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1.
  • Ageberg, Eva, et al. (author)
  • Planning injury prevention training for youth handball players : Application of the generalisable six-step intervention development process
  • 2020
  • In: Injury Prevention. - : BMJ. - 1353-8047 .- 1475-5785. ; 26:2, s. 164-169
  • Journal article (peer-reviewed)abstract
    • Background: Youth handball players are vulnerable to injuries. Because there is no available injury prevention training specifically developed for youth handball players targeting both upper and lower limbs or incorporating psychological aspects of injury, we undertook the € Implementing injury Prevention training ROutines in TEams and Clubs in youth Team handball (I-PROTECT)' project. We used an ecological participatory design incorporating the perspectives of multiple stakeholders (health beneficiaries, programme deliverers and policy makers). The aim of this paper was to describe the process of developing the I-PROTECT model, featuring injury prevention training and an accompanying implementation strategy. Design: We used the generalisable six-step intervention development process, outlined to guide researchers when developing implementable, evidence-based sports injury prevention interventions, to develop the I-PROTECT model. The six-step process involves establishing a research-stakeholder collaborative partnership to (1) identify and synthesise research evidence and clinical experience; (2) consult with relevant experts; (3) engage end users to ensure their needs, capacity and values are considered; (4) test the feasibility and acceptability of the intervention; (5) evaluate the intervention against theory; and (6) obtain feedback from early implementers. Two community handball clubs in southern Sweden, offering organised training for youth male and female players, and the district handball federation, participate in the intervention development. Drafts of the I-PROTECT model will be developed and revised with key stakeholder advice and input throughout all six steps. Conclusion: The I-PROTECT model described will be an end user-driven intervention, including evidence-based, theory-informed and context-specific injury prevention training for youth handball, and an associated implementation strategy.
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  • Ahmad Kiadaliri, Aliasghar, et al. (author)
  • Fall-related mortality in southern Sweden : a multiple cause of death analysis, 1998-2014
  • 2019
  • In: Injury Prevention. - : BMJ. - 1353-8047 .- 1475-5785. ; 25:2, s. 129-135
  • Journal article (peer-reviewed)abstract
    • OBJECTIVES: To investigate temporal trend in fall mortality among adults (aged ≥20 years) in southern Sweden using multiple cause of death data.METHODS: We examined all death certificates (DCs, n=2 01 488) in adults recorded in the Skåne region during 1998-2014. We identified all fall deaths using International Statistical Classification of Diseases (ICD)-10 codes (W00-W19) and calculated the mortality rates by age and sex. Temporal trends were evaluated using joinpoint regression and associated causes were identified by age-adjusted and sex-adjusted observed/expected ratios.RESULTS: Falls were mentioned on 1.0% and selected as underlying cause in 0.7% of all DCs, with the highest frequency among those aged ≥70 years. The majority (75.6%) of fall deaths were coded as unspecified fall (ICD-10 code: W19) followed by falling on or from stairs/steps (7.7%, ICD-10 code: W10) and other falls on the same level (6.3%, ICD-10 code: W18). The mean age at fall deaths increased from 77.5 years in 1998-2002 to 82.9 years in 2010-2014 while for other deaths it increased from 78.5 to 79.8 years over the same period. The overall mean age-standardised rate of fall mortality was 8.3 and 4.0 per 1 00 000 person-years in men and women, respectively, and increased by 1.7% per year in men and 0.8% per year in women during 1998-2014. Head injury and diseases of the circulatory system were recorded as contributing cause on 48.7% of fall deaths.CONCLUSIONS: There is an increasing trend of deaths due to falls in southern Sweden. Further investigations are required to explain this observation particularly among elderly men.
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  • Al-Ketbi, Alfan, et al. (author)
  • School bullying prevention and intervention strategies in the United Arab Emirates : a scoping review
  • 2024
  • In: Injury Prevention. - : BMJ Publishing Group Ltd. - 1353-8047 .- 1475-5785.
  • Research review (peer-reviewed)abstract
    • INTRODUCTION: Schools in the United Arab Emirates (UAE) witnessed an increase of 7% in bullying prevalence since 2005. This review aimed to map antibullying interventions in the UAE.METHODS: A systematic search was performed in five electronic databases (EMBASE, PubMed, PsycINFO, Scopus and Eric) using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review. Studies addressing antibullying interventions and grey literature in the UAE from 2010 to 2021 were included. Interventions were mapped using distribution across key sectors, public health practice levels, and organisation types. RESULTS: Of the 2122 identified papers, only 2 were included. Both articles were published in 2019 and used qualitative methods. From the search of governmental and non-governmental websites, 22 multilevel interventions were included and presented on the three levels of public health practice across the different sectors and target stakeholders. Eight interventions were at the federal level, and six were by private stakeholders. The government funded 59% of all interventions. Four interventions addressed cyberbullying, and three used multisectoral collaboration.CONCLUSIONS: Although the UAE is building capacity for bullying prevention, we found limited knowledge of antibullying prevention efforts. Further studies are needed to assess current interventions, strategies and policies.
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  • Bergström, Monica Frick, et al. (author)
  • Extent and consequences of misclassified injury diagnoses in a national hospital discharge registry
  • 2011
  • In: Injury Prevention. - : BMJ. - 1353-8047 .- 1475-5785. ; 17:2, s. 108-113
  • Journal article (peer-reviewed)abstract
    • Background Classification of injuries and estimation of injury severity on the basis of ICD-10 injury coding are powerful epidemiological tools. Little is known about the characteristics and consequences of primary coding errors and their consequences for such applications. Materials and methods From the Swedish national hospital discharge register, 15 899 incident injury cases primarily admitted to the two hospitals in Uppsala County between 2000 and 2004 were identified. Of these, 967 randomly selected patient records were reviewed. Errors in injury diagnosis were corrected, and the consequences of these changes were analysed. Results Out of 1370 injury codes, 10% were corrected, but 95% of the injury codes were correct to the third position. In 21% (95% CI 19% to 24%) of 967 hospital admissions, at least one ICD-10 code for injury was changed or added, but only 13% (127) had some change made to their injury mortality diagnosis matrix classification. Among the cases with coding errors, the mean ICD-based injury severity score changed slightly (difference 0.016; 95% CI 0.007 to 0.032). The area under the receiver operating characteristics curve was 0.892 for predicting hospital mortality and remained essentially unchanged after the correction of codes (95% CI for difference -0.022 to 0.013). Conclusion Errors in ICD-10-coded injuries in hospital discharge data were common, but the consequences for injury categorisation were moderate and the consequences for injury severity estimates were in most cases minor. The error rate for detailed levels of cause-of-injury codes was high and may be detrimental for identifying specific targets for prevention.
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  • Bonander, Carl, 1988-, et al. (author)
  • Are fire safe cigarettes actually fire safe? : Evidence from changes in US state laws
  • 2018
  • In: Injury Prevention. - : BMJ Publishing Group Ltd. - 1353-8047 .- 1475-5785. ; 24:3, s. 193-198
  • Journal article (peer-reviewed)abstract
    • OBJECTIVE: To estimate the effects of fire safe cigarette laws on fire mortality and cigarette-related fires in the USA.METHODS: We examined the gradual implementation of the laws to identify their average effects, using difference-in-differences analysis to account for common year effects, time-invariant state effects, state-specific trends and observable time-varying state-level covariates.RESULTS: We found no statistically significant effects on all-cause fire mortality, residential fire mortality or cigarette-caused fire rates. The estimates for cigarette-caused fire deaths were significant under some specifications, but were not robust to the inclusion of state-specific trends or comparisons to effects on other cause-determined fires.CONCLUSIONS: Given the mixed state of our results, we conclude that previous claims regarding the effects of fire safe cigarette laws may be premature.
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  • Bonander, Carl, 1988-, et al. (author)
  • Can the provision of a home help service for the elderly population reduce the incidence of fall-related injuries?
  • 2016
  • In: Injury Prevention. - : BMJ. - 1353-8047 .- 1475-5785. ; 22:Suppl.2, s. A181-A181
  • Journal article (peer-reviewed)abstract
    • Background Fall-related injuries are a global public health problem, especially in elderly populations. In this study, the effect of an intervention aimed at reducing the risk of falls in the homes of community-dwelling elderly persons was evaluated. The intervention, which involves home hazards reduction by providing a minor home help service, is provided in the majority of Swedish municipalities.Methods Intention-to-treat effect estimates were derived using quasi-experimental time series intervention (ITS) analysis for immediate effects and a difference-in-discontinuity (RD) design for long term effects, and community-level estimates were pooled using meta-analysis. The outcome measure was the incidence of fall-related hospitalizations in the treatment population, the age of which varied by municipality (≥65 years, ≥67 years, ≥70 years or ≥75 years).Results We found no statistically significant reductions in injury incidence in the ITS (IRR 1.01 [95% CI: 0.98–1.05]) or RD (IRR 1.00 [95% CI: 0.97–1.03]) analyses. The results are robust to several different model specifications, including segmented panel regression analysis with linear trend change and community fixed effects parameters.Conclusions It is unclear whether absence of an effect is due to a low efficacy of the home hazards modifications provided, or a result of low utilisation. Additional studies of the effects on other quality of life measures are recommended before conclusions are drawn regarding the cost-effectiveness of the provision of home help services
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  • Bonander, Carl, 1988-, et al. (author)
  • Can the provision of a minor home help service for the elderly population reduce the incidence of fall-related injuries? : A quasi-experimental study of the community-level effects on hospital admissions in Swedish municipalities
  • 2016
  • In: Injury Prevention. - : BMJ Publishing Group Ltd. - 1353-8047 .- 1475-5785. ; 22:6, s. 412-419
  • Journal article (peer-reviewed)abstract
    • BackgroundFall-related injuries are a global public health problem, especially in elderly populations. The effect of an intervention aimed at reducing the risk of falls in the homes of community-dwelling elderly persons was evaluated. The intervention mainly involves the performance of complicated tasks and hazards assessment by a trained assessor, and has been adopted gradually over the last decade by 191 of 290 Swedish municipalities.   MethodsA quasi-experimental design was used where intention-to-treat effect estimates were derived using panel regression analysis and a regression-discontinuity (RD) design. The outcome measure was the incidence of fall-related hospitalizations in the treatment population, the age of which varied by municipality (≥65 years, ≥67 years, ≥70 years or ≥75 years).ResultsWe found no statistically significant reductions in injury incidence in the panel regression (IRR 1.01 [95% CI: 0.98-1.05]) or RD (IRR 1.00 [95% CI: 0.97-1.03]) analyses. The results are robust to several different model specifications, including segmented panel regression analysis with linear trend change and community fixed effects parameters.ConclusionsIt is unclear whether the absence of an effect is due to a low efficacy of the services provided, or a result of low adherence. Additional studies of the effects on other quality of life measures are recommended before conclusions are drawn regarding the cost-effectiveness of the provision of home help service programs.
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  • Bonander, Carl, 1988- (author)
  • Compared with what? : Estimating the effects of injury prevention policies using the synthetic control method
  • 2018
  • In: Injury Prevention. - : BMJ Publishing Group Ltd. - 1353-8047 .- 1475-5785. ; 24, s. I60-I66
  • Journal article (peer-reviewed)abstract
    • Introduction This paper discusses the application of the synthetic control method to injury-related interventions using aggregate data from public information systems. The method selects and determines the optimal control unit in the data by minimising the difference between the pre-intervention outcomes in one treated unit (eg, a state) and a weighted combination of potential control units. Method I demonstrate the synthetic control method by an application to Florida's post-2010 policy and law enforcement initiatives aimed at bringing down opioid overdose deaths. Using opioid-related mortality data for a panel of 46 states observed from 1999 to 2015, the analysis suggests that a weighted combination of Maine (46.1%), Pennsylvania (34.4%), Nevada (5.4%), Washington (5.3%), West Virginia (4.3%) and Oklahoma (3.4%) best predicts the preintervention trajectory of opioid-related deaths in Florida between 1999 and 2009. Model specification and placebo tests, as well as an iterative leave-k-out sensitivity analysis are used as falsification tests. Results The results indicate that the policies have decreased the incidence of opioid-related deaths in Florida by roughly 40% (or -6.19 deaths per 100.000 person-years) by 2015 compared with the evolution projected by the synthetic control unit. Sensitivity analyses yield an average estimate of -4.55 deaths per 100.000 person-years (2.5th percentile: -1.24, 97.5th percentile: -7.92). The estimated cumulative effect in terms of deaths prevented in the postperiod is 3705 (2.5th percentile: 1302, 97.5th percentile: 6412). Discussion Recommendations for practice, future research and potential pitfalls, especially concerning low-count data, are discussed. Replication codes for Stata are provided.
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  • Bonander, Carl, 1988-, et al. (author)
  • Model-based economic evaluation of ice cleat distribution programmes for the prevention of outdoor falls among adults from a Swedish societal perspective
  • 2022
  • In: Injury Prevention. - : BMJ Publishing Group Ltd. - 1353-8047 .- 1475-5785. ; 28:2, s. 125-130
  • Journal article (peer-reviewed)abstract
    • Background: Slipping on snow or ice poses a significant health risk among older adults in Sweden. To combat this problem, about 80 Swedish municipalities have distributed ice cleats to older citizens (65+ years old) over the last decade. This paper details a cost-benefit analysis of such programmes. Materials and methods: We developed a decision-analytical model to estimate the costs and benefits of ice cleat programmes in Swedish municipalities compared with a business-as-usual scenario. The modelled benefits of the programme were based on effect estimates from previous research, data from population and healthcare registers and a survey of attitudes to and actual ice cleat use. The modelled costs of the programme were based on resource use data collected from 34 municipalities with existing ice cleat programmes. We assessed heterogeneity in the potential impact and benefit-to-cost ratios across all Swedish municipalities as a function of the average number of days with snow cover per year. Uncertainty in the cost-benefit results was assessed using deterministic and probabilistic sensitivity analyses. Results: The average benefit-to-cost ratio was 87, ranging from about 40 in low-risk municipalities to 140 in high-risk municipalities, implying that the potential benefits of ice cleat programmes greatly outweigh their costs. Probabilistic and deterministic sensitivity analyses support the robustness of this conclusion to parameter uncertainty and large changes in assumptions about the magnitude of the impact on ice cleat use and injuries. Conclusion: The benefits of distributing ice cleats to older adults appear to outweigh the costs from a Swedish societal perspective.
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  • Cryer, C, et al. (author)
  • Empirical validation of the New Zealand serious non-fatal injury outcome indicator for 'all injury'
  • 2018
  • In: Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention. - : BMJ. - 1475-5785. ; 24:4, s. 300-304
  • Journal article (peer-reviewed)abstract
    • Our purpose was to empirically validate the official New Zealand (NZ) serious non-fatal ’all injury' indicator. To that end, we aimed to investigate the assumption that cases selected by the indicator have a high probability of admission. Using NZ hospital in-patient records, we identified serious injury diagnoses, captured by the indicator, if their diagnosis-specific survival probability was ≤0.941 based on at least 100 admissions. Corresponding diagnosis-specific admission probabilities from regions in Canada, Denmark and Greece were estimated. Aggregate admission probabilities across those injury diagnoses were calculated and inference made to New Zealand. The admission probabilities were 0.82, 0.89 and 0.90 for the regions of Canada, Denmark and Greece, respectively. This work provides evidence that the threshold set for the official New Zealand serious non-fatal injury indicator for ’all injury' captures injuries with high aggregate admission probability. If so, it is valid for monitoring the incidence of serious injuries.
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