Injury Prevention最新文献

Background: High injury rates are evident in the community sport of ladies Gaelic football, and the costs associated with these injuries have major implications for players and the governing body. Injury prevention programmes have been designed but are not being widely adopted. This study aimed to elicit the expert opinion of academics and practitioners on the content and format of injury prevention programmes for ladies Gaelic football.

Methods: Twenty-four experts from the areas of coaching science, injury prevention, athletic therapy and physiotherapy took part in this three-round Delphi study. Each round contained multiple-choice, Likert scale and open-ended questions. For each question, consensus was defined as 67% or greater agreement among experts.

Results: The experts agreed that 17 components (eg, agility, balance) should be included in injury prevention programmes for ladies Gaelic football, with 12 considered vital for inclusion in most or every session. Programmes should require minimal/no equipment, be 10-15 min in duration and contain 3-4 versions of each exercise for progression and variation purposes. Experts recommended when certain components should be completed but generally agreed that programmes should be capable of being delivered throughout sessions. There was consensus among experts for 13 items (eg, pictures, exercise volume) to be included in full versions of programmes and six in condensed versions.

Conclusions: The outcomes of this study provide the foundation for the development of future injury prevention programmes for ladies Gaelic football. Combining these findings with the preferences of end-users throughout programme development may enhance the efficacy of future injury prevention programmes.

Introduction: WHO guidance supports implementation of drowning prevention interventions. This study aimed to examine barriers and facilitators of use of WHO guidance on basic swimming and water safety skills in low-resource settings, gathering insights inform codesign of technical resources.

Methods: Mixed methods were used comprising WHO guidance gap analysis, participant surveys and thematic analysis of workshop discussions (17 participants and 13 countries). WHO document analysis and analysis of pre-workshop survey responses were combined to identify topic areas where additional guidance was required. Inductive thematic analysis of workshop discussions spanned current practice, challenges and opportunities. Postworkshop anonymous evaluation forms were also analysed.

Results: Four topic areas were identified that required additional technical guidance to support implementation: Site Safety Auditing; Medical Screening of Participants; Informed Consent and Emergency Action Planning. Barriers broadly spanned a lack of trained personnel and equipment as well as a lack of community understanding and varying support from external agencies. Opportunities identified included partnering with local organisations with specific expertise (ie, medical, emergency planning), improving programme administration and challenging traditional community practices (ie, informed consent, superstitions). Participants agreed the workshop would lead to changes in practice, however this remains to be confirmed.

Discussion: Additional technical resources to address gaps and support implementation were suggested and should now be developed, implemented and evaluated.

Conclusion: This study identified additional technical resources and the development of a community of practice to support effective teaching of school age children swimming and water safety skills in low-resource settings.

Drowning is a significant cause of preventable mortality and morbidity and has been described as a serious, preventable and neglected public health challenge. Amid building momentum for drowning prevention, most notably with recent United Nations and World Health Assembly Declarations, researchers, policymakers and practitioners convened at the World Conference on Drowning Prevention (WCDP) 2023 under the conference theme of 'shaping a global strategy - mobilizing for local action'. In this special feature, we reflect on the outcomes of the WCDP 2023. Throughout the work presented by more than 750 research, policy and technical experts from over 50 countries, five overarching themes emerged: (1) advancing further contextualisation and interventions, especially in Africa; (2) integrating drowning prevention into climate and disaster agendas; (3) addressing the threats and opportunities in migration; (4) positioning drowning prevention as an issue of social justice; and (5) expanding focus on implementation research. WCDP 2023 delegates co-designed a conference call to action comprising of 16 statements designed to further strengthen global efforts on drowning prevention between now and the WCDP 2025. These actions aim to encourage increased collaboration, create new knowledge, address inequities, amplify voices of those most affected and continue shared commitments to eliminate drowning.

Objective: Adolescents with acquired brain injuries are at risk for additional injuries after hospital discharge. We asked healthcare providers to identify and prioritise urgent hazards in the home setting for this population.

Methods: We used a convergent mixed methods approach. Healthcare providers who do discharge planning and community re-integration for adolescent patients with brain injury were recruited from hospitals in the US Midwest. Participants completed two structured surveys, semi-structured interviews and a Hazard Prioritisation Matrix Activity. We analysed quantitative data via descriptive statistics and qualitative data via inductive thematic analysis to identify hazards, urgency, interactive themes and generate a conceptual model.

Results: All participants validated four preidentified hazards in the surveys and the interviews: slippery objects on the floor, large furniture/objects in the path of travel, unattended open flames and inappropriate use of cooking appliances. 59 hazards were self-identified during the Hazard Priority Matrix Activity and assigned an urgency rating, with 12 (20.3%) urgent, 20 (33.9%) major, 19 (32.2%) moderate and 8 (13.6%) minor risks. We identified seven interactive themes about hazard factors: hazardous activities, hazardous situations, hazardous objects, hazardous others, hazardous spaces, harms and client factors. A conceptual model for home safety concerns links hazards, risks and harms.

Conclusions: Adolescents with acquired brain injuries need healthcare providers to recognise unique and complex hazards in their homes that could lead to harm. Mitigating home hazards may prevent additional unintentional injury for these adolescents. More research is needed to generalise this information for this population across clinical settings.

Trial registration number: NCT04768946.

Introduction: Road traffic injuries (RTIs) are the leading cause of mortality among children and adolescents. This study aimed to compare clinical characteristics and identify factors associated with severe RTIs based on types of road users among children and adolescents with RTIs.

Methods: A retrospective multicentre observational study was conducted using the Emergency Department-based Injury In-depth Surveillance registry in South Korea. A total of 78 021 participants younger than 19 years who presented with RTIs to the participating emergency departments from 2011 to 2021 were classified into four groups: passengers, pedestrians, motorcyclists and bicyclists. Demographic and injury-related factors were analysed using a multivariate logistic regression model to determine associations with severe RTIs, as indicated by the Excess Mortality Ratio-based Injury Severity Score of ≥16. The prevalence of traumatic brain injury (TBI), hospitalisations, intensive care unit (ICU) admissions and severe RTIs among road users was compared.

Results: Head injuries were most prevalent in passengers (55.3%), motorcyclists (46.7%) and bicyclists (50.1%). Motorcyclists exhibited the highest proportion of TBI (8.3%), total admissions (28.8%), ICU admissions (8.2%), severe RTIs (41.0%) and mortality (2.0%). Safety devices significantly reduced severe RTIs in passengers and motorcyclists (adjusted OR (95% CI) 0.77 (0.70 to 0.85) and 0.69 (0.62 to 0.76), respectively.

Conclusion: The distinct clinical characteristics and factors associated with severe RTIs among different road user types in children and adolescents highlight the need for targeted interventions. Tailoring strategies to the specific requirements of each group is essential for effectively mitigating the occurrence of severe RTIs in this vulnerable demographic.

Objectives: This study investigated whether honor ideology, or a belief that one's reputation must be defended at all costs, is related to firearms ownership in soldiers.

Methods: N=301 active-duty soldiers completed online self-report measures in this cross-sectional study.

Results: Honor ideology was higher in soldiers who privately own a firearm compared with those who do not currently own and do not plan to after military separation. Higher honor ideology was correlated with a disbelief that private firearms ownership is related to soldier suicide risk. Levels of honor ideology were equal in soldiers who own a private firearm for protection versus other reasons (eg, hunting, maintaining a collection).

Conclusions: Honor ideology may be related to suicide risk through increased likelihood of owning a private firearm and disbelief in private firearm ownership being related to one's own suicide risk in soldiers. Honor ideology could be relevant to consider when means safety initiatives are developed for active-duty military personnel.

Objectives: Older adults living in long-term care facilities (LTCFs) are at high risk for falls. Interventions to prevent falls and fall-related injury in this population may be individual-level or system-focused interventions. However, relatively little attention has been given to research on system-focused interventions. This scoping review seeks to synthesise previous studies on the effects of system-focused interventions for fall prevention in LTCFs.

Methods: We searched Ovid-Medline, CINAHL and Embase databases from 2007 to 2024 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews. We conducted a narrative synthesis to summarise findings from the included studies.

Results: In the initial search, 403 studies were identified and underwent title and abstract screening resulting in 116 articles retrieved for full-text review. 20 studies were included in the final data extraction. System-level fall prevention interventions evaluated in LTCFs include (1) multicomponent and multidisciplinary programmes, (2) environmental adaptations, (3) technological adaptations, and (4) staff education and training programmes. 11 out of 17 included quantitative studies reported significant effects of system-focused interventions to reduce falls in LTCFs.

Conclusions: This scoping review reveals the effectiveness of system-level fall prevention strategies in LTCFs. Enhancing training, customising tools and fostering a supportive leadership culture are vital for improving fall prevention practices in LTCFs.

Background: Femoral shaft fractures tend to be rare among children; however, these injuries are the most common major paediatric injuries treated by orthopaedic surgeons. The purpose of this study is to characterise the demographics and mechanisms of femoral injury associated with consumer products in the age group treated with spica casting, children 6 months to 6 years, to identify areas for injury prevention.

Methods: Data from 2012 to 2021 were obtained from the National Electronic Injury Surveillance System maintained by the Consumer Products Safety Commission, documenting emergency department visits for unintentional injuries associated with consumer products. Narrative descriptions were analysed to identify common factors in the injury events such as location, products and mechanisms of action.

Results: From 2012 to 2021, the estimated incidence of femur fractures was 23.5 cases per 100 000 children with no significant difference in yearly frequency. The most common mechanism of injury was a fall with the most frequent fracture sources being bed/bunk beds (16.1%), floor (slips/falls, 9.7%) and trampolines (9.7%). Most fractures occurred at the patient's home (58.4%). The incidence of injury outside of the home and frequency of fractures involving play structures/trampolines increased with age.

Conclusions: The incidence and demographic characteristics of paediatric femur fractures associated with consumer products have remained consistent over the past 10 years. As home was the most common location of fracture, prevention of femur fractures should focus on caregiver education around high-risk sources of fracture (bed, stairs and trampolines) and manufacturers should consider design alternatives that discourage potential misuse.

Background: Suicide is a leading cause of death among adolescents, yet most adolescents who report suicidal ideation do not attempt nor die by suicide. To prevent injury and death, it is thus vital to explore factors potentiating the transition from suicidal ideation to suicidal attempt, especially in high-risk groups like sexual and gender minority (SGM) adolescents. Guided by an "ideation-to-action" framework, we explored risk factors for suicide attempt (ie, "painful and provocative experiences") among adolescents reporting suicidal ideation by SGM status.

Methods: Data were drawn from the cross-sectional 2022 Minnesota Student Survey and restricted to 10 561 adolescents reporting past-year suicidal ideation (52.3% SGM; 47.7% non-SGM). Analyses first assessed prevalence of exposure to painful and provocative experiences (ie, non-suicidal self-injury, adverse childhood experiences, bullying) by SGM status. Then, in multivariable logistic regression models, analyses probed associations between these risk factors and past-year suicide attempt.

Results: Among adolescents reporting recent suicidal ideation, a higher proportion of SGM adolescents reported past-year suicide attempt than non-SGM adolescents (26.7% vs 21.6%, respectively). All examined painful and provocative experiences were more commonly reported among SGM adolescents. In analyses restricted to SGM adolescents, non-suicidal self-injury, sexual abuse by a family member, and bullying demonstrated the largest effect sizes of associations with suicide attempt.

Discussion: Guided by an "ideation-to-action" framework, this research identifies risk factors potentiating suicide attempt in SGM adolescents reporting recent suicidal ideation. Structural and clinical interventions focused on mitigating exposure to painful and provocative experiences may help to prevent suicide among SGM adolescents.

Objectives: There is a lack of evidence on interventions to improve the safety of cycling use in low- and middle-income countries. We investigated the impact of road design and traffic characteristics on the fatality risk of bicyclists.

Methods: Our study population is the road sites in the peri-urban areas of New Delhi, India. We used a retrospective, population-based case-control study design. We identified 50 case sites (road locations) where a fatal cycle crash had occurred over a 3-year period. For control sites, we intercepted and interviewed three cyclists at each case site, mapped their route to the crash location using Google Maps and selected one random location on each of those routes as controls. We recorded traffic and road design characteristics at the case and control sites. We used a logistic regression model to estimate ORs of site characteristics.

Results: We found a strong effect of the presence of U-turns on the likelihood of a bicycle fatality, with an OR of 4.4 (95% CI 1.8, 11.5). This effect is robust against multiple sensitivity analyses. We found that the volume of cars is associated with an increased likelihood and that of motorcycles with a reduced likelihood of bicycle fatalities.

Conclusions: Our results indicate that the presence of U-turns is a strong risk factor for bicycle fatalities in Delhi. Given the strong evidence of their impact on the safety of bicyclists, their construction should be discontinued in zones of high bicycle presence.