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Darrah T, Herbert S, Chambers T. A thematic analysis of alcohol and alcohol-related harm across health and social policy in Aotearoa New Zealand. Aust N Z J Public Health 2024; 48:100143. [PMID: 38626567 DOI: 10.1016/j.anzjph.2024.100143] [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: 07/09/2023] [Revised: 02/20/2024] [Accepted: 02/28/2024] [Indexed: 04/18/2024] Open
Abstract
OBJECTIVE This study aims to: 1) explore how alcohol and alcohol harm are framed in New Zealand national policy, strategy, and action plan documents; and 2) examine how these documents align with the WHO SAFER framework. METHODS Keyword searches across government websites and Google were conducted in January 2021. Inclusion and exclusion criteria were applied to all identified documents, resulting in 22 being included for analysis in this study. An inductive and deductive thematic analysis of those documents was performed. RESULTS Our inductive thematic analysis identified three themes, of which one is detailed in this study: 'Location of responsibility for addressing alcohol harms' with a focus on individuals and non-specific government agencies. Thematic results from the deductive analysis found that the most consistently referenced SAFER policies included brief interventions (68% of documents), followed by drink driving measures (45%), alcohol marketing (36%), alcohol availability (27%), and alcohol price (23%). The conversion rate from a document mentioning a SAFER framework policy area to making specific policy recommendations was usually less than or around 50%. CONCLUSIONS The lack of alignment between New Zealand alcohol policy and the SAFER framework can be partially attributable to the absence of an updated national alcohol strategy (NAS). An updated NAS should identify responsible agencies, create a systematic monitoring and evaluation mechanism, and be consistent with the WHO SAFER framework. IMPLICATIONS FOR PUBLIC HEALTH The analysis supports the need to update a national alcohol strategy to guide alcohol policy development.
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Affiliation(s)
- Tayla Darrah
- Department of Public Health, University of Otago, Wellington, New Zealand.
| | | | - Timothy Chambers
- University of Canterbury, Ngāi Tahu Research Centre, Christchurch, New Zealand
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du Toit F, Schwellnus M, Jordaan E, Swanevelder S, Wood P. Clinical characteristics of gradual onset injuries in recreational road cyclists - SAFER XXVII study over 5 years in 62758 race entrants. PHYSICIAN SPORTSMED 2023; 51:564-571. [PMID: 36281474 DOI: 10.1080/00913847.2022.2136984] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/10/2022] [Indexed: 10/31/2022]
Abstract
OBJECTIVE Gradual onset injuries (GOIs) in recreational cyclists are common but not well described. The aim of this study is to describe the clinical characteristics of GOIs (main anatomical regions, specific anatomical sites, specific GOIs, tissue type, severity of GOIs, and treatment modalities) of GOIs among entrants participating in a community-based mass participation-cycling event over 5 years. METHODS During the 2016-2020 Cape Town Cycle Tour, 62,758 consenting race entrants completed an online pre-race medical screening questionnaire. 1879 reported GOIs in the previous 12 months. In this descriptive epidemiological study, we report frequency (% entrants) of GOIs by anatomical region/sites, specific GOI, tissue type, GOI severity, and treatment modalities used. RESULTS The main anatomical regions affected by GOIs were lower limb (47.4%), upper limb (20.1%), hip/groin/pelvis (10.0%), and lower back (7.8%). Specifically, GOI were common in the knee (32.1%), shoulder (10.6%), lower back (7.8%) and the hip/buttock muscles (5.2%). The most common specific GOI was anterior knee pain (17.2%). 57.0% of GOIs were in soft tissue. Almost half (43.9%) of cyclists with a GOI reported symptom duration >12 months, and 40.3% of GOIs were severe enough to reduce/prevent cycling. Main treatment modalities used for GOIs were rest (45.9%), physiotherapy (43.0%), stretches (33.2%), and strength exercises (33.1%). CONCLUSION In recreational cyclists, >50% of GOIs affect the knees, shoulders, hip/buttock muscles and lower back, and 40% are severe enough to reduce/prevent cycling. Almost 45% of cyclists with GOIs in the lower back; or hip/groin/pelvis; or lower limbs; or upper limb reported a symptom duration of >12 months. Risk factors associated with GOIs need to be determined and preventative programs for GOIs need to be designed, implemented, and evaluated.
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Affiliation(s)
- François du Toit
- Division of Biokinetics and Sports Science, Department of Physiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Martin Schwellnus
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- International Olympic Committee (IOC) Research Centre, Pretoria, South Africa
| | - Esme Jordaan
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
- Statistics and Population Studies Department, University of the Western Cape, Cape Town, South Africa
| | - Sonja Swanevelder
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
| | - Paola Wood
- Division of Biokinetics and Sports Science, Department of Physiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Kato M, Ishikawa H, Kiuchi T, Akiyama M, Kawamura Y, Okuhara T, Ono N, Miyawaki R. Patterns of alcohol and alcohol-flavoured non-alcoholic beverage advertisements over Japanese free-to-air television networks. BMC Public Health 2022; 22:1864. [PMID: 36203148 PMCID: PMC9536255 DOI: 10.1186/s12889-022-14276-5] [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: 04/09/2021] [Revised: 08/07/2022] [Accepted: 09/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background Alcohol use is a serious public health challenge worldwide. Japan has no government regulations or legal penalties against advertising alcoholic beverages on television (TV). Instead, advertisements depend on the Japanese alcohol industry’s self-regulation on airtime (no advertisements from 5 am to 6 pm) and the content of alcoholic beverages, which must not tempt minors. However, many adolescents (10 to 19 years old) watch TV from 6 pm to 11 pm. The aim of this study was to describe the pattern in the advertising of alcoholic beverages and alcohol-flavoured non-alcoholic beverages (AFNAB) in Japan during the popular TV viewing time for adolescents. Methods A secondary analysis of advertising airtime data from five free-to-air Japanese TV networks in the Greater Tokyo area that aired between 12 August and 3 November 2019, was performed. Results During the study period, 5215 advertisements for alcoholic beverages and AFNABs aired (1451.75 min). In total, 2303 advertisements (44.2%) were beer, low-malt beer, or beer-taste beverages, 277 (5.3%) were whisky, 2334 (44.8%) were local alcoholic beverages (shochu and seishu), and 301 (5.8%) were AFNAB. On average, more advertisements aired on weekends (67.6 advertisements) than on weekdays (59.3 advertisements) per day. Approximately 30% of advertisements for AFNABs were aired during the time restricted for alcohol advertising, although AFNABs are considered alcohol according to industry guidelines. During the popular television viewing time for young adolescents, about two to three times more advertisements were aired per hour than during the rest of the day, on both weekdays and weekends (p < 0.001). Conclusion The number of alcohol advertisements aired at times when adolescents often watch TV is 2 to 3.2 times higher than that at other times of the day. Furthermore, despite the industry’s self-imposed regulations, some alcoholic beverages are still advertised. Therefore, other methods to protect children and adolescents from exposure to advertisements for alcoholic beverages should be investigated and implemented.
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Affiliation(s)
- Mio Kato
- Graduate School of Public Health, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan.
| | - Hirono Ishikawa
- Graduate School of Public Health, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan
| | - Takahiro Kiuchi
- Department of Health Communication, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Miki Akiyama
- Faculty of Environment and Information Studies, Keio University, 5322, Endo, Fujisawa-shi, Kanagawa, Japan
| | - Yoko Kawamura
- School of Health Sciences, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishi-ku Kitakyushu-shi, Fukuoka, Japan
| | - Tsuyoshi Okuhara
- Department of Health Communication, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Naoko Ono
- Graduate School of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Rina Miyawaki
- School of Arts and Letters, Meiji University, 1-9-1 Eifuku, Suginami-ku, Tokyo, Japan
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Sewry N, Wiggers T, Schwellnus M. Medical Encounters Among 94,033 Race Starters During a 16.1-km Running Event Over 3 Years in the Netherlands: SAFER XXVI. Sports Health 2022; 15:210-217. [PMID: 35384779 PMCID: PMC9950983 DOI: 10.1177/19417381221083594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/17/2022] Open
Abstract
BACKGROUND There are limited data on the medical encounters (MEs) occurring during mass community-based running events of shorter distances (10-21.1 km). The aim of this study was to determine the incidence and nature of MEs during the largest mass participation running event in the Netherlands. HYPOTHESIS We hypothesize that the incidence and nature of MEs will be similar to other running events. STUDY DESIGN Descriptive epidemiological study over 3 years of a 16.1-km (10-mile) running event. LEVEL OF EVIDENCE Level 4. METHODS We investigated a total of 94,033 race starters at the 2017-2019 Dam tot Damloop (16.1 km), a point-to-point road race from Amsterdam to Zaandam, the Netherlands. All MEs were recorded by race medical staff on race day each year. MEs were retrospectively coded by severity, organ system, and final specific diagnosis (2019 consensus statement definition on mass community-based events). Incidence (I) per 1000 starters (95% CIs) were calculated for all MEs and serious/life-threatening MEs. RESULTS The overall incidence (per 1000 starters) of all MEs was 2.75 (95% CI, 2.44-3.11), the overall incidence of serious/life-threatening MEs was 1.20 (95% CI, 1.00-1.45; 44% of MEs). Heat illnesses accounted for most MEs: hypothermia I = 0.54 (95% CI, 0.41-0.71) and hyperthermia I = 0.46 (95% CI, 0.34-0.62). Central nervous system MEs were also common (dizziness/nausea, I = 0.79; 95% CI 0.63-0.99), followed by the cardiovascular system MEs (exercise-associated postural hypotension, I = 0.36; 95% CI, 0.26-0.51). CONCLUSION The overall incidence of MEs was low compared with longer-distance races (21.1-90 km), but the incidence and relative frequency of serious/life-threatening MEs (44% of all MEs) was much higher. Heat illness (hypothermia and exertional heat stroke) accounted for most serious/life-threatening MEs. CLINICAL RELEVANCE There is a need to implement prevention strategies and interventions by specialized medical practitioners in this and similar events.
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Affiliation(s)
- Nicola Sewry
- Sport, Exercise Medicine and Lifestyle
Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, South
Africa,International Olympic Committee (IOC)
Research Centre, South Africa,Nicola Sewry, PhD, Sport,
Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences,
University of Pretoria, South Africa, Sports Campus, Burnett Street, Hatfield,
Pretoria 0020, South Africa ()
(Twitter: @NSewry)
| | - Tom Wiggers
- Department of Sports Medicine,
TopSupport, Sint Anna Hospital, Geldrop, The Netherlands
| | - Martin Schwellnus
- Sport, Exercise Medicine and Lifestyle
Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, South
Africa,International Olympic Committee (IOC)
Research Centre, South Africa
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Chambers T, Jackson N, Hoek J. New Zealand's proposed ban on alcohol sponsorship of sport: a cost-effective, pro-equity and feasible move towards reducing alcohol-related harm. Lancet Reg Health West Pac 2021; 13:100218. [PMID: 34527993 PMCID: PMC8403919 DOI: 10.1016/j.lanwpc.2021.100218] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 06/22/2021] [Accepted: 07/02/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Tim Chambers
- Department of Public Health, University of Otago, Wellington
| | | | - Janet Hoek
- Department of Public Health, University of Otago, Wellington
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Crenshaw JR, Bernhardt KA, Atkinson EJ, Achenbach SJ, Khosla S, Amin S, Kaufman KR. Posterior single-stepping thresholds are prospectively related to falls in older women. Aging Clin Exp Res 2020; 32:2507-2515. [PMID: 32060804 PMCID: PMC7426251 DOI: 10.1007/s40520-020-01480-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 01/11/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Falls are a leading cause of injury in older women. Stepping thresholds quantify balance-reaction capabilities. It is unclear how such evaluations predict falls in comparison to, or as a complement to, other objective measures of gait, standing postural control, strength, and balance confidence. AIMS The objective of this study was to determine if stepping thresholds are prospectively related to falls in older women. METHODS For this prospective cohort study, 125 ambulatory, community-dwelling women, age ≥ 65 years were recruited. Using a treadmill to deliver perturbations to standing participants, we determined anteroposterior single- and multiple-stepping thresholds. Here, thresholds represent the minimum perturbation magnitudes that consistently evoke one step or multiple steps. In addition, gait kinematics, obstacle-crossing kinematics, standing sway measures, unipedal stance time, the functional reach, lower extremity isometric strength, grip strength, balance confidence, and fall history were evaluated. Falls were prospectively recorded for one year. RESULTS Seventy-four participants (59%) fell at least once. Posterior single-stepping thresholds were the only outcome that predicted future fall status (OR = 1.50, 95% CI 1.01-2.28; AUC = .62). A multivariate approach added postural sway with eyes closed as a second predictive variable, although predictive abilities were not meaningfully improved. DISCUSSION These results align with the previous evidence that reactive balance is a prospective indicator of fall risk. Unlike previous studies, strength scaled to body size did not contribute to fall prediction. CONCLUSION Posterior single-stepping thresholds held a significant relationship with future fall status. This relationship was independent of, and superior to that of, other measures of standing balance, gait, strength, and balance confidence.
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Affiliation(s)
- Jeremy R Crenshaw
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA
| | | | - Elizabeth J Atkinson
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Sara J Achenbach
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Sundeep Khosla
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Shreyasee Amin
- Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Kenton R Kaufman
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
- Motion Analysis Laboratory, DAHLC 4-214, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
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Schwellnus M, Kipps C, Roberts WO, Drezner JA, D'Hemecourt P, Troyanos C, Janse van Rensburg DC, Killops J, Borresen J, Harrast M, Adami PE, Bermon S, Bigard X, Migliorini S, Jordaan E, Borjesson M. Medical encounters (including injury and illness) at mass community-based endurance sports events: an international consensus statement on definitions and methods of data recording and reporting. Br J Sports Med 2019; 53:1048-1055. [PMID: 30796105 DOI: 10.1136/bjsports-2018-100092] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [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: 09/17/2018] [Revised: 02/04/2019] [Accepted: 02/08/2019] [Indexed: 12/19/2022]
Abstract
Mass participation endurance sports events are popular but a large number of participants are older and may be at risk of medical complications during events. Medical encounters (defined fully in the statement) include those traditionally considered 'musculoskeletal' (eg, strains) and those due to 'illness' (eg, cardiac, respiratory, endocrine). The rate of sudden death during mass endurance events (running, cycling and triathlon) is between 0.4 and 3.3 per 100 000 entrants. The rate of other serious medical encounters (eg, exertional heat stroke, hyponatraemia) is rarely reported; in runners it can be up to 100 times higher than that of sudden death, that is, between 16 and 155 per 100 000 race entrants. This consensus statement has two goals. It (1) defines terms for injury and illness-related medical encounters, severity and timing of medical encounters, and diagnostic categories of medical encounters, and (2) describes the methods for recording data at mass participation endurance sports events and reporting results to authorities and for publication. This unifying consensus statement will allow data from various events to be compared and aggregated. This will inform athlete/patient management, and thus make endurance events safer.
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Affiliation(s)
- Martin Schwellnus
- Faculty of Health Sciences, Sport, Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, Gauteng, South Africa.,Director, IOC Research Centre of South Africa, Pretoria, Gauteng, South Africa
| | | | - William O Roberts
- Department of Family Medicine and Community Health, University of Minnesota, St Paul, Minnesota, USA
| | | | | | - Chris Troyanos
- International Institute for Race Medicine (IIRM), Boston, Massachusetts, USA
| | - Dina Christina Janse van Rensburg
- Section Sports Medicine and Sport, Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, Gauteng, South Africa
| | - Jannelene Killops
- Section Sports Medicine, Faculty of Health Sciences, Sport, Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, Gauteng, South Africa
| | - Jill Borresen
- Sport, Exercise Medicine and Lifestyle Institute, University of Pretoria, Pretoria, Gauteng, South Africa
| | - Mark Harrast
- Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Paolo E Adami
- IAAF Health and Science Department, International Association of Athletics Federations (IAAF), Rome, Italy
| | | | - Xavier Bigard
- Union Cycliste Internationale (UCI), Aigle, Switzerland
| | | | - Esme Jordaan
- Biostatistics Unit, Medical Research Council, Parow, South Africa
| | - Mats Borjesson
- Neuosciences and Physiology, Goteborgs Universitet Sahlgrenska Akademin, Goteborg, Sweden.,Ostra Sjukhuset, Goteborg, Sweden
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Mohan-Gibbons H, Dolan ED, Reid P, Slater MR, Mulligan H, Weiss E. The Impact of Excluding Food Guarding from a Standardized Behavioral Canine Assessment in Animal Shelters. Animals (Basel) 2018; 8:ani8020027. [PMID: 29419746 PMCID: PMC5836035 DOI: 10.3390/ani8020027] [Citation(s) in RCA: 11] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 02/03/2018] [Accepted: 02/05/2018] [Indexed: 11/18/2022] Open
Abstract
Simple Summary Recent research has called into question the value of the food guarding assessment as a predictive tool for determining the safety of shelter dogs. This study examined the effect of eliminating the food guarding assessment in nine U.S. animal shelters. It was found that when the food guarding assessment was removed, bites or other injuries to staff or adopters did not increase. However, dogs exhibiting food guarding behavior were less likely to be adopted, had a longer shelter stay, and were more likely to be euthanized than dogs in the general population. Based on previous research and this study’s findings, the authors recommend that shelters discontinue the food guarding assessment. Abstract Many shelters euthanize or restrict adoptions for dogs that exhibit food guarding while in the animal shelter. However, previous research showed that only half the dogs exhibiting food guarding during an assessment food guard in the home. So, dogs are often misidentified as future food guarders during shelter assessments. We examined the impact of shelters omitting food guarding assessments. Nine shelters conducted a two-month baseline period of assessing for food guarding followed by a two-month investigative period during which they omitted the food guarding assessment. Dogs that guarded their food during a standardized assessment were less likely to be adopted, had a longer shelter stay, and were more likely to be euthanized. When the shelters stopped assessing for food guarding, there was no significant difference in the rate of returns of food guarding dogs, even though more dogs were adopted because fewer were identified with food guarding behavior. Additionally, the number of injuries to staff, volunteers, and adopters was low (104 incidents from a total of 14,180 dogs) and did not change when the food guarding assessment was omitted. These results support a recommendation that shelters discontinue the food guarding assessment.
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Affiliation(s)
- Heather Mohan-Gibbons
- Strategy, Research and Development, American Society for the Prevention of Cruelty to Animals (ASPCA®), New York, NY 10018, USA.
| | - Emily D Dolan
- Strategy, Research and Development, American Society for the Prevention of Cruelty to Animals (ASPCA®), New York, NY 10018, USA.
| | - Pamela Reid
- Anti-Cruelty Behavior Team, Anti-Cruelty Group, American Society for the Prevention of Cruelty to Animals (ASPCA®), New York, NY 10018, USA.
| | - Margaret R Slater
- Strategy, Research and Development, American Society for the Prevention of Cruelty to Animals (ASPCA®), New York, NY 10018, USA.
| | - Hugh Mulligan
- Strategy, Research and Development, American Society for the Prevention of Cruelty to Animals (ASPCA®), New York, NY 10018, USA.
| | - Emily Weiss
- Equine Welfare, Anti-Cruelty Group, American Society for the Prevention of Cruelty to Animals (ASPCA®), New York, NY 10018, USA.
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Crenshaw JR, Bernhardt KA, Achenbach SJ, Atkinson EJ, Khosla S, Kaufman KR, Amin S. The circumstances, orientations, and impact locations of falls in community-dwelling older women. Arch Gerontol Geriatr 2017; 73:240-247. [PMID: 28863352 PMCID: PMC5858880 DOI: 10.1016/j.archger.2017.07.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 07/20/2017] [Accepted: 07/20/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE We sought to characterize the circumstances, orientations, and impact locations of falls in community-dwelling, ambulatory, older women. METHODS For this longitudinal, observational study, 125 community-dwelling women age≥65years were recruited. Over 12-months of follow-up, fall details were recorded using twice-monthly questionnaires. RESULTS More than half (59%) of participants fell, with 30% of participants falling more than once (fall rate=1.3 falls per person-year). Slips (22%) and trips (33%) accounted for the majority of falls. Approximately 44% of falls were forward in direction, while backward falls accounted for 41% of falls. About a third of all falls were reported to have lateral (sideways) motion. Subjects reported taking a protective step in response to 82% of forward falls and 37% of backward falls. Of falls reporting lateral motion, a protective step was attempted in 70% of accounts. Common impact locations included the hip/pelvis (47% of falls) and the hand/wrist (27%). Backwards falls were most commonly reported with slips and when changing direction, and increased the risk of hip/pelvis impact (OR=12.6; 95% CI: 4.7-33.8). Forward falls were most commonly reported with trips and while hurrying, and increased the risk of impact to the hand/wrist (OR=2.6; 95% CI: 1.2-5.9). CONCLUSION Falls in older ambulatory women occur more frequently than previously reported, with the fall circumstance and direction dictating impact to common fracture locations. Stepping was a common protective recovery strategy and that may serve as an appropriate focus of interventions to reduce falls in this high risk population.
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Affiliation(s)
- Jeremy R Crenshaw
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA.
| | | | - Sara J Achenbach
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Elizabeth J Atkinson
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Sundeep Khosla
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Kenton R Kaufman
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Shreyasee Amin
- Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA; Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
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