An Evaluation of the Cool 2 Be Safe Program: An Evidence-Based Community-Disseminated Program to Positively Impact Children’s Beliefs About Injury Risk on Playgrounds

Abstract Purpose Medications are commonly associated with acute kidney injury (AKI). However, in both clinical practice and research, consideration of specific medications as nephrotoxic varies widely. The Nephrotoxic Injury Negated by Just-in-time Action quality improvement collaborative was formed to focus on prevention or reduction of nephrotoxic medication-associated AKI in noncritically ill hospitalized children. However, there were discrepancies among institutions as to which medications should be considered nephrotoxic. The collaborative convened a Nephrotoxic Medication (NTMx) Subcommittee to develop a consensus for the classification of nephrotoxic medications. Summary The NTMx Subcommittee initially included pediatric nephrologists, a pharmacist, and a pediatric intensivist. The committee reviewed NTMx lists from the collaborative and identified changes from the initial NTMx list. The NTMx Subcommittee conducted a literature review of the disputed medications and assigned an evidence grade based on the reported association with nephrotoxicity and the quality of the data. The association between medication exposure and AKI was also determined using administrative data from the Pediatric Health Information Systems database. The NTMx Subcommittee then came to a majority consensus regarding which medications should be included on the list. The subcommittee’s recommendations were presented to the larger collaborative for approval, and consensus was achieved. The list continues to be reviewed and updated annually. Conclusion Formation of a multicenter quality-improvement initiative exposed current limitations as to which medications are considered nephrotoxic in clinical and research settings and presented an opportunity to approach this problem using an evidence-based process. A consensus definition of nephrotoxic-medication exposure was achieved.

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What are the perceptions of runners and healthcare professionals on footwear and running injury risk?

BMJ Open Sport & Exercise Medicine ◽

10.1136/bmjsem-2020-000767 ◽

2020 ◽

Vol 6 (1) ◽

pp. e000767

Author(s):

Gurmeet K Dhillon ◽

Michael A Hunt ◽

Andrea L Reid ◽

Jean-Francois Esculier

Keyword(s):

Injury Risk ◽

Online Survey ◽

Healthcare Professionals ◽

Perceived Usefulness ◽

Selection Strategy ◽

Evidence Based ◽

Educational Module ◽

Future Studies ◽

Online Module ◽

Running Injury

ObjectivesThere is a gap in research exploring perceptions of runners and healthcare professionals (HCPs) about running footwear and injury risk. The objectives of this study were: (1) to document factors considered by runners when selecting footwear; (2) to compare perceptions on footwear and injury risk in runners and HCPs; and (3) to evaluate the perceived usefulness of an online educational module.MethodsUsing an online survey, we collected information on demographics and perceptions about footwear and injury risk. Runners reported their footwear selection strategy, and HCPs their typical recommendations. An evidence-based educational module was presented, and participants rated its usefulness.ResultsThe survey was completed by 2442 participants, of which 1035 completed the optional postmodule questions. Runners reported relying mostly on comfort and advice from retailers when selecting shoes. Perceptions regarding the effects of specific footwear types (minimalist, maximalist), characteristics (softness, drop) and selection strategy (foot type, transition) on biomechanics and injury risk were different between HCPs and runners. Overall, runners perceived footwear as more important to prevent injury than did HCPs (7.6/10, 99% CI 7.4 to 7.7 vs 6.2/10, 99% CI 6.0 to 6.5; p<0.001). Both runners (8.1/10, 99% CI 7.9 to 8.3) and HCPs (8.7/10, 99% CI 8.6 to 8.9) found the educational module useful. A majority of respondents indicated the module changed their perceptions.ConclusionFootwear is perceived as important in reducing running injury risk. This online module was deemed useful in educating about footwear evidence. Future studies should evaluate if changes in perceptions can translate to behaviour change and, ultimately, reduced injury risk.

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Managing the Training Load in Adolescent Athletes

International Journal of Sports Physiology and Performance ◽

10.1123/ijspp.2016-0334 ◽

2017 ◽

Vol 12 (s2) ◽

pp. S2-42-S2-49 ◽

Cited By ~ 11

Author(s):

Andrew Murray

Keyword(s):

Athletic Performance ◽

Injury Risk ◽

Systematic Approach ◽

Training Load ◽

Evidence Based ◽

Adolescent Athletes ◽

Training Dose ◽

Modern Times ◽

Load Monitoring ◽

Athletic Development

While historically adolescents were removed from their parents to prepare to become warriors, this process repeats itself in modern times but with the outcome being athletic performance. This review considers the process of developing athletes and managing load against the backdrop of differing approaches of conserving and maximizing the talent available. It acknowledges the typical training “dose” that adolescent athletes receive across a number of sports and the typical “response” when it is excessive or not managed appropriately. It also examines the best approaches to quantifying load and injury risk, acknowledging the relative strengths and weaknesses of subjective and objective approaches. Making evidence-based decisions is emphasized, while the appropriate monitoring techniques are determined by both the sporting context and individual situation. Ultimately a systematic approach to training-load monitoring is recommended for adolescent athletes to both maximize their athletic development and allow an opportunity for learning, reflection, and enhancement of performance knowledge of coaches and practitioners.

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Development of a preliminary evidence-based neuromusculoskeletal exercise guideline to reduce injury risk in the lower limb

Physical Therapy in Sport ◽

10.1016/j.ptsp.2016.08.012 ◽

2017 ◽

Vol 25 ◽

pp. 76-83 ◽

Cited By ~ 3

Author(s):

Michael E. Lehr ◽

Devin Kime ◽

Cayce Onks ◽

Matthew Silvis ◽

Megan Streisel

Keyword(s):

Lower Limb ◽

Injury Risk ◽

Preliminary Evidence ◽

Evidence Based ◽

Exercise Guideline

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Prevention of sports injuries in children at school: a systematic review of policies

BMJ Open Sport & Exercise Medicine ◽

10.1136/bmjsem-2018-000346 ◽

2018 ◽

Vol 4 (1) ◽

pp. e000346 ◽

Cited By ~ 4

Author(s):

Anya Göpfert ◽

Maria Van Hove ◽

Alan Emond ◽

Julie Mytton

Keyword(s):

Injury Prevention ◽

Psychological Health ◽

Injury Risk ◽

Grey Literature ◽

National Level ◽

Evidence Base ◽

Evidence Based ◽

Prevention Measures ◽

Framework Analysis ◽

School Sports

BackgroundParticipation in sports as a child improves physical and psychological health. Schools need to promote sport while protecting against injury. It is not clear whether increasing evidence on injury prevention generated from professional sport is influencing school sports practices. This study reviewed policies promoting sport safety in schools to determine whether exposure to injury risk is recognised and whether evidence based prevention and management are included.MethodsA search strategy to identify policies for children aged 4–18 years was applied to electronic databases and grey literature sources. Safeguarding policies were excluded. Included policies were critically appraised and synthesised using modified framework analysis.ResultsTwenty-six policies were analysed. Most (57.7%) were from the USA. Ten (38.5%) focused solely on concussion. Synthesis identified primary, secondary and tertiary injury prevention measures relating to people (staff, students and parents), systems, school physical environment and national-level factors.ConclusionsRobust, evidence-based policies for reducing injury risk in school sports are limited. Guidelines with the largest evidence base were focused on concussion, with other school sport guidelines showing limited inclusion of evidence. Where included, evidence focused on injury management rather than prevention and frequently applied evidence from adult to children. Guidance was not specific to the child’s age, gender or developmental stage.

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Reducing hospital-acquired pressure injuries

BMJ Open Quality ◽

10.1136/bmjoq-2018-000464 ◽

2019 ◽

Vol 8 (1) ◽

pp. e000464

Author(s):

Yasser K Al-Otaibi ◽

Noura Al-Nowaiser ◽

Arshur Rahman

Keyword(s):

Risk Assessment ◽

Injury Risk ◽

Assessment Tool ◽

P Value ◽

Evidence Based ◽

Improvement Project ◽

Healthcare Improvement ◽

Pressure Injury ◽

Evidenced Based ◽

Hospital Acquired

Hospital-acquired pressure injury is a common preventable condition. Our hospital is a 144-bed governmental hospital in the Kingdom of Saudi Arabia that was found to have a 7.5% prevalence of hospital-acquired pressure injury in 2016. The aim of the improvement project was to reduce the prevalence of pressure injuries in our hospital from 7.5% to below 4% by the end of 2017. Our strategy for improvement was based on the Institute for Healthcare Improvement Model for Improvement. The change strategy was based on implementing an evidence-based risk assessment tool and a bundled evidence-based pressure injury prevention (PIP) intervention termed PIP bundle. After implementing the change package, we observed a reduction in the prevalence of pressure injuries by 84% (RR 0.16;95% CI 0.07 to 0.3; p value <0.0001) over a period of 12 weeks, in addition to an improvement in the compliance of pressure injury risk assessment and PIP interventions. The use of an evidenced-based bundled approach to prevent hospital-acquired pressure injuries has resulted in a significant reduction in the rate of pressure injuries. Improvement results were sustainable. In addition, our outcome measure exhibited minimal variability.

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Injury-Free Children and Adolescents: Towards Better Practice in Swedish Football (FIT project)

Research Ideas and Outcomes ◽

10.3897/rio.4.e30729 ◽

2018 ◽

Vol 4 ◽

Author(s):

Solveig Hausken ◽

Natalie Barker-Ruchti ◽

Astrid Schubring ◽

Stefan Grau

Keyword(s):

Injury Risk ◽

Scientific Evidence ◽

Large Body ◽

Medical Knowledge ◽

Injury Rate ◽

Youth Sport ◽

Evidence Based ◽

Youth Football ◽

Interdisciplinary Research Project ◽

And Training

This interdisciplinary research project will produce evidence-based recommendations on how injuries in Swedish youth football (soccer) can be prevented. Fewer injuries will positively impact athlete health, performance and career longevity and have the potential to promote life-long physical activity and wellbeing. Injury pattern research demonstrates that injuries are a significant problem in (Swedish) youth sport. Football has a higher traumatic and overuse injury rate than many contact/collision sports (e.g., field hockey, basketball). In research on youth football, the incidence of overuse training injuries was measured as high as 15.4 injuries per 1000 training hours, and the incidence of traumatic and overuse match injuries was 47.5 injuries per 1000 match hours. The injury frequency is alarming and applies to the 54% of children aged 7-14 and the 39% of youths aged 15-19 years who participate in Swedish organised sports. A large body of research identifies injury risk factors and preventative strategies; however, as the recent IOC consensus statement on youth athletic development points out, the existing, mostly bio-medical knowledge does not provide effective evidence-based injury prevention strategies. To address this deficit, interdisciplinary and context-driven knowledge on injury development in youth sport is needed. The proposed project will produce scientific evidence through four consecutive studies: a) Questionnaire to register the types, frequency and management of injuries; b) Laboratory testing of biomechanical, clinical and training-specific parameters to establish individual physical and sport-specific dispositions; c) Observation of sporting contexts to understand sporting cultures, coaching methods and coach-athlete relationships; and d) Interviews with coaches and players to recognize knowledge that shapes coaching and training. The sample of youth players will be recruited from Sweden’s most popular and injury-prone sport: football. Each of the four studies will conduct its own data production and analyses, and a collective analysis will produce integrated evidence. Concrete recommendations for best sporting practice will be developed, which will serve sporting federations, sport education institutions, coaches, sport support staff and players.

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Abstraction: An alternative neurocognitive account of recognition, prediction, and decision making

Behavioral and Brain Sciences ◽

10.1017/s0140525x19003017 ◽

2020 ◽

Vol 43 ◽

Author(s):

Valerie F. Reyna ◽

David A. Broniatowski

Keyword(s):

Decision Making ◽

Software Engineering ◽

Systems Engineering ◽

Evidence Based ◽

Extensive Literature ◽

Trace Theory ◽

Fuzzy Trace Theory ◽

Abstract Representations ◽

Technical Systems

Abstract Gilead et al. offer a thoughtful and much-needed treatment of abstraction. However, it fails to build on an extensive literature on abstraction, representational diversity, neurocognition, and psychopathology that provides important constraints and alternative evidence-based conceptions. We draw on conceptions in software engineering, socio-technical systems engineering, and a neurocognitive theory with abstract representations of gist at its core, fuzzy-trace theory.

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Misophonia: An Evidence-Based Case Report

American Journal of Audiology ◽

10.1044/2020_aja-19-00111 ◽

2020 ◽

Vol 29 (4) ◽

pp. 685-690

Author(s):

C. S. Vanaja ◽

Miriam Soni Abigail

Keyword(s):

Quality Of Life ◽

Case Report ◽

Case History ◽

Pure Tone ◽

Physiological Responses ◽

Evidence Based ◽

Management Option ◽

Pure Tone Audiogram

Purpose Misophonia is a sound tolerance disorder condition in certain sounds that trigger intense emotional or physiological responses. While some persons may experience misophonia, a few patients suffer from misophonia. However, there is a dearth of literature on audiological assessment and management of persons with misophonia. The purpose of this report is to discuss the assessment of misophonia and highlight the management option that helped a patient with misophonia. Method A case study of a 26-year-old woman with the complaint of decreased tolerance to specific sounds affecting quality of life is reported. Audiological assessment differentiated misophonia from hyperacusis. Management included retraining counseling as well as desensitization and habituation therapy based on the principles described by P. J. Jastreboff and Jastreboff (2014). A misophonia questionnaire was administered at regular intervals to monitor the effectiveness of therapy. Results A detailed case history and audiological evaluations including pure-tone audiogram and Johnson Hyperacusis Index revealed the presence of misophonia. The patient benefitted from intervention, and the scores of the misophonia questionnaire indicated a decrease in the severity of the problem. Conclusions It is important to differentially diagnose misophonia and hyperacusis in persons with sound tolerance disorders. Retraining counseling as well as desensitization and habituation therapy can help patients who suffer from misophonia.

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