Injury Prevention Resources Research Articles

Preventing Anterior Cruciate Ligament (ACL) Injuries in High School Sports Participants: An Executive Summary of the Inaugural Meeting of the National ACL Injury Coalition.

To address the increasing rates of anterior cruciate ligament (ACL) injury among young sports participants, the Hospital for Special Surgery (HSS) and the Aspen Institute convened a meeting of a new national coalition to make ACL injury prevention a fundamental aspect of youth sports. This executive summary outlines the National ACL Injury Coalition's goals as defined at its inaugural meeting held at HSS on March 27, 2023. Using a theory of change called "collective impact" designed to support collaboration and drive systems-level change, the coalition focused on 4 strategic priorities intended to reduce ACL injury rates in high school sports participants: widespread implementation of interventions (ensuring that student athletes are adequately trained), high-quality education (raising awareness among many stakeholders), equitable access (ensuring that all high school sports participants, regardless of the resources available at their schools, have access to injury prevention resources), and aligning stakeholders (uniting disparate entities-schools, sports clubs, parents, coaches, and others in these efforts). The group outlined short-range, medium-range, and long-range goals over a 3-year period, including the launch of an ACL injury prevention toolkit for use by adolescent sports participants and teams, athletic trainers, coaches, and other key stakeholders.

Postpartum Women’s Perceptions of Risk of Musculoskeletal Injuries in the Canadian Armed Forces: A Qualitative Research Study

Musculoskeletal injuries (MSKi) are a major concern within military forces, significantly reducing productivity and military readiness. Within the Canadian Armed Forces (CAF), MSKi are the most common cause of delayed deployment of members. There is a lack of research specifically focused on the experiences of postpartum CAF members and their perceived risk of MSKi. Drawing on Giles et al.’s equity-centered 4 E’s injury prevention framework (education, engineering, enforcement, and equity), we highlight that individuals who experience pregnancy may perceive themselves to be at heightened risk of injury due to sex and gender-based inequities in their workplace. This qualitative research draws on data from focus groups with 32 individuals who experienced pregnancy while serving in the CAF. Using reflexive thematic analysis, we identified the following findings related to perceived increased risk of MSKi: (a) nature of relevant physiological and anatomical changes in pregnancy, (b) unreasonable pressures to return to work at peak physical readiness, and (c) perceived challenges associated with accessing resources and services to support physical recovery. There are opportunities to improve access to injury prevention resources and support for pregnant and postpartum CAF members to reduce rates of MSKi. Findings from this study may be additionally relevant to armed forces more broadly or other professions that require return to physical readiness.

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

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.

Co-Designing a Farm Safety Gamified Educational Resource With Secondary School Students and Their Teachers: Qualitative Study Protocol

Unintentional injuries are a leading cause of preventable harm among adolescents. Adolescents also experience an increased risk of farm injury, and in Australia, injury-related farm fatalities among adolescents have remained largely unchanged over the past two decades. A third of all incidents involve farm visitors, indicating the need for population-level safety information. This project uses qualitative data to inform a co-design process with adolescents, and their teachers, to develop a game-based farm injury prevention online educational resource. This protocol describes the multi-phase co-design project. Focus group discussions regarding farm injury prevention will be held with students (Year 7 & 8; ∼12–14 years of age) and teachers at high schools with an agricultural focus across two Australian states. Inductive thematic analysis of discussion transcripts, and analysis of farm injury data, will inform the development of the modules and content of the game. User experience testing of the prototype will form the final phase of the project. This process is supported by a Stakeholder Advisory Group, which includes representatives of youth farming organisations, agricultural educators, and national child safety organisations. This group will assist in interpretation and dissemination of findings and promoting the resultant educational resource in schools. Ethical approval has been granted by the University of New South Wales Human Research Ethics Committee. Results will be disseminated through peer-reviewed publications, mass media releases, academic conferences, and the agricultural education sector in Australia via the stakeholder advisory group. This study will provide useful insights into co-designing injury prevention resources for adolescents using gamification and result in a co-designed farm injury prevention educational resource for schools and the general community via mobile and web-based applications.

Characterization of Traumatic Injury During the Early COVID-19 Pandemic: Results From a National Healthcare Database.

Objective: To characterize traumatic injury patterns after stay-at-home orders were implemented in the United States in response to the coronavirus disease 2019 (COVID-19).Methods: A retrospective review of a convenience sample of patients from a national healthcare research database (TriNetX) was conducted from April 1, 2020, to June 30, 2020. Inclusion criteria included all patients with documentation of both injury pattern and mechanism of injury. A comparison was made to a matched pre-pandemic timeframe. Changes in percentage and rate ratio (RR) with a 95% confidence interval were reported. RRs were calculated using Poisson regression analysis.Results: A total of 238,661 patients in the control and 178,224 patients in the study cohorts were analyzed. Significant increases in assaults (RR: 1.17, 95% CI: 1.14, 1.20) and bicycle accidents (RR: 1.07, 95% CI: 1.04, 1.11) were noted. There was a relative increase in patients who were male (+1.78%) and white (+2.01%). More injuries were alcohol-related (+0.76%) and occurred at home (+0.79%). A decrease in motor vehicle accidents (-1.17%), foot and ankle injuries (-1.63%), and injuries occurring at sporting events (-0.54%) was noted.Conclusions: Changes in injury patterns were observed during the study period. During future crises, particular public health and injury prevention resources may be required to address assaults, substance abuse, and home safety.

Where to start? Injury prevention priority scores for traumatic injuries in Canada.

Background:Given limited resources for injury prevention, it is essential to determine which mechanisms of injury to target to provide the most benefit to the largest proportion of the population. We developed objective, evidence-based injury prevention priority scores (IPPSs) for the Canadian population across 4 prevention perspectives: mortality, injury severity, resource use and societal cost.Methods:We performed a retrospective cohort study of all injuries in Canada from 2009/10 to 2013/14. Hospital admissions were obtained from the Discharge Database, and deaths from the Statistics Canada Canadian Vital Statistics Death Database. For each mechanism of injury, we calculated an IPPS as a balanced measure of injury frequency and 1) mortality rate, 2) median 1 – ICISS (Injury Severity Score derived from the International Statistical Classification of Diseases and Related Health Problems, 10th revision, enhanced Canadian version), 3) median cost per hospital stay or 4) median potential years of life lost (PYLL), providing a ranking of mechanisms of injury in priority order. The IPPS by definition has a mean of 50 and a standard deviation of 10. The higher the IPPS, the higher the priority for injury prevention.Results:A total of 694 535 injuries were identified over the study period. The most frequent mechanism of injury was falls (391 068 [56.3%]). The overall mortality rate was 0.09 deaths/injured person, the median 1 – ICISS was 0.017, the median cost was $5217, and the median PYLL was 0. The mechanisms with the 3 highest IPPSs were falls (75), self-harm (67) and drowning (66) for mortality; falls (77), drowning (70) and suffocation (61) for severity; falls (80), suffocation (63) and fire (60) for resource use; and falls (72), assault (62), and firearms and legal interventions (59 in both cases) for societal cost.Conclusion:This study produced IPPSs for traumatic injuries in Canada that provide objective and quantifiable methods for identifying mechanisms of injury to target for specific prevention initiatives. Preventing falls would provide the most benefit to the largest proportion of Canadians and should be prioritized in injury-prevention policy.

Individual and neighborhood level characteristics of pediatric firearm injuries presenting at trauma centers in Colorado.

Firearm injuries are the second leading cause of death among children and adolescents in the United States. In Colorado, firearm injuries have surpassed motor vehicle accidents as the leading cause of death in youth. Local research is necessary to characterize risk factors associated with pediatric firearm injuries. We sought to categorize demographics, neighborhood characteristics, and trends in pediatric firearm injuries in Colorado. A review of pediatric firearm-injured patients (18 years or younger) evaluated at four trauma centers in Colorado from 2008 to 2019 was conducted. Clinical information, injury intent, and demographics were collected. Patient addresses were geocoded to census tracts to obtain neighborhood-level characteristics. Annual trends in firearm injury incidence per trauma evaluation were analyzed using regression modeling. There were 446 firearm injuries during the study period. The median age was 16 years, and 87.0% were male. Assault was the most common injury intent (64.6%), and 92.0% of patients were from metropolitan (rural-urban continuum code 1-3) areas. Neighborhoods associated with firearm injuries were characterized by lower median household income ($47,112 vs. $63,443, p < 0.001) and higher levels of poverty (19.1% vs. 9.4%, p < 0.001) compared with median state levels. There was a 14.0% increase in firearm injuries compared with overall trauma evaluations for each year in the study period (incidence rate ratio, 1.14; 95% confidence interval, 1.08-1.20; p < 0.001). The incidence of pediatric firearm injuries increased significantly from 2008 to 2019 compared with overall trauma evaluations in Colorado. Children and adolescents who live in more socially vulnerable neighborhoods are disproportionately impacted, and injury prevention resources should be focused on these communities. Prognostic and Epidemiolgic; Level III.

Sport and leisure activities in the heat: What safety resources exist?

ObjectivesTo conduct a document analysis of sports and leisure activity heat-related injury prevention resources in Australia and develop an understanding of the content within those resources. Design & MethodsHeat resources were included if they dealt specifically with, or could be extrapolated to, prevention of heat-related injuries. Collating strategies for the catalogue included: (1) a detailed search of the organisation's website and (2) an online search for sport specific heat resources. A content analysis of each resource was first performed, and descriptive codes were assigned to the data using qualitative data analysis software. Every coded text was recorded as an individual data point (n). Common sub-categories were identified by thematic analysis and collated under three broader categories. ResultsA total of 468 data points were identified within the 64 heat resources found. Guidelines (n = 20) and policies (n = 18) were the most common type of resources followed by factsheets (n = 9), webpages (n = 8), laws and by-laws (n = 2). Three overarching categories emerged through the data analysis process: preventive strategies (n = 299, 63.9%), risk factors (n = 94, 20.1%), treatment (n = 75, 16.0%). Activity modification, which included information on rescheduling games and extra breaks, was the most common intervention. Cricket, soccer, swimming and triathlon had the most complete set of heat resources. ConclusionsThe findings of this study provide an insight into the composition of heat-related sports injury prevention resources within Australia and identify areas for development. As the resources were incomplete for many sports, the development of more comprehensive heat safety resources is required to ensure the safety of participants.

Active & Safe Central: using a mixed-methods design and the RE-AIM framework to evaluate a sport and recreational injury prevention resource for practitioners in Canada

ObjectivesAn online, evidence-based resource was created to support the development of sport and recreational injury prevention programmes. The resource, called Active & Safe Central (www.activesafe.ca), provides evidence-based information across the...

Exploring Farm Parenting Styles and Child Agricultural Injury

HighlightsOver a third of respondents (34.3%) reported a child agricultural injury.About 41% of parents were classified as authoritative (high level of involvement and control), 35.7% as uninvolved, 13.3% as permissive, and 10% as authoritarian.In our sample of farm parents, authoritative parenting is protective against risk-taking behaviors in childhood as well as reducing potential injury among children.Abstract. Four distinct parenting styles have been described: authoritative, authoritarian, permissive, and uninvolved. Parenting styles have been associated with a myriad of child safety and health outcomes. However, the association between parenting style and child agricultural injury has not been explored. This study was conducted among farm parents in Wisconsin and Pennsylvania using a self-administered paper questionnaire. Parents responded to items inquiring about parenting styles, previous child agricultural injuries, personal demographics, and farm characteristics. A total of 238 farm parents responded to the survey. Over a third of respondents (34.3%) reported a child agricultural injury. About 41% of parents were classified as authoritative (demonstrating a high level of involvement and control), 35.7% as uninvolved, 13.3% as permissive, and 10% as authoritarian. In the univariable analyses of parenting style, notable elevations in child injury rates occurred for the authoritarian (RR = 1.96, 95% confidence interval (CI) 1.08 to 3.58, p = 0.0274) and uninvolved (RR = 1.58, 95% CI 1.00 to 2.50, p = 0.0506) categories as compared to the referent category of authoritative. In the multivariable analyses that were adjusted for confounding variables, the magnitude of the corresponding RR estimates were less dramatic, although a 69% elevation was still present for the authoritarian parenting style (RR = 1.69, 95% CI 0.91 to 3.15, p = 0.0975). The results of this study contribute to the growing body of literature suggesting that authoritative parenting is protective against risk-taking behaviors in childhood as well as reducing potential injury among children. Clinicians and safety experts should consider parenting styles when developing child agricultural injury prevention resources or interventions. Keywords: Children, Health, Injury prevention, Parenting styles, Safety.

Pediatric Health Care Provider Perspectives on Injury Prevention Counseling in Acute and Primary Care Settings.

The objective of this study was to characterize how pediatric primary care and emergency medicine health care providers and trainees engage in injury prevention counseling and assess perceptions toward injury prevention resources. We surveyed physicians, advanced practice providers, and trainees in the Emergency Department, Primary Care Network, and Pediatric Residency Program at Children's Hospital of Philadelphia from September to November 2019. Of the 578 eligible participants, 208 (36.0%) completed the survey. When asked to rank the suitability of alternative personnel for providing counseling, 63.0% of the participants selected an injury prevention specialist as best suited. Seventy-six percent of the providers considered a tablet or mobile device used before a patient encounter to be a helpful resource. Variability existed in provider comfort, knowledge, and frequency of counseling by injury topic. Free-text responses cited time as a barrier to counseling. Opportunities exist to improve the provision of injury education through the utilization of novel resources and personnel.

Risk factors associated with road traffic injuries at the prone-areas in Kampala city: a retrospective cross-sectional study.

:Background:Road traffic injuries (RTIs) pose a disproportionate public health burden in the low and middle-income countries (LMICs) like Uganda, with 85% of all the fatalities and 90% of all disability-adjusted life years lost reported worldwide. Of all RTIs which are recorded in Uganda, 50% of cases happen in Kampala —the capital city of Uganda and the nearby cities. Identifying the RTI prone-areas and their associated risk factors can help to inform road safety and prevention measures aimed at reducing RTIs, particularly in emerging cities such as Kampala. Methods:This study was based on a retrospective cross-sectional design to analyze a five year (2011 – 2015) traffic crash data of the Uganda Police Force.Results:Accordingly, 60 RTI prone-areas were identified to exist across the Kampala. They were ranked as low and high risk areas; 41 and 19, respectively and with the majority of the latter based in the main city center. The bivariate analysis showed a significant association between identified prone-areas and population flow (OR: 4.89, P–value: 0.01) and traffic flow time (OR: 9.06, P–value: 0.01). On the other hand, the multivariate regression analysis only showed traffic flow time as the significant predictor (OR: 6.27, P–value: 0.02) at identified RTI prone-areas. Conclusions:The measures devised to mitigate RTI in an emerging city like Kampala should study thoroughly the patterns of traffic and population flow to help to optimize the use of available resources for effective road safety planning, injury prevention and sustainable transport systems.

2016 Indiana Farm Fatality Summary with Historical Comparisons

Highlights1,412 farm-related fatalities have been documented in Indiana since 1970.There were 30.7 fatalities annually, with an average of 25.2 over the past ten years.Victims age 60 and older have increased slightly, accounting for about 48% of all documented fatalities.Fatalities involving youth under the age of 18 have decreased in frequency.Tractors accounted for 45% of all farm fatalities over the past 20 years.Tractor rollovers continue to be the most frequent cause of farm-related fatalities.Abstract. Purdue University’s Agricultural Safety and Health Program (PUASHP) has been monitoring farm-related fatalities in Indiana for more than 70 years. The earliest identified summary of cases was published in 1960. This database, although recognized as not comprehensive for all farm-related deaths, provides a unique opportunity to explore trends that have occurred over several decades during which agricultural production has experienced considerable transformation in technology and practices. Analysis of earlier unpublished Indiana fatality data gathered during the 1940s and early 1950s identified the leading causes of deaths during that period as livestock related, primarily involving horses and bulls. These animal-related causes of injury and death have been largely replaced, at a much lower frequency, with tractors and machinery. Over the past five decades, the data show a clear downward trend that closely parallels the decline in the number and ongoing consolidation of farm operations, with the exception of the last decade, during which there has been a slightly increasing frequency of incidents. No fewer than 1,412 farm-related fatalities have been documented in Indiana since 1970, or approximately 30.7 fatalities annually, with an average over the past ten years of 25.2. Fatalities involving children and youth ages 1 to 17 have also continued to decline in number from 5 to 9 per year to an average of less than 2 per year over the last five years. On the other hand, incidents involving those over the age of 60 are trending slightly upward, accounting for about 48% of all documented fatalities and for 33% in 2016. For the past two decades, tractors accounted for 45% of all farm fatalities, including in 1998 when the percentage of cases involving tractors reached a high of 75%. Since 1970, tractor overturns have been the single most frequently identified cause of farm-related deaths. In 2016, 36% of all documented fatalities involved tractors, of which nearly all were related to an overturn. Findings suggest that the diversity of causative agents involved is increasing, the problem remains male-centric with ages that exceed the average age of Indiana farmers, children no longer make up a significant number of cases, and the Amish/Old Order communities and part-time farmers in the state account for a disproportionate share of farm-related deaths. Hazards identified as needing special attention include the operation of older, non-rollover protective structure (ROPS) equipped tractors by older workers, working in wood lots and tree felling on farms, operating self-propelled mowing equipment on farms, working with livestock, including horses, and falls from agricultural structures. The findings are being used to aid in allocation of diminishing injury prevention resources and development of more evidenced-based educational programming. Keywords: Farm, Farm fatalities, Fatality, Indiana, Tractor overturn.

Evaluation of an After-Hours Child Passenger Safety Resource Guide.

Motor vehicle crashes are a leading cause of unintentional injury deaths for children in the United States. Child safety seats are effective in reducing the rate and severity of injury for children. Families seen in an emergency department (ED) outside of injury prevention (IP) operational hours may not have the same opportunity to obtain a child safety seat due to the unavailability of IP resources. This study evaluated the effectiveness of a resource guide that assists the ED staff to screen and provide the appropriate child safety seat. Two retrospective cohort analyses were conducted to assess the following: (1) patients seen in the ED who were eligible to be screened through the resource guide; and (2) patients who were screened and received a restraint system through the resource guide. Records for both cohorts were reviewed from May 1, 2015, to February 29, 2016. Descriptive statistics were used to describe each cohort. In Cohort 1, 10.6% of the 113 patients meeting criteria were screened for a restraint system. In Cohort 2, 20 patients received a restraint system through the resource guide and 90% of these received the appropriate restraint system for their age and weight. Our results demonstrate the need for an algorithm to increase consistency of the resource guide's utilization. Algorithm development to identify screening candidates, further refinement of the guide's restraint identification process, and staff training may improve this tool to ensure that all patients, despite the availability of IP staff, are screened for the appropriate child safety seat.

‘Active & Safe Central’: development of an online resource for the prevention of injury in sport and recreational activity

BackgroundSport and recreation related injuries exert a significant cost on the healthcare system. As prevention researchers and practitioners, we have a responsibility to provide guidance towards prevention to those who...

American Association for the Surgery of Trauma Prevention Committee topical update: Impact of community violence exposure, intimate partner violence, hospital-based violence intervention, building community coalitions and injury prevention program evaluation.

An effective injury prevention program is an important component of a successful trauma system. Maintaining support for a hospital-based injury prevention program is challenging, given competing institutional and trauma program priorities and limited resources. In light of those pressures, the American College of Surgeons Committee on Trauma mandates that trauma centers demonstrate financial support for an injury prevention program as part of the verification process, recognizing that hospital administrators might see such support as discretionary and ripe as a target for expense reduction efforts. This Topical Update from the American Association for the Surgery of Trauma Injury Prevention Committee focuses on strategies to be more effective with the limited resources that are allocated to hospital-based injury prevention programs. First, this review tackles two of the many social determinates of violence, including activities aimed at mitigating the impact of both community violence exposure and intimate partner/domestic violence. Developing or participating in coalitions for injury prevention, both in general with any injury prevention initiative, and specifically while developing a hospital-based violence intervention program, efficiently extends the hospital's efforts by gaining access to expertise, resources, and influence over the target population that the hospital might otherwise have difficulty impacting. Finally, the importance of systematic program evaluation is explored. In an era of dwindling resources for injury prevention, both at the national level and the institutional level, it is important to measure the effectiveness of injury prevention efforts on the target population, and when necessary, make changes to programs to both improve their effectiveness and to assist organizations in making wise choices in the use of their limited resources.

USING AN INTEGRATED KNOWLEDGE TRANSLATION APPROACH TO INFORM THE DEVELOPMENT AND EVALUATION OF ACTIVE &amp; SAFE CENTRAL: AN ON-LINE PLATFORM OF EVIDENCE-BASED SPORT AND RECREATIONAL INJURY INFORMATION

Background: Sport and recreational injuries place a significant burden on the health care system and represent a large proportion of all injuries that report to emergency departments in Canada. An initiative to address this significant burden was to develop of an on-line platform providing information on the incidence of injury, risk factors, and effective interventions to reduce the risk of injury in over 51 sport and recreational activities. The information was collected by systematic review of the evidence which was critically appraised, synthesized and translated into an on-line platform, called Active and Safe Central. The objective of this project was to use an integrated knowledge translation approach to develop and evaluate the Active and Safe Central on-line tool. Methods: A mixed-methods design was used to develop and evaluate the Active and Safe Central Tool. Data was collected using a two-phased focus group format as well as an on-line survey, embedded in the on-line tool. Participants were recruited using purposive sampling and included a variety of stakeholders including parents, athletes, coaches, athletic therapists, injury prevention researchers and practitioners from local sport organizations. Focus groups were designed to be 60-minutes in duration and used a semi-structured format, led by a trained facilitator, to collect specific information on the design, use and information contained in the tool. The focus groups were both audio and visually recorded, with one project team member taking notes to supplement data collection. The on-line feedback form was created in consultation with experts in evaluation from the digital team as well as injury prevention researchers. The first focus group, at the build and mock-up phase collected information on: A) participants’ previous experiences with injury prevention resources and B) feedback on the proposed design, perceived usefulness and suggestions for the tool on use and content. The second focus group collected information on the interactivity of the tool, including live navigation with the beta version of the digital platform. Participants provided feedback on the functionality, visual appeal and usefulness of the site. Information from the focus groups and on-line feedback forms was synthesized and used to inform the design and reimaging of the Active and Safe Central tool during build, mock-up, beta and live versions. Results: Information collected from focus group participants was used to inform necessary changes in the on-line platform including critical navigation issues, visualizations, and interactivity. Initial post-launch results from the focus group (n=14) and from the on-line survey (n=87) suggest that the tool is a helpful resource for sport and recreational injury information (88.5% agreement). The majority of users agreed that the tool was easy to use (89.6%), that they learned something new after using the site (89.6%) and that they would use the recommendations presented in the prevention section of the site. Finally, 86.2% responded affirmatively to share the information gathered on the site, with others in their community. Conclusions: The Active and Safe Central resource was developed using an integrated knowledge translation approach with evaluation indices embedded throughout the process. Information collected through focus groups was critical in the initial development and subsequent iterations of the on-line tool. Initial evaluation results suggest the tool is an effective resource for sport and recreational injury information that has significant potential to impact prevention practice.

Epidemiology of Joint Dislocations and Ligamentous/Tendinous Injuries among 2,700 Patients: Five-year Trend of a Tertiary Center in Iran.

The epidemiology of traumatic dislocations and ligamentous/tendinous injuries is poorly understood. In this study, we aimed to evaluate the prevalence and distribution of various dislocations and ligamentous/tendinous injuries in a tertiary orthopedic hospital in Iran. Musculoskeletal injuries in an academic tertiary health care center in Tehran February 2005 to October 2010 were recorded. The demographic details of patients with pure dislocations and ligamentous/tendinous injuries were extracted and the type and site of injuries were classified according to their specific age/gender groups. Among 18,890 admitted patients, 628 (3.3%) were diagnosed with dislocations and 2.081 (11%) with ligamentous/tendinous injuries. The total male/female ratio was 4.2:1 in patients with dislocations and 1.7:1 in patients with ligamentous/tendinous injuries. Shoulder was the most prevalent site of dislocation (50.6%), followed by fingers (10.1%), toes (7.6%), hip (7.3%), and elbow (6.5%). Ankle was the most common site of ligamentous/tendinous injury (53.5%), followed by midfoot (12.3%), knee (8.3%), hand (7%), and shoulder (5%). The mean ages of the patients in dislocations and ligamentous/tendinous injuries were 35.0±18.2 and 31.3± 15.1, respectively. There was no seasonal variation. Shoulder dislocation and ankle ligamentous injury are the most frequent injuries especially in younger population and have different distribution patterns in specific age and sex groups. Epidemiologic studies can help develop and evaluate the injury prevention strategies, resource allocation, and training priorities.

Workers' compensation loss prevention representative contact and risk of lost-time injury in construction policyholders

IntroductionInsurance loss prevention (LP) representatives have access and contact with businesses and employees to provide targeted safety and health resources. Construction firms, especially those smaller in size, are a high-risk population. This research evaluated the association between LP rep contact and risk for lost-time injuries in construction policyholders. MethodsWorkers' compensation data were utilized to track LP rep contact with policyholders and incidence of lost-time injury over time. Survival analysis with repeated events modeling calculated hazard ratios (HR) and 95% confidence intervals (CI). ResultsCompared no LP contact, one contact was associated with a 27% reduction of risk (HR=0.73, CI=0.65–0.82), two with a 41% (HR=0.59, CI=0.51–0.68), and three or more contacts with a 28% reduction of risk (HR=0.72, CI=0.65–0.81). ConclusionsLP reps appear to be a valuable partner in efforts to reduce injury burden. Their presence or contact with policyholders is consistent with reduction in overall incidence of lost-time injuries. Practical applicationsReduction in lost-time injuries, resulting in reduced workers' compensation costs for policyholders and insurance companies, builds a business-case for safety and injury prevention. LP reps are often a low or no-cost benefit for insurance policyholders and may be an important injury prevention resource for small firms and/or those with lack of safety resources and staff.

The translation of sports injury prevention and safety promotion knowledge: insights from key intermediary organisations

BackgroundA recognised research-to-practice gap exists in the health research field of sports injury prevention and safety promotion. There is a need for improved insight into increasing the relevancy, accessibility and legitimacy of injury prevention and safety promotion research knowledge for sport settings. The role of key organisations as intermediaries in the process of health knowledge translation for sports settings remains under-explored, and this paper aims to determine, and describe, the processes of knowledge translation undertaken by a set of key organisations in developing and distributing injury prevention and safety promotion resources.MethodsThe National Guidance for Australian Football Partnerships and Safety (NoGAPS) project provided the context for this study. Representatives from five key NoGAPS organisations participated in individual face-to-face interviews about organisational processes of knowledge translation. A qualitative descriptive methodology was used to analyse participants’ descriptions of knowledge translation activities undertaken at their respective organisations.ResultsSeveral themes emerged around health knowledge translation processes and considerations, including (1) identifying a need for knowledge translation, (2) developing and disseminating resources, and (3) barriers and enablers to knowledge translation.ConclusionsThis study provides insight into the processes that key organisations employ when developing and disseminating injury prevention and safety promotion resources within sport settings. The relevancy, accessibility and legitimacy of health research knowledge is foregrounded, with a view to increasing the influence of research on the development of health-related resources suitable for community sport settings.