Towards Better Written Discharge Information: Health Literacy and the Comprehension of Head Injury Advice Sheets in a New Zealand Emergency Department

Background: Non-tackle football (ie, flag, touch, 7v7) is purported to be a lower-risk alternative to tackle football, particularly in terms of head injuries. However, data on head injuries in non-tackle football are sparse, particularly among youth participants. Purpose: To describe the epidemiology of emergency department visits for head injuries due to non-tackle football among youth players in the United States and compare the data with basketball, soccer, and tackle football. Study Design: Descriptive epidemiology study. Methods: Injury data from 2014 to 2018 were obtained from the National Electronic Injury Surveillance System database. Injury reports coded for patients aged 6 to 18 years and associated with basketball, football, or soccer were extracted. Data were filtered to include only injuries to the head region, specifically, the head, ear, eyeball, mouth, or face. Football injuries were manually assigned to “non-tackle” or “tackle” based on the injury narratives. Sports & Fitness Industry Association data were used to estimate annual sport participation and calculate annual injury rates per 100,000 participant-years. Results: A total of 26,770 incident reports from 2014 to 2018 were analyzed. For head region injuries in non-tackle football, the head was the most commonly injured body part, followed by the face; the most common diagnosis was a laceration, followed by concussion and internal injury (defined as an unspecified head injury or internal head injury [eg, subdural hematoma or cerebral contusion]). The most common contacting object was another player. The projected national rate of head region injuries was lowest for non-tackle football across the 4 sports. In particular, the projected rate of injuries to the head for non-tackle football (78.0 per 100,000 participant-years) was less than one-fourth the rates for basketball (323.5 per 100,000 participant-years) and soccer (318.2 per 100,000 participant-years) and less than one-tenth the rate for tackle football (1478.6 per 100,000 participant-years). Conclusion: Among youth in the United States aged 6 to 18 years who were treated in the emergency department for injuries related to playing non-tackle football, the most common diagnosis for injuries to the head region was a laceration, followed by a concussion. Head region injuries associated with non-tackle football occurred at a notably lower rate than basketball, soccer, or tackle football.

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Use of an accident and emergency department observation ward in the management of head injury

British Journal of Surgery ◽

10.1002/bjs.1800800858 ◽

1993 ◽

Vol 80 (8) ◽

pp. 1079-1079 ◽

Cited By ~ 2

Author(s):

A. F. T. Brown ◽

G. J. Wilkes ◽

C. T. Myers ◽

R. E. Maclaren

Keyword(s):

Emergency Department ◽

Head Injury ◽

Accident And Emergency ◽

Accident And Emergency Department

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Emergency department presentations in the Southern District of New Zealand during the 2020 COVID ‐19 pandemic lockdown

Emergency Medicine Australasia ◽

10.1111/1742-6723.13749 ◽

2021 ◽

Author(s):

Manurereau T Allen ◽

Brianna C Thompson ◽

Brad Atkinson ◽

Christie E Fyfe ◽

Meghan J Scanlan ◽

...

Keyword(s):

Emergency Department ◽

New Zealand ◽

Southern District

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Preoperative bariatric surgery programme barriers facing Pacific patients in Auckland, New Zealand as perceived by health sector professionals: a qualitative study

BMJ Open ◽

10.1136/bmjopen-2019-029525 ◽

2019 ◽

Vol 9 (11) ◽

pp. e029525

Author(s):

Tamasin Taylor ◽

Wendy Wrapson ◽

Ofa Dewes ◽

Nalei Taufa ◽

Richard J Siegert

Keyword(s):

Bariatric Surgery ◽

New Zealand ◽

Health Literacy ◽

Health Professionals ◽

Health Sector ◽

Publicly Funded ◽

Attrition Rates ◽

Pacific Health ◽

Emotional Safety ◽

Minority Ethnic

Minority ethnic patient groups typically have the highest bariatric surgery preoperative attrition rates and lowest surgery utilisation worldwide. Eligible patients of Pacific Island ethnicity (Pacific patients) in New Zealand (NZ) follow this wider trend.ObjectivesThe present study explored structural barriers contributing to Pacific patients’ disproportionately high preoperative attrition rates from publicly-funded bariatric surgery in Auckland, NZ.SettingPublicly-funded bariatric surgery programmes based in the wider Auckland area, NZ.DesignSemi-structured interviews with health sector professionals (n=21) were conducted.Data were analysed using an inductive thematic approach.ResultsTwo primary themes were identified: (1) Confidence negotiating the medical system, which included Emotional safety in clinical settings and Relating to non-Pacific health professionals and (2) Appropriate support to achieve preoperative goals, which included Cultural considerations, Practical support and Relating health information. Clinical environments and an under-representation of Pacific staff were considered to be barriers to developing emotional safety, trust and acceptance of the surgery process with patients and their families. Additionally, economic deprivation and lower health literacy impacted preoperative goals.ConclusionsHealth professionals’ accounts indicated that Pacific patients face substantial levels of disconnection in bariatric surgery programmes. Increasing representation of Pacific ethnicity by employing more Pacific health professionals in bariatric teams and finding novel solutions to implement preoperative programme components have the potential to reduce this disconnect. Addressing cultural competency of staff, increasing consultancy times and working in community settings may enable staff to better support Pacific patients and their families. Programme structures could be more accommodating to practical barriers of attending appointments, managing patients’ preoperative health goals and improving patients’ health literacy. Given that Pacific populations, and other patients from minority ethnic backgrounds living globally, also face high rates of obesity and barriers accessing bariatric surgery, our findings are likely to have broader applicability.

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Postcard intervention for repeat self-harm: randomised controlled trial

The British Journal of Psychiatry ◽

10.1192/bjp.bp.109.075754 ◽

2010 ◽

Vol 197 (1) ◽

pp. 55-60 ◽

Cited By ~ 69

Author(s):

Annette L. Beautrais ◽

Sheree J. Gibb ◽

Alan Faulkner ◽

David M. Fergusson ◽

Roger T. Mulder

Keyword(s):

Emergency Department ◽

New Zealand ◽

Randomised Controlled Trial ◽

Outcome Measures ◽

Suicidal Behaviour ◽

Controlled Trial ◽

Elevated Risk ◽

Emergency Department Presentation ◽

Self Harm ◽

Randomised Controlled

BackgroundSelf-harm and suicidal behaviour are common reasons for emergency department presentation. Those who present with self-harm have an elevated risk of further suicidal behaviour and death.AimsTo examine whether a postcard intervention reduces self-harm re-presentations in individuals presenting to the emergency department.MethodRandomised controlled trial conducted in Christchurch, New Zealand. The intervention consisted of six postcards mailed during the 12 months following an index emergency department attendance for self-harm. Outcome measures were the proportion of participants re-presenting with self-harm and the number of re-presentations for self-harm in the 12 months following the initial presentation.ResultsAfter adjustment for prior self-harm, there were no significant differences between the control and intervention groups in the proportion of participants re-presenting with self-harm or in the total number of re-presentations for self-harm.ConclusionsThe postcard intervention did not reduce further self-harm. Together with previous results this finding suggests that the postcard intervention may be effective only for selected subgroups.

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The relationship between medication adherence, health literacy and social support network in the hypertensive emergency department patient

10.32469/10355/86502 ◽

2020 ◽

Author(s):

◽

Benjamin L. Coe

Keyword(s):

Social Support ◽

Emergency Department ◽

Medication Adherence ◽

Health Literacy ◽

Chronic Health Conditions ◽

Support Network ◽

Health Conditions ◽

Social Support Network ◽

Chronic Health ◽

Ed Visits

Hypertension (HTN) is a major risk factor for the development of heart disease, which is the number one cause of death in the United States (U.S.). The Affordable Care Act of 2010 (ACA) led to a significant increase in emergency department (ED) visits: up to 20 [percent] of visits are considered as avoidable. Many patients present to EDs with uncontrolled chronic health conditions, such as HTN, which can be successfully managed in the outpatient setting. Factors contributing to the large volume of patients that present to the ED with uncontrolled HTN has been understudied. This cross-sectional study examined relationships between selected demographic and health variables, medication adherence, health literacy and social support network among adults (n=50) with HTN that presented to the ED. Participants were predominantly male (56 [percent]), 41-60 years old (46 [percent]), and Caucasian (60 [percent]). Only 36 [percent] of participants were adherent to their HTN medications, 42 [percent] had adequate health literacy, and 38 [percent] perceived high levels of social support. The variable with the strongest correlation to medication adherence was last primary care provider (PCP) visit (-0.473, p [less than] 0.001). However only 54 [percent] of participants had seen a PCP over the last 6 months. Increasing PCP visits and reducing avoidable ED visits has the potential to improve chronic disease health outcomes and reduce health care costs. This study has provided evidence that it is both acceptable and feasible to perform research in the ED setting that addresses chronic health conditions, such as HTN. Findings from this study may be used to inform novel ED interventions that can help adults to better manage their chronic health conditions, such as HTN, outside of the acute care setting.

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