Recommendations For Injury Prevention Research Articles

Maternal Knowledge, Attitudes, and Behavioral Intention after Exposure to Injury Prevention Recommendations in the News Media

Introduction: Injury prevention recommendations are frequently presented in the media. Parental understanding and response to these recommendations remain uninvestigated. Methods: A nationally representative sample of 1,081 mothers completed a cross-sectional survey measuring knowledge, attitudes, and behavioral intention after watching/reading video news stories and print articles on two child safety topics. Results: Of the 1,081 respondents, 33% reported hearing little about injury prevention in the media in the past 30 days, and 32% reported never hearing about injury prevention. Nearly one-half (46%) reported the injury prevention studies they had previously read or heard about in the media were confusing to them at least some of the time. The proportion of mothers who recalled the correct key statistic presented in the story varied by safety topic and medium in which the story was presented. A greater proportion of mothers correctly recalled information from the story narrative than the statistics. Mothers also rated the most interesting part of the story differently based on safety topic and medium. A small proportion were not planning to follow the safety recommendations after viewing the news story. Conclusions: There are gaps in making injury news stories understandable and memorable for mothers in order to encourage behavioral change.

Ready To Tri: Characteristics Of Recreational Triathletes

PURPOSE: The sport of triathlon has been increasing in popularity, especially among recreational athletes. As triathletes compete in races ranging from around 16 miles to 140.6 miles or more and train in 3 disciplines simultaneously, it is difficult to identify consistent risk factors for injury among these athletes. The aim of this study was to evaluate characteristics of a group of recreational triathletes in regards to their medical history, training habits, and musculoskeletal injuries. METHODS: Endurance athletes were recruited for participation from local triathlon clubs and upon presentation to the University of Miami Sports Medicine clinic. Triathletes over the age of 18 years were considered for participation. After consenting, they were sent a link via e-mail to complete an online survey. RESULTS: Twenty-two triathletes completed the survey. The average age was 46.5 years old (range 24-60 years). Seventy-three percent reported an injury in the past year, and 32% reported multiple injuries. The lower extremity represented 66% of injuries. The knee accounted for 27%, followed closely by the hip at 23%. The back and shoulder accounted for 15% each. Other reported locations of injuries were the foot, ankle, leg, and neck. Athletes spent the most training time per week biking at 4.9 hours, followed by running at 3.9 hours, and then swimming at 2.3 hours. Almost 60% reported weight training for an average of 2 hours per week. Of these, 77% reported at least 1 injury, but only 23% had multiple injuries. Only 14% participated in some type of yoga or Pilates. The majority of athletes, 59%, trained with the help of a coach. Only 18% reported working with a nutritionist, and less than 5% reported working with a sports psychologist. Thirty-six percent reported having a current, chronic medical condition. The most common conditions were asthma and anxiety. Sixty-four percent used some type of vitamin or supplement, with multivitamins being the most common (35%). A gluten free diet was followed by 21%, and 16% reported following a vegetarian or vegan diet. CONCLUSION: Establishing a better understanding of the characteristics of recreational triathletes along with trends in their training habits can help guide further research on injury risks and lead to training recommendations for injury prevention.

Agricultural Youth Injuries: A Review of 2015-2017 Cases from U.S. News Media Reports

ABSTRACTBackground: The hazardous nature of the agricultural environment, reflected in the numerous injuries and deaths to children who live, work and play on farms, coupled with the lack of a comprehensive national surveillance system in the United States, highlights the need for making the best use of publicly available youth agricultural injury data.Objective: The purpose of this study was to describe a 3-year collection of youth agricultural injuries using the publicly available injury and fatality data from AgInjuryNews.org and present recommendations for future injury prevention strategies.Methods: Data were obtained from AgInjuryNews.org, a web-based collection of U.S. news reports of agricultural injuries. We analyzed cases from 2015 to 2017 for youth aged 0–17. We classified injuries as occupational and non-occupational related, based on the Farm and Agricultural Injury Classification (FAIC) code. Each case was also coded for source and event using the Occupational Injury and Illness Classification System (OIICS).Results: Of the 348 injury reports reviewed, 51% were fatal, and about one-third of the victims were 6 years old or younger. Most injuries were non-occupational, and the most frequent injury sources were vehicles (includes tractors and all-terrain vehicles) and machinery. Youth operators, extra riders, roadway operations, and unsupervised youth playing near or in a worksite were four key contributing factors associated with vehicle and machinery related injuries.Conclusions: This study reaffirms that youth agricultural-related injuries and fatalities are still a persistent problem in the United States. The hypothesis generating AgInjuryNews system can provide more current data than traditional surveillance datasets as a tool for understanding the sources of youth agricultural injuries, monitoring injury trends, and informing policy efforts and prevention strategies. Future studies should continue to explore and evaluate the comprehensiveness of this system’s data and the impact of its dissemination, as well as similar rural health informatics solutions for integration into sustainable interventions that can be customized and delivered domestically and abroad.

Pediatric Dog Bite Injuries in Central Texas

PurposeIdentify children at greatest risk for dog bite injuries and to provide injury prevention recommendations. MethodsA retrospective review of patients aged ≤18 years treated for dog bite injuries from October 2011 to October 2016 was performed. Data collected included patient demographics, parental presence, time of injury, dog breed and ownership status, injury location and characteristics, need for operative intervention, and hospitalization. ResultsOne-hundred and two patients met the inclusion criteria. The mean age was 5.84 years, and 43.1% were preschool-aged (2–5 years). Parental presence was reported in 43.6% of cases, and most attacks occurred in the evening (46.8%). Injuries often involved the head–neck region (92.1%), and 72.5% were of major severity. Pet dogs were responsible for 42% of injuries, and pit bull was the most-identified breed (36.2%). Most injuries occurred while the child was at home (57.8%) and was petting or playing with the dog (28.4%). Intervention in the operating room was required in 34.3% of patients. Major injury was more likely to require operative intervention (p = 0.015) but was not associated with patient age, sex, pet status, or the need for hospitalization. ConclusionsPreschool-aged children are more likely to be injured by dog bites, and dog bites can result in major injury to the head and neck region. Prevention efforts should focus on dog training, public education (children and adults), vigilant adult supervision, and a zero-tolerance policy. Level of clinical evidenceLevel IV—case series with no comparison group. Type of studyPrognostic.

Change-of-Direction Biomechanics: Is What's Best for Anterior Cruciate Ligament Injury Prevention Also Best for Performance?

Change-of-direction maneuvers (e.g., side-step cutting) are an important aspect of performance in multi-directional sports, but these maneuvers are also associated with anterior cruciate ligament (ACL) injury. Despite this, the impact of biomechanics on ACL injury risk and performance is often examined in isolation. The purpose of this review was to examine the alignment between biomechanical recommendations for ACL injury prevention and performance with regard to change-of-direction maneuvers. Several studies linking change-of-direction biomechanics to both ACL injury risk and performance were examined. A degree of overlap was identified between biomechanical strategies that could both reduce ACL injury risk and enhance performance during change-of-direction maneuvers. A fore-foot footfall pattern along with trunk rotation and lateral flexion in the intended cutting direction were identified as biomechanical strategies that could both reduce potentially hazardous knee joint moments and enhance change-of-direction speed. Minimizing knee valgus during change-of-direction maneuvers may also reduce ACL injury risk, with this biomechanical strategy found to have no impact on performance. Certain biomechanical strategies proposed to reduce ACL injury risk were linked to reduced change-of-direction performance. A narrow foot placement and "soft" landings with greater knee flexion were identified as ACL injury prevention strategies that could have a negative impact on performance. The findings of this review emphasize the need to consider both ACL injury risk and performance when examining the biomechanics of change-of-direction maneuvers.

Sonographers – Are We Looking After Ourselves?

Aim: Echocardiography is a mainstay of cardiac imaging. It is accessible, comprehensive and cost-effective. However, it is also recognised that this investigation is responsible for an increased risk of injury and discomfort to sonographers. There are guidelines for reducing sonographer injuries. We set out to investigate how closely sonographers adhered to these guidelines, in particular individual controls, across Australia and New Zealand. Method: Following ethics approval, a confidential electronic survey was widely distributed through professional networks across Australia and New Zealand. Sonographers responded to questions relating to “individual controls”, as published in multiple guidelines for sonographer safety. Results: 1494 sonographers completed the survey, 97% were based in Australia and New Zealand. We found that some recommendations were followed by the vast majority of sonographers, such as optimizing the patient's position (93%) and optimizing bed/stool height (90%). 77% of sonographers claim to maintain a good level of fitness; however, only 37% stretch on a daily basis. Conclusion: Some recommendations for sonographer injury prevention have been thoroughly embraced by sonographers in Australia and New Zealand. However, there is still room for improvement. Considering that sonography is a high-risk profession, it is important for staff to be aware of these recommendations and take them on board. These individual controls can be utilized by sonographers regardless of their workplace. Table 1P31 Table 1Sonographer adherence to safety recommendations for individual controls.

Investigation of sports injuries and health in university female baseball players

Ulnar collateral ligament (UCL) injuries commonly occur in baseball players. Strategies for injury prevention have long been accepted without clinical data informing which risk factors lead to serious injury.The objective of this study was to systematically review the impact of various pitching-related risk factors for UCL injury in baseball players from all levels of play.The electronic databases MEDLINE, EMBASE and PubMed were systematically searched until 4 March 2018, and pertinent data were abstracted by two independent reviewers. Search terms included ‘ulnar collateral ligament’, ‘medial ulnar collateral ligament’, ‘Tommy John’, ‘risk’ and ‘association’. Inclusion criteria were English-language studies, level of evidence I–IV and studies reporting risk factors for UCL injury of the elbow in baseball players. Study quality was assessed using the methodological index for non-randomised studies (MINORS) criteria. The results are presented in a narrative summary.Pitching practices (workload and pitch characteristics) were reported in 9/15 studies. Specifically, three of four studies (n=1810) reported increased pitch workload as a risk factor for native UCL injury (p<0.001 to 0.02). The most common pitch characteristic reported was pitch velocity with four of five studies showing increased velocity being significantly associated with native UCL injury (p<0.01 to 0.02). Biomechanical risk factors reported were increased humeral retrotorsion (two studies; n=324), poor lower extremity and trunk balance (one study; n=42) and loss of total arc of shoulder motion (two studies; n=118), all significantly associated with UCL injury (p<0.0001 to 0.05). One of three studies assessing pitch workload as a risk factor for re-rupture of UCL reconstruction found a significant association (p<0.01).Pitching practices, reflected by increased pitch workload and velocity, were most commonly associated with UCL injury; however, the definition of workload (number of pitches per game, inning or season) was inconsistently reported. Biomechanical risk factors were less commonly reported and lack sufficient evidence to recommend preventative strategies. More quality data is needed to refine the current recommendations for injury prevention in baseball players.III.

Estradiol contributes to aggressive behaviors in a mouse model of pathological aggression

Ulnar collateral ligament (UCL) injuries commonly occur in baseball players. Strategies for injury prevention have long been accepted without clinical data informing which risk factors lead to serious injury.The objective of this study was to systematically review the impact of various pitching-related risk factors for UCL injury in baseball players from all levels of play.The electronic databases MEDLINE, EMBASE and PubMed were systematically searched until 4 March 2018, and pertinent data were abstracted by two independent reviewers. Search terms included ‘ulnar collateral ligament’, ‘medial ulnar collateral ligament’, ‘Tommy John’, ‘risk’ and ‘association’. Inclusion criteria were English-language studies, level of evidence I–IV and studies reporting risk factors for UCL injury of the elbow in baseball players. Study quality was assessed using the methodological index for non-randomised studies (MINORS) criteria. The results are presented in a narrative summary.Pitching practices (workload and pitch characteristics) were reported in 9/15 studies. Specifically, three of four studies (n=1810) reported increased pitch workload as a risk factor for native UCL injury (p<0.001 to 0.02). The most common pitch characteristic reported was pitch velocity with four of five studies showing increased velocity being significantly associated with native UCL injury (p<0.01 to 0.02). Biomechanical risk factors reported were increased humeral retrotorsion (two studies; n=324), poor lower extremity and trunk balance (one study; n=42) and loss of total arc of shoulder motion (two studies; n=118), all significantly associated with UCL injury (p<0.0001 to 0.05). One of three studies assessing pitch workload as a risk factor for re-rupture of UCL reconstruction found a significant association (p<0.01).Pitching practices, reflected by increased pitch workload and velocity, were most commonly associated with UCL injury; however, the definition of workload (number of pitches per game, inning or season) was inconsistently reported. Biomechanical risk factors were less commonly reported and lack sufficient evidence to recommend preventative strategies. More quality data is needed to refine the current recommendations for injury prevention in baseball players.III.

Elbow Injuries in Professional Baseball: Epidemiological Findings From the Major League Baseball Injury Surveillance System

Background: Elbow injuries cause significant disability for the throwing athlete. Scant data are available on the distribution and characteristics of these injuries in elite baseball players. No study exists that focuses solely on the epidemiological characteristics of elbow injuries in professional baseball players using a comprehensive injury surveillance system. Hypothesis: Professional baseball players have a high occurrence of elbow injuries influenced by factors including length of time playing, time period within the annual baseball season, and specific position played. Study Design: Descriptive epidemiological study. Methods: Data on elbow injuries occurring during the 2011-2014 seasons were collected from Major League Baseball’s Health Injury and Tracking System, a comprehensive injury surveillance system. Each specific type of elbow injury was evaluated with respect to overall injury rate, years as a professional player, mechanism of injury, treatment, average time lost, and return to play. Results: During the study period, 3185 elbow injuries (n = 430 Major League; n = 2755 Minor League) occurred. The mean number of days missed and percentage requiring surgery were similar between Major and Minor League players. Overall, 20.0% (650/3185) of the injuries required surgical treatment. Pitchers were the most likely to incur an elbow injury (40.0% of injured athletes were pitchers), were the most likely to require surgery (34.2% of injured pitchers required surgery), and had the greatest mean number of days missed when treated nonsurgically (33.2 days). Medial injuries composed 42.1% (1342/3185) of all elbow injuries. Of all elbow surgeries performed during the study period, the highest percentage involved ligaments (372/650; 57.2%). Conclusion: Elbow injuries are a considerable source of disability in professional baseball players. Pitchers are most likely to incur these injuries, are most likely to require surgery, and have the highest mean number of days missed when treated nonsurgically. The most common injuries involve the medial elbow, with ligament injuries most often requiring surgery. This study represents the only investigation to date using a comprehensive injury surveillance system to examine elbow injuries in professional baseball players. It provides a basis for injury prevention and treatment recommendations, establishes the most thorough framework for determining elbow injury risk, and focuses continued research on elbow injury prevention in the elite baseball player.

Racial and Ethnic Differences in Injury Prevention Behaviors Among Caregivers of Infants.

African American and Latino children experience higher rates of traumatic injury and mortality, but the extent to which parents of different races and ethnicities disparately enact injury prevention behaviors has not been fully characterized. The objective of this study is to evaluate the association between caregiver race/ethnicity and adherence to injury prevention recommendations. This was a cross-sectional analysis of caregiver-reported baseline data from the Greenlight study, a cluster-randomized pediatric obesity prevention trial. Data were collected between 2010 and 2012 in four academic pediatric practices and analyzed in 2015. Non-adherence to injury prevention recommendations was based on five domains: car seat safety, sleeping safety, fire safety, hot water safety, and fall prevention. Among 864 caregiver-infant pairs (17.7% white, non-Hispanic; 49.9% Hispanic; 27.7% black, non-Hispanic; 4.7 % other, non-Hispanic), mean number of non-adherent injury prevention behaviors was 1.8 (SD=0.9). In adjusted regression, Hispanic caregivers had higher odds of non-adherence to car seat safety (AOR=2.1, 95% CI=1.2, 3.8), and lower odds of non-adherence with fall prevention (AOR=0.4, 95% CI=0.3, 0.7) compared with whites. Black, non-Hispanic caregivers had higher odds of non-adherence to car seat safety (AOR=2.4, 95% CI=1.3, 4.4) and sleeping safety (AOR=2.1, 95% CI=1.3, 3.2), but lower odds of fall prevention non-adherence (AOR=0.5, 95% CI=0.3, 0.8) compared with whites. A high prevalence of non-adherence to recommended injury prevention behaviors is common across racial/ethnic categories for caregivers of infants among a diverse sample of families from low-SES backgrounds.

Factors hindering critical care nurses' compliance with evidence based guidelines for prevention of secondary brain injury

Background: Evidence-based clinical guidelines provide nurses with a method to use critically appraised. But, there are several barriers to their implementation which can be grouped as barriers related to individual nurse characteristics, organizational characteristics, and the nature of research information. The aim of the study: was to identify hindering factors for critical care nurses' compliance with evidence based guidelines for prevention of secondary brain injury. Materials & Method: Two tools were developed to collect data. “Evidence based guidelines for prevention of secondary brain injury observational checklist tool” and “Factors hindering nurses' compliance with Evidenced based guidelines for prevention of secondary brain injury questionnaire tool” to determine factors hinder nurses' compliance with evidenced based guidelines for prevention of secondary brain injury. Results: The study revealed that the overall average compliance with seizure control recommendations was the highest (91.9%) followed by maintaining adequate nutrition and preventing DVT recommendations which were more than two thirds among secondary brain injury prevention recommendations. Moreover, the organizational barriers were the most reported barriers by the majority of the CCNs (84%). Conclusion: In conclusion, the barriers to studied nurses' compliance are ranked and categorized as organizational barriers, followed by nature of research information barriers, then personal barriers.

Injuries in the Martial Arts Judo, Taekwondo and Wrestling - ASystematic Review

Martial arts such as judo, taekwondo and wrestling are regulated, usually athletic duels. The aim is to score better than your opponent or to win. As with any type of sport, athletes in martial arts sustain minor and major injuries, which may have many negative consequences. In addition, sports injuries and their rehabilitation generate high costs to the healthcare system. In contrast to the FIFA 11+ warm-up program, no preventive programs have been postulated for injury prevention in these martial arts. Therefore, the aim of this systematic review was to summarise the latest research findings and to evaluate whether initial recommendations can be given for the reduction of injuries in the martial arts judo, wrestling and taekwondo. To gain an overview of the latest research findings, we searched for systematic reviews in PEDro, PubMed, Cochrane and the internet search engine Google Scholar. The methodological quality of these reviews was assessed using the Critical Appraisal Tool for a Systematic Review (CASP), and data was extracted on the risk of injury, injury location and injury type. It was found that all three review articles are of low to moderate methodological quality. Regarding injury location, it became evident that the extremities are particularly vulnerable to injury in all three martial arts. Effusion was observed to be the most common type of injury. Due to the moderate methodological quality and the injury type of effusion, it is not possible to formulate recommendations for injury prevention. Moreover, uniform definitions should be developed to describe sports injuries.

Impact of Loading and Rest Intervals on Muscle Microtrauma

The purpose of this study is to determine whether different rest intervals and load-repetition combinations with different frequencies and durations would have an impact on the microtrauma response of the muscle and the development of musculoskeletal disorders (MSDs). Serum Creatine Kinase (CK) level, the physical response measured in this study, is collected before exercise and at days 1, 2, 4, 8 post- eccentric exercise of the human elbow flexor muscles through phlebotomy and serum analysis. A two-factor (loading and rest interval) factorial regression model is established for muscle microtrauma response. The findings of the study would assist in understanding the effect of different rest intervals and load-repetition combinations on muscle microtrauma response and healing process to eccentric exercise, foster injury-prevention recommendations to manufacturing job design in terms of promoting rest intervals with suitable frequency, as well as force and repetition balance. The regression model could provide guidance to future ergonomic assessment tool design. The results of the study show that higher force with a low repetition frequency leads to greater response than lower force with high repetition frequency, when given a predetermined total work time, total rest time and total work volume. Though not greatly significant, experiment data show that longer rest intervals, although given less frequently, discourages the peak response of muscle microtrauma compared to shorter rest intervals given more frequently, when total work time, rest time and workload are predetermined.

Exercise prescription to prevent injuries during recreational alpine skiing and snowboarding

Background: Skiing and snowboarding are popular recreational sports worldwide, promoting health through physical activity. Regrettably, participation in snow sports also involves injury risk. Each year, skiing and snowboarding activities contribute to the total number of sports-related injuries, and associated high socio-economic and personal costs. In several sports, targeted exercise programs are reported to be effective in reducing injury rates, and therefore have the potential to prevent skiing and snowboarding injuries. Purpose: The purpose of this work was to systematically review the literature to identify exercises and/or training strategies that are suggested to prevent alpine skiing and snowboarding injuries in recreational participants. Methods: Fourteen electronic databases were systematically searched using relevant MeSH terms and keywords. Articles were included when they addressed injury prevention, recreational alpine skiing or snowboarding, and musculoskeletal injuries. Two independent reviewers quality assessed all articles meeting inclusion using a validated checklist with higher percentage scores indicating higher quality. Data were subsequently extracted from articles using a standard form and categorized to facilitate data synthesis and interpretation. Results: Thirty articles met the defined inclusion criteria and scored 72± 17% (range: 23–100%) during quality assessment. From these articles, 80 recommendations for the prevention of musculoskeletal injuries in recreational alpine skiers and snowboarders were sourced, but none pertained to exercise prescription per se. The recommendations were instead grouped into 5 main categories: equipment (n= 24), education and knowledge (n= 11), awareness and behaviour (n= 15), experience (n= 10) and third-party involvement (n= 20). Most articles (73%) contained recommendations relevant to than one of these areas. Conclusion(s): The importance of targeting physical fitness in injury prevention is accepted in sports medicine and rehabilitation; yet, exercise programs for the prevention of injuries in snow sports are not readily available. As these sports involve high velocities and impact forces, it is not surprising that equipment related injury prevention recommendations were often reported. However, the nature of these sports also indicates a need for appropriate levels of strength, endurance, and conditioning to ensure an adequate control of alpinemanoeuvres and avoidance of injuries. Despite the lack of documented exercise programs, the value of using a multi-facetted approach to preventing injuries was evident. The lack of published data in this area is perhaps due to the challenges of performing an exercise-based injury prevention study in recreational skiers and snowboarders, which would need relatively large sample sizes, long-term follow-up, and extensive documentation and attention to confounding variables for valid, reliable and conclusive results. Implications: Until large-scale experimental research is performed, the prescription of exercises for the prevention of injuries in recreational alpine skiers and snowboarders has limited specificity and depends on empirical evidence from other sports.

An educational video to promote multi-factorial approaches for fall and injury prevention in long-term care facilities.

BackgroundOlder adults living in long term care (LTC) settings are vulnerable to fall-related injuries. There is a need to develop and implement evidence-based approaches to address fall injury prevention in LTC. Knowledge translation (KT) interventions to support the uptake of evidence-based approaches to fall injury prevention in LTC need to be responsive to the learning needs of LTC staff and use mediums, such as videos, that are accessible and easy-to-use. This article describes the development of two unique educational videos to promote fall injury prevention in long-term care (LTC) settings. These videos are unique from other fall prevention videos in that they include video footage of real life falls captured in the LTC setting.MethodsTwo educational videos were developed (2012–2013) to support the uptake of findings from a study exploring the causes of falls based on video footage captured in LTC facilities. The videos were developed by: (1) conducting learning needs assessment in LTC settings via six focus groups (2) liaising with LTC settings to identify learning priorities through unstructured conversations; and (3) aligning the content with principles of adult learning theory.ResultsThe videos included footage of falls, interviews with older adults and fall injury prevention experts. The videos present evidence-based fall injury prevention recommendations aligned to the needs of LTC staff and: (1) highlight recommendations deemed by LTC staff as most urgent (learner-centered learning); (2) highlight negative impacts of falls on older adults (encourage meaning-making); and, (3) prompt LTC staff to reflect on fall injury prevention practices (encourage critical reflection).ConclusionsEducational videos are an important tool available to researchers seeking to translate evidence-based recommendations into LTC settings. Additional research is needed to determine their impact on practice.

Effectiveness of a Media Campaign to Motivate Farm Parents to Seek Child Farm Injury Prevention Information Online

Farm children continue to experience high rates of premature mortality, morbidity, and disability due to injury in the agricultural environment. Many recommendations for injury prevention have been...

Overuse Injuries and Burnout in Youth Sports

Overuse Injuries and Burnout in Youth Sports

Implementing AORN Recommended Practices for Sharps Safety

Prevention of percutaneous sharps injuries in perioperative settings remains a challenge. Occupational transmission of bloodborne pathogens, not only from patients to health care providers but also from health care providers to patients, is a significant concern. Legislation and position statements geared toward ensuring the safety of patients and health care workers have not resulted in significantly reduced sharps injuries in perioperative settings. Awareness and understanding of the types of percutaneous injuries that occur in perioperative settings is fundamental to developing an effective sharps injury prevention program. The AORN “Recommended practices for sharps safety” clearly delineates evidence-based recommendations for sharps injury prevention. Perioperative RNs can lead efforts to change practice for the safety of patients and perioperative team members by promoting the elimination of sharps hazards; the use of engineering, work practice, and administrative controls; and the proper use of personal protective equipment, including double gloving.

THE IMPACT OF THE TACKLE: SHOULDER INJURIES IN A RUGBY UNION TEAM

BackgroundRugby Union (rugby) is the third most popular contact sport in the world and has one of the highest reported incidences of injuries amongst all sports. Thoroughly characterising these injuries...

Preventing child unintentional injury deaths: prioritising the response to the New Zealand Child and Adolescent Injury Report Card

To develop recommendations for child unintentional injury prevention by comparing New Zealand's child unintentional injury mortality and injury prevention policies with those of European countries. Unintentional child injury death rates based on external cause of injury were calculated and ranked. NZ's score for each of the 12 domains (based on external causes of injury) from the New Zealand Child and Adolescent Report Card was compared to European scoring. Policy priorities are identified by domains where mortality makes up a high proportion of overall child unintentional injury mortality (high burden of injury) and where report card score for that domain is low in comparison to other countries (under-utilisation of effective interventions). Death as a motor vehicle occupant accounts for 49% of all child unintentional injury deaths, followed by pedestrian (10%) and drowning deaths (8%). The overall score for the 12 policy domains of the NZ Report Card ranks NZ as 15(th) among the 25 European countries. There are important policy and legislative actions which NZ has not implemented. A number of evidence-based injury prevention policy and legislative actions are available that could target areas of greatest childhood injury mortality in NZ. A set of injury prevention policy and legislation priorities are presented which, if implemented, would result in a significant reduction in the injury mortality and morbidity rates of NZ children.