Adolescent physical activity during school lunch breaks : Same thing, different day
- Authors: Telford, Amanda , Casey, Meghan , Richards, G. , Finch, Caroline
- Date: 2009
- Type: Text , Conference paper
- Relation: Paper presented at 2009 Australia Conference of Science and Medicine in Sport, Seventh National Physical Activity Conference, Sixth National Sports Injury Prevention Conference, Be Active '09, Brisbane, Queensland : 14th-17th October 2009
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- Description: School settings are an essential source of physical activity for adolescents because they provide curricular, co-curricular opportunities in addition to time during scheduled breaks. There has been limited previous research examining the physical activity behaviour of adolescents during break periods. Purpose: The aim of this study was to investigate the inter-day variability of adolescent's physical activity (PA) during school lunchtime periods. Methods: Participants (n = 40) from yr 8 to 10 (mean age = 14.5 ± 0.8 yrs) wore a SPI-Elite Global Positioning System (GPS) unit during five lunchtimes during a school week. Heart rate (HR), speed, distance, global position, and G force were measured for each participant and reported across a range of play spaces including a cricket net area, grassed oval, quadrangle, basketball/netball court area and seated shaded area for each participant across the five days. Analyses were performed on time periods randomly selected from three days for windows of 20 min+. Time spent within the various play spaces was determined by overlaying GPS data with Google Earth images of the school playground. Results: Independent samples t-tests revealed males (mean = 2.5 ± .97 km) covered a greater distance compared to females (mean = 1.5 ± .73 km) at the p < 0.01 level. Males also displayed significantly higher HR than did females during lunch breaks, at the p < 0.01 level. Students spent significantly more time and covered the greatest distance on the oval (grassed area) when compared to other play spaces (p < 0.01), and girls spent significantly more time in the seated shaded area than did males (p < 0.01). There were no significant differences for inter-day variability of average time, distance, HR, speed or G force within adolescent students’ physical activity during lunchtimes. Conclusions: The results suggest adolescents’ physical activity during lunch breaks is relatively stable across days. There are a number of feasibility issues relating to the use of GPS technology within the context of school settings and these are discussed. Future physical activity interventions targeting adolescents should consider the nature of the play space and may need to be tailored differently for males and females.
- Description: 2003008134
Coaches' perspectives on implementing an evidence-informed injury prevention programme in junior community netball
- Authors: Saunders, Natalie , Otago, Leonie , Romiti, Maria , Donaldson, Alex , White, Peta , Finch, Caroline
- Date: 2010
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 44, no. 15 (2010), p. 1128-1132
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Objective For effective sports injury prevention, information is needed about the implementation context for interventions. This study describes coaches' feedback on the implementation of an evidence-informed injury prevention programme in community junior netball using coaches' perceptions and the RE–AIM framework. Methods A lower-limb injury prevention programme (Down to Earth; D2E), for teaching safe-landing techniques, was delivered to 31 coaches from 31 junior community netball teams in a 1-h workshop. Coaches then delivered a 6-week programme at team training sessions starting in the week before the competition season commenced. 65% of coaches completed a feedback survey 17 weeks after they had delivered the programme. Results Most (88%) coaches believed that D2E improved their players' ability to perform correct landing techniques in games and that players had retained these improvements over the season. The majority (83%) indicated that an improvement in player athletic attributes was the greatest advantage of D2E, followed by a reduction in injury risk. Identified barriers to implementing D2E were running out of time and very young players finding the drills too difficult. Coaches reported that they needed more ideas for training drills that could be incorporated into their programmes and believed that their own coaching training did not adequately prepare them to implement an injury prevention programme. Conclusions Although coaches believed that D2E was effective in developing correct landing techniques, some modifications are needed to make it more suitable for younger players and coach education by accreditation courses could be improved to support the implementation of injury prevention programmes.
Protective equipment to prevent wrist fractures
- Authors: Finch, Caroline
- Date: 2008
- Type: Text , Book chapter
- Relation: World report on child injury prevention Chapter 5 p. 108
- Full Text: false
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- Description: 2003006719
Knowledge, beliefs and attitudes of squash venue operators relating to use of protective eyewear
- Authors: Eime, Rochelle , Finch, Caroline , Owen, Neville , Gifford, Sandra , Vear, Paul
- Date: 2004
- Type: Text , Journal article
- Relation: International Journal of Injury Control and Safety Promotion Vol. 11, no. 1 (2004), p. 47-53
- Full Text: false
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- Description: Sports venues are in a position to potentially influence the safety practices of their patrons. This study examined the knowledge, beliefs and attitudes of venue operators that could influence the use of protective eyewear by squash players. A 50% random sample of all private and public squash venues affiliated with the Victorian Squash Federation in metropolitan Melbourne was selected. Face-to-face interviews were conducted with 15 squash venue operators during August 2001. Interviews were transcribed and content and thematic analyses were performed. The content of the interviews covered five topics: (1) overall injury risk perception, (2) eye injury occurrence, (3) knowledge, behaviors, attitudes and beliefs associated with protective eyewear, (4) compulsory protective eyewear and (5) availability of protective eyewear at venues. Venue operators were mainly concerned with the severe nature of eye injuries, rather than the relatively low incidence of these injuries. Some venue operators believed that players should wear any eyewear, rather than none at all, and believed that more players should use protective eyewear. Generally, they did not believe that players with higher levels of experience and expertise needed to wear protective eyewear when playing. Only six venues had at least one type of eyewear available for players to hire or borrow or to purchase. Operators expressed a desire to be informed about correct protective eyewear. Appropriate protective eyewear is not readily available at squash venues. Better-informed venue operators may be more likely to provide suitable protective eyewear. [ABSTRACT FROM AUTHOR] Copyright of Injury Control & Safety Promotion is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Description: 2003001113
Parent/caregiver supervision and child injury : A systematic review of critical dimensions for understanding this relationship
- Authors: Petrass, Lauren , Blitvich, Jennifer , Finch, Caroline
- Date: 2009
- Type: Text , Journal article
- Relation: Family & Community Health Vol. 33, no. 2 (Apr-Jun 2009), p. 123-135
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- Description: This study reviewed the relationship between recognized dimensions of supervision and children's injuries based on Saluja et al's (Injury Control and Safety Promotion. 2004; 11: 17-22) hierarchal model of supervision strategies. A systematic review of peer-review studies was clone with the earliest records available to 2007. There were 112 potentially relevant articles identified; 31 studies met all inclusion criteria. Reported Studies were categorized according to the dimensions Of supervision they addressed. Studies were not evenly distributed across the dimensions. There was evidence from the Study that directly linking dimensions of supervision to child injury risk and outcomes is scarce. future studies should consider attention, proximity, and continuity Of supervision to provide a holistic understanding of the relationship between Supervision and injury
- Description: 2003008201
Changes in muscle activation following balance and technique training and a season of Australian football
- Authors: Donnelly, Cyril , Elliott, Bruce , Doyle, Tim , Finch, Caroline , Dempsey, Alasdair , Lloyd, David
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 18, no. 3 (2014), p.348-352
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Objectives: Determine if balance and technique training implemented adjunct to 1001 male Australian football players' training influenced the activation/strength of the muscles crossing the knee during pre-planned and unplanned sidestepping. Design: Randomized Control Trial. Methods: Each Australian football player participated in either 28 weeks of balance and technique training or 'sham' training. Twenty-eight Australian football players (balance and technique training, n = 12; 'sham' training, n = 16) completed biomechanical testing pre-to-post training. Peak knee moments and directed co-contraction ratios in three degrees of freedom, as well as total muscle activation were calculated during pre-planned and unplanned sidestepping. Results: No significant differences in muscle activation/strength were observed between the 'sham' training and balance and technique training groups. Following a season of Australian football, knee extensor (p = 0.023) and semimembranosus (p = 0.006) muscle activation increased during both pre-planned sidestepping and unplanned sidestepping. Following a season of Australian football, total muscle activation was 30% lower and peak valgus knee moments 80% greater (p = 0.022) during unplanned sidestepping when compared with pre-planned sidestepping. Conclusions: When implemented in a community level training environment, balance and technique training was not effective in changing the activation of the muscles crossing the knee during sidestepping. Following a season of Australian football, players are better able to support both frontal and sagittal plane knee moments. When compared to pre-planned sidestepping, Australian football players may be at increased risk of anterior cruciate ligament injury during unplanned sidestepping in the latter half of an Australian football season.
What do community football players think about different exercise-training programmes? Implications for the delivery of lower limb injury prevention programmes
- Authors: Finch, Caroline , Doyle, Tim , Dempsey, Alasdair , Elliott, Bruce , Twomey, Dara , White, Peta , Diamantopoulou, Kathy , Young, Warren , Lloyd, David
- Date: 2014
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 48, no. 8 (2014), p.702-707
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Background: Players are the targeted end-users and beneficiaries of exercise-training programmes implemented during coach-led training sessions, and the success of programmes depends upon their active participation. Two variants of an exercise-training programme were incorporated into the regular training schedules of 40 community Australian Football teams, over two seasons. One variant replicated common training practices, while the second was an evidence-based programme to alter biomechanical and neuromuscular factors related to risk of knee injuries. This paper describes the structure of the implemented programmes and compares players’ end-of-season views about the programme variants. Methods: This study was nested within a larger group-clustered randomised controlled trial of the effectiveness of two exercise-training programmes (control and neuromuscular control (NMC)) for preventing knee injuries. A post-season self-report survey, derived from Health Belief Model constructs, included questions to obtain players’ views about the benefits and physical challenges of the programme in which they participated. Results: Compared with control players, those who participated in the NMC programme found it to be less physically challenging but more enjoyable and potentially of more benefit. Suggestions from players about potential improvements to the training programme and its future implementation included reducing duration, increasing range of drills/exercises and promoting its injury prevention and other benefits to players. Conclusions: Players provide valuable feedback about the content and focus of implemented exercise-training programmes, that will directly inform the delivery of similar, or more successful, programmes in the future.
What would you like? Identifying the required characteristics of an industry-wide incident reporting and learning system for the led outdoor activity sector
- Authors: Goode, Natassia , Finch, Caroline , Cassell, Erin , Lenne, Michael , Salmon, Paul
- Date: 2014
- Type: Text , Journal article
- Relation: Australian Journal of Outdoor Education Vol. 17, no. 2 (July 2014), p. 2-15
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
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- Description: The aim of this study was to identify the characteristics that led outdoor activity providers agree are necessary for the development of a new industry-wide incident reporting and learning system (UPLOADS). The study involved: 1) a literature review to identify a set of characteristics that are considered to be hallmarks of successful reporting and learning systems in other safety-critical domains; and (2) the presentation of these characteristics to 25 Australian led outdoor activity providers using a two round modified-Delphi technique to obtain consensus views on their relative importance in this domain. Thirteen out of 30 characteristics were endorsed as "essential" for developing an incident reporting and learning system for the led outdoor activity sector, and a further 13 were endorsed as "required". "Essential" characteristics primarily related to operational or practical characteristics of the system, while "required" characteristics primarily related to system infrastructure, data quality and the basis for developing of countermeasures to address identified injury risks. The findings indicate that although led outdoor activity providers are primarily concerned that the demands of reporting do not adversely impact on their day to day operations, they also recognise that data collection methods and countermeasure development need to be of high quality. The paper concludes by highlighting some potential strategies for implementing the characteristics considered "essential" and "required".
Self-reported supervisory behavior and beliefs vs. actual observations of caregiver behavior at beaches
- Authors: Petrass, Lauren , Blitvich, Jennifer , Finch, Caroline
- Date: 2011
- Type: Text , Journal article
- Relation: International Journal of Aquatic Research and Education Vol. 5, no. 2 (May 2011), p. 199-209
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565904
- Full Text: false
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- Description: This study examined self-reported supervisory behaviors of caregivers at beaches and ascertained whether self-reported supervision reflects observed behavior. 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 behavior was associated with child age, while 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 behavior 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.
Implementing injury surveillance systems alongside injury prevention programs: evaluation of an online surveillance system in a community setting
- Authors: Ekegren, Christina , Donaldson, Alex , Gabbe, Belinda , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: Injury Epidemiology Vol. 1, no. 1 (2014), p. 1-15
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Relation: http://purl.org/au-research/grants/nhmrc/565907
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- Description: BACKGROUND:Previous research aimed at improving injury surveillance standards has focused mainly on issues of data quality rather than upon the implementation of surveillance systems. There are numerous settings where injury surveillance is not mandatory and having a better understanding of the barriers to conducting injury surveillance would lead to improved implementation strategies. One such setting is community sport, where a lack of available epidemiological data has impaired efforts to reduce injury. This study aimed to i) evaluate use of an injury surveillance system following delivery of an implementation strategy; and ii) investigate factors influencing the implementation of the system in community sports clubs. METHODS:A total of 78 clubs were targeted for implementation of an online injury surveillance system (approximately 4000 athletes) in five community Australian football leagues concurrently enrolled in a pragmatic trial of an injury prevention program called FootyFirst. System implementation was evaluated quantitatively, using the RE-AIM framework, and qualitatively, via semi-structured interviews with targeted-users. RESULTS:Across the 78 clubs, there was 69% reach, 44% adoption, 23% implementation and 9% maintenance. Reach and adoption were highest in those leagues receiving concurrent support for the delivery of FootyFirst. Targeted-users identified several barriers and facilitators to implementation including personal (e.g. belief in the importance of injury surveillance), socio-contextual (e.g. understaffing and athlete underreporting) and systems factors (e.g. the time taken to upload injury data into the online system). CONCLUSIONS:The injury surveillance system was implemented and maintained by a small proportion of clubs. Outcomes were best in those leagues receiving concurrent support for the delivery of FootyFirst, suggesting that engagement with personnel at all levels can enhance uptake of surveillance systems. Interview findings suggest that increased uptake could also be achieved by educating club personnel on the importance of recording injuries, developing clearer injury surveillance guidelines, increasing club staffing and better remunerating those who conduct surveillance, as well as offering flexible surveillance systems in a range of accessible formats. By increasing the usage of surveillance systems, data will better represent the target population and increase our understanding of the injury problem, and how to prevent it, in specific settings.
Cardiac emergency preparedness in health/fitness facilities in Australia
- Authors: Sekendiz, Betul , Gass, Gregory , Norton, Kevin , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: The Physician and sportsmedicine Vol. 42, no. 4 (November 2014), p. 14-19
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text: false
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- Description: BACKGROUND: Health/fitness facilities are popular venues for physical activity, where increasingly more individuals at risk of cardiovascular events exercise to achieve positive health outcomes. The aim of our study was to analyze cardiac emergency preparedness in health/fitness facilities in Queensland, Australia. DESIGN: Cross-sectional survey of health/fitness facilities in Queensland. METHODS: A risk management questionnaire was administered over 7 months, July 2009 to January 2010, using an online or paper-based version. The data are presented as the proportion of survey respondents giving specific responses to questionnaire items related to cardiac emergency preparedness, especially the provision of automated external defibrillators (AEDs). RESULTS: Fifty-two health/fitness facility managers responded to the survey. Most of the surveyed facilities conducted pre-activity screening (92%). Of those with a written emergency plan (79%), only 37% physically rehearsed their emergency response systems at regular intervals. Ninety-five percent of the facilities had fitness employees with a current first aid/cardiopulmonary resuscitation certificate and training. Of the 10 (19%) facilities with an on-site AED, only 6 had staff qualified to use the AED in an emergency, and only 6 had the AED as part of a public access defibrillator program. CONCLUSION: This is the first study to report that cardiac emergency preparedness is not optimal in the health/fitness facilities in Australia. Development of policies and procedures for training health/fitness professionals in emergency procedures is needed to minimize the risk when exercise-induced cardiac events occur at health/fitness facilities.
The safety attitudes of people who use multi-purpose recreation facilities as a physical activity setting
- Authors: Finch, Caroline , Otago, Leonie , White, Peta , Donaldson, Alex , Mahoney, Mary
- Date: 2011
- Type: Text , Journal article
- Relation: International Journal of Injury Control and Safety Promotion Vol. 18, no. 2 (2011), p. 107-112
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- Description: Multi-purpose recreation facilities (MPRFs) are a popular setting for physical activity and it is therefore important that they are safe for all patrons. However, the attitudes of MPRF users towards safety are a potential barrier to the success of injury prevention programmes implemented within MPRFs. This article reports a survey of the safety attitudes of over 700 users of four indoor MPRFs. Factor analysis of 12 five-point Likert scale statements showed that the attitudes clustered around three major dimensions - the importance of safety, the benefits of safety and the perceptions of injury risk. Together, these three dimensions accounted for 49% of the variability in the attitudes. More than 85% of respondents agreed/strongly agreed that: safety was an important aspect of physical activity participation; being injured affected enjoyment of physical activity; people should adopt appropriate safety measures for all physical activity; and individuals were responsible for their own safety. The MPRF users, particularly women and older people, were generally safety conscious, believed in adopting safety measures, and were willing to take responsibility for their own safety. Facility managers can be confident that if they provide evidence-based injury prevention interventions in these settings, then users will respond appropriately and adopt the promoted behaviours. © 2011 Taylor & Francis.
Implementing studies into real life
- Authors: Finch, Caroline
- Date: 2010
- Type: Text , Book chapter
- Relation: Sports injury research p. 213-235
- Full Text: false
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Community-dwelling older people hospitalised for fall-related injury: characterising high length of stay users
- Authors: Vu, Trang , Finch, Caroline , Day, Lesley
- Date: 2012
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 18, no. Supplement 1 (2012), p. A121
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- Description: Background: Nearly half to 60% of falls in community-dwelling older people aged 65+ years result in physical injuries and 20%–50% of these require medical attention, including emergency department visit and hospitalisation. Fallers who stay in hospital longer than would be expected based on the primary injury diagnosis create an excess financial burden on the health system and represent a priority target group for fall prevention. Objectives: To identify and characterise high-length-of-stay (HLOS) patients among community-dwelling older people aged 65+ years hospitalised for fall-related injury. Methods: We analysed hospital discharge data from Victoria, Australia, to identify and characterise HLOS patients among community-dwelling older people aged 65+ years hospitalised for fall-related injury. We defined an episode as HLOS if the length of stay (LOS) was more than three times the average LOS for a particular diagnosis-related group. Results: Between 2005/06 and 2007/08 6822 patients (14.2% of the study group of which 73.8% were women) had ≥1 episode classified as HLOS. The HLOS patients accounted for 19.9% of episodes and 39.9% of bed days. HLOS patients were similar to non-HLOS patients in terms of indigenous status, in-hospital mortality and ethnicity. However, HLOS patients were older, less likely to be married, less likely to have hospital insurance and more likely to have comorbidity than non-HLOS patients. Significance/Contribution to the Field: This study identifies priority groups for a targeted prevention approach.
The biomechanical basis of injury during childhood
- Authors: Finch, Caroline , Twomey, Dara
- Date: 2012
- Type: Text , Book chapter
- Relation: Paediatric biomechanics and motor control: Theory and application p. 209-232
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Encouraging junior community netball players to learn correct safe landing technique
- Authors: White, Peta , Ullah, Shahid , Donaldson, Alex , Otago, Leonie , Saunders, Natalie , Romiti, Maria , Finch, Caroline
- Date: 2011
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol.15 , no.1 (2011), p.19-24
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
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- Description: Behavioural factors and beliefs are important determinants of the adoption of sports injury interventions. This study aimed to understand behavioural factors associated with junior community netball players' intentions to learn correct landing technique during coach-led training sessions, proposed as a means of reducing their risk of lower limb injury. 287 female players from 58 junior netball teams in the 2007/2008-summer competition completed a 13-item questionnaire developed from the Theory of Planned Behaviour (TPB). This assessed players' attitudes (four items), subjective norms (four), perceived behavioural control (four) and intentions (one) around the safety behaviour of learning correct landing technique at netball training. All items were rated on a seven-point bipolar scale. Cluster-adjusted logistic regression was used to assess which TPB constructs were most associated with strong intentions. Players had positive intentions and attitudes towards learning safe landing technique and perceived positive social pressure from significant others. They also perceived themselves to have considerable control over engaging (or not) in this behaviour. Players' attitudes (p < 0.001) and subjective norms (p < 0.001), but not perceived behavioural control (p = 0.49), were associated with strong intentions to learn correct landing technique at training. Injury prevention implementation strategies aimed at maximising junior players' participation in correct landing training programs should emphasise the benefits of learning correct landing technique (i.e. change attitudes) and involve significant others and role models whom junior players admire (i.e. capitalise on social norms) in the promotion of such programs. © 2011 Sports Medicine Australia.
The burden of hospitalised fall-related injury in community-dwelling older people in Victoria : A database study
- Authors: Vu, Trang , Day, Lesley , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: Australian and New Zealand Journal of Public Health Vol. 38, no. 2 (April 2014), p. 128-133
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
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- Description: Objective: To estimate the burden of hospitalised fall-related injury in community-dwelling older people in Victoria. Methods: We analysed fall-related, person-identifying hospital discharge data and patient-level hospital treatment costs for community-dwelling older people aged 65+ years from Victoria between 1 July 2005 and 30 June 2008, inclusive. Key outcomes of interest were length of stay (LOS)/episode, cumulative LOS (CLOS)/patient and inpatient costs. Results: The burden of hospitalised fall-related injury in community-dwelling older people aged 65+ years in Victoria was 284,781 hospital bed days in 2005-06, rising to 310,031 hospital bed days in 2007-08. Seventy-one per cent of episodes were multiday. One in 15 acute care episodes was a high LOS outlier and 14% of patients had ≥1 episode classified as high LOS outlier. The median CLOS/patient was nine days (interquartile range 2-27). The annual costs of inpatient care, in June 2009 prices, for fall-related injury in community-dwelling people aged 65+ years in Victoria rose from $213 million in 2005-06 to $237 million in 2007-08. The burden of hospitalised fall-related injury in community-dwelling older women, people aged 85+ years and those with comorbidity was considerable. Conclusions: The burden of hospitalised fall-related injury in community-dwelling older people aged 65+ years in Victoria is significantly more than previously projected. Importantly, this study identifies that women, patients with comorbidity and those aged 85+ years account for a considerable proportion of this burden. Implications: A corresponding increase in falls prevention effort is required to ensure that the burden is properly addressed.
Patterns of comorbidity in community-dwelling older people hospitalised for fall-related injury: A cluster analysis
- Authors: Vu, Trang , Finch, Caroline , Day, Lesley
- Date: 2011
- Type: Text , Journal article
- Relation: BMC Geriatrics Vol. 11, no. 45 (2011), p. 1-10
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Background: Community-dwelling older people aged 65+ years sustain falls frequently; these can result in physical injuries necessitating medical attention including emergency department care and hospitalisation. Certain health conditions and impairments have been shown to contribute independently to the risk of falling or experiencing a fall injury, suggesting that individuals with these conditions or impairments should be the focus of falls prevention. Since older people commonly have multiple conditions/impairments, knowledge about which conditions/impairments coexist in at-risk individuals would be valuable in the implementation of a targeted prevention approach. The objective of this study was therefore to examine the prevalence and patterns of comorbidity in this population group. Methods: We analysed hospitalisation data from Victoria, Australia's second most populous state, to estimate the prevalence of comorbidity in patients hospitalised at least once between 2005-6 and 2007-8 for treatment of acute fall-related injuries. In patients with two or more comorbid conditions (multicomorbidity) we used an agglomerative hierarchical clustering method to cluster comorbidity variables and identify constellations of conditions. Results: More than one in four patients had at least one comorbid condition and among patients with comorbidity one in three had multicomorbidity (range 2-7). The prevalence of comorbidity varied by gender, age group, ethnicity and injury type; it was also associated with a significant increase in the average cumulative length of stay per patient. The cluster analysis identified five distinct, biologically plausible clusters of comorbidity: cardiopulmonary/metabolic, neurological, sensory, stroke and cancer. The cardiopulmonary/metabolic cluster was the largest cluster among the clusters identified. Conclusions: The consequences of comorbidity clustering in terms of falls and/or injury outcomes of hospitalised patients should be investigated by future studies. Our findings have particular relevance for falls prevention strategies, clinical practice and planning of follow-up services for these patients.
An Anterior cruciate ligament Injury prevention framework : Incorporating the recent evidence
- Authors: Donnelly, Cyril , Elliott, Bruce , Ackland, Timothy , Doyle, Tim , Beiser, Thor , Finch, Caroline , Cochrane, Jodie , Dempsey, Alasdair , Lloyd, David
- Date: 2012
- Type: Text , Journal article
- Relation: Research in Sports Medicine Vol. 20, no. 3/4 (2012), p. 239-262
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text: false
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- Description: Anterior cruciate ligament (ACL) injury rates have increased by ∼50% over the last 10 years. These figures suggest that ACL focused research has not been effective in reducing injury rates among community level athletes. Training protocols designed to reduce ACL injury rates have been both effective (n = 3) and ineffective (n = 7). Although a rationale for the use of exercise to reduce ACL injuries is established, the mechanisms by which they act are relatively unknown. This article provides an injury prevention framework specific to noncontact ACL injuries and the design of prophylactic training protocols. It is also apparent that feedback within this framework is needed to determine how biomechanically relevant risk factors like peak joint loading and muscular support are influenced following training. It is by identifying these links that more effective ACL injury prevention training programs can be developed, and, in turn, lead to reduced ACL injury rates in the future.
Implementing and evaluating interventions
- Authors: Finch, Caroline
- Date: 2012
- Type: Text , Book chapter
- Relation: Injury research: Theories, methods, and approaches p. 619-639
- Full Text: false
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- Description: Real-world implementation of injury prevention interventions and evaluation of their effectiveness need to take into account the broad ecological context in which they are introduced. This chapter provides perspectives and guidance on (1) the design, conduct, and evaluation of studies that are concerned with the effectiveness of injury prevention and safety promotion interventions and (2) research to better understand the context for intervention delivery. It begins with an overview of why research into intervention delivery and evaluation of its outcomes is necessary for the broad field of injury prevention and control. This includes a comparison of the aims and approaches of efficacy and effectiveness studies and the recognized gap between the two. The ecological context for injury prevention is summarized and the implications for intervention delivery and evaluation are described. The chapter then covers key theoretical, conceptual, and methodological issues involved in evaluation research and introduces some of the current thinking about translation research. Particular emphasis is given to Intervention Mapping as a tool to assist in the intervention development process, Diffusion of Innovations theory to guide efforts in the planning of intervention strategies and the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) health promotion framework and their reported applications to injury prevention interventions to date.