(s)
- Mohammad-Reza Malekpour
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyyed-Hadi Ghamari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Erfan Ghasemi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyedamirhossein Hejaziyeganeh
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Abbasi-Kangevari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kavi Bhalla
- Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeid Shahraz
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - Arezou Dilmaghani-Marand
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Taghi Heydari
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Kamran B Lankarani
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Ortmann N, Haddad YK, Beck L. Special Report from the CDC: Provider knowledge and practices around driving safety and fall prevention screening and recommendations for their older adult patients, DocStyles 2019. J Safety Res 2023; 86:401-408. [PMID: 37718068 DOI: 10.1016/j.jsr.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 06/30/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION Falls and motor-vehicle crashes (MVCs) are leading causes of unintentional injury deaths among older adults (65+) in the United States. Injury prevention resources exist to help healthcare providers reduce fall and MVC risk among older adult patients. However, awareness of these resources among healthcare providers is unclear. METHODS Questions were included in the 2019 DocStyles survey that assessed healthcare provider awareness of three injury prevention resources: (1) the American Geriatrics Society's (AGS's) Clinician's Guide to Assessing and Counseling Older Drivers, (2) the Clinical Assessment of Driving Related Skills (CADReS), and (3) the Centers for Disease Control and Prevention's (CDC) Stopping Elderly Accidents, Deaths, and Injuries (STEADI) initiative. We also explored the circumstances and current practices for counseling older adult patients on fall prevention and driving safety. RESULTS Only 20% of providers reported awareness of any of the injury prevention resources. Providers were more likely to report either screening for fall risk or unsafe driving when an older adult presented with a fall concern (74.5%) or driving concern or recent crash (85.1%), compared to annual screening for fall risk (67.7%) or driving safety (47.7%). More providers reported discussing the increased fall or MVC risk associated with patient medications, referring patient for driving fitness evaluations, or discussing alternative transportation options with the patient after adverse events or patient-initiated concerns compared to routine annual discussions. CONCLUSION Healthcare gaps persist in the screening and assessment of older adult risk factors for falls and unsafe driving. Limited provider awareness of clinical resources related to preventing older adult falls and unsafe driving may be contributing to these healthcare gaps. PRACTICAL APPLICATIONS Improving healthcare provider awareness of these resources could help them identify older adults at risk of a fall or MVC and promote injury prevention efforts in their clinical practices.
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Affiliation(s)
- Neil Ortmann
- Division of Injury Prevention, National Center of Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA; Cherokee Nation Operational Solutions, Atlanta, GA, USA.
| | - Yara K Haddad
- Division of Injury Prevention, National Center of Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Laurie Beck
- Division of Injury Prevention, National Center of Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Wagemans J, De Leeuw AW, Catteeuw P, Vissers D. Development of an algorithm-based approach using neuromuscular test results to indicate an increased risk for non-contact lower limb injuries in elite football players. BMJ Open Sport Exerc Med 2023; 9:e001614. [PMID: 37397264 PMCID: PMC10314682 DOI: 10.1136/bmjsem-2023-001614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2023] [Indexed: 07/04/2023] Open
Abstract
Objectives This retrospective cohort study explored an algorithm-based approach using neuromuscular test results to indicate an increased risk for non-contact lower limb injuries in elite football players. Methods Neuromuscular data (eccentric hamstring strength, isometric adduction and abduction strength and countermovement jump) of 77 professional male football players were assessed at the start of the season (baseline) and, respectively, at 4, 3, 2 and 1 weeks before the injury. We included 278 cases (92 injuries; 186 healthy) and applied a subgroup discovery algorithm. Results More injuries occurred when between-limb abduction imbalance 3 weeks before injury neared or exceeded baseline values (threshold≥0.97), or adduction muscle strength of the right leg 1 week before injury remained the same or decreased compared with baseline values (threshold≤1.01). Moreover, in 50% of the cases, an injury occurred if abduction strength imbalance before the injury is over 97% of the baseline values and peak landing force in the left leg 4 weeks before the injury is lower than 124% compared with baseline. Conclusions This exploratory analysis provides a proof of concept demonstrating that a subgroup discovery algorithm using neuromuscular tests has potential use for injury prevention in football.
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Affiliation(s)
- Jente Wagemans
- Department of Rehabilitation Science and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | | | | | - Dirk Vissers
- Department of Rehabilitation Science and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Malekpour F, Moeini B, Tapak L, Sadeghi-Bazargani H, Rezapur-Shahkolai F. Prediction of Seat Belt Use Behavior among Adolescents Based on the Theory of Planned Behavior. J Res Health Sci 2021; 21:e00536. [PMID: 36511232 PMCID: PMC8957667 DOI: 10.34172/jrhs.2021.71] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 10/18/2021] [Accepted: 10/09/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Road Traffic Injuries (RTIs) are the important causes of unintentional injuries and deaths. In this respect, seat belt wearing is an influential factor in reducing the mortality and severity of road traffic injuries. The rate of seat belt use among is lower adolescents, compared to adults. The present study aimed to investigate the influential factors on seat belt-weraing behavior among adolescent students as car occupants based on the Theory of Planned Behavior (TPB). STUDY DESIGN A cross-sectional design. METHODS This study was conducted among 952 adolescent students studying in grades 7, 8, and 9 in the schools of Tabriz, Iran, in the 2019-20 academic year. A researcher-made questionnaire was designed based on TPB for data collection, the validity and reliability of which have been confirmed. RESULTS The results indicated that the rate of seat belt use in the front seat inside the city was lower than that outside the city. Regarding TPB constructs, perceived behavioral control (β=0.137; 95% CI: 0.006-0.013; P<0.001), subjective norm (β=0.313; 95% CI: 0.021-0.032; P<0.001), and attitude (β=0.322; 95% CI: 0.034-0.053; P<0.001) had a significant and positive relationship with the intention of seat belt-wearing behavior. Moreover, the behavioral intention (β=0.571; 95% CI: 0.62-0.64; P<0.001) had a significantly positive relationship with seat belt-wearing behavior. CONCLUSION The Theory of Planned Behavior is appropriate to determine predictor factors of seat belt-weraing behavior among adolescent students as car occupants. In addition, the results of the present study may provide a theoretical basis for policy-making to improve adolescent students' seat belt use.
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Affiliation(s)
- Fatemeh Malekpour
- Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Babak Moeini
- Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
,Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Leili Tapak
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Science, Hamadan, Iran
,Noncommunicable Diseases Research Center, Hamadan University of Medical Science, Hamadan, Iran
| | | | - Forouzan Rezapur-Shahkolai
- Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
,Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
,Correspondence: Forouzan Rezapur-Shahkolai (PhD) Tel: +98 81 38380090 E-mail:
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Boserup B, Sutherland M, Paloka R, McKenney M, Elkbuli A. The Impact of Seatbelt Use on Trauma Outcomes in Adult Motor Vehicle Collision Patients With Rib Fractures: A National ACS-TQP-PUF Database Analysis. J Surg Res 2021; 270:376-385. [PMID: 34739997 DOI: 10.1016/j.jss.2021.06.067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 06/11/2021] [Accepted: 06/21/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Motor vehicle collisions (MVCs) are a leading cause of morbidity and mortality. However, there is limited evidence examining the effects seatbelt use has on MVC-related injuries and outcomes in patients with rib fractures. We aim to assess how seatbelt use affects associated injuries and outcomes in adult MVC patients with ≥2 rib fractures. METHODS This retrospective study utilized the American College of Surgeons (ACS) Trauma Quality Programs (TQP) Participant Use File (PUF) Database. Drivers/passengers who sustained ≥2 rib fractures following an MVC and had an AIS ≤2 for extra-thoracic body regions were analyzed. Patients were then subdivided by presence of flail chest into two cohorts, which were subdivided according to injury severity score (ISS) and seatbelt use. Logistic and linear regression was used to assess the impact of seatbelt use on outcomes. RESULTS Among both low and intermediate ISS classifications, restrained patients in the non-flail chest cohort had decreased incidence of pneumothorax, pulmonary contusion, and liver injury (P < 0.001). After adjusting for confounders, restrained patients (versus unrestrained) had decreased odds of pneumothorax (aOR = 0.91, P = <0.001) and acute respiratory distress syndrome (aOR=0.65, P = 0.02), while having increased odds of splenic laceration (aOR = 1.18, P = 0.003) (intermediate ISS group). Compared to unrestrained patients, restrained non-flail chest patients had a significantly decreased hospital length of stay (LOS) and intensive care unit LOS (P < 0.05). CONCLUSIONS Seatbelt use may be protective against serious injuries in patients with ≥2 rib fractures, resulting in improved outcomes. Education programs should be developed to bolster seatbelt compliance.
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Affiliation(s)
- Brad Boserup
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, Florida
| | - Mason Sutherland
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, Florida
| | - Rinald Paloka
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, Florida
| | - Mark McKenney
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, Florida; Department of Surgery, University of South Florida, Tampa, Florida
| | - Adel Elkbuli
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, Florida.
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Zarei M, Eshghi S, Hosseinzadeh M. The effect of a shoulder injury prevention programme on proprioception and dynamic stability of young volleyball players; a randomized controlled trial. BMC Sports Sci Med Rehabil 2021; 13:71. [PMID: 34193267 PMCID: PMC8246688 DOI: 10.1186/s13102-021-00300-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 06/21/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND The "FIFA 11 + Shoulder" programme has been reported to reduce the incidence of upper extremity injuries among soccer goalkeepers. It has also been recommended for overhead sports. The purpose of this study was therefore to investigate the effect of an 8-week "FIFA 11 + shoulder" (11 + S) programme on shoulder joint position sense (JPS), threshold to detect passive motion (TTDPM) and upper quarter Y Balance Test in young male volleyball players. METHODS Thirty-two healthy young elite male volleyball players (17.49 ± 1.47 years) participated in this quasi-experimental study. Participants, recruited from two clubs participating in Iranian premier league, were randomly assigned into two groups; (1) the intervention group who performed the "FIFA 11 + shoulder" programme as their warm up protocol, three times per week, and (2) the control group who kept their routine warm up protocol meanwhile. Proprioception tests including JPS and TTDPM of internal and external rotator muscles of the dominant shoulder were recorded via the isokinetic system pro 4. The upper quarter Y Balance Test determined the shoulder dynamic stability. RESULTS No statistically significant differences were observed for JPS and TTDPM of shoulder internal and external rotator muscles; shoulder stability however significantly increased only in the intervention group (p = 0.03, ηp2=0.02). CONCLUSION Upper quarter dynamic stability improvement due to the 11+S programme leads to volleyball players' performance and may therefore contribute to a reduction in risk of sustaining injury if applied long-term. TRIAL REGISTRATION The trial was retrospectively registered atIranian Registry of Clinical Trials with the number of IRCT20201030049193N1 at 04/12/2020.
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Affiliation(s)
- Mostafa Zarei
- Sport Rehabilitation and Health Department, Faculty of Sports Sciences and Health, Shahid Beheshti University, Velenjak Square, Evin, 1983963113 Tehran, Iran
| | - Saeed Eshghi
- Sport Rehabilitation and Health Department, Faculty of Sports Sciences and Health, Shahid Beheshti University, Velenjak Square, Evin, 1983963113 Tehran, Iran
| | - Mahdi Hosseinzadeh
- Department of Sport Injuries and Corrective Exercises, Sport Sciences Research Institute, Tehran, Iran
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Drury B, Peacock D, Moran J, Cone C, Ramirez-Campillo R. Effects of Different Inter-Set Rest Intervals during the Nordic Hamstring Exercise in Young Male Athletes. J Athl Train 2021; 56:952-959. [PMID: 33406234 DOI: 10.4085/318-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT The Nordic hamstring exercise (NHE) is known to reduce hamstrings injury (HIS) risk in athletes. In order to optimise the NHE it is important to understand how acute resistance training variables influence its performance. OBJECTIVE To examine the effects of different inter-set rest intervals (ISRI) on force indices during performance of the NHE. Design: Crossover Study. SETTING Laboratory based. PATIENTS OR PARTICIPANTS Ten (age = 20.7 ± 2.3 years; height = 179.4 ± 5.5 cm; body mass = 83.9 ± 12.4 kg) well-trained young male team-sport athletes. INTERVENTION Participants performed 2 x 6 repetitions of the NHE with either a SHORT (one-minute) or LONG (three-minute) ISRI. All sets were performed on the NordBord. MAIN OUTCOMES MEASURE(S) Peak force (N), average force (N), percent maintenance (%) and percent decline (%) were recorded for both dominant and non-dominant limbs as well as inter-limb force asymmetries (%) calculated. RESULTS Analyses revealed no statistically significant interactions or main effects (p > 0.05) between conditions and sets in all variables. However, analysis of individual repetitions showed significant reductions (p < 0.05, ES = 0.58-1.28) in peak force from repetition four onwards. CONCLUSIONS Our findings suggest that a one-minute ISRI is sufficient to maintain force production qualities and inter-limb asymmetries between sets during the NHE in well-trained athletes. However, practitioners should be aware of the potentially high decrements in peak force production that may occur within the set.
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Affiliation(s)
- Benjamin Drury
- 1Department of Applied Sport Sciences, Hartpury University, Hartpury, England, United Kingdom,
| | - Daniel Peacock
- 2Sport Science Department, Bristol City Football Club, Ashton Rd, Bristol, United Kingdom,
| | - Jason Moran
- 3School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, United Kingdom,
| | - Chris Cone
- 4Sport Science Department, Bristol Rovers Football Club, Filton Avenue, Bristol, United Kingdom,
| | - Rodrigo Ramirez-Campillo
- 5Laboratory of Human Performance. Quality of Life and Wellness Research Group. Department of Physical Activity Sciences, Universidad de Los Lagos, Osorno, Chile,
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Coogan SM, Schock CS, Hansen-Honeycutt J, Caswell S, Cortes N, Ambegaonkar JP. FUNCTIONAL MOVEMENT SCREEN™ (FMS™) SCORES DO NOT PREDICT OVERALL OR LOWER EXTREMITY INJURY RISK IN COLLEGIATE DANCERS. Int J Sports Phys Ther 2020; 15:1029-35. [PMID: 33344019 DOI: 10.26603/ijspt20201029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Purpose Dance is a physically demanding activity, with 50-85% of dancers suffering injury during a single performance season. The majority of dancers' injuries are in the lower extremity (LE) and chronic in nature. These injuries often arise when causal factors are not identified early and addressed before they ultimately result in an injury. Practitioners often use movement screens such as the Functional Movement Screen™ (FMS™) to detect and quantify kinetic chain dysfunction. Prior researchers have suggested that these screens can stratify at-risk individuals and allow practitioners to devise targeted interventions to reduce their injury risk. However, whether the FMS™ can identify at-risk dancers remains unclear. Thus, the purpose of this study was to examine whether FMS™ scores predicted injury risk in collegiate dancers. Methods In this prospective study, 43 collegiate dance majors (34 female, 9 male; 18.3 ± 0.7yrs; 163.9 ± 7.3cm; 60.8 ± 8.1kg) in a program which emphasizes modern dance were scored on the seven FMS™ movements (scale 0-3, total maximum score=21) where 3=movement completed without compensation, 2=movement completed, but with compensation(s), 1=unable to complete movement, 0=pain during movement or during clearing tests as described in prior literature at the start of the academic year. An in-house certified athletic trainer documented dancer's overall and LE injuries over an academic year (40 weeks). Separate Receiver Operator Characteristic (ROC) curve analyses examined whether composite FMS™ score predicted (1) Overall or (2) LE injury status. Results The subjects FMS™ scores were 16.2 + 1.7 (range=11-19). Twenty dancers were injured, whereas 23 remained injury-free. Injured dancers had 55 overall (1.28 injuries/dancer) and 44 LE injuries (1.02 LE injuries/dancer). FMS™ score did not predict overall (AUC=.28, SE=.08, p=.02, 95%CI=.13-.43) or LE injury risk (AUC=.38, SE=.1, p=.21, 95% CI=.21-.56). Discussion While nearly half of the dancers in this group suffered from injury over the year, composite FMS™ scores did not predict overall or LE injury risk in collegiate dancers. Dancers face unique and challenging physical demands that distinguish them from traditional sport-athletes including greater ranges of movement during performance. Thus, the FMS™ may not be sensitive enough to distinguish 'appropriate' from 'excessive' mobility and adequately identify injury risk in dancers. Overall, it is suggested that practitioners should use caution before using the FMS™ as a primary screening mechanism to identify collegiate dancers at overall or LE injury risk. Level of Evidence 2.
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Short S, Tuttle M. THE GAP BETWEEN RESEARCH AND CLINICAL PRACTICE FOR INJURY PREVENTION IN ELITE SPORT: A CLINICAL COMMENTARY. Int J Sports Phys Ther 2020; 15:1229-34. [PMID: 33344038 DOI: 10.26603/ijspt20201229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
As clinicians strive to apply evidence-based principles, team-based practitioners have identified a large gap as it relates to published research, ideal applications of evidence-based practice, and actual clinical practice related to injury prevention in elite sport within the United States. For rehabilitation professionals, especially those intimately involved in the research of injury prevention, the solution often seems quite clear and defined. However, preventing injury by implementing the latest recommendation from the most recent prospective study on the using the FIFA 11 + warm-up, a Copenhagen Adduction exercise, or a plyometric drill with elite athletes may not be as effective as was seen among the cohort used in the study. In addition to extrapolating research, clinicians face additional challenges such as variance among professions, schedule density, and off-season contacts with athletes. There is an inherent difficulty in the application of research to practice in elite sport as it relies on the teamwork of not only the practitioner and athlete, but the entire sporting organizational structure and those involved in athlete participation. The purpose of this clinical commentary is to explore the difficulty with application of research in clinical practice and to discuss potential strategies for improving carry over from research to clinical practice.
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Poploski KM, Picha KJ, Winters JD, Royer SD, Heebner NR, Lambert B, Lephart SM, Abt JP. INFLUENCE OF LIMB DOMINANCE AND SHOULDER INJURY ON STRENGTH AND EXPLOSIVE FORCE IN US MARINES. Int J Sports Phys Ther 2020; 15:1129-40. [PMID: 33344030 DOI: 10.26603/ijspt20201129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background The specialized roles of many military personnel require specific skills and high physical demands, placing unique stresses on the shoulders and increasing risk of injury. As normal dominant/nondominant shoulder asymmetries have been established in military personnel, bilateral strength comparisons must be understood in context of daily physical demands to monitor patients' progress or readiness to return to duty. Purpose This study aims to assess bilateral differences in strength and explosive force in United States Marines with a history of dominant or nondominant shoulder pathology. Study Design Cross-Sectional. Methods A total of 52 full-duty, male US Marines with a shoulder injury within the prior year participated. Bilateral isokinetic shoulder internal (IR) and external (ER) rotation strength, and peak force (Peak Force) and average rate of force production (Avg Rate) during an explosive push-up were collected. Dominant versus nondominant side data were independently examined within each group (DOM: dominant injury, NOND: nondominant injury). Comparison between DOM and NOND, as well as previously published CON (no history of shoulder injury) was also completed. Results NOND (n = 26) demonstrated significantly less IR (p < 0.001) and ER (p = 0.003) strength and Peak Force (p = 0.001) and Avg Rate (p = 0.047) on the injured side, while DOM (n = 26) demonstrated no bilateral differences in strength or push-up performance. Comparison between the three groups showed that NOND demonstrated significantly less ER strength than CON (p = 0.022). Conclusions Military personnel demonstrate asymmetric strength patterns likely due to increased demand of the dominant shoulder. US Marines with a history of injury to the nondominant shoulder performed differently than those with a dominant side injury, presenting with both strength and push-up asymmetries. They also demonstrated significant ER strength deficits compared to CON. Common clinical practice and previous literature often compare injured and uninjured limbs or injured individuals to healthy controls, but further distinction of dominant or nondominant side may provide more accurate information needed to develop targeted treatment strategies. Clinical Relevance Recognizing unique occupational demands and how patients may present differently with dominant versus nondominant side shoulder injuries are important considerations for ensuring accurate assessment and effective individualized rehabilitation. Level of Evidence 3.
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16
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Schmitz E, Figueira S, Lampron J. Injury Prevention in Medical Education: A Systematic Literature Review. J Surg Educ 2019; 76:700-710. [PMID: 30466883 DOI: 10.1016/j.jsurg.2018.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 09/14/2018] [Accepted: 10/08/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Traumatic injury is the first cause of death for Canadians aged 1 to 44 years old. To reduce the global burden of injury, the need for healthcare professionals with injury prevention proficiency is growing. The aim of this study was to review the literature to identify and analyze current injury prevention curriculums amongst medical undergraduate and residency programs. DESIGN A systematic literature review (no date restriction was used) was conducted using Embase, Medline, ERIC, and CINAHL. Three reviewers independently selected studies, extracted data, checked accuracy, assessed risk of bias, and assessed quality. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guideline was followed. The study was registered with PROSPERO, #CRD42016048805. PARTICIPANTS Articles were included if they were peer-reviewed, published in the English language, and reported data on injury prevention and control curriculum. RESULTS Eight hundred and twenty-four articles were identified with the initial search strategy. Internal consistency reliability, generalizability, evidence for content, criterion-related and construct validity was performed. The systematic review synthesized the characteristics (population, intervention type, outcome measures) described in the literature. This review is the first step in identifying gaps in injury prevention teaching and curriculums for medical students and residents. CONCLUSION The number of studies reporting the incidence and/or effectiveness of injury prevention and control curriculum is limited across the literature. Therefore, there is a knowledge gap in providing injury prevention education. Given that physicians play a vital role in the prevention or control of injuries, further development of medical undergraduate and residency programs to include core concepts of injury prevention would be unquestionably paramount.
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Affiliation(s)
- Erika Schmitz
- University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada.
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17
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Vriend I, Gouttebarge V, Finch CF, van Mechelen W, Verhagen EALM. Intervention Strategies Used in Sport Injury Prevention Studies: A Systematic Review Identifying Studies Applying the Haddon Matrix. Sports Med 2018; 47:2027-2043. [PMID: 28303544 PMCID: PMC5603636 DOI: 10.1007/s40279-017-0718-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Prevention of sport injuries is crucial to maximise the health and societal benefits of a physically active lifestyle. To strengthen the translation and implementation of the available evidence base on effective preventive measures, a range of potentially relevant strategies should be considered. OBJECTIVE Our aim was to identify and categorise intervention strategies for the prevention of acute sport injuries evaluated in the scientific literature, applying the Haddon matrix, and identify potential knowledge gaps. METHODS Five electronic databases were searched (PubMed, EMBASE, SPORTDiscus, CINAHL, Cochrane) for studies that evaluated the effect of interventions on the occurrence of acute sport injuries. Studies were required to include a control group/condition, prospective data collection, and a quantitative injury outcome measure. RESULTS A total of 155 studies were included, mostly randomised controlled trials (43%). The majority of studies (55%) focussed on strategies requiring a behavioural change on the part of athletes. Studies predominantly evaluated the preventive effect of various training programmes targeted at the 'pre-event' phase (n = 73) and the use of equipment to avoid injury in the 'event phase' (n = 29). A limited number of studies evaluated the preventive effect of strategies geared at rules and regulations (n = 14), and contextual modifications (n = 18). Studies specifically aimed at preventing re-injuries were a minority (n = 8), and were mostly related to ankle sprains (n = 5). CONCLUSIONS Valuable insight into the extent of the evidence base of sport injury prevention studies was obtained for 20 potential intervention strategies. This approach can be used to monitor potential gaps in the knowledge base on sport injury prevention.
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Affiliation(s)
- Ingrid Vriend
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health and Safety in Sports, IOC Research Center, AMC/VUmc, Amsterdam, The Netherlands.,Consumer Safety Institute VeiligheidNL, Amsterdam, The Netherlands
| | - Vincent Gouttebarge
- Amsterdam Collaboration on Health and Safety in Sports, IOC Research Center, AMC/VUmc, Amsterdam, The Netherlands.,Consumer Safety Institute VeiligheidNL, Amsterdam, The Netherlands.,Division of Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Caroline F Finch
- Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Australia
| | - Willem van Mechelen
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health and Safety in Sports, IOC Research Center, AMC/VUmc, Amsterdam, The Netherlands.,School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia.,Division of Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Evert A L M Verhagen
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands. .,Amsterdam Collaboration on Health and Safety in Sports, IOC Research Center, AMC/VUmc, Amsterdam, The Netherlands. .,Division of Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. .,Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Australia.
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18
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Sedain B, Pant PR. Status of drowning in Nepal: A study of central police data. F1000Res 2018; 7:576. [PMID: 30467520 PMCID: PMC6113885 DOI: 10.12688/f1000research.14563.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/03/2018] [Indexed: 09/29/2023] Open
Abstract
Background: Drowning is a serious and mostly preventable injury-related cause of death. Low-and-middle income countries represent 90% of total drowning deaths worldwide. There is lack of epidemiological studies of drowning in Nepal. The aim of this paper is to describe the status of drowning in Nepal. Methods: Cases of drowning, occurring between January 2013 and December 2015 were extracted from the Daily Incident Recording System of Nepal Police. Variables on age, sex of the deceased, types of water bodies, places, season when drowning occurred and activities of deceased were extracted and descriptive analysis was done. Results: A total of 1,507 drowning cases were recorded over a 3 year period. The rate of drowning was 1.9 per 100,000 (2.95 for males and 0.92 for females). Majority of drowning occurred among males (76%) and more than half were (53%) under 20 years of age. Mostly drowning occurred in rivers (natural water bodies). The findings provide strong indication that drowning occurs throughout the year in Nepal. Children were highly vulnerable to drowning. The magnitude of drowning was found to be lower than estimated by global burden of disease (GBD) study. Conclusion: The burden of drowning in Nepal is considerable, but mostly unknown to the public. Despite only having access to a limited data source, this study provides useful evidence that comprehensive research in Nepal is needed urgently.
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Affiliation(s)
- Bhagabati Sedain
- Padma Kanya Multiple Campus, Tribhuvan University, Kathmandu, Nepal
| | - Puspa Raj Pant
- Centre for Child and Adolescent Health, University of the West of England, Bristol, UK
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19
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Abstract
Background: Drowning is a serious and mostly preventable injury-related cause of death. Low-and-middle income countries represent over 90% of total drowning deaths worldwide. There is lack of epidemiological studies of drowning in Nepal. The aim of this paper is to describe the status of drowning in Nepal. Methods: Cases of drowning, occurring between 1 January 2013 and 31 December 2015 were extracted from the Daily Incident Recording System of Nepal Police. Drowning cases were extracted and analysed regardless of their intent. Variables on age, sex of the deceased, types of water bodies, geographical locations, season when drowning occurred and activities of deceased were extracted and descriptive analysis was conducted. Results: A total of 1,507 drowning cases were recorded over a 3 year period. The rate of drowning was 1.9 per 100,000 (2.95 for males and 0.92 for females). Majority of drowning occurred among males (76%) and more than half were (53%) under 20 years of age. Mostly drowning occurred in rivers (natural water bodies). The findings provide strong indication that drowning occurs throughout the year in Nepal. Children were highly vulnerable to drowning. The magnitude of drowning was found to be lower than estimated by global burden of disease (GBD) study. Conclusion: The burden of drowning in Nepal is considerable, but mostly unknown to the public. Despite only having access to a limited data source, this study provides useful evidence that comprehensive research in Nepal is needed urgently.
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Affiliation(s)
- Bhagabati Sedain
- Padma Kanya Multiple Campus, Tribhuvan University, Kathmandu, Nepal
| | - Puspa Raj Pant
- Centre for Child and Adolescent Health, University of the West of England, Bristol, UK
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Farquhar M. Fifteen-minute consultation: problems in the healthy paediatrician-managing the effects of shift work on your health. Arch Dis Child Educ Pract Ed 2017; 102:127-132. [PMID: 27986787 DOI: 10.1136/archdischild-2016-312119] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 11/21/2016] [Accepted: 11/23/2016] [Indexed: 01/09/2023]
Abstract
"You're not healthy unless your sleep is healthy"Professor William Dement, Stanford University, one of the founders of modern sleep medicineSleep is fundamental to good health. Healthcare professionals receive little teaching on the importance of sleep, particularly with respect to their own health when working night shifts. Knowledge of basic sleep physiology, together with simple strategies to improve core sleep and the ability to cope with working nights, can result in significant improvements both for healthcare professionals and for the patients they care for.
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Emond A, Sheahan C, Mytton J, Hollén L. Developmental and behavioural associations of burns and scalds in children: a prospective population-based study. Arch Dis Child 2017; 102:428-483. [PMID: 28424177 PMCID: PMC6234232 DOI: 10.1136/archdischild-2016-311644] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 10/15/2016] [Accepted: 10/23/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate child developmental and behavioural characteristics and risk of burns and scalds. DESIGN Data on burns in children up to 11 years from 12 966 participants in the Avon Longitudinal Study of Parents and Children were linked to developmental profiles measured before the burn injury. MEASURES Preinjury profiles of the children derived from maternal questionnaires completed in pregnancy, and at 6, 18, 42, 47 and 54 months. Injury data collected by questionnaire at 6, 15 and 24 months and 3.5, 4.5, 5.5, 6.5, 8.5 and 11 years of age. RESULTS Incidence: Burn rates were as follows: birth-2 years 71.9/1000/year; 2-4.5 years 42.2/1000/year; 5-11 years 14.3/1000/year. Boys <2 years were more likely to sustain burns, and girls had more burns between age 5 and 11 years. Medical attention was sought for 11% of burn injuries. Development: Up to age 2 years, burns were more likely in children with the most advanced gross motor developmental scores and the slowest fine motor development. Children with coordination problems at 4.5 years of age had increased risk of burns between 5 and 11 years. No associations were observed with cognitive skills. Behaviour: At 3.5 years, the Strengths and Difficulties Questionnaire scores and reported frequent temper tantrums predicted subsequent burns in primary school age. After adjustment for confounders, burns in the preschool period were related to gender and motor development, and in school-aged children, to frequent temper tantrums, hyperactivity and coordination difficulties. CONCLUSION Child factors associated with increased risk of burns were male gender in infancy and female gender at school age, advanced gross motor development, coordination difficulties, hyperactivity and problems with emotional regulation.
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Affiliation(s)
- Alan Emond
- Scar Free Foundation Children's Burns Research Centre, University of Bristol, Bristol, UK
| | - Clare Sheahan
- Centre for Child and Adolescent Health, University of Bristol, Bristol, UK
| | - Julie Mytton
- Centre for Child and Adolescent Health, University of the West of England, Bristol, UK
| | - Linda Hollén
- Scar Free Foundation Children's Burns Research Centre, University of Bristol, Bristol, UK
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22
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Arya R, Williams G, Kilonback A, Toward M, Griffin M, Blair PS, Fleming P. Is the infant car seat challenge useful? A pilot study in a simulated moving vehicle. Arch Dis Child Fetal Neonatal Ed 2017; 102:F136-F141. [PMID: 27694399 PMCID: PMC5339573 DOI: 10.1136/archdischild-2016-310730] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 06/23/2016] [Accepted: 06/27/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND OBJECTIVE The American Academy of Pediatrics recommends that preterm infants complete a predischarge 'car seat challenge' observation for cardiorespiratory compromise while in a car seat. This static challenge does not consider the more upright position in a car or the vibration of the seat when the car is moving. This pilot study was designed to assess the cardiorespiratory effects of vibration, mimicking the effect of being in a moving car, on preterm and term infants. METHODS A simulator was designed to reproduce vertical vibration similar to that in a rear-facing car seat at 30 mph. 19 healthy newborn term and 21 preterm infants, ready for hospital discharge, underwent cardiorespiratory measurements while lying flat in a cot (baseline), static in the seat (30°), simulator (40°) and during motion (vibration 40°). RESULTS Median test age was 13 days (range 1-65 days) and median weight was 2.5 kg (IQR: 2.1-3.1 kg).Compared with baseline observations, only the total number of desaturations was significantly increased when infants were placed at 30° (p=0.03). At 40°, or with vibration, respiratory and heart rates increased and oxygen saturation decreased significantly. Profound desaturations <85% significantly increased during motion, regardless of gestational age. CONCLUSIONS This is the first study to assess the effect of motion on infants seated in a car safety seat. Term and preterm infants showed significant signs of potentially adverse cardiorespiratory effects in the upright position at 40°, particularly with simulated motion, not identified in the standard challenge. A larger study is required to investigate the significance of these results.
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Affiliation(s)
- Renu Arya
- Department of Paediatrics, Great Western Hospitals NHS Foundation Trust, Swindon, UK
| | - Georgina Williams
- Department of Paediatrics, Great Western Hospitals NHS Foundation Trust, Swindon, UK
| | - Anna Kilonback
- Department of Paediatrics, Great Western Hospitals NHS Foundation Trust, Swindon, UK
| | - Martin Toward
- Institute of Sound and Vibration Research, University of Southampton, Southampton, UK
| | - Michael Griffin
- Institute of Sound and Vibration Research, University of Southampton, Southampton, UK
| | - Peter S Blair
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Peter Fleming
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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Lea CL, Smith-Collins A, Luyt K. Protecting the premature brain: current evidence-based strategies for minimising perinatal brain injury in preterm infants. Arch Dis Child Fetal Neonatal Ed 2017; 102:F176-F182. [PMID: 28011793 DOI: 10.1136/archdischild-2016-311949] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 11/22/2016] [Accepted: 12/01/2016] [Indexed: 11/04/2022]
Abstract
Improving neurodevelopmental outcome for preterm infants is an important challenge for neonatal medicine. The disruption of normal brain growth and neurological development is a significant consequence of preterm birth and can result in physical and cognitive impairments. While advances in neonatal medicine have led to progressively better survival rates for preterm infants, there has only been a modest improvement in the proportion of surviving infants without neurological impairment, and no change in the proportion with severe disability. The overall number of children with neurodisability due to prematurity is increasing. Trials investigating novel therapies are underway and many have promising early results; however, in the interim, current treatments and management strategies that have proven benefit for neurodevelopment or reduction in neonatal brain injury are often underutilised. We collate the evidence for the efficacy of such interventions, recommended by guidelines or supported by large meta-analysis or randomised control trials. We address controversies that have hindered uptake and problems with translating research into practice. We then look to the future of preterm neuroprotective care.
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Affiliation(s)
- Charlotte L Lea
- Department of Neonatal Neuroscience, St Michael's Hospital, Bristol, UK.,School of Clinical Sciences, University of Bristol, Bristol, UK
| | - Adam Smith-Collins
- Department of Neonatal Neuroscience, St Michael's Hospital, Bristol, UK.,School of Clinical Sciences, University of Bristol, Bristol, UK
| | - Karen Luyt
- Department of Neonatal Neuroscience, St Michael's Hospital, Bristol, UK.,School of Clinical Sciences, University of Bristol, Bristol, UK
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Abstract
Road traffic injuries (RTI) impose a substantial health burden among children. Globally, 186 300 children (under 18 years) die from RTI each year. It is the fourth leading cause of death among children aged 5-9 years, third among children aged 10-14 years and first among children aged 15-17 years. At the regional level, sub-Saharan Africa accounts for 35.2% of global child deaths caused by RTI; that number is still increasing. Male children are about two times more likely to die due to RTI than female children. RTI are also related to socioeconomic inequalities; low-income and middle-income countries (LMIC) account for 95% of global child RTI deaths, and children from poor households are more likely to fall victims to RTI. Intervention strategies promoted in the five pillars of the Decade of Action for Road Safety 2011-2020 are available to prevent mortality and morbidity caused by RTI, though validation and implementation of such interventions are urgently needed in the LMIC. Through concerted efforts to cultivate strong political will, build action and advocacy capacity, increase global funding and enhance multisectoral collaboration promoted by the Sustainable Development Goals, the world is challenged to do better in saving children from RTI.
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Affiliation(s)
- Qingfeng Li
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Olakunle Alonge
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Adnan A Hyder
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
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25
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Shams Vahdati S, Rajaei Ghafouri R, Razavi S, Mazouchian H. Bicycle-Related Injuries Presenting to Tabriz Imam Reza Hospital, Iran. Trauma Mon 2016; 21:e20856. [PMID: 27626000 PMCID: PMC5003494 DOI: 10.5812/traumamon.20856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Revised: 10/09/2014] [Accepted: 11/24/2014] [Indexed: 11/16/2022] Open
Abstract
Background Rising fuel cost and subsequent increase in transportation prices encourage people to use cheap transportation such as a bicycle. This vehicle can also be used for sports and recreation. Bicycles are widely used in Iran, like other countries. There is not enough data about bicycle-related traumas in our country. Objectives The aim of this study was to obtain the epidemiology of this type of injury in Tabriz Imam Reza Hospital as a referral center in northwest of Iran during 2009 to 2012. Materials and Methods One hundred bicycle-related patients during the three years were entered in this descriptive cross-sectional study. Patient’s demographics, place and time of crash, mechanism of trauma, helmet and other safety device usage, and disposition information were gathered by a researcher-made checklist. Admission rate and ward as well as the site of injuries were also collected. The data were analyzed by SPSS 16 software using descriptive statistics. Results All the patients were males with a mean age of 31.3 ± 23.12. Seventy six bicycle-related injuries occurred during weekdays and 24 happened on holidays; 71 patients attended the emergency department in the morning and 29 at night. Only three of 100 cyclists had helmets during the accident. The rates of injuries were as follows: 65 head and face, 20 abdomen, 14 chest, 11 soft tissue, eight lower limb, eight cervical spine, six upper limb, four thoracic and lumbar spine, and three pelvis injuries. Conclusions Head and face are the most common sites of injury and skull fracture is the most common one. Considering the preventable entity of trauma, the use of helmets seems to be beneficial to prevent most bicycle-related injuries.
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Affiliation(s)
- Samad Shams Vahdati
- Medical Education Research Centre, Tabriz University of Medical Sciences, Tabriz, IR Iran
- Emergency Medicine Department, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | | | - Sajjad Razavi
- Emergency Medicine Department, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Hossein Mazouchian
- Medical Education Research Centre, Tabriz University of Medical Sciences, Tabriz, IR Iran
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, IR Iran
- Corresponding author: Hossein Mazouchian, Student Research Committee, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel/Fax: +98-4133366581, E-mail:
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26
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Gerry F, Rowland A, Fowles S, Smith S, Hodes D, Creighton S. Failure to evaluate introduction of female genital mutilation mandatory reporting. Arch Dis Child 2016; 101:778-9. [PMID: 27281454 DOI: 10.1136/archdischild-2016-311000] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/20/2016] [Indexed: 11/03/2022]
Affiliation(s)
- Felicity Gerry
- Queen's Counsel in London and Darwin, specialising in FGM law School of Law, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Andrew Rowland
- Pennine Acute Hospitals NHS Trust, Manchester, UK University of Salford, Salford, UK
| | - Sam Fowles
- University of Birmingham, Birmingham, UK University of London Institute in Paris, Paris, France
| | - Suzanne Smith
- Pennine Acute Hospitals NHS Trust, Manchester, UK University of Huddersfield, Huddersfield, UK
| | - Deborah Hodes
- University College London Hospitals NHS Foundation Trust, London, UK Royal Free London NHS Foundation Trust, London, UK
| | - Sarah Creighton
- University College London Hospitals NHS Foundation Trust, London, UK
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27
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Trefan L, Houston R, Pearson G, Edwards R, Hyde P, Maconochie I, Parslow RC, Kemp A. Epidemiology of children with head injury: a national overview. Arch Dis Child 2016; 101:527-532. [PMID: 26998632 PMCID: PMC4893082 DOI: 10.1136/archdischild-2015-308424] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 11/05/2015] [Accepted: 11/11/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND The National Confidential Enquiry describes the epidemiology of children admitted to hospital with head injury. METHOD Children (<15 years old) who died or were admitted for >4 h with head injury were identified from 216 UK hospitals (1 September 2009 to 28 February 2010). Data were collected using standard proformas and entered on to a database. A descriptive analysis of the causal mechanisms, child demographics, neurological impairment, CT findings, and outcome at 72 h are provided. RESULTS Details of 5700 children, median age 4 years (range 0-14.9 years), were analysed; 1093 (19.2%) were <1 year old, 3500 (61.4%) were boys. There was a significant association of head injury with social deprivation 39.7/100 000 (95% CI 37.0 to 42.6) in the least deprived first quintile vs. 55.1 (95% CI 52.1 to 58.2) in the most deprived fifth quintile (p<0.01). Twenty-four children died (0.4%). Most children were admitted for one night or less; 4522 (79%) had a Glasgow Coma Scale score of 15 or were Alert (on AVPU (Alert, Voice, Pain, Unresponsive)). The most common causes of head injury were falls (3537 (62.1%); children <5 years), sports-related incidents (783 (13.7%); median age 12.4 years), or motor vehicle accidents (MVAs) (401 (7.1%); primary-school-aged children). CT scans were performed in 1734 (30.4%) children; 536 (30.9%) were abnormal (skull fracture and/or intracranial injury or abnormality): 269 (7.6%) were falls, 82 (10.5%) sports related and 100 (25%). A total of 357 (6.2%) children were referred to social care because of child protection concerns (median age 9 months (range 0-14.9 years)). CONCLUSIONS The data described highlight priorities for targeted age-specific head injury prevention and have the potential to provide a baseline to evaluate the effects of regional trauma networks (2012) and National Institute of Health and Care Excellence (NICE) head injury guidelines (2014), which were revised after the study was completed.
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Affiliation(s)
- L Trefan
- College of Biomedical and Life Sciences, School of Medicine, Cardiff University, Cardiff, Wales, UK
| | - R Houston
- Placements Manager at Kids Company, London, UK
| | - G Pearson
- Birmingham Children's Hospital, Birmingham, UK
| | - R Edwards
- Department of Neurosurgery, Bristol Hospital for Children, Bristol, UK
| | - P Hyde
- Paediatric Intensive Care Unit, Southampton Children's Hospital, Southampton, UK
| | - I Maconochie
- Imperial College NHS Healthcare Trust, London, UK
| | - R C Parslow
- Leeds Institute of Cardiovascular and Metabolic Medicine, School of Medicine, University of Leeds, Leeds, UK
| | - A Kemp
- College of Biomedical and Life Sciences, School of Medicine, Cardiff University, Cardiff, Wales, UK
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28
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Hughes J, Maguire S, Jones M, Theobald P, Kemp A. Biomechanical characteristics of head injuries from falls in children younger than 48 months. Arch Dis Child 2016; 101:310-5. [PMID: 26384509 DOI: 10.1136/archdischild-2014-306803] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 05/10/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND A fall-height threshold is important when evaluating the likelihood of structural head injury or abusive head trauma. This study investigates witnessed falls to correlate the fall characteristics with the extent of injury. METHOD Case-control study of children aged ≤48 months who attended one hospital following a fall from <3 m (10 ft), comparing cases who sustained a skull fracture or intracranial injury (ICI) with controls, who had minor head injuries. Characteristics included: the mechanism of injury, surface of impact, site of impact to the head and fall height. RESULTS Forty-seven children had a skull fracture or ICI, while 416 children had minor head injuries. The mean fall height for minor head injuries was significantly lower than that causing skull fracture/ICI (p<0.001). No skull fracture/ICI was recorded in children who fell <0.6 m (2 ft), based on the height of the head centre of gravity. Skull fractures/ICI were more likely in children aged ≤12 months (p<0.001) from impacts to the temporal/parietal or occipital region (p<0.001), impacts onto wood (p=0.004) and falls from a carer's arms, particularly when on stairs (p<0.001). No significant difference was reported between the mean fall heights of children who had a simple skull fracture (n=17) versus those who had a complex fracture or ICI (n=30). CONCLUSIONS An infant is more likely to sustain a skull fracture/ICI from a fall above a 0.6 m (2 ft) threshold, based on the height of the head centre of gravity, or with a parietal/temporal or occipital impact. These variables should be recorded when evaluating the likelihood of skull fracture/ICI.
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Affiliation(s)
- Jonathon Hughes
- Institute of Medical Engineering and Medical Physics, Cardiff School of Engineering, Cardiff University, Cardiff, UK
| | - Sabine Maguire
- Institute of Primary Care and Public Health, Cardiff School of Medicine, Cardiff, UK
| | - Michael Jones
- Institute of Medical Engineering and Medical Physics, Cardiff School of Engineering, Cardiff University, Cardiff, UK
| | - Peter Theobald
- Institute of Medical Engineering and Medical Physics, Cardiff School of Engineering, Cardiff University, Cardiff, UK
| | - Alison Kemp
- Institute of Primary Care and Public Health, Cardiff School of Medicine, Cardiff, UK
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29
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Marlow R, Mytton J, Maconochie IK, Taylor H, Lyttle MD. Trends in admission and death rates due to paediatric head injury in England, 2000-2011. Arch Dis Child 2015; 100:1136-40. [PMID: 26272910 DOI: 10.1136/archdischild-2015-308615] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 07/25/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND The number of children admitted to hospital is increasing year on year, with very short-stay admissions doubling in the last decade. Childhood head injury accounts for half a million emergency department attendances in the UK every year. The National Institute for Health and Care Excellence (NICE) has issued three iterations of evidence-based national guidance for head injury since 2003. OBJECTIVES To assess if any changes in the rates of admission, death or causes of head injury could be temporally associated with the introduction of sequential national guidelines by longitudinal analysis of the epidemiology of paediatric head injury admissions in England from 2000 to 2011. METHODS Retrospective analysis of English Hospital Episode Statistics data of children under the age of 16 years old admitted to hospital with the discharge diagnosis of head injury. RESULTS The number of hospital admissions with paediatric head injury in England rose by 10% from 34 150 in 2000 to 37 430 in 2011, with the proportion admitted for less than 1 day rising from 38% to 57%. The main cause of head injury was falls (42-47%). Deaths due to head injury decreased by 52% from 76 in 2000 to 40 in 2011. Road traffic accidents were the main cause of death in the year 2000 (67%) but fell to 40% by 2011. In 2000, children who were admitted or died from head injuries were more than twice as likely to come from the most deprived homes compared with least deprived homes. By 2011, the disparity for risk of admission had narrowed, but no change was seen for risk of death. CONCLUSIONS Temporal relationships exist between implementation of NICE head injury guidance and increased admissions, shorter hospital stay and reduced mortality. The underlying cause of this association is likely to be multifactorial.
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Affiliation(s)
- Robin Marlow
- Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Bristol, UK School of Clinical Sciences, University of Bristol, UK
| | - Julie Mytton
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Ian K Maconochie
- Emergency Department, St Mary's Hospital, Imperial College NHS Healthcare Trust, London, UK
| | - Hazel Taylor
- Research and Innovation, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Mark D Lyttle
- Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Bristol, UK Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
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30
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Busse H, Harrop T, Gunnell D, Kipping R. Prevalence and associated harm of engagement in self-asphyxial behaviours ('choking game') in young people: a systematic review. Arch Dis Child 2015; 100:1106-14. [PMID: 26111816 PMCID: PMC4680200 DOI: 10.1136/archdischild-2015-308187] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 05/21/2015] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To assess the prevalence of engagement in self-asphyxial (risk-taking) behaviour (SAB) ('choking game') and associated morbidity and mortality in children and young people up to age 20. DESIGN Systematic literature review. SEARCH STRATEGY Electronic database search of MEDLINE, Embase, PsycINFO, CINAHL, PubMed, Web of Science Core Collection, BIOSIS citation index and the Cochrane register with no language or date limits applied. References of key papers were reviewed, and experts were contacted to identify additional relevant papers. ELIGIBILITY CRITERIA Systematic reviews, cross-sectional, cohort and case-control studies, and case reports examining SAB with regard to individuals aged 0-20 years, without explicitly stated autoerotic, suicidal or self-harm intentions were included. RESULTS Thirty-six relevant studies were identified, and SAB was reported in 10 countries. In North America, France and Colombia, awareness of SAB ranged from 36% to 91% across studies/settings, and the median lifetime prevalence of engagement in SAB was 7.4%. Six studies identified the potential for SAB to be associated with engagement in other risk behaviours. Ninety-nine fatal cases were reported. Of the 24 cases described in detail, most occurred when individuals engaged in SAB alone and used a ligature. CONCLUSIONS The current evidence on SAB among young people is limited, and stems predominantly from North America and France. Awareness of SAB among young people is high, and engagement varies by setting. Further research is needed to understand the level of risk and harm associated with SAB, and to determine the appropriate public health response.
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Affiliation(s)
- H Busse
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - T Harrop
- Independent Public Health Doctor
| | - D Gunnell
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - R Kipping
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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31
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Abstract
During the last decade, there has been a significant increase in the number of magnetic toys available for children. Two or more magnets separate from each other along the gastrointestinal course can attract each other across bowel walls, resulting in pressure necrosis, bowel perforations and fistulas formation. This has led to an increasing number of case reports describing serious complications from ingesting more than one magnet. We report the ingestion of a large number of magnets from one toy (>60 pieces). Our patient presented with generalised peritonitis and shock. During emergency laparotomy, she was found to have gross abdominal contamination with multiple bowel perforations and fistulae. This report emphasises the danger of such toys and how important that parents, physicians and manufacturers are aware of such fatal hazards that can arise from 'unsupervised' ingestion of these 'nice-looking' toys.
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Affiliation(s)
- Mohamed Sameh Shalaby
- Department of Paediatric Surgery, Bristol Royal Children's Hospital, Bristol, UK Department of Paediatric Surgery, Ain Shams University, Cairo, Egypt
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32
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Burrows P, Trefan L, Houston R, Hughes J, Pearson G, Edwards RJ, Hyde P, Maconochie I, Parslow RC, Kemp AM. Head injury from falls in children younger than 6 years of age. Arch Dis Child 2015; 100:1032-7. [PMID: 26297697 PMCID: PMC4680174 DOI: 10.1136/archdischild-2014-307119] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 04/13/2015] [Indexed: 01/12/2023]
Abstract
UNLABELLED The risk of serious head injury (HI) from a fall in a young child is ill defined. The relationship between the object fallen from and prevalence of intracranial injury (ICI) or skull fracture is described. METHOD Cross-sectional study of HIs from falls in children (<6 years) admitted to UK hospitals, analysed according to the object fallen from and associated Glasgow Coma Score (GCS) or alert, voice, pain, unresponsive (AVPU) and CT scan results. RESULTS Of 1775 cases ascertained (median age 18 months, 54.7% boys), 87% (1552) had a GCS=15/AVPU=alert. 19.3% (342) had a CT scan: 32% (110/342) were abnormal; equivalent to 5.9% of the overall population, 16.9% (58) had isolated skull fractures and 13.7% (47) had ICI (49% (23/47) had an associated skull fracture). The prevalence of ICI increased with neurological compromise; however, 12% of children with a GCS=15/AVPU=alert had ICI. When compared to falls from standing, falls from a person's arms (233 children (mean age 1 year)) had a significant relative OR for a skull fracture/ICI of 6.94 (95% CI 3.54 to 13.6), falls from a building (eg, window or attic) (mean age 3 years) OR 6.84 (95% CI 2.65 to 17.6) and from an infant or child product (mean age 21 months) OR 2.75 (95% CI 1.36 to 5.65). CONCLUSIONS Most HIs from a fall in these children admitted to hospital were minor. Infants, dropped from a carer's arms, those who fell from infant products, a window, wall or from an attic had the greatest chance of ICI or skull fracture. These data inform prevention and the assessment of the likelihood of serious injury when the object fallen from is known.
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Affiliation(s)
- P Burrows
- Institute of Primary Care and Public Health, Cardiff School of Medicine, Cardiff, Wales, UK
| | - L Trefan
- Institute of Primary Care and Public Health, Cardiff School of Medicine, Cardiff, Wales, UK
| | - R Houston
- Placements Manager at Kids Company, London, UK
| | - J Hughes
- Institute of Primary Care and Public Health, Cardiff School of Medicine, Cardiff, Wales, UK
| | - G Pearson
- Department of Anaesthesia and Intensive Care, University of Birmingham
| | - R J Edwards
- Department of Neurosurgery, Bristol Hospital for Children, Bristol, UK
| | - P Hyde
- Paediatric Intensive Care Unit, Southampton Childrens Hospital, Southampton, UK
| | - I Maconochie
- National Institute for Health Research (NIHR) Biomedical Research Centre based at Imperial College Healthcare NHS Trust and Imperial College London
| | - R C Parslow
- Division of Epidemiology and Biostatistics, Leeds Institute of Genetics, Health and Therapeutics (LIGHT), University of Leeds, Leeds, UK
| | - A M Kemp
- Institute of Primary Care and Public Health, Cardiff School of Medicine, Cardiff, Wales, UK
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33
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Affiliation(s)
- Mike Thomson
- Department of Paediatric Gastroenterology, Sheffield Children's Hospital, Sheffield, South Yorkshire, UK
| | - Shishu Sharma
- Department of Paediatric Gastroenterology, Sheffield Children's Hospital, Sheffield, South Yorkshire, UK
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Andersen CC, Karayil SM, Hodyl NA, Stark MJ. Early red cell transfusion favourably alters cerebral oxygen extraction in very preterm newborns. Arch Dis Child Fetal Neonatal Ed 2015; 100:F433-5. [PMID: 25877287 DOI: 10.1136/archdischild-2014-307565] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 03/21/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND Elevated cerebral fractional tissue oxygen extraction (cFTOE; ≥0.4) predicts early brain injury in very preterm infants. While blood transfusion increases oxygen-carrying capacity, its ability to improve cerebral oxygen kinetics in the immediate newborn period remains unknown. OBJECTIVE To investigate the effect of red blood cell (RBC) transfusion in the first 24 h of life on cFTOE in infants ≤29 weeks gestation. METHODS cFTOE was calculated from cerebral tissue oxygenation index (TOI) and cutaneous oximetry measured over a 30 min epoch before and after transfusion. Infants were dichotomised according to pre-transfusion cFTOE (low <0.4 vs high ≥0.4). RESULTS 24 babies were included, 12 in each group. Pre- and post-transfusion Hb were similar between the groups. cFTOE significantly reduced after transfusion in the high but not low-extraction group (p<0.01). CONCLUSIONS Early RBC transfusion favourably alters cerebral oxygen kinetics in infants with elevated cFTOE, showing potential for modification of the risk of hypoxic (brain) injury.
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Affiliation(s)
- C C Andersen
- Department of Neonatal Medicine, Women's and Children's Hospital, Adelaide, South Australia, Australia The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, South Australia, Australia
| | - S M Karayil
- Department of Neonatal Medicine, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - N A Hodyl
- Department of Neonatal Medicine, Women's and Children's Hospital, Adelaide, South Australia, Australia The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, South Australia, Australia
| | - M J Stark
- Department of Neonatal Medicine, Women's and Children's Hospital, Adelaide, South Australia, Australia The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, South Australia, Australia
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35
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Hollingsworth C, Clarke P, Sharma A, Upton M. National survey of umbilical venous catheterisation practices in the wake of two deaths. Arch Dis Child Fetal Neonatal Ed 2015; 100:F371-2. [PMID: 25862724 DOI: 10.1136/archdischild-2015-308327] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/22/2015] [Indexed: 11/04/2022]
Affiliation(s)
- Clare Hollingsworth
- Neonatal Intensive Care Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Paul Clarke
- Neonatal Intensive Care Unit, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
| | - Alok Sharma
- Neonatal Intensive Care Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Michele Upton
- Patient Safety Lead, Maternity and Newborn, Patient Safety Domain 5, NHS England, London, UK
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36
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Affiliation(s)
- Susannah Pye
- Starlight Ward (Paediatric Unit), Homerton Hospital, London, UK
| | - Joanna Banks
- Starlight Ward (Paediatric Unit), Homerton Hospital, London, UK
| | - Cauvery Pal
- Starlight Ward (Paediatric Unit), Homerton Hospital, London, UK
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Abstract
INTRODUCTION This study aims to identify the prevalence and pattern of bruises in preschool children over time, and explore influential variables METHODS Prospective longitudinal study of children (<6 years) where bruises were recorded on a body chart, weekly for up to 12 weeks. The number and location of bruises were analysed according to development. Longitudinal analysis was performed using multilevel modelling. RESULTS 3523 bruises recorded from 2570 data collections from 328 children (mean age 19 months); 6.7% of 1010 collections from premobile children had at least one bruise (2.2% of babies who could not roll over and 9.8% in those who could), compared with 45.6% of 478 early mobile and 78.8% of 1082 walking child collections. The most common site affected in all groups was below the knees, followed by 'facial T' and head in premobile and early mobile. The ears, neck, buttocks, genitalia and hands were rarely bruised (<1% of all collections). None of gender, season or the level of social deprivation significantly influenced bruising patterns, although having a sibling increased the mean number of bruises. There was considerable variation in the number of bruises recorded between different children which increased with developmental stage and was greater than the variation between numbers of bruises in collections from the same child over time. CONCLUSIONS These data should help clinicians understand the patterns of 'everyday bruising' and recognise children who have an unusual numbers or distribution of bruises who may need assessment for physical abuse or bleeding disorders.
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Affiliation(s)
- Alison M Kemp
- Early Years Research Programme, Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, UK
| | - Frank Dunstan
- Early Years Research Programme, Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, UK
| | - Diane Nuttall
- Early Years Research Programme, Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, UK
| | - M Hamilton
- Arthur Bloom Haemophilia Centre, Institute of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Peter Collins
- Arthur Bloom Haemophilia Centre, Institute of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Sabine Maguire
- Early Years Research Programme, Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, UK
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38
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Abstract
We conducted a population based time-trend analysis of all unplanned admissions to National Health Service hospitals for poisoning in preschool children (aged <5 years) in England, between 2000 and 2011. Hospital admission rates for poisoning (medicinal and non-medicinal) decreased overall from 179 per 100 000 in 2000 to 139 per 100 000 in 2011 (rate ratio 0.77, 95% CI 0.74 to 0.81). The relative risk of hospital admission from the most deprived quintile compared with the least deprived quintile reduced from 2.37 (95% CI 2.15 to 2.60) in 2001 to 1.54 (95% CI 1.40 to 1.70) in 2011. Poisoning admissions in preschool children have decreased by 23% over the past decade. Although social gradients have narrowed, those from the most deprived areas are at higher risk of poisoning, and may benefit from targeted schemes of home safety education in deprived areas.
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Affiliation(s)
- Cordelle N A Mbeledogu
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Elizabeth V Cecil
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Christopher Millett
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Sonia Saxena
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
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39
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Abstract
BACKGROUND Injuries are a neglected cause of child mortality globally and the burden is unequally distributed in resource poor settings. The aim of this study is to explore the share and distribution of child injury mortality across country economic levels and the correlation between country economic level and injuries. METHODS All-cause and injury mortality rates per 100,000 were extracted for 187 countries for the 1-4 age group and under 5s from the Global Burden of Disease Study 2010. Countries were grouped into four economic levels. Gross domestic product (GDP) per capita was used to determine correlation with injury mortality. RESULTS For all regions and country economic levels, the share of injuries in all-cause mortality was greater when considering the 1-4 age group than under 5s, ranging from 36.6% in Organization for Economic Cooperation and Development countries to 10.6% in Sub-Saharan Africa. Except for Sub-Saharan Africa, there is a graded association between country economic level and 1-4 injury mortality across regions, with all low-income countries having the highest rates. Except for the two regions with the highest overall injury mortality rates, there is a significant negative correlation between GDP and injury mortality in Latin America and the Caribbean, Eastern Europe/Central Asia, Asia East/South-East and Pacific and North Africa/ Middle East. CONCLUSIONS Child injury mortality is unevenly distributed across regions and country economic level to the detriment of poorer countries. A significant negative correlation exists between GDP and injury in all regions, exception for the most resource poor where the burden of injuries is highest.
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Affiliation(s)
- Uzma Rahim Khan
- Department of Public Health Sciences, Karolinska Institutet, Global Health, Stockholm, Sweden Department of Emergency Medicine, Aga Khan University, Karachi, Pakistan
| | - Mathilde Sengoelge
- Department of Public Health Sciences, Karolinska Institutet, Global Health, Stockholm, Sweden
| | - Nukhba Zia
- Department of Emergency Medicine, Aga Khan University, Karachi, Pakistan
| | - Junaid Abdul Razzak
- Department of Emergency Medicine, Aga Khan University, Karachi, Pakistan Aman Healthcare Services, Karachi, Pakistan
| | - Marie Hasselberg
- Department of Public Health Sciences, Karolinska Institutet, Global Health, Stockholm, Sweden
| | - Lucie Laflamme
- Department of Public Health Sciences, Karolinska Institutet, Global Health, Stockholm, Sweden University of South Africa, College of Graduate Studies, Institute for Social and Health Sciences, Pretoria, South Africa
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40
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Bere T, Bahr R. Injury prevention advances in alpine ski racing: harnessing collaboration with the International Ski Federation (FIS), long-term surveillance and digital technology to benefit athletes. Br J Sports Med 2014; 48:738. [PMID: 24719403 DOI: 10.1136/bjsports-2014-093528] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Tone Bere
- Aspetar Orthopaedic and Sports Medicine Hospital, , Doha, Qatar
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41
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Affiliation(s)
- Todd S Ellenbecker
- ATP World Tour, Physiotherapy Associates Scottsdale Sports Clinic, , Scottsdale, Arizona, USA
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42
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Affiliation(s)
- Sanjay Gupta
- Department of Paediatrics, Good Hope Hospital, Birmingham, UK
| | - Anjum Gandhi
- Department of Paediatrics, Good Hope Hospital, Birmingham, UK
| | - Ravi Manikonda
- Department of Paediatrics, Good Hope Hospital, Birmingham, UK
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43
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Affiliation(s)
- Joshua Osowicki
- Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Nigel Curtis
- Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia Murdoch Children's Research Institute, Parkville, Victoria, Australia
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44
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Edouard P, Branco P, Alonso JM. Challenges in Athletics injury and illness prevention: implementing prospective studies by standardised surveillance. Br J Sports Med 2014; 48:481-2. [PMID: 24620035 DOI: 10.1136/bjsports-2013-093093] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Pascal Edouard
- Department of Clinical and Exercise Physiology, Sports Medicine Unity, Faculty of Medicine, University Hospital of Saint-Etienne, , Saint-Etienne, France
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45
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Affiliation(s)
- Benjamin Clarsen
- Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, , Oslo, Norway
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46
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DiFiori JP, Benjamin HJ, Brenner JS, Gregory A, Jayanthi N, Landry GL, Luke A. Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine. Br J Sports Med 2014; 48:287-8. [PMID: 24463910 DOI: 10.1136/bjsports-2013-093299] [Citation(s) in RCA: 365] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- John P DiFiori
- Division of Sports Medicine and Non-Operative Orthopaedics, Departments of Family Medicine and Orthopaedics, University of California, , Los Angeles, California, USA
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47
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Affiliation(s)
- H Murch
- Department of Paediatrics, University Hospital of Wales, Cardiff, UK
| | - B Heatman
- Department of Child Death Review, Public Health Wales, Swansea, UK
| | - A Naughton
- Department of Paediatrics, Neville Hall Hospital, Abergavenny, UK
| | - J R Sibert
- Department of Child Health, Cardiff University, Cardiff, UK
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48
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Schwellnus MP, Thomson A, Derman W, Jordaan E, Readhead C, Collins R, Morris I, Strauss O, Van der Linde E, Williams A. More than 50% of players sustained a time-loss injury (>1 day of lost training or playing time) during the 2012 Super Rugby Union Tournament: a prospective cohort study of 17,340 player-hours. Br J Sports Med 2014; 48:1306-15. [PMID: 24982503 DOI: 10.1136/bjsports-2014-093745] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Professional Rugby Union is a contact sport with a high risk of injury. OBJECTIVE To document the incidence and nature of time-loss injuries during the 2012 Super Rugby tournament. DESIGN Prospective cohort study. SETTING 2012 Super Rugby tournament (Australia, New Zealand, South Africa). PARTICIPANTS 152 players from 5 South African teams. METHODS Team physicians collected daily injury data through a secure, web-based electronic platform. Data included size of the squad, type of day, main player position, training or match injury, hours of play (training and matches), time of the match injury, mechanism of injury, main anatomical location of the injury, specific anatomical structure of the injury, the type of injury, the severity of the injury (days lost). RESULTS The proportion (%) of players sustaining a time-loss injury during the tournament was 55%, and 25% of all players sustained >1 injury. The overall incidence rate (IR/1000 player-hours) of injuries was 9.2. The IR for matches (83.3) was significantly higher than for training (2.1) and the IR was similar for forwards and backs. Muscle/tendon (50%) and joint/ligament (32.7%) injuries accounted for >80% of injuries. Most injuries occurred in the lower (48.1%) and upper limb (25.6%). 42% of all injuries were moderate (27.5%) or severe (14.8%), and tackling (26.3%) and being tackled (23.1%) were the most common mechanisms of injury. The IR of injuries was unrelated to playing at home compared with away (locations ≥6 h time difference). CONCLUSIONS 55% of all players were injured during the 4-month Super Rugby tournament (1.67 injuries/match). Most injuries occurred in the lower (knee, thigh) or upper limb (shoulder, clavicle). 42% of injuries were severe enough for players to not play for >1 week.
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Affiliation(s)
- Martin P Schwellnus
- Clinical Sport and Exercise Medicine Research Group, UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Newlands, South Africa International Olympic Committee Research Centre, Cape Town, South Africa
| | - Alan Thomson
- Clinical Sport and Exercise Medicine Research Group, UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Newlands, South Africa
| | - Wayne Derman
- Clinical Sport and Exercise Medicine Research Group, UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Newlands, South Africa International Olympic Committee Research Centre, Cape Town, South Africa
| | - Esme Jordaan
- Biostatistics Unit, Medical Research Council, Parow, South Africa Statistics and Population Studies Department, University of the Western Cape, Cape Town, South Africa
| | | | - Rob Collins
- Golden Lions Rugby Union, Johannesburg, South Africa Section Sports Medicine, University of Pretoria, Pretoria, South Africa
| | - Ian Morris
- Cheetahs Rugby Union, Bloemfontein, South Africa
| | - Org Strauss
- Section Sports Medicine, University of Pretoria, Pretoria, South Africa Blue Bulls Rugby Union, Pretoria, South Africa
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49
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Affiliation(s)
- Steven J Kamper
- EMGO+ Institute, VU University Medical Center, , Amsterdam, The Netherlands
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50
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Abstract
BACKGROUND Groin/hip injuries are common in the athletic population, particularly in sports requiring kicking, twisting, turning and rapid acceleration and deceleration. Chronic hip, buttock and groin pain account for 10% of all attendances to sports medicine centres. Understanding risk factors for field-based sports (FBS) players is important in developing preventive measures for injury. OBJECTIVE This systematic review aims to identify and examine the evidence for groin/hip injury risk factors in FBS. METHODS 14 electronic databases were searched using keywords. Studies were included if they met the inclusion criteria and investigated one or more risk factors with relation to the incidence of groin/hip injuries in FBS. Studies were accumulated and independently analysed by two reviewers under a 12-point quality assessment scale (modified CASP (for cohort study design) assessment scale). Owing to the heterogeneity of studies and measures used, a meta-analysis could not be conducted. As a result risk factors were pooled for analysis and discussion. RESULTS Of the 5842 potentially relevant studies, 7 high-quality studies were included in this review. Results demonstrated that previous groin/hip injury was the most prominent risk factor, identified across four studies (OR range from 2.6 (95% CI 1.1 to 6.11) to 7.3, (p=0.001)), followed by older age (OR 0.9, p=0.05) and weak adductor muscles (OR 4.28, 95% CI 1.31 to 14.0, p=0.02) each identified in two studies. Eight other significant risk factors were identified once across the included studies. CONCLUSIONS 11 significant risk factors for groin/hip injury for FBS players were identified. The most prominent risk factor identified was previous groin/hip injury. Future research should include a prospective study of a group of FBS players to confirm a relationship between the risk factors identified and development of groin/hip injuries.
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Affiliation(s)
- Julianne Ryan
- Department of Physiotherapy, University Hospital Galway, Galway, Ireland
| | - Neasa DeBurca
- Department of Physiotherapy, University Hospital Galway, Galway, Ireland
| | - Karen Mc Creesh
- Department of Clinical Therapies, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
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