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

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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Prevention and education evidence review: Gambling-related harm

10.33684/2021.006 ◽

2021 ◽

Author(s):

Margo Hilbrecht ◽

Sally M. Gainsbury ◽

Nassim Tabri ◽

Michael J. A. Wohl ◽

Silas Xuereb ◽

...

Keyword(s):

At Risk ◽

Research Evidence ◽

Grey Literature ◽

Evidence Base ◽

Unintended Consequences ◽

Evidence Based ◽

Negative Consequences ◽

Age Cohorts ◽

Gambling Harm ◽

Harm Prevention

This report supports an evidence-based approach to the prevention and education objective of the National Strategy to Reduce Harm from Gambling. Applying a public health policy lens, it considers three levels of measures: universal (for the benefit of the whole population), selective (for the benefit of at-risk groups), and indicated (for the benefit of at-risk individuals). Six measures are reviewed by drawing upon a range of evidence in the academic and grey literature. The universal level measures are “Regulatory restriction on how gambling is provided” and “Population-based safer gambling/responsible gambling efforts.” Selective measures focus on age cohorts in a chapter entitled, “Targeted safer gambling campaigns for children, youth, and older adults.” The indicated measures are “Brief internet delivered interventions for gambling,” “Systems and tools that produced actual (‘hard’) barriers and limit access to funds,” and “Self-exclusion.” Since the quantity and quality of the evidence base varied by measure, appropriate review methods were selected to assess publications using a systematic, scoping, or narrative approach. Some measures offered consistent findings regarding the effectiveness of interventions and initiatives, while others were less clear. Unintended consequences were noted since it is important to be aware of unanticipated, negative consequences resulting from prevention and education activities. After reviewing the evidence, authors identified knowledge gaps that require further research, and provided guidance for how the findings could be used to enhance the prevention and education objective. The research evidence is supplemented by consultations with third sector charity representatives who design and implement gambling harm prevention and education programmes. Their insights and experiences enhance, support, or challenge the academic evidence base, and are shared in a separate chapter. Overall, research evidence is limited for many of the measures. Quality assessments suggest that improvements are needed to support policy decisions more fully. Still, opportunities exist to advance evidence-based policy for an effective gambling harm prevention and education plan.

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Role of sex and stature on the biomechanics of normal and loaded walking: implications for injury risk in the military

BMJ Military Health ◽

10.1136/bmjmilitary-2020-001645 ◽

2021 ◽

pp. bmjmilitary-2020-001645

Author(s):

Niamh Gill ◽

A Roberts ◽

T J O'Leary ◽

A Liu ◽

K Hollands ◽

...

Keyword(s):

Injury Prevention ◽

Injury Risk ◽

Load Carriage ◽

Ground Reaction Forces ◽

Prevention Measures ◽

Lower Limb Injury ◽

Walking Gait ◽

Transition Speed ◽

Reaction Forces ◽

The Military

Load carriage and marching ‘in-step’ are routine military activities associated with lower limb injury risk in service personnel. The fixed pace and stride length of marching typically vary from the preferred walking gait and may result in overstriding. Overstriding increases ground reaction forces and muscle forces. Women are more likely to overstride than men due to their shorter stature. These biomechanical responses to overstriding may be most pronounced when marching close to the preferred walk-to-run transition speed. Load carriage also affects walking gait and increases ground reaction forces, joint moments and the demands on the muscles. Few studies have examined the effects of sex and stature on the biomechanics of marching and load carriage; this evidence is required to inform injury prevention strategies, particularly with the full integration of women in some defence forces. This narrative review explores the effects of sex and stature on the biomechanics of unloaded and loaded marching at a fixed pace and evaluates the implications for injury risk. The knowledge gaps in the literature, and distinct lack of studies on women, are highlighted, and areas that need more research to support evidence-based injury prevention measures, especially for women in arduous military roles, are identified.

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Spit guards, ethical policing and the need for an evidence-based approach

Safer Communities ◽

10.1108/sc-04-2018-0013 ◽

2018 ◽

Vol 17 (3) ◽

pp. 145-155 ◽

Cited By ~ 1

Author(s):

Peter Joyce ◽

Wendy Laverick

Keyword(s):

Police Officers ◽

Grey Literature ◽

Primary Source ◽

Evidence Base ◽

Evidence Based ◽

Content Type ◽

Secondary Sources ◽

Advantages And Disadvantages ◽

Wide Range ◽

The Uk

Purpose The purpose of this paper is to assess the advantages and disadvantages of the use of spit guards by police forces in the UK and to make recommendations regarding an evidence-based approach to decisions related to the use of such equipment. Design/methodology/approach The paper is based upon an examination of a range of primary source material, secondary sources and grey literature. Findings Although the use of spit guards can be justified by factors that include the need to protect police officers from contracting serious infectious diseases, there are a number of problems that concern ethical policing and human rights. Concerns arise when spit guards are deployed against vulnerable individuals, are used offensively rather than defensively and when such equipment is deployed disproportionately against persons from Black and Minority Ethnic (BME) communities. Additionally, the image of the police may suffer if spit guards are accompanied by the use of excessive force which may be perceived as an abuse of police power. Practical implications The paper makes recommendations that a comprehensive evidence base is required to assist practitioners to make informed decisions regarding the deployment of spit guards. This evidence base should include the extent to which officers are spat at, medical evidence relating to spitting and the transmission of serious diseases, the views of the public concerning the deployment of spit guards and estimations as to whether such equipment will deter spitting by suspects of crime. Originality/value This paper provides an original academic contribution to the ongoing debate on the use of spit guards within policing. In particular, it brings together a wide range of material that relates to this topic and presents it as a coherent set of arguments located in a single source.

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National Strategy for Preventing Injuries from Skiing and Snowboarding in Switzerland

Swiss Sports & Exercise Medicine ◽

10.34045/ssem/2015/8 ◽

2015 ◽

Vol 63 (2) ◽

Keyword(s):

Risk Factors ◽

Medical Treatment ◽

Injury Prevention ◽

Prevention Programs ◽

Accident Prevention ◽

Occupational Accidents ◽

Evidence Based ◽

National Strategy ◽

Prevention Measures ◽

Snow Sports

Skiing and snowboarding are very popular sports in Switzerland. However, every year, around 67,000 skiers and 18,000 snowboarders are injured so seriously that they need medical treatment. Moreover around 8 people die on the slopes in Switzerland. Therefore, there is a need to reduce the burden of injuries in snow sports. The Swiss Council for Accident Prevention (bfu) developed a strategy that utilized scientifically-based injury prevention, using an effect-oriented prevention cycle. The aim of this study is to present this systematic and evidence-based strategy for snow sports. Throughout the prevention cycle, the incidence and severity of injuries are established, risk factors and possible prevention measures are identified and rated, prevention goals are set, prevention programs are developed and implemented, and the success of the measures and processes are monitored. In addition, the effect-oriented prevention cycle involves collaboration with other prevention-minded partners. This strategy allows the bfu to carry out its legal mandate to prevent non-occupational accidents and to coordinate prevention measures throughout Switzerland that are effective, efficient, and practical. Furthermore, the collaboration with other prevention-minded agencies greatly improves the implementation.

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Evidence-Based Assessment of Pediatric Injury and Injury Risk

PsycEXTRA Dataset ◽

10.1037/e590072013-001 ◽

2013 ◽

Author(s):

Bryan T. Karazsia ◽

Keri J. Brown Kirschman

Keyword(s):

Injury Risk ◽

Evidence Based ◽

Pediatric Injury

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Dissemination and Implementation Research in Health

10.1093/oso/9780190683214.001.0001 ◽

2017 ◽

Cited By ~ 48

Keyword(s):

Evidence Base ◽

Dissemination And Implementation ◽

Evidence Based ◽

Collaborative Partnerships ◽

Social Service Agencies ◽

Effective Interventions ◽

Health Related Research ◽

Health Related ◽

Dissemination And Implementation Research ◽

Policies And Programs

Fifteen to twenty years is how long it takes for the billions of dollars of health-related research to translate into evidence-based policies and programs suitable for public use. Over the past 15 years, an exciting science has emerged that seeks to narrow the gap between the discovery of new knowledge and its application in public health, mental health, and health care settings. Dissemination and implementation (D&I) research seeks to understand how to best apply scientific advances in the real world, by focusing on pushing the evidence-based knowledge base out into routine use. To help propel this crucial field forward, leading D&I scholars and researchers have collaborated to put together this volume to address a number of key issues, including: how to evaluate the evidence base on effective interventions; which strategies will produce the greatest impact; how to design an appropriate study; and how to track a set of essential outcomes. D&I studies must also take into account the barriers to uptake of evidence-based interventions in the communities where people live their lives and the social service agencies, hospitals, and clinics where they receive care. The challenges of moving research to practice and policy are universal, and future progress calls for collaborative partnerships and cross-country research. The fundamental tenet of D&I research—taking what we know about improving health and putting it into practice—must be the highest priority. This book is nothing less than a roadmap that will have broad appeal to researchers and practitioners across many disciplines.

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Injury prevention knowledge, beliefs and strategies in elite female footballers at the FIFA Women’s World Cup France 2019

British Journal of Sports Medicine ◽

10.1136/bjsports-2020-103131 ◽

2021 ◽

pp. bjsports-2020-103131

Author(s):

Celeste Geertsema ◽

Liesel Geertsema ◽

Abdulaziz Farooq ◽

Joar Harøy ◽

Chelsea Oester ◽

...

Keyword(s):

Risk Factors ◽

Injury Prevention ◽

Injury Risk ◽

Risk Level ◽

Attitudes And Beliefs ◽

Implementation Barriers ◽

World Cup ◽

Positive Attitudes ◽

High Level ◽

Women's Football

ObjectivesThis study assessed knowledge, beliefs and practices of elite female footballers regarding injury prevention.MethodsA survey was sent to players participating in the FIFA Women’s World Cup France 2019. Questions covered three injury prevention domains: (1) knowledge; (2) attitudes and beliefs; (3) prevention practices in domestic clubs. Additionally, ACL injury history was assessed.ResultsOut of 552 players, 196 women responded (35.5%). More than 80% of these considered injury risk to be moderate or high. Players listed knee, ankle, thigh, head and groin as the most important injuries in women’s football. The most important risk factors identified were low muscle strength, followed by poor pitch quality, playing on artificial turf, too much training, reduced recovery and hard tackles. In these elite players, 15% did not have any permanent medical staff in their domestic clubs, yet more than 75% had received injury prevention advice and more than 80% performed injury prevention exercises in their clubs. Players identified the two most important implementation barriers as player motivation and coach attitude. Two-thirds of players used the FIFA 11+ programme in their clubs.ConclusionsThis diverse group of elite players demonstrated good knowledge of risk level and injury types in women’s football. Of the risk factors emphasised by players, there was only one intrinsic risk factor (strength), but several factors out of their control (pitch quality and type, training volume and hard tackles). Still players had positive attitudes and beliefs regarding injury prevention exercises and indicated a high level of implementation, despite a lack of medical support.

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PP469 From Theory To Practice: Which Value Framework Is Applied For Onco-Hematology Therapies In Italy? A 5-year Retrospective Analysis

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462320001816 ◽

2020 ◽

Vol 36 (S1) ◽

pp. 37-37

Author(s):

Americo Cicchetti ◽

Rossella Di Bidino ◽

Entela Xoxi ◽

Irene Luccarini ◽

Alessia Brigido

Keyword(s):

Real World ◽

Ad Hoc ◽

Grey Literature ◽

National Level ◽

Pharmaceutical Products ◽

European Medicines Agency ◽

The Real ◽

R Process ◽

The One ◽

The Impact

IntroductionDifferent value frameworks (VFs) have been proposed in order to translate available evidence on risk-benefit profiles of new treatments into Pricing & Reimbursement (P&R) decisions. However limited evidence is available on the impact of their implementation. It's relevant to distinguish among VFs proposed by scientific societies and providers, which usually are applicable to all treatments, and VFs elaborated by regulatory agencies and health technology assessment (HTA), which focused on specific therapeutic areas. Such heterogeneity in VFs has significant implications in terms of value dimension considered and criteria adopted to define or support a price decision.MethodsA literature research was conducted to identify already proposed or adopted VF for onco-hematology treatments. Both scientific and grey literature were investigated. Then, an ad hoc data collection was conducted for multiple myeloma; breast, prostate and urothelial cancer; and Non Small Cell Lung Cancer (NSCLC) therapies. Pharmaceutical products authorized by European Medicines Agency from January 2014 till December 2019 were identified. Primary sources of data were European Public Assessment Reports and P&R decision taken by the Italian Medicines Agency (AIFA) till September 2019.ResultsThe analysis allowed to define a taxonomy to distinguish categories of VF relevant to onco-hematological treatments. We identified the “real-world” VF that emerged given past P&R decisions taken at the Italian level. Data was collected both for clinical and economical outcomes/indicators, as well as decisions taken on innovativeness of therapies. Relevant differences emerge between the real world value framework and the one that should be applied given the normative framework of the Italian Health System.ConclusionsThe value framework that emerged from the analysis addressed issues of specific aspects of onco-hematological treatments which emerged during an ad hoc analysis conducted on treatment authorized in the last 5 years. The perspective adopted to elaborate the VF was the one of an HTA agency responsible for P&R decisions at a national level. Furthermore, comparing a real-world value framework with the one based on the general criteria defined by the national legislation, our analysis allowed identification of the most critical point of the current national P&R process in terms ofsustainability of current and future therapies as advance therapies and agnostic-tumor therapies.

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Getting It Straight: Accommodating Rectilinear Behavior in Captive Snakes—A Review of Recommendations and Their Evidence Base

Animals ◽

10.3390/ani11051459 ◽

2021 ◽

Vol 11 (5) ◽

pp. 1459

Author(s):

Clifford Warwick ◽

Rachel Grant ◽

Catrina Steedman ◽

Tiffani J. Howell ◽

Phillip C. Arena ◽

...

Keyword(s):

Scientific Evidence ◽

Grey Literature ◽

Evidence Base ◽

Short Term ◽

Absolute Minimum ◽

Scientific Letter ◽

General Welfare ◽

Other Information ◽

Enclosure Size ◽

Current Guidance

Snakes are sentient animals and should be subject to the accepted general welfare principles of other species. However, they are also the only vertebrates commonly housed in conditions that prevent them from adopting rectilinear behavior (ability to fully stretch out). To assess the evidence bases for historical and current guidance on snake spatial considerations, we conducted a literature search and review regarding recommendations consistent with or specifying ≥1 × and <1 × snake length enclosure size. We identified 65 publications referring to snake enclosure sizes, which were separated into three categories: peer-reviewed literature (article or chapter appearing in a peer-reviewed journal or book, n = 31), grey literature (government or other report or scientific letter, n = 18), and opaque literature (non-scientifically indexed reports, care sheets, articles, husbandry books, website or other information for which originating source is not based on scientific evidence or where scientific evidence was not provided, n = 16). We found that recommendations suggesting enclosure sizes shorter than the snakes were based entirely on decades-old ‘rule of thumb’ practices that were unsupported by scientific evidence. In contrast, recommendations suggesting enclosure sizes that allowed snakes to fully stretch utilized scientific evidence and considerations of animal welfare. Providing snakes with enclosures that enable them to fully stretch does not suggest that so doing allows adequate space for all necessary normal and important considerations. However, such enclosures are vital to allow for a limited number of essential welfare-associated behaviors, of which rectilinear posturing is one, making them absolute minimum facilities even for short-term housing.

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Implementation of the Activate injury prevention exercise programme in English schoolboy rugby union

BMJ Open Sport & Exercise Medicine ◽

10.1136/bmjsem-2020-001018 ◽

2021 ◽

Vol 7 (2) ◽

pp. e001018

Author(s):

Craig Barden ◽

Keith A Stokes ◽

Carly D McKay

Keyword(s):

Injury Prevention ◽

Injury Risk ◽

Behavioural Change ◽

Exercise Programme ◽

Rugby Union ◽

Support Staff ◽

Barriers To Implementation ◽

Common Barriers ◽

Perceptions Of School ◽

Intervention Uptake

ObjectivesThe implementation of the Activate injury prevention exercise programme has not been assessed in an applied context. This study aimed to (1) describe the knowledge and perceptions of school rugby coaches and players towards injury risk, prevention and Activate and (2) evaluate Activate implementation in schoolboy rugby using the reach, effectiveness, adoption, implementation and maintenance framework.MethodsBespoke electronic surveys were administered to coaches (including support staff) and players at participating English schools (2018–2020). Most questions and statements were answered using a 7-point Likert scale. At baseline, participants detailed their Activate awareness and perceptions of injury risk and prevention in schoolboy rugby. At postseason, participants reported Activate use throughout the study and their perceptions towards the programme.ResultsAt baseline, significant differences existed between coaches (n=106) and players (n=571) in Activate awareness (75% and 13% respectively; χ2=173.5, p<0.001). Coaches perceived rugby had a significantly greater injury risk than players, while holding more positive perceptions towards injury prevention. At postseason, coaches reported greater Activate adoption compared with players (76% and 18% respectively; χ2=41.8, p<0.001); 45% of players were unaware if they used the programme. Median session adherence was twice weekly, with a median duration of 10–15 min. This suggests Activate was not implemented as intended, with recommendations of three 20 min sessions per week. Both groups identified common barriers to implementation, such as lack of time and inclusion of a ball.ConclusionCoaches are instrumental in the decision to implement Activate. Targeting behavioural change in these individuals is likely to have the greatest impact on intervention uptake.

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