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Advocacy

Happy International Women’s Day 2017!

8 Mar, 17 | by Bridie Scott-Parker

Today is International Women’s Day 2017, and while each and every one of us has our own experiences relating to this year’s theme, I thought I would share with you my own recent reflections on how I have been Bold for Change. I was honoured to share my experiences at the Graduate Women Queensland Sunshine Coast Branch International Women’s Day Breakfast last Saturday, and in preparing for this event – as any good researcher would proceed – I leapt into my homework activity and asked Google for definitions of “bold”. While some were rather risqué, I found some definitions with which I sensed a strong affiliation, and I shared some of my good, and less-good, life experiences around these definitions.

  1. Confident and courageous, daring and brave. Regular readers of the blog, and anyone who knows me beyond my peer-reviewed publications, will know that I have had more than my share of physical challenges. It never ceases to surprise me that, on a weekly basis at a minimum, I encounter someone who is surprised to see me working, mothering, contributing to my local community or the global community more generally. Yes, staying at home and resting all day would definitely be the easy thing to do, but I do not seem have the gene that allows me to do this! I was also brought up by a confident and courageous, daring and brave mum (and dad) who encouraged me from the cradle to leave my small farming community and move to the capital city and gain a degree, something girls are NOT supposed to do. I see my own daughter being confident and courageous, daring and brave, doing the same, and it reinforces that I (and my mum) have done the right thing, and I couldn’t be more proud of both of them.
  2. Not hesitating in the face of rebuff, or to break rules of propriety. Kudos again is needed for my mum (and dad) for raising a strong-willed (I prefer ‘tenacious and resilient’, while my husband is more likely to use ‘stubborn and pig-headed’) daughter, who is living the family motto of leave-the-world-better. Sometimes this means that there will be rebuff, and sometimes this means breaking rules of propriety. So be it. I am confident and courageous, daring and brave, and I WILL leave the world better.
  3. Not afraid to speak up for what she believes, even to people with more power.  Change will not happen unless people – women! – who are confident and courageous, daring and brave, and who do not hesitate in the face of rebuff and do not hesitate to break the rules of propriety are not afraid to speak up for what they believe. Others may have more power, but to me that means that others can join me in tireless quest to prevent injury among our most precious, our children. I have worked very hard through my studies, and my life post-PhD, and through these efforts (and experimentation with my own children!) have developed, implemented, and evaluated some highly innovative projects. Change not only requires bold thinking, but bold actions, so I walk-the-walk, not just talk-the-talk.
  4. Not afraid of difficult situations. Every day is an opportunity to learn: you might learn something about yourself, about another, or about something as lovely as a pet cat or dog. I am a big fan of reframing and looking at the positive of any situation, no matter how dire. A difficult situation is a fantastic opportunity to learn, and not only can you learn to manage difficult situations, you will also learn from these difficult situations, by being confident and courageous, daring and brave, and speaking up. It’s important however to remember to listen, and to talk with, not just talk at or be talked at. Everyone likes to be talked with 🙂
  5. Willingness to take risks. I am willing to take risks. I have been in a medication trial, and being number 23 in a world’s first double-blind study was scary, particularly when there was a massive list of potential side-effects, including death, and I had two small children, a husband and a mortgage. I have also taken many risks during my studies and in my post-doctoral life by treading a less-conventional path, and indeed I prefer to live life generally as an open book. Life is much simpler that way. Doing this has required me to be confident and courageous, daring and brave; to speak up; to not be afraid of difficult situations; and to be willing to take risks. I take educated risks, however, and use all my nous, research skills, and social supports to take every step to help these risks translate into injury prevention, whatever my endeavour.
  6. A final message?  Whether you are a woman on International Women’s Day, or someone who shares the planet with a woman on International Women’s Day (or indeed any other day), you can make a difference and you can prevent injury, by being bold for change 🙂

Meet Graham and Almost Impossible Cancer Spaghetti: The intersection between injury prevention and the arts

22 Nov, 16 | by Sheree Bekker

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“The artist is distinguished from all other responsible actors in society — the politicians, legislators, educators, and scientists — by the fact that he is his own test tube, his own laboratory, working according to very rigorous rules, however unstated these may be, and cannot allow any consideration to supersede his responsibility to reveal all that he can possibly discover concerning the mystery of the human being.

Society must accept some things as real; but he must always know that visible reality hides a deeper one, and that all our action and achievement rest on things unseen. A society must assume that it is stable, but the artist must know, and he must let us know, that there is nothing stable under heaven. One cannot possibly build a school, teach a child, or drive a car without taking some things for granted.

The artist cannot and must not take anything for granted, but must drive to the heart of every answer and expose the question the answer hides”

 ~ James Baldwin*

Meet Graham

Over this past weekend I met Graham: the only person designed to survive on our roads. Graham is a remarkable sculpture. He has been designed with the bodily features that humans would need if we were to withstand motor vehicle crashes:

As much as we like to think we’re invincible, we’re not. But what if we were to change? What if our bodies were built to survive a low impact crash? What might we look like? The result of these questions is Graham, a reminder of just how vulnerable our bodies really are.

The piece forms part of the Towards Zero campaign – a vision for a future free of deaths and serious injuries on Australian roads:

In a shift from its traditional road safety campaigns, the Transport Accident Commission has collaborated with a leading trauma surgeon, a crash investigation expert and a world-renowned Melbourne artist to produce ‘Graham’, an interactive lifelike sculpture demonstrating human vulnerability.

Meeting Graham over the weekend was a revelation. As an injury prevention researcher, it is always exciting to be able to view and interact with innovative campaigns that take knowledge translation to the next level. This installation makes use of Google Tango, an immersive augmented reality technology, to allow the viewer to learn more about Graham’s unique features (such as his ribcage – my favourite feature – think airbags rather than armour). The campaign also features a school curriculum, and the ability to Meet Graham online – where one can view the sculpture in 360 degrees, as well as see videos from the surgeon, researcher, and artist.

Almost Impossible Cancer Spaghetti

In an innovative move, The BMJ is working with interactive data visualisation designerWill Stahl-Timmins, to present medical research findings in more visually appealing ways. His infographic development process, as detailed in the blog post Almost Impossible Cancer Spaghetti, is a fascinating study in attention to detail – something that communication and information designers are skilled at.

front

The knowledge translation gap

We know that a 17 year gap exists between research and its translation. The field of injury prevention – as an area of public health research – has a long and successful history with educational, media, and social marketing campaigns aimed at reducing this gap. In the quest for more rapid distribution of knowledge, many journals have moved toward open access publishing. Researchers are increasingly working to present research findings in more useful formats, including developing consensus statements, guidelines, and posters, as well as in more engaging formats such as apps, or – in the latest craze – designing their own infographics.

A pertinent question must be raised here: when does the pursuit of knowledge translation through formatting information in new and colourful ways tip over into the realm of creating “too much information” – merely adding to the sea of white noise rather than effectively increasing knowing and influencing behaviour change? We know that viral does not necessarily equal effective, and the problem remains that even if people do know about scientific evidence, they fail to use it anyway.

The intersection between injury prevention and the arts

In the age of viral marketing, art – to my mind – has a different quality, with new and exciting possibilities for better injury prevention knowledge and knowledge translation. Art provides the visual language for the kind of aesthetic knowing that is currently lacking in the ways in which we approach research and knowledge translation in this field. The arts are situated in the liminal space which moves us towards a different kind of embodied knowledge. Perhaps it is because art speaks to the unseen, in the words of James Baldwin.

Is there space in our field for fine art, design, sculpture, craft, poetry, spoken word, performance art, dance, music, photography, film-making? Should there be? What can we learn from other fields of research that do make use of arts-based methods? What can we learn from art itself?

This is not to say that researchers should necessarily be creating art and designing visual information themselves. We need to leave art to the artists, and design to the designers**. But perhaps we do need to collaborate with, and commission, artists and designers (and pay them!) to convey our messages in new and exciting ways – as the above two examples show. Further, the possibilities of arts-based research methods hold possibilities for the generation of different kinds of knowledge in our field, thereby enriching our understanding of injury and its prevention. A recent webinar from artist and academic Dr Mandy Archibald – on the intersection between the arts, research and knowledge translation – sheds light on this practice.

The examples of Meet Graham and the Almost Impossible Cancer Spaghetti have left me wholly inspired as to the possibilities of the art and science of injury prevention research and knowledge translation.

The science of injury prevention is ripe for collaboration with the arts.

I am curious as to other similar initiatives that sit at the intersection of injury prevention and art – please do share links in the comments section below.

*Of course, this was written at a time before the recognition of the importance of gender-neutral language

**Of course, all humans are creative and should all be making art – this statement refers solely to using art for knowledge translation purposes as part of specific research/advocacy projects

 

Quantifying the burden of injury in ‘data-poor’ setting; a local-need- driven approach?

12 Oct, 16 | by Brian Johnston

Editor’s Note: earlier this year the journal published injury data from the Global Burden of Disease project. In an accompanying editorial I noted that many of the regional or sub-national estimates were “derived from aggregation and extrapolation of limited primary sources “and yet could “become the basis for policy or programming at an intensely local level.”

I saw this as a challenge to researchers, a call to “crowd source” burden of disease data from  the subregions and subpopulations unrepresented, or simply estimated, in the global aggregate. If we identified those needs and provided resources for good data collection, data management and data reporting , the information collected would be immediately useful at the global scale and  – one hopes – at the local level too. 

Dr. Safa Abdalla, a member of our editorial board, approaches that suggestion with some caution and – in this guest post – draws distinctions between the needs and experience of researchers and public health professionals in “data-rich” and “data poor” environments. – Brian Johnston (Editor-in-Chief)

 

safa-abdallaSome parts of the world, typically in the low- and middle- income country classification range, lack solid basic information about frequency and distribution of injuries in their population. That is not to say that they lack the sources or the capacity to measure them, but in those same places, the public health practice machinery had been occupied (not entirely unduly of course) with a cluster of conditions like communicable diseases that international actors have been investing heavily to tackle. In such environment, local objective assessments of all potentially impactful conditions may not have been deemed necessary. As a result, priority setting has been skewed towards those conditions of historical focus without heavy reliance on local epidemiological evidence.
The very first global burden of disease and injury assessment and subsequent versions have highlighted the need to consider the burden of all realistically possible conditions that affect human health – including injuries – in a way that allows objective comparisons and consequently objective priority setting. Arguably, data from so called ‘data-poor’ countries had not always been sufficient and/or accessible enough to feed into these global-level estimation projects and data gaps were filled with an assortment of methods that continue to evolve to date, probably at a rate that surpasses the rate of improvement in the quantity and quality of data from those countries.
The burden of disease assessment methodology is very demanding, not only computationally but in terms of data input, requiring epidemiological estimates at the very granular level of disease and injury sequelae, and synthesizing those into a range of novel summary measures (Disability-adjusted life years for example). Yet, incidence, prevalence and mortality of any condition at a broader level are key inputs for country- or locality-level policy development and health service planning and monitoring. It is in measuring those epidemiological quantities that the value of country-level estimation in data-poor settings lies, without necessarily delving into the complexities (and relatively unnecessary luxury for the time-being) of summary measure calculation. In addition, country-level assessments can uncover gaps in data systems that, when addressed, can create a seamless flow of better quality data for local decision making.
But with whom does the onus of carrying out such local-level estimation reside? Undeniably, global estimation efforts have produced country-specific estimates, stimulated country data hunts that fed data into their machinery and, in a few ‘data-rich’ countries, facilitated full burden of disease and injury assessments too. However, to date, injury burden estimates for the vast majority of ‘data-poor’ countries come from indirect estimation in these global projects. One can argue that alternatively, an approach that is driven by the need for public health action (be it strategy updating or service development) would be the most beneficial for producing estimates for those very countries at national, sub-national or subgroup levels. This approach entails that a local team of researchers, public health practitioners and other stakeholders evaluate all their data sources, use them in a simple and transparent fashion to develop the best estimates that fit their purpose, and take action based on the estimates and other relevant input while also identifying the data gaps and working on filling them. Arguably, informing local public health action should take priority over informing the global view, but global burden estimation efforts can still (and must) benefit from the products of this process. However, the process needs to be driven by local demand for estimates and not by the need to fill gaps for the global estimates. It should also be led, undertaken and owned by local teams of public health practitioners, analysts and researchers. The reason for this is that assessing and using health data are basic public health functions that all public health practitioners and analysts in any country should be capable of carrying out. Relying on external support from ‘global project’ teams to develop country estimates denies public health practitioners and researchers in those ‘data-poor’ countries the opportunity to hone their skills in public health data assessments and epidemiological estimation. It also denies them ownership of any subsequent efforts to improve data availability via epidemiological studies or administrative data collection.
This approach need not be limited to injury burden assessment but is much more needed for that latter. This is mainly because injuries in many low- and middle- income countries had been neglected for so long that epidemiological assessments of other conditions traditionally associated with those countries are likely more abundant. Hopefully as more and more country teams assess, use and improve their own injury data sources, this reality will eventually change.

Safa Abdalla
drsafa@yahoo.com
twitter: @Safa12233

Guest Blog: ‘Breaking Down Walls – Taking Translation and Dissemination to the Next Level’

26 Sep, 16 | by Angy El-Khatib

 

Often, when people think of translational research, it is through the lens of Grand Rounds, seminars, and conference presentations. It is usually clinical in nature and comes directly from the researcher. There is another type of translational research – NIH calls it Type 2 translation.

I am part of a Type 2 translational research team at a child injury research center. Our team of five has a mission to educate and empower the vast audience of people who care about kids and keeping them safe. We do this by sharing information on child injury in a format that is accessible by meeting health literacy guidelines and providing opportunities for prevention through realistic, actionable safety steps.

That’s a pretty lofty goal but we are very good at what we do. When researchers from our center publish papers, it is not unusual for their work to be picked up by media around the world. In the last six months, we’ve had two papers that had over one billion impressions (estimates of potential audience size), and two others that have had around one million impressions. It helps that our product is related to kids – it makes people care. But there is more to it than that.

In working with media, we strive to understand their needs and how to create value for them to cover our work. This is not as simple as it sounds. We spend several days working on a press release. Our hospital sees the value in the work we do and often contributes resources for us to create supporting videos, including sound bites, demonstrations, and B-roll.

We pay attention to the ever-changing way the masses consume information, staying up to date on the pulse of the public to meet them where they are. Gone are the early days of technology where you could create a website, direct people there, and then forget about it. Now, a website must stay fresh, providing new content frequently. It must also stay current in the way it looks. If its appearance is outdated, no one will look at your information because there will be the assumption (correct or not) that what is on the site is also likely outdated. People may believe you and/or your organization are outdated, or worse yet, irrelevant. We constantly assess social media platforms, analyze how we can best use them for maximum effect, and then develop our marketing plans.

We talk to doctors, administrators, researchers, and other public health professionals about the findings of our research. We also train them to effectively communicate with those who trust them and look to them for guidance. After that, we can’t sit back and rest on our laurels – we have to do it all over again, and then again. By doing all of this, we increase the likelihood of and the speed with which our research can lead to changes in policy, regulation, and behavior.

In the realm of translational research, teams like ours are not the norm and our team didn’t become this successful overnight. When our manager began her quest to have a team devoted to translational research, translation and dissemination were barely on the radar. Beyond journal publication, dissemination typically just meant printing  copies of a paper and having it available upon request or presenting it at conferences. Our manager had a vision of something bigger and better. She specializes in health communication and has the passion and drive to push for what she believes in. Her director supported her vision and was willing to take a chance on, and fund, something that really hadn’t been done.

Slowly, she grew her team. What makes us effective and successful is that although we each have our own projects to manage, we bring our complementary sets of skills and experiences to the table, both literally and figuratively, collaborating on all of our products. These products include press releases, multi-media releases, media interviews, blog articlescynthia-anderson-profile-picture, website development and management, social media outreach, toolkits, photo shoots, conference planning, and network building. We hone our work through brainstorming sessions, writes, edits, and re-writes. Our work is always better after it has been through the rounds of the team.

Our manager began winning over colleagues one researcher at a time, as they saw the reach and the impact of their work grow. It took 10 years for her to get her team to where we are now – having a big impact and doing innovative work that can help keep kids safer.

Written by:
Cynthia Anderson, MPH, CHES.
She is a Program Coordinator at The Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio. She can be contacted at cynthia.anderson@nationwidechildrens.org.

 

 

How to cut violence painlessly: Increase alcohol taxes

1 Sep, 16 | by Sheree Bekker

photo-1455641064490-74f5f8dbf598

[SB] This post is by Nicholas Page and Jonathan Shepherd.

Nicholas Page is a Senior Research Assistant at the Wales Institute of Social and Economic Research, Data and Methods (WISERD) and former Research Associate at Cardiff University’s Violence Research Group. Follow Nick on Twitter @Nick_Alan_Page

Jonathan Shepherd is a Professor of Oral and Maxillofacial Surgery and Director of the award winning Violence Research Group based at Cardiff University. Follow the Violence Society RG on Twitter @ViolenceSociety

[NP & JS] Alcohol abuse is a major risk factor for violence. For this reason, interventions seeking to reduce alcohol consumption often form a central part of violence prevention strategies, both globally and domestically. Increasing the price of alcohol, for instance, has been linked to significant reductions in many alcohol-related disease and injury conditions, including violent injury. A study in England and Wales, for example, found a negative relationship between violent injury and the price of beer, after accounting for other potentially influential factors. The logic here is that higher prices mean we buy and drink less alcohol – an assumption that is well supported by numerous peer-reviewed studies. From this, we understand the relationship between alcohol price and violence as a two-stage process; first, from alcohol price to alcohol consumption and second, from alcohol consumption to acts of violence.

But, in this previous study, violence was measured using rates of emergency department (ED) attendance between 1995 and 2000, and the price of beer was based on the average value of a single pub-bought (tavern-bought) pint over the same period. Acknowledging that purchasing trends and licensing laws have changed over the last two decades, we at Cardiff University’s Violence Research Group – the authors of the original study – repeated the study using the same ED violence measure but substantially extended the scope of the research beyond the price just of beer and on-license prices.

This latest study – recently published online in Injury Prevention – compares violence-related attendances from 100 EDs across England and Wales between 2005 and 2012, with alcohol prices (including beers, wines, spirits, and ‘alcopops’ – flavoured alcoholic beverages) from both on-trade (e.g. pubs and clubs) and off-trade (e.g. supermarkets and off-licenses) alcohol outlets. In support of our previous finding, the risk of violent injury was once more strongly negatively related to the price of alcohol in both outlet types; again, taking into account the influence of other potential confounding factors.

The implications of these findings are both theoretical and practical. First, because alcohol prices are not affected by rates of violence, the argument that links between violence and alcohol simply reflect the propensity of violent people to drink more alcohol than people who are nonviolent can be dismissed in this instance. Second, and most importantly, our findings showed that as little as a 1% increase in alcohol prices could reduce the number of patients attending EDs for treatment of violence-related injuries in England and Wales by around 6,000 patients per year. Crucially, to achieve such a substantial reduction, the price of alcohol must be raised in both on-trade and off-trade outlets. This would mean, since on-trade prices were found to be more influential in driving violence and that alcohol prices in this trade are already far in excess of the proposed minimum unit price (MUP) range of around 45-50 pence in the UK, that alcohol pricing policies which focus on tax increases are likely to have a greater influence on violent injury than MUP.

Together with similar findings from the USA, this research provides compelling evidence that making alcohol more expensive would reduce violence. Increasing the price of alcohol through tax increases is a national intervention which would be relatively straightforward to implement. The evidence speak for itself: even small price increases could substantially reduce alcohol-related harms, lead to safer towns and cities, decrease costs to health and criminal justice services, and increase revenue for governments.

So what are policy makers waiting for?

 

Celebrating science and inspiring the next generation of scientists

22 Aug, 16 | by Bridie Scott-Parker

Last week in Australia was National Science Week, a nation-wide celebration of science and technology via three key pathways.

Pathway one is to inspire the general public to be involved in science – creating new knowledge – through engaging activities such as Citizen Science. This year’s Citizen Scientists are identifying Australian wildlife that are featured in photos captured via automatic cameras, and anyone with internet access can participate whether they have a university qualification or not. This fantastic activity means that science is indeed inclusive, when many times it can feel like science is a members-only club.

The second pathway is through showcasing the contributions of scientists to the world of knowledge through the Australian Institute of Policy and Science Tall Poppy Awards. As the joint-Queensland 2015 winner of this award, I was delighted to attend the 2016 award evening on Wednesday and was pleased to learn about innovative projects across a breadth of disciplines, such as infecting coeliacs with hookworms, the sexual attractiveness of facial hair, and optimising agricultural irrigation to name a few. Next month I will be one of the inaugural Flying Scientists, bringing science to rural regions in which exposure to science can be limited.

The third pathway relates to a flurry of activities to inspire the next generation to be scientists – both today and in their future education and career paths. Recognising the importance of encouraging girls in particular to become – and stay – engaged in scientific pursuits, I was delighted to host the first University of the Sunshine Coast Growing Tall Poppies program in my research unit here at the University of the Sunshine Coast earlier this year.

Adolescent Risk Research Unit team members Jeanne, Jamie, and Natalie, mentoring Sasha, Isabella, Mikayala, and Sian.

The four Grade 10 students learnt about career paths through and in science, and conducted their own research project under the guidance of members of my team, before making a presentation of their research activities and the key findings before the senior school assembly on Wednesday morning. This presentation was very well-received by the students and teachers in attendance, further breaking silos such as ‘academics’, ‘schools’, and ‘science’ which can pervade.

Bridie with the 4 GTPs after the school assembly presentation

Bridie and the 4 GTP stars after their school assembly presentation.

If we are to continue to effectively prevent injury, we need to make science accessible to everyone, and to the next generation especially.

 

Censoring research

23 Jun, 16 | by Barry Pless

I am posting this for all Injury Prevention blog readers who are researchers or interested in research. I do so in part because John Langley is one of the pioneers in our field and was one of the Senior members of our editorial board from IP’s earliest days. But I also do so because the issue that prompted him to write this op-ed for his local Otago paper is by no means restricted to New Zealand. It is a widespread and important issue that has the potential to corrupt research in all manner of ways. IBP 

Read it and think carefully about the implications for your own work. Thanks to John for sharing it and for ODT for permission to reproduce it. Thankfully Injury Prevention, to the best of my knowledge, has never had to deal with this issue.

 Restrictive publication clauses in health research contracts

I was both pleased and disappointed to read the two ODT articles (20 February, 5 March) on this subject. Public airing of this important issue is long overdue. I was disappointed as I gained the impression that despite several scientists publicly expressing their concerns, the University of Otago Deputy Vice-Chancellor for Research appeared to have none. The Deputy Vice-Chancellor’s apparent lack of concern, however, is consistent with my experiences of research administration at the University.

For 20 years I was the Director of the University of Otago’s Injury Prevention Research Unit. This Unit was entirely dependent on funds from government agencies. Contrary to my expectations, the University of Otago did not pro-actively seek to protect me, or the public, from clauses in draft contracts that placed restrictions on publishing research findings. Protecting researchers increases the chances that they can serve the public interest, and meet the University’s legislated role of being the critic and conscience of society.

I spent a significant amount of time challenging clauses that would allow a government agency to censor a finding they disagreed with, or deny the right to publish work at all. On a couple of occasions during contract negotiations I was reminded by government agencies that they could purchase the outputs they wanted from other Universities or private organisations who would accept the restrictive clauses.

Why would Universities be accepting these clauses? I believe a key factor is the importance of, and competition associated with, generating research income. Collectively, NZ’s eight publicly funded universities derive approximately 15% of their income from research contracts. The success a University has, relative to others, in obtaining external research funds also has a significant role in determining the funding it receives from government through the Performance Based Research Funding scheme. Research income is critical to ensuring high quality research, thereby maintaining and enhancing a university’s reputation and thus attracting students, staff, and further funding. The purchasers of research can use the competition between universities, and researchers, to their advantage in getting restrictive publication clauses accepted.

Private research suppliers can accept restrictive publication clauses as they are typically uninterested in publishing in peer-reviewed journals and have no statutory or moral obligation to serve the public interest. While they would produce a research report for the purchaser, these reports are not frequently published, easy to access, or subject to rigorous quality control, e.g., independent peer review.

It was also my experience that many senior researchers did not care about the restrictive clauses. Why would this be so? Success in attracting research funding is, for most researchers, critical to pursuing their research, producing publications, and to promotion and public recognition.

This behaviour contrasts with Royal Society of New Zealand’s (RSNZ) Code of Professional Standards and Ethics in Science, Technology, and the Humanities. Section 8.1 of that code states that members of the Society must: “oppose any manipulation of results to meet the perceived needs or requirements of employers, funding agencies, the media or other clients and interested parties whether this be attempted before or after the relevant data have been obtained;”

I accept the right of a purchaser of research to see an advance copy of any paper for publication and to make any comments on it. But requiring modification beyond correcting factual errors is unacceptable. Even purchasers suggesting toning down a phrase here and there and putting in some qualifiers is problematic from a purchaser who is concerned to minimize bad publicity that might arise from the paper. It also places the researchers in a bind. Should they comply? If they don’t comply are they putting at risk future research funding from the purchaser? I suggest they might be. Why deal again with a ‘difficult’ group of researchers when you can purchase the work elsewhere?

The best approach to this issue is transparency. Make the deliberations between researchers and purchaser accessible to all as in the open review practiced by some scientific journals so readers can trace the discussion. This approach would not deal with contracts that explicitly prohibit the researchers publishing at all.

The Health Promotion Agency (HPA), a crown entity, charged with promoting healthy lifestyles recently put out a request for proposals (RFP) to assess whether the reduction in trading hours in Wellington has any impact on alcohol-related harm. The ‘indicative’ contract for this RFP stated: The Supplier will not publish the results of the Services undertaken pursuant to this Contract”. Only when challenged did HPA advise that it was a negotiable clause. Potential University researchers interested in bidding for such research should be able to take the ‘indicative’ contract as a reflection of the intent of the purchaser. Irrespective of this, preparing a high quality research proposal involves significant resources and many researchers would consider it was not worth the effort given the uncertainty of their right to publish.

In effect, some government purchasers are getting to decide what findings, if any, the public gets to see from research the public has paid for, either by pressuring some universities to accept restrictive clauses or by buying what they want from private suppliers.

Universities of New Zealand, the representative body of New Zealand’s eight universities, and the RSNZ need to enter in discussions with Government with a view to ensuring government research RFPs do not impose these restrictions. Interference with researchers ability to bid for, execute, and publish research compromises the role universities have as critics and conscience of society.

We need an independent audit of government research contracting to determine to what degree restrictive publication practices and the use of private suppliers is undermining the public’s right to be fully informed of the findings of research they have paid for.

Emeritus Prof John Langley

Fatality Free Friday | Road Safety | Australia

27 May, 16 | by Sheree Bekker

Fatality Free Friday is an initiative that started in Australia in 2007, and the campaign has continued to expand its operation and is now recognised as Australia’s only national community based road safety program.

Road safety is a complex issue but we believe that if drivers consciously think about road safety and safe driving for just one Friday in the year, that day’s toll – statistically about 5.3* deaths – could be reduced to zero.

That’s our aim. Not a single road death in Australia for just one day. Just one Fatality Free Friday.

We believe that if drivers are asked to actively concentrate on road safety and safe driving for just one day in the year, they’ll drive safer for the next few days too and, over time, change their outlook completely, consciously thinking about safety each and every day they get behind the wheel.

*DataSource: Australian Transport Safety Bureau

(From Fatality Free Friday)

Drivers can take the pledge to drive safely here.

On advocacy: championing young driver safety

2 May, 16 | by Sheree Bekker

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[SB] In this post, public health consultant Dr Sarah J Jones (follow her on Twitter @GDLSarahJones), an advocate for better safety for young drivers and all
who share the roads with them, shares her experiences on her efforts to advocate for Graduated Driver Licencing in the UK
. In her previous role, Sarah was an injury epidemiologist at Cardiff University, researching a range of injury prevention topics and completing a PhD on Child Pedestrian Injuries and Deprivation, a study that included analysis of the links between traffic calming distribution, deprivation and narrowing inequalities. 

[SJJ] It all began in 2008. I was in the final stages of Public Health Registrar Training when my supervisor told me to “go somewhere and do something”. My interests in road traffic crash prevention lead me first to Dot Begg at Otago, Dunedin and then on to Erin Cassell at Monash, Melbourne. The main objective, as well as a fascinating insight into how pandemic flu and other public health issues were being dealt with (I travelled the week after the 2009 swine flu pandemic first emerged), was an estimate of the effect that Graduated Driver Licensing (GDL) could have if implemented in the UK.

Back home, I presented what I had done, sat back, exceptionally pleased with myself, after all the case was now made, and awaited the “pat on the back” from my supervisor. “Nice” he said. “Now get it implemented”. “How” I lamely asked. “I don’t know. Work it out” was the response.

I’m still trying to work it out. Seven years on I have talked to a lot of people. I’ve given presentations to vaguely interested lay people in village halls, as well as to Members of Parliament. I have written articles for newspapers, magazines and peer reviewed journals. I have given newspaper, television and radio interviews, some live, and have participated in “phone-ins”.

Yet, we still do not have GDL in the UK. So, in seven years, I have achieved nothing.

I think people are more generally aware of GDL than when I started talking, but that may be completely unrelated to anything I have done. I am still looking for the guide on “How to bring about legislative change”, but there does not seem to be one. I have learned a lot about the policy process in the UK and about how reluctant people are to change their viewpoint, even in the face of overwhelming evidence to the contrary.

I always knew that the pace of Public Health change was painfully slow, but even with that knowledge continuing to advocate for change is difficult and often demoralising. It’s little wonder that we have become locked into a cycle of quick fixes (action that is just a proxy for effective action) to match political cycles that can then be quietly sidelined when they do not have the effect that was intended.

After 8 years in research / academia, my move into service based public health was my “translational research”. I am coming to believe that advocacy is the most important, but most overlooked area of both public health and injury prevention, partly because it is so difficult to measure the effect of what is being done. How we support people to become effective advocates is likely to be key to effective intervention prevention in the future.

[SB] I too have written on the vital importance of advocacy: here and here. As researchers, it is important to remember that we do not always need to disseminate purely our most up-to-date research results, or even the most innovative interventions; sometimes our work life’s work is bigger than that. Sometimes we need to advocate for the very heart that lies at our work: simple, credible information and resources that can make a difference in even one person’s life.

“The Beautiful Game”… minus headers?: Discussing USSF’s recent announcement to limit headers in youth soccer leagues

23 Nov, 15 | by Angy El-Khatib

In the United States, sports-related traumatic brain injuries (concussions and otherwise) have been a HOT topic. In 2013, approximately 4,500 former NFL players sued the league, claiming that the NFL failed to educate, manage, and protect its players from head injuries. Judges approved a settlement of $765 million that would fund concussion-related compensation, including medical exams and research for ex-players. This past year, Chris Borland, a 24 year-old, highly revered linebacker, decided to retire after playing only one year of professional football. His reasoning was that football was “not worth the risk” to his health.

The NFL is not the only sporting organization looking at concussions among its players; other organizations include the National Hockey League (NHL) and the National Collegiate Athletic Association (NCAA). Most recently, the U.S. Soccer Federation (USSF) announced that it has developed a set of guidelines for its youth leagues in which it recommends a ban on headers for players ages 10 and under and a limit on headers for players between 11 and 13 years of age. The USSF also developed a standard protocol in which medical professionals, as opposed to coaches or referees, make decisions about return-to-play for players who are suspected of sustaining a concussion.

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The USSF developed these guidelines in response to a class-action lawsuit which targeted six of the largest youth soccer groups, including FIFA, U.S. Youth Soccer, and the American Youth Soccer Organization. The lawsuit claims that these organizations have “failed to adopt effective policies to evaluate and manage concussions.”

But will policy changes – “banning headers” – solve the concussion problem among youth soccer players?

Unlikely.

A September 2015 study in JAMA by Comstock, et al. evaluated trends in soccer concussions among youth players. The study found that the most common concussion mechanism was contact with another player (player-player), not a ball – this is consistent with other literature.

The most common mechanism for all concussions was contact with another player, accounting for 68.8% of all concussions among boys and 51.3% among girls. The most common mechanism among heading-related concussions was also contact with another player, accounting for 78.1% of heading-related concussions among boys and 61.9% among girls.

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Among soccer-specific activities, heading was responsible for 30.6% of concussions among boys and 25.3% of concussions among girls.

The study concludes that reducing athlete-athlete contact across all phases of play – not just headers – would be more likely to prevent concussions. It also mentions that, culturally, banning headers may not be a feasible prevention effort. After all, an integral part of the Beautiful Game is headers (Robin Van Persie during the 2014 FIFA World Cup, anyone?). The soccer community, anecdotally, seems exceptionally resistant to the prospect of banning headers. As injury researchers, we know that one of the most important aspects of a successful and effective public health intervention is cultural feasibility.

With this in mind, I don’t think it is likely the USSF’s announcement about banning or limiting headers will significantly affect the epidemiology of concussions in youth soccer.  At most, this sends a strong message to coaches and brings safety management to the forefront. (The new rule which requires a Health Care Professional, [shoutout to Athletic Trainers!] to be present to make decisions regarding concussions instead of coaches or referees could be positive, though!)

Either way, one has to commend USSF’s attempt at targeted prevention efforts to bring soccer to its high and honorable state:

 

Joga Bonito!

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P.S. – you’re not allowed to make fun of me for calling it “soccer” instead of “football”! 🙂

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