Despite evolutionary changes in protective equipment, head injury remains common in football. We investigated concussion in football and associated epidemiologic issues such as 1) incidence of injury, 2) common signs and symptoms, and 3) patterns in making return-to-play decisions. We received 242 of 392 surveys (62%) that were sent to high school and collegiate certified athletic trainers at the beginning of three football seasons. Of the 17,549 football players represented, 888 (5.1%) sustained at least one concussion, and 131 (14.7% of the 888) sustained a second injury during the same season. The greatest incidence of concussion was found at the high school (5.6%) and collegiate division III (5.5%) levels, suggesting that there is an association between level of play and the proportion of players injured. Players who sustained one concussion in a season were three times more likely to sustain a second concussion in the same season compared with uninjured players. Contact with artificial turf appears to be associated with a more serious concussion than contact with natural grass. Only 8.9% of all injuries involved loss of consciousness, while 86% involved a headache. Overall, 30.8% of all players sustaining a concussion returned to participation on the same day of injury.
Dissemination and implementation (D&I) Research is increasingly Recognized as an important function of academia and is a growing priority for major health-related funders. Because D&I Research in the health field has emerged from Research traditions in diverse disciplines Ranging from agriculture to education, there are inconsistencies in the use and meaning of terms and main concepts. This glossary provides definitions for the key concepts and terms of D&I Research in health (in both public health and clinical settings). Definitions are organized under five major sections: (1) foundation concepts; (2) types of Research; (3) models, theories, and frameworks; (4) factors influencing the D&I processes; and (5) measurement/evaluation of the D&I process. The aim of this glossary is to aid in the development of more standardized and established terminology for D&I Research, facilitate the communication across different stakeholders, and ultimately contribute to higher-quality D&I Research.
A prospective cohort study was used to quantify risk factors for sports concussions. Analysis was based on a stratified cluster sample of North Carolina high school athletes followed during 1996-1999. Clustering was by school and sport, and the sample included 15,802 athletes with 1-8 seasons of follow-up per athlete. Concussion rates were estimated for 12 sports, and risk factors were quantified using generalized Poisson regression. Concussion rates ranged from 9.36 (95% confidence interval: 1.93, 16.80) per 100,000 athlete-exposures in cheerleading to 33.09 (95% confidence interval: 24.74, 41.44) per 100,000 athlete-exposures in football, where "athlete-exposure" is one athlete participating in one practice or game. The overall rate of concussion was 17.15 (95% confidence interval: 13.30, 21.00) per 100,000 athlete-exposures. Cheerleading was the only sport for which the practice rate was greater than the game rate. Almost two thirds of cheerleading concussions involved two-level pyramids. Concussion rates were elevated for athletes with a history of concussion, and they increased with the increasing level of body contact permitted in the sport. After adjustment for sport, body mass index, and year in school, history of concussion(s) remained a moderately strong risk factor for concussion (rate ratio = 2.28, 95% confidence interval: 1.24, 4.19). The fact that concussion history is an important predictor of concussion incidence, even in this young population, underscores the importance of primary prevention efforts, timely identification, and careful clinical management of these injuries.
Sports-related injuries are an issue of concern in high school sports athletes. A prospective cohort study of injury risk factors was conducted from 1996 to 1999 among varsity high school athletes in 12 sports in 100 North Carolina high schools. Data were collected by trained school personnel. Unadjusted and adjusted incidence rates and rate ratios were estimated using Poisson regression models. The overall rate of injury was 2.08 per 1,000 athlete-exposures (95% confidence interval (CI): 1.79, 2.41). At 3.54 per 1,000 athlete-exposures (95% CI: 2.87, 4.37), football had the highest rate of injury of all sports. The adjusted rate ratio for athletes with a history of injury, compared with those without a prior injury, was 1.94 (95% CI: 1.69, 2.22). The injury rate rose with each year of playing experience (rate ratio=1.06, 95% CI: 1.01, 1.12). In a subanalysis restricted to gender-comparable sports, boys had a higher rate of injury than did girls (rate ratio=1.33, 95% CI: 0.99, 1.79). All other factors did not appear to be independent predictors of the injury rate. The influence of prior injury suggests that proper rehabilitation and primary prevention of the initial injury are important strategies for injury control.
OBJECTIVES. The effects of a computer kiosk intervention on parents' child safety seat, smoke alarm, and poison storage knowledge and behaviors were evaluated in a pediatric emergency department serving predominantly low-income, urban families. The effects of parent anxiety and the reason for the child's emergency department visit also were examined. METHODS.A randomized, controlled trial of a Safety in Seconds program with a 2-to 4-week follow-up interview was conducted with 759 parents of young children (4 -66 months of age). The intervention group received a personalized report containing tailored, stage-based safety messages based on the precaution adoption process model. The control group received a report on other child health topics.RESULTS. The intervention group had significantly higher smoke alarm, poison storage, and total safety knowledge scores. The intervention group was more likely to report correct child safety seat use. Neither parent anxiety nor the reason for the emergency department visit was related to the safety behaviors. Virtually all (93%) intervention parents read at least some of the report; 57% read it all, and 68% discussed it with others. Lower-income intervention parents who read all of the report and discussed it with others were more likely than control parents to practice safe poison storage. Higher-income intervention parents were more likely than control parents to report correct child safety seat use.CONCLUSIONS. These results bode well for widespread applicability of computer technology to patient education in busy emergency departments and other child health care settings. Reducing financial barriers to certain safety behaviors should continue to be a high priority.www.pediatrics.org/cgi/
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