Updating the international research agenda for sport injury prevention

The International Olympic Committee's World Conference on Prevention of Injury and Illness in Sport, the third in a series of triennial international conferences, was held in Monaco in April 2011. This conference is now the leading research event for many sports injury prevention and sports medicine researchers, and was well attended by over 940 delegates from 85 countries. A particularly pleasing part of the programme was the large emphasis of a number of sessions (including a keynote, several symposia and proffered papers) on the primary prevention of sports injuries, particularly issues relating to the delivery, implementation and uptake of preventive measures in this important context of injury. Abstracts from this meeting have been published in the April Injury Prevention and Health Promotion issue of the British Journal of Sports Medicine (http://bjsm.bmj.com/content/45/4.toc) and online presentations are available for viewing at the conference website (http://www.ioc-preventionconference.org/)

Integrating and maintaining automated external defibrillators and emergency planning in community sport settings: a qualitative case study

Introduction A voluntary State Government-led programme in Victoria, Australia ‘Defibrillators for Sporting Clubs and Facilities Program’ ran from 2015 to 2019, broadly aimed at increasing access to automated external defibrillators (AEDs), together with a greater number of community members trained for management of medical emergencies. This study aimed to understand whether participating sport clubs/facilities had successfully integrated an AED and medical planning with other club/facility safety practices, 12 months after delivery of the programme. Methods This was a qualitative case study of 14 sport clubs/facilities in Victoria, Australia in 2017, underpinned by the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. We conducted observational audits of facilities (to locate AED placement, signage and other relevant location-specific factors) and semi-structured, face-to-face interviews with representatives of the clubs/facilities. Interview questions were designed to determine if and how the related, mandated emergency management programme was adapted for the long term (embedding), whether this aligned to ongoing organisational mission (active engagement), and whether or not it was still ongoing 6 months postinitial implementation (sustainability). Data were evaluated using qualitative descriptive methodology. For reporting, descriptive summaries of the audit were combined with interview data to contextualise and visualise the sport club/facility setting and key results. Results Key issues identified were accessibility and visibility of the AED, with inadequate signage and challenges identifying an efficient location for access and storage. Most interviewees reported the AED and training were received with no further actions taken towards safety planning or integration with club/facility practice. Several challenges regarding remaining up to date with training and ensuring required routine checks of the AED take place were also raised. Conclusions This study identified several challenges for community sport clubs/facilities in the implementation of an AED and medical planning programme, including where to store the AED, how to make its presence known to the community and how to integrate changes alongside other club/facility practices

Improving musculoskeletal injury surveillance methods in Special Operation Forces: A Delphi consensus study

Musculoskeletal injury mitigation is a priority in military organisations to protect personnel health and sustain a capable workforce. Despite efforts to prevent injury, inconsistencies exist in the evidence used to support these activities. There are many known limitations in the injury surveillance data reported in previous Special Operation Forces (SOF) research. Such studies often lack accurate, reliable, and complete data to inform and evaluate injury prevention activities. This research aimed to achieve expert consensus on injury surveillance methods in SOF to enhance the quality of data that could be used to inform injury prevention in this population. A Delphi study was conducted with various military injury surveillance stakeholders to seek agreement on improving surveillance methods in SOF. Iterative questionnaires using close and open-ended questions were used to collect views about surveillance methods related to injury case definitions and identifying essential and optional data requirements. Consensus was predefined as 75 % group agreement on an item. Sixteen participants completed two rounds of questionnaires required. Consensus was achieved for 17.9 % (n = 7) of questions in the first-round and 77.5 % (n = 38) of round two questions. Several challenges for surveillance were identified, including recording injury causation, SOF personnel’s injury reporting behaviours influencing accurate data collection, and surveillance system infrastructure limitations. Key military injury surveillance stakeholders support the need for improved data collection to enhance the evidence that underpins injury prevention efforts. The consensus process has resulted in preliminary recommendations to support future SOF injury surveillance

Self-Reported Supervisory Behavior and Belief vs. Actual Observations of Caregiver Behavior at Beaches

This study examined self-reported supervisory behaviours of caregivers at beaches and ascertained whether self-reported supervision reflects observed behaviour. Observations were conducted of caregiver/child pairs at 18 Australian beaches, with questionnaires subsequently completed by caregivers. Caregivers identified visual contact as essential for close supervision and proximity a key determinant in distinguishing supervision and close supervision. Supervisory behaviour was associated with child age, whilst lifeguard patrol had no effect on supervision. All supervision statements from the PSAPQ-BEACH were associated with supervision. Only three statements were significant independent predictors of supervision. Comparisons suggest caregivers’ self-reported supervisory behaviour reflects actual supervision. As this is the first study of its kind, it is essential that further prospective research using mixed-method approaches build on this information

Injury surveillance in community cricket: A new inning for South Africa

Published injury rates amongst elite and club-level youth cricketers highlight the need to implement injury risk-reducing strategies amongst the youth cricketing population. Data from sports injury surveillance systems are a prerequisite for the development and evaluation of strategies to reduce injury risk. Therefore, collecting injury surveillance data is a positive move towards reducing injuries in cricket. In South Africa, a systematic, standardised, evidence-informed injury surveillance system currently does not exist for community levels of play, namely, in cricket-playing high schools and cricket clubs. Although injury surveillance systems exist at elite levels, the obvious differences in elite versus community cricket settings mean that these systems cannot be implemented in their current form at community-level cricket. An innovative model is required to implement an injury surveillance system in community cricket. Clinical implications: This article proposes and describes a new research–practice partnership model to implement a systematic, standardised, evidence-informed injury surveillance system at cricket-playing high schools or cricket clubs within South Africa. Once this model has been employed, database systems will need to be established to allow long-term data management and sharing

Injury deaths in Australian sport and recreation: Identifying and assessing priorities for prevention

Introduction Sport and recreation is beneficial for health and wellbeing but comes with a probability of loss, including occasional fatal injuries. Following high-profile injury deaths in Australia, concerns are raised regarding the safety of sport participation. To understand the scale and scope of injury deaths, and identify potential prevention opportunities, the aim of this investigation was to describe the number and nature of fatal injuries in Australian sport and recreation. Methods This is a retrospective cohort study of injury deaths reported between 1 July 2000 to 31 December 2019 using data from the National Coronial Information System, Australia. Unintentional deaths with an external cause, where the activity was recorded as sport and exercise during leisure time were included. Drowning deaths were excluded. Presented are the number and % of cases by age, sex, sport, broad cause and annual crude death rate (population). Results There were 1192 deaths, averaging 63 per year. Deaths were mostly in males (84.4%), with the largest proportion in people aged 15–24 years (23.1%). Wheeled motor (26.9%) and non-motor (16.2%) sports accounted for the highest proportion of cases. The primary mechanism of death was most commonly blunt force (85.4%), followed by piercing/penetrating force (5.0%). The years 2001 and 2005 recorded the highest crude injury death rate (2001, n = 92, 0.47 per 100,000 population; 2005, n = 95, 0.47 per 100,000 population). Conclusions On average, there is more than one injury death per week in a sport or recreation setting in Australia. Cases occurred in many sports and recreation activities, including those generally considered to be safe (e.g. individual athletic activities, team ball sports.) Detailed investigation of the coronial recommendations that are present within each case is now needed to understand and identify potential prevention opportunities

Relative survival after hospitalisation for hip fracture in older people in New South Wales, Australia

Survival after hospitalisation for hip fracture by age group and sex relative to survival in the general population was assessed in people aged 65+. Men had double the risk of death compared with women to 1 year, but age effects lasted only to 3 months. Clinical outcomes need to be improved.We assessed the relative survival of hospitalised fall-related hip fracture patients aged 65+ years leaving hospital in New South Wales, Australia, between July 2000 and December 2003.We carried out a population-based study of all hospital separations for NSW residents with a principal diagnosis of hip fracture (ICD-10-AM S72.0 to S72.2) and first external cause of fall (ICD-10-AM codes W00 to W19), linked to NSW death data. A total of 16,836 cases were included. Relative survival 3 to 36 months post-admission by 10-year age groups and sex was calculated, using NSW life tables for 2002-2004. Relative excess risk was modelled using a generalised linear model with Poisson error structure, using the life table data.One-year cumulative relative survival in 65- to 74-year-olds was 82% (men), 90% (women); in 85+-year-olds 65% (men), 80% (women). Men have a relative excess risk of death of 2.2 (95% CI 2.03-2.38) times that of women. Only 21% of deaths mention the hip fracture as contributing to death.There is a need to reduce the number of hip fractures and improve clinical outcomes for older people hospitalised with hip fractures

Risk perceptions for exertional heat illnesses in junior cricket in Sri Lanka

Objectives Exertional heat illnesses (EHI) can occur when sport is played in hot and humid environments, such as those common across Asia. Measures to reduce the risk of EHI are important; however, causal data on EHI occurrence are limited and challenging to capture. To gain an initial understanding of EHI risks, we aimed to assess the risk perceptions of EHI of youth cricketers. Methods A descriptive cross-sectional survey, comprised of 14 questions on EHI risks, was conducted with 365 Sri Lankan junior male cricketers (age=12.9±0.9 years) who typically play in hot and humid conditions. Results For climate related risks, relative humidity was perceived as having a low risk of EHI compared with ambient temperature. The EHI risk associated with wearing protective gear, as commonly used in cricket, was perceived as low. Most junior cricketers perceived a low level of risk associated with recommended preventive measures such as body cooling and heat-acclimatisation. Conclusion This is the first study to explore EHI risk perceptions in any sporting context. Young players may not be mindful of all risks. Therefore, leadership and initiative from competition organisers and parents is required to promote countermeasures. © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ